bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Arctic Exception and the IMO’s PSSA Mechanism: Assessing their Value as Sources of Protection for the Northwest Passage
Authors: Lalonde Suzanne 
Published: September 2013

Abstract
For more than half a century, Canada has affirmed that all of the waters within its Arctic archipelago, including the Northwest Passage, are Canadian historic internal waters over which it exercises sovereign control. Canada’s detractors have qualified the Canadian position as excessive, arguing that the Northwest Passage is an international strait and that international legal regimes guarantee the preservation of the Arctic waterway. It is this contention, that international legal tools exist—specifically Article 234 of the LOSC and the IMO’s PSSA mechanism—and that they would adequately protect the Northwest Passage even if it came to be recognized as an international strait, which is the subject of investigation.
How Does the Quasi-Biennial Oscillation Affect the Stratospheric Polar Vortex?
Authors: Watson Peter A. G. , Gray Lesley J. 
Published: September 2013

Abstract
The stratospheric polar vortex is weaker in the easterly phase of the quasi-biennial oscillation (QBO-E) than in the westerly phase (QBO-W), but the mechanism behind the QBO's influence is not well understood. The composite difference of the atmospheric state between QBO-E and QBO-W is found to closely resemble the structure of the northern annular mode, the leading empirical orthogonal function of stratospheric variability, including its wave components. Studies of dynamical systems indicate that many different forcings could give rise to this response, and therefore this composite difference does not provide much information about the forcing mechanism. It is argued that the full transient response of a system to an applied forcing is likely to be much more informative about the dynamics of the forcing mechanism, especially the response on time scales shorter than the dynamical time scale, which is about a week for vortex variability. It is shown that the transient response of the vortex to forcing by the QBO in a general circulation model is consistent with the proposed mechanism of Holton and Tan, indicating that this mechanism has a role in the QBO modulation of vortex strength, in contrast to the conclusions of several recent studies. This novel approach of examining the transient response to a forcing on short time scales may be useful in various other outstanding problems.
Lagrangian Time Scales and Eddy Diffusivity at 1000 m Compared to the Surface in the South Pacific and Indian Oceans
Authors: Chiswell Stephen M. 
Published: September 2013

Abstract
Argo floats cannot be regarded as true Lagrangian drifters because they periodically rise to the surface. Hence, previous estimates of eddy diffusivity at depth using single-particle statistics have been limited to one submerged cycle. However, unless the Lagrangian time scale is significantly shorter than the Argo cycle time, this single-particle calculation can have a large bias. Here, eddy diffusivity computed from single-particle statistics using Argo data is compared to that computed by assuming that Eulerian scales at depth are the same as at the surface, and that the relationship between Lagrangian and Eulerian time scales derived by Middleton is valid. If the methods provide the same answer, one can have confidence in both methods. Eddy diffusivity calculated from the single-particle statistics shows the same spatial structure as that computed from inferred time scale, but is smaller by a factor of about 2. It is suggested that this is because the deep Lagrangian time scale over much of the region is comparable to, or longer than, the 10-day Argo submergence cycle.
The Effects of Human Finger and Chinese Character on Chinese Handwriting Performance on Mobile Touch Devices
Authors: Chen Zhe , Rau Pei-Luen Patrick , Chen Cuiling 
Published: September 2013

Objective: The aim of the present study is to investigate Chinese handwriting on mobile touch devices, considering the effects of three characteristics of the human finger (type, length, and width) and three characteristics of Chinese characters (direction of the first stroke, number of strokes, and structure). Background: Due to the popularity of touch devices in recent years, finger input for Chinese characters has attracted more attention from both industry and academia. However, previous studies have no systematical consideration on the effects of human finger and Chinese characters on Chinese handwriting performance. Method: An experiment was reported in this article to illustrate the effects of the human finger and Chinese characters on the Chinese handwriting performance (i.e., input time, accuracy, number of protruding strokes, mental workload, satisfaction, and physical fatigue). Results: The experiment results indicated that all six factors have significant effects on Chinese handwriting performance, especially on the input time, accuracy, and number of protruding strokes. Conclusion: Finger type, finger length, finger width, direction of the first stroke, number of strokes, and character structures are significantly influencing Chinese handwriting performance. These factors should be taken into more consideration in future research and the practical design for Chinese handwriting systems.
Effectiveness of a Community Health Worker–led Diabetes Self-Management Education Program and Implications for CHW Involvement in Care Coordination Strategies
Authors: Collinsworth Ashley W. , Vulimiri Madhulika , Schmidt Kathryn L. , Snead Christine A. 
Published: September 2013

Purpose The purpose of this study was to evaluate the effectiveness of a Community Health Worker (CHW)–led diabetes self-management education (DSME) program and to understand how CHWs and primary care providers (PCPs) work together to provide comprehensive diabetes care. Methods A quantitative pre- and postassessment of change in patients’ blood glucose levels (A1C), blood pressure, and body mass index was performed to determine the clinical effectiveness of the program. Qualitative, semi-structured interviews with 5 CHWs and 7 PCPs were conducted to assess how CHWs were incorporated into clinical teams and their impact on care delivery and diabetes-related outcomes. Results Patients who participated in the program experienced a statistically significant decrease in mean A1C levels and systolic blood pressure readings 1 year post baseline. CHWs provided high-quality care and bridged the gap between patients and care providers through diabetes management support and education, medication assistance, access to community resources, and social support. Conclusions CHWs play a variety of roles in helping patients overcome barriers to diabetes control and can be successfully integrated into a health care system’s care coordination strategy.
Clinical outcomes and safety of rituximab treatment for patients with systemic lupus erythematosus (SLE) – results from a nationwide cohort in Germany (GRAID)
Authors: Witt M , Grunke M , Proft F , Baeuerle M , Aringer M , Burmester G , Chehab G , Fiehn C , Fischer-Betz R , Fleck M , Freivogel K , Haubitz M , Kötter I , Lovric S , Metzler C , Rubberth-Roth A , Schwarting A , Specker C , Tony H-P , Unger L , Wassenberg S , Dörner T , Schulze-Koops H 
Published: September 2013

Objective The objective of this article is to evaluate the safety and clinical outcome of rituximab treatment in systemic lupus erythematosus (SLE) patients refractory to standard of care therapy in a real-life setting in Germany. Methods The GRAID registry included patients with different autoimmune diseases who were given off-label treatment with rituximab. Data on safety and clinical response were collected retrospectively. In SLE patients, clinical parameters included tender and swollen joint counts, fatigue, myalgia, general wellbeing, Raynaud’s and the SLEDAI index. Laboratory tests included dsDNA antibody titres, complement factors, hematologic parameters and proteinuria. Finally, the investigators rated their patients as non-, partial or complete responders based on clinical grounds. Results Data from 85 SLE patients were collected, 69 female and 16 male, with a mean disease duration of 9.8 years. The mean follow-up period was 9.6 ± 7.4 months, resulting in 66.8 patient years of observation. A complete response was reported in 37 patients (46.8%), partial response in 27 (34.2%), no response in 15 (19.0%). On average, major clinical as well as laboratory efficacy parameters improved substantially, with the SLEDAI decreasing significantly from 12.2 to 3.3 points. Concerning safety, one infusion reaction leading to discontinuation of treatment occurred. Infections were reported with a rate of 19.5 (including six severe infections) per 100 patient years. Conclusion With the restrictions of a retrospective data collection, the results of this study confirm data of other registries, which suggest a favourable benefit-risk ratio of rituximab in patients with treatment-refractory SLE.
Preferences of Patients With Parkinson’s Disease for Communication About Advanced Care Planning
Authors: Tuck Keiran K. , Brod Lissa , Nutt John , Fromme Erik K. 
Published: September 2013

Background: Despite shortening life, Parkinson’s disease (PD) is often not considered “terminal.” Uncertainty exists about when to discuss end-of-life planning. Methods: A survey was sent to patients with PD assessing attitudes toward the timing and initiation of discussions regarding their disease. Data were analyzed for patient preferences regarding communication. Results: Of 585 surveys, 267 were returned. Ninety-four percent of patients wanted prognosis and treatment information early. Half of the patients wanted to discuss advanced care documents early. Some wanted early discussions about end-of-life care planning (27%) or end-of-life care options such as hospice (21%). The majority felt shared responsibility for initiating discussions about life expectancy, advance care documents, and end-of-life care planning. Conclusions: Preferences regarding end-of-life discussions vary. Consequently, neurologists should ask patients about their preferences for this information and offer discussion periodically.
Bowel preparation regimens for colon capsule endoscopy: a review
Authors: Singhal Shashideep , Nigar Sofia , Paleti Vani , Lane Devin , Duddempudi Sushil 
Published: September 2013

Colon capsule endoscopy (CCE) is being actively evaluated as an emerging complementary or alternative procedure for evaluation of the colon. The yield of CCE is significantly dependent on the quality of bowel preparation. In addition to achieving a stool-free colon the bowel preparation protocols need to decrease bubble effect and aid propulsion of the capsule. An extensive English literature search was done using PubMed with search terms of colon capsule endoscopy, PillCam and bowel preparation. Full-length articles which met the criteria were included for review. A total of 12 studies including 1149 patients were reviewed. There was significant variability in the type of bowel preparation regimens. Large-volume (3–4 liters) polyethylene glycol (PEG) was the most widely used laxative. Lower volumes of PEG showed comparable results but larger studies are needed to determine efficacy. Sodium phosphate was used as an effective booster in most studies. Magnesium citrate and ascorbic acid are emerging as promising boosters to replace sodium phosphate when it is contraindicated. The potential benefit of prokinetics needs further evaluation. Over the past decade there has been significant improvement in the bowel preparation regimens for CCE. Further experience and studies are likely to standardize the bowel preparation regimens before CCE is adopted into routine clinical practice.
EZH2 mutations are frequent and represent an early event in follicular lymphoma
Authors: Bödör Csaba , Grossmann Vera , Popov Nikolay , Okosun Jessica , O’Riain Ciarán , Tan King , Marzec Jacek , Araf Shamzah , Wang Jun , Lee Abigail M. , Clear Andrew , Montoto Silvia , Matthews Janet , Iqbal Sameena , Rajnai Hajnalka , Rosenwald Andreas , Ott German , Campo Elias , Rimsza Lisa M. , Smeland Erlend B. , Chan Wing C. , Braziel Rita M. , Staudt Louis M. , Wright George , Lister T. Andrew , Elemento Olivier , Hills Robert , Gribben John G. , Chelala Claude , Matolcsy András , Kohlmann Alexander , Haferlach Torsten , Gascoyne Randy D. , Fitzgibbon Jude 
Published: September 2013

Key Points
EZH2 mutations occur in more than 25% of follicular lymphoma patients. Mutations predominantly represent an early/clonal event in the pathogenesis of the disease.
Management of the refractory aplastic anemia patient: what are the options?
Authors: Marsh Judith C. W. , Kulasekararaj Austin G. 
Published: September 2013

Abstract
Refractory aplastic anemia (AA) is defined as a lack of response to first-line immunosuppressive therapy (IST) with antithymocyte globulin and cyclosporin and is manifested as persistence of severe cytopenias at 6 months after IST. Although supportive care is critical for AA patients, it is of paramount importance for refractory disease in view of the longer duration of pancytopenia and susceptibility to life-threatening infections due to IST. Improvements in supportive care have largely contributed to better outcome over the past 2 decades, with 5-year overall survival reaching 57% during 2002 to 2008 for patients with AA unresponsive to initial IST. Exclusion of hypocellular myelodysplastic syndrome and constitutional BM failure masquerading as apparent idiopathic AA should be done in conjunction with centers of excellence. Hematopoietic stem cell transplantation is indicated if refractory AA patients are fit and have a suitably matched donor, either a sibling (>40-50 years) or unrelated donor. Patients lacking a fully matched donor should be considered for a second course of antithymocyte globulin plus cyclosporin, although response in the refractory setting is only ∼30% to 35%. Response may also occur with alemtuzumab or the thrombopoietin mimetic eltrombopag in refractory AA. The emerging data for alternate donor (cord or haploidentical) transplantation in AA has provided additional therapeutic choices to consider in refractory disease.
Detection of human leptospirosis as a cause of acute fever by capture ELISA using a Leptospira interrogansserovar Copenhageni (M20) derived antigen
Authors: Canal Enrique , Pollett Simon , Heitzinger Kristen , Gregory Michael , Kasper Matthew , Halsey Eric , Meza Yocelinda , Campos Kalina , Perez Juan , Meza Rina , Bernal Maruja , Guillen Alfredo , Kochel Tadeusz J , Espinosa Benjamin , Hall Eric R , Maves Ryan C 
Published: September 2013

Abstract

Background
Leptospirosis is a potentially lethal zoonosis mainly affecting low-resource tropical countries, including Peru and its neighbouring countries. Timely diagnosis of leptospirosis is critical but may be challenging in the regions where it is most prevalent. The serodiagnostic gold standard microagglutination test (MAT) may be technically prohibitive. Our objective in this study was to assess the sensitivity, specificity, and predictive value of an IgM antibody capture enzyme-linked immunoassay (MAC-ELISA) derived from the M20 strain of Leptospira interrogans serovar Copenhageni (M20) by comparison to MAT, which was used as the gold standard method of diagnosis.

Methods
Acute and convalescent sera from participants participating in a passive febrile surveillance study in multiple regions of Peru were tested by both IgM MAC-ELISA and MAT. The sensitivity, specificity, positive and negative predictive value (PPV, NPV) of the MAC-ELISA assay for acute, convalescent and paired sera by comparison to MAT were calculated.

Results
The sensitivity, specificity, PPV and NPV of the MAC-ELISA assay for acute sera were 92.3%, 56.0%, 35.3% and 96.6% respectively. For convalescent sera, the sensitivity, specificity, PPV and NPV of the MAC-ELISA assay were 93.3%, 51.5%, 63.6% and 89.5% respectively. For paired sera, the sensitivity, specificity, PPV and NPV of the MAC-ELISA assay were 93.6%, 37.5%, 59.2%, 85.7% respectively.

Conclusions
The M20 MAC-ELISA assay performed with a high sensitivity and low specificity in the acute phase of illness. Sensitivity was similar as compared with MAT in the convalescent phase and specificity remained low. Paired sera were the most sensitive but least specific by comparison to MAT serodiagnosis. NPV for acute, convalescent and paired sera was high. The limited specificity and high sensitivity of the MAC-ELISA IgM suggests that it would be most valuable to exclude leptospirosis in low-resource regions that lack immediate access to definitive reference laboratory techniques such as MAT.
Better together? a naturalistic qualitative study of inter-professional working in collaborative care for co-morbid depression and physical health problems
Authors: Knowles Sarah E , Chew-Graham Carolyn , Coupe Nia , Adeyemi Isabel , Keyworth Chris , Thampy Harish , Coventry Peter A 
Published: September 2013

Abstract

Background
Mental-physical multi-morbidities pose challenges for primary care services that traditionally focus on single diseases. Collaborative care models encourage inter-professional working to deliver better care for patients with multiple chronic conditions, such as depression and long-term physical health problems. Successive trials from the United States have shown that collaborative care effectively improves depression outcomes, even in people with long-term conditions (LTCs), but little is known about how to implement collaborative care in the United Kingdom. The aim of the study was to explore the extent to which collaborative care was implemented in a naturalistic National Health Service setting.

Methods
A naturalistic pilot study of collaborative care was undertaken in North West England. Primary care mental health professionals from IAPT (Increasing Access to Psychological Therapies) services and general practice nurses were trained to collaboratively identify and manage patients with co-morbid depression and long-term conditions. Qualitative interviews were performed with health professionals at the beginning and end of the pilot phase. Normalization Process Theory guided analysis.

Results
Health professionals adopted limited elements of the collaborative care model in practice. Although benefits of co-location in primary care practices were reported, including reduced stigma of accessing mental health treatment and greater ease of disposal for identified patients, existing norms around the division of mental and physical health work in primary care were maintained, limiting integration of the mental health practitioners into the practice setting. Neither the mental health practitioners nor the practice nurses perceived benefits to joint management of patients.

Conclusions
Established divisions between mental and physical health may pose particular challenges for multi-morbidity service delivery models such as collaborative care. Future work should explore patient perspectives about whether greater inter-professional working enhances experiences of care. The study demonstrates that research into implementation of novel treatments must consider how the introduction of innovation can be balanced with the need for integration into existing practice.
Evaluation of losses of replacement heifers in pastoral and peri-urban camel herds in semi-arid northern Kenya
Authors: Shibia Mumina G , Owuor George , Bebe Bockline O 
Published: September 2013

Abstract
This study estimated heifer losses and associated determinants in peri-urban camel herds characterized by market orientation and domination of lactating camels grazing closer to urban market outlets for milk. In this evolving peri-urban camel production system in semi-arid Kenya, the proportion of heifers born that survives to breeding age is important in sustaining the herds and the extent to which households obtain tangible and intangible benefits from camel keeping. Data was obtained through progeny history recall on 2,000 heifer loss cases out of 4,398 heifers born between 1991 and 2009. The estimated heifer loss was 0.455 and was 11.8% higher (P < 0.0001) in peri-urban herds (0.505 ± 0.040) than in pastoral herds (0.387 ± 0.047). The extent of heifer loss was significantly associated with veterinary service access (P < 0.05), labour hire (P < 0.01) and state of security (P < 0.01). Results provide lessons for policy intervention to support evolution of peri-urban camel milk production. Improving infrastructure and the security situation is necessary to enhance delivery of veterinary service and feed supply interventions to peri-urban camel herds for production of milk and breeding stock.
Raltegravir does not revert efflux activity of MDR1-P-glycoprotein in human MDR cells
Authors: Dupuis Maria Luisa , Ascione Alessandro , Palmisano Lucia , Vella Stefano , Cianfriglia Maurizio 
Published: September 2013

Abstract

Background
Raltegravir (Isentress®)(RALT) has demonstrated excellent efficacy in both treatment-experienced and naïve patients with HIV-1 infection, and is the first strand transfer integrase inhibitor to be approved for use in HIV infected adults worldwide. Since the in vivo efficacy of this class of antiviral drugs depends on their access to intracellular sites where HIV-1 replicates, we analyzed the biological effects induced by RALT on human MDR cell systems expressing multidrug transporter MDR1-P-glycoprotein (MDR1-Pgp).

Methods
Our study about RALT was performed by using a set of consolidated methodologies suitable for evaluating the MDR1-Pgp substrate nature of chemical and biological agents, namely: i) assay of drug efflux function; ii) analysis of MDR reversing capability by using cell proliferation assays; iii) monoclonal antibody UIC2 (mAb) shift test, as a sensitive assay to analyze conformational transition associated with MDR1-Pgp function; and iv) induction of MDR1-Pgp expression in MDR cell variant subjected to RALT exposure.

Results
Functional assays demonstrated that the presence of RALT does not remarkably interfere with the efflux mechanism of CEM-VBL100 and HL60 MDR cells. Accordingly, cell proliferation assays clearly indicated that RALT does not revert MDR phenotype in human MDR1-Pgp expressing cells. Furthermore, exposure of CEM-VBL10 cells to RALT does not induce MDR1-Pgp functional conformation intercepted by monoclonal antibody (mAb) UIC2 binding; nor does exposure to RALT increase the expression of this drug transporter in MDR1-Pgp expressing cells.

Conclusions
No evidence of RALT interaction with human MDR1-Pgp was observed in the in vitro MDR cell systems used in the present investigation, this incorporating all sets of studies recommended by the FDA guidelines. Taken in aggregate, these data suggest that RALT may express its curative potential in all sites were HIV-1 penetrates, including the MDR1-Pgp protected blood/tissue barrier. Moreover RALT, evading MDR1-Pgp drug efflux function, would not interfere with pharmacokinetic profiles of co-administered MDR1-Pgp substrate antiretroviral drugs.