bluuebunny/crossref_metadata_2025_split huggingface dataset:
A hospital-wide transition from paper to digital problem-oriented clinical notes
Authors: Cillessen Felix HJM , de Vries Robbé Pieter , Biermans Marion 
Published: May 2017

SummaryObjectives: To evaluate the use, usability, and physician satisfaction of a locally developed problem-oriented clinical notes application that replaced paper-based records in a large Dutch university medical center.Methods: Using a clinical notes database and an application event log file and a cross-sectional survey of usability, authors retrospectively analyzed system usage for medical specialties, users, and patients over 4 years. A standardized questionnaire measured usability. Authors analyzed the effects of sex, age, professional experience, training hours, and medical specialty on user satisfaction via univariate analysis of variance. Authors also examined the correlation between user satisfaction in relation to users’ intensity of use of the application.Results: In total 1,793 physicians used the application to record progress notes for 219,755 patients. The overall satisfaction score was 3.2 on a scale from 1 (highly dissatisfied) to 5(highly satisfied). A statistically significant difference occurred in satisfaction by medical specialty, but no statistically significant differences in satisfaction took place by sex, age, professional experience, or training hours. Intensity of system use did not correlate with physician satisfaction.Conclusions: By two years after the start of the implementation, all medical specialties utilized the clinical notes application. User satisfaction was neutral (3.2 on a 1–5 scale). Authors believe that the significant factors facilitating this transition mirrored success factors reported by other groups: a generic, consistent, and transparent design of the application; intensive collaboration; continuous monitoring; and an incremental rollout.Citation: Cillessen FHJM, de Vries Robbé PF, Biermans MCJ. A hospital-wide transition from paper to digital problem-oriented clinical note. Appl Clin Inform 2017; 8: 502–514 https://doi.org/10.4338/ACI-2016-08-RA-0137
Enhanced stratospheric water vapor over the summertime continental United States and the role of overshooting convection
Authors: Herman Robert L. , Ray Eric A. , Rosenlof Karen H. , Bedka Kristopher M. , Schwartz Michael J. , Read William G. , Troy Robert F. , Chin Keith , Christensen Lance E. , Fu Dejian , Stachnik Robert A. , Bui T. Paul , Dean-Day Jonathan M. 
Published: May 2017

Abstract. The NASA ER-2 aircraft sampled the lower stratosphere over North America during the field mission for the NASA Studies of Emissions and Atmospheric Composition, Clouds and Climate Coupling by Regional Surveys (SEAC4RS). This study reports observations of convectively influenced air parcels with enhanced water vapor in the overworld stratosphere over the summertime continental United States and investigates three case studies in detail. Water vapor mixing ratios greater than 10 ppmv, which is much higher than the background 4 to 6 ppmv of the overworld stratosphere, were measured by the JPL Laser Hygrometer (JLH Mark2) at altitudes between 16.0 and 17.5 km (potential temperatures of approximately 380 to 410 K). Overshooting cloud tops (OTs) are identified from a SEAC4RS OT detection product based on satellite infrared window channel brightness temperature gradients. Through trajectory analysis, we make the connection between these in situ water measurements and OT. Back trajectory analysis ties enhanced water to OT 1 to 7 days prior to the intercept by the aircraft. The trajectory paths are dominated by the North American monsoon (NAM) anticyclonic circulation. This connection suggests that ice is convectively transported to the overworld stratosphere in OT events and subsequently sublimated; such events may irreversibly enhance stratospheric water vapor in the summer over Mexico and the United States. A regional context is provided by water observations from the Aura Microwave Limb Sounder (MLS).
Comparison of optical-feedback cavity-enhanced absorption spectroscopy and gas chromatography for ground-based and airborne measurements of atmospheric CO concentration
Authors: Ventrillard Irène , Xueref-Remy Irène , Schmidt Martina , Yver Kwok Camille , Faïn Xavier , Romanini Daniele 
Published: May 2017

Abstract. We present the first comparison of carbon monoxide (CO) measurements performed with a portable laser spectrometer that exploits the optical-feedback cavity-enhanced absorption spectroscopy (OF-CEAS) technique, against a high-performance automated gas chromatograph (GC) with a mercuric oxide reduction gas detector (RGD). First, measurements of atmospheric CO mole fraction were continuously collected in a Paris (France) suburb over 1 week. Both instruments showed an excellent agreement within typically 2 ppb (part per billion in volume), fulfilling the World Meteorological Organization (WMO) recommendation for CO inter-laboratory comparison. The compact size and robustness of the OF-CEAS instrument allowed its operation aboard a small aircraft employed for routine tropospheric air analysis over the French Orléans forest area. Direct OF-CEAS real-time CO measurements in tropospheric air were then compared with later analysis of flask samples by the gas chromatograph. Again, a very good agreement was observed. This work establishes that the OF-CEAS laser spectrometer can run unattended at a very high level of sensitivity ( <  1 ppb) and stability without any periodic calibration.
Prevailing climatic trends and runoff response from Hindukush–Karakoram–Himalaya, upper Indus Basin
Authors: Hasson Shabeh , Böhner Jürgen , Lucarini Valerio 
Published: May 2017

Abstract. Largely depending on the meltwater from the Hindukush–Karakoram–Himalaya, withdrawals from the upper Indus Basin (UIB) contribute half of the surface water availability in Pakistan, indispensable for agricultural production systems, industrial and domestic use, and hydropower generation. Despite such importance, a comprehensive assessment of prevailing state of relevant climatic variables determining the water availability is largely missing. Against this background, this study assesses the trends in maximum, minimum and mean temperatures, diurnal temperature range and precipitation from 18 stations (1250–4500 m a.s.l.) for their overlapping period of record (1995–2012) and, separately, from six stations of their long-term record (1961–2012). For this, a Mann–Kendall test on serially independent time series is applied to detect the existence of a trend, while its true slope is estimated using the Sen's slope method. Further, locally identified climatic trends are statistically assessed for their spatial-scale significance within 10 identified subregions of the UIB, and the spatially (field-) significant climatic trends are then qualitatively compared with the trends in discharge out of corresponding subregions. Over the recent period (1995–2012), we find warming and drying of spring (field-significant in March) and increasing early melt season discharge from most of the subregions, likely due to a rapid snowmelt. In stark contrast, most of the subregions feature a field-significant cooling within the monsoon period (particularly in July and September), which coincides well with the main glacier melt season. Hence, a decreasing or weakly increasing discharge is observed from the corresponding subregions during mid- to late melt season (particularly in July). Such tendencies, being largely consistent with the long-term trends (1961–2012), most likely indicate dominance of the nival but suppression of the glacial melt regime, altering overall hydrology of the UIB in future. These findings, though constrained by sparse and short observations, largely contribute in understanding the UIB melt runoff dynamics and address the hydroclimatic explanation of the Karakoram Anomaly.
The content of polyphenols and chosen heavy metals in faba bean (Faba vulgaris Moench) relating to different doses of zinc application
Authors: Timoracká Mária , Vollmannová Alena , Ismael Dalaram S. 
Published: May 2017

We investigated the impact of zinc on chosen heavy metals contents (Cu, Zn, Co, Cd, Pb, Cr, Ni) and polyphenols content and antioxidant capacity of chosen legume. Used soil was from Cakajovce locality (located in Nitra upland) with the neutral soil reaction suitable for the legume cultivation. Determined Cd content as well as Pb content in the soil was on the level of critical value given for the relationship between soil and plant. The values of both elements were far below threshold values proposed by European Commission. In experiment we used two cultivars of fababean - Saturn, Zobor. Seeds of fababean were harvested in milk ripeness. The different high doses of zinc (as ZnSO4.7H2O) were applied into the uncontaminated soil in model conditions. The strong statistical relationship between added Zn content in the soil and in seeds of both faba bean cultivars as well as was the total polyphenols content and the total antioxidant capacity values was confirmed. In all variants the determined Zn amount was below (Saturn) or slightly above (Zobor) the hygienic limit given by the legislative. On the other hand faba bean of both cultivars accumulated high amounts of Pb and Cd - in all variants higher than hygienic limits. The contents of all other heavy metals (Ni, Co, Cr, Cu) were lower than hygienic limits. The polyphenols content ranged from 2208 to 4622 milligrams per kilogram of fresh sample calculated as gallic acid equivalents. Faba bean shows a very small antioxidant capacity - 4.66 - 5.71% of DPPH inhibition.
Biogenic amines degradation by microorganisms isolated from cheese
Authors: Butor Irena , Pištěková Hana , Purevdorj Khatantuul , Jančová Petra , Buňka František , Buňková Leona 
Published: May 2017

The aim of this study was the isolation and characterization of microorganisms able to degrade biogenic amines and their identification. Individual microorganisms were obtained by isolation from commercially available foodstuffs and food produced in the technological laboratories of Faculty of Technology, Tomas Bata University in Zlín and subsequently identified by MALDI-TOF MS. The results of MALDI-TOF MS identification were verified by 16S rRNA sequenation. In this work was studied the ability of 5 bacterial strains positive to biogenic amines degradation isolated from dairy products to decrease biogenic amines content in vitro and quantified reduction in the concentration of biogenic amines tryptamine, β-phenylethylamine, putrescine, cadaverine, histamine and tyramine. The level of degradation (decrease of biogenic amines) was determined on the base of the ability to grow in media with biogenic amines as the sole source carbon and nitrogen. The isolated strains with the ability of degradation of one or more biogenic amines were cultured in medium supplemented with relevant biogenic amines, the media derivatized with dansyl chloride and these amines separated by HPLC at a wavelength of 254 nm. From five tested strains identified as Bacillus subtilis, Bacillus pumilus, Enterobacter cloacae, Rhizobium radiobacter and Acinetobacter pitii, isolated from gouda type cheese, the greatest ability of degradation was observed in Bacillus subtilis, which was capable to degrade almost all amount of histamine, cadaverine and putrescine. Other four strains showed a lower rate of degradation than Bacillus subtilis, but the ability to degrade biogenic amines with these microorganisms was still significant.
Un nuevo modelo de construcción de paz
Authors: Smith, Jr. Dane F. 
Published: May 2017

Los cristianos han estado comprometidos en la construcción de paz desde que Jesús comenzó a reunir discípulos. Sin embargo, se ha prestado poca atención sistemática a su papel como promotores de la paz. La Biblia no ofrece una teología coherente de la paz, pero pasajes clave como la bendición de Jesús para los pacificadores (Mateo 5: 9) y su consejo de “volver la otra mejilla” -una iniciativa transformadoraproporcionan un marco para tal teología.Pablo de Tarso vio las iglesias (ekklesiae), un término que significa las comunidades políticas, económicas y religiosas de los convertidos, como instrumentos en manos de Dios, para la transformación pacífica de un mundo reconciliado a través de la muerte y resurrección de Jesucristo. A lo largo de los milenios evolucionaron dos modelos básicos de consolidación de la paz; el pacifismo fue el enfoque de los primeros padres de la iglesia como Tertuliano, reemplazado por el modelo de guerra justa lanzado por Agustín y refinado por Tomás de Aquino, que establece pautas para los líderes políticos sobre el uso de la fuerza.Lutero y Calvino apoyaron básicamente el enfoque católico, mientras que los reformadores radicales como Menno Simons insistieron en la aplicación literal del llamado de Jesús a la resistencia no violenta al conflicto armado. Un tercer enfoque - la Guerra santa - ganó el apoyo papal en las Cruzadas y todavía tiene ecos en el período actual, pero ha sido rechazado por la mayoría de los líderes cristianos responsables. Ninguno de los modelos básicos proporciona mucha orientación para los activistas cristianos por la paz.En las últimas dos décadas, ha surgido un nuevo modelo, “Paz justa”, para llenar esa brecha, basado en “iniciativas transformadoras” del Nuevo Testamento, aprovechando las lecciones aprendidas de la lucha contra la esclavitud, el colonialismo y el racismo y aplicando las ideas extraídas de las teologías de liberación centrada en los pobres, las mujeres y los pueblos indígenas. Paz justa apoya el activismo en nombre de la paz mediante la abogacía, la promoción del diálogo entre las partes en conflicto y la acción directa no violenta. El nuevo modelo puede ser utilizado tanto por pacifistas como por aquellos que creen que la fuerza armada a veces puede ser necesaria para hacer frente a un conflicto violento.
Damiana Corea: Creadora de texturas y colores
Authors: Lovo Anastasio 
Published: May 2017

Para mí es una satisfacción descubrir la obra pictórica de Damiana Corea Arellano (Juigalpa, 1979) y entenderla a ésta como posibilidad real de un relevo solvente en la plástica nicaragüense. Con dominio magistral de la espátula, digna discípula de Vincent van Gogh o Raúl Marín, crea sus densas texturas de mares, cielos, cuerpos, frutas y fondos encrespados, para llamar la atención del espectador a esa dimensión de la pintura, que en experimentación y búsqueda, reflexiona sobre sí misma y su estética: la metapintura.
Concomitant contraceptive implant and efavirenz use in women living with HIV: perspectives on current evidence and policy implications for family planning and HIV treatment guidelines
Authors: Patel Rena C. , Morroni Chelsea , Scarsi Kimberly K. , Sripipatana Tabitha , Kiarie James , Cohen Craig R. 
Published: May 2017

AbstractIntroduction: Preventing unintended pregnancies is important among all women, including those living with HIV. Increasing numbers of women, including HIV‐positive women, choose progestin‐containing subdermal implants, which are one of the most effective forms of contraception. However, drug–drug interactions between contraceptive hormones and efavirenz‐based antiretroviral therapy (ART) may reduce implant effectiveness. We present four inter‐related perspectives on this issue.Discussion: First, as a case study, we discuss how limited data prompted country‐level guidance against the use of implants among women concomitantly using efavirenz in South Africa and its subsequent negative effects on the use of implants in general. Second, we discuss the existing clinical data on this topic, including the observational study from Kenya showing women using implants plus efavirenz‐based ART had three‐fold higher rates of pregnancy than women using implants plus nevirapine‐based ART. However, the higher rates of pregnancy in the implant plus efavirenz group were still lower than the pregnancy rates among women using common alternative contraceptive methods, such as injectables. Third, we discuss the four pharmacokinetic studies that show 50–70% reductions in plasma progestin concentrations in women concurrently using efavirenz‐based ART as compared to women not on any ART. These pharmacokinetic studies provide the biologic basis for the clinical findings. Fourth, we discuss how data on this topic have marked implications for both family planning and HIV programmes and policies globally.Conclusion: This controversy underlines the importance of integrating family planning services into routine HIV care, counselling women appropriately on increased risk of pregnancy with concomitant implant and efavirenz use, and expanding contraceptive method mix for all women. As global access to ART expands, greater research is needed to explore implant effectiveness when used concomitantly with newer ART regimens. Data on how HIV‐positive women and their partners choose contraceptives, as well as information from providers on how they present and counsel patients on contraceptive options are needed to help guide policy and service delivery. Lastly, greater collaboration between HIV and reproductive health experts at all levels are needed to develop successful strategies to ensure the best HIV and reproductive health outcomes for women living with HIV.
What is it going to take to move youth‐related HIV programme policies into practice in Africa?
Authors: Mark Daniella , Taing Lina , Cluver Lucie , Collins Chris , Iorpenda Kate , Andrade Catarina , Hatane Luann 
Published: May 2017

AbstractIntroduction: HIV has been reported to be the leading cause of mortality amongst adolescents in Africa. This has brought attention to the changes in service provision and health management that many adolescents living with HIV experience when transferring from specialized paediatric‐ or adolescent‐focused services to adult care. When transition is enacted poorly, adherence may be affected and the continuum of care disrupted. As the population of HIV‐infected adolescents grows, effective and supported transition increases in significance as an operational imperative.Discussion: Considerable gaps remain in moving policy to practice at global, national, and local levels. Policies that give clear definition to transition and provide standard operating procedures or tools to support this process are lacking. National guidelines tend to neglect transition. Beyond transition itself, there has been slow progress on the inclusion of adolescents in national policies and strategies. Guidance often overlooks the specific needs and rights of adolescents, in particular for those living with HIV. In some cases, prohibitive laws can impede adolescent access by applying age of consent restriction to HIV testing, counselling and treatment, as well as SRH services. Where adolescent‐focused policies do exist, they have been slow to emerge as tangible operating procedures at health facility level. A key barrier is the nature of existing transition guidance, which tends to recommend an individualized, client‐centred approach, driven by clinicians. In low‐ and middle‐income settings, flexible responses are resource intensive and time consuming, and therefore challenging to implement amidst staff shortages and administrative challenges. First, national governments must adopt transition‐specific policies to ensure that adolescents seamlessly receive appropriate and supportive care. Second, transition policies must form part of a broader adolescent‐centred policy landscape and adolescent‐friendly orientation and approach at health system level. Third, national actors must ensure that transition policies are supported at implementation level. Fourth, youth involvement and community mobilization are essential. Finally, further implementation research is urgently needed to better understand how to support young people and providers in achieving smooth transitions.Conclusions: Only by moving from policy to practice through supportive policies and their implementation will we be closer to including adolescents in the 2030 goal of ending AIDS.
The Happy Teen programme: a holistic outpatient clinic‐based approach to prepare HIV‐infected youth for the transition from paediatric to adult medical care services in Thailand
Authors: Lolekha Rangsima , Boon‐yasidhi Vitharon , Na‐Nakorn Yossawadee , Manaboriboon Boonying , Vandepitte Warunee Punpanich , Martin Michael , Tarugsa Jariya , Nuchanard Wipada , Leowsrisook Pimsiri , Lapphra Ketwadee , Suntarattiwong Piyarat , Thaineua Vorapathu , Chokephaibulkit Kulkanya ,   Happy Teen Working Group
Published: May 2017

AbstractIntroduction: We developed an 18‐month Happy Teen 2 (HT2) programme comprised of a one‐day workshop, two half‐day sessions, and three individual sessions to prepare HIV‐infected youth for the transition from paediatric to adult HIV care services. We describe the programme and evaluate the change in youth's knowledge scores.Methods: We implemented the HT2 programme among HIV‐infected Thai youth aged 14–22 years who were aware of their HIV status and receiving care at two hospitals in Bangkok (Siriraj Hospital, Queen Sirikit National Institute of Child Health [QSNICH]). Staff interviewed youth using a standardized questionnaire to assess HIV and health‐related knowledge at baseline and at 12 and 18 months while they participated in the programme. We examined factors associated with a composite knowledge score ≥95% at month 18 using logistic regression.Results: During March 2014–July 2016, 192 of 245 (78%) eligible youth were interviewed at baseline. Of these, 161 (84%) returned for interviews at 12 and 18 months. Among the 161 youth, the median age was 17 years, 74 (46%) were female, and 99% were receiving antiretroviral treatment. The median composite score was 45% at baseline and increased to 82% at 12 months and 95% at 18 months (P < 0.001). The range of median knowledge scores for antiretroviral management, HIV monitoring, HIV services, and family planning significantly increased from baseline (range 0–75%) to (range 67–100%) at 12 months and to 100% at 18 months (P < 0.001). Almost all youth were able to describe education and career goals at 12 and 18 months compared to 75% at baseline. In multivariable analysis, a composite knowledge score at 18 months >95% was associated with education level >high school (aOR: 2.15, 95%CI, 1.03–4.48) and receipt care at QSNICH (aOR: 2.43, 95%CI, 1.18–4.98). Youth whose mother and father had died were less likely to have score ≥95% (aOR: 0.22, 95%CI, 0.07–0.67) than those with living parents.Conclusions: Knowledge useful for a successful transition from paediatric to adult HIV care increased among youth participating in the HT2 programme. Youth follow‐up will continue to assess the impact of improved knowledge on outcomes following the transition to adult care services.