bluuebunny/crossref_metadata_2025_split huggingface dataset:
Could low Safety Attitudes Questionnaire scores be indicative of an environment where it may be difficult to get new training practices established?
Authors: Channing Sarah , Ryan Neil , Barnes Sophie , Collins Kate , van der Nelson Helen , Mears Jane , Siassakos Dimitrios 
Published: January 2017

IntroductionSimulation-based, multiprofessional team training (SBMPTT) is used widely in healthcare, with evidence that it can improve clinical outcomes and be associated with a positive safety culture. Our aim was to explore the impact of introducing this type of training to a gynaecological team.MethodsIn this interrupted time-series study, ‘Safety Attitudes Questionnaire’ (SAQ) data was collected both before and after SBMPTT was introduced to a gynaecological team.ResultsLow baseline SAQ scores coincided with difficulty in establishing the training, meaning that at the end of our study period only a small proportion of staff had actually attended a training session. Despite trends towards improvement in scores for safety climate, teamwork climate and job satisfaction, no statistically significant difference was observed. There was however an improved perception of the level of collaboration between nursing staff and doctors after the introduction of training.Conclusions and DiscussionIn this paper we explore a hypothesis that low baseline SAQ scores may highlight that the multiprofessional teams most in need of training work in environments where it is more challenging to implement. There is evidence from other specialties that multiprofessional team training works, now we need to understand how to address the barriers to getting it started. In this paper we suggest how the SAQ could be used as a directive tool for improvement; using the detailed analysis of the local safety culture it provides to both inform future training design and also provide management with an objective marker of progress.
Clot friction variation with fibrin content; implications for resistance to thrombectomy
Authors: Gunning Gillian M , McArdle Kevin , Mirza Mahmood , Duffy Sharon , Gilvarry Michael , Brouwer Patrick A 
Published: January 2017

BackgroundDespite significant advancements in the procedural efficacy of mechanical thrombectomy in patients with ischemic stroke in recent years, there still remains a portion of the population that does not achieve good recanalization. The reasons for this may be varied. We hypothesized that static friction between the clot and the vessel, or catheter wall might contribute to the difficulty in removing the clot.ObjectiveTo determine if there is a relationship between clot composition and the resistance to sliding (friction) which might contribute to resistance to clot removal.MethodsAs clot composition can vary significantly, we investigated five different types of clot in order to measure their respective frictional properties. To do this, a custom-made testing apparatus was created, consisting of various replaceable low-friction surfaces on which the clots could be placed. The surface was then gradually tilted until the clots began to slide; the angle at which this occurred is related to the coefficient of friction of the clots. The experiment was repeated on a bovine aortic surface in order to confirm the results.ResultsWe found that fibrin-rich clots (<20% red blood cell content) have a significantly higher coefficient of friction than clots with a red blood cell content >20%. This result was confirmed by repeating the experiment on a bovine aortic surface as a representation of the interaction between clots and the arterial wall.ConclusionsThe friction properties of clots were found to be related to the content ratio of fibrin to red blood cells. Future imaging techniques that could show fibrin and red blood cell content might help us to predict the ‘stickiness’ of a clot.
Walking in Virtual Reality
Authors: Janeh Omar , Langbehn Eike , Steinicke Frank , Bruder Gerd , Gulberti Alessandro , Poetter-Nerger Monika 
Published: January 2017

Walking constitutes the predominant form of self-propelled movement from one geographic location to another in our real world. Likewise, walking in virtual environments (VEs) is an essential part of a users experience in many application domains requiring a high degree of interactivity. However, researchers and practitioners often observe that basic implementations of virtual walking, in which head-tracked movements are mapped isometrically to a VE are not estimated as entirely natural. Instead, users estimate a virtual walking velocity as more natural when it is slightly increased compared to the users physical body movement.
In this article, we investigate the effects of such nonisometric mappings between physical movements and virtual motions in the VE on walking velocity and biomechanics of the gait cycle. Therefore, we performed an experiment in which we measured and analyzed parameters of the biomechanics of walking under conditions with isometric as well as nonisometric mappings. Our results show significant differences in most gait parameters when walking in the VE in the isometric mapping condition compared to the corresponding parameters in the real world. For nonisometric mappings we found an increased divergence of gait parameters depending on the velocity of visual self-motion feedback. The results revealed a symmetrical effect of gait detriments for up- or down-scaled virtual velocities, which we discuss in the scope of the previous findings.
Rhetorical Tools for Discovery and Amplification of Design Arguments
Authors: Halstrøm Per Liljenberg 
Published: January 2017

Design processes and designed artifacts are perceived as instances of argumentation in this article. A design process is defined as a process of deliberation about what to do when seeking to design artifacts that aim to be persuasive about how we are to lead our lives. The intention of employing the argumentative perspective is to demonstrate how rhetorical theory, on discovery and amplification of arguments, may lend support to designers in two ways. One way is for the purpose of exploring abundant ways of designing design methods and processes. Another way is to support designers in discovering persuasive arguments about their choices. The article provides examples of how such a rhetorical design process may be carried out in practice.
Design Without Borders: Ideologies, Realities, and Results
Authors: Skjerven Astrid 
Published: January 2017

Design without Borders (DWB) was founded in Norway in 2001. As a child of the design, its ideological traditions has had strong impact on its aims and enterprises. However, its sphere of operation and financial conditions have been those of development aid. These facts have directed its work both ideologically and practically, and thereby also the results. The idea of development aid goes back to the era of Colonialism. A sense of guilt towards what this conception has led to has rightfully been established. There has been little focus on the altruistic side of the idea of the idea. The ideological aim of the design community to contribute to a better human life, is also related to this idea. The investigation consists of an analysis of DWB's ideological background and its achievements, seen at the backdrop of its origin in the ideas of development aid and its way of financing. Two of the projects are used as case studies and a comparative analysis in order to uncover effects and possible improvements. The article is an “insider view,” through which its history and two examples are reported.
Tropical–Extratropical Interactions Associated with East Asian Cold Air Outbreaks. Part I: Interannual Variability
Authors: Abdillah Muhammad Rais , Kanno Yuki , Iwasaki Toshiki 
Published: January 2017

Interannual variability of winter-mean East Asian cold air outbreaks (CAOs) and its relationship with the tropical climate system during 56 boreal winters (DJF) are investigated. The magnitude of CAO is quantified as winter-mean equatorward cold airmass (CAM) flux below 280-K potential temperature across the 45°N latitude. EOF analysis shows that the interannual variation of East Asian CAOs is attributed mainly to the contributions from western and eastern CAOs. In particular, the western and eastern CAOs tend to be remotely forced by La Niña and El Niño events, respectively. The western and eastern CAOs have distinct climate variability. The western CAO, which is enhanced under the climatic anomalies of high pressure over northern Eurasia and low pressure over the western North Pacific, causes negative CAM anomalies over northern Eurasia and positive ones over midlatitude East Asia. In the tropical region, the western CAO negatively correlates with the eastern Pacific and Indian Ocean SST, both of which enhance precipitation over the Maritime Continent. On the other hand, the eastern CAO is enhanced by the strong Aleutian low and results in positive CAM anomalies in the western North Pacific and substantial negative anomalies in western North America. The eastern CAO positively correlates with the tropical SST anomalies and accordingly precipitation anomalies over the central Pacific. ENSO influences western and eastern CAOs through upper and poleward Rossby wave trains excited by convective anomalies over the Maritime Continent and central Pacific, respectively.
Baroclinic Effects on Wind-Driven Lateral Circulation in Chesapeake Bay
Authors: Xie Xiaohui , Li Ming , Boicourt William C. 
Published: January 2017

AbstractThe 2-month-long mooring data were collected in a straight midsection of Chesapeake Bay to document the lateral circulation driven by along-channel winds. Under upestuary winds, the lateral circulation featured a clockwise (looking into estuary) circulation in the surface layer, with lateral Ekman forcing as the dominant generation mechanism. Under downestuary winds, however, the lateral circulation displayed a structure dependent on the Wedderburn number W: a counterclockwise circulation at small W and two counterrotating vortices at large W. The surface lateral velocity was phase locked to the along-channel wind speed. Analysis of the streamwise vorticity equation showed that the strength and structure of the lateral circulation in this stratified estuary were largely determined by the competition between the tilting of planetary vorticity by along-channel currents and lateral baroclinic forcing due to sloping isopycnals. Under strong, downestuary winds, the lateral baroclinic forcing offset or reversed the tilting of planetary vorticity on the western half of the estuarine channel, resulting in two counterrotating lateral circulation cells. A bottom lateral flow was observed in the deep channel and appeared to be generated by lateral Ekman forcing on the along-channel currents.
An Empirical Cumulative Density Function Approach to Defining Summary NWP Forecast Assessment Metrics
Authors: Hoffman Ross N. , Boukabara Sid-Ahmed , Kumar V. Krishna , Garrett Kevin , Casey Sean P. F. , Atlas Robert 
Published: January 2017

Abstract
The empirical cumulative density function (ECDF) approach can be used to combine multiple, diverse assessment metrics into summary assessment metrics (SAMs) to analyze the results of impact experiments and preoperational implementation testing with numerical weather prediction (NWP) models. The main advantages of the ECDF approach are that it is amenable to statistical significance testing and produces results that are easy to interpret because the SAMs for various subsets tend to vary smoothly and in a consistent manner. In addition, the ECDF approach can be applied in various contexts thanks to the flexibility allowed in the definition of the reference sample.
The interpretations of the examples presented here of the impact of potential future data gaps are consistent with previously reported conclusions. An interesting finding is that the impact of observations decreases with increasing forecast time. This is interpreted as being caused by the masking effect of NWP model errors increasing to become the dominant source of forecast error.
Clonal evolution leading to ibrutinib resistance in chronic lymphocytic leukemia
Authors: Ahn Inhye E. , Underbayev Chingiz , Albitar Adam , Herman Sarah E. M. , Tian Xin , Maric Irina , Arthur Diane C. , Wake Laura , Pittaluga Stefania , Yuan Constance M. , Stetler-Stevenson Maryalice , Soto Susan , Valdez Janet , Nierman Pia , Lotter Jennifer , Xi Liqiang , Raffeld Mark , Farooqui Mohammed , Albitar Maher , Wiestner Adrian 
Published: January 2017

Key Points
Most cases of ibrutinib-resistant CLL were due to mutations in BTK and/or PLCG2 and often composed of multiple independent subclones. High sensitivity testing identified resistance mutations up to 15 months before manifestation of clinical progression.
Polyphosphate nanoparticles on the platelet surface trigger contact system activation
Authors: Verhoef Johan J. F. , Barendrecht Arjan D. , Nickel Katrin F. , Dijkxhoorn Kim , Kenne Ellinor , Labberton Linda , McCarty Owen J. T. , Schiffelers Raymond , Heijnen Harry F. , Hendrickx Antoni P. , Schellekens Huub , Fens Marcel H. , de Maat Steven , Renné Thomas , Maas Coen 
Published: January 2017

Key Points
Activated platelets expose insoluble membrane-associated polyphosphate nanoparticles that are complexed with divalent metal ions. Platelet polyphosphate nanoparticles, but not soluble polyphosphate polymers, activate the contact system.
Risk of venous thromboembolism in pregnant women with essential thrombocythemia: a systematic review and meta-analysis
Authors: Skeith Leslie , Carrier Marc , Robinson Susan E. , Alimam Samah , Rodger Marc A. 
Published: January 2017

Abstract
We performed a meta-analysis to evaluate the risk of venous thromboembolism (VTE) in pregnant women with essential thrombocythemia. Twenty-one trials and 756 pregnancies met inclusion criteria. The absolute VTE risk in the antepartum period is not above a threshold where low-molecular-weight heparin (LMWH) prophylaxis is clearly indicated or below a threshold where LMWH should be withheld (2.5%; 95% CI, 1.3-4.3). Postpartum, the absolute VTE risk is above a threshold where postpartum LMWH prophylaxis should be considered (4.4%; 95% CI, 1.2-9.5).
Mobilization of hematopoietic stem cells with the novel CXCR4 antagonist POL6326 (balixafortide) in healthy volunteers—results of a dose escalation trial
Authors: Karpova Darja , Bräuninger Susanne , Wiercinska Eliza , Krämer Ariane , Stock Belinda , Graff Jochen , Martin Hans , Wach Achim , Escot Christophe , Douglas Garry , Romagnoli Barbara , Chevalier Eric , Dembowski Klaus , Hooftman Leon , Bonig Halvard 
Published: January 2017

Abstract
Background
Certain disadvantages of the standard hematopoietic stem and progenitor cell (HSPC) mobilizing agent G-CSF fuel the quest for alternatives. We herein report results of a Phase I dose escalation trial comparing mobilization with a peptidic CXCR4 antagonist POL6326 (balixafortide) vs. G-CSF.

Methods
Healthy male volunteer donors with a documented average mobilization response to G-CSF received, following ≥6 weeks wash-out, a 1–2 h infusion of 500–2500 µg/kg of balixafortide. Safety, tolerability, pharmacokinetics and pharmacodynamics were assessed.

Results
Balixafortide was well tolerated and rated favorably over G-CSF by subjects. At all doses tested balixafortide mobilized HSPC. In the dose range between 1500 and 2500 µg/kg mobilization was similar, reaching 38.2 ± 2.8 CD34 + cells/µL (mean ± SEM). Balixafortide caused mixed leukocytosis in the mid-20 K/µL range. B-lymphocytosis was more pronounced, whereas neutrophilia and monocytosis were markedly less accentuated with balixafortide compared to G-CSF. At the 24 h time point, leukocytes had largely normalized.

Conclusions
Balixafortide is safe, well tolerated, and induces efficient mobilization of HSPCs in healthy male volunteers. Based on experience with current apheresis technology, the observed mobilization at doses ≥1500 µg/kg of balixafortide is predicted to yield in a single apheresis a standard dose of 4× 10E6 CD34+ cells/kg from most individuals donating for an approximately weight-matched recipient. Exploration of alternative dosing regimens may provide even higher mobilization responses.
Trial Registration European Medicines Agency (EudraCT-Nr. 2011-003316-23) and clinicaltrials.gov (NCT01841476)
A current perspective on cancer immune therapy: step‐by‐step approach to constructing the magic bullet
Authors: D’Errico Gabriele , Machado Heather L. , Sainz Bruno 
Published: January 2017

AbstractImmunotherapy is the new trend in cancer treatment due to the selectivity, long lasting effects, and demonstrated improved overall survival and tolerance, when compared to patients treated with conventional chemotherapy. Despite these positive results, immunotherapy is still far from becoming the perfect magic bullet to fight cancer, largely due to the facts that immunotherapy is not effective in all patients nor in all cancer types. How and when will immunotherapy overcome these hurdles? In this review we take a step back to walk side by side with the pioneers of immunotherapy in order to understand what steps need to be taken today to make immunotherapy effective across all cancers. While early scientists, such as Coley, elicited an unselective but effective response against cancer, the search for selectivity pushed immunotherapy to the side in favor of drugs focused on targeting cancer cells. Fortunately, the modern era would revive the importance of the immune system in battling cancer by releasing the brakes or checkpoints (anti‐CTLA‐4 and anti‐PD‐1/PD‐L1) that have been holding the immune system at bay. However, there are still many hurdles to overcome before immunotherapy becomes a universal cancer therapy. For example, we discuss how the redundant and complex nature of the immune system can impede tumor elimination by teeter tottering between different polarization states: one eliciting anti‐cancer effects while the other promoting cancer growth and invasion. In addition, we highlight the incapacity of the immune system to choose between a fight or repair action with respect to tumor growth. Finally we combine these concepts to present a new way to think about the immune system and immune tolerance, by introducing two new metaphors, the “push the accelerator” and “repair the car” metaphors, to explain the current limitations associated with cancer immunotherapy.
A systematic approach to cancer: evolution beyond selection
Authors: Miller William B. , Torday John S. 
Published: January 2017

AbstractCancer is typically scrutinized as a pathological process characterized by chromosomal aberrations and clonal expansion subject to stochastic Darwinian selection within adaptive cellular ecosystems. Cognition based evolution is suggested as an alternative approach to cancer development and progression in which neoplastic cells of differing karyotypes and cellular lineages are assessed as self‐referential agencies with purposive participation within tissue microenvironments. As distinct self‐aware entities, neoplastic cells occupy unique participant/observer status within tissue ecologies. In consequence, neoplastic proliferation by clonal lineages is enhanced by the advantaged utilization of ecological resources through flexible re‐connection with progenitor evolutionary stages.
Nutritional management for Alzheimer’s disease in all stages: mild, moderate, and severe
Authors: Pivi Glaucia Akiko Kamikado , Vieira Neusa Maria de Andrade , da Ponte Jaqueline Botelho , de Moraes Débora Santos Coca , Bertolucci Paulo Henrique Ferreira 
Published: January 2017

AbstractAlzheimer’s disease corresponds to 50–70% of all dementia syndromes, classified as a progressive neurodegenerative disease showing diffuse cortical atrophy with three stages of evolution: mild, moderate, and severe. Behavioral symptoms and memory loss are major manifestations of the disease. Non-pharmacological interventions are essential to improve the quality of life of these patients. Interdisciplinary assistance is essential throughout the disease course. Regarding nutrition for patients with Alzheimer’s disease, weight loss and behavioral changes related to food are major objects of scientific study, as they trigger deterioration of the quality of life of patients and caregivers. Knowing which nutritional guidelines should be used helps in clinical decisions. The study of nutrition in dementia is, therefore, critical for patient management.
Engagement and outcomes for a computerised cognitive-behavioural therapy intervention for anxiety and depression in African Americans
Authors: Jonassaint Charles R. , Gibbs Patrice , Belnap Bea Herbeck , Karp Jordan F. , Abebe Kaleab Z. , Rollman Bruce L. 
Published: January 2017

BackgroundComputerised cognitive-behavioural therapy (CCBT) helps improve mental health outcomes in White populations. However, no studies have examined whether CCBT is acceptable and beneficial for African Americans.AimsWe studied differences in CCBT use and self-reported change in depression and anxiety symptoms among 91 African Americans and 499 White primary care patients aged 18–75, enrolled in a randomised clinical trial of collaborative care embedded with an online treatment for depression and anxiety.MethodPatients with moderate levels of mood and/or anxiety symptoms (PHQ-9 or GAD-7≥10) were randomised to receive either care-manager-guided access to the proven-effective Beating the Blues® CCBT programme or usual care from their primary care doctor.ResultsCompared with White participants, African Americans were less likely to start the CCBT programme (P=0.01), and those who did completed fewer sessions and were less likely to complete the full programme (P=0.03). Despite lower engagement, however, African Americans who started the CCBT programme experienced a greater decrease in self-reported depressive symptoms (estimated 8-session change: −6.6 v. −5.5; P=0.06) and similar decrease in anxiety symptoms (−5.3 v. −5.6; P=0.80) compared with White participants.ConclusionsCCBT may be an efficient and scalable first-step to improving minority mental health and reducing disparities in access to evidence-based healthcare.
Minimizing Risk Exposure When the Choice of a Risk Measure Is Ambiguous
Authors: Delage Erick , Li Jonathan Yu-Meng 
Published: January 2017

Since the financial crisis of 2007–2009, there has been a renewed interest in quantifying more appropriately the risks involved in financial positions. Popular risk measures such as variance and value-at-risk have been found inadequate because we now give more importance to properties such as monotonicity, convexity, translation invariance, positive homogeneity, and law invariance. Unfortunately, the challenge remains that it is unclear how to choose a risk measure that faithfully represents a decision maker’s true risk attitude. In this work, we show that one can account precisely for (neither more nor less than) what we know of the risk preferences of an investor/policy maker when comparing and optimizing financial positions. We assume that the decision maker can commit to a subset of the above properties (the use of a law invariant convex risk measure for example) and that he can provide a series of assessments comparing pairs of potential risky payoffs. Given this information, we propose to seek financial positions that perform best with respect to the most pessimistic estimation of the level of risk potentially perceived by the decision maker. We present how this preference robust risk minimization problem can be solved numerically by formulating convex optimization problems of reasonable size. Numerical experiments on a portfolio selection problem, where the problem reduces to a linear program, will illustrate the advantages of accounting for the fact that the choice of a risk measure is ambiguous. This paper was accepted by Yinyu Ye, optimization.