bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and predictors of hospital prealerting in acute stroke: a mixed methods study
Authors: Sheppard J P , Lindenmeyer A , Mellor R M , Greenfield S , Mant J , Quinn T , Rosser A , Sandler D , Sims D , Ward M , McManus R J 
Published: June 2016

BackgroundThrombolysis can significantly reduce the burden of stroke but the time window for safe and effective treatment is short. In patients travelling to hospital via ambulance, the sending of a ‘prealert’ message can significantly improve the timeliness of treatment.ObjectiveExamine the prevalence of hospital prealerting, the extent to which prealert protocols are followed and what factors influence emergency medical services (EMS) staff's decision to send a prealert.MethodsCohort study of patients admitted to two acute stroke units in West Midlands (UK) hospitals using linked data from hospital and EMS records. A logistic regression model examined the association between prealert eligibility and whether a prealert message was sent. In semistructured interviews, EMS staff were asked about their experiences of patients with suspected stroke.ResultsOf the 539 patients eligible for this study, 271 (51%) were recruited. Of these, only 79 (29%) were eligible for prealerting according to criteria set out in local protocols but 143 (53%) were prealerted. Increasing number of Face, Arm, Speech Test symptoms (1 symptom, OR 6.14, 95% CI 2.06 to 18.30, p=0.001; 2 symptoms, OR 31.36, 95% CI 9.91 to 99.24, p<0.001; 3 symptoms, OR 75.84, 95% CI 24.68 to 233.03, p<0.001) and EMS contact within 5 h of symptom onset (OR 2.99, 95% CI 1.37 to 6.50 p=0.006) were key predictors of prealerting but eligibility for prealert as a whole was not (OR 1.92, 95% CI 0.85 to 4.34 p=0.12). In qualitative interviews, EMS staff displayed varying understanding of prealert protocols and described frustration when their interpretation of the prealert criteria was not shared by ED staff.ConclusionsUp to half of the patients presenting with suspected stroke in this study were prealerted by EMS staff, regardless of eligibility, resulting in disagreements with ED staff during handover. Aligning the expectations of EMS and ED staff, perhaps through simplified prealert protocols, could be considered to facilitate more appropriate use of hospital prealerting in acute stroke.
Implementation of a teaching programme to improve doctors’ awareness of DVLA guidelines: a multicentre study
Authors: Maruthappu Mahiben , Sykes Mark , Green Ben L , Watson Robert , Gollop Nicholas D , Shalhoub Joseph , Ng Ka Ying Bonnie 
Published: June 2016

ABSTRACTIntroductionOver half of the UK population holds a driver’s licence. Driver and Vehicle Licensing Authority (DVLA) guidelines are available for conditions from most specialties. Despite this, no focused training occurs in the undergraduate or postgraduate setting. We evaluate the impact of a teaching programme to improve guideline awareness.MethodsA 25-point questionnaire was designed using the current DVLA guidelines. Five questions were included for the following fields: neurology, cardiology, drug and alcohol abuse, visual disorders and respiratory. This was distributed to doctors in training at five hospitals. Four weeks later, a single-session teaching programme was implemented. The questionnaire was redistributed. Preintervention and postintervention scores were compared using the Wilcoxon rank sum test.Results139 preteaching and 144 post-teaching questionnaires were completed. Implementation of a single-session teaching programme significantly improved the knowledge of DVLA guidelines in all five areas explored. Median scores: neurology, preteaching 40%, post-teaching 100%, p&lt;0.001; cardiology, 0%, 100%, p&lt;0.001; drug and alcohol misuse, 0%, 100%, p&lt;0.001; visual disorders, 40%, 100%, p&lt;0.001; respiratory disorders, 20%, 100%, p&lt;0.001; and overall, 28%, 92%, p&lt;0.001.ConclusionsKnowledge of DVLA guidelines among our cohort was poor. Implementation of a single-session teaching programme can significantly improve guideline knowledge and awareness, serving as a cost-effective intervention.
Evolution of the South Atlantic lacustrine deposits in response to Early Cretaceous rifting, subsidence and lake hydrology
Authors: Sabato Ceraldi Teresa , Green Darryl 
Published: June 2016

Abstract
The discovery of the giant Lula Field (Santos Basin, Brazil) has focused exploration on the pre-salt lacustrine carbonate play in both Brazil and Angola. Understanding the main controls on deposition and the link to the unique tectonic setting of the South Atlantic during the Early Cretaceous is paramount in successful exploration. Observations from conjugate regional seismic lines between the Kwanza and South Campos basins define the key megasequences as pre-rift, rift, sag, salt basin, post-salt carbonates and post-salt clastic sediments. The pre-salt stratigraphy can be described by three significant phases. In the first phase, the synrift lakes (Valanginian–Hauterivian), representing the onset of continental break-up and the formation of synrift graben, created several deep basins leading to overfilled freshwater lakes. In the second phase, Sag 1 (Barremian–Aptian), there was widespread subsidence created by syn-kinematic stretching of the continental crust and/or continuous rifting. Lacustrine sediments composed of coarse Pelecypod coquina with moderate faunal diversity are found, suggesting a fresh to brackish, balanced-filled, interconnected lake. In the third phase, Sag 2 (Aptian), there was continuous subsidence and isolation of the lake. Base level falls below sea-level resulted in an under-filled, alkaline and hypersaline lake with widespread microbialite growth. Based on the integration of seismic data, well data, biostratigraphy and tectonic models, a regional predictive model has been developed for reservoirs in phases 2 and 3.
Pacific Influences on Tropical Atlantic Teleconnections to the Southern Hemisphere High Latitudes
Authors: Simpkins Graham R. , Peings Yannick , Magnusdottir Gudrun 
Published: June 2016

AbstractSeveral recent studies have connected Antarctic climate variability to tropical Atlantic sea surface temperatures (SST), proposing a Rossby wave response from the Atlantic as the primary dynamical mechanism. In this investigation, reanalysis data and atmospheric general circulation model experiments are used to further diagnose these dynamical links. Focus is placed on the possible mediating role of Pacific processes, motivated by the similar spatial characteristics of Southern Hemisphere (SH) teleconnections associated with tropical Atlantic and Pacific SST variability. During austral winter (JJA), both reanalyses and model simulations reveal that Atlantic teleconnections represent a two-mechanism process, whereby increased tropical Atlantic SST promotes two conditions: 1) an intensification of the local Atlantic Hadley circulation (HC), driven by enhanced interaction between SST anomalies and the ITCZ, that increases convergence at the descending branch, establishing anomalous vorticity forcing from which a Rossby wave emanates, expressed as a pattern of alternating positive and negative geopotential height anomalies across the SH extratropics (the so-called HC-driven components); and 2) perturbations to the zonal Walker circulation (WC), driven primarily by an SST-induced amplification, that creates a pattern of anomalous upper-level convergence across the central/western Pacific, from which an ENSO-like Rossby wave train can be triggered (the so-called WC-driven components). While the former are found to dominate, the WC-driven components play a subsidiary yet important role. Indeed, it is the superposition of these two separate but interrelated mechanisms that gives the overall observed response. By demonstrating an additional Pacific-related component to Atlantic teleconnections, this study highlights the need to consider Atlantic–Pacific interactions when diagnosing tropical-related climate variability in the SH extratropics.
Climate Feedback Variance and the Interaction of Aerosol Forcing and Feedbacks
Authors: Gettelman A. , Lin L. , Medeiros B. , Olson J. 
Published: June 2016

AbstractAerosols can influence cloud radiative effects and, thus, may alter interpretation of how Earth’s radiative budget responds to climate forcing. Three different ensemble experiments from the same climate model with different greenhouse gas and aerosol scenarios are used to analyze the role of aerosols in climate feedbacks and their spread across initial condition ensembles of transient climate simulations. The standard deviation of global feedback parameters across ensemble members is low, typically 0.02 W m−2 K−1. Feedbacks from high (8.5 W m−2) and moderate (4.5 W m−2) year 2100 forcing cases are nearly identical. An aerosol kernel is introduced to remove effects of aerosol cloud interactions that alias into cloud feedbacks. Adjusted cloud feedbacks indicate an “aerosol feedback” resulting from changes to climate that increase sea-salt emissions, mostly in the Southern Ocean. Ensemble simulations also indicate higher tropical cloud feedbacks with higher aerosol loading. These effects contribute to a difference in cloud feedbacks of nearly 50% between ensembles of the same model. These two effects are also seen in aquaplanet simulations with varying fixed drop number. Thus aerosols can be a significant modifier of cloud feedbacks, and different representations of aerosols and their interactions with clouds may contribute to multimodel spread in climate feedbacks and climate sensitivity in multimodel archives.
Deriving AMVs from Geostationary Satellite Images Using Optical Flow Algorithm Based on Polynomial Expansion
Authors: Wu Qiong , Wang Hong-Qing , Lin Yin-Jing , Zhuang Yi-Zhou , Zhang Yan 
Published: June 2016

AbstractAn optical flow algorithm based on polynomial expansion (OFAPE) was used to derive atmospheric motion vectors (AMVs) from geostationary satellite images. In OFAPE, there are two parameters that can affect the AMV results: the sizes of the expansion window and optimization window. They should be determined according to the temporal interval and spatial resolution of satellite images. A helpful experiment was conducted for selecting those sizes. The limitations of window sizes can cause loss of strong wind speed, and an image-pyramid scheme was used to overcome this problem. Determining the heights of AMVs for semitransparent cloud pixels (STCPs) is challenging work in AMV derivation. In this study, two-dimensional histograms (H2Ds) between infrared brightness temperatures (6.7- and 10.8-μm channels) formed from a long time series of cloud images were used to identify the STCPs and to estimate their actual temperatures/heights. The results obtained from H2Ds were contrasted with CloudSat radar reflectivity and CALIPSO cloud-feature mask data. Finally, in order to verify the algorithm adaptability, three-month AMVs (JJA 2013) were calculated and compared with the wind fields of ERA data and the NOAA/ESRL radiosonde observations in three aspects: speed, direction, and vector difference.
Identification of Tropical Cyclone Storm Types Using Crowdsourcing
Authors: Knapp Kenneth R. , Matthews Jessica L. , Kossin James P. , Hennon Christopher C. 
Published: June 2016

AbstractThe Cyclone Center project maintains a website that allows visitors to answer questions based on tropical cyclone satellite imagery. The goal is to provide a reanalysis of satellite-derived tropical cyclone characteristics from a homogeneous historical database composed of satellite imagery with a common spatial resolution for use in long-term, global analyses. The determination of the cyclone “type” (curved band, eye, shear, etc.) is a starting point for this process. This analysis shows how multiple classifications of a single image are combined to provide probabilities of a particular image’s type using an expectation–maximization (EM) algorithm. Analysis suggests that the project needs about 10 classifications of an image to adequately determine the storm type. The algorithm is capable of characterizing classifiers with varying levels of expertise, though the project needs about 200 classifications to quantify an individual’s precision. The EM classifications are compared with an objective algorithm, satellite fix data, and the classifications of a known classifier. The EM classifications compare well, with best agreement for eye and embedded center storm types and less agreement for shear and when convection is too weak (termed no-storm images). Both the EM algorithm and the known classifier showed similar tendencies when compared against an objective algorithm. The EM algorithm also fared well when compared to tropical cyclone fix datasets, having higher agreement with embedded centers and less agreement for eye images. The results were used to show the distribution of storm types versus wind speed during a storm’s lifetime.
A mixed-methods evaluation of the Move it Move it! before-school incentive-based physical activity programme
Authors: Garnett Bernice R , Becker Kelly , Vierling Danielle , Gleason Cara , DiCenzo Danielle , Mongeon Louise 
Published: June 2016

Objective: Less than half of young people in the USA are meeting the daily physical activity requirements of at least 60 minutes of moderate or vigorous physical activity. A mixed-methods pilot feasibility assessment of Move it Move it! was conducted in the Spring of 2014 to assess the impact of a before-school physical activity programme on student academic measures and behavioural health. Design: Move it Move it! encourages students and families to run/walk laps in the recess yard. Student miles are tracked and incentives are awarded at several benchmarks Setting: Launched in 2012, Move it Move it! is a voluntary morning running/walking programme at the Integrated Arts Academy (IAA) elementary school designed to build community, increase fitness and prepare students for learning. Methods: Self-reported surveys were administered to all consented students in grades 3–5 ( N = 129). Semi-structured interviews were conducted with school personnel ( N = 11). Results: Average Move it Move it! miles ran/walked were significantly positively associated with commitment to school and The New England Common Assessment Program (NECAP) mathematics testing scores. Interviews with school staff/faculty further explained quantitative results including the perceived impact of the programme on academic success and school engagement and the perceived impact of the programme on student behaviour and school climate. Conclusion: Results from this pilot assessment of a community-based initiative suggested that positive academic and behavioural outcomes were associated with engagement in a before-school incentive-based physical activity programme.
Effect of TGF-beta1 on MMP/TIMP and TGF-beta1 receptors in great saphenous veins and its significance on chronic venous insufficiency
Authors: Serralheiro Pedro , Cairrão Elisa , Maia Cláudio J , João Marina , Almeida Carlos M Costa , Verde Ignacio 
Published: June 2016

Objectives Transforming growth factor-beta1 (TGF-β1) may participate in local chronic inflammatory processes in varicose veins and in venous wall structure modifications through regulation of matrix metalloproteinases (MMP) and their inhibitors (tissue inhibitor of metalloproteinase (TIMP)). The aim of this study was to analyze the effect of TGF-β1 in the vein wall, namely on the gene expression of selected MMP, TIMP and TGF-β1 receptors. Methods Healthy vein samples were harvested from eight subjects who underwent coronary bypass graft surgery with great saphenous vein. Each vein sample was divided into two segments, which were cultivated separately in vitro (one of the segments had TGF-β1 added) and then submitted to gene expression analysis. Results In the TGF-β1 supplemented group, there was a general increase in the mean gene expression. Specifically, expression of MMP9, MMP12, TIMP1 and TIMP2 were statistically significant. Conclusion The results of this study demonstrate that the gene expression of MMP9, MMP12, TIMP1 and TIMP2 was influenced by the addition of TGF-β1. These results may be translated to chronic venous insufficiency framework and suggest involvement of TGF-β1 in the vein wall pathology.
A guide to management of neuropsychiatric manifestations of Parkinson’s disease
Authors: Molina Ruiz Rosa M , Evans Andrew H , Velakoulis Dennis , Looi Jeffrey CL 
Published: June 2016

Objective: This clinical update review focuses on treatment approaches of neuropsychiatric manifestations in Parkinson’s disease. Methods: We conducted a systematic search of the literature using Pubmed and selected recent and relevant papers for this review. Results: Neuropsychiatric symptoms in Parkinson’s disease usually require optimization of levodopa therapy as a first step. Most psychotropic drugs can be used in Parkinson’s disease, however there is still lack of an evidence base due to limited studies and difficulties in diagnosis of neuropsychiatric disorders. Non-pharmacological treatments have also proved effective in Parkinson’s disease. Cognitive impairment requires special consideration. Conclusions: Management of neuropsychiatric manifestations in Parkinson’s disease is complicated by the lack of evidence. Treatment should be individualized and benefits and risks must be balanced.
Evaluation of the role and usefulness of a pharmacist outpatient service for patients undergoing monotherapy with oral anti-cancer agents
Authors: Kimura Michio , Go Makiko , Iwai Mina , Usami Eiseki , Teramachi Hitomi , Yoshimura Tomoaki 
Published: June 2016

Introduction When rapid feedback to physicians must be provided, e.g. monitoring therapy with the oral anticoagulant warfarin or providing therapeutic support for patients undergoing cancer chemotherapy, the involvement of pharmacists is required for outpatients. We launched a pharmacist outpatient service for patients with cancer taking oral anti-cancer agents. We evaluated the role and usefulness of the pharmacist outpatient service for these patients undergoing oral monotherapy with anti-cancer agents. Methods Data regarding prescription recommendations were collected from the drug management guidance records of 154 patients who consulted the pharmacist outpatient service between July 2013 and September 2015. In addition, the rates of prescription recommendation adherence were calculated. Between April and August 2015, a self-reported questionnaire was administered to 47 patients undergoing therapy with oral anti-cancer agents who were visiting the pharmacist outpatient service at the Ogaki Municipal Hospital (Ogaki, Japan). Results Prescription recommendations were given to 235 cases. The total rate of adherence to the prescription recommendations was 94.9% (223/235 cases). The majority of prescription recommendations regarding supportive care were those for moisturizing agents (20.9%), analgesics (20.9%), steroid ointments (12.7%), and antihypertensive agents (10.8%). When continued guidance was provided, significant changes were observed for survey items 3 (knowing the side effects of the medication), 8 (worrying about side effects), and 12 (interest in prescribed medicine) ( p = 0.0049, p < 0.0001, and p = 0.0164, respectively). Conclusion Our study showed that continued pharmaceutical intervention resulted in a deeper understanding of the medications’ side effects, and it reduced anxiety levels in patients undergoing monotherapy with oral anti-cancer agents.
Association of serum levels of AngII, KLK1, and ACE/KLK1 polymorphisms with acute myocardial infarction induced by coronary artery stenosis
Authors: Dai Shu-hong , Li Ji-fu , Feng Jin-bo , Li Rui-jian , Li Chuan-bao , Li Zhuo , Zhang Yun , Li Da-qing 
Published: June 2016

Introduction: The study aims to confirm the association of acute myocardial infarction (AMI) with serum angiotensin II (AngII), kallikrein1 (KLK1), and ACE/KLK1 polymorphisms. Materials and methods: Serum AngII/KLK1 levels and ACE and KLK1 genotypes were determined in 208 patients with AMI and 216 normal controls. Binary logistic regression was used for data analysis. Results: The differences in serum AngII levels were statistically significant between the groups. After adjusting for potential confounding factors, high serum levels of AngII and KLK1 significantly increased the risk of AMI. The individuals with ACE DD and KLK1 GG genotypes significantly increased the risk of AMI compared with those harboring the ACE II and KLK1 AA genotypes (OR = 8.77, 95% CI = 1.74–44.16). Conclusions: (1) Increasing the serum levels of AngII increased the risk of AMI. (2) The risk of AMI increased significantly when the serum levels of AngII and KLK1 simultaneously increased. (3) Individuals with the combined genotypes of ACE DD and KLK1 GG showed significantly increased risk of AMI compared with those with the combined genotypes of ACE II and KLK1 AA.
Finding a solution: Heparinised saline versus normal saline in the maintenance of invasive arterial lines in intensive care
Authors: Everson Matthew , Webber Lucy , Penfold Chris , Shah Sanjoy , Freshwater-Turner Dan 
Published: June 2016

Background We assessed the impact of heparinised saline versus 0.9% normal saline on arterial line patency. Maintaining the patency of arterial lines is essential for obtaining accurate physiological measurements, enabling blood sampling and minimising line replacement. Use of heparinised saline is associated with risks such as thrombocytopenia, haemorrhage and mis-selection. Historical studies draw variable conclusions but suggest that normal saline is at least as effective at maintaining line patency, although recent evidence has questioned this. Methods We conducted a prospective analysis of the use of heparinised saline versus normal saline on unselected patients in the intensive care of our hospital. Data concerning duration of 471 lines insertion and reason for removal was collected. Results We found a higher risk of blockage for lines flushed with normal saline compared with heparinised saline (RR = 2.15, 95% CI 1.392–3.32, p ≤ 0.001). Of the 56 lines which blocked initially (19 heparinised saline and 37 normal saline lines), 16 were replaced with new lines; 5 heparinised saline lines and 11 normal saline lines were reinserted; 5 of these lines subsequently blocked again, 3 of which were flushed with normal saline. Conclusions Our study demonstrates a clinically important reduction in arterial line longevity due to blockages when flushed with normal saline compared to heparinised saline. We have determined that these excess blockages have a significant clinical impact with further lines being inserted after blockage, resulting in increased risks to patients, wasted time and cost of resources. Our findings suggest that the current UK guidance favouring normal saline flushes should be reviewed.