bluuebunny/crossref_metadata_2025_split huggingface dataset:
Design of Electro Cardiograph Machine Based on Atmega Microcontroller
Authors: Irianto Bambang Guruh , Budhiaji Budhiaji , Syaifudin Syaifudin 
Published: June 2016

ECG machine on the market, has a considerable cost, the technology used is still very complicated. In efficient and display ECG still not interconnect with other devices. In this study, the researchers designed ECG machine 12 channels to take advantage ATMega microcontroller technology, Graphic LCD 64x12, which can be obtained on the market at low prices, thus yielding a portable ECG apparatus, can interconnect with other devices and cheap. Objective is to design a ECG machine using ATMega microcontroller technology, by making a series of bio amplifier ECG, measuring the amplitude and frequency response bio amplifier, and make the ECG signal processing circuit with microcontroller, which can be displayed on a 128x64 graphic LCD or PC. To answer the research objectives, the design of the research is to use pure experimental research is the design of experimental series. The independent variable ECG phantom or human and the dependent variable is the ECG machine. While the design ECG machine through the stages as follows: circuit design, circuit testing and calibration output. The conclusion of this study: The result of the design of microcontroller ATMega program listings can be used transform and run the program to the ECG machine to know the number of heartbeats, a beep sound every wave R the ECG signal, displayed on the graphical LCD, PC, printed through a computer, and can be stored in computer.
Informed Consent Obtainment, Malpractice Litigation, and the Potential Role of Shared Decision-making Approaches
Authors: Birkeland Søren Fryd 
Published: June 2016

AbstractMalpractice lawsuits are a substantial concern in health systems with miscommunication, inadequate information, and unsuccessful patient involvement in decision-making seeming to be contributing factors. This paper draws attention to the explicit role of informed consent (IC) obtainment in actualized complaint cases and to what extent novel methods to exercise IC through means of shared decision-making (SDM) and supporting tools might be applicable. A national sample of cases from the Health Professionals Disciplinary Board in Denmark is reviewed and discussed together with international legal instruments and case law. It is confirmed that patients claim their right to participate in decision-making about healthcare options. In many situations SDM and accompanying tools would apply and possibly they could sometimes prevent IC duty breaches, assist documenting IC procedures, and help avert the need for litigation.
TRACHEID AND PIT ANATOMY VARY IN TANDEM IN A TALL SEQUOIADENDRON GIGANTEUM TREE
Authors: Lazzarin Martina , Crivellaro Alan , Williams Cameron B. , Dawson Todd E. , Mozzi Giacomo , Anfodillo Tommaso 
Published: June 2016

Across land plants there is a general pattern of xylem conduit diameters widening towards the stem base thus reducing the accumulation of hydraulic resistance as plants grow taller.
In conifers, xylem conduits consist of cells with closed end-walls and water must flow through bordered pits imbedded in the side walls. As a consequence both cell size, which determines the numbers of walls that the conductive stream of water must cross, as well as the characteristics of the pits themselves, crucially affect total hydraulic resistance. Because both conduit size and pit features influence hydraulic resistance in tandem, we hypothesized that features of both should vary predictably with one another. To test this prediction we sampled a single tall (94.8 m) Sequoiadendron giganteum tree (giant sequoia), collecting wood samples from the most recent annual ring progressively downwards from the tree top to the base. We measured tracheid diameter and length, number of pits per tracheid, and the areas of pit apertures, tori, and margos. Tracheid diameter widened from treetop to base following a power law with an exponent (tracheid diameterstem length slope) of approximately 0.20. A similar scaling exponent was found between tracheid length and distance from tree top. Additionally, pit aperture, torus, and margo areas all increased (again with a power of ~0.20) with distance from tree top, paralleling the observed variation in tracheid diameter and length. Pit density scaled isometrically with tracheid length. Within individual tracheids, total permeable area of pits, measured as the sum of the margo areas, scaled isometrically with lumen area. Given that pores of the margo membrane are believed to increase in parallel with membrane area, from a strictly anatomical perspective, our results support the interpretation that pit resistance remains a relatively constant fraction of total resistance along the hydraulic pathway.
INTRA-ANNUAL DENSITY FLUCTUATIONS IN TREE RINGS: HOW, WHEN, WHERE, AND WHY?
Authors: De Micco V. , Campelo F. , De Luis M. , Bräuning A. , Grabner M. , Battipaglia G. , Cherubini P. 
Published: June 2016

Intra-annual density fluctuations (IADFs) in tree rings are generally considered structural anomalies caused by deviations from the “normal course” of xylogenesis during the growing season. This definition is based on the bias that, under “normal conditions”, cambial activity stops once a year. Each tree ring can thus be dated to one calendar year, which is one of the principles of dendrochronology. The formation of IADFs can be triggered directly by environmental changes, especially in precipitation and temperature, that affect cambial activity and cell differentiation. It can also be the result of limited photosynthesis, due to defoliation induced by biotic or abiotic constraints.
Often indicated with alternative terms, IADFs were first described in the 1930s, and recently reported for many trees and shrubs from different ecosystems throughout the world, particularly for Mediterranean species. Different types of IADFs have been detected; their formation and structural properties depend on many factors including tree genotype, age, size, rooting depth, habitat, soil, climate, photosynthetic activity, and allocation strategies. Whether IADFs affect the adaptive capability of plants remains, however, unclear.
We provide an overview of the main anatomical features of IADFs and their occurrence in tree rings from various environments and climatic regimes. We propose a simplified way of classifying them and discuss the hypotheses about their functional role and the factors triggering their formation. To understand the ecological role of IADFs better, we recommend a multidisciplinary approach, involving wood anatomy, dendroecology, and stable isotopes, which has already been applied for Mediterranean species. We conclude by considering that IADFs appear to be the “rule” rather than “anomalies” in some ecosystems where they help plants cope with fluctuating environmental conditions. Moreover, their anatomical structure represents a valuable proxy of past climatic conditions at a sub-seasonal resolution and may be relevant to adapt hydraulic functioning of living trees to changing climatic conditions.
So, How Much of the Earth’s Surface Is Covered by Rain Gauges?
Authors: Kidd Chris , Becker Andreas , Huffman George J. , Muller Catherine L. , Joe Paul , Skofronick-Jackson Gail , Kirschbaum Dalia B. 
Published: June 2016

Abstract
The measurement of global precipitation, both rainfall and snowfall, is critical to a wide range of users and applications. Rain gauges are indispensable in the measurement of precipitation, remaining the de facto standard for precipitation information across Earth’s surface for hydrometeorological purposes. However, their distribution across the globe is limited: over land their distribution and density is variable, while over oceans very few gauges exist and where measurements are made, they may not adequately reflect the rainfall amounts of the broader area. Critically, the number of gauges available, or appropriate for a particular study, varies greatly across the Earth owing to temporal sampling resolutions, periods of operation, data latency, and data access. Numbers of gauges range from a few thousand available in near–real time to about 100,000 for all “official” gauges, and to possibly hundreds of thousands if all possible gauges are included. Gauges routinely used in the generation of global precipitation products cover an equivalent area of between about 250 and 3,000 m2. For comparison, the center circle of a soccer pitch or tennis court is about 260 m2. Although each gauge should represent more than just the gauge orifice, autocorrelation distances of precipitation vary greatly with regime and the integration period. Assuming each Global Precipitation Climatology Centre (GPCC)–available gauge is independent and represents a surrounding area of 5-km radius, this represents only about 1% of Earth’s surface. The situation is further confounded for snowfall, which has a greater measurement uncertainty.
Investigations into Precipitation and Drought Climatologies in South Central Asia with Special Focus on Pakistan over the Period 1951–2010
Authors: Adnan Shahzada , Ullah Kalim , Shouting Gao 
Published: June 2016

Abstract
The climatology of precipitation and drought are analyzed by using different indices in the region of south central Asia (SCA). The spatial precipitation pattern is delineated by using principal component analysis (PCA) over the period of 1951–2010, which identifies six subregions in the SCA. The monthly and annual trends of precipitation were analyzed by applying the five statistical tests: Student’s t, Mann–Kendall, and Spearman’s rho tests for linear trend and turning point analysis and Sen’s slope for randomness and slope magnitude, respectively, at the α = 0.05 significance level. The time series analysis shows data similarity between Global Precipitation Climatology Centre (GPCC) and area-weighted precipitation of 52 meteorological stations in Pakistan, which results in a high correlation (R2 = 0.93). Two main drought periods were identified (1971 and 2000–02); also, 2001 was an extremely dry year in the SCA region. The drought in 1952 was the most severe in Pakistan; the longest drought period was 2000–02. Intense droughts were reported in the whole SCA region when the annual percent of precipitation was below 80%. It is noted that the A-5 region (northeast SCA), where 19 droughts were reported, is the most vulnerable. The monthly precipitation analysis shows a significant increasing trend in the months of September and June in the A-3 (northwest SCA) and A-5 regions, respectively, while a decreasing trend is observed in January and August in the A-4 region (east SCA). The decadal analysis shows significant decreasing trend (−21.5 mm decade−1) in region A-4, while the highest increasing trends (17.1 and 7.5 mm decade−1) are observed in Pakistan and the A-5 region respectively.
Subtidal Exchange in Eastern Long Island Sound
Authors: Whitney Michael M. , Ullman David S. , Codiga Daniel L. 
Published: June 2016

AbstractLong Island Sound (LIS) is a large and wide macrotidal estuary with distributed river inputs, including the Connecticut River (the largest freshwater source) that flows into the eastern LIS near the mouth. In 2010, shipboard surveys of salinity, temperature, and currents were collected along an across-estuary transect in eastern LIS. Numerical model results are compared to these observations and used to study the spatial and temporal variability of salinity, velocity, and freshwater and salt fluxes over a 4-yr period. For all low wind conditions, observations and model results indicate an outward-flowing, low-salinity wedge on the south side with an inward-flowing, higher-salinity area underneath and to the north. Observations and model results during the low wind surveys indicate that stratification substantially decreases with increased tidal amplitude and decreased river discharge; the velocity field is less variable among surveys. Model analysis indicates strong sensitivities to both tides and river discharge; with discharge response strongest for salinity and freshwater flux and tidal response larger for velocities, volume flux, and salt flux. The long-term average net freshwater and salt fluxes are outward and inward, respectively. For both flux types, subtidal shear dispersion is twice tidal oscillatory diffusion, and both contributions are in the same direction as the net flux. The uniform flow contribution is small for freshwater flux, yet it is the largest single term for salt flux and partially counters the inward contributions.
Determining the Best Method for Estimating the Observed Level of Maximum Detrainment Based on Radar Reflectivity
Authors: Carletta Nicholas D. , Mullendore Gretchen L. , Starzec Mariusz , Xi Baike , Feng Zhe , Dong Xiquan 
Published: June 2016

Abstract
Convective mass transport is the transport of mass from near the surface up to the upper troposphere and lower stratosphere (UTLS) by a deep convective updraft. This transport can alter the chemical makeup and water vapor balance of the UTLS, which affects cloud formation and the radiative properties of the atmosphere. It is, therefore, important to understand the exact altitudes at which mass is detrained from convection. The purpose of this study was to improve upon previously published methodologies for estimating the level of maximum detrainment (LMD) within convection using data from a single ground-based radar. Four methods were used to identify the LMD and validated against dual-Doppler-derived vertical mass divergence fields for six cases with a variety of storm types. The best method for locating the LMD was determined to be the method that used a reflectivity texture technique to determine convective cores and a multilayer echo identification to determine anvil locations. Although an improvement over previously published methods, the new methodology still produced unreliable results in certain regimes. The methodology worked best when applied to mature updrafts, as the anvil needs time to grow to a detectable size. Thus, radar reflectivity is found to be valuable in estimating the LMD, but storm maturity must also be considered for best results.
Phoenixin Activates Immortalized GnRH and Kisspeptin Neurons Through the Novel Receptor GPR173
Authors: Treen Alice K. , Luo Vicky , Belsham Denise D. 
Published: June 2016

Abstract
Reproductive function is coordinated by kisspeptin (Kiss) and GnRH neurons. Phoenixin-20 amide (PNX) is a recently described peptide found to increase GnRH-stimulated LH secretion in the pituitary. However, the effects of PNX in the hypothalamus, the putative signaling pathways, and PNX receptor have yet to be identified. The mHypoA-GnRH/GFP and mHypoA-Kiss/GFP-3 cell lines represent populations of GnRH and Kiss neurons, respectively. PNX increased GnRH and GnRH receptor (GnRH-R) mRNA expression, as well as GnRH secretion, in the mHypoA-GnRH/GFP cell model. In the mHypoA-Kiss/GFP-3 cell line, PNX increased Kiss1 mRNA expression. CCAAT/enhancer-binding protein (C/EBP)-β, octamer transcription factor-1 (Oct-1), and cAMP response element binding protein (CREB) binding sites are localized to the 5′ flanking regions of the GnRH, GnRH-R, and Kiss1 genes. PNX decreased C/EBP-β mRNA expression in both cell models and increased Oct-1 mRNA expression in the mHypoA-GnRH/GFP neurons. PNX increased CREB phosphorylation in both cell models and phospho-ERK1/2 in the mHypoA-GnRH/GFP cell model, whereas inhibiting the cAMP/protein kinase A pathway prevented PNX induction of GnRH and Kiss1 mRNA expression. Importantly, we determined that the G protein-coupled receptor, GPR173, was strongly expressed in both GnRH and kisspeptin cell models and small interfering RNA knockdown of GPR173 prevented the PNX-mediated up-regulation of GnRH, GnRH-R, and Kiss1 mRNA expression and the down-regulation of C/EBP-β mRNA expression. PNX also increased GPR173 mRNA expression in the mHypoA-GnRH/GFP cells. Taken together, these studies are the first to implicate that PNX acts through GPR173 to activate the cAMP/protein kinase A pathway through CREB, and potentially C/EBP-β and/or Oct-1 to increase GnRH, GnRH-R, and Kiss1 gene expression, ultimately having a stimulatory effect on reproductive function.
A report on an acute, in-hours, outpatient review clinic with ultrasonography facilities for the early evaluation of general surgical patients
Authors: Pidgeon TE , Shariff U , Devine F , Menon V 
Published: June 2016

Introduction In 2013 our hospital introduced an in-hours, consultant-led, outpatient acute surgical clinic (ASC) for emergency general surgical patients. In 2014 this clinic was equipped with a dedicated ultrasonography service. This prospective cohort study evaluated this service before and after the introduction of ultrasonography facilities. Methods Data were recorded prospectively for all patients attending the clinic during 2013 and 2014. The primary outcome was patient destination (whether there was follow-up/admission) after clinic attendance. Results The ASC reviewed patients with a wide age range and array of general surgical complaints. In 2013, 186 patients attended the ASC. After the introduction of the ultrasonography service in 2014, 304 patients attended. In 2014, there was a reduction in the proportion of patients admitted to hospital from the clinic (18.3% vs 8.9%, p=0.002). However, the proportion of patients discharged after ASC review remained comparable with 2013 (30.1% in 2013 vs 38.8% in 2014, p=0.051). The proportion of patients undergoing computed tomography (CT) scans also fell (14.0% vs 4.9%, p<0.001). Conclusions The ASC assessed a wide array of general surgical complaints. Only a small proportion required hospital admission. The introduction of an ultrasonography service was associated with a further reduction in admission rates and computed tomography.
Surgery in the older person: Training needs for the provision of multidisciplinary care
Authors: Pearce L , Bunni J , McCarthy K , Hewitt J 
Published: June 2016

Introduction Many older surgical patients are exposed to high risks of morbidity and mortality when undergoing both elective and emergency surgery. Methods We provide an overview of perioperative care teams and the educational opportunities available to surgeons who undertake surgery in the older person. Findings The number of older people undergoing surgery is increasing at a rate faster than the proportion of older people in the overall population. Management of the older surgical patient throughout the surgical pathway forms part of the Specialty Training Curriculum for Geriatric Medicine. While ‘surgery in childhood’ continues to form part of the general surgical higher training syllabus, surgery in the later years of life does not. There are limited postgraduate courses and training opportunities currently available to surgeons in this field. There is clear societal need to address perioperative care for older surgical patients, which has proved successful in some centers. Moreover, surgical trainees support the inclusion of geriatric medicine issues into their training. Conclusions The ageing population requires a multidisciplinary perioperative approach, with dedicated and appropriately trained clinicians and allied health care professionals to improve outcomes.
Modular emergency general surgery training: A pilot study of a novel programme
Authors: Egan RJ , Abdelrahman T , Tate S , Ansell J , Harries R , Davies L , Clark GWB , Lewis WG 
Published: June 2016

Introduction Pan-speciality consensus guidance advocates mandatory emergency general surgery (EGS) training modules for specialist registrars (StRs). This pilot study evaluated the impact of EGS modules aimed at StRs over 1 year. Methods Eleven StRs were allocated a focused 4-week EGS module, in addition to the standard 1:12 on-call duty rota, in a tertiary surgical centre. Primary outcome measures included the number of indicative emergency operations and validated Procedure Based Assessments (PBAs) performed, both during the EGS module and over the training year. Results StRs performed a median of 11 (range 5–15) laparotomies during the EGS module versus 31 (range 9-49) over the whole training year. StRs attended 43.7% of available laparotomies during the module (range 24.1–63.7%). EGS modules provided more than one-third of the total emergency laparotomy experience, and a quarter of the emergency colectomy, appendicectomy and Hartmann’s procedure experience. There were no differences in EGS module-related outcomes between junior and senior StRs. Significantly more PBAs related to laparotomy and segmental colectomy were completed during EGS modules than the on-call duty rota, at 32% versus 14% (p<0.001) and 48% versus 22% (p=0.019), respectively. Performance levels were maintained following module completion. Conclusions These findings provide an important baseline when considering future modular EGS training.
Racial and Ethnic Health Disparities Among People With Intellectual and Developmental Disabilities
Authors: Magaña Sandra , Parish Susan , Morales Miguel A. , Li Henan , Fujiura Glenn 
Published: June 2016

AbstractRacial and ethnic health disparities are a pervasive public health problem. Emerging research finds similar health disparities among people with intellectual and developmental disabilities (IDD) compared to nondisabled adults. However, few studies have examined racial and ethnic health disparities among adults with IDD. Using national data, we examined racial and ethnic disparities in health status among adults with IDD, and investigated differences in health status between adults with IDD and nondisabled adults within each racial and ethnic group. We found that Latino and Black adults with IDD had worse health outcomes compared to White adults with IDD, and Latino and Black adults with IDD had worse health outcomes than nondisabled adults from the same racial and ethnic group.
Propertymanagement als Professional Service – Implikationen für die Outsourcing-Praxis
Authors: Lüttringhaus Sigrun 
Published: June 2016

Zusammenfassung
Assetmanager, die das Wertsteigerungspotenzial ihrer Immobilienportfolios während der Haltephase nutzen wollen, sind auf ein professionelles Propertymanagement ihrer Liegenschaften angewiesen. Letzteres wird häufig an einen Dienstleister outgesourct mit dem Ziel, Kosten einzusparen. Angestrebt werden insbesondere Skaleneffekte durch den Fremdbezug standardisierter Dienstleistungen, die anhand von zuvor festgelegten Service-Levels in Auftrag gegeben und gemessen werden. Dieser Ansatz greift in den meisten Fällen jedoch zu kurz, da das Propertymanagement eine doppelköpfige Dienstleistung ist, die nicht nur generic services umfasst, sondern aufgrund ihrer Management-Bestandteile vielmehr den Professional Services zuzurechnen ist. Die Propertymanagement-Dienstleistung ist wissenschaftlich bislang kaum erforscht. Diese Lücke sucht der vorliegende Beitrag zu schließen. Ziel ist eine theoretisch fundierte Konzeption des Propertymanagements als Professional Service. In einem ersten Schritt erfolgt eine kurze Erläuterung des Dienstleistungsbegriffes und speziell der Professional Services. Sodann wird das Propertymanagement als Teil des Immobilienmanagements verortet. Im Anschluss wird der Leistungskatalog des Propertymanagements dargestellt, und es erfolgt eine Abgrenzung zur Schwesterdisziplin Facilitymanagement. Schließlich wird die komplexe und personalintensive Propertymanagement-Dienstleistung als Professional Service identifiziert. Diese Klassifizierung hat weitreichende Konsequenzen für den gesamten Prozess des Fremdbezugs der Dienstleistung. Am Ende des Beitrags wird beispielhaft auf die Praxis-Implikationen für das Propertymanagement-Outsourcing und speziell die Partnerwahlphase eingegangen.