bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Vertical Structure of Radiative Heating Rates: A Multimodel Evaluation Using A-Train Satellite Observations
Authors: Cesana G. , Waliser D. E. , Henderson D. , L’Ecuyer T. S. , Jiang X. , Li J.-L. F. 
Published: December 2018

Abstract
We assess the vertical distribution of radiative heating rates (RHRs) in climate models using a multimodel experiment and A-Train satellite observations, for the first time. As RHRs rely on the representation of cloud amount and properties, we first compare the modeled vertical distribution of clouds directly against lidar–radar combined cloud observations (i.e., without simulators). On a near-global scale (50°S–50°N), two systematic differences arise: an excess of high-level clouds around 200 hPa in the tropics, and a general lack of mid- and low-level clouds compared to the observations. Then, using RHR profiles calculated with constraints from A-Train and reanalysis data, along with their associated maximum uncertainty estimates, we show that the excess clouds and ice water content in the upper troposphere result in excess infrared heating in the vicinity of and below the clouds as well as a lack of solar heating below the clouds. In the lower troposphere, the smaller cloud amount and the underestimation of cloud-top height is coincident with a shift of the infrared cooling to lower levels, substantially reducing the greenhouse effect, which is slightly compensated by an erroneous excess absorption of solar radiation. Clear-sky RHR differences between the observations and the models mitigate cloudy RHR biases in the low levels while they enhance them in the high levels. Finally, our results indicate that a better agreement between observed and modeled cloud profiles could substantially improve the RHR profiles. However, more work is needed to precisely quantify modeled cloud errors and their subsequent effect on RHRs.
A User-Satisfaction Approach to IS Effectiveness Measurement
Authors: Remenyi Dan , Money Arthur 
Published: December 2018

This paper reports on research conducted by the authors into how to measure the effectiveness of a personal computer network used by a business school to deliver a range of personal productivity tools to MBA students, as well as academic and administrative staff. The use of user-satisfaction is recognized by many IT researchers as an appropriate surrogate for IT effectiveness. The authors decided to use a user-satisfaction model which is based on the gap between users’ beliefs of what is important and their perception of what is delivered by the ISD, to measure the effectiveness of the personal computer network. In brief, the research showed that all was not well with the personal computer network in use. The gaps on the two perceptual performance factors, namely effective benefits and system access, are significant in assessing overall satisfaction with the network. The gap on effective benefits is approximately twice as important as system's access in terms of its impact on overall satisfaction. This research study showed that this gap approach is quite effective. It is inexpensive. It does not require an enormous amount of expertize, although an acquaintance with factor analysis is necessary. The study need not take a long period of time; the total lapse time for the above research was six weeks, requiring the equivalent of five person-days work.
IT Directors and it Strategy
Authors: Coulson-Thomas Colin J. 
Published: December 2018

Organizations are transitioning to more flexible and adaptable forms. There is a strategic opportunity for IT that supports the facilitation of change, the building of closer relationships with customers, and the harnessing of human talent. Yet in many organizations there is a gulf of suspicion and misunderstanding between the chief executive and board, and the IT community. There is a requirement for IT professionals, and particularly IT directors, who share the vision of the ‘network organization’, and who can work at board level to bring it about. There is a need for facilitating directors in the boardroom. More IT professionals would secure board appointments if they could demonstrate the skills and qualities needed by a company director. IT directors require directorial qualities which are distinct from those demanded of IT managers. They need a broader, and more strategic awareness and perspective. This article examines the qualities that distinguish directors, and the key issues which should feature on the IT directors agenda. It draws upon three surveys and a report concerning directors and boards, and four organizational surveys.
Scenario Playing for Critical Success Factor Analysis
Authors: Barat Janos 
Published: December 2018

This paper presents a structured method, based on practical experience, to derive critical success factors using a business game called ‘scenario playing’. It aims to show why this method is superior to other well-known focusing techniques or group evaluation methods. The scenario playing business game consists of submitting to managers a sequence of reports, one after the other. Each report (called a scenario) contains randomly generated outcome values for some parameters of the business (called candidate critical success factors) which the manager deemed to be most important for the business at hand. After reviewing each report i.e. scenario, the manager has to give a value judgement about it, like ‘good’, ‘bad’ or ‘indifferent’, reflecting his perception of how the business would be doing if the report was real. A statistical method is used to evaluate these answers and deduct from them which parameters are the most important for the manager who played the given session of the game. The paper contains a short outline of the statistical evaluation (learning) algorithm used by the author and the description of a software tool that contains an implementation of this technique. Finally, the experience gained by using this tool and approach to derive critical success factors on different projects is discussed.
Dealing with Risk: A Practical Approach
Authors: Heemstra Fred J. , Kusters Rob J. 
Published: December 2018

Most software projects take place in a volatile environment in which many dangers exist that may affect the successful outcome of the project. After completion of the project an evaluation may show that many of the problems encountered during the project could have been foreseen before they actually occurred. Risk management is an approach that is aimed at predicting the occurrence of this type of problem and at taking counter measures to either prevent them from affecting the project or to soften their impact. In this paper the basic activities related to risk management are described. Furthermore a concrete method aimed at supporting risk management is presented. This method has been used successfully in practice. Some of the results obtained by using it are presented on the basis of five cases. Some conclusions are that: (1) the use of a short and structured checklist will ease identification of and discussions about risks, (2) a risk management method in which explicit use is made of a group related approach, involving all parties, will increase reliability and acceptance of the results, and (3) involvement of a neutral process risk advisor will further both the successful use of the method and the acceptance of the results.
Postoperative Outcomes in Primary Total Knee Arthroplasty Patients With Preexisting Cognitive Impairment: A Systematic Review
Authors: Luan Erfe Betty M. , Boehme Jacqueline , Erfe J. Mark , Brovman Ethan Y. , Bader Angela M. , Urman Richard D. 
Published: December 2018

Introduction: To evaluate the body of evidence on the predictive value of preoperative cognitive impairment on in-hospital, short-term, and midterm postoperative outcomes for elderly patients undergoing total knee arthroplasty (TKA). Significance: With an aging population, an increasing percentage of the U.S. patient population will be living with cognitive impairment. There is currently no systematic review that assesses postoperative outcomes of patients with mild cognitive impairment (MCI) or preexisting diagnosis of dementia while undergoing elective primary TKA. Results: A database search between January 1, 1997, and November 1, 2017 in EMBASE, MEDLINE, and PubMed was conducted to identify articles that compared postoperative outcomes after TKA between patients aged 60 years with and without cognitive impairment. Cognitive impairment included preexisting diagnosis of dementia or MCI identified during preoperative assessment. Eligible articles were selected using dual reviewer and third-party arbitrator. The quality of the studies was evaluated using the Newcastle-Ottawa Scale. The strength of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. A total of 6163 abstracts were screened. Only 11 full text articles met inclusion criteria, including 1 case–control, 5 prospective cohort, and 5 retrospective cohort studies. Two studies were of poor quality. Overall, there is moderate strength of evidence for increased risk of postoperative delirium, increased length of stay, and discharge to health-care facility among patients with preoperative MCI or preexisting dementia. The body of evidence is weak for other outcomes of interest including mortality, functionality and complications while in-hospital and in the short- and midterm. Conclusion: This review highlights the need for additional good quality studies to provide more information about MCI and dementia as risk factors in primary TKA.
Phase 2 clinical trial of PBI-4050 in patients with idiopathic pulmonary fibrosis
Authors: Khalil Nasreen , Manganas Helene , Ryerson Christopher J. , Shapera Shane , Cantin Andre M. , Hernandez Paul , Turcotte Eric E. , Parker Joseph M. , Moran John E. , Albert Gary R. , Sawtell Renata , Hagerimana Aline , Laurin Pierre , Gagnon Lyne , Cesari Frank , Kolb Martin 
Published: December 2018

PBI-4050 is a novel orally active small-molecule compound with demonstrated anti-fibrotic activity in several models of fibrosis, including lung fibrosis. We present results from our first clinical study of PBI-4050 in patients with idiopathic pulmonary fibrosis (IPF).This 12-week open-label study explored the safety, efficacy and pharmacokinetics of daily oral doses of 800 mg PBI-4050 alone and in combination with nintedanib or pirfenidone in patients with predominantly mild or moderate IPF. Nine patients received PBI-4050 alone, 16 patients received PBI-4050 with nintedanib and 16 patients received PBI-4050 with pirfenidone.PBI-4050 alone or in combination with nintedanib or pirfenidone was well tolerated. Pharmacokinetic profiles for PBI-4050 were similar in the PBI-4050 alone and PBI-4050+nintedanib groups but reduced in the PBI-4050+pirfenidone group, suggesting a drug–drug interaction. There were no significant changes in forced vital capacity (FVC), either in % predicted or mL, from baseline to week 12 for PBI-4050 alone or PBI-4050+nintedanib. In contrast, a statistically significant reduction (p<0.024) in FVC % pred was seen for PBI-4050+pirfenidone after 12 weeks.There were no safety concerns with PBI-4050 alone or in combination with nintedanib or pirfenidone in IPF patients. The stability of FVC between baseline and week 12 looked encouraging for PBI-4050 alone and in combination with nintedanib.
Role of anlotinib-induced CCL2 decrease in anti-angiogenesis and response prediction for nonsmall cell lung cancer therapy
Authors: Lu Jun , Zhong Hua , Chu Tianqing , Zhang Xueyan , Li Rong , Sun Jiayuan , Zhong Runbo , Yang Yuqin , Alam Mohammad Shah , Lou Yuqing , Xu Jianlin , Zhang Yanwei , Wu Jun , Li Xiaowei , Zhao Xiaodong , Li Kai , Lu Liming , Han Baohui 
Published: December 2018

BackgroundAnlotinib has been demonstrated in clinical trials to be effective in prolonging the progression-free survival (PFS) and overall survival (OS) of refractory advanced nonsmall cell lung cancer (NSCLC) patients. However, the underlying molecular mechanisms and predictive biomarkers of anlotinib are still unclear.MethodsA retrospective analysis of anlotinib administered to 294 NSCLC patients was performed to screen for underlying biomarkers of anlotinib-responsive patients. Transcriptome and functional assays were performed to understand the antitumour molecular mechanisms of anlotinib. Changes in serum CCL2 levels were analysed to examine the correlation of the anlotinib response between responders and nonresponders.ResultsAnlotinib therapy was beneficial for prolonging OS in NSCLC patients harbouring positive driver gene mutations, especially patients harbouring the epithelial growth factor receptor (EGFR)T790Mmutation. Moreover, anlotinib inhibited angiogenesis in an NCI-H1975-derived xenograft modelviainhibiting CCL2. Finally, anlotinib-induced serum CCL2 level decreases were associated with the benefits of PFS and OS in refractory advanced NSCLC patients.ConclusionsOur study reports a novel anti-angiogenesis mechanism of anlotinibviainhibiting CCL2 in an NCI-H1975-derived xenograft model and suggests that changes in serum CCL2 levels may be used to monitor and predict clinical outcomes in anlotinib-administered refractory advanced NSCLC patients using third-line therapy or beyond.
Antimicrobial consumption in five adult intensive care units: a 33-month surveillance study
Authors: Balkhy Hanan H. , El-Saed Aiman , El-Metwally Ashraf , Arabi Yaseen M. , Aljohany Sameera M. , Al Zaibag Muayed , Baharoon Salim , Alothman Adel F. 
Published: December 2018

Abstract
Background
Estimating the baseline antimicrobial consumption is extremely important to monitor the impact of antimicrobial stewardship activities that aim to reduce the burden and cost of antimicrobial consumption.

Objectives
To quantify service-specific antimicrobial consumption using different metrics.

Methods
A surveillance study was conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia, between October 2012 and June 2015 in five adult intensive care units (ICUs). Consumption data were collected manually on a daily basis by infection control practitioners. Data were presented as defined daily dose (DDD), days of therapy (DOT) per 1000 patient days, and frequency of daily consumption.

Results
A total of 43,970 DDDs and 46,940 DOTs were monitored during 54,116 patient-days. For the most frequently consumed antimicrobials, the consumption of carbapenems, piperacillin/tazobactam, vancomycin, and colistin (respectively) in all ICUs combined were 255.9, 134.3, 98.2, and 13.6 DDDs per 1000 patient-days and 235.7, 145.9, 129.5, and 117.5 DOTs per 1000 patient-days. For the frequency of daily consumption, carbapenems were the most frequently consumed antimicrobial group in medical/surgical, burn, and step-down ICUs while piperacillin/tazobactam was the most frequently consumed antimicrobial in neuro-surgical and cardio-thoracic ICUs.

Conclusion
High consumption of broad-spectrum antimicrobial agents such as meropenem and piperacillin/tazobactam is observed in multiple ICUs in a tertiary care hospital. Meropenem consumption is considerably higher than similar ICUs internationally. Future studies focusing on concurrent monitoring of antimicrobial resistance and identifying patient and physician characteristics associated with specific prescription patterns may help in improving judicious antimicrobial consumption.
Mental health presentations to acute psychiatric services: 3-year study of prevalence and readmission risk for personality disorders compared with psychotic, affective, substance or other disorders
Authors: Lewis Kate L. , Fanaian Mahnaz , Kotze Beth , Grenyer Brin F. S. 
Published: December 2018

BackgroundThe relative burden and risk of readmission for people with personality disorders in hospital settings is unknown.AimsTo compare hospital use of people with personality disorder with that of people with other mental health diagnoses, such as psychoses and affective disorders.MethodNaturalistic study of hospital presentations for mental health in a large community catchment. Mixed-effects Cox regression and survival curves were generated to examine risk of readmission for each group.ResultsOf 2894 people presenting to hospital, patients with personality disorder represented 20.5% of emergency and 26.6% of in-patients. Patients with personality disorder or psychoses were 2.3 times (95% CI 1.79–2.99) more likely than others to re-present within 28 days. Personality disorder diagnosis increases rate of readmission by a factor of 8.7 (s.e. = 0.31), marginally lower than psychotic disorders (10.02, s.e. = 0.31).ConclusionsPersonality disorders place significant demands on in-patient and emergency departments, similar to that of psychoses in terms of presentation and risk of readmission.Declaration of interestNone.
Reducing Cancer Costs Through Symptom Management and Triage Pathways
Authors: Barkley Ronald , Soobader Mah-Jabeen , Wang Jun , Blau Sibel , Page Ray D. 
Published: December 2018

Confounding Factor(S), Drawbacks: Certain limitations to the study are acknowledged. We have attempted to identify events that did not actually occur, although we are confident that the methodology used to identify the ER nonevents was rigorous and highly reliable. Our study consists of a small sample size exacerbated by evaluating small (6% to 7%) changes in ER visits over a short study period, thus limiting our ability to confirm statistical significance in the reduction in ER events. Limitations inherent in the OCM claims data did not allow for rigorous risk adjustments for patient comorbidities, which can potentially impact findings. We have relied on the findings of others to determine the cost ratio of commercial costs to Medicare costs for the same service, which could impact the accuracy of the total savings among commercial patients. Finally, we recognize that medical practices incur operating expenses in providing these services and pathways and that such expenses would be a deduction from any economic gain to the practices resulting from their programs. Real-Life Implications: To demonstrate the value in value-based care, reliable quantification of economic impacts is a critical component. In this study, we have developed a methodology and approach to quantify the economic impacts of symptom management and triage pathways, which may have broader application in the continuing pursuit of value-based care and in the negotiation of the alternative payment models associated with such care.
Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals
Authors: Arshad Iqra , Mohsin Sara , Iftikhar Sana , Kazmi Tahseen , Nagi Luqman F. 
Published: December 2018

Background and Objective: Initiation of Insulin therapy during earlier stages has proved to significantly improve health outcomes among diabetics in comparison to oral medications. Not only patients but physicians are also often resistant to early initiation of insulin therapy. The objective was to assess misconceptions and barriers to early initiation of insulin therapy among diabetic patients coming to a diabetic clinic.
Methods: This cross sectional study was conducted on 300 patients selected by convenience sampling arriving in Diabetes Outdoor Clinics of Mayo and Services Hospitals, Lahore during August 2017 to May 2018. The data was entered and analyzed by using SPSS version 17.
Results: Out of 300 patients included in study, 39% (n= 117) were males and 61% (n=183) were females. The mean age of the participants at presentation was 48.46±13.15 years with a range of 13 to 80 years. Study participants considered it embarrassing to inject insulin in public place (p-value 0.01). The fear associated with lifelong commitment to insulin therapy once it is started, was also found statistically significant (p-value 0.001)particularly in subjects who have long duration of DM (>5 years).
Conclusion: Perceptions of diabetic patients about insulin therapy are still barriers to early initiation of therapy and tend to prevail in Pakistan and around the globe.
How to cite this:Arshad I, Mohsin S, Iftikhar S, Kazmi T, Nagi LF. Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals. Pak J Med Sci. 2019;35(1):39-44. doi: https://doi.org/10.12669/pjms.35.1.237
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Restraining the game-changer: A decade of uneven development in the petroleum sector
Authors: Jiyad Ahmed Mousa 
Published: December 2018

Abstract
The development of the Iraqi petroleum sector during the period 2008−18 represents, from all related aspects, a distinct phase in the sector and in its role in the national economy. The petroleum sector comprises three different but interrelated sub-sectors through critical forward-backward linkages: upstream (including exploration, field development and production); midstream (pipeline, storage, export terminals); and downstream (crude refining, gas processing, petroleum product distribution and petrochemicals).
Iraq must now take the path of healing and recovery
Authors: Kubba Juman 
Published: December 2018

Abstract
What is done is done. Iraq, over the past fifteen years, took huge leaps backwards. It is very important for politicians, historians, experts and judicial bodies to analyse what happened, why it happened, who is responsible and how to hold them accountable. But what is more important now is to ensure that Iraqi society recovers from the calamities of the past fifteen years and the preceding 30 years and that the country’s resources are used to serve Iraqis and provide them with good living conditions and never again be wasted and dissipated. This article focuses on the pathway of healing Iraqi society from the aftermath of decades of war, poverty and immense suffering. Restoring good education and health care is the first step on the pathway of healing and recovery and some aspects related to this will be discussed in this article. Also, neutralizing and reversing several dangerous post conflict societal problems that have arisen over the years such as traumatized war children, warinjured young men, drug abuse among youth and an alarming increase in neoplastic diseases just to name a few are a priority. Given the weakness of the government, corruption and contradictions between legislation and jurisdiction, one must consider new non-traditional approaches to solving these problems; a few focusing on health and well-being are presented in the article. The success of any future government should be measured by how much it can ameliorate the essential life-sustaining and life-enhancing services for ordinary citizens.
Exploring the networked image in ‘post’ art practices
Authors: Lynch Garrett 
Published: December 2018

Abstract
This article presents and discusses a series of four networked artworks undertaken since 2013. The artworks are performative, created within the web over a duration of time, are visible to an audience throughout their creation and as such can be considered as durational networked performances. Different in subject matter they overlap considerably in the themes, form and methods employed and constitute a body of research that explores the networked image in relation to a number of ‘post’ art practices. Specifically, this includes the questioning of media and form through postmedia, post-photographic, post-digital, post-Internet and post-screen practices in addition to addressing the manner in which the artist creates through postdisciplinary and postproduction methods.