bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in Daily Temperature and Precipitation Extremes for the Southeastern United States: 1948–2012
Authors: Powell Emily J. , Keim Barry D. 
Published: November 2014

Abstract
Spatial and temporal trends in temperature and precipitation extremes were investigated for the period 1948–2012 across the southeastern United States using 27 previously defined indices. Results show that regionwide warming in extreme minimum temperatures and cooling in extreme maximum temperatures occurred. The disproportionate changes in extreme daytime and nighttime temperatures are narrowing diurnal temperature ranges for most locations. The intensity and magnitude of extreme precipitation events increased overall, except for more easterly locations, particularly in South Carolina. These indices further show that warming in minimum temperatures has been pronounced most in summer and least in winter. Fall has become significantly wetter, while spring and summer have become drier, on average. Principal component analysis (PCA) was used to characterize a “geography of extremes” based on temperature and precipitation extreme indices. The PCA based on temperature indices revealed two coherent western and eastern subregions that share common modes of variability in extremes. Precipitation indices resulted in a greater number of smaller, spatially coherent groups exhibiting similar modes of variability. This classification regime illustrates important variations in extremes that exist on subregional scales. These findings have relevance for established climate research institutes, local governments, resource managers, and community planners interested in the variability of extreme events throughout the region.
Governmental budgetary reporting systems in the European Union: is the accounting basis relevant for the deficit reliability?
Authors: Jesus Maria Antónia , Jorge Susana 
Published: November 2014

When reporting to Eurostat for the purpose of deficit assessment, EU member states follow National Accounts (NA) rules, specifically the European System of National and Regional Accounts. However, the information reported is gathered from Governmental Accounting (GA), namely budgetary reporting. Consequently, several adjustments are needed when translating data from GA into NA, including those concerning the accounting basis – in some countries GA budgetary balance is already accrual-based while in others it is still cash-based. This research aims to analyse adjustments derived from different accounting bases adopted in GA and NA, demonstrating their diversity and materiality and the consequences for EU member states’ deficit/surplus reliability. It analyses cash-accrual adjustments to be made in Central Government data, using a few EU countries and data from the respective Excessive Deficit Procedure notifications covering the years 2005 to 2010. The main findings show that cash-accrual adjustments are more diverse and tend to be material in relation to the final deficit/surplus, in countries still adopting cash-based budgetary reporting in GA, raising questions concerning the reliability of the deficit/surplus they report. Points for practitioners This article contributes to a better understanding of the accounting basis differences for the convergence process between GA and NA, allowing for more reliable and informative budgetary reporting to be reached from both micro and macro perspectives. It highlights how important it is that GA moves from cash to accruals, namely concerning budgetary accounting and reporting systems. The diversity and materiality of accounting basis adjustments are important starting points for the development of a common framework to deal with these adjustments, and this is to be learned by policy-makers, especially accounting standard-setters and statistics agencies.
Strengthening of the executive centre: looking beyond NPM as the explanation for change
Authors: Kolltveit Kristoffer 
Published: November 2014

In several countries, attempts have been made to increase the capacity to coordinate and control public policy in the executive centre. The literature on whole-of-government and joined-up government describes these changes as reassertion efforts to counter the negative effects of former New Public Management (NPM) reforms. The main research question discussed in this article is whether the strengthening of the executive centre also should be explained by broader developments in society and by features of the cabinet itself. The research question is answered by looking at changes in Norway over the last three decades. Although former NPM reforms play a part in the Norwegian case, the article finds that the efforts undertaken should also be explained by the wish to improve cabinet decision-making and to solve conflicts between parties in cabinet. Points for practitioners This article examines different explanations for change in the executive centre in Norway. Over the last three decades, the Norwegian executive centre has been strengthened by the increased number of political appointees in ministries, by the enlargement of the Prime Minister’s Office where its own coordination minister was appointed in 2009, and by the formalization of an inner cabinet. The empirical data are gathered from internal cabinet documents and semi-structured interviews with administrative and political leaders. The article finds that developments in Norway have several explanations, suggesting that changes in the executive centre are heterogeneous, and are seldom undertaken to serve only one purpose.
Community Disadvantage, Parental Network, and Commitment to Social Norms
Authors: Valdimarsdóttir Margrét , Bernburg Jón Gunnar 
Published: November 2014

Objectives: Social disorganization theory implies that neighborhood disadvantage influences delinquency in part through the weakening of neighborhood-level social ties and residents’ commitment to social norms. We test these associations by focusing on social ties among neighborhood parents and adolescent commitment to social norms. Methods: We use a population survey of adolescents and combine it with administrative (population) data on school neighborhood characteristics in Iceland. We use multilevel data on 83 school communities and 5,865 adolescents in Iceland to analyze our hypotheses. Results: We find partial support for our hypotheses. Thus, adolescents living in neighborhoods characterized by concentrated disadvantage are more delinquent, net of individual-level (household) characteristics. Moreover, neighborhood-level parental networks and adolescent commitment to social norms mediate a part of this contextual effect. Conclusion: By supporting community theories in a different societal context (i.e., in a small homogeneous society) than most prior work, our study strengthens the external validity of the existing research. As we use cross-sectional data, the study faces the limitation of not being able to separate the constructs temporally.
Evidence for brain morphometric changes during the migraine cycle: A magnetic resonance-based morphometry study
Authors: Coppola Gianluca , Di Renzo Antonio , Tinelli Emanuele , Iacovelli Elisa , Lepre Chiara , Di Lorenzo Cherubino , Di Lorenzo Giorgio , Di Lenola Davide , Parisi Vincenzo , Serrao Mariano , Pauri Flavia , Fiermonte Giancarlo , Bianco Federico , Pierelli Francesco 
Published: November 2014

Neurophysiological investigations have demonstrated that there are unique fluctuations in the migraine brain functional activity between the ictal and interictal periods. Here we investigated the possibility that there are fluctuations over time also in whole brain morphometry of patients affected by episodic migraine without aura (MO). Twenty-four patients with untreated MO underwent 3T MRI scans during ( n = 10) or between attacks ( n = 14) and were compared to a group of 15 healthy volunteers (HVs). We then performed voxel-based-morphometry (VBM) analysis of structural T1-weighted MRI scans to determine if changes in brain structure were observed over the course of the migraine cycle. Interictally, MO patients had a significantly lower gray matter (GM) density within the right inferior parietal lobule, right temporal inferior gyrus, right superior temporal gyrus, and left temporal pole than did HVs. Ictally, GM density increased within the left temporal pole, bilateral insula, and right lenticular nuclei, but no areas exhibited decreased GM density. These morphometric GM changes between ictal and interictal phases suggest that abnormal structural plasticity may be an important mechanism of migraine pathology. Given the functional neuroanatomy of these areas, our findings suggest that migraine is a condition associated with global dysfunction of multisensory integration and memory processing.
Development of practice principles for the management of ongoing suicidal ideation in young people diagnosed with major depressive disorder
Authors: Rice Simon M , Simmons Magenta B , Bailey Alan P , Parker Alexandra G , Hetrick Sarah E , Davey Christopher G , Phelan Mark , Blaikie Simon , Edwards Jane 
Published: November 2014

Objectives: There is a lack of clear guidance regarding the management of ongoing suicidality in young people experiencing major depressive disorder. This study utilised an expert consensus approach in identifying practice principles to complement relevant clinical guidelines for the treatment of major depressive disorder in young people. The study also sought to outline a broad treatment framework for clinical intervention with young people experiencing ongoing suicidal ideation. Methods: In-depth focus groups were undertaken with a specialist multidisciplinary clinical team (the Youth Mood Clinic at Orygen Youth Health Clinical Program, Melbourne) working with young people aged 15–25 years experiencing ongoing suicidal ideation. Each focus group was audio recorded and transcribed verbatim using orthographic conventions. Principles of grounded theory and thematic analysis were used to analyse and code the resultant data. Results: The identified codes were subsequently synthesised into eight practice principles reflecting engagement and consistency of care, ongoing risk assessment and documentation, individualised crisis planning, engaging systems of support, engendering hopefulness, development of adaptive coping, management of acute risk, and consultation and supervision. Conclusions: The identified practice principles provide a broad management framework, and may assist to improve treatment consistency and clinical management of young people experiencing ongoing suicidal ideation. The practice principles may be of use to health professionals working within a team-based setting involved in the provision of care, even if peripherally, to young people with ongoing suicidal ideation. Findings address the lack of treatment consistency and shared terminology and may provide containment and guidance to multidisciplinary clinicians working with this at-risk group.
Evaluating the outcomes of a podiatry‐led assessment service in a public hospital orthopaedic unit
Authors: Bonanno Daniel R , Medica Virginia G , Tan Daphne S , Spring Anita A , Bird Adam R , Gazarek Jana 
Published: November 2014

AbstractBackgroundIn Australia, the demand for foot and ankle orthopaedic services in public health settings currently outweighs capacity. Introducing experienced allied health professionals into orthopaedic units to initiate the triage, assessment and management of patients has been proposed to help meet demand. The aim of this study was to evaluate the effect of introducing a podiatry‐led assessment service in a public hospital orthopaedic unit. The outcomes of interest were determining: the proportion of patients discharged without requiring an orthopaedic appointment, agreement in diagnosis between the patient referral and the assessing podiatrist, the proportion of foot and ankle conditions presenting to the service, and the proportion of each condition to require an orthopaedic appointment.MethodsThis study audited the first 100 patients to receive an appointment at a new podiatry‐led assessment service. The podiatrist triaged ‘Category 3’ referrals consisting of musculoskeletal foot and ankle conditions and appointments were provided for those considered likely to benefit from non‐surgical management. Following assessment, patients were referred to an appropriate healthcare professional or were discharged. At the initial appointment or following a period of care, patients were discharged if non‐surgical management was successful, surgery was not indicated, patients did not want surgery, and if patient's failed to attend their appointments. All other patients were referred for an orthopaedic consultation as indicated.ResultsNinety‐five of the 100 patients (69 females and 31 males; mean age 51.9, SD 16.4 years) attended their appointment at the podiatry‐led assessment service. The 95 referrals contained a total of 107 diagnoses, of which the podiatrist agreed with the diagnosis stated on the referral in 56 cases (Kappa =0.49, SE = 0.05). Overall, 34 of the 100 patients were referred to an orthopaedic surgeon and the remaining 66 patients were discharged from the orthopaedic waiting list without requiring an orthopaedic consultation.ConclusionsTwo‐thirds of patients who had an appointment at the podiatry‐led assessment service were discharged without requiring a surgical consultation. The introduction of a podiatry‐led service assists with timely provision of patient care and ensures those with the greatest need for orthopaedic surgery have improved access to specialist care.
Limited ankle dorsiflexion increases the risk for mid‐portion Achilles tendinopathy in infantry recruits: a prospective cohort study
Authors: Rabin Alon , Kozol Zvi , Finestone Aharon S 
Published: November 2014

AbstractBackgroundAchilles tendinopathy (AT) is a prevalent condition among runners and military personnel. Although ankle dorsiflexion (DF) range of motion (ROM) as measured with the knee bent has not been previously associated with AT, the literature concerning its role is limited. In addition, the role of lower extremity movement pattern in the pathogenesis of AT has not been studied prospectively.The purpose of this study was to further explore the role of ankle DF ROM as measured with the knee bent and that of lower extremity movement pattern as risk factors for mid‐portion AT.MethodsSeventy healthy male military recruits (mean ± SD age, height and body mass of 19.6 ± 1.0 years, 176.0 ± 10.0 cm, and 71.5 ± 7.4 kg) participated in this study. Ankle DF ROM as measured with the knee bent in weight‐bearing (WB) and non‐weight‐bearing (NWB), as well as lower extremity quality of movement during a lateral step down (LSD) test were measured at baseline. Participants were then followed for a 6‐month period of army basic training with recording of the development of AT.ResultsFive participants developed AT during training. Participants that developed AT had a more limited NWB ankle DF ROM (27.40 versus 21.10, p = 0.025). The quality of lower extremity movement did not differ between injured and uninjured participants (p = 0.361).ConclusionsA more limited ankle DF ROM as measured in NWB with the knee bent increases the risk of developing AT among military recruits taking part in intensive physical training.
Sedation assessment in a mobile intensive care unit: a prospective pilot-study on the relation of clinical sedation scales and the bispectral index
Authors: Prottengeier Johannes , Moritz Andreas , Heinrich Sebastian , Gall Christine , Schmidt Joachim 
Published: November 2014

Abstract
Introduction
The critically-ill undergoing inter-hospital transfers commonly receive sedatives in continuation of their therapeutic regime or to facilitate a safe transfer shielded from external stressors. While sedation assessment is well established in critical care in general, there is only little data available relating to the special conditions during patient transport and their effect on patient sedation levels. The aim of this prospective study was to investigate the feasibility and relationship of clinical sedation assessment (Richmond Agitation-Sedation Scale (RASS)) and objective physiological monitoring (bispectral index (BIS)) during patient transfers in our Mobile-ICU.

Methods
The levels of sedation of 30 pharmacologically sedated patients were evaluated at 12 to 17 distinct measurement points spread strategically over the course of a transfer by use of the RASS and BIS. To investigate the relation between the RASS and the BIS, Spearman’s squared rank correlation coefficient (ρ2) and the Kendall’s rank correlation coefficient (τ) were calculated. The diagnostic value of the BIS with respect to the RASS was investigated by its sensitivity and positive predictive value for possible patient awakening. Therefore, measurements were dichotomized considering a clinically sensible threshold of 80 for BIS-values and classifying RASS values being nonnegative.

Results
Spearman’s rank correlation resulted to ρ2 = 0.431 (confidence interval (CI) = 0.341 to 0.513). The Kendall’s correlation coefficient was calculated as τ = 0.522 (CI = 0.459 to 0.576). Awakening of patients (RASS ≥0) was detected by a BIS value of 80 and above with a sensitivity of 0.97 (CI = 0.89 to 1.00) and a positive predictive value of 0.59 (CI = 0.45 to 0.71).

Conclusions
Our study demonstrates that the BIS-Monitor can be used for the assessment of sedation levels in the intricate environment of a Mobile-ICU, especially when well-established clinical scores as the RASS are impracticable. The use of BIS is highly sensitive in the detection of unwanted awakening of patients during transfers.
Differential expression of the nuclear-encoded mitochondrial transcriptome in pediatric septic shock
Authors: Weiss Scott L , Cvijanovich Natalie Z , Allen Geoffrey L , Thomas Neal J , Freishtat Robert J , Anas Nick , Meyer Keith , Checchia Paul A , Shanley Thomas P , Bigham Michael T , Fitzgerald Julie , Banschbach Sharon , Beckman Eileen , Howard Kelli , Frank Erin , Harmon Kelli , Wong Hector R 
Published: November 2014

Abstract
Introduction
Increasing evidence supports a role for mitochondrial dysfunction in organ injury and immune dysregulation in sepsis. Although differential expression of mitochondrial genes in blood cells has been reported for several diseases in which bioenergetic failure is a postulated mechanism, there are no data about the blood cell mitochondrial transcriptome in pediatric sepsis.

Methods
We conducted a focused analysis using a multicenter genome-wide expression database of 180 children ≤10 years of age with septic shock and 53 healthy controls. Using total RNA isolated from whole blood within 24 hours of PICU admission for septic shock, we evaluated 296 nuclear-encoded mitochondrial genes using a false discovery rate of 1%. A series of bioinformatic approaches were applied to compare differentially expressed genes across previously validated gene expression-based subclasses (groups A, B, and C) of pediatric septic shock.

Results
In total, 118 genes were differentially regulated in subjects with septic shock compared to healthy controls, including 48 genes that were upregulated and 70 that were downregulated. The top scoring canonical pathway was oxidative phosphorylation, with general downregulation of the 51 genes corresponding to the electron transport system (ETS). The top two gene networks were composed primarily of mitochondrial ribosomal proteins highly connected to ETS complex I, and genes encoding for ETS complexes I, II, and IV that were highly connected to the peroxisome proliferator activated receptor (PPAR) family. There were 162 mitochondrial genes differentially regulated between groups A, B, and C. Group A, which had the highest maximum number of organ failures and mortality, exhibited a greater downregulation of mitochondrial genes compared to groups B and C.

Conclusions
Based on a focused analysis of a pediatric septic shock transcriptomic database, nuclear-encoded mitochondrial genes were differentially regulated early in pediatric septic shock compared to healthy controls, as well as across genotypic and phenotypic distinct pediatric septic shock subclasses. The nuclear genome may be an important mechanism contributing to alterations in mitochondrial bioenergetic function and outcomes in pediatric sepsis.
Vancomycin population pharmacokinetics during extracorporeal membrane oxygenation therapy: a matched cohort study
Authors: Donadello Katia , Roberts Jason A , Cristallini Stefano , Beumier Marjorie , Shekar Kiran , Jacobs Frédérique , Belhaj Asmae , Vincent Jean-Louis , de Backer Daniel , Taccone Fabio Silvio 
Published: November 2014

Abstract
Introduction
The aim of this study was to describe the population pharmacokinetics of vancomycin in critically ill patients treated with and without extracorporeal membrane oxygenation (ECMO).

Methods
We retrospectively reviewed data from critically ill patients treated with ECMO and matched controls who received a continuous infusion of vancomycin (35 mg/kg loading dose over 4 hours followed by a daily infusion adapted to creatinine clearance, CrCl)). The pharmacokinetics of vancomycin were described using non-linear mixed effects modeling.

Results
We compared 11 patients treated with ECMO with 11 well-matched controls. Drug dosing was similar between groups. The median interquartile range (IQR) vancomycin concentrations in ECMO and non-ECMO patients were 51 (28 to 71) versus 45 (37 to 71) mg/L at 4 hours; 23 (16 to 38) versus 29 (21 to 35) mg/L at 12 hours; 20 (12 to 36) versus 23 (17–28) mg/L at 24 hours (ANOVA, P =0.53). Median (ranges) volume of distribution (Vd) was 99.3 (49.1 to 212.3) and 92.3 (22.4 to 149.4) L in ECMO and non-ECMO patients, respectively, and clearance 2.4 (1.7 to 4.9) versus 2.3 (1.8 to 3.6) L/h (not significant). Insufficient drug concentrations (that is drug levels <20 mg/dL) were more common in the ECMO group. The pharmacokinetic model (non-linear mixed effects modeling) was prospectively validated in five additional ECMO-treated patients over a 6-month period. Linear regression analysis comparing the observed concentrations and those predicted using the model showed good correlation (r2 of 0.67; P <0.001).

Conclusions
Vancomycin concentrations were similar between ECMO and non-ECMO patients in the early phase of therapy. ECMO treatment was not associated with significant changes in Vd and drug clearance compared with the control patients.