bluuebunny/crossref_metadata_2025_split huggingface dataset:
FACTORS ASSOCIATED WITH END OF LIFE TRANSITION FOR OLDER ADULTS LIVING AT HOME: ANALYSIS OF CARERS' POST-BEREAVEMENT SURVEY
Authors: Evans CJ , Bone AE , Yi D , Wei G , Gomes B , Maddocks M , Sleeman KE , Wright J , Mc Crone P , Higginson IJ ,   on behalf of OPTCare Elderly
Published: February 2015

IntroductionTransfer to hospital in the last weeks of life is common for older adults. It is imperative to better understand factors associated with transition to enable older people to remain in their usual place of care.Aim(s) and method(s)To explore possible determinants of transition from home to institutional care settings in last weeks of life. Post-bereavement survey of carers to people aged over 75 who died in 2012 in the South of England (n=883). Main outcome is death at home versus hospital/care home (hospice deaths excluded) for decedents whose usual place of care was home. Exploration of socio-demographic factors and illness factors using multivariate modified Poisson regression.Results235 decedents spent most of the last 3 months of life at home. The majority died from non-malignant conditions (71.9%) with mean age 86 years. 51.1% died at home and 48.9% transitioned in the last 3 months to a hospital (44.7%) or care home (4.3%). Death outside usual place of care was independently associated with increasing age (85–90 years [PR=3.4; 95% CI 1.9–6.1] compared with 75–80 years), and severity of breathlessness (PR=1.9; 95% CI 1.2–3.4) and difficulty communicating (PR=2.0; 95% CI 1.5–2.8).Conclusion(s)Transition to hospital at the end of life is common for older adults living at home. Transition occurs most frequently for the oldest old and those with severe symptoms of breathlessness and difficulty communicating. To reduce reliance on hospital care at the end of life requires timely services responsive to increasing symptom distress and wider anticipation of end of life for adults of advanced age.
PATIENT AND FAMILY EXPERIENCES OF DNACPR DISCUSSIONS: AN INTEGRATIVE REVIEW OF THE LITERATURE
Authors: Hall CC , Carduff E , Lugton J , Spiller J 
Published: February 2015

IntroductionDNACPR decisions and the communication of such advance decisions have relevance in all areas of clinical care. An advance decision not to attempt CPR is taken if such an attempt is deemed be futile or if the patient does not wish it to occur. Following the recent release of revised National Guidance from the British Medical Association, the Resuscitation Council (UK) and the Royal College of Nursing, there is an increased awareness of good practice guidance around DNACPR decision making and communication. However little is known about patients' and their family members' experience of DNACPR discussions. This information will be useful in informing the development of recommendations for current clinical practise.Aim(s) and method(s)The aim of this review is to identify patient and family views on DNACPR decisions and their experiences after having had DNACPR discussions. Methods: A literature search of multiple databases was performed including all (adult) patients in hospital, hospice and community settings, for all countries over the last 10 years.ResultsInitial search results generated 558 papers. Abstracts were coded by relevance, power of study and country of origin. Exclusion criteria were applied and full texts were analysed to elucidate and summarise important themes. Analysis is currently on going.Conclusion(s)Conclusions will be drawn taking in to account limitations such as cultural differences for the study population. Separate conclusions regarding UK specific data will be drawn. Areas for further study and recommendations for improving clinical practise will be suggested.
MALIGNANT BOWEL OBSTRUCTION—A SYSTEMATIC LITERATURE REVIEW AND EVALUATION OF CURRENT PRACTICE
Authors: Longford E , Scott A , Fradsham S , Jeffries C , Ahmad F , Holland G , Telfer R , Carlson J , Ferguson H 
Published: February 2015

IntroductionMalignant bowel obstruction (MBO) is a recognized complication of advanced pelvic or abdominal malignancy frequently occurring in advanced stages of illness. Suggested incidences in ovarian carcinoma range from 5.5 to 42% and in colorectal cancer 4.4 to 24%. Where surgery for MBO is inappropriate medical management may help bring about resolution of the unpleasant symptoms.Aim(s) and method(s)The aim of this review was to evaluate current evidence and opinion on treatment of symptoms associated with MBO.A comprehensive systematic review of the literature was undertaken to evaluate the evidence for themedicalmanagement of MBO. A questionnaire-based survey was used to establish professional attitudes, opinions and to review current practice.ResultsFollowing exclusions 44 relevant papers were systematically appraised.There is good evidence for the use of octreotide to reduce secretions and corticosteroids may help bring about resolution of MBO. Ranitidine may also reduce secretions. Venting gastrostomies can alleviate nausea and vomiting with low complication rates and may be considered where prognosis is greater than 2 weeks. No evidence was found for any specific medication to treat vomiting or pain associated with MBO.In local current practice hyoscine buytlbromide is used first line to treat colic; cyclizine and/or haloperidol to treat vomiting with levomepromazine second line. Corticosteroids and octreotide are routinely prescribed. In practice consideration for referral for venting gastrostomies is guided by local surgical practice.Conclusion(s)There is a paucity of evidence with regards to medical management of MBO, much more is required. Subsequent to this review, new local guidelines have been developed.
CHEMICAL COMPATIBILITY/STABILITY OF ALFENTANIL WITH COMMONLY USED SUPPORTIVE DRUG COMBINATIONS ADMINISTERED BY CONTINUOUS SUBCUTANEOUS INFUSIONS FOR END OF LIFE CARE
Authors: Dickman Andrew , Roberts Ellen , Bickerstaff Matthew , Jackson Richard , Weir Phil , Ellershaw John 
Published: February 2015

IntroductionIn 2007, the National Patient Safety Agency recommended that healthcare staff need to have full technical information about compatibility of commonly used mixtures used in specialist areas only. In 2008, the Commission on Human Medicine (CHM) recommended that research should be commissioned to develop authoritative national advice on mixing of medicines to encompass compatibility and stability data.In the UK, a continuous subcutaneous infusion (CSCI) is considered to be the preferred method of drug administration to maintain symptom management at the end of life. Alfentanil is occasionally administered via CSCI and compatibility data are lacking. Analysis of national practice (1) identified 8 commonly used drug combinations administered by CSCI that included alfentanil.Aim(s) and method(s)To determine the chemical compatibility/stability of alfentanil with other supportive drugs in 8 commonly encountered drug combinations, at minimum and maximum concentrations.A CME T34 syringe pump was used to simulate infusion of the syringe preparation over a 24 hr period. A total of 16 combinations were analysed by High Performance Liquid Chromatography-Diode Array Detection (HPLC-DAD).ResultsThirteen combinations were identified as compatible by HPLC-DAD. These combinations also remained clear and free from visible particulate matter and the pH remained constant over the monitored period. Three combinations will require additional analysis as the HPLC peaks were small and difficult to distinguish.Conclusion(s)This research is the first step towards providing technical information required by healthcare staff for the mixing of injectable medicines in the same syringe.
Facies architecture of a microbial–siliceous sponge-dominated carbonate platform: the Bajocian of Moscardón (Middle Jurassic, Spain)
Authors: Aurell M. , Bádenas B. 
Published: February 2015

Abstract
Extensive facies analysis of the outcrops located near Moscardón (Iberian basin, NE Spain) resulted in a precise reconstruction of the facies architecture of a Bajocian (Middle Jurassic) carbonate platform. Different types of microbialites occurred in the transitional area between the shallow and relatively deep carbonate platform domains, located above and below wave base level, respectively. The most significant volume of the micorbialites is found in the platform slope, located below wave base level, in a depth range of around 30–50 m. In the lower slope, during stages of rapid accommodation gain, the vertical aggradation of individual stratiform building blocks results in the formation of up to 25 m-thick microbial–siliceous sponge buildups. During stages of sea-level highstand the individual building blocks are dominated by lateral (down-slope) progradational accretion, resulting in flatter, lens-shaped buildups. The transition between the upper slope and the shallow platform area is characterized by microbial-encrusted intraclastic–bioclastic packstones. Microbial crust development helped to stabilize the seafloor, allowing the eventual accumulation and preservation of the sand-sized grains above wave base.
Importance of depositional texture in pore characterization of subsalt microbialite carbonates, offshore Brazil
Authors: Rezende M. F. , Pope M. C. 
Published: February 2015

Abstract
Microbialite carbonates (e.g. stromatolites, thrombolites, shrubs and spherulites) are sedimentary deposits highly influenced by their environmental settings such as water depth, water chemistry and relative energy. Lower Cretaceous subsalt microbialite carbonates, in the Santos Basin (Brazil), have complex pore systems produced by their growth framework, which are related to carbonate precipitation by biotic and abiotic processes and also influenced by subsequent cementation and dissolution. Complex pore systems and high spatial reservoir heterogeneity result in reservoirs having total porosity ranging from 2 to 27% and permeability from less than 0.01 milidarcys to 4.9 darcys. Differences in textural characteristics such as shrub size, sorting and packing lead to different pore systems that subsequently control the petrophysical properties. Cements and dissolution also modify these texturally controlled pore systems by respectively reducing or enhancing the pore volume and pore-throats. The shrub size is a primary control on changes in the pore size and affects the permeability, whereas the shrub sorting influences the primary porosity, and secondarily the permeability. Packing acts as a secondary control on porosity. As result, a sample with small shrubs, well-sorted and tight packing has lower permeability for the same range of porosity than a sample with the same characteristics, but larger shrubs.
IL10 and PD-1 Cooperate to Limit the Activity of Tumor-Specific CD8+ T Cells
Authors: Sun Zhaojun , Fourcade Julien , Pagliano Ornella , Chauvin Joe-Marc , Sander Cindy , Kirkwood John M. , Zarour Hassane M. 
Published: February 2015

AbstractImmune checkpoint inhibitors show great promise as therapy for advanced melanoma, heightening the need to determine the most effective use of these agents. Here, we report that programmed death-1high (PD-1high) tumor antigen (TA)–specific CD8+ T cells present at periphery and at tumor sites in patients with advanced melanoma upregulate IL10 receptor (IL10R) expression. Multiple subsets of peripheral blood mononucleocytes from melanoma patients produce IL10, which acts directly on IL10R+ TA-specific CD8+ T cells to limit their proliferation and survival. PD-1 blockade augments expression of IL10R by TA-specific CD8+ T cells, thereby increasing their sensitivity to the immunosuppressive effects of endogenous IL10. Conversely, IL10 blockade strengthened the effects of PD-1 blockade in expanding TA-specific CD8+ T cells and reinforcing their function. Collectively, our findings offer a rationale to block both IL10 and PD-1 to strengthen the counteraction of T-cell immunosuppression and to enhance the activity of TA-specific CD8+ T cell in advanced melanoma patients. Cancer Res; 75(8); 1635–44. ©2015 AACR.
Targeting MPS1 Enhances Radiosensitization of Human Glioblastoma by Modulating DNA Repair Proteins
Authors: Maachani Uday Bhanu , Kramp Tamalee , Hanson Ryan , Zhao Shuping , Celiku Orieta , Shankavaram Uma , Colombo Riccardo , Caplen Natasha J. , Camphausen Kevin , Tandle Anita 
Published: February 2015

Abstract
To ensure faithful chromosome segregation, cells use the spindle assembly checkpoint (SAC), which can be activated in aneuploid cancer cells. Targeting the components of SAC machinery required for the growth of aneuploid cells may offer a cancer cell–specific therapeutic approach. In this study, the effects of inhibiting Monopolar spindle 1, MPS1 (TTK), an essential SAC kinase, on the radiosensitization of glioblastoma (GBM) cells were analyzed. Clonogenic survival was used to determine the effects of the MPS1 inhibitor NMS-P715 on radiosensitivity in multiple model systems, including GBM cell lines, a normal astrocyte, and a normal fibroblast cell line. DNA double-strand breaks (DSB) were evaluated using γH2AX foci, and cell death was measured by mitotic catastrophe evaluation. Transcriptome analysis was performed via unbiased microarray expression profiling. Tumor xenografts grown from GBM cells were used in tumor growth delay studies. Inhibition of MPS1 activity resulted in reduced GBM cell proliferation. Furthermore, NMS-P715 enhanced the radiosensitivity of GBM cells by decreased repair of DSBs and induction of postradiation mitotic catastrophe. NMS-P715 in combination with fractionated doses of radiation significantly enhanced the tumor growth delay. Molecular profiling of MPS1-silenced GBM cells showed an altered expression of transcripts associated with DNA damage, repair, and replication, including the DNA-dependent protein kinase (PRKDC/DNAPK). Next, inhibition of MPS1 blocked two important DNA repair pathways. In conclusion, these results not only highlight a role for MPS1 kinase in DNA repair and as prognostic marker but also indicate it as a viable option in glioblastoma therapy.
Implications: Inhibition of MPS1 kinase in combination with radiation represents a promising new approach for glioblastoma and for other cancer therapies. Mol Cancer Res; 13(5); 852–62. ©2015 AACR.
Enhanced Interhemispheric Functional Connectivity Compensates for Anatomical Connection Damages in Subcortical Stroke
Authors: Liu Jingchun , Qin Wen , Zhang Jing , Zhang Xuejun , Yu Chunshui 
Published: February 2015

Background and Purpose—
Motor recovery after stroke has been shown to be correlated with both the fractional anisotropy (FA) of the affected corticospinal tract (CST) and the interhemispheric resting-state functional connectivity (rsFC) of the primary motor cortex (M1). However, the role of the restoration or enhancement of the M1–M1 rsFC in motor recovery remains largely unknown. We aimed to clarify this issue by investigating the correlations between the M1–M1 rsFC and the integrity of the M1–M1 anatomic connection and the affected CST in chronic subcortical stroke patients with good motor outcomes.

Methods—
Twenty patients and 16 healthy controls underwent multimodal magnetic resonance imaging examinations. Diffusion tensor imaging was used to reconstruct the M1–M1 anatomic connection and bilateral CSTs. White matter integrity of these tracts was assessed using FA. Resting-state functional magnetic resonance imaging was used to calculate M1–M1 rsFC. Group differences in these measures were compared. Correlations between M1–M1 rsFC and FA of the M1–M1 anatomic connection and the affected CST were analyzed in patients with stroke.

Results—
Compared with healthy controls, patients with stroke exhibited significantly reduced FA in the affected CST and the M1–M1 anatomic connection and a significantly increased M1–M1 rsFC. The FA values of the affected CST were positively correlated with the M1–M1 anatomic connection, and these FA values were negatively correlated with the M1–M1 rsFC in these patients.

Conclusions—
Our findings suggest that the M1–M1 anatomic connection impairment is secondary to CST damage, and the M1–M1 rsFC enhancement may reflect compensatory or reactive neural plasticity in stroke patients with CST impairment.
On the Role of Inertial Instability in Stratosphere–Troposphere Exchange near Midlatitude Cyclones*
Authors: Rowe Shellie M. , Hitchman Matthew H. 
Published: February 2015

Abstract
In simulations of midlatitude cyclones with the University of Wisconsin Nonhydrostatic Modeling System (UWNMS), mesoscale regions with large negative absolute vorticity commonly occur in the upper troposphere and lower stratosphere (UTLS), overlying thin layers of air with stratospheric values of ozone and potential vorticity (PV). These locally enhanced stratosphere–troposphere exchange (STE) events are related to upstream convection by tracing negative equivalent potential vorticity (EPV) anomalies along back trajectories. Detailed agreement between the patterns of negative absolute vorticity, PV, and EPV—each indicators of inertial instability in the UTLS—is shown to occur in association with enhanced STE signatures. Results are presented for two midlatitude cyclones in the upper Midwest, where convection develops between the subpolar and subtropical jets.
Mesoscale regions of negative EPV air originate upstream in the boundary layer. As they are transported through convection, EPV becomes increasingly negative toward the tropopause. In association with the arrival of each large negative EPV anomaly, a locally enhanced poleward surge of the subpolar jet occurs, characterized by high turbulent kinetic energy and low Richardson number. Isosurfaces of wind speed show that gravity waves emanating from inertially unstable regions connect with and modulate the subpolar and subtropical jets simultaneously. Inertially unstable convective outflow surges can facilitate STE locally by fostering poleward acceleration in the UTLS, with enhanced folding of tropospheric air over stratospheric air underneath the poleward-moving jet.
3D Volumetric Analysis of Wind Turbine Wake Properties in the Atmosphere Using High-Resolution Doppler Lidar
Authors: Banta Robert M. , Pichugina Yelena L. , Brewer W. Alan , Lundquist Julie K. , Kelley Neil D. , Sandberg Scott P. , Alvarez II Raul J. , Hardesty R. Michael , Weickmann Ann M. 
Published: February 2015

AbstractWind turbine wakes in the atmosphere are three-dimensional (3D) and time dependent. An important question is how best to measure atmospheric wake properties, both for characterizing these properties observationally and for verification of numerical, conceptual, and physical (e.g., wind tunnel) models of wakes. Here a scanning, pulsed, coherent Doppler lidar is used to sample a turbine wake using 3D volume scan patterns that envelop the wake and simultaneously measure the inflow profile. The volume data are analyzed for quantities of interest, such as peak velocity deficit, downwind variability of the deficit, and downwind extent of the wake, in a manner that preserves the measured data. For the case study presented here, in which the wake was well defined in the lidar data, peak deficits of up to 80% were measured 0.6–2 rotor diameters (D) downwind of the turbine, and the wakes extended more than 11D downwind. Temporal wake variability over periods of minutes and the effects of atmospheric gusts and lulls in the inflow are demonstrated in the analysis. Lidar scanning trade-offs important to ensuring that the wake quantities of interest are adequately sampled by the scan pattern, including scan coverage, number of scans per volume, data resolution, and scan-cycle repeat interval, are discussed.
The prevalence and correlates of childhood trauma in patients with early psychosis
Authors: Duhig Michael , Patterson Sue , Connell Melissa , Foley Sharon , Capra Carina , Dark Frances , Gordon Anne , Singh Saveena , Hides Leanne , McGrath John J , Scott James 
Published: February 2015

Objective: To describe the prevalence and demographic, clinical and functional correlates of childhood trauma in patients attending early psychosis clinics. Method: Participants were recruited from outpatients attending four early psychosis services. Exposure to childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Psychopathology was measured using the Positive and Negative Syndrome Scale and the Depression, Anxiety and Stress Scale. Social and vocational functioning and substance use were also assessed. Results: Over three-quarters of the 100 patients reported exposure to any childhood trauma. Emotional, physical and sexual abuse were reported by 54%, 23% and 28% of patients, respectively, while 49% and 42% of patients reported emotional and physical neglect, respectively. Female participants were significantly more likely to be exposed to emotional and sexual abuse. Exposure to childhood trauma was correlated with positive psychotic symptoms and higher levels of depressive, anxiety and stress symptoms; however, it had no impact on social or vocational functioning or recent substance use. Conclusion: Exposure to childhood trauma was common in patients with early psychosis, and associated with increased symptomatology. Existing recommendations that standard clinical assessment of patients with early psychosis should include inquiry into exposure to childhood trauma are supported.
The ‘Bhojpuriya’ Mumbaikar
Authors: Shrivastava Madhusri 
Published: February 2015

Using Cultural Studies as the framework, this study investigates how north Indian migrants living in Kandivali east, Mumbai, exercise agency and appropriate Bhojpuri media texts to maintain their regional identity. Bhojpuri, a dialect of Hindi, has emerged as the lingua franca of these migrants hailing from the Indian states of Uttar Pradesh and Bihar. Beleaguered by the identity politics of the host city, the migrants turn to the Bhojpuri media to sustain the shared cultural beliefs that permeate their social relations. Familiar images in the media texts ensure continuity with tradition, feeding the resurgent pride of the community. The migrants’ aggressive defence of all things Bhojpuri, as well as their desire to sanitise Bhojpuri media of its bawdiness, is a manifestation of their embattled identities seeking validation.  This article examines how the Bhojpuri media are intertwined with the migrants’ everyday realities. The media reinforce gender roles, alleviate anxieties and gratify desires vicariously. Media representations meld cultural memory with the migrants’ newly acquired understanding of the metropolis. In the process, hybrid identities are being fashioned by people on different points of the socio-economic axis.
Emotional Support for Diabetes Management
Authors: Kowitt Sarah D. , Urlaub Diana , Guzman-Corrales Laura , Mayer Melissa , Ballesteros Juana , Graffy Jonathan , Simmons David , Cummings Doyle M. , Fisher Edwin B. 
Published: February 2015

Purpose The purpose of this study was to explore how emotional support emerged in interactions between peer supporters (PSs) and adults living with type 2 diabetes. Methods Qualitative data were analyzed from 22 semistructured interviews with PSs in 3 settings: low-income Latinos in Chicago, middle-class Caucasians in the United Kingdom, and low-income African American women in North Carolina. Emotional support was defined as expressions of empathy, trust, and caring. Results Across all sites, emotional support gradually emerged over time, was often combined with informational support, and was conveyed both implicitly (through nonverbal actions connoting emotional acceptance; eg, a walk together without discussion of problems) and explicitly (eg, by reassurance or discussion of stressors). Cross-site differences did appear regarding the strategies to address barriers to diabetes management (eg, PSs in North Carolina and Chicago reported providing support for social stressors) and the role of PSs (eg, PSs in Chicago reported providing directive support). Conclusions Across different settings and populations, emotional support for diabetes management evolved over time, was often integrated with informational support, and emerged through both implicit and explicit strategies that addressed varied context-specific stressors.