bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relations between surface and underground karst forms inferred from terrestrial laser scanning
Authors: Petrović Aleksandar S. , Ćalić Jelena , Spalević Aleksandra , Pantić Marko 
Published: February 2018

Abstract
This paper details methods that contribute towards solving the problem of the spatial relations between surface and underground karst morphology – relationships that are often unclear. The karst landforms studied in this context are karst valleys, through-caves and natural bridges. Two study sites are situated in the Carpatho-Balkan Mountains of eastern Serbia: the dry valley of the Radovanska Reka River on Mt Kučaj (together with the Pećura through-cave) and the Zamna Cave in the wider area of the Danube Gorge. The caves and the closest adjoining parts of the valleys were measured in detail using the terrestrial laser scanning method. The data obtained showed that some previous measurements at these locations, performed with classical traditional instruments, are insufficiently accurate and may lead to wrong conclusions.
Adjuvant Transarterial Chemoembolization for HBV-Related Hepatocellular Carcinoma After Resection: A Randomized Controlled Study
Authors: Wang Zheng , Ren Zhenggang , Chen Yi , Hu Jie , Yang Guohuan , Yu Lei , Yang Xinrong , Huang Ao , Zhang Xin , Zhou Shaolai , Sun Huichuan , Wang Yanhong , Ge Ningling , Xu Xiaoyu , Tang Zhaoyou , Lau Wanyee , Fan Jia , Wang Jiping , Zhou Jian 
Published: February 2018

Abstract
Purpose: The survival of patients with hepatocellular carcinoma (HCC) recurrence after curative resection is usually poor. We sought to evaluate the safety and efficacy of adjuvant transarterial chemoembolization (TACE) in HBV-related HCC patients with an intermediate (a single tumor larger than 5 cm without microvascular invasion) or high risk (a single tumor with microvascular invasion, or two or three tumors) of recurrence.
Experimental Design: In this randomized phase 3 trial, 280 eligible patients were assigned to adjuvant TACE (n = 140) or no adjuvant treatment (control; n = 140) groups. The primary endpoint was recurrence-free survival (RFS); secondary endpoints included overall survival (OS) and safety. Multivariable Cox-proportional hazards model was used to determine the independent impact of TACE on patients' outcomes.
Results: Patients who received adjuvant TACE had a significantly longer RFS than those in the control group [56.0% vs. 42.1%, P = 0.01; HR, 0.68; 95% confidence interval (CI), 0.49–0.93]. Patients in the adjuvant TACE group had 7.8% higher 3-year OS rate than the control group (85.2% vs. 77.4%; P = 0.04; HR, 0.59; 95% CI, 0.36–0.97). The impact of adjuvant TACE on RFS and OS remained significant after controlling for other known prognostic factors (HR, 0.67; P = 0.01 for RFS; and HR, 0.59; P = 0.04 for OS). There was no grade 3 or 4 toxicity after adjuvant TACE.
Conclusions: For patients with HBV-related HCC who had an intermediate or high risk of recurrence after curative hepatectomy, our study showed adjuvant TACE significantly reduced tumor recurrence, improved RFS and OS, and the procedure was well tolerated. Clin Cancer Res; 24(9); 2074–81. ©2018 AACR.
Uso de registro informatizado de imunização na vigilância de eventos adversos pós-vacina
Authors: Sato Ana Paula Sayuri , Ferreira Vinícius Leati de Rossi , Tauil Márcia de Cantuária , Rodrigues Laura Cunha , Barros Mariana Bernardes , Martineli Edmar , Costa Ângela Aparecida , Inenami Marta , Waldman Eliseu Alves 
Published: February 2018

OBJETIVO: Descrever os eventos adversos pós-vacina ocorridos em crianças com até dois anos de idade e analisar a tendência desses eventos, entre 2000 e 2013, em Araraquara, SP, Brasil. MÉTODOS: Estudo descritivo com dados da vigilância passiva de eventos adversos pós-vacina, disponíveis no registro informatizado de imunização do prontuário eletrônico do serviço municipal de saúde (Sistema Juarez). As variáveis de estudo foram: idade, sexo, vacina, dose, manifestações clínicas e hospitalização. As taxas foram estimadas tomando-se os casos de eventos adversos pós-vacina como numerador e as doses aplicadas, como denominador. Estimou-se a sensibilidade da vigilância de eventos adversos pós-vacina aplicando-se o método proposto pelo Centers for Disease Control and Prevention. Para análise de tendência utilizou-se a regressão de Prais-Winsten, considerando o nível de significância de 5,0%. RESULTADOS: A taxa anual média de eventos adversos pós-vacina foi de 11,3/10.000 doses aplicadas, porém, sem tendência no período estudado (p = 0,491). Houve predomínio de casos após a primeira dose (41,7%) e entre menores de um ano de idade (72,6%). As vacinas com componente pertussis, de febre amarela e de sarampo-caxumba-rubéola foram as mais reatogênicas. Destacou-se a frequência de episódio hipotônico hiporresponsivo e convulsão, com taxas de 4,1/10.000 e 1,5/10.000 doses de vacinas com componente pertussis, respectivamente, mais elevadas na primeira dose; 60,0% dos casos apresentaram sintomas nas primeiras 24 horas após a vacinação e 18,6% apresentaram-se após 96 horas. A sensibilidade da vigilância foi estimada em 71,9% e 78,9% para episódio hipotônico hiporresponsivo e convulsão, respectivamente. CONCLUSÕES: O sistema de vigilância de eventos adversos pós-vacina com base no registro informatizado de imunização mostrou-se útil e dotado de elevada sensibilidade para descrever o perfil de segurança das vacinas em um município de médio porte. Adicionalmente, a expressiva ampliação, na última década, das vacinas incluídas no esquema básico de vacinação na infância não alterou o elevado padrão de segurança do Programa Nacional de Imunizações.
Cytosolic DNA Sensing Promotes Macrophage Transformation and Governs Myocardial Ischemic Injury
Authors: Cao Dian J. , Schiattarella Gabriele G. , Villalobos Elisa , Jiang Nan , May Herman I. , Li Tuo , Chen Zhijian J. , Gillette Thomas G. , Hill Joseph A. 
Published: February 2018

Background:
Myocardium irreversibly injured by ischemic stress must be efficiently repaired to maintain tissue integrity and contractile performance. Macrophages play critical roles in this process. These cells transform across a spectrum of phenotypes to accomplish diverse functions ranging from mediating the initial inflammatory responses that clear damaged tissue to subsequent reparative functions that help rebuild replacement tissue. Although macrophage transformation is crucial to myocardial repair, events governing this transformation are poorly understood.

Methods:
Here, we set out to determine whether innate immune responses triggered by cytoplasmic DNA play a role.

Results:
We report that ischemic myocardial injury, along with the resulting release of nucleic acids, activates the recently described cyclic GMP-AMP synthase–stimulator of interferon genes pathway. Animals lacking cyclic GMP-AMP synthase display significantly improved early survival after myocardial infarction and diminished pathological remodeling, including ventricular rupture, enhanced angiogenesis, and preserved ventricular contractile function. Furthermore, cyclic GMP-AMP synthase loss of function abolishes the induction of key inflammatory programs such as inducible nitric oxide synthase and promotes the transformation of macrophages to a reparative phenotype, which results in enhanced repair and improved hemodynamic performance.

Conclusions:
These results reveal, for the first time, that the cytosolic DNA receptor cyclic GMP-AMP synthase functions during cardiac ischemia as a pattern recognition receptor in the sterile immune response. Furthermore, we report that this pathway governs macrophage transformation, thereby regulating postinjury cardiac repair. Because modulators of this pathway are currently in clinical use, our findings raise the prospect of new treatment options to combat ischemic heart disease and its progression to heart failure.
Embryonic exposure of chicken chicks (Gallus gallus domesticus) leads to heightened sensitivities towards the exposed scent
Authors: Hughes Ryan , Cunningham Gregory B. 
Published: February 2018

Abstract
In chickens, food consumption can be altered by exposing the chicks to scents as embryos. We exposed eggs to an orange-scented food additive in the final days of incubation. Following hatching, we tested these exposed chicks’ ability to detect this scent at a variety of concentrations. We found that orange-exposed chicks responded to an orange-scented solution at lower concentrations than control chicks. This sensitization may allow chicks to be more effective at locating acceptable food items but requires further testing to determine its significance. Orange-exposed and control chicks were also tested with the scent of raspberry. Orange-exposed chicks responded to the raspberry presentation significantly more than the control chicks did, suggesting that the embryonic exposure to orange may have influenced how the chicks responded towards another fruity smell. This result suggests that chicks may be learning general characteristics of exposed scents while in the egg, though this needs further research.
Protecting Outstanding Underwater Cultural Heritage through the World Heritage Convention: The Titanic and Lusitania as World Heritage Sites
Authors: Martin Josh B. 
Published: February 2018

Abstract
Despite growing recognition of the global value of underwater cultural heritage (uch), along with intensified international efforts to ensure its protection, the possibility of its inscription on the World Heritage List has never been comprehensively examined. Arguing that the unesco 2001 Convention on the Protection of Underwater Cultural Heritage (uch Convention) is insufficient alone to protect globally outstanding wrecks, such as the Titanic and the Lusitania, this article examines in detail the many legal and practical challenges involved with listing such sites under the World Heritage Convention. By reviewing key international agreements such as the uch Convention, World Heritage Convention, Law of the Sea Convention and the International Titanic Agreement, it draws the conclusion that it is the improved offshore management of uch—through ‘cultural’ marine protected areas operating under the framework of the uch Convention—which would open the possibility of nomination to the World Heritage List.
Understanding Model-Based Probable Maximum Precipitation Estimation as a Function of Location and Season from Atmospheric Reanalysis
Authors: Chen Xiaodong , Hossain Faisal 
Published: February 2018

Abstract
Extreme precipitation events bring huge societal and economic loss around the world every year, and they have undergone spatially heterogeneous changes in the past half-century. They are fundamental to probable maximum precipitation (PMP) estimation in engineering practice, making it important to understand how extreme storm magnitudes are related to key meteorological conditions. However, there is currently a lack of information that can potentially inform the engineering profession on the controlling factors for PMP estimation. In this study, the authors present a statistical analysis of the relationship between extreme 3-day precipitation and atmospheric instability, moisture availability, and large-scale convergence over the continental United States (CONUS). The analysis is conducted using the North America Regional Reanalysis (NARR) and ECMWF ERA-Interim reanalysis data and a high-resolution regional climate simulation. While extreme 3-day precipitation events across the CONUS are mostly related to vertical velocity and moisture availability, those in the southwestern U.S. mountain regions are also controlled by atmospheric instability. Vertical velocity and relative humidity have domainwide impacts, while no significant relationship is found between extreme precipitation and air temperature. Such patterns are stable over different seasons and extreme precipitation events of various durations between 1 and 3 days. These analyses can directly help in configuring the numerical models for PMP estimation at a given location for a given storm.
Marginalised young people’s healthcare journeys: Professionals’ perspectives
Authors: Robards Fiona , Kang Melissa , Tolley Kate , Hawke Catherine , Sanci Lena , Usherwood Tim 
Published: February 2018

Introduction: The pursuit of social justice includes a commitment to health equity for marginalised young people. Health professionals are central to marginalised young people’s engagement and access to health care and their navigation of health systems. They are also uniquely positioned to shed insight into structures and inefficiencies within the health system, including the role of technology, and to advocate for system change. Methods: This qualitative cross-sectional study employed in-depth semi-structured interviews with 22 health service managers and experienced clinicians to better understand service providers’ perspectives. The sampling frame comprised professionals from different sectors and levels of the health system. Analysis used Grounded Theory methods. Results: Three major themes were identified in the data: (1) intersectionalities – understanding the complexity of multiple disadvantage; (2) health system fragmentation – leading to inefficiencies, inertia and advocacy; and (3) services needing to be ‘turned on their head’ – rethinking service delivery and models of care. Conclusion: A better understanding of marginalised young people’s healthcare experiences, including the complexities of multiple disadvantage, and how this contributes to health inequalities could lead to more welcoming and respectful services. Services can reconceptualise their roles by reaching out to young people, both physically and online, to make the navigation of the health system easier. Marginalised young people’s healthcare journeys can be supported by advocates that help them navigate the health system.
Professional liability of the Psychiatric Nurse
Authors: Andrade Pamela D. , Andrade John C. 
Published: February 2018

Medical malpractice is an increasing problem for members of the health care professions. Nurses have, up to this point, been excluded from much of the litigations surrounding malpractice. Since making strides in upgrading their profession, nurses should be finding themselves held more accountable for their professional practice and thus, will be involved in malpractice claims. There are no guidelines for liability of the psychiatric nurse; it is developed by investigating cases and facts surrounding psychiatric and nonpsychiatric nurses. Since nurses are functioning in expanded roles of practice, it is recommended that nurses secure malpractice insurance for their own protection.
The Negotiation of Voluntary Admission in Chicago's State Mental Hospitals
Authors: Reed Susan C. , Lewis Dan A. 
Published: February 2018

This study examines the admission of emergency certified patients to Chicago's state mental hospitals and the process by which patients decide to sign a voluntary admission form. Involuntary commitment is rarely used to admit Chicago's state mental patients. Patients, staff and court personnel negotiate with a common interest in avoiding commitment court. Hospital staff use three different strategies to convince emergency certified patients to admit themselves voluntarily and avoid involuntary commitment: persuasion/coercion, bartering and stalling. Similar strategies are employed to discourage voluntary patients’ requests for release. Hospital staff in Chicago are disinclined to commit patients because they feel pressured to discharge the majority of patients as quickly as possible to make room for a steady flow of new admissions. Workers manage their caseload by choosing the most expedient form of admission, which is to obtain their patients’ signatures on a voluntary admission form. In order to accomplish this task, however, hospital staff sometimes circumvent legal standards of voluntariness in the admission process.
The incompatibility of healthcare services and end-of-life needs in advanced liver disease: A qualitative interview study of patients and bereaved carers
Authors: Hudson Benjamin , Hunt Victoria , Waylen Andrea , McCune Catherine Anne , Verne Julia , Forbes Karen 
Published: February 2018

Background: Liver disease represents the third commonest cause of death in adults of working age and is associated with an extensive illness burden towards the end of life. Despite this, patients rarely receive palliative care and are unlikely to be involved in advance care planning discussions. Evidence addressing how existing services meet end-of-life needs, and exploring attitudes of patients and carers towards palliative care, is lacking. Aim: To explore the needs of patients and carers with liver disease towards the end of life, evaluate how existing services meet need, and examine patient and carer attitudes towards palliative care. Design: Qualitative study – semi-structured interviews analysed using thematic analysis. Settings/participants: A total of 17 participants (12 patients, 5 bereaved carers) recruited from University Hospitals Bristol. Results: Participants described escalating physical, psychological and social needs as liver disease progressed, including disabling symptoms, emotional distress and uncertainty, addiction, financial hardship and social isolation. End-of-life needs were incompatible with the healthcare services available to address them; these were heavily centred in secondary care, focussed on disease modification at the expense of symptom control and provided limited support after curative options were exhausted. Attitudes towards palliative care were mixed, however, participants valued opportunities to express future care preferences (particularly relating to avoidance of hospital admission towards the end of life) and an increased focus on symptomatic and logistical aspects of care. Conclusion: The needs of patients with liver disease and their carers are frequently incompatible with the healthcare services available to them towards the end of life. Novel strategies, which recognise the life-limiting nature of liver disease explicitly and improve coordination with community services, are required if end-of-life care is to improve.
Financial Incentives for Chronic Disease Management: Results and Limitations of 2 Randomized Clinical Trials With New York Medicaid Patients
Authors: VanEpps Eric M. , Troxel Andrea B. , Villamil Elizabeth , Saulsgiver Kathryn A. , Zhu Jingsan , Chin Jo-Yu , Matson Jacqueline , Anarella Joseph , Roohan Patrick , Gesten Foster , Volpp Kevin G. 
Published: February 2018

Purpose: To identify whether financial incentives promote improved disease management in Medicaid recipients diagnosed with hypertension or diabetes, respectively. Design: Four-group, multicenter, randomized clinical trials. Setting and Participants: Between 2013 and 2016, New York State Medicaid managed care members diagnosed with hypertension (N = 920) or with diabetes (N = 959). Intervention: Participants in each 6-month trial were randomly assigned to 1 of 4 arms: (1) process incentives—earned by attending primary care visits and/or receiving prescription medication refills, (2) outcome incentives—earned by reducing systolic blood pressure (hypertension) or hemoglobin A1c (HbA1c; diabetes) levels, (3) combined process and outcome incentives, and (4) control (no incentives). Measures: Systolic blood pressure (hypertension) and HbA1c (diabetes) levels, primary care visits, and medication prescription refills. Analysis and Results: At 6 months, there were no statistically significant differences between intervention arms and the control arm in the change in systolic blood pressure, P = .531. Similarly, there were no significant differences in blood glucose control (HbA1c) between the intervention arms and control after 6 months, P = .939. The majority of participants had acceptable systolic blood pressure (<140 mm Hg) or blood glucose (<8.0%) levels at baseline and throughout the study. Conclusion: Financial incentives—regardless of whether they were delivered based on disease-relevant outcomes, process activities, or a combination of the two—have a negligible impact on health outcomes for Medicaid recipients diagnosed with either hypertension or diabetes in 2 studies in which, among other design and operational limitations, the majority of recipients had relatively well-controlled diseases at the time of enrollment.
Successful Phenobarbital Desensitization After DRESS Reaction in the Management of Refractory Status Epilepticus
Authors: Witcher Robert H. , Ramirez Michelle M. 
Published: February 2018

Purpose: Drug reaction with eosinophilia and systemic symptoms (DRESS) is associated with antiepileptic drug use and is a rare but life-threatening side effect. We present a case of phenobarbital-induced DRESS in a patient who subsequently required phenobarbital and was successfully desensitized. Summary: A 5-year-old male presented with medically refractory status epilepticus (SE). He had been trialed on several antiepileptic medications without achieving burst suppression. Burst suppression was achieved with a pentobarbital infusion, and thus, phenobarbital was initiated as the pentobarbital was weaned. After five days of phenobarbital, the patient developed signs and symptoms concerning for DRESS; a punch biopsy confirmed the drug reaction. Two months later, he again developed SE unresponsive to antiepileptic infusions. Burst suppression was achieved with pentobarbital, and it was decided to transition the patient to phenobarbital. Due to concerns of phenobarbital-induced DRESS, the patient underwent a phenobarbital desensitization consisting of 6 doses sequentially administered in 10-fold increasing concentrations before achieving therapeutic dosing. Three days later, the patient achieved therapeutic phenobarbital levels, was weaned off of pentobarbital, and remained seizure-free without recurrence of DRESS. Conclusions: Graded desensitization may be an option to minimize recurrence of DRESS in patients where avoidance of the offending agent is not possible.
Using modified early warning score to predict need of lifesaving intervention in adult non‐trauma patients in a tertiary state hospital
Authors: Peng Leong Shian , Hassan Azhana , Bustam Aida , Noor Azhar Muhaimin , Ahmad Rashidi 
Published: February 2018

Background:Modified early warning score has been validated in many uses in the emergency department. We propose that the modified early warning score performs well in predicting the need of lifesaving interventions in the emergency department, as a predictor of patients who are critically ill.Objective:The study aims to evaluate the use of modified early warning score in sorting out critically ill patients in the emergency department.Methods:The patients’ demographic data and first vital signs (blood pressure, heart rate, temperature, respiratory rate, and level of consciousness) were collected prospectively. Individual modified early warning score was calculated. The outcome was a patient received one or more lifesaving interventions toward the end of stay in emergency department. Multivariate logistic regression analysis was utilized to assess the association between modified early warning score and other potential predictors with outcome.Results:There are a total of 259 patients enrolled into the study. The optimal modified early warning score in predicting lifesaving intervention was ≥4 with a sensitivity of 95% and specificity of 81%. Modified early warning score ≥4 (odds ratio = 96.97, 95% confidence interval = 11.82–795.23, p < 0.001) was found to significantly increase the risk of receiving lifesaving intervention in the emergency department.Conclusion:Modified early warning score is found to be a good predictor for patients in need of lifesaving intervention in the emergency department.