bluuebunny/crossref_metadata_2025_split huggingface dataset:
Were they in the loop during automated driving? Links between visual attention and crash potential
Authors: Louw Tyron , Madigan Ruth , Carsten Oliver , Merat Natasha 
Published: September 2016

BackgroundA proposed advantage of vehicle automation is that it relieves drivers from the moment-to-moment demands of driving, to engage in other, non-driving related, tasks. However, it is important to gain an understanding of drivers’ capacity to resume manual control, should such a need arise. As automation removes vehicle control-based measures as a performance indicator, other metrics must be explored.MethodsThis driving simulator study, conducted under the European Commission (EC) funded AdaptIVe project, assessed drivers’ gaze fixations during partially-automated (SAE Level 2) driving, on approach to critical and non-critical events. Using a between-participant design, 75 drivers experienced automation with one of five out-of-the-loop (OOTL) manipulations, which used different levels of screen visibility and secondary tasks to induce varying levels of engagement with the driving task: 1) no manipulation, 2) manipulation by light fog, 3) manipulation by heavy fog, 4) manipulation by heavy fog plus a visual task, 5) no manipulation plus an n-back task.ResultsThe OOTL manipulations influenced drivers’ first point of gaze fixation after they were asked to attend to an evolving event. Differences resolved within one second and visual attention allocation adapted with repeated events, yet crash outcome was not different between OOTL manipulation groups. Drivers who crashed in the first critical event showed an erratic pattern of eye fixations towards the road centre on approach to the event, while those who did not demonstrated a more stable pattern.ConclusionsAutomated driving systems should be able to direct drivers’ attention to hazards no less than 6 seconds in advance of an adverse outcome.
Who to handover: a case–control study of a novel scoring system to prioritise handover of internal medicine inpatients
Authors: Bittman Jesse , Tam Penny , Little Chris , Khan Nadia 
Published: September 2016

ABSTRACTBackgroundHandover of patients between care providers is a critical event in patient care. There is, however, little evidence to guide the handover process, including determining which patients to handover.AimCompare the ability of gestalt-based handover with two structured scores, the modified early warning score (MEWS) and our novel iHAND clinical decision support system, to predict which patients will be assessed by a physician overnight.MethodsThis case–control study included 90 inpatients, comprising 32 patients assessed overnight (cases) and 58 patients not assessed overnight (controls) at a teaching hospital in British Columbia, Canada (May 2012). Gestalt, MEWS and iHAND scores were analysed against patients seen overnight using logistic regression and receiver-operating characteristic (ROC) curves.ResultsNeither current gestalt-based handover practice (odds ratio (OR) 1.50, 95% CI 0.89 to 3.83) nor MEWS (OR 0.96, 95% CI 0.75 to 1.24, area under the ROC curve (AUC) 0.61, 95% CI 0.49 to 0.73) were significantly associated with need to be seen overnight. The iHAND score was associated with need to be seen (OR 1.93, 95% CI 1.24 to 3.02, AUC 0.70, 95% CI 0.60 to 0.81).ConclusionsThe iHAND score had moderate ability to predict which patients required assessment overnight, while MEWS score and current gestalt approach correlated poorly, suggesting the iHAND score may help prioritisation of patients likely to be seen overnight for handover.
Tidally influenced shoal water delta and estuary in the Middle Jurassic of the Søgne Basin, Norwegian North Sea: sedimentary response to rift initiation and salt tectonics
Authors: Mellere Donatella , Mannie Aruna , Longhitano Sergio , Mazur Mike , Kulausa Hyelni , Brough Samme , Cotton James 
Published: September 2016

Abstract
Recent studies in the Middle Jurassic Bryne and Sandnes formations, primary reservoirs in several fields across the Norwegian and Danish North Sea, show the widespread occurrence of tidal-influenced and tide-dominated deposits. Aalenian–Bajocian Bryne cores reflect deposition by a shoal water, tidally influenced delta onto a low wave energy tidal platform (both supratidal and intertidal) that probably occupied the majority of the Søgne Basin, a narrow rift system connected to the Central and Danish graben and transgressed from an open-marine basin, possibly located to the south. At the Bathonian–Callovian boundary, a new phase of rifting and progressive salt movements led to the deposition of the upper Bryne and Sandnes formations within an 80–100 km long composite estuarine valley. Basin tilting to the south and continued transgression resulted in tidal deltas that offlap the northern margin of the basin. The basin was fully transgressed by the end of the Callovian. From the Late Bathonian onwards, differential tectonic movements along the broadly interconnected Middle Jurassic rift basins led to a change in the transgression direction from south to north, with an open-marine basin located in the Central and Viking graben.
A Recurrent ERCC3 Truncating Mutation Confers Moderate Risk for Breast Cancer
Authors: Vijai Joseph , Topka Sabine , Villano Danylo , Ravichandran Vignesh , Maxwell Kara N. , Maria Ann , Thomas Tinu , Gaddam Pragna , Lincoln Anne , Kazzaz Sarah , Wenz Brandon , Carmi Shai , Schrader Kasmintan A. , Hart Steven N. , Lipkin Steve M. , Neuhausen Susan L. , Walsh Michael F. , Zhang Liying , Lejbkowicz Flavio , Rennert Hedy , Stadler Zsofia K. , Robson Mark , Weitzel Jeffrey N. , Domchek Susan , Daly Mark J. , Couch Fergus J. , Nathanson Katherine L. , Norton Larry , Rennert Gad , Offit Kenneth 
Published: September 2016

Abstract
Known gene mutations account for approximately 50% of the hereditary risk for breast cancer. Moderate and low penetrance variants, discovered by genomic approaches, account for an as-yet-unknown proportion of the remaining heritability. A truncating mutation c.325C&gt;T:p.Arg109* (R109X) in the ATP-dependent helicase ERCC3 was observed recurrently among exomes sequenced in BRCA wild-type, breast cancer–affected individuals of Ashkenazi Jewish ancestry. Modeling of the mutation in ERCC3-deficient or CRISPR/Cas9-edited cell lines showed a consistent pattern of reduced expression of the protein and concomitant hypomorphic functionality when challenged with UVC exposure or treatment with the DNA alkylating agent IlludinS. Overexpressing the mutant protein in ERCC3-deficient cells only partially rescued their DNA repair–deficient phenotype. Comparison of frequency of this recurrent mutation in over 6,500 chromosomes of breast cancer cases and 6,800 Ashkenazi controls showed significant association with breast cancer risk (ORBC = 1.53, ORER+ = 1.73), particularly for the estrogen receptor–positive subset (P &lt; 0.007).
Significance: A functionally significant recurrent ERCC3 mutation increased the risk for breast cancer in a genetic isolate. Mutated cell lines showed lower survival after in vitro exposure to DNA-damaging agents. Thus, similar to tumors arising in the background of homologous repair defects, mutations in nucleotide excision repair genes such as ERCC3 could constitute potential therapeutic targets in a subset of hereditary breast cancers. Cancer Discov; 6(11); 1267–75. ©2016 AACR.
This article is highlighted in the In This Issue feature, p. 1197
A stromal cell population in the large intestine identified by tissue factor expression that is lost during colorectal cancer progression
Authors: Asplund Anna , Hegde Geeta , Edqvist Per-Henrik , Navani Sanjay , Pontén Fredrik , Eriksson Oskar , Siegbahn Agneta 
Published: September 2016

SummaryColorectal cancer (CRC) is a major cause of morbidity and mortality, and the composition of the tumour stroma is a strong predictor of survival in this cancer type. Tissue factor (TF) functions as the trigger of haemostasis together with its ligand coagulation factor VII/VIIa, and TF expression has been found in tumour cells of colorectal tumours. However, TF expression in the CRC tumour stroma or its relationship to patient outcome has not yet been studied. To address this question we developed and validated a specific anti-TF antibody using standardised methods within the Human Protein Atlas project. We used this antibody to investigate TF expression in normal colorectal tissue and CRC using immunofluorescence and immunohistochemistry in two patient cohorts. TF was strongly expressed in a cell population immediately adjacent to the colorectal epithelium. These TF-positive cells were ACTA2-negative but weakly vimentin-positive, defining a specific population of pericryptal sheath cells. In colorectal tumours, TF-positive sheath cells were progressively lost after the adenoma-to-carcinoma transition, demonstrating downregulation of this source of TF in CRC. Furthermore, loss of sheath cell TF was significantly associated with poor overall and disease-specific survival in rectal but not colon cancers. In conclusion, we demonstrate that TF is a marker of a specific cell population in the large intestine, which is lost during CRC progression. Our results highlight the role of the tumour stroma in this cancer type and suggest TF to be a potential prognostic biomarker in rectal cancers through the identification of pericryptal sheath cells.Supplementary Material to this article is available online at www.thrombosis-online.com.
Evolution of Cognitive Function After Transcatheter Aortic Valve Implantation
Authors: Schoenenberger Andreas W. , Zuber Chantal , Moser André , Zwahlen Marcel , Wenaweser Peter , Windecker Stephan , Carrel Thierry , Stuck Andreas E. , Stortecky Stefan 
Published: September 2016

Background—
This study aimed to assess the evolution of cognitive function after transcatheter aortic valve implantation (TAVI). Previous smaller studies reported conflicting results on the evolution of cognitive function after TAVI.

Methods and Results—

In this prospective cohort, cognitive function was measured in 229 patients ≥70 years using the Mini Mental State Examination before and 6 months after TAVI. Cognitive deterioration or improvement was defined as change of ≥3 points decrease or increase in the Mini Mental State Examination score between baseline and follow-up. Cognitive deterioration was found in 29 patients (12.7%). Predictive analysis using logistic regression did not identify any statistically significant predictor of cognitive deterioration. A review of individual medical records in 8 patients with a major Mini Mental State Examination score decrease of ≥5 points revealed specific causes in 6 cases (postinterventional delirium in 2; postinterventional stroke, progressive renal failure, progressive heart failure, or combination of preexisting cerebrovascular disease and mild cognitive impairment in 1 each). Among 48 patients with impaired baseline cognition (Mini Mental State Examination score <26 points), 18 patients (37.5%) cognitively improved. The preinterventional aortic valve area was lower in patients who cognitively improved (median aortic valve area 0.60 cm
2
) as compared with patients who did not improve (median aortic valve area 0.70 cm
2
;
P
=0.01).

Conclusions—
This is the first study providing evidence that TAVI results in cognitive improvement among patients who had impaired preprocedural cognitive function, possibly related to hemodynamic improvement in patients with severe aortic stenosis. Our results confirm that some patients experience cognitive deterioration after TAVI.
Point-of-Care Hemostatic Testing in Cardiac Surgery
Authors: Karkouti Keyvan , Callum Jeannie , Wijeysundera Duminda N. , Rao Vivek , Crowther Mark , Grocott Hilary P. , Pinto Ruxandra , Scales Damon C. , Achen B. , Brar S. , Morrison D. , Wong D. , Bussières J. S. , de Waal T. , Harle C. , de Médicis E. , McAdams †C. , Syed S. , Tran D. , Waters T. 
Published: September 2016

Background:
Cardiac surgery is frequently complicated by coagulopathic bleeding that is difficult to optimally manage using standard hemostatic testing. We hypothesized that point-of-care hemostatic testing within the context of an integrated transfusion algorithm would improve the management of coagulopathy in cardiac surgery and thereby reduce blood transfusions.

Methods:
We conducted a pragmatic multicenter stepped-wedge cluster randomized controlled trial of a point-of-care–based transfusion algorithm in consecutive patients undergoing cardiac surgery with cardiopulmonary bypass at 12 hospitals from October 6, 2014, to May 1, 2015. Following a 1-month data collection at all participating hospitals, a transfusion algorithm incorporating point-of-care hemostatic testing was sequentially implemented at 2 hospitals at a time in 1-month intervals, with the implementation order randomly assigned. No other aspects of care were modified. The primary outcome was red blood cell transfusion from surgery to postoperative day 7. Other outcomes included transfusion of other blood products, major bleeding, and major complications. The analysis adjusted for secular time trends, within-hospital clustering, and patient-level risk factors. All outcomes and analyses were prespecified before study initiation.

Results:

Among the 7402 patients studied, 3555 underwent surgery during the control phase and 3847 during the intervention phase. Overall, 3329 (45.0%) received red blood cells, 1863 (25.2%) received platelets, 1645 (22.2%) received plasma, and 394 (5.3%) received cryoprecipitate. Major bleeding occurred in 1773 (24.1%) patients, and major complications occurred in 740 (10.2%) patients. The trial intervention reduced rates of red blood cell transfusion (adjusted relative risk, 0.91; 95% confidence interval, 0.85–0.98;
P
=0.02; number needed to treat, 24.7), platelet transfusion (relative risk, 0.77; 95% confidence interval, 0.68–0.87;
P
<0.001; number needed to treat, 16.7), and major bleeding (relative risk, 0.83; 95% confidence interval, 0.72–0.94;
P
=0.004; number needed to treat, 22.6), but had no effect on other blood product transfusions or major complications.

Conclusions:
Implementation of point-of-care hemostatic testing within the context of an integrated transfusion algorithm reduces red blood cell transfusions, platelet transfusions, and major bleeding following cardiac surgery. Our findings support the broader adoption of point-of-care hemostatic testing into clinical practice.

Clinical Trial Registration:

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT02200419.
Four colorful new species of dragon millipedes, genus Desmoxytes Chamberlin, 1923, from northern Thailand (Diplopoda: Polydesmida: Paradoxosomatidae)
Authors: SRISONCHAI RUTTAPON , ENGHOFF HENRIK , LIKHITRAKARN NATDANAI , PANHA SOMSAK 
Published: September 2016

Four new dragon millipede species of the genus Desmoxytes from northern Thailand are described and illustrated: D. des sp. n. from Chiang Mai Province, D. breviverpa sp. n. from Phrae Province, D. takensis sp. n. from Tak Province and D. pinnasquali sp. n. from Phitsanulok Province. The new species were compared with type specimens of closely related species and were all found to exhibit explicit morphological differences from these. They can be distinguished from other members of Desmoxytes by the shape of the gonopods, the sternal process between male coxae 4, the pattern of spines or tubercles on the metaterga, and the shape of the paraterga. The coloration of all new species is clearly aposematic: ranging from purple-pink to red. The new species are discussed in relation to their congeners, and a distribution map is provided.
Incidence and Risk Factors for Stroke Among 14 European Countries
Authors: Tsendsuren Saruultuya , Li Chu-Shiu , Liu Chwen-Chi 
Published: September 2016

Background This study compared the risk factors for and incidence of stroke among 14 European countries by using the Survey of Health, Aging, and Retirement in Europe (SHARE). Methods The analysis was based on data collected during 2006 to 2007 from Wave 2 of SHARE and panel data from respondents interviewed during 2004 to 2005. Results and Conclusion The highest stroke incidence rates were found in Denmark, Poland, and Sweden; these incidence rates were more than double that of Spain. Stroke was mostly associated with elderly people (age, ≥65 years) in Sweden, France, Switzerland, the Czech Republic, and Greece. In addition, stroke incidence was high among young males (age, <65 years) in Italy and elderly males in Germany and Switzerland. A negative association was found between stroke and vigorous exercise for younger people in Sweden and elderly people in Poland, whereas moderate exercise was significantly associated with stroke only for elderly Belgians, Greeks, and Irish.
Factors Associated With the Increasing Rates of Discharges Directly Home From Intensive Care Units—A Direct From ICU Sent Home Study
Authors: Lau Vincent I. , Priestap Fran A. , Lam Joyce N. H. , Ball Ian M. 
Published: September 2016

Objectives: To evaluate the relationship between rates of discharge directly to home (DDH) from the intensive care unit (ICU) and bed availability (ward and ICU). Also to identify patient characteristics that make them candidates for safe DDH and describe transfer delay impact on length of stay (LOS). Methods: Retrospective cohort study of all adult patients who survived their stay in our medical–surgical–trauma ICU between April 2003 and March 2015. Results: Median age was 49 years (interquartile range [IQR]: 33.5-60.4), and the majority of the patients were males (54.8%). Median number of preexisting comorbidities was 5 (IQR: 2-7) diagnoses. Discharge directly to home increased from 28 (3.1% of all survivors) patients in 2003 to 120 (12.5%) patients in 2014. The mean annual rate of DDH was between 11% and 12% over the last 6 years. Approximately 62% (n = 397) of patients waited longer than 4 hours for a ward bed, with a median delay of 2.0 days (IQR: 0.5-4.7) before being DDH. There was an inverse correlation between ICU occupancy and DDH rates ( rP = −.55, P < .0001, 95% confidence interval [CI] = −0.36 to −0.69, R2 = .29). There was no correlation with ward occupancy and DDH rates ( rs = −.055, P = .64, 95% CI = −0.25 to 0.21). Conclusions: The DDH rates have been increasing over time at our institution and were inversely correlated with ICU bed occupancy but were not associated with ward occupancy. The DDH patients are young, have few comorbidities on admission, and few discharge diagnoses, which are usually reversible single system problems with low disease burden. Transfers to the ward are delayed in a majority of cases, leading to increased ICU LOS and likely increased overall hospital LOS as well.
The Sodium Paradox: Dysnatremia and Mortality in Patients Implanted With Extracorporeal Mechanical Circulatory Support Devices
Authors: Yost Gardner , Tatooles Antone , Bhat Geetha 
Published: September 2016

Introduction: Dysnatremia, abnormal serum sodium levels, has long been used as a marker for disease progression in heart failure patients. Classically, hyponatremia is associated with increased fluid volume in heart failure and is often a result of neuroendocrine dysfunction and poor cardiac output. Recent studies have noted that dysnatremia and hypernatremia are predictive of worsened outcomes in critical care and renal disease populations. We investigated the relationship between dysnatremia and postoperative outcomes in patients implanted with extracorporeal mechanical circulatory devices. Methods: A total of 97 patients who underwent implantation with the CentriMag mechanical circulatory assist system were included in this retrospective study. Patients were divided into 2 groups based on preoperative serum sodium level cutoff of 135 mEq/L. Outcomes and mortality were compared between groups. Results: The mean age for the study population was 56.21 ± 15.13 years, and 57 patients (58.8%) were male. The mean time on CentriMag support was 22.7 days. Patients with serum sodium levels ≤135 mEq/L were noted to have significantly worsened indicators of preoperative cardiac function. However, patients with serum sodium levels >135 mEq/L had significantly shorter postoperative survival ( P = .006). When entered into a multivariate Cox proportional hazards model, sodium was an independent predictor for increased risk of mortality (hazard ratio: 1.224; 95% confidence interval: 1.009-1.485; P = .040). Conclusion: Our results indicate that elevated preoperative sodium in patients undergoing implantation of a temporary mechanical circulatory support system is predictive of worsened postoperative survival.
Ethics of rationing of nursing care
Authors: Rooddehghan Zahra , Yekta Zohreh Parsa , Nasrabadi Alireza N 
Published: September 2016

Background: Rationing of various needed services, for example, nursing care, is inevitable due to unlimited needs and limited resources. Rationing of nursing care is considered an ethical issue since it requires judgment about potential conflicts between personal and professional values. Objectives: The present research sought to explore aspects of rationing nursing care in Iran. Research design: This study applied qualitative content analysis, a method to explore people’s perceptions of everyday life phenomena and interpret the subjective content of text data. Data collection was performed through in-depth, unstructured, face-to-face interviews with open-ended questions. Participants and research context: The study population included Iranian nurses of all nursing positions, from clinical nurses to nurse managers. Purposive sampling was employed to select 15 female and 3 male nurses (11 clinical nurses, 3 supervisors, 1 matron, 1 nurse, and 2 members of the Nursing Council) working in hospitals of three cities in Iran. Ethical considerations: The study protocol was approved by Tehran University of Medical Sciences (91D1302870). Written informed consent was also obtained from all participants. Findings: According to the participants, rationing of nursing care consisted of two categories, that is, causes of rationing and consequences of rationing. The first category comprised three subcategories, namely, patient needs and demands, routinism, and VIP patients. The three subcategories forming the second category were missed nursing care, patient dissatisfaction, and nurses’ feeling of guilt. Conclusion: Levels at which healthcare practices are rationed and clarity of the rationing are important structural considerations in the development of an equal, appropriate, and ethical healthcare system. Moreover, the procedure of rationing is critical as it not only influences people’s lives but also reflects the values that dominate in the society. Therefore, in order to minimize the negative consequences of rationing of nursing care, further studies on the ethical dimensions of this phenomenon are warranted.