bluuebunny/crossref_metadata_2025_split huggingface dataset:
UK doctors’ views on the implementation of the European Working Time Directive as applied to medical practice: a qualitative analysis
Authors: Clarke Rachel T , Pitcher Alex , Lambert Trevor W , Goldacre Michael J 
Published: February 2014

ObjectivesTo report on what doctors at very different levels of seniority wrote, in their own words, about their concerns about the European Working Time Directive (EWTD) and its implementation in the National Health Service (NHS).DesignAll medical school graduates from 1993, 2005 and 2009 were surveyed by post and email in 2010.SettingThe UK.MethodsUsing qualitative methods, we analysed free-text responses made in 2010, towards the end of the first year of full EWTD implementation, of three cohorts of the UK medical graduates (graduates of 1993, 2005 and 2009), surveyed as part of the UK Medical Careers Research Group's schedule of multipurpose longitudinal surveys of doctors.ResultsOf 2459 respondents who gave free-text comments, 279 (11%) made unprompted reference to the EWTD; 270 of the 279 comments were broadly critical. Key themes to emerge included frequent dissociation between rotas and actual hours worked, adverse effects on training opportunities and quality, concerns about patient safety, lowering of morale and job satisfaction, and attempts reportedly made in some hospitals to persuade junior doctors to collude in the inaccurate reporting of compliance.ConclusionsFurther work is needed to determine whether problems perceived with the EWTD, when they occur, are attributable to the EWTD itself, and shortened working hours, or to the way that it has been implemented in some hospitals.
Collaborative pharmaceutical care in an Irish hospital: uncontrolled before-after study
Authors: Grimes Tamasine C , Deasy Evelyn , Allen Ann , O'Byrne John , Delaney Tim , Barragry John , Breslin Niall , Moloney Eddie , Wall Catherine 
Published: February 2014

BackgroundWe investigated the benefits of the CollaborativePharmaceuticalCare inTallaght Hospital (PACT) service versus standard ward-based clinical pharmacy in adult inpatients receiving acute medical care, particularly on prevalence of medication error and quality of prescribing.MethodsUncontrolled before-after study, undertaken in consecutive adult medical inpatients admitted and discharged alive, using at least three medications. Standard care involved clinical pharmacists being ward-based, contributing to medication history taking and prescription review, but not involved at discharge. The innovative PACT intervention involved clinical pharmacists being team-based, leading admission and discharge medication reconciliation and undertaking prescription review. Primary outcome measures were prevalence per patient of medication error and potentially severe error. Secondary measures included quality of prescribing using the Medication Appropriateness Index (MAI) in patients aged ≥65 years.FindingsSome 233 patients (112 PACT, 121 standard) were included. PACT decreased the prevalence of any medication error at discharge (adjusted OR 0.07 (95% CI 0.03 to 0.15)); number needed to treat (NNT) 3 (95% CI 2 to 3) and no PACT patient experienced a potentially severe error (NNT 20, 95% CI 10 to 142). In patients aged ≥65 years (n=108), PACT improved the MAI score from preadmission to discharge (Mann–Whitney U p<0.05; PACT median −1, IQR −3.75 to 0; standard care median +1, IQR −1 to +6).ConclusionsPACT, a collaborative model of pharmaceutical care involving medication reconciliation and review, delivered by clinical pharmacists and physicians, at admission, during inpatient care and at discharge was protective against potentially severe medication errors in acute medical patients and improved the quality of prescribing in older patients.
We need to talk: an observational study of the impact of electronic medical record implementation on hospital communication
Authors: Taylor Stephanie Parks , Ledford Robert , Palmer Victoria , Abel Erika 
Published: February 2014

BackgroundIncreasing attention is being given to the importance of communication in the delivery of high-quality healthcare. We sought to determine whether communication improved in a hospital setting following the introduction of an electronic medical record (EMR).MethodsThis pre-post cohort design enrolled 75 patient-nurse-physician triads prior to the introduction of EMR, and 123 triads after the introduction of EMR. Nurses and patients reported whether they communicated with the physician that day. Patients, nurses and physicians answered several questions about the plan of care for the day. Responses were scored for degree of agreement and compared between pre-EMR and post-EMR cohorts. The primary outcome was Total Agreement Score, calculated as the sum of the agreement responses. Chart review was performed to determine patients’ actual length of stay.ResultsAlthough there was no difference between the frequency of nurses reporting communication with physicians before and after EMR, face-to-face communication was significantly reduced (67% vs 51%, p=0.03). Total Agreement Score was significantly lower after the implementation of EMR (p=0.03). Additionally, fewer patients accurately predicted their expected length of stay after EMR (34% vs 26%, p=0.001).ConclusionsThe implementation of EMR was associated with a decrease in face-to-face communication between physicians and nurses, and worsened overall agreement about the plan of care.
Geophysical characterization of the upper crust in the transitional zone between the Pampean flat slab and the normal subduction segment to the south (32–34°S): Andes of the Frontal Cordillera to the Sierras Pampeanas
Authors: Sánchez M. , Lince Klinger F. , Martinez M. P. , Alvarez O. , Ruiz F. , Weidmann C. , Folguera A. 
Published: February 2014

Abstract
The Nazca Plate subducting beneath the South American Plate has strongly influenced Cenozoic mountain growth in western Argentina and Chile sectors (32–34°S; 70–66°W). At these latitudes, the Pampean flat slab has induced the development of prominent mountain systems such as the Frontal Cordillera, the Precordillera, and the associated Sierras Pampeanas in the eastwards foreland region. Through a gravity study from the Frontal Cordillera to the Sierras Pampeanas region between 32 and 34°S, we delimit a series of geological structures that are accommodating shortening in the upper crust and others of regional and subsurface development, without any clearly defined mechanics of deformation. Additionally, through an isostatic residual anomaly map based on the Airy-Heiskanen local compensation model, we obtain a decompensative gravity anomaly map that highlights anomalous gravity sources emplaced in the upper crust, related to known geological structures. In particular, by applying the Tilt method which enhances the gravity anomalies, the NW-trending Tunuyan Lineament is depicted south of 33.4°S following previous proposals. Using the decompensative gravity anomaly, two profiles were modelled through the northern sector of the study area using deep seismic refraction lines, borehole data and geological information as constraints. These density models of the upper crust of this structurally complex area accurately represent basin geometries and basement topography and constitute a framework for future geological analysis.
Combination of Imatinib with CXCR4 Antagonist BKT140 Overcomes the Protective Effect of Stroma and Targets CML In Vitro and In Vivo
Authors: Beider Katia , Darash-Yahana Merav , Blaier Orly , Koren-Michowitz Maya , Abraham Michal , Wald Hanna , Wald Ori , Galun Eithan , Eizenberg Orly , Peled Amnon , Nagler Arnon 
Published: February 2014

Abstract
Functional role of CXCR4 in chronic myelogenous leukemia (CML) progression was evaluated. Elevated CXCR4 significantly increased the in vitro survival and proliferation in response to CXCL12. CXCR4 stimulation resulted in activation of extracellular signal-regulated kinase (Erk)-1/2, Akt, S6K, STAT3, and STAT5 prosurvival signaling pathways. In accordance, we found that in vitro treatment with CXCR4 antagonist BKT140 directly inhibited the cell growth and induced cell death of CML cells. Combination of BKT140 with suboptimal concentrations of imatinib significantly increased the anti-CML effect. BKT140 induced apoptotic cell death, decreasing the levels of HSP70 and HSP90 chaperones and antiapoptotic proteins BCL-2 and BCL-XL, subsequently promoting the release of mitochondrial factors cytochrome c and SMAC/Diablo. Bone marrow (BM) stromal cells (BMSC) markedly increased the proliferation of CML cells and protected them from imatinib-induced apoptosis. Furthermore, BMSCs elevated proto-oncogene BCL6 expression in the CML cells in response to imatinib treatment, suggesting the possible role of BCL6 in stroma-mediated TKI resistance. BKT140 reversed the protective effect of the stroma, effectively promoted apoptosis, and decreased BCL6 levels in CML cells cocultured with BMSCs. BKT140 administration in vivo effectively reduced the growth of subcutaneous K562-produced xenografts. Moreover, the combination of BKT140 with low-dose imatinib markedly inhibited tumor growth, achieving 95% suppression. Taken together, our data indicate the importance of CXCR4/CXCL12 axis in CML growth and CML–BM stroma interaction. CXCR4 inhibition with BKT140 antagonist efficiently cooperated with imatinib in vitro and in vivo. These results provide the rational basis for CXCR4-targeted therapy in combination with TKI to override drug resistance and suppress residual disease. Mol Cancer Ther; 13(5); 1155–69. ©2014 AACR.
Asparagine Depletion Potentiates the Cytotoxic Effect of Chemotherapy against Brain Tumors
Authors: Panosyan Eduard H. , Wang Yuntao , Xia Peng , Lee Wai-Nang Paul , Pak Youngju , Laks Dan R. , Lin Henry J. , Moore Theodore B. , Cloughesy Timothy F. , Kornblum Harley I. , Lasky Joseph L. 
Published: February 2014

Abstract
Targeting amino acid metabolism has therapeutic implications for aggressive brain tumors. Asparagine is an amino acid that is synthesized by normal cells. However, some cancer cells lack asparagine synthetase (ASNS), the key enzyme for asparagine synthesis. Asparaginase (ASNase) contributes to eradication of acute leukemia by decreasing asparagine levels in serum and cerebrospinal fluid. However, leukemic cells may become ASNase-resistant by upregulating ASNS. High expression of ASNS has also been associated with biologic aggressiveness of other cancers, including gliomas. Here, the impact of enzymatic depletion of asparagine on proliferation of brain tumor cells was determined. ASNase was used as monotherapy or in combination with conventional chemotherapeutic agents. Viability assays for ASNase-treated cells demonstrated significant growth reduction in multiple cell lines. This effect was reversed by glutamine in a dose-dependent manner—as expected, because glutamine is the main amino group donor for asparagine synthesis. ASNase treatment also reduced sphere formation by medulloblastoma and primary glioblastoma cells. ASNase-resistant glioblastoma cells exhibited elevated levels of ASNS mRNA. ASNase cotreatment significantly enhanced gemcitabine or etoposide cytotoxicity against glioblastoma cells. Xenograft tumors in vivo showed no significant response to ASNase monotherapy and little response to temozolomide alone. However, combinatorial therapy with ASNase and temozolomide resulted in significant growth suppression for an extended duration of time. Taken together, these findings indicate that amino acid depletion warrants further investigation as adjunctive therapy for brain tumors.
Implications: Findings have potential impact for providing adjuvant means to enhance brain tumor chemotherapy. Mol Cancer Res; 12(5); 694–702. ©2014 AACR.
Platelet Glycoprotein Ib-IX as a Regulator of Systemic Inflammation
Authors: Corken Adam , Russell Susan , Dent Judith , Post Steven R. , Ware Jerry 
Published: February 2014

Objective—
The platelet glycoprotein Ib-IX (GP Ib-IX) receptor is a well-characterized adhesion receptor supporting hemostasis and thrombosis via interactions with von Willebrand factor. We examine the GP Ib-IX/von Willebrand factor axis in murine polymicrobial sepsis, as modeled by cecal ligation and puncture (CLP).

Approach and Results—
Genetic absence of the GP Ib-IX ligand, von Willebrand factor, prolongs survival after CLP, but absence of the receptor, GP Ib-IX, does not. Because absence of either von Willebrand factor or GP Ib-IX significantly impairs hemostasis and thrombosis, we sought to define additional GP Ib-IX–dependent pathways impacting survival in the CLP model. We document that the absence of GP Ib-IX leads to reduced platelet–neutrophil and platelet–monocyte interactions. Twenty-four hours after CLP, absence of GP Ib-IX coincides with an alteration in cytokine levels, such as tumor necrosis factor-α secreted by monocytes, and increased macrophage-1 antigen expression by neutrophils.

Conclusions—
In contrast to the well-characterized proinflammatory properties of platelets, we describe in the CLP model an anti-inflammatory property associated with platelet GP Ib-IX. Thus, a single platelet receptor displays a dual modulatory role in both the thrombotic and inflammatory pathways associated with polymicrobial sepsis. In sharing leucine-rich motifs with toll-like receptors, platelet GP Ib-IX can be considered a multifunctional participant in hemostasis, thrombosis, and the inflammatory cascade. The results highlight a dynamic role for platelets in systemic inflammation and add to the complex pathophysiologic events that occur during the dysregulated coagulation and inflammation associated with sepsis.
Aberrant Chloride Intracellular Channel 4 Expression Contributes to Endothelial Dysfunction in Pulmonary Arterial Hypertension
Authors: Wojciak-Stothard Beata , Abdul-Salam Vahitha B. , Lao Ka Hou , Tsang Hilda , Irwin David C. , Lisk Christina , Loomis Zoe , Stenmark Kurt R. , Edwards John C. , Yuspa Stuart H. , Howard Luke S. , Edwards Robert J. , Rhodes Christopher J. , Gibbs J. Simon R. , Wharton John , Zhao Lan , Wilkins Martin R. 
Published: February 2014

Background—
Chloride intracellular channel 4 (CLIC4) is highly expressed in the endothelium of remodeled pulmonary vessels and plexiform lesions of patients with pulmonary arterial hypertension. CLIC4 regulates vasculogenesis through endothelial tube formation. Aberrant CLIC4 expression may contribute to the vascular pathology of pulmonary arterial hypertension.

Methods and Results—
CLIC4 protein expression was increased in plasma and blood-derived endothelial cells from patients with idiopathic pulmonary arterial hypertension and in the pulmonary vascular endothelium of 3 rat models of pulmonary hypertension. CLIC4 gene deletion markedly attenuated the development of chronic hypoxia-induced pulmonary hypertension in mice. Adenoviral overexpression of CLIC4 in cultured human pulmonary artery endothelial cells compromised pulmonary endothelial barrier function and enhanced their survival and angiogenic capacity, whereas CLIC4 shRNA had an inhibitory effect. Similarly, inhibition of CLIC4 expression in blood-derived endothelial cells from patients with idiopathic pulmonary arterial hypertension attenuated the abnormal angiogenic behavior that characterizes these cells. The mechanism of CLIC4 effects involves p65-mediated activation of nuclear factor-κB, followed by stabilization of hypoxia-inducible factor-1α and increased downstream production of vascular endothelial growth factor and endothelin-1.

Conclusion—
Increased CLIC4 expression is an early manifestation and mediator of endothelial dysfunction in pulmonary hypertension.
From the Book of Jeremiah to the Qumranic Apocryphon of Jeremiah
Authors: Dimant Devorah 
Published: February 2014

Abstract
The article shows that the two narrative fragments of the Qumran second century B.C.E. Apocryphon of Jeremiah C (4Q385a 18 and 4Q389 1) elaborate traditions of the prophet Jeremiah and his scribe Baruch. The juxtaposition of the two types of traditions in a single work attests to its early date. Such an early period, and perhaps even earlier one, is also reflected by the Hebrew Vorlage of the book of Jeremiah. Like the Greek translation this Hebrew Vorlage probably juxtaposed as appendix the book of Baruch 1:1–3:8 to the book of Jeremiah.
Attitudes to Gentiles in the Minor Prophets and in Corresponding Pesharim
Authors: Hagedorn Anselm C. , Tzoref Shani 
Published: February 2014

Abstract
This essay surveys the attitudes towards gentiles/foreign nations in constructions of the “other” in the Minor Prophets of the Hebrew Bible, and examines how the biblical trajectories are continued and reshaped in the corresponding pesharim from Qumran. The development of the biblical texts is examined from historical, literary, and theological perspectives. Thus, for example, the concrete historical encounter with Assyria shaped the original prophecies of the last three pre-exilic prophets (Nahum, Habakkuk and Zephaniah), while later redactional layers transform these texts by incorporating the experience of the Babylonian conquest. Literarily and theologically, the initial texts focus upon individual judgement against a concrete people, and the divine salvation of Israel from this threat. In the Persian period, there is an initial expansion of the focus to universal judgment, highlighting the special status of Israel vis-à-vis other nations. This is followed by a narrowing of the group selected for salvation, so that only the righteous of Judah will survive the final judgment. In the pesharim, there is further narrowing of the discourse of alterity for internal identity formation, as the biblical prophecies against foreign enemies are applied to the group’s contemporary antagonists, including rival Jewish groups. Pesher Habakkuk closely follows the book of Habakkuk in depicting Gentiles as idolators, and in portraying foreign nations as both instruments and objects of divine retribution. The references to the Babylonians (termed “Chaldeans”) in Habakkuk are applied in the pesher to the “Kittim,” understood by modern scholars to stand for Rome. This view of Rome as a significant existential and eschatological enemy reflects a profound theological and psychological development in sectarian thought. Pesher Nahum interprets the prophecies against Gentiles in Nahum primarily as condemnation of Jewish enemies.
Sophistische Satyrn
Authors: Bernhardt Jan 
Published: February 2014

Abstract
Since the discovery of the so-called Oineus fragment, which can with some certainty be attributed to Sophocles, it has been believed that the appearing Satyrs are a parody of the Sophists. This supposition has consequences for our understanding of the Satyr play: Usually, only Euripides᾿ Cyclops is believed to include contemporary allusions, but a closer examination of further fragments besides the Oineus fragment yields the conclusion that comic effects based on similar allusions might have been a common and regular feature of Satyr plays. So my aim is firstly, after a brief discussion of the fragment, to prove that the Satyrs are in fact a parody of the Sophists; in a second step I will analyze the Cyclops and some further fragments for contemporary allusions and then compare them with the Oineus fragment, until I finally draw my conclusion with regard to the appropriate interpretation of the Satyr play.
Irrational Animals in Porphyry’s Logical Works: A Problem for the Consensus Interpretation of On Abstinence
Authors: Edwards G. Fay 
Published: February 2014

Abstract
In book 3 of On Abstinence from Animal Food, Porphyry is traditionally taken to argue that animals are rational and that it is, therefore, unjust to kill them for food. Since the vast majority of scholars endorse this interpretation, I call it ‘the consensus interpretation’. Yet, strangely enough, elsewhere in his corpus Porphyry claims that the non-human animals are irrational. Jonathan Barnes notices this discrepancy and suggests that an appeal to the distinction between specific and non-specific predication can resolve the problem. This paper explains Barnes’ solution, but argues that it must ultimately be rejected. It concludes with a brief survey of other approaches to the problem, and with an outline of the proposed solution, in which the consensus interpretation of On Abstinence is rejected in favour of a dialectical reading of Book 3. Porphyry, this piece suggests, may not have believed that animals were rational after all.
Open Completeness: Messiaen’s “Quartet for the End of Time”
Authors: Greene David 
Published: February 2014

Abstract
Several of Messiaen’s compositional techniques are designed, he says, to “eliminate temporality.” They succeed. Still, in a variety of highly original and interesting ways, the piece also sustains temporality. Joining the elimination of temporality with its opposite in each movement puts listeners onto the infinitesimal interface of the temporal and the eternal. The undoing and the redoing of temporality happen so differently in the various movements, however, that no procession from one movement to the next takes place. This absence of temporal coherence in the Quartet as a whole is an additional mode of eliminating temporality, but one that is, in Messiaen’s hands, joined to a strange and new kind of completeness. The salient characteristic of the latter is that while the completeness is authentic, and brings the satisfaction that is a quality of completions, it is radically open to further, though not necessarily surpassing, completions.
Entanglements—Intimacy and Nonhuman Ethics
Authors: Reinert Hugo 
Published: February 2014

AbstractDrawing on ethnographic material from the Norwegian Arctic, this article explores issues of specificity, encounter, and emplacement in human-animal relations through the lens of modernizing indigenous reindeer pastoralism in the region. In turn, the main sections of the argument examine three things: first, the changing technological context of indigenous herding practice, focusing on the impact of mechanization and the emergence of “roundup corrals” in the second half of the twentieth century; second, the distinct modalities of specificity at work in human-reindeer relations, exemplified particularly in practices of enumeration; and third, how ongoing controversies over supplementary feeding bring into view a herding ethic of “liminality” that cultivates distance as a precondition for maintaining the autonomy and independence of the “semi-domesticated” reindeer—opening up the possibility of reframing apparent neglect (at least partially) as a practice of care. In closing, some questions are raised concerning nonhuman ethics at the intersection between visibility, presence, and encounter.
Between “Wild” and “Tame”: Placing Encounters with Sirocco the Kakapo Parrot in Aotearoa/New Zealand
Authors: Chambers Charlotte N. L. , Main Michelle E. 
Published: February 2014

AbstractThis article explores different dynamics and spatialities of nonhuman animal encounters to illuminate important intersections between place and human-animal relations. The article focuses on Sirocco the Kakapo, an endangered New Zealand parrot, who due to illness as a chick was hand-reared in isolation from other Kakapo. Informed by qualitative research, data was gathered through interviewing those involved in the Kakapo Recovery Programme and from Internet websites and publications featuring Sirocco. Based on this research, it can be demonstrated how Sirocco, unlike his fellow Kakapo, is a bird who can traverse the seemingly clear-cut and spatially inscribed boundaries between “wild” and “tame,” between “human” and “animal,” and between “wild” and “domestic” places. Drawing upon relational theories of space and place in human geography, the case of Sirocco is used to interrogate and inform theorizations concerning the place of nonhuman animals in both spatial and conceptual terms. Sirocco’s story illuminates the complex and heterogeneous relations of encounter that stretch between New Zealand’s wild and domestic places, which in turn rely upon particular notions of wild and tame and prescribed relations between humans and “wild animals” that inhere in conservation practice more broadly.