bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regional Ventricular Performance and Exercise Training in Children and Young Adults After Repair of Tetralogy of Fallot
Authors: Duppen Nienke , Geerdink Lianne M. , Kuipers Irene M. , Bossers Sjoerd S.M. , Koopman Laurens P. , van Dijk Arie P.J. , Roos-Hesselink Jolien W. , De Korte Chris L. , Helbing Willem A. , Kapusta Livia 
Published: March 2015

Background—
Public-health guidelines recommend patients with congenital heart disease to exercise. Studies have shown that patients with congenital heart disease can improve physical exercise capacity. The effect of training on regional ventricular performance has hardly been studied. We performed a pilot study to assess whether an exercise training program would result in adverse changes of regional ventricular performance in patients with corrected tetralogy of Fallot.

Methods and Results—
Multicenter prospective randomized controlled pilot study in patients with tetralogy of Fallot aged 10 to 25 years. A 12-week standardized aerobic dynamic exercise training program (3 one-hour sessions per week) was used. Pre- and post-training cardiopulmonary exercise tests, MRI, and echocardiography, including tissue-Doppler imaging, were performed. Patients were randomized to the exercise group (n=28) or control group (n=20). One patient in the exercise group dropped out. Change in tissue-Doppler imaging parameters was similar in the exercise group and control group (change in right ventricle free wall peak velocity E′ exercise group, 0.8±2.6 cm/s; control group, 0.9±4.1; peak velocity A′ exercise group, 0.4±2.4 m/s; control group 4.6±18.1 cm/s).

Conclusions—
This randomized controlled pilot study provides preliminary data suggesting that regional ventricular performance is well maintained during 3-month aerobic dynamic exercise training in children and young adults with repaired tetralogy of Fallot. This information might help patients adhere to current public-health guidelines.

Clinical Trial Registration—

URL:
http//:www.trialregister.nl
. Unique identifier: NTR2731.
Establishing the First Mobile Stroke Unit in the United States
Authors: Parker Stephanie A. , Bowry Ritvij , Wu Tzu-Ching , Noser Elizabeth A. , Jackson Kamilah , Richardson Laura , Persse David , Grotta James C. 
Published: March 2015

Background and Purpose—
Recently, the Mobile Stroke Unit (MSU) concept was introduced in Germany demonstrating prehospital treatment of more patients within the first hour of symptom onset. However, the details and complexities of establishing such a program in the United States are unknown. We describe the steps involved in setting up the first MSU in the United States.

Methods—
Implementation included establishing leadership, fund-raising, purchase and build-out, knitting a collaborative consortium of community stakeholders, writing protocols to ensure accountability, radiation safety, purchasing supplies, licensing, insurance, establishing a base station, developing a communication plan with city Emergency Medical Services, Emergency Medical Service training, staffing, and designing a research protocol.

Results—
The MSU was introduced after ≈1 year of preparation. Major obstacles to establishing the MSU were primarily obtaining funding, licensure, documenting radiation safety protocols, and establishing a smooth communication system with Emergency Medical Services. During an 8 week run-in phase, ≈2 patients were treated with recombinant tissue-type plasminogen activator per week, one-third within 60 minutes of symptom onset, with no complications. A randomized study to determine clinical outcomes, telemedicine reliability and accuracy, and cost effectiveness was formulated and has begun.

Conclusion—
The first MSU in the United States has been introduced in Houston, TX. The steps needed to accomplish this are described.
Linear Depolarization Ratios of Columnar Ice Crystals in a Deep Precipitating System over the Arctic Observed by Zenith-Pointing Ka-Band Doppler Radar
Authors: Oue Mariko , Kumjian Matthew R. , Lu Yinghui , Verlinde Johannes , Aydin Kultegin , Clothiaux Eugene E. 
Published: March 2015

AbstractThis study demonstrates that linear depolarization ratio (LDR) values obtained from zenith-pointing Ka-band radar Doppler velocity spectra are sufficient for detecting columnar ice crystals. During a deep precipitating system over the Arctic on 7 December 2013, the radar recorded LDR values up to −15 dB at temperatures corresponding to the columnar ice crystal growth regime. These LDR values were also consistent with scattering calculations for columnar ice crystals. Enhancements in LDR were suppressed within precipitation fallstreaks because the enhanced LDR values of columnar ice crystals were masked by the returns from the particles within the fallstreaks. However, Doppler velocity spectra of LDR within the fallstreak distinguished populations of slower-falling particles with high LDR (>−15 dB) and faster-falling particles with much lower LDR, suggesting that columnar ice crystals with high LDR coexisted with larger isometric particles that produced low LDR while dominating the total copolar reflectivity, thereby decreasing LDR. The measurements suggest that the columnar ice crystals originated in liquid-cloud layers through secondary ice production.
Comparison of Single- and Dual-Polarization–Based Rainfall Estimates Using NEXRAD Data for the NASA Iowa Flood Studies Project
Authors: Seo Bong-Chul , Dolan Brenda , Krajewski Witold F. , Rutledge Steven A. , Petersen Walter 
Published: March 2015

AbstractThis study compares and evaluates single-polarization (SP)- and dual-polarization (DP)-based radar-rainfall (RR) estimates using NEXRAD data acquired during Iowa Flood Studies (IFloodS), a NASA GPM ground validation field campaign carried out in May–June 2013. The objective of this study is to understand the potential benefit of the DP quantitative precipitation estimation, which selects different rain-rate estimators according to radar-identified precipitation types, and to evaluate RR estimates generated by the recent research SP and DP algorithms. The Iowa Flood Center SP (IFC-SP) and Colorado State University DP (CSU-DP) products are analyzed and assessed using two high-density, high-quality rain gauge networks as ground reference. The CSU-DP algorithm shows superior performance to the IFC-SP algorithm, especially for heavy convective rains. We verify that dynamic changes in the proportion of heavy rain during the convective period are associated with the improved performance of CSU-DP rainfall estimates. For a lighter rain case, the IFC-SP and CSU-DP products are not significantly different in statistical metrics and visual agreement with the rain gauge data. This is because both algorithms use the identical NEXRAD reflectivity–rain rate (Z–R) relation that might lead to substantial underestimation for the presented case.
Validation of Dual-Doppler Wind Profiles with in situ Anemometry
Authors: Gunter W. Scott , Schroeder John L. , Hirth Brian D. 
Published: March 2015

AbstractTypical methods used to acquire wind profiles from Doppler radar measurements rely on plan position indicator (PPI) scans being performed at multiple elevation angles to utilize the velocity–azimuth display technique or to construct dual-Doppler synthesis. These techniques, as well as those employed by wind profilers, often produce wind profiles that lack the spatial or temporal resolution to resolve finescale features. If two radars perform range–height indicator (RHI) scans (constant azimuth, multiple elevations) along azimuths separated by approximately 90°, then the intersection of the coordinated RHI planes represents a vertical set of points where dual-Doppler wind syntheses are possible and wind speed and direction profiles can be retrieved. This method also allows for the generation of high-resolution wind time histories that can be compared to anemometer time histories. This study focuses on the use of the coordinated RHI scanning strategy by two high-resolution mobile Doppler radars in close proximity to a 200-m instrumented tower. In one of the first high-resolution, long-duration comparisons of dual-Doppler wind synthesis with in situ anemometry, the mean and turbulence states of the wind measured by each platform were compared in varying atmospheric conditions. Examination of mean wind speed and direction profiles in both clear-air (nonprecipitating) and precipitating environments revealed excellent agreement above approximately 50 m. Below this level, dual-Doppler wind speeds were still good but slightly overestimated as compared to the anemometer-measured wind speeds in heavy precipitation. Bulk turbulence parameters were also slightly underestimated by the dual-Doppler syntheses.
Endoscopic retrograde cholangiopancreatography in Ayrshire, Scotland: a comparison of two age cohorts
Authors: Pericleous Stephanos , Smith Laura Isobel , Karim Muhammad Ali , Middleton Nicos , Musbahi Aya , Ali Abdulmajid 
Published: March 2015

Background and aims There is an increased trend in prevalence of pancreato-biliary disease in the elderly population. Consequently there is an increasing demand for endoscopic retrograde cholangiopancreatography (ERCP). The aims of this study were to compare ERCP outcomes in patients over 80 with those aged between 60 and 79 years and with the published literature. Methods and results Data were collected from a prospectively maintained database. All patients over the age of 60 years who underwent ERCP from May 2010 to May 2012 were identified. Two cohorts were formed, group A: 60–79 years ( n = 66) and group B: > 80 years old ( n = 49). Data on indications for ERCP, outcome, complications and repeat procedures were collected. One hundred and fifteen patients between the age of 60 and 92 years were identified. Group A had a total of 89 ERCPs and group B 69. Cannulation, overall procedure success, complication and mortality rates were comparable between both groups. Group B contained two cases of perforation with one associated mortality (1.4%) which did not reach statistical significance. Conclusions ERCP in octogenarians is safe and effective when compared to patients aged 60–79.
Outcomes and Resource Utilization of Endoscopic Mass‐Closure Technique for Laryngeal Clefts
Authors: Balakrishnan Karthik , Cheng Esther , de Alarcon Alessandro , Sidell Douglas R. , Hart Catherine K. , Rutter Michael J. 
Published: March 2015

ObjectiveTo compare resource utilization and clinical outcomes between endoscopic mass‐closure and open techniques for laryngeal cleft repair.Study DesignCase series with chart review.SettingTertiary academic children’s hospital.Subjects and MethodsPediatric patients undergoing repair for Benjamin‐Inglis type 1‐3 laryngeal clefts over a 15‐year period. All 20 patients undergoing endoscopic repair were included. Eight control patients undergoing open repair were selected using matching by age and cleft type. Demographic, clinical, and resource utilization data were collected.ResultsTwenty‐eight patients were included (20 endoscopic, 8 open). Mean age, rates of tracheostomy and vocal fold immobility, and distribution of cleft types were not different between the 2 groups (all P >. 2). Mean operative time (P =. 004) and duration of hospital stay (P <. 001) were significantly shorter in the endoscopic group. All repairs were intact in both groups at final postoperative endoscopy. Rates of persistent laryngeal penetration or aspiration on swallow study were not different between groups (P = 1.000), although results were available for only 11 patients.ConclusionEndoscopic laryngeal cleft repair using a mass‐closure technique provides a durable result while requiring significantly shorter operative times and hospital stays than open repair and avoiding the potential morbidity of laryngofissure. However, open repair may allow the simultaneous performance of other airway reconstructive procedures and may be a useful salvage technique when endoscopic repair fails. Postoperative swallowing results require further study.
How do young students with different profiles of reading skill mastery, perceived ability, and goal orientation respond to holistic diagnostic feedback?
Authors: Jang Eunice Eunhee , Dunlop Maggie , Park Gina , van der Boom Edith H. 
Published: March 2015

One critical issue with cognitive diagnostic assessment (CDA) lies in its lack of research evidence that shows how diagnostic feedback from CDA is interpreted and used by young students. This mixed methods research examined how holistic diagnostic feedback (HDF) is processed by young learners with different profiles of reading skills, goal orientations, and perceived ability. HDF provides three learner profiles: learners’ current skill mastery levels; self-assessed skill proficiency; and goal orientations. It also has a section for plans for future learning. A total of 44 Grades 5 and 6 students (aged 11–12) from two classrooms, their parents and teacher received individually customized HDF reports. Students’ reading skill mastery profiles were determined based on the application of cognitive diagnostic modeling to their performance on a provincial reading achievement measure, while their perceived ability and goal orientation profiles were created by using self-assessment and goal-orientation questionnaires. Students and parents provided written responses to their HDF reports. The study findings show the dynamic influence of young students’ profiles on the ways in which they perceive, interpret and use HDF. Students’ responses to diagnostic feedback did not differ substantially across reading mastery levels; however, psychological factors most strongly impacted the efficacy of learner feedback processing. Furthermore, the result that it was not students’ actual goal orientations but their perceived parent goal orientations that showed significant relationships with their skill mastery levels strongly indicates that young students’ responses to HDF are likely to be influenced by broader learning environments, and such influences are further filtered through their own perceptions. Understanding students’ interactions with diagnostic feedback is critical for maximizing its effect because their perceptions about ability and orientations to learning strongly influence the ways in which they process diagnostic feedback on their learning.
Community-based palliative care is associated with reduced emergency department use by people with dementia in their last year of life: A retrospective cohort study
Authors: Rosenwax Lorna , Spilsbury Katrina , Arendts Glenn , McNamara Bev , Semmens James 
Published: March 2015

Objective: To describe patterns in the use of hospital emergency departments in the last year of life by people who died with dementia and whether this was modified by use of community-based palliative care. Design: Retrospective population-based cohort study of people in their last year of life. Time-to-event analyses were performed using cumulative hazard functions and flexible parametric proportional hazards regression models. Setting/participants: All people living in Western Australia who died with dementia in the 2-year period 1 January 2009 to 31 December 2010 (dementia cohort; N = 5261). A comparative cohort of decedents without dementia who died from other conditions amenable to palliative care ( N = 2685). Results: More than 70% of both the dementia and comparative cohorts attended hospital emergency departments in the last year of life. Only 6% of the dementia cohort used community-based palliative care compared to 26% of the comparative cohort. Decedents with dementia who were not receiving community-based palliative care attended hospital emergency departments more frequently than people receiving community-based palliative care. The magnitude of the increased rate of emergency department visits varied over the last year of life from 1.4 (95% confidence interval: 1.1–1.9) times more often in the first 3 months of follow-up to 6.7 (95% confidence interval: 4.7–9.6) times more frequently in the weeks immediately preceding death. Conclusions: Community-based palliative care of people who die with or of dementia is relatively infrequent but associated with significant reductions in hospital emergency department use in the last year of life.
First-in-human trial of the safety, pharmacokinetics and immunogenicity of a PEGylated anti-CD40L antibody fragment (CDP7657) in healthy individuals and patients with systemic lupus erythematosus
Authors: Tocoian A , Buchan P , Kirby H , Soranson J , Zamacona M , Walley R , Mitchell N , Esfandiari E , Wagner F , Oliver R 
Published: March 2015

Objective The objective of this paper is to investigate the safety, pharmacokinetics (PK) and immunogenicity of CDP7657, a PEGylated anti-CD40L antibody fragment, in healthy individuals and patients with systemic lupus erythematosus (SLE). Methods This randomized, double-blind, single-dose, dose-escalation phase I study consisted of two parts. In part 1, 28 healthy individuals received CDP7657 IV (0.004–5 mg/kg) or placebo. In part 2, 17 patients with SLE received CDP7657 IV (5–60 mg/kg) or placebo. The CDP7657:placebo ratio was 3:1. Results Adverse events (AEs) were reported by 76% of healthy individuals and 100% of patients with SLE treated with CDP7657; most were mild or moderate in intensity. Two healthy individuals reported serious AEs (SAEs), one of which was considered treatment related (infusion-related reaction; 5 mg/kg cohort). One patient with SLE (60 mg/kg cohort) experienced three SAEs, one of which was considered treatment related (herpes zoster infection). No thromboembolic events were reported. CPD7657 exposure increased in a dose-proportional manner. Low anti-CDP7657 antibody titres were detected in the majority of CDP7657-treated participants with no apparent impact on the PK of CDP7657. Conclusion Single doses of CDP7657 showed predictable PK in healthy individuals and patients with SLE and were well tolerated, with no safety signals of concern. These findings support further investigation of CDP7657 as a therapy for SLE.
A qualitative evaluation of leadership development workshops for mental health workers from four Pacific Island Countries
Authors: Fung Paul , Montague Ros 
Published: March 2015

Objective: This paper provides a qualitative evaluation of a series of leadership development workshops held at the New South Wales Institute of Psychiatry (NSWIOP) for mental health workers from Papua New Guinea, Federated States of Micronesia, Republic of Marshall Islands, and Palau. Method: Fourteen mental health workers attended the week-long training focused on project management and partnership development skills. In-depth interviews were conducted with participants at the commencement and conclusion of the training, and questionnaires were completed. A focus group was conducted with the NSWIOP organisers. The data was analysed using qualitative techniques to identify emergent themes for both participants and NSWIOP project team. Findings: All Pacific Island participants responded positively to the training. All reported greater confidence in taking on formal or informal leadership roles in the workplace, developing project planning skills and interpersonal skills such as networking and partnerships. The NSWIOP organisers identified strengths and weaknesses in the delivery of this training. Conclusions: The strong partnerships developed between NSWIOP and the Ministry of Health in all four countries contributed to the success of the training. Leadership Development Programs are an important aspect of building capacity in the mental health services of Pacific Island Countries.
The dysfunctional consequences of a performance measurement system: the case of the Iranian national hospital grading programme
Authors: Aryankhesal Aidin , Sheldon Trevor A , Mannion Russell , Mahdipour Saeade 
Published: March 2015

Objectives Performance measurement systems are increasingly used to reward and improve provider performance. However, such initiatives may also inadvertently induce a range of unintended and dysfunctional side-effects. This study explores the unintended and adverse consequences induced by the Iranian national hospital grading programme, which incorporates financial incentives for meeting nationally defined standards. Methods We interviewed key informants across four key groups with a legitimate interest in healthcare performance: four purposively selected hospitals; four health insurance organizations; the Iranian hospital accreditation body; and one grading agency. The transcribed interviews and field notes were analysed thematically, and subsequently, member checking was conducted. Results Seven dysfunctional consequences were identified: misrepresentation of data by hospitals; increased anxiety and stress among hospital employees; tunnel vision; financial pressures on poorly graded hospitals; incentives to purchase unnecessary equipment; erosion of public trust; and restricting access to hospital services by patients. These were caused by the way the grading system was implemented: poor standards of audit; the way in which the audit process was conducted; and the timing of audits. The pay for performance element of the grading system and the focus on structural aspects in the standards made improvement in grading particularly difficult for those hospitals that had been assessed as under-performing. Conclusion Although the Iranian hospital grading system has resulted in a significant increase in the adoption of national standards, it has nevertheless induced a range of perverse outcomes. To mitigate these requires further refinement and recalibration of the system.
The psychological and linguistic profiles of self-reported code-switchers
Authors: Dewaele Jean-Marc , Zeckel Inga 
Published: March 2015

Aims and objectives/purpose/research questions: The study considers the relationships between multilinguals’ linguistic history, current linguistic practices, personality dimensions and self-reported frequency of code-switching (CS) in interactions with four types of interlocutors. It looks at variation in CS according to interlocutor type and the link with all the independent variables. Design/methodology/approach: Data was collected through an online questionnaire with closed questions on use of CS with friends, family members, colleagues and strangers. Data and analysis: A total of 298 adult multilingual participants of various nationalities provided scores on Likert scales. Statistical analyses were carried out to establish relationships between independent variables and CS. Findings/conclusions: The amount of self-reported CS differs significantly according to the type of interlocutor. A high level of multilingualism and early onset of bilingualism were linked with significantly more CS. High levels of Openmindedness and low levels of Flexibility were linked with significantly more frequent self-reported CS with certain types of interlocutors. Sex, age and education had no – or very little – effect on self-reported frequency of CS. Originality: The study confirms earlier research that considerable intra-individual variation exists in self-reported CS with various interlocutors. It shows that not just the linguistic but also the psychological profiles of participants determine the amount of self-reported CS. Significance/implications: Both linguistic and psychological variables need to be taken into account in the study of sociolinguistic phenomena. Limitations: Reporting frequency of CS with different categories of interlocutors requires a certain degree of metalinguistic awareness and some standard error cannot be excluded in self-reports.