bluuebunny/crossref_metadata_2025_split huggingface dataset:
Towards an optimal composition of general practitioners and nurse practitioners in out-of-hours primary care teams: a quasi-experimental study
Authors: Biezen Mieke van der , Wensing Michel , Burgt Regi van der , Laurant Miranda 
Published: May 2017

ObjectivesTo gain insights into the ability of general practitioners (GPs) and nurse practitioners (NPs) to meet patient demands in out-of-hours primary care by comparing the outcomes of teams with different ratios of practitioners.DesignQuasi-experimental study.SettingA GP cooperative (GPC) in the Netherlands.InterventionTeam 2 (1 NP, 3 GPs) and team 3 (2 NPs, 2 GPs) were compared with team 1 (4 GPs). Each team covered 35 weekend days.ParticipantsAll 9503 patients who were scheduled for a consultation at the GPC through a nurse triage system.Outcome measuresThe primary outcome was the total number of consultations per provider for weekend cover between 10:00 and 18:00 hours. Secondary outcomes concerned the numbers of patients outside the NPs’ scope of practice, patient safety, resource use, direct healthcare costs and GPs’ performance.ResultsThe mean number of consultations per shift was lower in teams with NPs (team 1: 93.9, team 3: 87.1; p<0.001). The mean proportion of patients outside NPs’ scope of practice per hour was 9.0% (SD 6.7), and the highest value in any hour was 40%. The proportion of patients who did not receive treatment within the targeted time period was higher in teams with NPs (team 2, 5.2%; team 3, 8.3%) compared with GPs only (team 1 3.5%) (p<0.01). Team 3 referred more patients to the emergency department (14.7%) compared with team 1 (12.0%; p=0.028). In teams with NPs, GPs more often treated urgent patients (team 1: 13.2%, team 2: 16.3%, team 3: 21.4%; p<0.01) and patients with digestive complaints (team 1: 11.1%, team 2: 11.8%, team 3: 16.7%; p<0.01).ConclusionsPrimary healthcare teams with a ratio of up to two GPs and two NPs provided sufficient capacity to provide care to all patients during weekend cover. Areas of concern are the number of consultations, delay in patient care and referrals to the emergency department.Trial registrationNCT02407847
Can agent-based simulation be used as a tool to support polypharmacy prescribing practice?
Authors: Chalk Daniel , Manzi Sean , Britten Nicky , Kluettgens Bettina , Magura Ratidzai , Valderas Jose 
Published: May 2017

ObjectiveWe sought to develop a simulation modelling method to help better understand the complex interplay of factors that lead to people with type 2 diabetes and asthma not taking all of their medication as prescribed when faced with multiple medications (polypharmacy).Research design and methodsIn collaboration with polypharmacy patients, general practitioners, pharmacists and polypharmacy researchers, we developed a map of factors that directly and indirectly affect somebodyâ€™s decision to take their medication as prescribed when faced with multiple type 2 diabetes and asthma medications. We then translated these behavioural influences into logical rules using data from the literature and developed a proof-of-concept agent-based simulation model that captures the medicine-taking behaviours of those with type 2 diabetes and asthma taking multiple medications and which predicts both the clinical effectiveness and rates of adherence for different combinations of medications.ConclusionsThe model we have developed could be used as a prescription support tool or a way of estimating medicine-taking behaviour in cost-effectiveness analyses.
OPEN FOR INNOVATION? PRACTICES SUPPORTING COLLABORATION IN SWEDISH REGIONAL CLUSTERS
Authors: YSTRÖM ANNA , ASPENBERG HEDVIG 
Published: May 2017

While it could be argued that globalisation would diminish the importance of a company’s location, research has shown that in an increasingly complex, knowledge-based and dynamic economy, regional collaboration has in fact become a critical aspect of enhancing competitiveness, locally as well as globally. Still, in order to create sustainable, innovative and successful clusters, interaction and collaboration among its members is necessary, which is not always easy to accomplish and requires actions that stimulate bottom-up activity rather than top-down directives.Taking a practice-based perspective, this paper explores what cluster management do in their everyday activities to support collaboration among cluster members, based on a qualitative case study of 14 Swedish regional clusters and cluster initiatives. The paper contributes by outlining and discussing two distinct and essential practices–orchestrating and narrating.
From Clarity to Efficiency for Distributed Algorithms
Authors: Liu Yanhong A. , Stoller Scott D. , Lin Bo 
Published: May 2017

This article describes a very high-level language for clear description of distributed algorithms and optimizations necessary for generating efficient implementations. The language supports high-level control flows in which complex synchronization conditions can be expressed using high-level queries, especially logic quantifications, over message history sequences. Unfortunately, the programs would be extremely inefficient, including consuming unbounded memory, if executed straightforwardly.
We present new optimizations that automatically transform complex synchronization conditions into incremental updates of necessary auxiliary values as messages are sent and received. The core of the optimizations is the first general method for efficient implementation of logic quantifications. We have developed an operational semantics of the language, implemented a prototype of the compiler and the optimizations, and successfully used the language and implementation on a variety of important distributed algorithms.
Optimization of Complex Dataflows with User-Defined Functions
Authors: Rheinländer Astrid , Leser Ulf , Graefe Goetz 
Published: May 2017

In many fields, recent years have brought a sharp rise in the size of the data to be analyzed and the complexity of the analysis to be performed. Such analyses are often described as dataflows specified in declarative dataflow languages. A key technique to achieve scalability for such analyses is the optimization of the declarative programs; however, many real-life dataflows are dominated by user-defined functions (UDFs) to perform, for instance, text analysis, graph traversal, classification, or clustering. This calls for specific optimization techniques as the semantics of such UDFs are unknown to the optimizer.
In this article, we survey techniques for optimizing dataflows with UDFs. We consider methods developed over decades of research in relational database systems as well as more recent approaches spurred by the popularity of Map/Reduce-style data processing frameworks. We present techniques for syntactical dataflow modification, approaches for inferring semantics and rewrite options for UDFs, and methods for dataflow transformations both on the logical and the physical levels. Furthermore, we give a comprehensive overview on declarative dataflow languages for Big Data processing systems from the perspective of their build-in optimization techniques. Finally, we highlight open research challenges with the intention to foster more research into optimizing dataflows that contain UDFs.
Transforming Growth Factor‐β Receptor III is a Potential Regulator of Ischemia‐Induced Cardiomyocyte Apoptosis
Authors: Sun Fei , Li Xin , Duan Wen‐Qi , Tian Wei , Gao Ming , Yang Jia , Wu Xia‐Yang , Huang Di , Xia Wei , Han Yan‐Na , Wang Jia‐Xin , Liu Yan‐Xin , Dong Chang‐Jiang , Zhao Dan , Ban Tao , Chu Wen‐Feng 
Published: May 2017

Background

Myocardial infarction (
MI
) is often accompanied by cardiomyocyte apoptosis, which decreases heart function and leads to an increased risk of heart failure. The aim of this study was to examine the effects of transforming growth factor‐β receptor
III
(
TGF
βR3) on cardiomyocyte apoptosis during
MI
.

Methods and Results

An
MI
mouse model was established by left anterior descending coronary artery ligation. Cell viability, apoptosis,
TGF
βR3, and mitogen‐activated protein kinase signaling were assessed by methylthiazolyldiphenyl‐tetrazolium bromide assay, terminal deoxynucleotidyl transferase‐mediated dUTP nick end labeling assay, immunofluorescence, electron microscopy, and Western blotting. Our results demonstrated that
TGF
βR3 expression in the border region of the heart was dynamically changed during
MI
. After stimulation with H
2
O
2
,
TGF
βR3 overexpression in cardiomyocytes led to increased cell apoptosis and activation of p38 signaling, whereas
TGF
βR3 knockdown had the opposite effect.
ERK
1/2 and
JNK
1/2 signaling was not altered by
TGF
βR3 modulation, and p38 inhibitor (
SB
203580) reduced the effect of
TGF
βR3 on apoptosis, suggesting that p38 has a nonredundant function in activating apoptosis. Consistent with the in vitro observations, cardiac
TGF
βR3 transgenic mice showed augmented cardiomyocyte apoptosis, enlarged infarct size, increased injury, and enhanced p38 signaling upon
MI
. Conversely, cardiac loss of function of
TGF
βR3 by adeno‐associated viral vector serotype 9–TGFβR3 short hairpin RNA attenuated the effects of
MI
in mice.

Conclusions

TGF
βR3 promotes apoptosis of cardiomyocytes via a p38 pathway–associated mechanism, and loss of
TGF
βR3 reduces
MI
injury, which suggests that
TGF
βR3 may serve as a novel therapeutic target for
MI
.
Financial Conditions Indexes and Monetary Policy in Asia
Authors: Debuque-Gonzales Margarita , Gochoco-Bautista Maria Socorro 
Published: May 2017

This paper constructs quarterly financial conditions indexes (FCIs) for eight Asian economies—namely, Hong Kong, Indonesia, Japan, South Korea, Malaysia, the Philippines, Singapore, and Thailand—using a common factor methodology based on Hatzius et al. ( 2010 ). A wide array of financial data is included in the indexes based on identified monetary transmission channels in the literature. Bank-related indicators, various measures of financial stress and risk, and credit surveys, where available, are incorporated to fully reflect the state of the financing environment. The FCIs for Asia successfully capture important episodes in each economy's financial history, but only the indexes of financially advanced economies Japan and Singapore have sufficient forecasting power to predict output growth and inflation. High co-movement of Asian FCIs suggests highly similar monetary policies in the region that are strongly linked with monetary policy in the United States.
Social and Nonsocial Relational Reasoning in Adolescence and Adulthood
Authors: Magis-Weinberg Lucía , Blakemore Sarah-Jayne , Dumontheil Iroise 
Published: May 2017

Abstract
Reasoning during social interactions requires the individual manipulation of mental representations of one's own traits and those of other people as well as their joint consideration (relational integration). Research using nonsocial paradigms has linked relational integration to activity in the rostrolateral PFC. Here, we investigated whether social reasoning is supported by the same general system or whether it additionally relies on regions of the social brain network, such as the medial PFC. We further assessed the development of social reasoning. In the social task, participants evaluated themselves or a friend, or compared themselves with their friend, on a series of traits. In the nonsocial task, participants evaluated their hometown or another town or compared the two. In a behavioral study involving 325 participants (11–39 years old), we found that integrating relations, compared with performing single relational judgments, improves during adolescence, both for social and nonsocial information. Thirty-nine female participants (10–31 years old) took part in a neuroimaging study using a similar task. Activation of the relational integration network, including the rostrolateral PFC, was observed in the comparison condition of both the social and nonsocial tasks, whereas the medial PFC showed greater activation when participants processed social as opposed to nonsocial information across conditions. Developmentally, the right anterior insula showed greater activity in adolescents compared with adults during the comparison of nonsocial versus social information. This study shows parallel recruitment of the social brain and the relational reasoning network during the relational integration of social information in adolescence and adulthood.
The Phenomenal Contents and Neural Correlates of Spontaneous Thoughts across Wakefulness, NREM Sleep, and REM Sleep
Authors: Perogamvros Lampros , Baird Benjamin , Seibold Mitja , Riedner Brady , Boly Melanie , Tononi Giulio 
Published: May 2017

Abstract
Thoughts occur during wake as well as during dreaming sleep. Using experience sampling combined with high-density EEG, we investigated the phenomenal qualities and neural correlates of spontaneously occurring thoughts across wakefulness, non-rapid eye movement (NREM) sleep, and REM sleep. Across all states, thoughts were associated with activation of a region of the midcingulate cortex. Thoughts during wakefulness additionally involved a medial prefrontal region, which was associated with metacognitive thoughts during wake. Phenomenologically, waking thoughts had more metacognitive content than thoughts during both NREM and REM sleep, whereas thoughts during REM sleep had a more social content. Together, these results point to a core neural substrate for thoughts, regardless of behavioral state, within the midcingulate cortex, and suggest that medial prefrontal regions may contribute to metacognitive content in waking thoughts.
Nonstationarity in Southern Hemisphere Climate Variability Associated with the Seasonal Breakdown of the Stratospheric Polar Vortex
Authors: Byrne Nicholas J. , Shepherd Theodore G. , Woollings Tim , Plumb R. Alan 
Published: May 2017

Abstract
Statistical models of climate generally regard climate variability as anomalies about a climatological seasonal cycle, which are treated as a stationary stochastic process plus a long-term seasonally dependent trend. However, the climate system has deterministic aspects apart from the climatological seasonal cycle and long-term trends, and the assumption of stationary statistics is only an approximation. The variability of the Southern Hemisphere zonal-mean circulation in the period encompassing late spring and summer is an important climate phenomenon and has been the subject of numerous studies. It is shown here, using reanalysis data, that this variability is rendered highly nonstationary by the organizing influence of the seasonal breakdown of the stratospheric polar vortex, which breaks time symmetry. It is argued that the zonal-mean tropospheric circulation variability during this period is best viewed as interannual variability in the transition between the springtime and summertime regimes induced by variability in the vortex breakdown. In particular, the apparent long-term poleward jet shift during the early-summer season can be more simply understood as a delay in the equatorward shift associated with this regime transition. The implications of such a perspective for various open questions are discussed.
Immediate Postoperative Pain Scores Predict Neck Pain Profile up to 1 Year Following Anterior Cervical Discectomy and Fusion
Authors: Adogwa Owoicho , Elsamadicy Aladine A. , Vuong Victoria D. , Mehta Ankit I. , Vasquez Raul A. , Cheng Joseph , Bagley Carlos A. , Karikari Isaac O. 
Published: May 2017

Study Design: Retrospective cohort review. Objective: To assess whether immediate postoperative neck pain scores accurately predict 12-month visual analog scale–neck pain (VAS-NP) outcomes following Anterior Cervical Discectomy and Fusion surgery (ACDF). Methods: This was a retrospective study of 82 patients undergoing elective ACDF surgery at a major academic medical center. Patient reported outcomes measures VAS-NP scores were recorded on the first postoperative day, then at 6-weeks, 3, 6, and 12-months after surgery. Multivariate correlation and logistic regression methods were utilized to determine whether immediate postoperative VAS-NP score accurately predicted 1-year patient reported VAS-NP Scores. Results: Overall, 46.3% male, 25.6% were smokers, and the mean age and body mass index (BMI) were 53.7 years and 28.28 kg/m2, respectively. There were significant correlations between immediate postoperative pain scores and neck pain scores at 6 weeks VAS-NP ( P = .0015), 6 months VAS-NP ( P = .0333), and 12 months VAS-NP ( P = .0247) after surgery. Furthermore, immediate postoperative pain score is an independent predictor of 6 weeks, 6 months, and 1 year VAS-NP scores. Conclusion: Our study suggests that immediate postoperative patient reported neck pain scores accurately predicts and correlates with 12-month VAS-NP scores after an ACDF procedure. Patients with high neck pain scores after surgery are more likely to report persistent neck pain 12 months after index surgery.
Neuromonitoring in Spinal Deformity Surgery: A Multimodality Approach
Authors: Laratta Joseph L. , Ha Alex , Shillingford Jamal N. , Makhni Melvin C. , Lombardi Joseph M. , Thuet Earl , Lehman Ronald A. , Lenke Lawrence G. 
Published: May 2017

Study Design: Literature review. Objective: The aim of this study was to provide an overview of the available intraoperative monitoring techniques and the evidence around their efficacy in vertebral column resection. Methods: The history of neuromonitoring and evolution of the modalities are reviewed and discussed. The authors’ specific surgical techniques and preferred methods are outlined in detail. In addition, the authors’ experience and the literature regarding vertebral column resection and surgical mitigation of neurologic alarms are discussed at length. Results: Risk factors for signal changes have been identified, including preoperative neurologic deficit, severe kyphosis, increased curve magnitude, and significant cord shortening. Even though no evidence-based treatment algorithm exist for signal changes, strategies are discussed that can help prevent alarms and address them appropriately. Conclusion: Through implementation of multimodal intraoperative monitoring techniques, potential neurologic injuries are localized and managed in real time. Intraoperative monitoring is a valuable tool for improving the safety and outcome of spinal deformity surgery.
Mechanisms underlying the control of responses to predator odours in aquatic prey
Authors: Mitchell Matthew D. , Bairos-Novak Kevin R. , Ferrari Maud C. O. 
Published: May 2017

ABSTRACTIn aquatic systems, chemical cues are a major source of information through which animals are able to assess the current state of their environment to gain information about local predation risk. Prey use chemicals released by predators (including cues from a predator's diet) and other prey (such as alarm cues and disturbance cues) to mediate a range of behavioural, morphological and life-history antipredator defences. Despite the wealth of knowledge on the ecology of antipredator defences, we know surprisingly little about the physiological mechanisms that control the expression of these defensive traits. Here, we summarise the current literature on the mechanisms known to specifically mediate responses to predator odours, including dietary cues. Interestingly, these studies suggest that independent pathways may control predator-specific responses, highlighting the need for greater focus on predator-derived cues when looking at the mechanistic control of responses. Thus, we urge researchers to tease apart the effects of predator-specific cues (i.e. chemicals representing a predator's identity) from those of diet-mediated cues (i.e. chemicals released from a predator's diet), which are known to mediate different ecological endpoints. Finally, we suggest some key areas of research that would greatly benefit from a more mechanistic approach.
Sex reversal induces size and performance differences among females of the African pygmy mouse, Mus minutoides
Authors: Ginot Samuel , Claude Julien , Perez Julie , Veyrunes Frederic 
Published: May 2017

ABSTRACT
Differences in biological performance, at both intra- and inter-specific levels, have often been linked to morphology but seldom to behavioural or genotypic effects. We tested performance at the intraspecific level by measuring bite force in the African pygmy mouse, Mus minutoides. This species displays an unusual sex determination system, with sex-reversed, X*Y females carrying a feminizing X* chromosome. X*Y females cannot be differentiated from XX females based on external or gonadal morphology; however, they are known to be more aggressive. We found that bite force was higher in X*Y females than in other females and males. We then performed geometric morphometric analyses on their skulls and mandibles and found that the higher performance of X*Y females was mainly explained by a greater overall skull size. The effects of the X* chromosome thus go beyond feminization, and extend to whole-organism performance and morphology. Our results also suggest limited effects of behaviour on bite force.
IN-SITU TESTS FOR BEHAVIOR OF DRILLINJECTIONHON PILES WITH CONTROLLED WIDENING IN PULVERESCENT–CLAY SOILS OF FLEXIBLE CONSISTENCY
Authors: Самохвалов Михаил , Samokhvalov Mikhail , Пронозин Яков , Pronozin Yakov , Ращупкина Валентина , Rashchupkina Valentina 
Published: May 2017

the paper discusses the results of in-situ tests for behavior of the drill injection pile with controlled widening at its end in pulverescent – clay foundation soil of flexible consistency carried out at an experimental site in Tyumen. The results make of possible to determine the radius of the consolidation zone, its tress – strain condition
and physical – mechanical properties. He soil bed in its active zone changed in the area of the drill – injection pile. The comparative analysis has been carried out to reveal the behavior of the drill – injection pile with controlled widening and without it with single and repeated injection grout under vertical static loading.
To a question of institute of family and legal responsibility in system of legal responsibility
Authors: Савельев Юрий , Savelev Yuriy 
Published: May 2017

The article is devoted to the analysis of an objective possibility of recognition of institute of family and legal responsibility as independent institute in system of legal responsibility. The emphasis is placed on regulations of the current legislation, provisions of regulations of various industries of the right then motivated conclusions are made are compared. Family and legal responsibility as an independent legal design acts as an object of research. In the course of the research prevailing uses a comparison method, and also the analysis, synthesis, deduction and induction. Having weighed all arguments, the author comes to own conclusion about a possibility of reckoning of institute of family and legal responsibility to an independent type of legal responsibility which has, besides, cross-industry nature.
Article is executed with assistance of RGNF, the project No. 16-33-00017 &#34;Complex, cross-industry institute of legal responsibility: a concept, structure, interrelations and the place in system of the right&#34;.
«Political multiformity»: modern tendencies in development of democracy
Authors: Доровских Дмитрий , Dorovskikh Dmitriy 
Published: May 2017

The article is devoted to the phenomenon of «political multiformity». The author makes an attempt to reveal the essence of this phenomenon: the article carries out the comparative historical analysis, and also explores theory, practice and regulation.
The results of the research tell about the special importance of civil society and, in particular, its function of civic control in the implementation of democracy. Article findings can be used in further theoretical investigations, rule-making and implementation of the law.