bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Person Order on Egress Time: A Simulation Model of Evacuation From a Neolithic Visitor Attraction
Authors: Stewart Arthur , Elyan Eyad , Isaacs John , McEwen Leah , Wilson Lyn 
Published: September 2017

Objective: The aim of this study was to model the egress of visitors from a Neolithic visitor attraction. Background: Tourism attracts increasing numbers of elderly and mobility-impaired visitors to our built-environment heritage sites. Some such sites have very limited and awkward access, were not designed for mass visitation, and may not be modifiable to facilitate disabled access. As a result, emergency evacuation planning must take cognizance of robust information, and in this study we aimed to establish the effect of visitor position on egress. Method: Direct observation of three tours at Maeshowe, Orkney, informed typical time of able-bodied individuals and a mobility-impaired person through the 10-m access tunnel. This observation informed the design of egress and evacuation models running on the Unity gaming platform. Results: A slow-moving person at the observed speed typically increased time to safety of 20 people by 170% and reduced the advantage offered by closer tunnel separation by 26%. Using speeds for size-specific characters of 50th, 95th, and 99th percentiles increased time to safety in emergency evacuation by 51% compared with able-bodied individuals. Conclusion: Larger individuals may slow egress times of a group; however, a single slow-moving mobility-impaired person exerts a greater influence on group egress, profoundly influencing those behind. Application: Unidirectional routes in historic buildings and other visitor attractions are vulnerable to slow-moving visitors during egress. The model presented in this study is scalable, is applicable to other buildings, and can be used as part of a risk assessment and emergency evacuation plan in future work.
Role of number of sentinel nodes in predicting non-sentinel node metastasis in breast cancer
Authors: Dong Li-Feng , Xu Shu-Ying , Long Jing-Pei , Wan Fang , Chen Yi-Ding 
Published: September 2017

Objective The aim of the present study was to determine how many sentinel lymph nodes (SLNs) are appropriate for predicting non-SLN metastasis in breast cancer. Methods The association between clinicopathological features and non-SLN metastasis was retrospectively analyzed in 472 patients who underwent axillary lymph node dissection (ALND) following SLN biopsy. Another 251 patients who underwent only SLN biopsy without ALND were analyzed and followed up for 2 years. Results A large tumor size, positive SLN, and HER-2 positivity were independent predictors of non-SLN metastasis. There were significant differences in non-SLN metastasis between patients with one negative SLN and patients with an absence of negative SLNs. There was no significant difference in non-SLN metastasis between patients with one negative SLN and two or more negative SLNs. The recurrence-free survival rate for patients who did not undergo ALND was 99.6% (245/246). Conclusion Surgeons should ensure that the number of SLNs obtained is appropriate. The presence of one negative SLN is enough in SLN biopsy. Considering the invasiveness of the surgery, two or more negative SLNs may be unnecessary.
International ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia
Authors: Torres Antoni , Niederman Michael S. , Chastre Jean , Ewig Santiago , Fernandez-Vandellos Patricia , Hanberger Hakan , Kollef Marin , Li Bassi Gianluigi , Luna Carlos M. , Martin-Loeches Ignacio , Paiva J. Artur , Read Robert C. , Rigau David , Timsit Jean François , Welte Tobias , Wunderink Richard 
Published: September 2017

The most recent European guidelines and task force reports on hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) were published almost 10 years ago. Since then, further randomised clinical trials of HAP and VAP have been conducted and new information has become available. Studies of epidemiology, diagnosis, empiric treatment, response to treatment, new antibiotics or new forms of antibiotic administration and disease prevention have changed old paradigms. In addition, important differences between approaches in Europe and the USA have become apparent.The European Respiratory Society launched a project to develop new international guidelines for HAP and VAP. Other European societies, including the European Society of Intensive Care Medicine and the European Society of Clinical Microbiology and Infectious Diseases, were invited to participate and appointed their representatives. The Latin American Thoracic Association was also invited.A total of 15 experts and two methodologists made up the panel. Three experts from the USA were also invited (Michael S. Niederman, Marin Kollef and Richard Wunderink).Applying the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) methodology, the panel selected seven PICO (population–intervention–comparison–outcome) questions that generated a series of recommendations for HAP/VAP diagnosis, treatment and prevention.
Evaluation of severity score-guided approaches to macrolide use in community-acquired pneumonia
Authors: Singanayagam Aran , Aliberti Stefano , Cillóniz Catia , Torres Antoni , Blasi Francesco , Chalmers James D. 
Published: September 2017

International guidelines including those in the UK, Japan, Australia and South Africa recommend the avoidance of macrolides in patients with low-severity community-acquired pneumonia (CAP). We hypothesised that severity scores are poor predictors of atypical pneumonia and response to macrolide therapy, and thus, inadequate tools for guiding antibiotic prescriptions.Secondary analysis of four independent prospective CAP datasets was conducted. The predictive values of the CURB-65 and pneumonia severity index (PSI) for clinically important groups of causative pathogens were evaluated. The effect of macrolide use according to risk class was assessed by multivariable analysis. Patients (3297) were evaluated, and the predictive values of CURB-65 and PSI for atypical pathogens were poor (AUC values of 0.37 and 0.42, respectively). No significant differences were noted among the effects of macrolide use on mortality in patients with mild, moderate and severe CAP, according to either CURB-65 (interaction testing severeversusmild disease OR=0.74 (0.29–1.89)) or PSI (severeversusmild disease OR=3.4 (0.055–2.10)), indicating that severity scores were not significant modifiers of response to macrolide therapy.Severity scores did not accurately predict response to macrolide therapy in CAP, suggesting that current guidance to use these tools for empirical antibiotic choices might not be justified.
On the notion of abstraction in systemic functional linguistics
Authors: Williams Jamie , Russell Noah , Irwin Derek 
Published: September 2017

AbstractThis article provides an in-depth analysis of the theoretical dimensions of stratification, instantiation, and delicacy within Systemic Functional Linguistics (SFL). It does so by examining the nature of the concept of ‘abstraction’ with respect to these terms. The claim is that, although the same term is used in each case, the precise meaning of abstraction differs depending on the theoretical focus. This conclusion is reached by examining three related, but distinct, factors: (1) omission of detail, (2) generalisation, and (3) decontextualisation. By using these criteria, this article develops a typology of abstraction types for SFL. The conclusion reached is that, although the dimensions of delicacy and instantiation can be described using the criteria above, the explicit ordering behind the dimension of stratification cannot. The paper concludes by examining a proposal that attempts to account for the explicit ordering between strata in terms of supervenience. We argue that this attempt fails to accurate describe inter-stratal relations in the theory. Therefore, the basis of this ordering is in need of further investigation.
Impact of involuntary out-patient commitment on reducing hospital services: 2-year follow-up
Authors: Castells-Aulet Laura , Hernández-Viadel Miguel , Jiménez-Martos Jesús , Cañete-Nicolás Carlos , Bellido-Rodríguez Carmen , Calabuig-Crespo Roman , Asensio-Pascual Pedro , Lera-Calatayud Guillem 
Published: September 2017

Aims and methodTo evaluate whether involuntary out-patient commitment (OPC) in patients with severe mental disorder reduces their use of hospital services. This is a retrospective case-control study comparing a group of patients on OPC (n = 75) and a control group (n = 75) which was composed of patients whose sociodemographic variables and clinical characteristics were similar to those of the OPC group. Each control case is paired with an OPC case, so the control case must have an involuntary admission in the month that the index OPC case admission occurred. Emergency room visits, admissions and average length of hospital stay over a 2-year follow-up after the initiation of OPC were compared.ResultsNo statistically significant evidence was found in the use of mental healthcare services between the two groups. Different reasons for admission found between the groups limit similarity when comparing the two.Clinical implicationsThe findings cast doubt over the effectiveness of this legal measure to reduce emergency visits, the number of admissions and the length of stay in the hospital.
Dementia in a Black and minority ethnic population: characteristics of presentation to an inner London memory service
Authors: Tuerk Rosalyn , Sauer Justin 
Published: September 2017

Aims and methodTo examine data on referrals to an inner-city London memory service to explore any differences in referral rates, cognitive assessments and stages of dementia at presentation between ethnic groups.ResultsAfrican–Caribbean patients were well represented in the memory service. They were diagnosed with dementia on average 4.5 years younger than their White British counterparts and were more likely to be diagnosed with a vascular or mixed type dementia. However, scores on initial cognitive testing were significantly lower in the African–Caribbean group, possibly representing more advanced disease at presentation.Clinical implicationsInitiatives to access Black and minority ethnic populations earlier in the course of their illness should be considered. Professionals need to consider the potential for cultural bias in memory testing and diagnosing dementia in these populations, and the importance of cultural competency in assessments.
Difficult to treat? a comparison of the effectiveness of treatment as usual in refugees and non-refugees
Authors: ter Heide F. Jackie June , Smid Geert E. 
Published: September 2017

Aims and methodTo examine treatment response in traumatised refugees, we compared routine outcome monitoring data (Harvard Trauma Questionnaire) of two refugee populations with those of individuals experiencing profession-related trauma who were treated at a specialised psychotrauma institute.ResultsAsylum seekers/temporary refugees (n = 21) and resettled refugees (n = 169) showed significantly lower post-traumatic stress disorder (PTSD) symptom reduction between intake and 1 year after intake than did a comparison group of non-refugees (n = 37), but the interaction effect was clinically small (partial η2 = 0.03). Refugees who had more severe symptoms at intake showed significantly greater symptom reduction after 1 year.Clinical implicationsTherapists and refugee patients should have realistic expectations about response to treatment as usual. Additional treatment focusing on improving quality of life may be needed for refugees whose PTSD symptom severity remains high. At the same time, novel approaches may be developed to boost treatment response in refugee patients with low responsiveness.
Culturally adapted mental healthcare: evidence, problems and recommendations
Authors: Dinos Sokratis 
Published: September 2017

SummaryEvidence suggests disparities in the prevalence of mental health problems and access to mental healthcare for a number of minority groups. The main response from mental health services falls into two related categories: (a) cultural adaptations of existing evidence-based interventions (EBIs) and/or (b) cultural competence of mental health professionals. This editorial looks at the evidence on culturally adapted EBIs and argues that although such interventions can be effective, they also carry the risk of alienating members of the groups they are aimed at. Recommendations focus on identifying issues that pertain to being from a racial minority and/or possessing other stigmatised identities that can have an impact on mental health problems, which may be overlooked by mental health services by assuming an overarching predominant cultural identity.
Perceptual distortions and deceptions: what computers can teach us
Authors: Nour Matthew M. , Nour Joseph M. 
Published: September 2017

SummaryThe nature of perception has fascinated philosophers for centuries, and has more recently been the focus of research in psychology and neuroscience. Many psychiatric disorders are characterised by perceptual abnormalities, ranging from sensory distortions to illusions and hallucinations. The distinction between normal and abnormal perception is, however, hard to articulate. In this article we argue that the distinction between normal perception and abnormal perception is best seen as a quantitative one, resting on the degree to which the observer's prior expectations influence perceptual inference. We illustrate this point with an example taken from researchers at Google working on computer vision.
Mental capacity and borderline personality disorder
Authors: Ayre Karyn , Owen Gareth S. , Moran Paul 
Published: September 2017

SummaryThe use of the Mental Capacity Act 2005 in assessing decision-making capacity in patients with borderline personality disorder (BPD) is inconsistent. We believe this may stem from persisting confusion regarding the nosological status of personality disorder and also a failure to recognise the fact that emotional dysregulation and characteristic psychodynamic abnormalities may cause substantial difficulties in using and weighing information. Clearer consensus on these issues is required in order to provide consistent patient care and reduce uncertainty for clinicians in what are often emergency and high-stakes clinical scenarios.
Adherence to medication in the community: Audit cycle of interventions to improve the assessment of adherence
Authors: Farooq Saeed , Choudry Abid 
Published: September 2017

Aims and methodTo investigate whether medication adherence is monitored during follow-up in out-patient reviews. A retrospective audit was carried out with a sample of 50 follow-up patients with a diagnosis of schizophrenia or schizoaffective disorder. Following this, interventions were made prior to the re-audit (including text messaging clinicians and prompt sheets in the out-patient department to encourage adherence discussions).ResultsThere was an improvement on all the standards set for this audit following the interventions. More doctors had discussed medication adherence (62% second cycle v. 50% first cycle) with their patient and there was increased discussion and documentation regarding medication side-effects (60% second cycle v. 30% first cycle). More clinicians discussed the response to medication (60% second cycle v. 46% first cycle).Clinical implicationsTreatment adherence is not regularly monitored or recorded in clinical notes in routine psychiatric out-patient appointments. This highlights the need for regular training to improve practice.
Effects of Inorganic Iodine Therapy Administered to Lactating Mothers With Graves Disease on Infant Thyroid Function
Authors: Hamada Katsuhiko , Mizokami Tetsuya , Maruta Tetsushi , Higashi Kiichiro , Konishi Kaoru , Momotani Naoko , Tajiri Junichi 
Published: September 2017

Abstract

Context
The effects of maternal inorganic iodine therapy on infant thyroid function are not well known.

Objective
This study investigated the effects on infant thyroid function of maternal inorganic iodine therapy when administered to lactating mothers with Graves disease.

Design and Setting
This study was a prospective case series performed at the Tajiri Thyroid Clinic, Kumamoto, Japan.

Participants
Subjects were 26 infants of lactating mothers with Graves disease treated with potassium iodide (KI) for postpartum thyrotoxicosis.

Main Outcome Measures
Infant blood levels of thyroid-stimulating hormone (TSH) and free thyroxine were measured using the dried filter-paper method. Iodine concentrations in breast milk and infant urine were measured on the same day. Subclinical hypothyroidism was defined as a blood TSH level of ≥10 or ≥5 μIU/mL in &lt;6-month-old and 6- to 12-month-old infants, respectively.

Results
The median age of the infants was 3 months (range, 0 to 10 months). The median KI dose was 50 mg/d (range, 10 to 100 mg/d). High median iodine concentrations were detected in breast milk (15,050 μg/L; range, 831 to 72,000 μg/L) and infant urine (15,650 μg/L; range, 157 to 250,000 μg/L). Twenty-five of 26 infants had normal thyroid function. Although one infant had subclinical hypothyroidism (blood TSH, 12.3 μIU/mL), the TSH level normalized to 2.3 μIU/mL at 2 months after KI discontinuation.

Conclusion
In Japan, where iodine intake is sufficient, administration of inorganic iodine to lactating mothers with Graves disease did not affect thyroid function in most infants despite high levels of exposure to iodine via breast milk.
La borrachera y sus pre-textos. El beber indígena en la literatura jesuítica sobre Chaco del siglo XVIII.
Authors: Paz Carlos D. 
Published: September 2017

A pesar de las múltiples y constantes referencias que los misioneros jesuitas hicieron sobre las borracheras, como un problema no sólo de índole moral entre los indígenas, no existe un tratado u obra de referencia dedicada exclusivamente a esa cuestión. El abordaje y descripción de las borracheras es construido por los jesuitas a partir de una mención crítica de un orden social que se fragiliza al punto de generar no sólo muertes si no que a la vez llegaba a constituirse como un marcador social de sentido. El sentido performativo de la borrachera es presentado como un problema de salud que corrompe el cuerpo de la civitas cristiana. El objetivo del artículo es brindar, en primer lugar, un panorama sobre el sentido social de las borracheras indias en el Chaco del siglo XVIII ponderando los abordajes que realizaron los miembros de la Compañía de Jesús; reflexiones que muestran a las sesiones de bebida como un ‘espejo del alma’ indígena. Un alma unida a cuerpos que se muestran indolentes ante el accionar misional reduccional. En segundo termino reflexionaré sobre la importancia de la conformación de un saber natural que permita no sólo intentar acotar las posibilidades nativas de preparación de bebidas si no que, al mismo tiempo, permita al jesuita conformar para sí una representación mental de una geografía física y social de la sociabilidad nativa ponderando a las borracheras como una parte de aquella naturaleza aunque no recalando en los aspectos ontológicos que movilizaban aquellas pasiones.
Electrochemical behavior, characterization and corrosion protection properties of poly(bithiophene+2-methylfuran) copolymer coatings on A304 stainless steel
Authors: Lamiri Leila , Nessark Belkacem 
Published: September 2017

AbstractPolybithiophene (PBTh), poly(2-methylfuran) (PMeFu) and poly(bithiophene+2-methylfuran) noted poly(BTh+MeFu) copolymer films were synthesized by electrochemical deposition on 304-stainless steel, from an acetonitrile (ACN) solution containing 10−2mbithiophene, 10−2m2-methylfuran and 10−1mlithium perchlorate (LiClO4), by cyclic voltammetry (CV) between 0 V and 2 V vs. SCE, with a scan rate of 50 mV·s−1. The copolymers coated were studied in a corrosive sulfuric acid medium (H2SO4·1 N) using the potensiodynamique polarization method and the electrochemical impedance spectroscopy (EIS). Copolymers coated characterization was performed using scanning electron microscopy (SEM) and Fourier transform infrared (FTIR) spectroscopy. The polarization curves show that the copolymer film formed on A304, shifts the corrosion potential towards more positive potentials. The presence of the poly(BTh+MeFu) improves the corrosion resistance of the metal in a corrosive medium, H2SO4. This protection against corrosion is caused by the barrier effect of the layer of copolymer, which covers the surface of the A304 stainless steel against the aggressive ions of the corrosive medium.
Evaluation of deformable image registration (DIR) methods for dose accumulation in nasopharyngeal cancer patients during radiotherapy
Authors: Nobnop Wannapha , Chitapanarux Imjai , Neamin Hudsaleark , Wanwilairat Somsak , Lorvidhaya Vicharn , Sanghangthum Taweap 
Published: September 2017

Abstract

Introduction
Deformable image registration (DIR) is used to modify structures according to anatomical changes for observing the dosimetric effect. In this study, megavoltage computed tomography (MVCT) images were used to generate cumulative doses for nasopharyngeal cancer (NPC) patients by various DIR methods. The performance of the multiple DIR methods was analysed, and the impact of dose accumulation was assessed.

Patients and methods
The study consisted of five NPC patients treated with a helical tomotherapy unit. The weekly MVCT images at the 1st, 6th, 11th, 16th, 21st, 26th, and 31st fractions were used to assess the dose accumulation by the four DIR methods. The cumulative dose deviations from the initial treatment plan were analysed, and correlations of these variations with the anatomic changes and DIR methods were explored.

Results
The target dose received a slightly different result from the initial plan at the end of the treatment. The organ dose differences increased as the treatment progressed to 6.8% (range: 2.2 to 10.9%), 15.2% (range: -1.7 to 36.3%), and 6.4% (range: -1.6 to 13.2%) for the right parotid, the left parotid, and the spinal cord, respectively. The mean uncertainty values to estimate the accumulated doses for all the DIR methods were 0.21 ± 0.11 Gy (target dose), 1.99 ± 0.76 Gy (right parotid), 1.19 ± 0.24 Gy (left parotid), and 0.41 ± 0.04 Gy (spinal cord).

Conclusions
Accuracy of the DIR methods affects the estimation of dose accumulation on both the target dose and the organ dose. The DIR methods provide an adequate dose estimation technique for observation as a result of inter-fractional anatomic changes and are beneficial for adaptive treatment strategies.
A Dynamic Clamp on Every Rig
Authors: Desai Niraj S. , Gray Richard , Johnston Daniel 
Published: September 2017

AbstractThe dynamic clamp should be a standard part of every cellular electrophysiologist’s toolbox. That it is not, even 25 years after its introduction, comes down to three issues: money, the disruption that adding dynamic clamp to an existing electrophysiology rig entails, and the technical prowess required of experimenters. These have been valid and limiting issues in the past, but no longer. Technological advances associated with the so-called maker movement render them moot. We demonstrate this by implementing a fast (∼100 kHz) dynamic clamp system using an inexpensive microcontroller (Teensy 3.6). The overall cost of the system is less than USD$100, and assembling it requires no prior electronics experience. Modifying it—for example, to add Hodgkin–Huxley-style conductances—requires no prior programming experience. The system works together with existing electrophysiology data acquisition systems (for Macintosh, Windows, and Linux); it does not attempt to supplant them. Moreover, the process of assembling, modifying, and using the system constitutes a useful pedagogical exercise for students and researchers with no background but an interest in electronics and programming. We demonstrate the system’s utility by implementing conductances as fast as a transient sodium conductance and as complex as the Ornstein–Uhlenbeck conductances of the “point conductance” model of synaptic background activity.