bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality improvement in emergency obstetric referrals: qualitative study of provider perspectives in Assin North district, Ghana
Authors: Afari Henrietta , Hirschhorn Lisa R , Michaelis Annie , Barker Pierre , Sodzi-Tettey Sodzi 
Published: May 2014

ObjectiveTo describe healthcare worker (HCW)-identified system-based bottlenecks and the value of local engagement in designing strategies to improve referral processes related to emergency obstetric care in rural Ghana.DesignQualitative study using semistructured interviews of participants to obtain provider narratives.SettingReferral systems in obstetrics in Assin North Municipal Assembly, a rural district in Ghana. This included one district hospital, six health centres and four local health posts. This work was embedded in an ongoing quality improvement project in the district addressing barriers to existing referral protocols to lessen delays.Participants18 HCWs (8 midwives, 4 community health officers, 3 medical assistants, 2 emergency room nurses, 1 doctor) at different facility levels within the district.ResultsWe identified important gaps in referral processes in Assin North, with the most commonly noted including recognising danger signs, alerting receiving units, accompanying critically ill patients, documenting referral cases and giving and obtaining feedback on referred cases. Main root causes identified by providers were in four domains: (1) transportation, (2) communication, (3) clinical skills and management and (4) standards of care and monitoring, and suggested interventions that target these barriers. Mapping these challenges allowed for better understanding of next steps for developing comprehensive, evidence-based solutions to identified referral gaps within the district.ConclusionsProviders are an important source of information on local referral delays and in the development of approaches to improvement responsive to these gaps. Better engagement of HCWs can help to identify and evaluate high-impact holistic interventions to address faulty referral systems which result in poor maternal outcomes in resource-poor settings. These perspectives need to be integrated with patient and community perspectives.
Differential motor neuron involvement in progressive muscular atrophy: a comparative study with amyotrophic lateral sclerosis
Authors: Riku Yuichi , Atsuta Naoki , Yoshida Mari , Tatsumi Shinsui , Iwasaki Yasushi , Mimuro Maya , Watanabe Hirohisa , Ito Mizuki , Senda Jo , Nakamura Ryoichi , Koike Haruki , Sobue Gen 
Published: May 2014

ObjectiveProgressive muscular atrophy (PMA) is a clinical diagnosis characterised by progressive lower motor neuron (LMN) symptoms/signs with sporadic adult onset. It is unclear whether PMA is simply a clinical phenotype of amyotrophic lateral sclerosis (ALS) in which upper motor neuron (UMN) signs are undetectable. To elucidate the clinicopathological features of patients with clinically diagnosed PMA, we studied consecutive autopsied cases.DesignRetrospective, observational.SettingAutopsied patients.ParticipantsWe compared clinicopathological profiles of clinically diagnosed PMA and ALS using 107 consecutive autopsied patients. For clinical analysis, 14 and 103 patients were included in clinical PMA and ALS groups, respectively. For neuropathological evaluation, 13 patients with clinical PMA and 29 patients with clinical ALS were included.Primary outcome measuresClinical features, UMN and LMN degeneration, axonal density in the corticospinal tract (CST) and immunohistochemical profiles.ResultsClinically, no significant difference between the prognosis of clinical PMA and ALS groups was shown. Neuropathologically, 84.6% of patients with clinical PMA displayed UMN and LMN degeneration. In the remaining 15.4% of patients with clinical PMA, neuropathological parameters that we defined as UMN degeneration were all negative or in the normal range. In contrast, all patients with clinical ALS displayed a combination of UMN and LMN system degeneration. CST axon densities were diverse in the clinical PMA group, ranging from low values to the normal range, but consistently lower in the clinical ALS group. Immunohistochemically, 85% of patients with clinical PMA displayed 43-kDa TAR DNA-binding protein (TDP-43) pathology, while 15% displayed fused-in-sarcoma (FUS)-positive basophilic inclusion bodies. All of the patients with clinical ALS displayed TDP-43 pathology.ConclusionsPMA has three neuropathological background patterns. A combination of UMN and LMN degeneration with TDP-43 pathology, consistent with ALS, is the major pathological profile. The remaining patterns have LMN degeneration with TDP-43 pathology without UMN degeneration, or a combination of UMN and LMN degeneration with FUS-positive basophilic inclusion body disease.
Alcoholic Chlorhexidine or Alcoholic Iodine Skin Antisepsis (ACAISA): protocol for cluster randomised controlled trial of surgical skin preparation for the prevention of superficial wound complications in prosthetic hip and knee replacement surgery
Authors: Peel T N , Cheng A C , Buising K L , Dowsey M M , Choong P F M 
Published: May 2014

IntroductionWound complications following arthroplasty are associated with significant impact on the patient and healthcare system. Skin cleansing prior to surgical incision is a simple and effective method to prevent wound complications however, the question of which agent is superior for surgical skin antisepsis is unresolved.Methods and analysisThis cluster randomised controlled trial aims to compare the incidence of superficial wound complications in patients undergoing elective prosthetic hip or knee replacement surgery receiving surgical skin antisepsis with either: 0.5% chlorhexidine gluconate (CHG) in 70% alcohol or 10% povidone in 70% alcohol. The trial will be conducted at an Australian tertiary, university affiliated hospital over a 3-year period involving 750 participants. Participants will be drawn from the surgical waiting list. Consent for this study will be ‘opt-out’ consent. On a given day, all eligible participants will have skin preparation either with 0.5% chlorhexidine in 70% alcohol or 10% povidone iodine in 70% alcohol. The primary outcome is superficial wound complications (comprised of superficial incisional surgical site infections (SSI) and/or prolonged wound ooze) in the first 30 days following prosthetic joint replacement surgery. Secondary outcomes will include the incidence of wound complications according to the joint replaced, assessment of the causative agents of SSI and cost-effectiveness analysis. The primary analysis is an intention-to-treat analysis including all participants who undergo randomisation and will be performed at the individual level taking into account the clustering effect.Ethics and disseminationThe study design and protocol was reviewed and approved by the St Vincent's Hospital Human Research Ethics Committee (HREC-A 016/14 10/3/2014). Study findings will be disseminated in the printed media, and learned forums. A written lay summary will be available to study participants on request.Trial registration numberThe trial has been registered with the Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12614000177651.
Preference for a single or shared room in a UK inpatient hospice: patient, family and staff perspectives
Authors: Williams Clare , Gardiner Clare 
Published: May 2014

ObjectiveThis study investigated the preferences of patients, family and staff for single or shared rooms in a UK hospice.MethodSemistructured interviews were conducted with patients, informal carers and staff at a hospice, focusing on room type preference.Results14 current and former hospice inpatients, 15 patients attending the hospice day centre, 23 carers of current and former inpatients and 10 hospice staff were interviewed. Patients most often stated a preference for a shared room, especially if they had experience of being in this room type at the hospice. The main reason for this preference was the company of others. Patients preferring single rooms cited the benefits of increased privacy, reduced noise and private facilities. Other patients said their room preference would depend on how ill they were. Carers valued the social contact and increased staff presence in shared rooms, but felt that single rooms were easier for visitors and more appropriate when patients reached the end of life. Staff found it easier to observe patients in a shared room, and to maintain privacy and confidentiality in a single room.ConclusionsThe study concludes that single and shared rooms should be available in a hospice. Innovative planning can enable the social benefits of shared rooms to be maintained without compromising patients’ privacy and dignity.
CREDIT-EQUITY MODELING UNDER A LATENT LÉVY FIRM PROCESS
Authors: KIJIMA MASAAKI , SIU CHI CHUNG 
Published: May 2014

Recent empirical studies have demonstrated the informative nature of the equity returns in explaining the variation of the underlying firm's credit default swap (CDS) spreads. Motivated by these findings, we propose a unified credit-equity model by extending the latent structural model in Kijima et al. (2009). As in the original latent model, we treat the actual status of the firm to be unobservable and one can extract information from the marker process that is observable to the investors. Default occurs when the actual firm value drops below a default threshold for the first time. Different from the model in Kijima et al. (2009), however, we define the marker process to be the firm's equity process. Choosing firm's equity process to be a marker process subsequently relaxes the restrictions imposed in Kijima et al. (2009), enabling us to price firm-related securities. Additionally, we enrich the original latent structural model with jump and regime-switching dynamics. The purpose of the extensions is to capture more realistic credit spreads and implied volatility skews under different economic environments. The proposed model maintains analytical tractability even under such complex dynamics, for the prices of CDSs and equity options admit semi-closed-form solutions. In sum, our model can evaluate corporate securities and their derivatives in a unified framework.
A Rare Polymorphic Variant of NBS1 Reduces DNA Repair Activity and Elevates Chromosomal Instability
Authors: Yamamoto Yuki , Miyamoto Mamiko , Tatsuda Daisuke , Kubo Michiaki , Nakagama Hitoshi , Nakamura Yusuke , Satoh Hitoshi , Matsuda Koichi , Watanabe Toshiki , Ohta Tsutomu 
Published: May 2014

Abstract
Failure to expeditiously repair DNA at sites of double-strand breaks (DSB) ultimately is an important etiologic factor in cancer development. NBS1 plays an important role in the cellular response to DSB damage. A rare polymorphic variant of NBS1 that resulted in an isoleucine to valine substitution at amino acid position 171 (I171V) was first identified in childhood acute lymphoblastic leukemia. This polymorphic variant is located in the N-terminal region that interacts with other DNA repair factors. In earlier work, we had identified a remarkable number of structural chromosomal aberrations in a patient with pediatric aplastic anemia with a homozygous polymorphic variant of NBS1-I171V; however, it was unclear whether this variant affected DSB repair activity or chromosomal instability. In this report, we demonstrate that NBS1-I171V reduces DSB repair activity through a loss of association with the DNA repair factor MDC1. Furthermore, we found that heterozygosity in this polymorphic variant was associated with breast cancer risk. Finally, we showed that this variant exerted a dominant-negative effect on wild-type NBS1, attenuating DSB repair efficiency and elevating chromosomal instability. Our findings offer evidence that the failure of DNA repair leading to chromosomal instability has a causal impact on the risk of breast cancer development. Cancer Res; 74(14); 3707–15. ©2014 AACR.
Effect of Mental Challenge Induced by Movie Clips on Action Potential Duration in Normal Human Subjects Independent of Heart Rate
Authors: Child Nicholas , Hanson Ben , Bishop Martin , Rinaldi Christopher A. , Bostock Julian , Western David , Cooklin Michael , O’Neil Mark , Wright Matthew , Razavi Reza , Gill Jaswinder , Taggart Peter 
Published: May 2014

Background—
Mental stress and emotion have long been associated with ventricular arrhythmias and sudden death in animal models and humans. The effect of mental challenge on ventricular action potential duration (APD) in conscious healthy humans has not been reported.

Methods and Results—

Activation recovery intervals measured from unipolar electrograms as a surrogate for APD (n=19) were recorded from right and left ventricular endocardium during steady-state pacing, whilst subjects watched an emotionally charged film clip. To assess the possible modulating role of altered respiration on APD, the subjects then repeated the same breathing pattern they had during the stress, but without the movie clip. Hemodynamic parameters (mean, systolic, and diastolic blood pressure, and rate of pressure increase) and respiration rate increased during the stressful part of the film clip (
P
=0.001). APD decreased during the stressful parts of the film clip, for example, for global right ventricular activation recovery interval at end of film clip 193.8 ms (SD, 14) versus 198.0 ms (SD, 13) during the matched breathing control (end film left ventricle 199.8 ms [SD, 16] versus control 201.6 ms [SD, 15];
P
=0.004). Respiration rate increased during the stressful part of the film clip (by 2 breaths per minute) and was well matched in the respective control period without any hemodynamic or activation recovery interval changes.

Conclusions—
Our results document for the first time direct recordings of the effect of a mental challenge protocol on ventricular APD in conscious humans. The effect of mental challenge on APD was not secondary to emotionally induced altered respiration or heart rate.
Impact of Metabolic Syndrome on Left Atrial Electroanatomical Remodeling and Outcomes After Radiofrequency Ablation of Nonvalvular Atrial Fibrillation
Authors: Dinov Borislav , Kosiuk Jedrzej , Kircher Simon , Bollmann Andreas , Acou Willem-Jan , Arya Arash , Hindricks Gerhard , Rolf Sascha 
Published: May 2014

Background—
Recent studies reported worse outcomes after atrial fibrillation (AF) ablation in patients with metabolic syndrome (MetS). However, mechanisms of AF recurrence in MetS remain unclear.

Method and Results—

We performed pulmonary vein isolation and voltage mapping in 236 patients with AF (age 61±9.6 years; persistent AF 64%; MetS 54%). Left atrial (LA) low voltage areas were semiquantitatively estimated and presented as low voltage index. MetS was defined according to National Cholesterol Education Program Adult Treatment Panel III. Follow-up for AF recurrence ≤12 months was performed. LA low voltage areas were observed in 46% of patients with MetS versus 8.2% patients without MetS ;
P
<0.0001. MetS was an independent predictor of LA low voltage areas: odds ratio, 11.64; 95% confidence interval, 4.381–30.903;
P
<0.0001. Observed AF recurrence at 12 months was 42.7% in MetS versus 36.1% in the non-MetS group (
P
=0.303). The presence of LA low voltage areas was a predictor of 12-month AF recurrence: odds ratio, 2.99; 95% confidence interval, 1.36–6.56;
P
=0.006. Probability of 12-month AF recurrence increased with 84.5% for every unit of low voltage Index.

Conclusions—
MetS was not associated with worse outcomes after radiofrequency catheter ablation of AF, but LA low voltage areas were more frequently observed in patients with MetS. The presence and extent of LA low voltage areas may influence the long-term outcomes after catheter ablation.
Noninducibility and Late Potential Abolition
Authors: Silberbauer John , Oloriz Teresa , Maccabelli Giuseppe , Tsiachris Dimitris , Baratto Francesca , Vergara Pasquale , Mizuno Hiroya , Bisceglia Caterina , Marzi Alessandra , Sora Nicoleta , Guarracini Fabrizio , Radinovic Andrea , Cireddu Manuela , Sala Simone , Gulletta Simone , Paglino Gabriele , Mazzone Patrizio , Trevisi Nicola , Bella Paolo Della 
Published: May 2014

Background—
Successful late potential (LP) abolition and postprocedural ventricular tachycardia (VT) noninducibility constitute significant end points after catheter ablation for VT. We investigated the prognostic impact of a combined procedural end point of VT noninducibility and LP abolition in a large series of post–myocardial infarction patients with VT.

Methods and Results—

A total of 160 (154 men, 94% with implantable cardioverter defibrillators) consecutive post–myocardial infarction patients undergoing first-time ablation procedures from 2010 to 2012 were included. Of the 159 patients surviving the procedure, 137 (86%) were either inducible or in VT at baseline and 103 (65%) had baseline LP presence, of which 79 (77%) underwent successful LP abolition. The combined end point was assessable in 155 (97%) patients. There were 50 (32%) patients with VT recurrences and 17 (11%) cardiac deaths during follow-up. Patients who fulfilled the combined end point of VT noninducibility and LP abolition compared with inducible patients exhibited a significantly lower incidence of VT recurrence (16.4% versus 47.4%; log-rank
P
<0.001) and cardiac death (4.1% versus 42.1%; log-rank
P
<0.001). Among noninducible patients, those with additional LP abolition also had a lower incidence of VT recurrence (16.4% versus 46.0%; log-rank
P
<0.001). After multivariate analysis, the combined end point of VT noninducibility and LP abolition (hazard ratio, 0.205,
P
<0.001) was independently associated with VT recurrence and cardiac death (hazard ratio, 0.106;
P
=0.001).

Conclusions—
Achieving a combined catheter ablation procedural end point of VT noninducibility and LP abolition reduces VT recurrence rates to low levels (16%). The overall strategy was associated with a significant impact on cardiac survival.
A Helmet from Filippovka-1 Burial-Ground
Authors: Frizen (Kurinskikh) Olga I. , Shemakhanskaya Marina S. , Yablonsky Leonid T. 
Published: May 2014

Abstract
This article is devoted to the find of a unique forged iron helmet from the Filippovka-1 Burial-ground of the Early Sarmatian culture, in the steppe near the southern foothills of the Urals. The helmet was found in a fragmentary state and was later restored. Analysis of the shape, manufacturing technology and specific features of its construction was carried out. Like the other finds from the burial, the helmet was dated to the 4th century bc. It is most probable that it was made by a craftsman who belonged to a nomadic population and was ordered so as to resemble bronze specimens.
Women in the Genealogy of Matthew
Authors: Hakh Samuel B. 
Published: May 2014

Abstract
The author of the gospel of Matthew has interpolated women’s names in the genealogy of Jesus: Tamar, Rahab, Ruth, the wife of Uriah (Bathsheba) and Mary. He interpolated those women’s names in order to convey to his community the image that Jesus has a genealogical relationship not only with Israel as the elected people of God but with all nations throughout the world. In other words, he endeavours to describe Jesus as the Saviour of all nations. This image was imparted by presenting the situation of his community as consisting not only of Jewish Christians but of non-Jews as well.
The Right to a Public Trial under Maltese Criminal Law
Authors: Aquilina Kevin 
Published: May 2014

This paper attempts to answer whether section 24(2) of the Maltese Official Secrets Act conforms, or is in conflict, with the right to a public hearing under section 39(3) of the Constitution of Malta and Article 10(1) of the European Convention for the Protection of Human Rights and Fundamental Freedoms. It reviews case law of the European Court of Human Rights on the right to a public hearing and concludes that Strasbourg case law has developed to allow restrictions upon this right even if they are not written down in this Convention. On the other hand, from a comparative exercise carried out with seven similar laws to the Maltese Official Secrets Act, it transpires that the Maltese provision is unique, does not find any counterpart in these seven laws surveyed and, worse still, appears to conflict with Article 6, paragraph 1, of the European Convention.
Retrieval Models of Water Vapor and Wet Tropospheric Path Delay for the HY-2A Calibration Microwave Radiometer
Authors: Zheng Gang , Yang Jingsong , Ren Lin 
Published: May 2014

Abstract
This paper focuses on the development and validation of retrieval models of water vapor (WV) and wet tropospheric path delay (PD) for the calibration microwave radiometer (CMR) on board the first ocean dynamic environment satellite of China—Haiyang-2A (HY-2A). The reference data are those of Jason-1 microwave radiometer (JMR) and Jason-2 advanced microwave radiometer (AMR). The crossover points of the HY-2A and Jason-1/2 satellite tracks are extracted, and the data pairs at these points are divided into fitting and validation datasets. The retrieval models of WV and PD are built for the CMR using the fitting dataset and genetic algorithm, and validated using the validation dataset. The validation shows that the results of the retrieval models are consistent with the JMR and AMR data, and the root-mean-square differences of WV and PD are 1.86 kg m−2 and 11.4 mm, respectively. Finally, the retrieved results from the CMR brightness temperature along-track data using the retrieval models and the AMR along-track data are gridded by the inverse distance weighted method. Their monthly-mean spatial distributions are compared in order to investigate the applicability of the retrieval models globally, namely, beyond locations of the data pairs in the validation dataset. The comparison shows that the retrieval models are applicable in most open ocean areas, and that the latitude and temporal inhomogeneity of the crossover point distribution in the fitting dataset does not lead to obvious latitude and temporal inhomogeneity in the gridded data.
Lack of RAAS inhibition by high-salt intake is associated with arterial stiffness in hypertensive patients
Authors: Kotliar Carol , Kempny Pablo , Gonzalez Sergio , Castellaro Carlos , Forcada Pedro , Obregon Sebastián , Cavanagh Elena , Chiabaut Svane Jorge , Casarini Maria Jesus , Rojas Mercedes , Inserra Felipe 
Published: May 2014

Hypothesis/introduction: The relationship between salt intake, blood pressure and RAAS activation is still controversial, being that both high- and low-salt intakes are associated with cardiovascular events in a J-shaped curve pattern. We hypothesized that different patterns of RAAS response to dietary salt intake among hypertensives could be identified, while vascular damage would be related to high-salt intake plus absence of expected RAAS inhibition. Objective: We aim to assess the relationship between sodium intake, RAAS and vascular stiffness in hypertension. Materials and methods: We screened 681 hypertensive patients for urinary/plasma electrolytes, renin, aldosterone and pulse wave velocity (PWV) under their usual salt intake level. Results: After applying exclusion criteria, an inverse relation between urinary sodium and RAAS was observed in the 300 remaining subjects. Additionally, four types of response were identified: 1) Low (L) sodium (S)-Low RAAS, 2) LS-High (H) SRAAS, 3) HS-Low RAAS, 4) HS-High RAAS. We found no differences in age/BP among groups, but type 4 response individuals included more females and a higher pulse wave velocity. Conclusions: We showed a) an inverse salt-RAAS relation, b) an association between HS plus high RAAS with increased PWV that could identify a higher-risk hypertensive condition.