bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Signature of Shallow Circulations, Not Cloud Radiative Effects, in the Spatial Distribution of Tropical Precipitation
Authors: Fläschner Dagmar , Mauritsen Thorsten , Stevens Bjorn , Bony Sandrine 
Published: September 2018

AbstractRecent research suggests cloud–radiation interaction as key for intermodel differences in tropical precipitation change with warming. This motivates the hypothesis that intermodel differences in the climatology of precipitation, and in its response to warming, should reduce in the absence of cloud–radiation interaction. The hypothesis is explored with the aquaplanet simulations by the Clouds On-Off Klimate Intercomparison Experiment performed by seven general circulation models, wherein atmospheric cloud radiative effects (ACREs) are active (ACRE-on) and inactive (ACRE-off). Contrary to expectation, models’ climatology of tropical precipitation are more diverse in the ACRE-off experiments, as measured by the position of the intertropical convergence zone (ITCZ), the subtropical precipitation minima, and the associated organization of the tropical circulation. Also the direction of the latitudinal shift of the ITCZ differs more in simulations with inactive cloud radiative effects. Nevertheless, both in ACRE-on and ACRE-off, the same relationship between tropical precipitation and the mean vertical velocity (zonally, temporally, and vertically averaged) emerges in all models. An analysis framework based on the moist static energy budget and used in the moisture space is then developed to understand what controls the distribution of the mean vertical velocity. The results suggest that intermodel differences in tropical circulation and zonal-mean precipitation patterns are most strongly associated with intermodel differences in the representation of shallow circulations that connect dry and moist regions.
Acute cardiac dyspnea in the emergency department: diagnostic value of N-terminal prohormone of brain natriuretic peptide and galectin-3
Authors: Stoica Alexandra , Şorodoc Victoriţa , Lionte Cătălina , Jaba Irina M. , Costache Irina , Anisie Ecaterina , Tuchiluș Cristina , Rusalim Petriș Ovidiu , Sîrbu Oana , Jaba Elisabeta , Ceasovschih Alexandr , Vâţă Luminiţa , Şorodoc Laurenţiu 
Published: September 2018

Objective This study was performed to determine whether a dual-biomarker approach using N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and galectin-3 optimizes the diagnosis and risk stratification of acute cardiac dyspnea. Atypical clinical manifestations and overlapping pathologies require objective and effective diagnostic methods to avoid treatment delays. Methods This prospective observational study included 208 patients who presented to the emergency department for acute dyspnea. NT-proBNP and galectin-3 were measured upon admission. The patients were divided into two groups according to the etiology of their clinical manifestations: cardiac and non-cardiac dyspnea. The patients’ New York Heart Association functional class, left ventricular ejection fraction, and discharge status were assessed. Results Diagnostic criteria for acute heart failure were fulfilled in 61.1% of the patients. NT-proBNP and galectin-3 were strongly and significantly correlated. Receiver operating characteristic analysis revealed similar areas under the curve for both markers in the entire group of patients as well as in the high-risk subsets of patients. Conclusions The diagnostic performance of NT-proBNP and galectin-3 is comparable for both the total population and high-risk subsets. Galectin-3 adds diagnostic value to the conventional NT-proBNP in patients with acute cardiac dyspnea, and its utility is of major interest in uncertain clinical situations.
Low to Intermediate Dose Atropine Administration During Dobutamine Stress Echocardiography in the Pre-Liver Transplant Population
Authors: Snipelisky David , Shipman Justin , Olson Nicole , Pellikka Patricia , Aqel Bashar , McCully Robert , Watt Kymberly 
Published: September 2018

Introduction: Dobutamine stress echocardiography (DSE) is frequently used to screen for obstructive coronary artery disease in the pre-liver transplant evaluation. Although atropine is a commonly used adjunctive medication, no study has evaluated its side effect profile in patients with end-stage liver disease (ESLD). Research Question: What is the safety of atropine in candidates undergoing pre-liver transplant evaluation when atropine is used in stress testing? Design: This multicenter, prospective study enrolled patients over a 6-month period undergoing pre-liver transplant evaluation. Each patient completed a questionnaire assessing anticholinergic-related symptoms within 24 hours of testing and 48 hours following. Comparisons were made among patients receiving any atropine dose versus those who did not and among patients receiving at least 1 mg atropine and those receiving less/none. Results: Forty patients were evaluated, and 32 (80%) had adjunctive atropine administered. No differences in clinical characteristics were noted. In comparisons among patients receiving any dose of atropine with those who did not, questionnaire results indicated a higher rate of nausea prior to testing and higher overall symptom severity following testing in patients not receiving atropine. In comparisons among patients receiving less than 1 mg atropine with those receiving at least 1 mg atropine, no difference in pre- or posttesting questionnaire responses was present. No patient in the study required reversal agents or hospitalization within 7 days of testing. Conclusions: Atropine, a hepatically metabolized medication, did not predispose patients with ESLD to an increased symptom burden, and clinical outcomes related to DSE were unaffected.
A Quality Control Study of the Adherence to Recommended Physiological Targets for the Management of Brain-Dead Organ Donors in South Australian Intensive Care Units
Authors: Sampson Brett G. , Wilson Steven R. , Finnis Mark E. , Hodak Alison M. , Jones Philippa N. , O’Connor Stephanie L. , Chapman Marianne J. 
Published: September 2018

Background: The Australian and New Zealand Intensive Care Society and the Australasian Transplant Coordinators Association provide recommendations on the physiological management of brain-dead donors. Problem statement: How often physiological targets are prescribed for brain-dead donors in Australian intensive care units (ICUs), and how well these compare to recommended targets is unknown. It is also unknown how often recommended targets are achieved, irrespective of prescribed targets. Methods: We performed a retrospective, observational quality control study in 81 adult (>18 years) brain-dead donors to describe how often physiological targets were prescribed, comparing these to current guidelines. We determined the proportion of observations within the recommended target range, irrespective of any prescribed target. We aimed to identify poor adherence to recommended targets to guide future quality improvement initiatives. Outcomes: Seventy-four (91%) donors had at least 1 prescribed physiological target written on the ICU chart, with a median of 2 (range 2-5), and a maximum of 13 targets. Prescribed targets appeared to adhere well with recommended targets. Most recommended physiological targets were met irrespective of any prescribed target. However, one-quarter of serum sodium observations and one-third of blood glucose levels were above the recommended target. Implications for practice: Quality improvement initiatives are required to improve the prescription of physiological targets in brain-dead donors in South Australia. Serum sodium and serum glucose targets were not met. However, this most likely reflects the need for current guidelines to be updated in line with current evidence.
Occupational Health Surveillance, Screening, and Prevention Activities in Occupational Health Nursing Practice
Authors: Rogers Bonnie , Livsey Kae 
Published: September 2018

Occupational health nursing practice is broad and encompasses surveillance, screening, and prevention activities as part of the scope of practice. While there has been some controversy about who is responsible for these activities, it is clear occupational health nurses play a pivotal role in overseeing, managing, implementing, and evaluating these programs. In fact, recent OSHA standards have included broad language that permits licensed health care professionals acting within their legal scope of practice to conduct medical and health surveillance activities. While the contributions of occupational health nurses are well documented, little is known about the degree and emphasis in practice related to surveillance, screening, and prevention programs. This study examined the scope of independent and interdependent practice by occupational health nurses related to these activities and found 71% of occupational health nurses had overall responsibility for program management, and the majority performed surveillance, screening, and prevention functions as independent practice. Physician supervision for any of these activities ranged from only 0% to 8% in reporting. The results of this study validate the independent functioning in scope of occupational health nursing practice related to surveillance, screening, and prevention activities while recognizing the contributions all providers make to a healthy work force.
Health and Safety at Work in Switzerland
Authors: Bischofberger Iren 
Published: September 2018

Switzerland, surrounded by European Union (EU) member states, rejected a 1992 referendum to join the European Economic Communities (EEC), which currently includes 15 member states. As a result, the country has had difficulties resolving economic issues with health and safety interests. This study analyzed the consequences of selected EU Directives of Health and Safety at Work in a country that chose not to join the EU. The Directives went into effect throughout the entire EU in 1993. Executive directors and safety advisors from the Swiss company “Migros” participated in a two round Delphi survey focused on timing, feelings, and preference of the legal system in relation to the EU, prioritizing selected EU directives, and implementing health and safety concepts. The results showed the effects of the Directives (although not legally required) demand careful consideration particularly in terms of the timing of the implementation and the priorities of the Swiss health and safety legal system. The two professional groups involved showed congruent opinions on several questions, presenting a solid foundation for planning common action. In conclusion, the growing awareness of occupational health and safety aspects observed during the survey should be pursued among all Migros key staff in decision making positions in occupational safety and health. In this way, Migros could serve as a role model in the occupational health and safety field, much as it has long been recognized as a pioneer in funding social causes throughout Swiss society.
Aching Backs? A Glimpse into the Hazards of Nursing
Authors: Uhl Joan E. , Wilkinson William E. , Wilkinson Connie S. 
Published: September 2018

This study evaluates a combination of extant and collected data that compute frequency and exposure to back injuries reported by nursing employees at a Northwest Medical Center system. A major problem of interest, and the focus of this study is whether there is objective evidence to support the commonly held belief that lifting patients is the main cause of back injuries experienced by nurses; and whether job classification and worksite unit might be confounded with back injuries reported and what demographic characteristics of the nursing personnel, e.g., sex, age, job classification, and worksite unit, might be confounded with occupations that are high at risk for back injuries. Personnel records and injury report forms provided objective data for 659 registered nurses, licensed practical nurses, and nurse aides. Injury report forms providing data for 123 nursing personnel filed during the most recent consecutive twelve-month period between January 1, 1982 and April 30, 1985, were abstracted, summarized, and analyzed for number of back injuries reported using DataBase III and SPSSx computer programs on an IBM-AT system. In addition, on-site observations of patient lifts were made for ten eight-hour shifts on 15 different occasions and different worksites by a nurse-research analyst. These observation data were compared with self-report questionnaire responses representing over 54% of the total population of nurses within this medical center system. An inverse relationship of reported numbers of patient lift per shift was found for the observation and self-report data. Of the 2.5 females to males reporting back injuries, the average age was 43 years, with greater numbers of those injuries working on surgical and medical units versus lesser numbers injured from psychiatry and long-term care units in decreasing order. The Chi-square test was used to compute associations found not significant between reported high and low numbers of lifts and the incidence of back injuries. The t-test compared data from the observed and self-reported number of patient lifts and provided a significant (t = p <.001) difference in favor of self-report for number of lifts per eight-hour shift. Results of this study will contribute to increasing validity of lifting patients resulting in back injuries and further study of feasible and effective methods for evaluating back injuries and preventive interventions for nursing personnel who are at high risk of developing or sustaining back injury from any cause, while on the job.
Injury Experience of Temporary Workers in a Manufacturing Setting: Factors that Increase Vulnerability
Authors: Morris Judy A. 
Published: September 2018

An apparent two to three times higher injury frequency rate for temporary employees compared to permanent workers was identified in one manufacturing setting. Data were collected using demographic surveys (N = 20) and three focus group interviews (n = 13), with a convenience sample of temporary employees as well as four structured interviews with temporary agency owners and managers to explore factors which increase the vulnerability of temporary employees to workplace injuries. Several physical and psychological stressors were identified as well as a perception by the temporary employees that the reporting of work injuries could lead to loss of a temporary work assignment or the opportunity for permanent employment. In contrast, the agency owners and managers were concerned that reported injuries were not always legitimate. All of them actively used strategies to control their injury experience but faced the challenge of lacking day to day control of both the work environment and employee work behaviors. This preliminary study cannot be generalized to manufacturing worksites. Additional research is needed to document the injury experience of temporary employees, identify training needs, and design interventions.
Quantifying the impact of inhalational burns: a prospective study
Authors: Chong Si Jack , Kok Yee Onn , Tay Rosanna Xiang Ying , Ramesh Desai Suneel , Tan Kok Chai , Tan Bien Keem 
Published: September 2018

Abstract

Background
Inhalational injury is a major cause of morbidity and mortality in burns patients. This study aims to analyse the clinical outcomes, complications and bacteriology of inhalational burn patients.

Methods
A prospective study was done on consecutive admissions to Burn Department, Singapore General Hospital over 15 months from January 2015 to March 2016. Presence of inhalational injury, demographics, complications and outcomes was recorded. Diagnosis of inhalational injury was based on history, symptoms and nasoendoscopy. Diagnosis of acute respiratory distress syndrome (ARDS), acute kidney injury (AKI) and infective complications were according to the Berlin criteria, acute kidney injury network (AKIN) classification stage 2 and above and the American Burns Association guidelines.

Results
Thirty-five patients (17.3%) had inhalational burns out of 202 patients (63.4% male, 57.4% Chinese population). The average age was 43 ± 16.7 years (range 16–86), and percentage of total body surface area (%TBSA) was 12.1 ± 18.0 (range 0–88). In patients with inhalational injury, age was 38.9 ± 17.2 years and %TBSA was 30.3 ± 32.3. In patients without inhalational injury, age was 44.1 ± 12.8 years and %TBSA was 8.3 ± 9.59. Compared to patients with cutaneous injury alone, patients with inhalational burns had more surgeries (3 ± 7.07 vs 1 ± 1.54, p = 0.003), increased length of stay (21 days vs 8 days, p = 0.004) and higher in-hospital mortality rate (17.1% vs 0.6%, p &lt; 0.001). Incidence of ARDS and AKI was 48.6% and 37.1%, respectively, compared to 0.6% and 1.2% in the patients without inhalational injury (p &lt; 0.001). Patients with inhalational injury had increased incidence of bacteraemia (31.4% vs 2.4%, p &lt; 0.001), pneumonia (37.1% vs 1.2%, p &lt; 0.001) and burn wound infection (51.4% vs 25.1%, p = 0.004). Inhalational injury predicted AKI with an adjusted odds ratio (OR) of 17.43 (95% confidence interval (CI) 3.07–98.87, p &lt; 0.001); ARDS, OR = 106.71 (95% CI 12.73–894.53, p &lt; 0.001) and pneumonia, OR = 13.87 (95% CI 2.32–82.94, p = 0.004). Acinetobacter baumannii was the most frequently cultured bacteria in sputum, blood and tissue cultures with inhalational injury. Gram-negative bacteria were predominantly cultured from tissue in patients with inhalational injury, whereas gram-positive bacteria were predominantly cultured from tissue in patients without inhalational injury.

Conclusions
Inhalational injury accompanying burns significantly increases the length of stay, mortality and complications including AKI, ARDS, infection and sepsis.
Review and update of the Health of the Nation Outcome Scales for Elderly People (HoNOS65+)
Authors: James Mick , Buckingham Bill , Cheung Gary , McKay Roderick , Painter Jon , Stewart Malcom W. 
Published: September 2018

Aims and methodThe Health of the Nation Outcome Scales for Elderly People (HoNOS65+) has been used widely for 20 years, but has not been updated to reflect contemporary clinical practice. The Royal College of Psychiatrists convened an advisory board, with expertise from the UK, Australia and New Zealand, to propose amendments. The aim was to improve rater experience when using the HoNOS65+ glossary by removing ambiguity and inconsistency, rather than a more radical revision.ResultsViews and experience from the countries involved were used to produce a series of amendments intended to improve intra- and interrater reliability and improve validity. This update will be called HoNOS Older Adults to reflect the changing nature of the population and services provided to meet their needs. These improvements are reported verbatim, together with the original HoNOS65+ to aid comparison.Clinical implicationsFormal examination of the psychometric properties of the revised measure is needed. However, clinician training will remain crucial.Declaration of interestNone.
Failure is not an option – mitochondrial genome segregation in trypanosomes
Authors: Schneider André , Ochsenreiter Torsten 
Published: September 2018

ABSTRACT
Unlike most other model eukaryotes, Trypanosoma brucei and its relatives have a single mitochondrion with a single-unit mitochondrial genome that is termed kinetoplast DNA (kDNA). Replication of the kDNA is coordinated with the cell cycle. During binary mitochondrial fission and prior to cytokinesis, the replicated kDNA has to be faithfully segregated to the daughter organelles. This process depends on the tripartite attachment complex (TAC) that physically links the kDNA across the two mitochondrial membranes with the basal body of the flagellum. Thus, the TAC couples segregation of the replicated kDNA with segregation of the basal bodies of the old and the new flagellum. In this Review, we provide an overview of the role of the TAC in kDNA inheritance in T. brucei. We focus on recent advances regarding the molecular composition of the TAC, and discuss how the TAC is assembled and how its subunits are targeted to their respective TAC subdomains. Finally, we will contrast the segregation of the single-unit kDNA in trypanosomes to mitochondrial genome inheritance in yeast and mammals, both of which have numerous mitochondria that each contain multiple genomes.
Significance of Hierarchical and Markov Clustering in Grouping Aware Data Placement for Data Intensive Applications Having Interest Locality
Authors: Shanmugasundaram Vengadeswaran , Sadhu Ramakrishnan Balasundaram 
Published: September 2018

In this data era, massive volumes of data are being generated every second in variety of domains such as Geoscience, Social Web, Finance, e-Commerce, Health Care, Climate modelling, Physics, Astronomy, Government sectors etc. Hadoop has been well-recognized as de factobig data processing platform that have been extensively adopted, and is currently widely used, in many application domains processing Big Data. Even though it is considered as an efficient solution for such complex query processing, it has its own limitation when the data to be processed exhibit interest locality. The data required for any query execution follows grouping behavior wherein only a part of the Big-Data is accessed frequently. During such scenarion, the time taken to execute a queryand return results, increases exponentially as the amount of data increases leading to much waiting time for the user. Since Hadoop default data placement strategy (HDDPS) does not consider such grouping behavior, it does not perform efficiently resulting in lacunas such as decreased local map task execution, increased query execution time etc. Hence proposed an Optimal Data Placement Strategy (ODPS) based on grouping semantics. In this paper we experiment the significance oftwo most promising clustering techniques viz. Hierarchical Agglomerative Clustering (HAC) and Markov Clustering (MCL) in grouping aware data placement for data intensive applications having interest locality. Initially user access pattern is identified by dynamically analyzing history log.Then both clustering techniques (HAC & MCL) are separately applied over the access pattern to obtain independent clusters. These clusters are interpreted and validated to extract the Optimal Data Groupings (ODG). Finally proposed strategy reorganizes the default data layouts in HDFSbased on ODG to achieve maximum parallel execution per group subjective to Load Balancer and Rack Awareness. Our proposed strategy is tested in 10 node cluster placed in a multi rack with Hadoop installed in every node deployed in cloud platform. Proposed strategy reduces the query execution time, significantly improves the data locality and has proved to be more efficient for massive datasets processing in heterogeneous distributed environment. Also MCL shows a marginal improved performance over HAC for queries exhibiting interest localities.