bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reducing time to reperfusion for ST elevation myocardial infarction patients by a simple process change in the Emergency Department
Authors: Byrne Jill 
Published: June 2014

AbstractCurrent reperfusion guidelines from the European Society of Cardiology (ESC) recommend that First Medical Contact to Balloon times (FMC-B) for ST elevation myocardial infarction (STEMI) should not exceed 120 minutes. Many factors can cause delay in door to balloon times for patients suffering from STEMI. Previous studies have found that longest times for FMC-B occur if the patient presents initially to a non-percutaneous intervention (PCI) capable hospital. As a non-PCI capable site we looked at ways of reducing FMC-B times. Audit revealed that registration to electrocardiogram (ECG) times were sometimes prolonged due to undertriage, long waiting times and lack of space and staff to record an ECG, resulting in some prolonged FMC-B times.To address this, we have changed the system so that patients bypass triage and go directly to a dedicated investigation cubicle for an ECG. The patient books on at reception with chest pain and is immediately directed to the investigation cubicle. The ECG is reviewed immediately and the patient is either kept in the department for further management or allowed back to the waiting room to await triage if the ECG is non-diagnostic and history not worrying.Data on patients presenting with STEMI on the initial ECG were collected for one year pre-intervention (n =21 )and one year post-intervention (n=17). The median FMC-B time for the pre-intervention group was 108.5 minutes (IQR 96 – 143.5). Median FMC-B time for the post-intervention group was 82 minutes (IQR 66.5 - 93.5).This is a simple, low-cost intervention which could be transferable to other sites who have an interest in reducing FMC-B times. It is necessary to have a key person to carry out audit of all potential areas of delay, and a collaborative, multidisciplinary approach to making change to improve quality of care.
Application of smoothed continuous labile haemoglobin A1c reference intervals for identification of potentially spurious HbA1c results
Authors: Loh Tze Ping , Peng Weng Kung , Chen Lan , Sethi Sunil Kumar 
Published: June 2014

AimsWe aim to develop smoothed continuous 2.5th and 97.5th percentile values for labile glycated haemoglobin A1cto glycated haemoglobin A1c(LHbA1c:HbA1c) ratio against HbA1c, and apply them on our patient population for identification of potentially spurious HbA1cmeasurements.MethodsThe LHbA1cand HbA1cwere measured using Bio-rad Variant II high-performance liquid chromatography system. We recorded the LHbA1cand HbA1cvalues of 1555 patients who had normal chromatograms. Using these results, the 2.5th and 97.5th percentile reference limits of the LHbA1c:HbA1cratio were described by LHbA1c:HbA1c=−0.0072×HbA1c+0.2925 and LHbA1c:HbA1c=−0.0132×HbA1c+0.5327, respectively.ResultsWhen the reference intervals were applied on a separate 1000 patients, 34 and 29 of them had abnormally high and low LHbA1c:HbA1cratios, respectively. Most of the observed high ratios were associated concurrently with elevated plasma glucose, anaemia, chronic liver and kidney diseases. A suppressed ratio was mostly associated with haemoglobin variants. Patients with heterozygous HbE or HbS variants tend to have lower LHbA1c:HbA1cratios while the converse is true for heterozygous HbJ.ConclusionsThe continuous LHbA1c:HbA1cratio may be used to detect confounding factors or spurious HbA1cresults, but its performance is confounded and reduced by the ambient plasma glucose.
Molecular Testing for Lymph Node Metastases as a Determinant of Colon Cancer Recurrence: Results from a Retrospective Multicenter Study
Authors: Sargent Daniel J. , Shi Qian , Gill Sharlene , Louvet Christophe , Everson Richard B. , Kellner Udo , Clancy Thomas E. , Pipas J. Marc , Resnick Murray B. , Meyers Michael O. , Wu Tsung-Teh , Huntsman David , Validire Pierre , Farooq Umar , Pavey Emily S. , Beaudry Guillaume , Haince Jean-Francois , Fradet Yves 
Published: June 2014

Abstract
Purpose: Recurrence risk assessment to make treatment decisions for early-stage colon cancer patients is a major unmet medical need. The aim of this retrospective multicenter study was to evaluate the clinical utility of guanylyl cyclase C (GCC) mRNA levels in lymph nodes on colon cancer recurrence.
Methods: The proportion of lymph nodes with GCC-positive mRNA (LNR) was evaluated in 463 untreated T3N0 patients, blinded to clinical outcomes. One site's (n = 97) tissue grossing method precluded appropriate lymph node assessment resulting in post hoc exclusion. Cox regression models tested the relationship between GCC and the primary endpoint of time to recurrence. Assay methods, primary analyses, and cut points were all prespecified.
Results: Final dataset contained 366 patients, 38 (10%) of whom had recurrence. Presence of four or more GCC-positive lymph nodes was significantly associated with risk of recurrence [hazard ratio (HR) = 2.46, 95% confidence interval (CI), 1.07–5.69, P = 0.035], whereas binary GCC LNR risk class (HR = 1.87, 95% CI, 0.99–3.54, P = 0.054) and mismatch repair (MMR) status (HR = 0.77, 95% CI, 0.36–1.62, P = 0.49) were not. In a secondary analysis using a 3-level GCC LNR risk group classification of high (LNR &gt; 0.20), intermediate (0.10 &lt; LNR ≤ 0.20), and low (LNR ≤ 0.10), high-risk patients had a 2.5 times higher recurrence risk compared with low-risk patients (HR = 2.53, 95% CI, 1.24–5.17, P = 0.011).
Conclusions: GCC status is a promising prognostic factor independent of traditional histopathology risk factors in a contemporary population of patients with stage IIa colon cancer not treated with adjuvant therapy, but GCC determination must be performed with methodology adapted to the tissue procurement and fixation technique. Clin Cancer Res; 20(16); 4361–9. ©2014 AACR.
To “Grow” or “Go”: TMEM16A Expression as a Switch between Tumor Growth and Metastasis in SCCHN
Authors: Shiwarski Daniel J. , Shao Chunbo , Bill Anke , Kim Jean , Xiao Dong , Bertrand Carol A. , Seethala Raja S. , Sano Daisuke , Myers Jeffery N. , Ha Patrick , Grandis Jennifer , Gaither L. Alex , Puthenveedu Manojkumar A. , Duvvuri Umamaheswar 
Published: June 2014

Abstract
Purpose: Tumor metastasis is the leading cause of death in patients with cancer. However, the mechanisms that underlie metastatic progression remain unclear. We examined TMEM16A (ANO1) expression as a key factor shifting tumors between growth and metastasis.
Experimental Design: We evaluated 26 pairs of primary and metastatic lymph node (LN) tissue from patients with squamous cell carcinoma of the head and neck (SCCHN) for differential expression of TMEM16A. In addition, we identified mechanisms by which TMEM16A expression influences tumor cell motility via proteomic screens of cell lines and in vivo mouse studies of metastasis.
Results: Compared with primary tumors, TMEM16A expression decreases in metastatic LNs of patients with SCCHN. Stable reduction of TMEM16A expression enhances cell motility and increases metastases while decreasing tumor proliferation in an orthotopic mouse model. Evaluation of human tumor tissues suggests an epigenetic mechanism for decreasing TMEM16A expression through promoter methylation that correlated with a transition between an epithelial and a mesenchymal phenotype. These effects of TMEM16A expression on tumor cell size and epithelial-to-mesenchymal transition (EMT) required the amino acid residue serine 970 (S970); however, mutation of S970 to alanine does not disrupt the proliferative advantages of TMEM16A overexpression. Furthermore, S970 mediates the association of TMEM16A with Radixin, an actin-scaffolding protein implicated in EMT.
Conclusions: Together, our results identify TMEM16A, an eight transmembrane domain Ca2+-activated Cl− channel, as a primary driver of the “Grow” or “Go” model for cancer progression, in which TMEM16A expression acts to balance tumor proliferation and metastasis via its promoter methylation. Clin Cancer Res; 20(17); 4673–88. ©2014 AACR.
O cerco dos canaviais: contradições e conflitos nos assentamentos rurais
Authors: Bellacosa Julia Marques , Hoffmann Martin 
Published: June 2014

O avanço dos canaviais no interior dos assentamentos rurais de São Paulo expõe as contradições do desenvolvimento capitalista no campo ao mesmo tempo em que sinaliza a necessidade de um contínuo debate a respeito da reprodução do campesinato brasileiro. Desde que a cana ingressou oficialmente no assentamento Monte Alegre, situado na região de Araraquara, em uma área de agricultura modernizada, 317 famílias aderiram ao plantio com as usinas – o que corresponde a 89% de todas as famílias do assentamento. A transformação desses espaços em um “mar” de cana exige uma análise atenta dos rumos pelos quais avança a reforma agrária brasileira. Na perspectiva de refletir sobre essa questão, apresentamos neste artigo uma análise dos impactos da renda advinda da cana no interior do assentamento.
A resistência dos trabalhadores nos canaviais alagoanos
Authors: Verçoza Lúcio Vasconcellos de , Silva Maria Aparecida de Moraes 
Published: June 2014

O mais recente processo de reestruturação produtiva da agroindústria canavieira alagoana – iniciado a partir dos anos 1990 – alterou profundamente os critérios de seleção dos trabalhadores, a organização do trabalho e a sua forma de gestão. Essas mudanças, que afetam diretamente os trabalhadores, resultaram em intensificação do ritmo de trabalho, elevação de sua produtividade e diminuição do número de empregos. Em face dessas novas configurações da relação capital e trabalho, o objetivo do presente artigo é analisar as formas de resistência construídas pelos trabalhadores canavieiros em Alagoas. Para atingir tal escopo, foram realizadas pesquisas de campo e entrevistas com cortadores de cana, operadores de carregadeiras, cabos (fiscais) e dirigentes de sindicatos de trabalhadores rurais.
O etanol e a reprodução do capital em crise
Authors: Pitta Fábio T. , Mendonça Maria Luisa 
Published: June 2014

O artigo analisa as tendências mais recentes no setor canavieiro e avalia o crescente processo de formação de monopólios, principalmente com participação de empresas multinacionais. O estudo observa que a maior concentração de capitais é acompanhada pelo aumento da expansão territorial do monocultivo da cana, principalmente em áreas com acesso a infraestrutura, como a região Sudeste, e em regiões com vastas bacias hidrográficas, como o Cerrado. Este processo de crescimento contraditório tem como determinação a crise econômica mundial, no momento de preponderância de capitais financeiros. Neste contexto, o estudo mostra a constante dependência da indústria da cana de créditos estatais e subsídios, além da permanência da superexploração do trabalho.
Radiative–Convective Equilibrium over a Land Surface
Authors: Rochetin Nicolas , Lintner Benjamin R. , Findell Kirsten L. , Sobel Adam H. , Gentine Pierre 
Published: June 2014

Abstract
Radiative–convective equilibrium (RCE) describes an idealized state of the atmosphere in which the vertical temperature profile is determined by a balance between radiative and convective fluxes. While RCE has been applied extensively over oceans, its application over the land surface has been limited. The present study explores the properties of RCE over land using an atmospheric single-column model (SCM) from the Laboratoire de Météorologie Dynamique–Zoom, version 5B (LMDZ5B) general circulation model coupled in temperature and moisture to a land surface model using a simplified bucket model with finite moisture capacity. Given the presence of a large-amplitude diurnal heat flux cycle, the resultant RCE exhibits multiple equilibria when conditions are neither strictly water nor energy limited. By varying top-of-atmosphere insolation (through changes in latitude), total system water content, and initial temperature conditions the sensitivity of the land RCE states is assessed, with particular emphasis on the role of clouds. Based on this analysis, it appears that a necessary condition for the model to exhibit multiple equilibria is the presence of low-level clouds coupled to the diurnal cycle of radiation. In addition the simulated surface precipitation rate varies nonmonotonically with latitude as a result of a tradeoff between in-cloud rain rate and subcloud rain reevaporation, thus underscoring the importance of subcloud layer processes and unsaturated downdrafts. It is shown that clouds, especially at low levels, are key elements of the internal variability of the coupled land–atmosphere system through their feedback on radiation.
The Seasonality of Convective Events in the Labrador Sea
Authors: Luo Hao , Bracco Annalisa , Zhang Fan 
Published: June 2014

Abstract
Modeling deep convection is a key challenge for climate science. Here two simulations of the Labrador Sea circulation obtained with the Regional Ocean Modeling System (ROMS) run at a horizontal resolution of 7.5 km are used to characterize the response of convection to atmospheric forcing and its seasonal variability over the period 1980–2009. The integrations compare well with the sparse observations available. The modeled convection varies in three key aspects over the 30 years considered. First, its magnitude changes greatly at decadal scales. This aspect is supported by the in situ observations. Second, the initiation and peak of convection (i.e., initiation and maximum) shift by 2–3 weeks between strong and weak convective years. Third, the duration of convection varies by approximately one month between strong and weak years. The last two changes are associated with the variability of the time-integrated surface heat fluxes over the Labrador Sea during winter and spring, while the first results from changes in both atmospheric heat fluxes and oceanic conditions through the lateral inflow of warm Irminger Water from the boundary current system to the basin interior. Changes in surface heat fluxes over the convective region are linked to large-scale modes of variability, the North Atlantic Oscillation and Arctic Oscillation. Implications for modeling the climate variability of the Labrador basin are discussed.
Motion-Cuing Algorithms
Authors: Casas Sergio , Coma Inmaculada , Riera José Vicente , Fernández Marcos 
Published: June 2014

Objective: The aim of this study was to characterize the human response to motion-cuing algorithms (MCAs) by comparing users’ perception to several proposed objective indicators. Background: Other researchers have proposed several MCAs, but few improvements have been achieved lately. One of the reasons for this lack of progress is that fair comparisons between different algorithms are hard to achieve, for their evaluation needs to be performed with humans and the tuning process is slow. Method: This characterization is performed by means of a comparison of the subjective perception of vehicle simulation users (90 participants) against several proposed objective indicators that try to measure MCA performance. Two motion platforms (3 and 6 degrees of freedom [DoF]) and two vehicle simulators (a driving simulator and a speedboat simulator) were tested using the classical washout algorithm, considered to be the main reference in MCA literature. Results: Results show that users are more sensitive to correlation and delay with respect to the expected motion rather than its magnitude and that specific force is more of a factor than angular speed in the driving simulator. The opposite happens in the speedboat simulator. Conclusions: Human drivers’ reaction to MCA is mainly characterized by the normalized Pearson correlation between output and input signals of the algorithm. This finding validates the main MCA strategy that consists of downscaling the signals and slightly distorting their frequency spectrum. The 6-DoF simulator is perceived as a modest improvement of the 3-DoF platform. Applications: These results set the basis for future automatic tuning, evaluation, and comparison of MCA in motion platforms.
Comparison of heating and cooling energy simulation using multi-years and typical weather data in South Korea
Authors: Yoo Hochun , Lee Kwanho , Levermore Geoffrey J 
Published: June 2014

Typical weather data (TWD) consists of 8760 values of various selected meteorological parameters such as ambient temperature, solar radiation, relative humidity and wind velocity, and are originally derived from long-term data. In this paper, TWDs have been generated, using three different methodologies, from hourly meteorological data measured in Seoul, Daejeon, Daegu, Gwangju, and Busan. The aims of this study were to compare the simulation results from the three methodologies (ISO Test Reference Year, CIBSE Test Reference Year, and Typical Meteorological Year) with those from individual years and their long-term means to assess the important five components of the building envelope (wall-to-window ratio, window overhang, window transmissivity, window U-value, and wall U-value) for the influence on the heating and cooling load and to study the influence of the different weather parameters (temperature and solar radiation). Results of the comparison show that predicted monthly load and energy consumption profiles from the TWD tended to follow the long-term mean quite closely. The load calculations vary almost linearly as the building envelope components varied apart from the window U-value. The yearly average values of mean bias error and root mean squared error for the heating and cooling loads were evaluated for the three TWDs and long-term measured meteorological data. Practical application: This paper will enable engineers and building designers of buildings in South Korea to assess the heating and cooling loads with more confidence. The paper will enable designers to use the appropriate weather data when using computer simulation for the design. The designer will also be able to assess the energy efficiency better.
Centrifugal pump performance during low-flow extracorporeal CO2 removal; safety considerations
Authors: Simons AP , Martens EGHJ , Ganushchak YM , Weerwind PW 
Published: June 2014

Aim: The aim of this study was to examine the hydrodynamic performance and gaseous microemboli (GME) activity of two centrifugal pumps for possible use in low-flow extracorporeal CO2 removal. Materials & Methods: The performance of a Rotassist 2.8 and a Rotaflow 32 centrifugal pump (Maquet Cardiopulmonary AG, Hirrlingen, Germany) was evaluated in a water-glycerine mixture-filled in vitro circuit that enabled measurement of pressures and GME at the pump inlet and pump outlet. Pressure-flow curves were acquired in a 1,000 to 5,000 rpm range while increasing drainage resistance in one series and outlet resistance in another. Results: Respective minimum pump inlet and maximum pump outlet pressures were −539 mmHg and 754 mmHg for the Rotassist 2.8 and −606 mmHg and 806 mmHg for the Rotaflow 32. Maximum standard deviations on pump pressures and flow amounted to 3.0 mmHg and 0.03 L/min, respectively, regardless of pump type and drainage or outlet resistance. The GME at the pump outlet were detectable at pump inlet pressures below −156 mmHg at 0.2 L/min and 2,500 rpm for the Rotassist 2.8 and below −224 mmHg at 0.9 L/min and 3,000 rpm for the Rotaflow 32. Conclusion: Both the Rotassist 2.8 and Rotaflow 32 centrifugal pumps show a comparably high hydrodynamic stability, but potential GME formation with decreasing pump inlet pressures should be taken into account to ensure safe centrifugal pump-based low-flow extracorporeal CO2 removal.
Motion planning with sequential convex optimization and convex collision checking
Authors: Schulman John , Duan Yan , Ho Jonathan , Lee Alex , Awwal Ibrahim , Bradlow Henry , Pan Jia , Patil Sachin , Goldberg Ken , Abbeel Pieter 
Published: June 2014

We present a new optimization-based approach for robotic motion planning among obstacles. Like CHOMP (Covariant Hamiltonian Optimization for Motion Planning), our algorithm can be used to find collision-free trajectories from naïve, straight-line initializations that might be in collision. At the core of our approach are (a) a sequential convex optimization procedure, which penalizes collisions with a hinge loss and increases the penalty coefficients in an outer loop as necessary, and (b) an efficient formulation of the no-collisions constraint that directly considers continuous-time safety Our algorithm is implemented in a software package called TrajOpt. We report results from a series of experiments comparing TrajOpt with CHOMP and randomized planners from OMPL, with regard to planning time and path quality. We consider motion planning for 7 DOF robot arms, 18 DOF full-body robots, statically stable walking motion for the 34 DOF Atlas humanoid robot, and physical experiments with the 18 DOF PR2. We also apply TrajOpt to plan curvature-constrained steerable needle trajectories in the SE(3) configuration space and multiple non-intersecting curved channels within 3D-printed implants for intracavitary brachytherapy. Details, videos, and source code are freely available at: http://rll.berkeley.edu/trajopt/ijrr .
Breastfeeding Knowledge, Confidence, Beliefs, and Attitudes of Canadian Physicians
Authors: Pound Catherine M. , Williams Kathryn , Grenon Renee , Aglipay Mary , Plint Amy C. 
Published: June 2014

Background: Physicians’ attitudes and recommendations directly affect breastfeeding duration. Yet, studies in many nations have shown that physicians lack the skills to offer proper guidance to breastfeeding mothers. Objective: This study aims to assess breastfeeding knowledge, confidence, beliefs, and attitudes of Canadian physicians. Methods: A breastfeeding questionnaire was developed and piloted prior to study enrollment. These questionnaires were sent to 1429 pediatricians (PED), 1329 family physicians (FP), and final-year pediatric and final-year family medicine residents (PR and FMR). Results: The analysis included 397 PED, 322 FP, 17 PR, and 44 FMR who completed the questionnaire. Mean overall correct knowledge score was 67.8% for PED, 64.3% for FP, 72.7% for PR, and 66.8% for FMR. Two hundred eighty-five PED (74.2%), 228 FP (73.1%), 7 PR (41.2%), and 21 FMR (53.8%) felt confident with their breastfeeding counseling skills. Less than half (49.6% of PED and 45.4% of FP) believed that evaluating breastfeeding was a primary care physician’s responsibility, and few PED or FP (5.1% and 11.3%) routinely observed breastfeeding in mother-infant pairs. Conclusion: Several areas of potential deficits were identified in Canadian physicians’ breastfeeding knowledge. Physicians would benefit from greater education and support, to optimize care of infants and their mothers.
We need to talk about depot: effect of Community Treatment Order on depot antipsychotic medication compliance
Authors: Suetani Shuichi , Foo Edward , Wilson Douglas 
Published: June 2014

Objective: The current study compares the compliance rates of patients on depot who were on Community Treatment Orders with those who were not on such Order with a view to objectively quantify the effect of Community Treatment Orders on depot antipsychotics medication compliance. Methods: “Day difference” measurements between the scheduled depot data and the administered date were collected for both voluntary and involuntary patients receiving depot medication at the same community clinic over a 6-month period. Results: The results demonstrated a trend for greater compliance to depot medications by those not on a Community Treatment Order compared with those who were, but there was no statistically significant difference between the two groups. Conclusions: The current study highlighted that while Community Treatment Order may be a reasonable short-term tool to encourage patients’ compliance at an early treatment stage, ongoing effort should be put into improving patients’ attitude towards depot medications to ensure a better long-term outcome for individuals with schizophrenia.