bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serial assessment of the index of microcirculatory resistance during primary percutaneous coronary intervention comparing manual aspiration catheter thrombectomy with balloon angioplasty (IMPACT study): a randomised controlled pilot study
Authors: Hoole Stephen P , Jaworski Catherine , Brown Adam J , McCormick Liam M , Agrawal Bobby , Clarke Sarah C , West Nick E J 
Published: May 2015

ObjectiveUtilising a novel study design, we evaluated serial measurements of the index of microcirculatory resistance (IMR) in patients undergoing primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) to assess the impact of device therapy on microvascular function, and determine what proportion of microvascular injury is related to the PPCI procedure, and what is an inevitable consequence of STEMI.Design41 patients undergoing PPCI for STEMI were randomised to balloon angioplasty (BA, n=20) or manual thrombectomy (MT, n=21) prior to stenting. Serial IMR measurements, corrected for collaterals, were recorded at baseline and at each stage of the procedure. Microvascular obstruction (MVO) and infarct size at 24 h and 3 months were measured by troponin and cardiac MRI (CMR).ResultsIMR did not change significantly following PPCI, but patients with lower IMR values (<32, n=30) at baseline had a significant increase in IMR following PPCI (baseline: 21.2±7.9 vs post-stent: 33.0±23.7, p=0.01) attributable to prestent IRA instrumentation (baseline: 21.7±8.0 vs post-BA or MT: 36.9±25.9, p=0.006). Post-stent IMR correlated with early MVO on CMR (p=0.01). There was no significant difference in post-stent IMR, presence of early MVO or final infarct size between patients with BA and patients treated with MT.ConclusionsPatients with STEMI and less microcirculatory dysfunction may be susceptible to acute iatrogenic microcirculatory injury from prestent coronary devices. MT did not appear to be superior to BA in maintaining microcirculatory integrity when the guide wire partially restores IRA flow during PPCI.Trial registration numberISRCTN31767278.
Human Resource Allocation in Software Project with Practical Considerations
Authors: Park Jihun , Seo Dongwon , Hong Gwangui , Shin Donghwan , Hwa Jimin , Bae Doo-Hwan 
Published: May 2015

Software planning is very important for the success of a software project. Even if the same developers work on the same project, the time span of the project and the quality of software may change based on the project plan. When software managers plan a software project, they strive to allocate human resources in a more efficient way to produce a better software with less cost. The planning process is, however, time-consuming and complicated, especially when the size of the software project is large. Many approaches have been proposed to help software project managers by providing optimal human resource allocations in terms of minimizing the cost. Previous approaches, however, only concentrated on minimizing the cost, and no existing works have considered the practical issues affecting project schedules in practice. We elicited the practical considerations relating to the human resource allocation problem through discussions with a group of software project experts. The practical considerations can affect the project schedule in practice, but their importance has not been taken into consideration in previous approaches. Reflecting the practical considerations, we propose an approach for solving the human resource allocation problem using a genetic algorithm (GA). We compare our approach to an approach that only considers minimization of the time span. Our evaluation shows that the proposed algorithm considers the practical considerations well, in terms of continuous allocation on relevant tasks, minimization of developer multitasking time, and balance of allocation. We also conducted a survey targeting software developers and managers, and the responses showed that practical considerations are as important as minimizing the cost, and our approach would be helpful to software managers. We also investigate the effect of weight factors and coefficient between sub-scores, and find that it is difficult to consider some practical considerations at the same time.
Two Positive Solutions of Third-Order BVP with Integral Boundary Condition and Sign-Changing Green's Function
Authors: Niu Bing-Wei , Sun Jian-Ping , Ren Qiu-Yan 
Published: May 2015

We are concerned with the following third-order boundary value problem with integral boundary condition:  u′′′(t)=f(t,u(t)),  t∈[0,1],  u′(0)=u(1)=0,  u′′(η)+∫αβ‍u(t)dt=0,where1/2<α≤β≤1, α+β≤4/3, andη∈(1/2,α]. Although the corresponding Green's function is sign-changing, we still obtain the existence of at least two positive and decreasing solutions under some suitable conditions onfby using the two-fixed-point theorem due to Avery and Henderson. An example is also included to illustrate the main results obtained.
Involvement of Endoplasmic Reticulum Stress–Mediated C/EBP Homologous Protein Activation in Coxsackievirus B3–Induced Acute Viral Myocarditis
Authors: Cai Zhejun , Shen Li , Ma Hong , Yang Jin , Yang Du , Chen Han , Wei Jia , Lu Qiulun , Wang Dao Wen , Xiang Meixiang , Wang Jian’an 
Published: May 2015

Background—
This study tested the hypothesis whether endoplasmic reticulum (ER) stress/C/EBP homologous protein (CHOP) signaling is linked with coxsackievirus B3 (CVB3)–induced acute viral myocarditis (AVMC) in vivo.

Methods and Results—

AVMC was induced by intraperitoneal injection of 1000 tissue culture infectious dose (TCID
50
) of CVB3 virus in mice. In AVMC mouse hearts (n=11), ER stress and CHOP were significantly activated, and were linked to the induction of proapoptotic signaling including reduction of Bcl-2, activation of Bax and caspase 3, compared with the controls (n=10), whereas these could be markedly blocked by ER stress inhibitor tauroursodeoxycholic acid administration (n=11). Moreover, chemical inhibition of ER stress significantly attenuated cardiomyocytes apoptosis, and prevented cardiac troponin I elevation, ameliorated cardiac dysfunction assessed by both hemodynamic and echocardiographic analysis, reduced viral replication, and increased survival rate after CVB3 inoculation. We further discovered that genetic ablation of CHOP (n=10) suppressed cardiac Bcl-2/Bax ratio reduction and caspase 3 activation, and prevented cardiomyotes apoptosis in vivo, compared with wild-type receiving CVB3 inoculation (n=10). Strikingly, CHOP deficiency exhibited dramatic protective effects on cardiac damage, cardiac dysfunction, viral replication, and promoted survival in CVB3-caused AVMC.

Conclusions—
Our data imply the involvement of ER stress/CHOP signaling in CVB3-induced AVMC via proapoptotic pathways, and provide a novel strategy for AVMC treatment.
Projected Changes in Intense Precipitation over Europe at the Daily and Subdaily Time Scales*
Authors: Scoccimarro Enrico , Villarini Gabriele , Vichi Marcello , Zampieri Matteo , Fogli Pier Giuseppe , Bellucci Alessio , Gualdi Silvio 
Published: May 2015

Abstract
Heavy precipitation is a major hazard over Europe. It is well established that climate model projections indicate a tendency toward more extreme daily rainfall events. It is still uncertain, however, how this changing intensity translates at the subdaily time scales. The main goal of the present study is to examine possible differences in projected changes in intense precipitation events over Europe at the daily and subdaily (3-hourly) time scales using a state-of-the-science climate model. The focus will be on one representative concentration pathway (RCP8.5), considered as illustrative of a high rate of increase in greenhouse gas concentrations over this century. There are statistically significant differences in intense precipitation projections (up to 40%) when comparing the results at the daily and subdaily time scales. Over northeastern Europe, projected precipitation intensification at the 3-hourly scale is lower than at the daily scale. On the other hand, Spain and the western seaboard exhibit an opposite behavior, with stronger intensification at the 3-hourly scale rather than the daily scale. While the mean properties of the precipitation distributions are independent of the analyzed frequency, projected precipitation intensification exhibits regional differences. This finding has implications for the extrapolation of impacts of intense precipitation events, given the daily time scale at which the analyses are usually performed.
Strongly Coupled Data Assimilation Using Leading Averaged Coupled Covariance (LACC). Part I: Simple Model Study*
Authors: Lu Feiyu , Liu Zhengyu , Zhang Shaoqing , Liu Yun 
Published: May 2015

Abstract
This paper studies a new leading averaged coupled covariance (LACC) method for the strongly coupled data assimilation (SCDA). The SCDA not only uses the coupled model to generate the forecast and assimilate observations into multiple model components like the weakly coupled version (WCDA), but also applies a cross update using the coupled covariance between variables from different model components. The cross update could potentially improve the balance and quality of the analysis, but its implementation has remained a great challenge in practice because of different time scales between model components. In a typical extratropical coupled system, the ocean–atmosphere correlation shows a strong asymmetry with the maximum correlation occurring when the atmosphere leads the ocean by about the decorrelation time of the atmosphere. The LACC method utilizes such asymmetric structure by using the leading forecasts and observations of the fast atmospheric variable for cross update, therefore, increasing the coupled correlation and enhancing the signal-to-noise ratio in calculating the coupled covariance. Here it is applied to a simple coupled model with the ensemble Kalman filter (EnKF). With the LACC method, the SCDA reduces the analysis error of the oceanic variable by over 20% compared to the WCDA and 10% compared to the SCDA using simultaneous coupled covariance. The advantage of the LACC method is more notable when the system contains larger errors, such as in the cases with smaller ensemble size, bigger time-scale difference, or model biases.
Toward a Postmodern Chaplaincy
Authors: Sims C. Leon 
Published: May 2015

We have decided for reason against outgrown traditions and honored superstitions. That was a great and courageous decision, and it gave a new dignity to man. But we have, in that decision, excluded the soul, the ground and power of life. —Paul Tillich, The Shaking of the Foundations Explores metaphorical models for chaplaincy which yokes scientific and theological projects in an effort to stimulate dialogue regarding ways the healing arts of spirituality and the roles of chaplains may be crafted. Uses clinical case materials and theological and scientific perspectives to illustrate a vision for a postmodern chaplaincy.
Designer Genes: Three Photographs of the Future and a Call for Debate
Authors: Stone Howard W. 
Published: May 2015

Snapshot: A small, windowless doctor's examining room. A hip-high examination table in the center of the room is covered by a disposable paper sheet. Someone has painted the walls a soothing shade of mauve. At the far end of the room are a sink, a cabinet above the sink, a sterilizer and needle disposal unit on the counter top (all stainless steel). The opposite corner of the room holds a reproduction mission oak chair, the seat upholstered in leather, and a matching magazine stand. A pair of jeans and a white T-shirt hang from a row of wooden hooks above the chair. Brenda Calloway, a stylishly career-dressed woman of about fifty, sits on the chair holding a portfolio-style purse and a denim bag. Her make-up and hair are impeccable. Her daughter Samantha, age 17, sits on the end of the examining table; she is wearing a short green paper gown. Her hair is blond, straight and very long. She thumbs through an old copy of People magazine, glancing somewhat nervously at the door every few seconds. Brenda is the chief financial officer of a medium-sized restaurant supply company. Samantha is her only child, born when Brenda and her husband were in their early thirties. Brenda has high hopes for her daughter's future, for her accomplishments, and happiness. Samantha sometimes chafes under her mother's expectations, but the two have a very close relationship.
Självskattad hälsa hos äldre kvinnor och män – En tvärsnittsstudie
Authors: Westerholm Bodil , Glasberg Ann-Louise 
Published: May 2015

Background The aging population is a challenge for the health care in Finland. Disease prevention and health promotion improves the quality of life for the elderly and reduces health-care costs. Knowledge about the health of the elderly is crucial in order for improvements to be carried out. Aim The aim of this study was to describe disease prevalence and self-rated health among 65-, 70-, 75- and 80-year-old women and men in three municipalities in Ostrobothnia, Finland. Method Altogether 502 persons, out of which 274 were women, participated in the present research. The participants completed a form comprising 75 questions. Data were analysed by means of descriptive and comparative statistics. Findings The results showed that the most common national disease was hypertension, followed by cancer and diabetes. Stroke and myocardial infarction were the least frequent among the participants. Nevertheless, the majority of older people felt that their health was good. However, women stated more frequently than men that they were subject to a group named ‘other diseases’ than men, and they feared more so than men that something might happen to them. A tenth of the population felt the emptiness of life. Conclusions The results indicate that there are no gender differences in the most common national diseases but women suffer more from ‘other diseases’ and from fear although the majority of the population were satisfied with their health.
Patient Experience in a Coordinated Care Model Featuring Diabetes Self-management Education Integrated Into the Patient-Centered Medical Home
Authors: Janiszewski Debra , O’Brian Catherine A. , Lipman Ruth D. 
Published: May 2015

Purpose The purpose of this study is to gain insight about patient experience of diabetes self-management education in a patient-centered medical home. Methods Six focus groups consisting of 37 people with diabetes, diverse in race and ethnicity, were conducted at 3 sites. Participants described their experience in the program and their challenges in diabetes self-management; they also suggested services to meet their diabetes care needs. Results The most common theme was ongoing concerns about care and support. There was much discussion about the value of the support provided by health navigators integrated in the diabetes health care team. Frequent concerns expressed by participants centered on personal challenges in engaging in healthy lifestyle behaviors. Ongoing programmatic support of self-management goals was widely valued. Conclusions Individuals who received health care in a patient-centered medical home and could participate in diabetes self-management education with integrated support valued both activities. The qualitative results from this study suggest need for more formalized exploration of effective means to meet the ongoing support needs of people with diabetes.
Effectiveness of the Liverpool care pathway for the dying in residential care homes: An exploratory, controlled before-and-after study
Authors: Brännström Margareta , Fürst Carl Johan , Tishelman Carol , Petzold Max , Lindqvist Olav 
Published: May 2015

Background: Clinical pathways aim to ensure that individuals receive appropriate evidence-based care and interventions, with the Liverpool Care Pathway for the Dying Patient focusing on end of life. However, controlled studies of the Liverpool Care Pathway for the Dying Patient, particularly outside of cancer settings, are lacking. Aim: To compare the effects of the Liverpool Care Pathway for the Dying Patient and usual care on patients’ symptom distress and well-being during the last days of life, in residential care homes. Design: Exploratory, controlled before-and-after study. During a 15-month baseline, usual care was carried out in two areas. During the following 15-months, usual care continued in the control area, while residential care home staff implemented Liverpool Care Pathway for the Dying Patient use in the intervention area. The intervention was evaluated by family members completing retrospective symptom assessments after the patient’s death, using the Edmonton Symptom Assessment System and Views of Informal Carers – Evaluation of Services. Settings/participants: Patients who died at all 19 residential care homes in one municipality in Sweden. Results: Shortness of breath (estimate = −2.46; 95% confidence interval = −4.43 to −0.49) and nausea (estimate = −1.83; 95% confidence interval = −3.12 to −0.54) were significantly reduced in Edmonton Symptom Assessment System in patients in the intervention compared to the control area. A statistically significant improvement in shortness of breath was also found on the Views of Informal Carers – Evaluation of Services item (estimate = −0.47; 95% confidence interval = −0.85 to −0.08). Conclusion: When implemented with adequate staff training and support, the Liverpool Care Pathway for the Dying Patient may be a useful tool for providing end-of-life care of elderly people at the end of life in non-cancer settings.
Evaluation of the Patterns of Care Provided to Patients With COPD Compared to Patients With Lung Cancer Who Died in Hospital
Authors: Hyasat Kais , Sriram Krishna B. 
Published: May 2015

Introduction: There is limited information about the end-of-life care provided to patients with end-stage chronic obstructive pulmonary disease (COPD) in comparison to patients with lung cancer. Aim and Methods: We compared the end-of-life care provided to patients with COPD versus patients with lung cancer who died in hospital over a 12-month period in our institution. Results: During the study period, 89 patients died due to COPD (n = 34) or lung cancer (n = 55). Compared to patients with lung cancer, patients with COPD received less palliative care services (50% vs 9%, P < .001) and underwent more diagnostic tests and received more life-prolonging measures. Conclusion: Toward the end of their life, patients with COPD received fewer symptom-alleviating treatments and palliative care services.
A Retrospective Review of Reconstructive Options and Outcomes of 202 Cases Large Facial Mohs Micrographic Surgical Defects, Based on the Aesthetic Unit Involved
Authors: van Leeuwen Anne C. , The Ayleen , Moolenburgh Sanne E. , de Haas Ellen R.M. , Mureau Marc A.M. 
Published: May 2015

Background: For optimal treatment of facial defects following Mohs micrographic surgery (MMS), the aesthetic unit principles should be applied. Often multiple staged procedures and revisions are necessary. Objective: To analyze the reconstructive options and outcomes for complex facial defects per aesthetic unit. Methods: Data of 202 patients, who underwent a facial reconstruction at the department of plastic and reconstructive surgery following MMS, were collected. Results: The central facial units were affected in more than 70%, with over 20% of the defects involving more than 1 unit. Nasal defects required the longest reconstruction time (3-staged forehead flap) and periocular defects the most revisional procedures. In more than 50%, additional operations (range, 1-5) were needed. In 12%, postoperative complications occurred. Conclusion: An overview for the reconstructive options of extensive facial skin cancer is presented. Proper treatment requires a structured multidisciplinary approach in order to achieve excellent tumour control and a satisfactory aesthetic and functional end result.
Ethics in Pastoral Care and Counseling: A Contemporary Review of Updated Standards in the Field
Authors: Eliason Grafton Todd , Lepore Mark , Holmes Douglas 
Published: May 2015

This article reviews ethical responsibilities that must be considered when engaging in pastoral care, counseling, and psychotherapy. It discusses important contemporary issues counselors will want to contemplate in pursuing a high quality of care in their counseling practices. Examples and case studies are provided. Readers will be able to: Understand the function of ethical standards in the practice of counseling Be able to differentiate between pastoral care, pastoral counseling, and pastoral psychotherapy and their ethical implications Understand the importance of identifying one's limitations in counseling situations and how to proceed under such circumstances. Understand the need for pastoral counselors to attain the necessary credentials for practice in the area of counseling they intend to undertake. Become aware of the legal requirements when engaged in a counseling relationship.
Sticks and Stones Can Break My Bones but Labels Scar My Soul
Authors: Seitler Burton Norman 
Published: May 2015

Influenced by the followers of Descartes several centuries ago, philosophy, science and society took a turn in the road, one that has lead us astray. Mind was separated and cast away from its body, and so-called rationalism, reductionism and mechanism soon held sway over holism and humanism. Individuals were swept up, homogenized and subsumed under the provenance of arbitrarily created group norms for conduct. Those who did not follow were marginalized, or worse, demonized. Individuality, now being lost, inexorably would be replaced by all-encompassing clinical labels, that furthered the dehumanizing process begun and enforced so long ago. A new dialectic about the human circumstance based on humanism, empathy, understanding and respect, is proposed.
Predictors of Hypoglycemia in the ASPIRE In-Home Study and Effects of Automatic Suspension of Insulin Delivery
Authors: Weiss Ram , Garg Satish K. , Bergenstal Richard M. , Klonoff David C. , Bode Bruce W. , Bailey Timothy S. , Thrasher James , Schwartz Frank , Welsh John B. , Kaufman Francine R. ,   ASPIRE In-Home Study Group, Brazg R. , Casaubon L. , Horowitz B. , Liljenquist D. , Odugbesan O. , Bhargava A. , Goland R. , Weinstock R. 
Published: May 2015

Background: Hypoglycemia varies between patients with type 1 diabetes and is the main obstacle to therapy intensification. We investigated known and potential risk factors for hypoglycemia in subjects with type 1 diabetes. Method: In the ASPIRE In-Home study (NCT01497938), a randomized trial of the threshold suspend (TS) feature of sensor-augmented insulin pump (SAP) therapy, subjects’ propensity to nocturnal hypoglycemia (NH) was established in a 2-week run-in phase and assessed in a 3-month study phase via continuous glucose monitoring. Categorical variables were tested for association with NH rates in both phases. Results: Elevated rates of NH were significantly associated with baseline A1C ≤7%, with bolus insulin deliveries unassisted by the bolus estimation calculator, and with assignment to the control group during the study phase. Conclusions: Routine use of the TS feature and the bolus estimation calculator are strategies that may reduce the risk of NH.