bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring the roots of unintended safety threats associated with the introduction of hospital ePrescribing systems and candidate avoidance and/or mitigation strategies: a qualitative study
Authors: Mozaffar Hajar , Cresswell Kathrin M , Williams Robin , Bates David W , Sheikh Aziz 
Published: February 2017

ObjectiveHospital electronic prescribing (ePrescribing) systems offer a wide range of patient safety benefits. Like other hospital health information technology interventions, however, they may also introduce new areas of risk. Despite recent advances in identifying these risks, the development and use of ePrescribing systems is still leading to numerous unintended consequences, which may undermine improvement and threaten patient safety. These negative consequences need to be analysed in the design, implementation and use of these systems. We therefore aimed to understand the roots of these reported threats and identify candidate avoidance/mitigation strategies.MethodsWe analysed a longitudinal, qualitative study of the implementation and adoption of ePrescribing systems in six English hospitals, each being conceptualised as a case study. Data included semistructured interviews, observations of implementation meetings and system use, and a collection of relevant documents. We analysed data first within and then across the case studies.ResultsOur dataset included 214 interviews, 24 observations and 18 documents. We developed a taxonomy of factors underlying unintended safety threats in: (1) suboptimal system design, including lack of support for complex medication administration regimens, lack of effective integration between different systems, and lack of effective automated decision support tools; (2) inappropriate use of systems—in particular, too much reliance on the system and introduction of workarounds; and (3) suboptimal implementation strategies resulting from partial roll-outs/dual systems and lack of appropriate training. We have identified a number of system and organisational strategies that could potentially avoid or reduce these risks.ConclusionsImperfections in the design, implementation and use of ePrescribing systems can give rise to unintended consequences, including safety threats. Hospitals and suppliers need to implement short- and long-term strategies in terms of the technology and organisation to minimise the unintended safety risks.
Magnetic resonance spectroscopy of current hand amputees reveals evidence for neuronal-level changes in former sensorimotor cortex
Authors: Cirstea Carmen M. , Choi In-Young , Lee Phil , Peng Huiling , Kaufman Christina L. , Frey Scott H. 
Published: February 2017

Deafferentation is accompanied by large-scale functional reorganization of maps in the primary sensory and motor areas of the hemisphere contralateral to injury. Animal models of deafferentation suggest a variety of cellular-level changes including depression of neuronal metabolism and even neuronal death. Whether similar neuronal changes contribute to patterns of reorganization within the contralateral sensorimotor cortex of chronic human amputees is uncertain. We used functional MRI-guided proton magnetic resonance spectroscopy to test the hypothesis that unilateral deafferentation is associated with lower levels of N-acetylaspartate (NAA, a putative marker of neuronal integrity) in the sensorimotor hand territory located contralateral to the missing hand in chronic amputees ( n = 19) compared with the analogous hand territory of age- and sex-matched healthy controls ( n = 28). We also tested whether former amputees [i.e., recipients of replanted ( n = 3) or transplanted ( n = 2) hands] exhibit NAA levels that are indistinguishable from controls, possible evidence for reversal of the effects of deafferentation. As predicted, relative to controls, current amputees exhibited lower levels of NAA that were negatively and significantly correlated with the time after amputation. Contrary to our prediction, NAA levels in both replanted and transplanted patients fell within the range of the current amputees. We suggest that lower levels of NAA in current amputees reflects altered neuronal integrity consequent to chronic deafferentation. Thus local changes in NAA levels may provide a means of assessing neuroplastic changes in deafferented cortex. Results from former amputees suggest that these changes may not be readily reversible through reafferentation. NEW & NOTEWORTHY This study is the first to use functional magnetic resonance-guided magnetic resonance spectroscopy to examine neurochemical mechanisms underlying functional reorganization in the primary somatosensory and motor cortices consequent to upper extremity amputation and its potential reversal through hand replantation or transplantation. We provide evidence for selective alteration of cortical neuronal integrity associated with amputation-related deafferentation that may not be reversible.
Impaired auditory-to-motor entrainment in Parkinson’s disease
Authors: te Woerd Erik S. , Oostenveld Robert , de Lange Floris P. , Praamstra Peter 
Published: February 2017

Several electrophysiological studies suggest that Parkinson's disease (PD) patients have a reduced tendency to entrain to regular environmental patterns. Here we investigate whether this reduced entrainment concerns a generalized deficit or is confined to movement-related activity, leaving sensory entrainment intact. Magnetoencephalography was recorded during a rhythmic auditory target detection task in 14 PD patients and 14 control subjects. Participants were instructed to press a button when hearing a target tone amid an isochronous sequence of standard tones. The variable pitch of standard tones indicated the probability of the next tone to be a target. In addition, targets were occasionally omitted to evaluate entrainment uncontaminated by stimulus effects. Response times were not significantly different between groups and both groups benefited equally from the predictive value of standard tones. Analyses of oscillatory beta power over auditory cortices showed equal entrainment to the tones in both groups. By contrast, oscillatory beta power and event-related fields demonstrated a reduced engagement of motor cortical areas in PD patients, expressed in the modulation depth of beta power, in the response to omitted stimuli, and in an absent motor area P300 effect. Together, these results show equally strong entrainment of neural activity over sensory areas in controls and patients, but, in patients, a deficient translation of the adjustment to the task rhythm to motor circuits. We suggest that the reduced activation reflects not merely altered resonance to rhythmic external events, but a compromised recruitment of an endogenous response reflecting internal rhythm generation. NEW & NOTEWORTHY Previous studies suggest that motor cortical activity in PD patients has a reduced tendency to entrain to regular environmental patterns. This study demonstrates that the deficient entrainment in PD concerns the motor system only, by showing equally strong entrainment of neural activity over sensory areas in controls and patients but, in patients, a deficient translation of this adjustment to the task rhythm to motor circuits.
Circular RNA ciRS-7—A Promising Prognostic Biomarker and a Potential Therapeutic Target in Colorectal Cancer
Authors: Weng Wenhao , Wei Qing , Toden Shusuke , Yoshida Kazuhiro , Nagasaka Takeshi , Fujiwara Toshiyoshi , Cai Sanjun , Qin Huanlong , Ma Yanlei , Goel Ajay 
Published: February 2017

Abstract
Purpose: Colorectal cancer is one of the most common malignancies worldwide. Recently, a novel circular RNA, ciRS-7, was proposed to be a potential miR-7 sponge. As miR-7, a putative tumor-suppressor, regulates the expression of several important drivers of colorectal cancer, we analyzed the clinical significance of ciRS-7 in colorectal cancer patients.
Experimental Design: Initially, we evaluated the expression levels of ciRS-7 in a training cohort comprising of 153 primary colorectal cancer tissues and 44 matched normal mucosae. We subsequently confirmed its clinical relevance in an independent validation cohort (n = 165), and evaluated the effect of ciRS-7 on miR-7, and its target genes EGFR and RAF1. Functional analyses were performed in cell lines and an animal model to support clinical findings.
Results: Our data revealed that ciRS-7 was significantly upregulated in colorectal cancer tissues compared with matched normal mucosae (P = 0.0018), and its overexpression was associated with poor patient survival (P = 0.0224 and 0.0061 in the training and validation cohorts, respectively). Multivariate survival analysis revealed that ciRS-7 emerged as an independent risk factor for overall survival (P = 0.0656 and 0.0324 in the training and validation cohorts, respectively). Overexpression of ciRS-7 in HCT116 and HT29 cells led to the blocking of miR-7 and resulted in a more aggressive oncogenic phenotype, and ciRS-7 overexpression permitted the inhibition of miR-7 and subsequent activation of EGFR and RAF1 oncogenes.
Conclusions: CiRS-7 is a promising prognostic biomarker in colorectal cancer patients and may serve as a therapeutic target for reducing EGFR-RAF1 activity in colorectal cancer patients. Clin Cancer Res; 23(14); 3918–28. ©2017 AACR.
The APC/C E3 Ligase Complex Activator FZR1 Restricts BRAF Oncogenic Function
Authors: Wan Lixin , Chen Ming , Cao Juxiang , Dai Xiangpeng , Yin Qing , Zhang Jinfang , Song Su-Jung , Lu Ying , Liu Jing , Inuzuka Hiroyuki , Katon Jesse M. , Berry Kelsey , Fung Jacqueline , Ng Christopher , Liu Pengda , Song Min Sup , Xue Lian , Bronson Roderick T. , Kirschner Marc W. , Cui Rutao , Pandolfi Pier Paolo , Wei Wenyi 
Published: February 2017

AbstractBRAF drives tumorigenesis by coordinating the activation of the RAS/RAF/MEK/ERK oncogenic signaling cascade. However, upstream pathways governing BRAF kinase activity and protein stability remain undefined. Here, we report that in primary cells with active APCFZR1, APCFZR1 earmarks BRAF for ubiquitination-mediated proteolysis, whereas in cancer cells with APC-free FZR1, FZR1 suppresses BRAF through disrupting BRAF dimerization. Moreover, we identified FZR1 as a direct target of ERK and CYCLIN D1/CDK4 kinases. Phosphorylation of FZR1 inhibits APCFZR1, leading to elevation of a cohort of oncogenic APCFZR1 substrates to facilitate melanomagenesis. Importantly, CDK4 and/or BRAF/MEK inhibitors restore APCFZR1 E3 ligase activity, which might be critical for their clinical effects. Furthermore, FZR1 depletion cooperates with AKT hyperactivation to transform primary melanocytes, whereas genetic ablation of Fzr1 synergizes with Pten loss, leading to aberrant coactivation of BRAF/ERK and AKT signaling in mice. Our findings therefore reveal a reciprocal suppression mechanism between FZR1 and BRAF in controlling tumorigenesis.Significance: FZR1 inhibits BRAF oncogenic functions via both APC-dependent proteolysis and APC-independent disruption of BRAF dimers, whereas hyperactivated ERK and CDK4 reciprocally suppress APCFZR1 E3 ligase activity. Aberrancies in this newly defined signaling network might account for BRAF hyperactivation in human cancers, suggesting that targeting CYCLIN D1/CDK4, alone or in combination with BRAF/MEK inhibition, can be an effective anti-melanoma therapy. Cancer Discov; 7(4); 424–41. ©2017 AACR.See related commentary by Zhang and Bollag, p. 356.This article is highlighted in the In This Issue feature, p. 339
Modified SVPWM Algorithm for 3-level Inverter Fed DTC Induction Motor Drive
Authors: Swamy G. Kumara , Obulesu YP 
Published: February 2017

In this paper, a modified space vector pulse width modulation (MSVPWM) algorithm is developed for 3-level inverter fed direct torque controlled induction motor drive (DTC-IMD). MSVPWM algorithm simplifies conventional space vector pulse width modulation (CSVPWM) algorithm for multilevel inverter(MLI), whose complexity lies in sector/subsector/sub-subsector identification; which will commensurate with number of levels. In the proposed algorithm sectors are identified as in two level inverter and subsectors/sub-subsectors are identified by shifting the original reference vector to sector 1 (S1). This is valid due to the fact that a three level space vector plane is a composition of six two level space planes, and are symmetrical with reference to six pivot states. Switching state/sequence selection is also very important while dealing with SVPWM strategy for MLI. In the proposed algorithm out of 27 available switching states apt switching state is selected based on sector and subsector number, such that voltage ripple is considerably less. To validate the proposed algorithm, it is tested on a three level neutral point clamped (NPC) inverter fed DTC-IMD. The performance of the MSVPWM algorithm is analyzed by comparing no load stator current ripple of the three level DTC-IMD with two level DTC-IMD. Significant reduction in steady state torque and flux ripple is observed. Hence, reduced acoustic noise is a distinctive facet of the proposed method.
Performance and Energy Saving Analysis of Grid Connected Photovoltaic in West Sumatera
Authors: Ghazali Syafii , Nazir Refdinal 
Published: February 2017

<p>The paper presents performance and energy saving analysis of 1.25 kWp grid connected Photovoltaic system under difference weather condition in West Sumatera. The measured data were performed during weather data that often occur in West Sumatra i.e. sunny, overcast, raining and cloudy. The synchronizing process successfully done even bad weather conditions when sunlight was low automatically. Photovoltaic in average start producing power from 7:00 AM to 6:00 PM for normal or clear sky, however under overcast, raining and cloudy weather, the PV power decreased and disconnected earlier before sunset. During intermittent raining, overcast and cloud covered the PV power output show an irregular profile. The PV energy saving performed for three residential connection cases: 1300 VA, 900 VA with subsidized and 900 VA without subsidized. The solar PV installation have more benefits and energy saving for 1300 VA, 900 VA without subsidized with payback period around 8.5 years. However, the 900 VA with subsidized take longer 20.8 years, but still in PV lifespan 25 years. In the future, household subsidies may be reduced or eliminated, the solar energy will be viable alternative of energy resources when it can produce electricity at a cost equivalent to utility grid PLN rate. </p>
Modelling of Virtual Synchronous Converter for Grid-inverter Synchronization in Microgrids Applications
Authors: Amin Md. Ruhul , Zulkifli Shamsul Aizam 
Published: February 2017

<span lang="EN-US">In this paper, virtual synchronous converter (VSCon) is modelled which behaves as synchronous generator including its all real-time characteristics in operating inverter. This VSCon is used to synchronize grid and inverter while integrating distributed generated power to microgrids. The frequency and voltage synchronization can be controlled by using synchronous generator mathematical model is installed into the inverter. The whole unit of VSCon operated is simulated in Matlab/Simulink for observing all consequences for synchronizing voltage, frequency and phase-angle. It is verified that the next generation energy resources can be integrated into microgrid making synchronization grid-inverter using VSCon. The simulation results are given to verify the concept of modelling VSCon functioning inverter as a synchronous generator. </span>
Modified Distribution Transformer for Enhancing Power Quality in Distribution Systems
Authors: P.K. Preetha , Chandramohanan Nair P.S. 
Published: February 2017

<p>The percentage of non-linear loads in the power distribution sector is increasing day by day. Harmonics injected by these non-linear loads circulate in the delta windings of the conventional distribution transformer thereby increasing the temperature and losses. This reduces the efficiency and life of the transformers. In a modified distribution transformer configuration proposed recently, called star-star-delta_utilized configuration (YYD_utilized), the harmonics circulating in the delta winding was utilized and the drainage power thus recovered was used to power auxiliary loads. This paper presents the experimental studies conducted on YYD_utilized distribution transformer. When compared to conventional star-star, delta-star and star-star-delta transformers, the new configuration of YYD_utilized transformer has shown considerable improvement in transformer efficiency. The results obtained show that when the power from the circulating harmonics is recovered and utilized, it not only improves transformer efficiency but also improves the power factor and reduces the harmonic distortions at the primary side of the transformer. The results obtained also suggest the existence of maximum power point or an optimum loading for the recovered harmonic power.</p>
Prognostic Value of Right Ventricular Ejection Fraction Assessed by Transthoracic 3D Echocardiography
Authors: Nagata Yasufumi , Wu Victor Chien-Chia , Kado Yuichiro , Otani Kyoko , Lin Fen-Chiung , Otsuji Yutaka , Negishi Kazuaki , Takeuchi Masaaki 
Published: February 2017

Background—
Cardiac magnetic resonance is the gold standard for the evaluation of right ventricular (RV) volumes, but it is impractical to perform in every patient. Although reference values of RV volumes and RV ejection fraction by 3D transthoracic echocardiography (3DTTE) have been established, their prognostic values have not been elucidated yet. We hypothesized that RV ejection fraction measured by 3DTTE (3DRVEF) predicts future cardiovascular events.

Methods and Results—

In protocol 1, we determined the accuracy of RV volumes and RV ejection fraction measurements by 3DTTE against cardiac magnetic resonance in 60 subjects. In protocol 2, 3DRVEF was measured in 446 patients with various cardiovascular diseases. Study subjects were followed up to record cardiac death and major adverse cardiovascular events. In protocol 1, 3DTTE-determined RV end-diastolic volume, end-systolic volume, and RV ejection fraction had good correlations to those by cardiac magnetic resonance (
r
=0.74–0.90). In protocol 2, 38 cardiac deaths and 88 major adverse cardiovascular events occurred during a median follow-up of 4.1 years. Univariable Cox proportional analysis revealed that 3DRVEF was associated with both cardiac death (
P
<0.0001) and major adverse cardiovascular event (
P
<0.0001). 3DRVEF remained as an independent predictor for cardiac death (
P
<0.0001) and major adverse cardiovascular event (
P
<0.0001) even in a stepwise multivariable Cox proportional hazard analysis. Classification and regression-tree analysis demonstrated that 3DRVEF played an important role for risk stratification.

Conclusions—
3DTTE-determined RV ejection fraction was independently associated with cardiac outcomes in patients with diverse backgrounds. 3DRVEF offered incremental value over clinical risk factors and the other echocardiographic parameters including left ventricular systolic and diastolic function for predicting future adverse outcome.
Intravenous Thrombolysis in Unknown-Onset Stroke
Authors: Dorado Laura , Ahmed Niaz , Thomalla Götz , Lozano Manuel , Malojcic Branko , Wani Mushtaq , Millán Mònica , Tomek Ales , Dávalos Antoni 
Published: February 2017

Background and Purpose—
Stroke patients with unknown onset (UKO) are excluded from thrombolytic therapy. We aim to study the safety and efficacy of intravenous alteplase in ischemic stroke patients with UKO of symptoms compared with those treated within 4.5 hours in a large cohort.

Methods—
Data were analyzed from 47 237 patients with acute ischemic stroke receiving intravenous tissue-type plasminogen activator in hospitals participating in the Safe Implementation of Treatment in Stroke-International Stroke Thrombolysis Registry between 2010 and 2014. Two groups were defined: (1) patients with UKO (n=502) and (2) patients treated within 4.5 hours of stroke onset (n=44 875). Outcome measures were symptomatic intracerebral hemorrhage per Safe Implementation of Treatment in Stroke on the 22 to 36 hours post-treatment neuroimaging and mortality and functional outcome assessed by the modified Rankin Scale at 3 months.

Results—
Patients in UKO group were significantly older, had more severe stroke at baseline, and longer door-to-needle times than patients in the ≤4.5 hours group. Logistic regression showed similar risk of symptomatic intracerebral hemorrhage (adjusted odds ratio, 1.09; 95% confidence interval, 0.44–2.67) and no significant differences in functional independency (modified Rankin Scale score of 0–2; adjusted odds ratio, 0.79; 95% confidence interval, 0.56–1.10), but higher mortality (adjusted odds ratio, 1.58; 95% confidence interval, 1.04–2.41) in the UKO group compared with the ≤4.5 hours group. Patients treated within 4.5 hours showed reduced disability over the entire range of modified Rankin Scale compared with the UKO group (common adjusted odds ratio, 1.29; 95% confidence interval, 1.01–1.65).

Conclusions—
Our data suggest no excess risk of symptomatic intracerebral hemorrhage but increased mortality and reduced favorable outcome in patients with UKO stroke compared with patients treated within the approved time window.
Modeling Evapotranspiration over China’s Landmass from 1979 to 2012 Using Multiple Land Surface Models: Evaluations and Analyses
Authors: Sun Shaobo , Chen Baozhang , Shao Quanqin , Chen Jing , Liu Jiyuan , Zhang Xue-jun , Zhang Huifang , Lin Xiaofeng 
Published: February 2017

Abstract
Land surface models (LSMs) are useful tools to estimate land evapotranspiration at a grid scale and for long-term applications. Here, the Community Land Model, version 4.0 (CLM4.0); Dynamic Land Model (DLM); and Variable Infiltration Capacity model (VIC) were driven with observation-based forcing datasets, and a multiple-LSM ensemble-averaged evapotranspiration (ET) product (LSMs-ET) was developed and its spatial–temporal variations were analyzed for the China landmass over the period 1979–2012. Evaluations against measurements from nine flux towers at site scale and surface water budget–based ET at regional scale showed that the LSMs-ET had good performance in most areas of China’s landmass. The intercomparisons between the ET estimates and the independent ET products from remote sensing and upscaling methods suggested that there were fairly consistent patterns between each dataset. The LSMs-ET produced a mean annual ET of 351.24 ± 10.7 mm yr−1 over 1979–2012, and its spatial–temporal variation analyses showed that (i) there was an overall significant ET increasing trend, with a value of 0.72 mm yr−1 (p &lt; 0.01), and (ii) 36.01% of Chinese land had significant increasing trends, ranging from 1 to 9 mm yr−1, while only 6.41% of the area showed significant decreasing trends, ranging from −6.28 to −0.08 mm yr−1. Analyses of ET variations in each climate region clearly showed that the Tibetan Plateau areas were the main contributors to the overall increasing ET trends of China.