bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rhythmic Influence of Top–Down Perceptual Priors in the Phase of Prestimulus Occipital Alpha Oscillations
Authors: Sherman Maxine T. , Kanai Ryota , Seth Anil K. , VanRullen Rufin 
Published: April 2016

Abstract
Prior expectations have a powerful influence on perception, biasing both decision and confidence. However, how this occurs at the neural level remains unclear. It has been suggested that spontaneous alpha-band neural oscillations represent rhythms of the perceptual system that periodically modulate perceptual judgments. We hypothesized that these oscillations instantiate the effects of expectations. While collecting scalp EEG, participants performed a detection task that orthogonally manipulated perceptual expectations and attention. Trial-by-trial retrospective confidence judgments were also collected. Results showed that, independent of attention, prestimulus occipital alpha phase predicted the weighting of expectations on yes/no decisions. Moreover, phase predicted the influence of expectations on confidence. Thus, expectations periodically bias objective and subjective perceptual decision-making together before stimulus onset. Our results suggest that alpha-band neural oscillations periodically transmit prior evidence to visual cortex, changing the baseline from which evidence accumulation begins. In turn, our results inform accounts of how expectations shape early visual processing.
Spatial and Seasonal Variations in Aridification across Southwest North America
Authors: Jones Shannon M. , Gutzler David S. 
Published: April 2016

Abstract
Southwestern North America (SWNA) is projected to become drier in the twenty-first century as both precipitation (P) and evaporation (E) rates change with increasing greenhouse gas concentration. The authors diagnose the relative contributions of changes in P and E to the local surface moisture balance (P − E) in cold and warm halves of the year across SWNA. Trends in P − E vary spatially between the arid southern subregion (mostly northern Mexico) and the more temperate northern subregion (southwest United States), although both subregions exhibit a negative trend in P − E (trending toward more arid conditions) in CMIP5 projections for the twenty-first century. The P − E trend is biggest in the cold season, when much of the base flow to rivers in the southwest United States is generated. The downward trend in cold season P − E across SWNA is caused primarily by increasing E in the north and decreasing P in the south. Decreasing P is the primary contributor to modest warm season drying trends in both northern and southern subregions. Also, P accounts for most of the interannual variability in SWNA P − E and is strongly correlated with modes of oceanic natural variability during the cold season. SWNA aridification is therefore most readily distinguished from the region’s large natural climate variability in the cold season in the northern subregion, where the projected temperature-driven increase in E is greater than the projected decrease in P.
The Evaporative Demand Drought Index. Part I: Linking Drought Evolution to Variations in Evaporative Demand
Authors: Hobbins Michael T. , Wood Andrew , McEvoy Daniel J. , Huntington Justin L. , Morton Charles , Anderson Martha , Hain Christopher 
Published: April 2016

Abstract
Many operational drought indices focus primarily on precipitation and temperature when depicting hydroclimatic anomalies, and this perspective can be augmented by analyses and products that reflect the evaporative dynamics of drought. The linkage between atmospheric evaporative demand E0 and actual evapotranspiration (ET) is leveraged in a new drought index based solely on E0—the Evaporative Demand Drought Index (EDDI). EDDI measures the signal of drought through the response of E0 to surface drying anomalies that result from two distinct land surface–atmosphere interactions: 1) a complementary relationship between E0 and ET that develops under moisture limitations at the land surface, leading to ET declining and increasing E0, as in sustained droughts, and 2) parallel ET and E0 increases arising from increased energy availability that lead to surface moisture limitations, as in flash droughts. To calculate EDDI from E0, a long-term, daily reanalysis of reference ET estimated from the American Society of Civil Engineers (ASCE) standardized reference ET equation using radiation and meteorological variables from the North American Land Data Assimilation System phase 2 (NLDAS-2) is used. EDDI is obtained by deriving empirical probabilities of aggregated E0 depths relative to their climatologic means across a user-specific time period and normalizing these probabilities. Positive EDDI values then indicate drier-than-normal conditions and the potential for drought. EDDI is a physically based, multiscalar drought index that that can serve as an indicator of both flash and sustained droughts, in some hydroclimates offering early warning relative to current operational drought indices. The performance of EDDI is assessed against other commonly used drought metrics across CONUS in Part II.
Quantile Regression in Regional Frequency Analysis: A Better Exploitation of the Available Information
Authors: Ouali D. , Chebana F. , Ouarda T. B. M. J. 
Published: April 2016

Abstract
Classical regression models are widely used in hydrological regional frequency analysis (RFA) in order to provide quantile estimates at ungauged sites given physio-meteorological information. Since classical regression-based methods only provide the conditional mean of the response variable, estimated at-site quantiles at gauged sites are commonly used to calibrate the regression models in RFA. Generally, only at-site quantiles estimated with long data records are retained for the calibration and the evaluation steps, whereas hydrological information from stations with few data is ignored. In addition, even if the at-site quantiles are estimated with long data series, they are always subject to model selection and parameter estimation. Hence, their use for the calibration of the RFA models may induce significant uncertainties in the modeled relationships. The aim of this paper is to propose a quantile regression (QR) model that gives directly the conditional quantile for RFA and avoids using at-site estimated quantiles in the calibration step. The proposed model presents another advantage where all the available hydrological information can be used in the calibration step including stations with very short data records. An evaluation criterion using observed data is also proposed in a cross-validation procedure. The proposed QR model is applied on a dataset representing 151 hydrometric stations from the province of Quebec and compared with a classical regression model. According to the proposed evaluation criterion, the QR is shown to be a viable model for regional estimations. Indeed, the proposed model proved to be robust and flexible, allowing for consideration of all the region’s sites, even those with extremely short flood records.
Electrically powered indoor/outdoor chair performance for children aged 7 to 9 years
Authors: McCourt Eileen , Casey Jackie 
Published: April 2016

Introduction Northern Ireland wheelchair guidelines state that wheelchair users who wish to drive their National Health Service provided powered wheelchairs outdoors must complete an electrically powered indoor/outdoor chair test. Within the same guidelines, children in Northern Ireland under the age of 10 years are not permitted to complete this assessment. Research was completed to evaluate how children under 10 years would perform in electrically powered indoor/outdoor chair training and testing under adult supervision. Method A case-study design was utilised with three children aged 7–9 years to evaluate if: (a) these children can complete electrically powered indoor/outdoor chair training/testing safely with adult supervision; (b) the length of time using an electric powered indoor chair correlates with performance on electrically powered indoor chair training/testing; (c) the current Northern Ireland guidelines on age restriction should be re-evaluated so that each child is assessed on an individual basis rather than age. Findings Paediatric powered wheelchair users aged seven to nine years can become competent electrically powered indoor/outdoor chair users with adequate training and adult supervision. Length of time (years) driving an electrically powered indoor chair may not correlate with improved electrically powered indoor/outdoor chair performance. Conclusion Regional Northern Ireland criteria relating to electrically powered indoor/outdoor chair provision for children should be revised in order to consider an individual needs assessment, rather than imposing an age restriction.
Prediction and Outcome of Intensive Care Unit-Acquired Paresis
Authors: Peñuelas Oscar , Muriel Alfonso , Frutos-Vivar Fernando , Fan Eddy , Raymondos Konstantinos , Rios Fernando , Nin Nicolás , Thille Arnaud W. , González Marco , Villagomez Asisclo J. , Davies Andrew R. , Du Bin , Maggiore Salvatore M. , Matamis Dimitrios , Abroug Fekri , Moreno Rui P. , Kuiper Michael A. , Anzueto Antonio , Ferguson Niall D. , Esteban Andrés 
Published: April 2016

Background: Intensive care unit-acquired paresis (ICUAP) is associated with poor outcomes. Our objective was to evaluate predictors for ICUAP and the short-term outcomes associated with this condition. Methods: A secondary analysis of a prospective study including 4157 mechanically ventilated adults in 494 intensive care units from 39 countries. After sedative interruption, patients were screened for ICUAP daily, which was defined as the presence of symmetric and flaccid quadriparesis associated with decreased or absent deep tendon reflexes. A multinomial logistic regression was used to create a predictive model for ICUAP. Propensity score matching was used to estimate the relationship between ICUAP and short-term outcomes (ie, weaning failure and intensive care unit [ICU] mortality). Results: Overall, 114 (3%) patients had ICUAP. Variables associated with ICUAP were duration of mechanical ventilation (relative risk ratio [RRR] per day, 1.10; 95% confidence interval [CI] 1.08-1.12), steroid therapy (RRR 1.8; 95% CI, 1.2-2.8), insulin therapy (RRR 1.8; 95% CI 1.2-2.7), sepsis (RRR 1.9; 95% CI: 1.2 to 2.9), acute renal failure (RRR 2.2; 95% CI 1.5-3.3), and hematological failure (RRR 1.9; 95% CI: 1.2-2.9). Coefficients were used to generate a weighted scoring system to predict ICUAP. ICUAP was significantly associated with both weaning failure (paired rate difference of 22.1%; 95% CI 9.8-31.6%) and ICU mortality (paired rate difference 10.5%; 95% CI 0.1-24.0%). Conclusions: Intensive care unit-acquired paresis is relatively uncommon but is significantly associated with weaning failure and ICU mortality. We constructed a weighted scoring system, with good discrimination, to predict ICUAP in mechanically ventilated patients at the time of awakening.
Assessment of Drug Therapy-Related Issues in an Outpatient Heart Failure Population and the Potential Impact of Pharmacist-Driven Intervention
Authors: Dempsey Jillian T. , Matta Lina S. , Carter Danielle M. , Stevens Craig A. , Stevenson Lynne W. , Desai Akshay S. , Cheng Judy W. 
Published: April 2016

Background: The Ambulatory Cardiac Triage, Intervention, and Education (ACTIVE) infusion unit is an outpatient center that aims to provide heart failure (HF) patients with comprehensive multidisciplinary interventions. Objective: To describe the patient population served in ACTIVE and to document the prevalence of comorbidities and drug therapy-related issues (DRIs) in order to define the most effective role of a pharmacist in the unit. Methods: Patients who have been interviewed by a pharmacist in ACTIVE were included. Comprehensive medical and medication profile reviews were performed. Patient comorbidities were documented, and DRIs were classified. Results: Sixty patients were included. Most prevalent cardiac comorbidities included hypertension (73%) and hyperlipidemia (62%). Top 3 noncardiac comorbidities included chronic kidney disease (60%), diabetes (50%), and obesity (35%). The prevalence of DRI was reported as follows: (1) needs additional/alternative therapy (untreated indication [37] or suboptimal therapeutic choice [46]), (2) wrong drug (major drug–drug interaction [90], contraindication [11], or duplicate therapy [1]), (3) suboptimal dosing (17), (4) dose exceeds recommended maximum (9), and (5) adverse drug reaction (93). In 63 (22%) of the DRIs, a pharmacist made recommendations to modify the regimen. Conclusion: The prevalence of DRI is high even among HF patients managed in a subspecialty cardiovascular practice. Pharmacists in this setting play a vital role in more effectively resolving DRI.
Multi-axis vibration testing of an aerodynamically excited structure
Authors: Roberts C , Ewins D 
Published: April 2016

Missile vibration testing has undergone significant advances in the past decade. This has been the result of improvements in signal processing and test specification development, but more recently due to the implementation of Multi-Input Multi-Output (MIMO) testing. To date, much of the focus of MIMO testing has been on either a twin-shaker, single-axis configuration or multi-axis testing on a 3 or 6 Degree of Freedom (DOF) shaker system. There has been little attention to replication of the 3-dimensional operating deflection shapes that a missile system experiences during its carriage or operation. This paper presents a systematic approach to 3-axis vibration testing, using current MIMO rectangular controller technology, and demonstrates through an experimental setup a near-3 fold improvement in matching the vibration response of the item under test over the more traditional single axis SISO and MIMO test methods.
Improved technical performance of a multifunctional prehospital telemedicine system between the research phase and the routine use phase – an observational study
Authors: Felzen Marc , Brokmann Jörg C , Beckers Stefan K , Czaplik Michael , Hirsch Frederik , Tamm Miriam , Rossaint Rolf , Bergrath Sebastian 
Published: April 2016

Introduction Telemedical concepts in emergency medical services (EMS) lead to improved process times and patient outcomes, but their technical performance has thus far been insufficient; nevertheless, the concept was transferred into EMS routine care in Aachen, Germany. This study evaluated the system’s technical performance and compared it to a precursor system. Methods The telemedicine system was implemented on seven ambulances and a teleconsultation centre staffed with experienced EMS physicians was established in April 2014. Telemedical applications included mobile vital data, 12-lead, picture transmission and video streaming from inside the ambulances. The tele-EMS physician filled in a questionnaire regarding the technical performance of the applications, background noise and assessed clinical values of the transmitted pictures and videos after each mission between 15 May 2014–15 October 2014. Results Teleconsultation was established during 539 emergency cases. In 83% of the cases ( n = 447), only the paramedics and the tele-EMS physician were involved. Transmission success rates ranged from 98% (audio connection) to 93% (12-lead electrocardiogram (ECG) transmission). All functionalities, except video transmission, were significantly better than the pilot project ( p < 0.05). Severe background noise was detected to a lesser extent ( p = 0.0004) and the clinical value of the pictures and videos were considered significantly more valuable. Discussion The multifunctional system is now sufficient for routine use and is the most reliable mobile emergency telemedicine system compared to other published projects. Dropouts were due to user errors and network coverage problems. These findings enable widespread use of this system in the future, reducing the critical time intervals until medical therapy is started.
Nanoallergens: A multivalent platform for studying and evaluating potency of allergen epitopes in cellular degranulation
Authors: Deak Peter E , Vrabel Maura R , Pizzuti Vincenzo J , Kiziltepe Tanyel , Bilgicer Basar 
Published: April 2016

Degranulation caused by type I hypersensitivity (allergies) is a complex biophysical process, and available experimental models for studying relevant immunoglobulin E binding epitopes on allergen proteins lack the ability to adequately evaluate, rank, and associate these epitopes individually and with each other. In this study, we propose a new allergy model system for studying potential allergen epitopes using nanoallergens, liposomes modified to effectively display IgE binding epitopes/haptens. By utilizing the covalently conjugated lipid tails on two hapten molecules (dinitrophenol and dansyl), hapten molecules were successfully incorporated into liposomes with high precision to form nanoallergens. Nanoallergens, with precisely controlled high-particle valency, can trigger degranulation with much greater sensitivity than commonly used bovine serum albumin conjugates. In rat basophil leukemia cell experiments, nanoallergens with only 2% hapten loading were able to trigger degranulation in vitro at concentrations as low as 10 pM. Additionally, unlike bovine serum albumin-hapten conjugates, nanoallergens allow exact control over particle size and valency. By varying the nanoallergen parameters such as size, valency, monovalent affinity of hapten, and specific IgE ratios, we exposed the importance of these variables on degranulation intensity while demonstrating nanoallergens’ potential for evaluating both high- and low-affinity epitopes. The data presented in this article establish nanoallergen platform as a reliable and versatile allergy model to study and evaluate allergen epitopes in mast cell degranulation.
Healthcare in the age of open innovation – A literature review
Authors: Wass Sofie , Vimarlund Vivian 
Published: April 2016

Background: In spite of an increased interest in open innovation and strategies that call for an increased collaboration between different healthcare actors, there is a lack of open innovation research in public contexts. Objective: This article presents the results of a review regarding the healthcare sector’s engagement in open innovation as well as constraining factors and positive outcomes of open innovation in healthcare. Method: The literature search focused on papers published in English between 2003 and 2014. Based on specified inclusion criteria, 18 articles were included. Results: Results reveal that most studies focus on inbound open innovation where external knowledge is integrated with the internal knowledge base at an initial phase of the innovation process. Innovation primarily results in products and services through innovation networks. We also identified constraining factors for open innovation in healthcare, including the complex organizations of healthcare, the need to establish routines for capturing knowledge from patients and clinicians, regulations and healthcare data laws as well as the positive outcome patient empowerment. Conclusion: The healthcare sector’s engagement in open innovation is limited, and it is necessary to perform further research with a focus on how open innovation can be managed in healthcare.
Adverse events and near misses relating to information management in a hospital
Authors: Jylhä Virpi , Bates David W , Saranto Kaija 
Published: April 2016

Objective: This study described information management incidents and adverse event reporting choices of health professionals. Methods: Hospital adverse events reported in an anonymous electronic reporting system were analysed using directed content analysis and descriptive and inferential statistics. The data consisted of near miss and adverse event incident reports ( n = 3075) that occurred between January 2008 and the end of December 2009. Results: A total of 824 incidents were identified. The most common information management incident was failure in written information transfer and communication, when patient data were copied or documented incorrectly. Often patient data were transferred using paper even though an electronic patient record was in use. Reporting choices differed significantly among professional groups; in particular, registered nurses reported more events than other health professionals. Conclusion: A broad spectrum of information management incidents was identified, which indicates that preventing adverse events requires the development of safe practices, especially in documentation and information transfer.
Design and Methods of a Randomized Trial of Continuous Glucose Monitoring in Persons With Type 1 Diabetes With Impaired Glycemic Control Treated With Multiple Daily Insulin Injections (GOLD Study)
Authors: Lind Marcus , Polonsky William , Hirsch Irl B. , Heise Tim , Bolinder Jan , Dahlqvist Sofia , Pehrsson Nils-Gunnar , Moström Peter 
Published: April 2016

Background: The majority of individuals with type 1 diabetes today have glucose levels exceeding guidelines. The primary aim of this study was to evaluate whether continuous glucose monitoring (CGM), using the Dexcom G4 stand-alone system, improves glycemic control in adults with type 1 diabetes treated with multiple daily insulin injections (MDI). Methods: Individuals with type 1 diabetes and inadequate glycemic control (HbA1c ≥ 7.5% = 58 mmol/mol) treated with MDI were randomized in a cross-over design to the Dexcom G4 versus conventional care for 6 months followed by a 4-month wash-out period. Masked CGM was performed before randomization, during conventional treatment, and during the wash-out period to evaluate effects on hypoglycemia, hyperglycemia, and glycemic variability. Questionnaires were used to evaluate diabetes treatment satisfaction, fear of hypoglycemia, hypoglycemia confidence, diabetes-related distress, overall well-being, and physical activity during the different phases of the trial. The primary endpoint was the difference in HbA1c at the end of each treatment phase. Results: A total of 205 patients were screened, of whom 161 were randomized between February and December 2014. Study completion is anticipated in April 2016. Conclusions: It is expected that the results of this study will establish whether using the Dexcom G4 stand-alone system in individuals with type 1 diabetes treated with MDI improves glycemic control, reduces hypoglycemia, and influences quality-of-life indicators and glycemic variability.
Atrial fibrillation and flutter following coronary artery bypass graft surgery: A retrospective study and review
Authors: Premaratne Shyamal , Premaratne Ishani D , Fernando Naomi D , Williams Lashira , Hasaniya Nahidh W 
Published: April 2016

Introduction and objectives Atrial fibrillation is a common arrhythmia following coronary artery bypass graft surgery. Its incidence can range from 10 to 60% of patients undergoing coronary artery bypass graft. This rhythm can result in shorter or longer intervals between beats. Methods Medical records of 143 patients from the Queen’s Medical Center, Kuakini Medical Center, Saint Francis Medical Center, and Straub Hospital and Clinic, all of which are located in Honolulu, Hawaii were reviewed. An additional 39 records of patients who did not develop these complications were also reviewed as a control group. Patients were selected according to the ICD codes for atrial fibrillation/flutter and coronary artery bypass graft. Both anomalies can lead to increased health care costs, morbidity, and mortality. In this study, possible predisposing factors to these complications were investigated. The time of onset, weight gain, elapsed time, fluid status (in/out), hematocrit, and drug regimens were compared between the two groups. Results The differences in weight gain, fluid status, and hematocrit between the groups were not significant. There were a total of 17 different drugs prescribed to the group as a whole but not every patient received the same regimen. Conclusions Atrial fibrillation and flutter were found to be more common in males, particularly between the ages of 60 and 69 years. There were no other significant findings.