bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical motivation and the surgical safety checklist
Authors: Yu X , Huang Y , Guo Q , Wang Y , Ma H , Zhao Y , Wang Y , Yu X , Tan G , Ma S , Wu X , Xu M , Zhang S , Shang H , Xin S , Zhang X , Wang J , Li L , Wu S , Zhao S , Yang J , Wen H , Sun H , Xiong Y , Wang Y , He J , Liu Q , Li J , Jiang J , Xue F , Han W , Wang Z , Wang Y , Hu Y , Wang L 
Published: February 2017

Abstract

Background
Although the surgical safety checklist (SSC) has been adopted worldwide, its efficacy can be diminished by poor clinical motivation. Systematic methods for improving implementation are lacking.

Methods
A multicentre prospective study was conducted in 2015 in four academic/teaching hospitals to investigate changes during revision of the SSC for content, staffing and workflow. All modifications were based on feedback from medical staff. Questionnaires were used to monitor dynamic changes in surgeons', nurses' and anaesthetists' perceptions.

Results
Complete information was obtained from 30 654 operations in which the newly developed SSC system was used. Implementation quality was evaluated in 1852 operations before, and 1822 after the changes. The revised SSC content was simplified from 34 to 22 items. Anaesthetists achieved widespread recommendation as SSC coordinators. Completion rates of all stages reached over 80·0 per cent at all sites (compared with 10·2–59·5 per cent at the sign-out stage in the baseline survey). There was a significant change in doctors who participated (for example, surgeon: from 24·6 to 64·5 per cent at one site). The rates of hasty (15·1–33·7 per cent) or casual (0·4–4·4 per cent) checking decreased to less than 6·0 per cent overall. Perceptions about the SSC were studied from 2211 forms. They improved, with a converging trend among the three different professions, to a uniform 80·0 per cent agreeing on the need for its regular use.

Conclusion
Medical staff members are both the users and owners of the SSC. High-quality SSC implementation can be achieved by clinically motivated adaptation.
Subclavian artery stenting for coronary‐subclavian steal syndrome
Authors: Che Wuqiang , Dong Hui , Jiang Xiongjing , Peng Meng , Zou Yubao , Song Lei , Zhang Huimin , Yang Yuejin , Gao Runlin 
Published: February 2017

Objectives: To evaluate the safety and feasibility of subclavian artery stenting for coronary‐subclavian steal syndrome (CSSS).Background: CSSS is a rare cause of myocardial ischemia due to ipsilateral subclavian artery stenosis in patients who have undergone coronary artery bypass graft. However, current knowledge of the optimal therapy for CSSS is limited.Methods: The clinical data of 37 patients (33 male; mean age 65 ± 6 years) with CSSS who had undergone subclavian artery stenting between April 2007 and December 2015 were analyzed.Results: The time elapsed between bypass surgery and the diagnosis of CSSS was 6.3 ± 4.3 years (median 5.2 years, range 1.3 months to 17.8 years). The technical success rate was 97.3% (100% for stenosis, 85.7% for occluded lesions). One patient experienced a transient ischemic attack; a second patient developed flow‐limiting dissection involving the ostium of the internal mammary artery; and a third patient had a puncture site hematoma. The mean stenosis of target lesions decreased from 87.6 ± 10.6% to 5.9 ± 5.0% immediately after the procedure. A total of 35 (94.6%) patients were discharged with a complete remission of myocardial ischemia. During a follow‐up of 44 ± 32 (range 6–112) months, no patient suffered from stroke or myocardial infarction. Stent‐restenosis related unstable angina developing in one patient at 36 months and in another patient at 11 months, both of whom were relieved after balloon angioplasty and remained asymptomatic until the last follow‐up.Conclusion: Subclavian artery stenting is feasible and safe in patients with CSSS, with a low incidence of perioperative complications and stent restenosis rate. © 2017 Wiley Periodicals, Inc.
AgRuO3, a Strongly Exchange‐Coupled Honeycomb Compound Lacking Long‐Range Magnetic Order
Authors: Prasad Beluvalli E. , Kanungo Sudipta , Jansen Martin , Komarek Alexander C. , Yan Binghai , Manuel Pascal , Felser Claudia 
Published: February 2017

AbstractQuasi two‐dimensional (2D) oxide‐based honeycomb lattices have attracted great attention for displaying specific electronic instabilities, which give rise to unconventional bonding patterns and unexpected magnetic exchange couplings. The synthesis of AgRuO3, another representative exhibiting unique structural properties, is reported here. The stacking sequence of the honeycomb layers (Ru2O6) differs from analogous precedents; in particular, the intercalating silver atoms are shifted from the middle of the interspaces and cap the void octahedral sites of the (□Ru2O6) slabs from both sides. This way, charge neutral, giant 2D “molecules” of Ag/Ru2O6/Ag result; a feature that significantly enhances the overall 2D character of AgRuO3. Measurements of magnetization have revealed extremely strong magnetic exchange coupling to be present, surviving to a temperature as high as 673 K, which is the temperature of thermal decomposition. No indication for long‐range magnetic order has, however, been observed. Theoretical analyses confirm the pronounced 2D character of the electronic system, and in particular reveal the inter‐honeycomb layer coupling Jc to be distinctly weak.
Efficient allocation of LTE downlink spectral resource to improve fairness and throughput
Authors: Wang You‐Chiun , Jhong Dai‐Rong 
Published: February 2017

SummaryFor the current generation of cellular communication systems, long‐term evolution (LTE) has been the major protocol to support high‐speed data transmission. It is critical to allocate downlink spectral resource in LTE, namely, resource blocks (RBs), but the issue is not well addressed in the standard. Therefore, the paper develops an efficient RB allocation algorithm with 4 mechanisms to improve both fairness and throughput in LTE. For fairness concern, our RB allocation algorithm uses a resource‐reservation mechanism to prevent cell‐edge user equipments from starvation, and a credit‐driven mechanism to keep track of the amount of resource given to each user equipment. For throughput concern, it adopts both weight‐assignment and RB‐matching mechanisms to allocate each RB to a packet according to its flow type and length. Through simulations, we demonstrate that the proposed RB allocation algorithm can significantly increase both throughput and fairness while reducing packet dropping and delays of real‐time flows, as compared with previous methods.
Image analysis and multi‐layer perceptron artificial neural networks for the discrimination between benign and malignant endometrial lesions
Authors: Makris Georgios‐Marios , Pouliakis Abraham , Siristatidis Charalampos , Margari Niki , Terzakis Emmanouil , Koureas Nikolaos , Pergialiotis Vasilios , Papantoniou Nikolaos , Karakitsos Petros 
Published: February 2017

BackgroundThis study aims to investigate the efficacy of an Artificial Neural Network based on Multi‐Layer Perceptron (ANN–MPL) to discriminate between benign and malignant endometrial nuclei and lesions in cytological specimens.MethodsWe collected 416 histologically confirmed liquid‐based cytological smears from 168 healthy patients, 152 patients with malignancy, 52 with hyperplasia without atypia, 20 with hyperplasia with atypia, and 24 patients with endometrial polyps. The morphometric characteristics of 90 nuclei per case were analyzed using a custom image analysis system; half of them were used to train the MPL–ANN model, which classified each nucleus as benign or malignant. Data from the remaining 50% of cases were used to evaluate the performance and stability of the ANN. The MLP–ANN for the nuclei classification (numeric and percentage classifiers) and the algorithms for the determination of the optimum threshold values were estimated with in‐house developed software for the MATLAB v2011b programming environment; the diagnostic accuracy measures were also calculated.ResultsThe accuracy of the MPL–ANN model for the classification of endometrial nuclei was 81.33%, while specificity was 88.84% and sensitivity 69.38%. For the case classification based on numeric classifier the overall accuracy was 90.87%, the specificity 93.03% and the sensitivity 87.79%; the indices for the percentage classifier were 95.91%, 93.44%, and 99.42%, respectively.ConclusionComputerized systems based on ANNs can aid the cytological classification of endometrial nuclei and lesions with sufficient sensitivity and specificity. Diagn. Cytopathol. 2017;45:202–211. © 2016 Wiley Periodicals, Inc.
Severe pneumonia associated with ibrutinib monotherapy for CLL and lymphoma
Authors: Kreiniz Natalia , Bejar Jacob , Polliack Aaron , Tadmor Tamar 
Published: February 2017

AbstractIn recent years, there have been major advances in the treatment of chronic lymphocytic leukemia (CLL) particularly since the development of novel therapeutic agents, mostly “biological drugs.” One of the obvious advantages of these agents is the decreased rate of infectious complications occurring during the course of therapy, compared to the use of standard immuno‐chemotherapy regimens. Here, we describe 3 patients with CLL and 1 with mantle cell lymphoma who developed severe life‐threatening pneumonias, during monotherapy with ibrutinib. The first case was a 70‐year‐old woman with relapsed CLL who developed bilateral pneumonia with hypoxia 1 week after starting ibrutinib. She did not respond to broad‐spectrum antibiotics and was treated empirically with trimethoprim‐sulphamethoxazole and improved. In the second case, we describe a 76‐year‐old woman with relapsed CLL who developed recurrent pneumonia after 3 years of treatment with ibrutinib. Presuming that ibrutinib was the cause of pneumonitis with secondary infection, it was stopped with subsequent improvement. The third patient a 67 year‐old man died because of severe bilateral necrotizing pneumonia due to invasive aspergillosis and mucormycosis with pulmonary hemorrhage. The fourth patient with relapsed mantle cell lymphoma died because of severe bilateral pneumonia, caused by pseudomonas and candida, despite receiving appropriate antibiotics. From this experience, we hypothesize that the etiology of severe pneumonia associated with ibrutinib treatment is probably multifactorial, involving factors like preexisting immune‐suppression, drug induced pneumonitis and infections. We suggest that patients with CLL or other lymphoproliferative disorders with suspected pneumonia during monotherapy with ibrutinib should be very carefully evaluated and need to undergo complete diagnostic workup to establish an exact diagnosis. Understanding which patients with CLL or lymphoma treated with kinase inhibitors are at a higher risk for developing pulmonary complications could be one of the important future challenges, when selecting the best available therapy for these patients.
A qualitative study on human resources for primary health care in Iran
Authors: Nekoei Moghadam Mahmood , Amiresmaili Mohammadreza , Sadeghi Vahideh , Zeinalzadeh Ali‐Hossein , Tupchi Mahmud , Parva Sahar 
Published: February 2017

SummaryBackgroundAccording to World Bank Group report, while Primary Health Care (PHC) services in Iran were appropriate to the needs of the population in the late 1970s and 1980s, the changing burden of diseases and shifting demand patterns have rendered the existing PHC system no longer suitable to meet current and emergent needs. Based on previous studies, one of the main PHC challenges in Iran relates to human resources issues.MethodsThis study was conducted in 2012 at 3 scales of local (Tabriz city), provincial (East Azerbaijan), and national levels. Two qualitative methods were used in the study: free–focus group discussions and in‐depth interviews. Framework analysis was used to analyze collected data. Categories of analysis were developed using framework analysis approach, and main themes were emerged.ResultsFour themes were developed and finalized out of focus group discussions and interviews: availability of health workers in PHC, competency, PHC health workers' motivation, and PHC managerial issues.ConclusionBased on findings and issues discovered in this study, several suggestions can be made, including development, implementation, and evaluation of needs assessment strategies for various vocational posts, promotion of educational courses and PHC‐based training, strengthening of relationships and coordination between practical and scientific bodies, application of incentive programs in PHC, and strengthening of system management capacity through use of qualified managers.
Influence of cover cropping on water uptake dynamics in an irrigated Mediterranean vineyard
Authors: Tomaz A. , Pacheco C.A. , Coleto Martinez J.M. 
Published: February 2017

AbstractAs a result of its physiological characteristics, vine's yield and quality responses are greatly affected by water availability in the soil. Knowledge about water uptake of grapevines in pedoclimatic conditions of high water availability is essential when considering the increasing use of irrigation in a previously rainfed crop. We studied the water uptake of irrigated grapevines under different soil covers. The study was carried out over 2 years in southern Portugal, a Mediterranean climate region, in ‘Aragonez’ grapevines planted in Vertisols. A cover crop was sown in half the area while maintaining the permanent resident vegetation in the remaining area. Five levels of annual irrigation supply were applied: 200, 150, 100 and 50 mm, and no irrigation. Soil moisture was monitored every 2 or 3 weeks, and weekly after the start of irrigation. Results show that water uptake in the interrows did not cease after the beginning of irrigation. Water uptake by the vines occurred to depths of approximately 3 m, hence 7.5 times greater than the cover crop root system depth. Results suggest that over time, the presence of the cover crop forces the vine root system, mainly its thinner roots, to seek water in increasingly deeper soil compartments. Copyright © 2017 John Wiley & Sons, Ltd.
The Benefit of Adjuvant Radiation in Surgically‐Treated T1‐2 N1 Oropharyngeal Squamous Cell Carcinoma
Authors: Monroe Marcus M. , Buchmann Luke O. , Hunt Jason P. , Hitchcock Ying J. , Lloyd Shane , Hashibe Mia 
Published: February 2017

ImportanceThe benefit of adjuvant radiation in surgically treated T1‐2N1 oropharyngeal cancer without adverse pathologic features remains unclearObjectivesTo compare population‐level survival outcomes in surgically‐treated T1‐2N1 oropharyngeal squamous cell carcinoma (OPSCC) with and without the use of adjuvant radiation.Study DesignRetrospective population‐based study using the Surveillance, Epidemiology, and End Results (SEER) registry data from 1998–2011.SettingPopulation‐level study.ParticipantsPatients with T1‐2N1 OPSCC treated with surgical resection and neck dissection with or without adjuvant radiation.Intervention(s) for Clinical Trials or Exposure(s) for observational studiesThe use of postoperative adjuvant radiation.Main Outcome(s) and MeasuresOverall and disease‐specific survival.ResultsRadiation was utilized in 74% of patients and was positively associated with extracapsular extension and well‐differentiated histology. The use of radiation was associated with improved mean overall survival (124 v. 108 months, p=0.023) and a non‐significant increase in mean disease‐specific survival (138 v. 131 months, p=0.053).Conclusions and RelevanceThe use of adjuvant radiation is associated with improved survival in surgically‐treated T1‐2N1 squamous cell carcinoma of the oropharynx with unknown HPV status.Level of EvidenceIV
Comparative charge transfer studies in nonmetallated and metallated porphyrin fullerene dyads
Authors: Gupta Neha , Naqvi Samya , Jewariya Mukesh , Chand Suresh , Kumar Rachana 
Published: February 2017

AbstractSingle material organic solar cells become an interesting area of research to overcome the challenges with efficient charge separation efficiencies in conventional organic solar cells. In this article, we have synthesized nonmetallated and metallated porphyrin‐fullerene dyad materials (H2P‐C60 and ZnP‐C60, respectively) with simple structure, comprehensively studied their charge transfer mechanism, and established a proof of concept that nonmetallated porphyrin‐fullerene dyads are better candidates to be used in organic solar cells compared with metallated dyads. Absorption and electrochemical analysis revealed the ground state electronic interactions between donor‐acceptor moieties in both types of dyads. Driving force (−ΔGoET) for intramolecular electron transfer process was calculated by first oxidation and reduction potentials of dyads. The excited state electronic interactions were characterized by time‐resolved fluorescence and pump‐probe transient absorption experiments. Strong fluorescence quenching of porphyrin along with reduced lifetimes in dyads due to deactivation of singlet excited states by photoinduced charge transfer process between porphyrin/Zn‐porphyrin core and fullerene in different polarity solvents was observed. Transient absorption spectroscopy was also applied to identify the transient spectral features, ie, cationic (H2P+/ZnP+) and anionic (C60−) radicals formed because of the charge separation in both types of dyads. Finally, organic solar cell device was also fabricated using the dyads. We obtained higher Voc, Jsc, and fill factor in single material organic solar cell using H2P‐C60 compared to previous reports.
Dietary protein content and tissue type control 13C discrimination in mammals: an analytical approach
Authors: Hobbie Erik A. 
Published: February 2017

RationaleCarbon isotope measurements on collagen and other tissues are used in modern and paleodiet studies, and relating these patterns to the dietary protein fraction (fdp) and to δ13C values of dietary protein and energy (lipids and carbohydrates) remains important for determining diets.MethodsCarbon fluxes from dietary protein to tissues in feeding studies of mice, rats, and pigs were estimated to test how tissue δ13C values related to the δ13C values of dietary protein, dietary energy, fdp, or loge fdp. Values of fdp, protein δ13C, and energy δ13C were used in stepwise regressions that estimated the metabolic routing of dietary protein and the 13C enrichment of tissues relative to dietary protein.ResultsThe 13C enrichment of rat collagen and mouse muscle relative to dietary protein depended on loge fdp and the 13C enrichment of dietary protein on energy:

urn:x-wiley:09514198:media:rcm7830:rcm7830-math-0001
The collagen (fcp) or muscle (fmp) fractions derived from dietary protein were estimated as:

urn:x-wiley:09514198:media:rcm7830:rcm7830-math-0002
The coefficients of loge fdp reflected the higher proportion of non‐essential amino acids in collagen (79%) than in muscle (61%). In rats, dietary protein contributed from 66% (liver) to 85% (hair) whereas, in mice, dietary protein contributed from 76% (liver) to 85% (body protein). In pigs, collagen derived primarily (83 ± 5%) from dietary protein.ConclusionsThese equations provided analytical frameworks to interpret dietary patterns from isotopic measurements. Metabolic routing and 13C enrichment varied with fdp and with the tissue amino acid composition. Thus, fdp and tissue amino acid compositions were key parameters to assess dietary sources from isotopic values. Incorporating these insights will improve our ability to interpret the isotopic paleorecord and modern diet studies. Copyright © 2017 John Wiley & Sons, Ltd.
Current and Future Perspectives on Alginate Encapsulated Pancreatic Islet
Authors: Strand Berit L. , Coron Abba E. , Skjak-Braek Gudmund 
Published: February 2017

Abstract
Transplantation of pancreatic islets in immune protective capsules holds the promise as a functional cure for type 1 diabetes, also about 40 years after the first proof of principal study. The concept is simple in using semipermeable capsules that allow the ingress of oxygen and nutrients, but limit the access of the immune system. Encapsulated human islets have been evaluated in four small clinical trials where the procedure has been evaluated as safe, but lacking long-term efficacy. Host reactions toward the biomaterials used in the capsules may be one parameter limiting the long-term function of the graft in humans. The present article briefly discusses important capsule properties such as stability, permeability and biocompatibility, as well as possible strategies to overcome current challenges. Also, recent progress in capsule development as well as the production of insulin-producing cells from human stem cells that gives promising perspectives for the transplantation of encapsulated insulin-producing tissue is briefly discussed.
Gamma-Secretase Inhibitor IX (GSI) Impairs Concomitant Activation of Notch and Wnt-Beta-Catenin Pathways in CD44+ Gastric Cancer Stem Cells
Authors: Barat Samarpita , Chen Xi , Cuong Bui Khac , Bozko Przemyslaw , Götze Julian , Christgen Matthias , Krech Till , Malek Nisar P. , Plentz Ruben R. 
Published: February 2017

Abstract
Cancer stem cells (CSC) are associated with tumor resistance and are characterized in gastric cancer (GC). Studies have indicated that Notch and wnt-beta-catenin pathways are crucial for CSC development. Using CD44+ CSCs, we investigated the role of these pathways in GC carcinogenesis. We performed cell proliferation, wound healing, invasion, tumorsphere, and apoptosis assays. Immunoblot analysis of downstream signaling targets of Notch and wnt-beta-catenin were tested after gamma-secretase inhibitor IX (GSI) treatment. Immunohistochemistry, immunofluorescence, and Fluorescence activated cell sorting (FACS) were used to determine CD44 and Hairy enhancer of split-1 (Hes1) expression in human GC tissues. CD44+ CSCs were subcutaneously injected into NMR-nu/nu mice and treated with vehicle or GSI. GC patients with expression of CD44 and Hes1 showed overall reduced survival. CD44+ CSCs showed high expression of Hes1. GSI treatment showed effective inhibition of cell proliferation, migration, invasion, tumor sphere formation of CD44+ CSCs, and induced apoptosis. Importanly, Notch1 was found to be important in mediating a crosstalk between Notch and wnt-beta-catenin in CD44+ CSCs. Our study highlights a crosstalk between Notch and wnt-beta-catenin in gastric CD44+ CSCs. Expression of CD44 and Hes1 is associated with patient overall survival. GSI could be an alternative drug to treat GC.
Shaking table test on seismic resonant behavior of core‐outrigger structure
Authors: Sun Feifei , Hu Zhibin , Chen Guangyuan , Xie Liming , Sheng Li 
Published: February 2017

SummaryIn order to investigate disastrous seismic resonant effect of resonant ground motions on tall building structures, a 1/40 scaled planar test model of a 56‐story core‐outrigger structure was tested on shaking table considering two types of ground motions, that is, non‐resonant and resonant ground motions. The non‐resonant ground motions were chosen from far‐field natural earthquake records, whereas the resonant ground motions were generated through scaling Fourier spectra of the non‐resonant ones in a target period region covering one of the first two natural periods of the test model. The test results showed that (a) with the same small peak ground acceleration of 0.07 g, the test model exhibited significant hysteretic behavior, residual displacement, and even overturning collapse under the resonant ground motions but behaved elastically under the non‐resonant ones; (b) the first‐period resonant ground motion caused extremely large displacements on the upper floors and large moments on the lower stories, whereas the second‐period resonant ground motion resulted in extremely large accelerations on the upper and middle floors; (c) the first‐period resonant ground motion was more probable to trigger overturning collapse of the core‐outrigger system after some exterior columns had reached their axial compression strength, even for those columns on the middle stories.