bluuebunny/crossref_metadata_2025_split huggingface dataset:
Addressing the human resources crisis: a case study of Cambodia’s efforts to reduce maternal mortality (1980–2012)
Authors: Fujita Noriko , Abe Kimiko , Rotem Arie , Tung Rathavy , Keat Phuong , Robins Ann , Zwi Anthony B 
Published: May 2013

ObjectiveTo identify factors that have contributed to the systematic development of the Cambodian human resources for health (HRH) system with a focus on midwifery services in response to high maternal mortality in fragile resource-constrained countries.DesignQualitative case study. Review of the published and grey literature and in-depth interviews with key informants and stakeholders using an HRH system conceptual framework developed by the authors (‘House Model’; Fujita et al, 2011). Interviews focused on the perceptions of respondents regarding their contributions to strengthening midwifery services and the other external influences which may have influenced the HRH system and reduction in the maternal mortality ratio (MMR).SettingThree rounds of interviews were conducted with senior and mid-level managers of the Ministries of Health (MoH) and Education, educational institutes and development partners.ParticipantsA total of 49 interviewees, who were identified through a snowball sampling technique.Main outcome measuresScaling up the availability of 24 h maternal health services at all health centres contributing to MMR reduction.ResultsThe incremental development of the Cambodian HRH system since 2005 focused on the production, deployment and retention of midwives in rural areas as part of a systematic strategy to reduce maternal mortality. The improved availability and access to midwifery services contributed to significant MMR reduction. Other contributing factors included improved mechanisms for decision-making and implementation; political commitment backed up with necessary resources; leadership from the top along with a growing capacity of mid-level managers; increased MoH capacity to plan and coordinate; and supportive development partners in the context of a conducive external environment.ConclusionsLessons from this case study point to the importance of a systemic and comprehensive approach to health and HRH system strengthening and of ongoing capacity enhancement and leadership development to ensure effective planning, implementation and monitoring of HRH policies and strategies.
Dry blood spot testing for hepatitis C in people who injected drugs: reaching the populations other tests cannot reach
Authors: Tait J M , Stephens Brian P , McIntyre Paul G , Evans Morgan , Dillon John F 
Published: May 2013

ObjectiveThe aim of the study was to evaluate the effectiveness of Dry Blood Spot testing (DBST) for hepatitis C within a geographical area.DesignThis is a prospective cohort study of all individuals living in Tayside who had received a hepatitis C virus (HCV) DBST between 2009 and 2011.ResultsDuring the study, 1123 DBSTs were carried out. 946 individuals had one test. 295 (31.2%) of these individuals were HCV antibody positive on their first test. Overall, 94.3% (902/956) individuals returned for the results of their test. During the course of the study 177 individuals were retested and 29 new cases of hepatitis C were detected. 249 individuals attended for further follow-up, and 164 (65.5%) were PCR positive. All 164 PCR-positive individuals were offered referral into specialist HCV services for further assessment. Data showed 62.5% were genotype 3, 65.1% had a low viral load (<600 000 iu/ml) and 77.5% had a Fibroscan score below 7 KPa. To date, 40 have commenced treatment and a further 16 are currently in the assessment period. Overall, we have retained in services or treated 63.6% (105/164) of patients who were initially referred and with effective support mechanisms in place we have achieved sustained viral response rates of 90%.ConclusionsThe study has shown that DBST is a complementary technique to conventional venepuncture for the diagnosis of HCV. The majority of patients have low viral loads and low fibrosis scores, so that while this group of patients may be difficult to reach and may be challenging to maintain in therapy, they are easier to cure.
John Jeremiah Bigsby, MD: British Army physician and pioneer North American geologist
Authors: Wilson Leonard G. 
Published: May 2013

Abstract
In the years from 1817 to 1825 when Dr John Bigsby was stationed in Canada with the British Army, he studied the geology from the lower St Lawrence Valley to the centre of the continent. In sedimentary strata of the Great Lakes, he collected a wealth of fossils, many of unusual size. He described the mineralogy of the Canadian Shield, recognizing the igneous origin of the basalt precipices of the north shore of Lake Superior. In 1819 when the International Boundary Commission was surveying the western end of Lake Erie, the whole staff fell ill with malarial fevers and some died. Bigsby was appointed in 1820 as medical officer to the Commission. He accompanied the British survey team from 1820 to 1823 to provide medical care. In his leisure time he collected fossils from the shores of the Great Lakes. In 1823 Bigsby travelled by canoe with the surveyors completing the survey from Lake Superior to Lake of the Woods. During the journey he observed the great volcanic formations of that region. Bigsby returned to England in 1825, resigning from the British Army in 1830. He entered private medical practice but maintained a life-long interest in geology, particularly fossils.
Carbon, oxygen and strontium isotopes as a tool to decipher marine and non-marine environments: Implications from a case study of cyclic Upper Cretaceous sediments
Authors: Hofer Gerald , Wagreich Michael , Spötl Christoph 
Published: May 2013

Abstract

The interplay of Late Cretaceous basin subsidence and oscillations in sea level produced a mixed freshwater–marine succession within the Upper Cretaceous Gosau Group of the Northern Calcareous Alps. Cored sections from wells of the Glinzendorf and Gießhübl Syncline, as well as sediments from the outcrop area of Grünbach–Neue Welt and Slovakian equivalents have been investigated for their stable isotopic composition. Bulk carbonate δ
13
C and δ
18
O values of 116 fine-grained samples (shales, siltstones, marls) and
87
Sr/
86
Sr values of 10 samples from the borehole Markgrafneusiedl T1 were analysed in order to distinguish between non-marine and marine deposits and to compare and correlate isotope characteristics of the different Gosau synclines and basins.

Non-marine samples have significantly lower mean δ
13
C values compared to the mean of marine samples. The discrimination between a marine and non-marine group using δ
18
O is also highly significant statistically, even though the difference between the average non-marine and marine values is small. Strontium isotope values of marine intervals are near the range of values of normal Upper Cretaceous sea water but show a trend towards higher ratios in marginal marine and non-marine deposits. Although diagenesis and the detrital carbonate admixture partly influence the isotopic composition, the original environmental signal can still be reliably identified.
NMS-E973, a Novel Synthetic Inhibitor of Hsp90 with Activity against Multiple Models of Drug Resistance to Targeted Agents, Including Intracranial Metastases
Authors: Fogliatto Gianpaolo , Gianellini Laura , Brasca Maria G. , Casale Elena , Ballinari Dario , Ciomei Marina , Degrassi Anna , De Ponti Anna , Germani Massimiliano , Guanci Marco , Paolucci Mauro , Polucci Paolo , Russo Micaela , Sola Francesco , Valsasina Barbara , Visco Carlo , Zuccotto Fabio , Donati Daniele , Felder Eduard , Pesenti Enrico , Galvani Arturo , Mantegani Sergio , Isacchi Antonella 
Published: May 2013

Abstract
Purpose: Recent developments of second generation Hsp90 inhibitors suggested a potential for development of this class of molecules also in tumors that have become resistant to molecular targeted agents. Disease progression is often due to brain metastases, sometimes related to insufficient drug concentrations within the brain. Our objective was to identify and characterize a novel inhibitor of Hsp90 able to cross the blood–brain barrier (BBB).
Experimental Design: Here is described a detailed biochemical and crystallographic characterization of NMS-E973. Mechanism-based anticancer activity was described in cell models, including models of resistance to kinase inhibitors. Pharmacokinetics properties were followed in plasma, tumor, liver, and brain. In vivo activity and pharmacodynamics, as well as the pharmacokinetic/pharmacodynamic relationships, were evaluated in xenografts, including an intracranially implanted melanoma model.
Results: NMS-E973, representative of a novel isoxazole-derived class of Hsp90 inhibitors, binds Hsp90α with subnanomolar affinity and high selectivity towards kinases, as well as other ATPases. It possesses potent antiproliferative activity against tumor cell lines and a favorable pharmacokinetic profile, with selective retention in tumor tissue and ability to cross the BBB. NMS-E973 induces tumor shrinkage in different human tumor xenografts, and is highly active in models of resistance to kinase inhibitors. Moreover, consistent with its brain penetration, NMS-E973 is active also in an intracranially implanted melanoma model.
Conclusions: Overall, the efficacy profile of NMS-E973 suggests a potential for development in different clinical settings, including tumors that have become resistant to molecular targeted agents, particularly in cases of tumors which reside beyond the BBB. Clin Cancer Res; 19(13); 3520–32. ©2013 AACR.
Receptors to interleukin-6 and adhesion molecules on circulating monocyte subsets in acute myocardial infarction
Authors: Wrigley Benjami , Montoro-Garcia Silvia , Shantsila Eduard , Tapp Luke , Lip Gregory 
Published: May 2013

SummaryThe role of individual monocyte subsets in inflammation and recovery post-myocardial infarction (MI) is insufficiently understood. It was the objective of this study to evaluate the dynamics of monocyte expression of receptors to vascular cell adhesion molecule (VCAM-1r), intercellular adhesion molecule (ICAM-1r), and interleukin-6 (IL-6r) following MI and their relation to inflammatory cytokines, fibrinolytic factors and annexin V-binding microparticles. Expression of VCAM-1r, ICAM-1r, IL-6r on CD14++CD16–(Mon1), CD14++CD16+(Mon2), CD14+CD16++(Mon3) monocyte subsets were quantified by flow cytometry in patients with ST-elevation MI (STEMI, n=50), non-STEMI (n=48) and stable coronary artery disease (n=40). In STEMI, parameters were measured on days 1, 3, 7, 30. On admission with STEMI, VCAM-1r expression was reduced on Mon1 (p=0.007), Mon2 (p=0.036), Mon3 (p=0.005), whilst in NSTEMI there was significant up-regulation of expression by Mon2 (p=0.024) and Mon3 (p=0.049). VCAM-1r on Mon1 correlated positively with plasma IL-1β levels (p=0.001). IL-6r was reduced on Mon2 in acute STEMI, with upregulation of the receptor on Mon1 and Mon2 during follow-up. IL-6r density correlated negatively with plasma levels of tissue-type plasminogen activator (p=0.0005 for Mon1, p=0.001 for Mon2 and Mon3), and positively with annexin V-binding microparticles (p=0.03 for Mon1, p=0.005 for Mon2 and p=0.005 for Mon3). There was no change in monocyte ICAM-1r expression. In conclusion, expression of IL-6r and VCAM-1r is reduced on circulating monocyte subsets involved in inflammatory responses in STEMI. This may represent a regulatory feed-back mechanism aiming to re-balance the marked inflammation which is typically present following acute MI or selective homing of monocytes with high receptor expression to damaged myocardium.Note: The review process for this manuscript was fully handled by Christian Weber, Editor in Chief.
Efficacy of Implantable Cardioverter Defibrillators in Young Patients With Catecholaminergic Polymorphic Ventricular Tachycardia
Authors: Miyake Christina Y. , Webster Gregory , Czosek Richard J. , Kantoch Michal J. , Dubin Anne M. , Avasarala Kishor , Atallah Joseph 
Published: May 2013

Background—
The effectiveness of implantable cardioverter-defibrillator (ICD) therapy for the management of catecholaminergic polymorphic ventricular tachycardia (VT) in young patients is not known. ICD discharges are not always effective and inappropriate discharges are common, both resulting in morbidity and mortality.

Methods and Results—

This is a multicenter, retrospective review of young patients with catecholaminergic polymorphic VT and ICDs from 5 centers. ICD discharges were evaluated to determine arrhythmia mechanism, appropriateness, efficacy of therapy, and complications. A total of 24 patients were included. Median (interquartile range) ages at onset of catecholaminergic polymorphic VT symptoms and ICD implant were 10.6 (5.0–13.8) years and 13.7 (10.7–16.3) years, respectively. Fourteen patients received 140 shocks. Ten patients (42%) experienced 75 appropriate shocks and 11 patients (46%) received 65 inappropriate shocks. On actuarial analysis, freedom from appropriate shock at 1 year after ICD implant was 75%. Of appropriate shocks, only 43 (57%) demonstrated successful primary termination. All successful appropriate ICD discharges were for ventricular fibrillation. No episodes of polymorphic VT or bidirectional VT demonstrated successful primary termination. The adjusted mean (95% confidence interval) cycle length of successful discharges was significantly shorter than unsuccessful discharges (168 [152–184] ms versus 245 [229–262] ms; adjusted
P
=0.002). Electrical storm occurred in 29% (4/14) and induction of more malignant ventricular arrhythmias in 36% (5/14). There were no deaths.

Conclusions—
ICD efficacy in catecholaminergic polymorphic VT depends on arrhythmia mechanism. Episodes of ventricular fibrillation were uniformly successfully treated, whereas polymorphic and bidirectional VT did not demonstrate successful primary termination. Inappropriate shocks, electrical storm, and ICD complications were common.
Isolated Conduction Within the Left His-Purkenje System During Sinus Rhythm and Idiopathic Left Ventricle Tachycardia
Authors: Long De-Yong , Dong Jian-Zeng , Sang Cai-Hua , Jiang Chen-Xi , Tang Ri-Bo , Yan Qian , Yu Rong-Hui , Li Song-Nan , Yao Yan , Ning Man , Lin Tao , Salim Mohamed , Du Xin , Ma Chang-Sheng 
Published: May 2013

Background—
Functionally, left His-Purkenje system (HPS) is insulated from the adjacent myocardium and exhibits isolated conduction during sinus rhythm (SR), but in vivo human study is rare. Meanwhile, whether the isolated conduction also exists during idiopathic left ventricle tachycardia (ILVT) is not clearly defined. The current study aimed to delineate the activation sequence and gross anatomy of left HPS during SR and ILVT.

Methods and Results—

The study involved 25 consecutive patients with ILVT. During SR, left HPS exhibited antegrade activation sequence, and its surrounding myocardium depolarized after HPS in an apical to base direction. During ILVT, the earliest retrograde presystolic potentials were mainly located at the middle portion of left posterior fascicle (0.5±0.1 [95% confidence interval, 0.46–0.58] of its full length) with an average of 29.5±6.0 mm (19.8–41.5) away from the His position. Left posterior fascicle was depolarized from the earliest retrograde presystolic potentials via 2 opposite wavefronts with significantly shorter activation time than that during SR (15.1±2.1 versus 30.0±3.2 ms;
P
<0.001). The left anterior fascicle was depolarized after left posterior fascicle with an antegrade activation sequence and comparable activation time with that during SR (21.9±2.9 versus 22.0±4.1 ms;
P
=0.932). The depolarization of ventricle septum also occurred after HPS in an apical to base direction.

Conclusions—
During SR, isolated conduction within the HPS is demonstrated by documenting the reverse activation sequence with its surrounding myocardium. During ILVT, the earliest retrograde presystolic potentials were usually recorded at the middle segment of left posterior fascicle, and the isolated conduction within the HPS remained.
The Striate Artery, Hematoma, and Spot Sign on Coronal Images of Computed Tomography Angiography in Putaminal Intracerebral Hemorrhage
Authors: Sorimachi Takatoshi , Osada Takahiro , Baba Tanefumi , Inoue Go , Atsumi Hideki , Ishizaka Hideo , Hotta Kazuko , Hayashi Naokazu , Matsumae Mitsunori 
Published: May 2013

Background and Purpose—
A spot sign is a bright spot on computed tomography angiography source images, which is predictive of hematoma growth in spontaneous intracerebral hemorrhage, although the cause of the spot sign is unclear. Our aim was to investigate the spot sign seen on computed tomography angiography and a striate artery, which is a presumed site of intracerebral hemorrhage bleeding origin in the putamen.

Methods—
In consecutive cases of spontaneous intracerebral hemorrhage in the putamen, spot signs and striate arteries were evaluated. Coronal reformat images of computed tomography angiography were created to visualize the striate arteries. Acute deterioration, defined as hematoma enlargement, emergency hematoma removal, or death within the day of admission, was reviewed.

Results—

Of the 141 patients undergoing computed tomography angiography, 15 of the 30 patients (50%) who had spot signs showed an intrahematoma striate artery (termed spot and tail sign), which was a linear density extending from the middle cerebral artery toward the spot sign. Acute deterioration occurred more frequently in patients who had a spot and tail sign compared with patients who had spot signs without intrahematoma striate arteries (
P
<0.05). Multivariate analysis revealed that hematoma volume, spot signs, and intrahematoma striate arteries were independent predictors of acute deterioration (
P
<0.05).

Conclusions—
The presence of a spot and tail sign, assumed to indicate active bleeding from the striate artery, could be a more sensitive predictor of acute deterioration than the presence of a simple spot sign.
Investing in Schooling In Chile: The Role of Information about Financial Aid for Higher Education
Authors: Dinkelman Taryn , Martínez A. Claudia 
Published: May 2013

Abstract
We investigate the impacts of providing low-income Chilean adolescents with information about how to finance higher education and ask whether providing parents with the same information magnifies the effects on schooling outcomes. We randomly assigned eighth graders and some parents to receive information about aid for higher education. Exposure to information raised college preparatory high school enrollment, primary school attendance, and financial aid knowledge, with gains concentrated among medium- and high-grade students. Parental exposure to information did not significantly magnify these effects. Our results demonstrate that access to relevant information about financial aid affects important schooling choices long before tertiary education begins.
Ministry and Spiritual Care
Authors: Smeets Wim 
Published: May 2013

Abstract
This article presents an empirical exploration of the attitudes of spiritual caregivers in health care institutions in the Netherlands towards ministry and their professional goals. Ministry can be classified into ministry per se and the position and modes of operation of spiritual care. A distinction is made between an immediate professional goal (communication on worldviews) and an ultimate goal (contribution to spiritual health). We examine the effects of beliefs about ministry on the professional goals, while controlling for relevant population and institutional characteristics. Attitudes towards ministry have the greatest impact on the ultimate goal of spiritual health. They also have a substantial impact on one immediate goal: the experiential-affective goal. The broader concept of worldview or spiritual competence and its relevance to the goals of spiritual care needs further research.
Regional Energy and Water Cycles: Transports from Ocean to Land
Authors: Trenberth Kevin E. , Fasullo John T. 
Published: May 2013

Abstract
The flows of energy and water from ocean to land are examined in the context of the land energy and water budgets, for land as a whole and for continents. Most atmospheric reanalyses have large errors of up to 15 W m−2 in the top-of-atmosphere (TOA) energy imbalance, and none include volcanic eruptions. The flow of energy from ocean to land is more reliable as it relies on analyzed wind, temperature, and moisture fields. It is examined for transports of the total, latent energy (LE), and dry static energy (DSE) to land as a whole and as zonal means. The net convergence of energy onto land is balanced by the loss of energy at TOA, measured by Clouds and the Earth’s Radiant Energy System (CERES), and again there are notable discrepancies. Only the ECMWF Interim Re-Analysis (ERA-I) is stable and plausible. Strong compensation between variations in LE and DSE transports onto land means that their sum is more stable over time, and the net transport of energy onto land is largely that associated with the hydrological cycle (LE). A more detailed examination is given of the energy and water budgets for Eurasia, North and South America, Australia, and Africa, making use of Gravity Recovery and Climate Experiment (GRACE) data for water storage on land and data on river discharge into the ocean. With ERA-I, the new land estimates for both water and energy are closer to achieving balances than in previous studies. As well as the annual means, the mean annual cycles are examined in detail along with uncertainty sampling estimates, but the main test used here is that of closure.
Beliefs of Australian health professionals about the helpfulness of interventions for mental disorders: Differences between professions and change over time
Authors: Morgan Amy J , Jorm Anthony F , Reavley Nicola J 
Published: May 2013

Objective: To assess the beliefs of general practitioners (GPs), psychiatrists and clinical psychologists about the helpfulness of different interventions for mental disorders, and to examine change in beliefs over time. Methods: A questionnaire was mailed to 6848 GPs, psychiatrists and clinical psychologists registered with Medicare Australia. The questionnaire was based around one of six vignettes describing a person with a mental disorder: depression, depression with suicidal thoughts, early schizophrenia, chronic schizophrenia, social phobia and post-traumatic stress disorder. The depression and early schizophrenia vignettes were identical to those used in a similar survey of health professionals conducted in 1996. A range of interventions were rated for their likely helpfulness for each disorder, and consensus was defined as at least 66% of each profession rating an intervention as helpful. Results: Responses were received from 1536 health professionals. A broader array of interventions were endorsed for depression than in 1996, including GPs, psychiatrists, psychologists, becoming more physically active, reading about people with similar problems and how they have dealt with them, psychotherapy, and cognitive behaviour therapy. For the schizophrenia vignettes, GPs, psychiatrists and antipsychotics were thought to be helpful by a majority of professionals. A variety of professionals, psychological treatments and lifestyle activities were endorsed for the anxiety disorders. Differences between professions were noted in beliefs about the helpfulness of antidepressants and counsellors for anxiety disorders and depression, as well as cognitive behaviour therapy for schizophrenia. Conclusion: Consensus across professions was reached on the helpfulness of a variety of interventions for each mental disorder, although there were some notable differences in beliefs. The study gives an updated overview of treatment beliefs for mental disorders by Australian health professionals, which can be used as a benchmark with which to compare the beliefs of the Australian public.