bluuebunny/crossref_metadata_2025_split huggingface dataset:
Climatology of Extreme Daily Precipitation in Colorado and Its Diverse Spatial and Seasonal Variability
Authors: Mahoney Kelly , Ralph F. Martin , Wolter Klaus , Doesken Nolan , Dettinger Michael , Gottas Daniel , Coleman Timothy , White Allen 
Published: December 2014

Abstract
The climatology of Colorado’s historical extreme precipitation events shows a remarkable degree of seasonal and regional variability. Analysis of the largest historical daily precipitation totals at COOP stations across Colorado by season indicates that the largest recorded daily precipitation totals have ranged from less than 60 mm day−1 in some areas to more than 250 mm day−1 in others. East of the Continental Divide, winter events are rarely among the top 10 events at a given site, but spring events dominate in and near the foothills; summer events are most common across the lower-elevation eastern plains, while fall events are most typical for the lower elevations west of the Divide. The seasonal signal in Colorado’s central mountains is complex; high-elevation intense precipitation events have occurred in all months of the year, including summer, when precipitation is more likely to be liquid (as opposed to snow), which poses more of an instantaneous flood risk. Notably, the historic Colorado Front Range daily rainfall totals that contributed to the damaging floods in September 2013 occurred outside of that region’s typical season for most extreme precipitation (spring–summer). That event and many others highlight the fact that extreme precipitation in Colorado has occurred historically during all seasons and at all elevations, emphasizing a year-round statewide risk.
The influence of acculturation on mental health and specialized mental healthcare for non-western migrants
Authors: Nap Annelies , van Loon Annelies , Peen Jaap , van Schaik Digna JF , Beekman Aartjan TF , Dekker Jack JM 
Published: December 2014

Background: The level of acculturation of migrants varies and is associated with variations in mental health. However, this association is complex and may differ among migrant groups. Aim: The aim of this study is to explore the association between acculturation, mental health and treatment effect. Methods: In a longitudinal cohort study of patients treated in specialized mental health facilities, different dimensions of acculturation (skills, social integration, traditions, norms/values and feelings of loss) were explored for Moroccan, Turkish and Surinamese migrants in the Netherlands. Furthermore, the associations between acculturation status and symptom levels, quality of life, care needs and effects of mental health treatment were examined. Data were analyzed with analysis of covariance, correlation analysis and multiple regression analysis. Results: Acculturation status differed among migrant groups. Turkish migrants showed most original culture maintenance (traditions, norms/values), Surinamese migrants showed most participation in Dutch society (skills, social integration), while Moroccan migrants were situated in between. Higher cultural adaptation was associated with less need for care, lower symptom levels and a higher quality of life. Participation significantly predicted lower symptom levels ( p < .001) and higher quality of life ( p < .001) 6 months after the start of treatment. Conclusion: This study confirms that acculturation status is associated with symptom levels, quality of life and perceived need for care of migrants. Moreover, participation in Dutch society appears to be a favorable factor for treatment effect. It is of importance for professionals in clinical practice to be attentive to this.
Humanities Promotion Policy in Korea
Authors: Song Ki Dong , Ra Eunjong 
Published: December 2014

AbstractThis paper presents the Humanities promotion policies implemented by the Korean government in the last years. It underlines the growing importance given to these disciplines in the current context of Korea's economic development. It explains why a background in the humanities is seen as a critical tool to enhance the national capacity of compete on global scale. The main actions and programmes for the upcoming years are presented here, along with medium- and long-term plans.
(Dis)-Trust in transitioning ventilator-dependent children from hospital to homecare
Authors: Manhas Kiran Pohar , Mitchell Ian 
Published: December 2014

Background: Scholarly work is needed to develop the conceptual and theoretical understanding of trust to nursing practice. The transition from hospital care to complex pediatric homecare involves nurses in myriad roles, including management and care provision. Complex pediatric homecare transforms children, families, professionals, and communities, but its exact implications are unclear. Research objectives: To conduct an ethical inquiry into the role and responsibilities of nurses in the qualitative experience of adults involved in the hospital-to-home transition of young, ventilator-dependent children. Research design: We followed methods described by Franco Carnevale. We used a sociologically grounded theoretical orientation—trust—to re-interpret qualitative data for an ethical inquiry into a specific facet of that data. Participants and study context: The participants included 26 adults, including 14 nurses, involved in the hospital-to-home transition in a Canadian province. Participants represented family, hospital, home, and government. Ethical considerations: The Conjoint Health Research Ethics Board at the University of Calgary approved this study. Findings: First, the concept and practice of trust was salient to the experience of transition. For example, responsibilities’ allocation between hospital-based professionals to mothers, home-based nurses, and non-professionals necessitated reliance and vulnerability. Second, the consequences of distrust connected to recognized challenges. For example, tensions along rural–urban, medical-family, and professional–personal divide each revealed suspicion and uncertainty that led to isolation and anxiety for all involved. Third, recommendations to improve the experience and mitigate the challenges of transition can be grounded in trust promotion. For example, transition-specific education programs and codes of ethics would promote openness, recognize mutual vulnerability, and advance trust in transition. Conclusions: The challenges to transition evidenced distrust, while trust represents a powerful tool to counter these challenges and their implications. A climate of trust could bridge divides between mothers and professionals; rural and urban professionals; and professionals with differing relationships with the family.
Bone marrow angiotensin AT2 receptor deficiency aggravates atherosclerosis development by eliminating macrophage liver X receptor-mediated anti-atherogenic actions
Authors: Kato Taku , Kawahito Hiroyuki , Kishida Sou , Irie Daisuke , Wakana Noriyuki , Kikai Masakazu , Takata Hiroki , Ogata Takehiro , Ueyama Tomomi , Matoba Satoaki , Yamada Hiroyuki 
Published: December 2014

Background: Bone marrow (BM) Angiotensin II (Ang II) type 1 (AT1) receptor plays a crucial role in atherosclerosis development; however, the effect of BM Ang II type 2 (AT2) receptor on atherogenesis remains undefined. Methods and results: We generated BM chimera apoE-deficient ( apoE−/−) mice whose BM cells were repopulated with AT2-deficient ( Agtr2−/−) or wild-type ( Agtr2+/+) cells. After 2 months of a high-cholesterol diet, the atherosclerotic lesion area was significantly increased in the apoE−/−/BM-Agtr2−/− mice compared with the apoE−/−/BM-Agtr2+/+ mice (51%, P < 0.05), accompanied by an augmented accumulation of lesion macrophages. Although phenotypic polarization in BM-derived macrophages and lipopolysaccharide-induced expression of proinflammatory cytokines in thioglycollate-induced peritoneal macrophages (TGPMs) were not affected by AT2-deficiency, mRNA and protein expression levels of macrophage liver X receptor β (LXRβ) were significantly decreased in Agtr2−/− TGPMs compared with Agtr2+/+ TGPMs. Anti-inflammatory effects of LXR agonist (GW3965) were markedly inhibited in Agtr2−/− TGPMs. Furthermore, the expression levels of ATP-binding cassette transporter ABCA1 and CCR7 were much lower in Agtr2−/− TGPMs than Agtr2+/+ TGPMs, accompanied by a significantly reduced cholesterol efflux. Conclusions: Our findings demonstrate that BM-AT2 deficiency aggravates atherosclerosis, at least in part, by eliminating the anti-atherogenic properties of macrophages elicited by LXRβ activation.
Clopidogrel and 1-Year Freedom From Amputation After Endovascular Lower Extremity Revascularization in the Medicare Population
Authors: Janzen Mark L. , Dombrovskiy Viktor Y. , Galiñanes Edgar Luis , Vogel Todd R. 
Published: December 2014

Objective: To evaluate freedom from amputation in patients identified utilizing clopidogrel following their lower extremity endovascular revascularization (LER). Methods: Patients, 65 years of age and older, undergoing LER were identified from Medicare Provider Analysis and Review and Carrier files utilizing International Classification of Diseases diagnosis and Current Procedural Terminology codes. Postprocedural use of clopidogrel was identified using the National Drug Code directory. Outcomes were evaluated. Results: A total of 14 353 patients were identified: 5697 (39.7%) with claudication, 1467 (10.2%) with rest pain, and 7189 (50.1%) with ulceration/tissue loss. In all, 5416 (37.7%) patients were identified using clopidogrel after LER. Overall, patients initiated on clopidogrel had lower amputation rates at 30 days (10.34% vs 14.09%; P < .0001), 90 days (14.05% vs 18.71%; P < .0001), and 1 year (19.68% vs 24.06%; P < .0001). Conclusion: Utilization of clopidogrel after LER was associated with lower rates of amputation, yet only 38% of the Medicare population was identified as using clopidogrel. Patients with ulceration and tissue loss benefited the most with significantly greater freedom from amputation and overall survival.
Nutrition habits in 24-hour mountain bike racers
Authors: Chlíbková Daniela , Knechtle Beat , Rosemann Thomas , Tomášková Ivana , Chadim Vlastimil , Shortall Marcus 
Published: December 2014

AbstractWe investigated seventy-four ultra-mountain bikers (MTBers) competing in the solo category in the first descriptive field study to detail nutrition habits and the most common food before during and after the 24 hour race using questionnaires. During the race, bananas (86.5%), energy bars (50.0%), apples (43.2%) and cheese (43.2%) were the most commonly consumed food, followed by bread (44.6%), rice (33.8%) and bananas (33.8%) after the race. Average fluid intake was 0.5 ± 0.2 l/h. The main beverage was isotonic sports drink (82.4%) during and pure water (66.2%) after the race. The most preferred four supplements in the four weeks before, the day before, during and after the race were vitamin C (35.1%), magnesium (44.6%), magnesium (43.2%) and branched-chain amino acids (24.3%), respectively. Total frequency of food intake (30.6 ± 10.5 times/24 hrs) was associated with fluid intake (r = 0.43,P = 0.04) and both were highest at the beginning of the race and lower during the night hours and the last race segment in a subgroup of twenty-three ultra-MTBers. Supplement intake frequency (6.8 ± 8.4 times/24 hrs) was highest during the night hours and lower at the beginning and end of the race. Elevated food and fluid intake among participants tracked across all race segments (P < 0.001). In conclusion, the nutrition strategy employed by ultra-MTBers was similar to those demonstrated in previous studies of ultra-cyclists with some exceptions among selected individuals.
Borderline pulmonary arterial pressure in systemic sclerosis patients: a post-hoc analysis of the DETECT study
Authors: Visovatti Scott H , Distler Oliver , Coghlan J Gerry , Denton Christopher P , Grünig Ekkehard , Bonderman Diana , Müller-Ladner Ulf , Pope Janet E , Vonk Madelon C , Seibold James R , Torres-Martin Juan-Vicente , Doelberg Martin , Chadha-Boreham Harbajan , Rosenberg Daniel M , McLaughlin Vallerie V , Khanna Dinesh 
Published: December 2014

Abstract
Introduction
Patients with mean pulmonary artery pressures (mPAP) of 21 to 24 mm Hg have a so-called borderline elevation of mPAP (BoPAP)—a condition thought to represent early-stage pulmonary arterial vasculopathy. Based on the DETECT study, this post-hoc analysis examined patient characteristics of systemic sclerosis (SSc) patients with normal mPAP, BoPAP and elevated mPAP, fulfilling pulmonary arterial hypertension (PAH) criteria.

Methods
Adult patients with a duration of SSc more than 3 years, a diffusing capacity of the lung for carbon monoxide less than 60% predicted, and no previous diagnosis of any form of pulmonary hypertension (PH) underwent screening tests followed by right heart catheterization. Subjects were divided into three groups: normal mPAP, BoPAP, and PAH. Exploratory comparative and binary logistic regression analyses were performed for the BoPAP versus normal mPAP and PAH versus BoPAP groups.

Results
Of 244 patients evaluated, 148 (60%) had normal mPAP, 36 (15%) had BoPAP, and 60 (25%) had definite PAH. Univariable logistic regression (ULR) showed the mean tricuspid regurgitation velocity in patients with BoPAP to be intermediate between normal mPAP and PAH. In the ULR analyses BoPAP versus normal mPAP and PAH versus BoPAP, the statistically significant predictors were, amongst others: demographic, clinical, pulmonary function, echocardiographic and hemodynamic variables.

Conclusions
In this exploratory post-hoc analysis of the DETECT study population patients with BoPAP could be distinguished from patients with normal mPAP and PAH, and it appears that BoPAP may be an intermediate stage on the continuum between normal PA pressures and PAH.
Quadriceps arthrogenic muscle inhibition: the effects of experimental knee joint effusion on motor cortex excitability
Authors: Rice David Andrew , McNair Peter John , Lewis Gwyn Nancy , Dalbeth Nicola 
Published: December 2014

Abstract
Introduction
Marked weakness of the quadriceps muscles is typically observed following injury, surgery or pathology affecting the knee joint. This is partly due to ongoing neural inhibition that prevents the central nervous system from fully activating the quadriceps, a process known as arthrogenic muscle inhibition (AMI). This study aimed to further investigate the mechanisms underlying AMI by exploring the effects of experimental knee joint effusion on quadriceps corticomotor and intracortical excitability.

Methods
Seventeen healthy volunteers participated in this study. Transcranial magnetic stimulation was used to measure quadriceps motor evoked potential area, short-interval intracortical inhibition, intracortical facilitation and cortical silent period duration before and after experimental knee joint effusion. Joint effusion was induced by the intraarticular infusion of dextrose saline into the knee.

Results
There was a significant increase in quadriceps motor evoked potential area following joint infusion, both at rest (P = 0.01) and during voluntary muscle contraction (P = 0.02). Cortical silent period duration was significantly reduced following joint infusion (P = 0.02). There were no changes in short interval intracortical inhibition or intracortical facilitation over time (all P > 0.05).

Conclusions
The results of this study provide no evidence for a supraspinal contribution to quadriceps AMI. Paradoxically, but consistent with previous observations in patients with chronic knee joint pathology, quadriceps corticomotor excitability increased after experimental knee joint effusion. The increase in quadriceps corticomotor excitability may be at least partly mediated by a decrease in gamma-aminobutyric acid (GABA)-ergic inhibition within the motor cortex.
Multicenter Phase II Trial of Temsirolimus and Bevacizumab in Pancreatic Neuroendocrine Tumors
Authors: Hobday Timothy J. , Qin Rui , Reidy-Lagunes Diane , Moore Malcolm J. , Strosberg Jonathan , Kaubisch Andreas , Shah Manisha , Kindler Hedy Lee , Lenz Heinz-Josef , Chen Helen , Erlichman Charles 
Published: December 2014

Purpose There are few effective therapies for pancreatic neuroendocrine tumors (PNETs). Recent placebo-controlled phase III trials of the mammalian target of rapamycin (mTOR) inhibitor everolimus and the vascular endothelial growth factor (VEGF)/platelet-derived growth factor receptor inhibitor sunitinib have noted improved progression-free survival (PFS). Preclinical studies have suggested enhanced antitumor effects with combined mTOR and VEGF pathway–targeted therapy. We conducted a clinical trial to evaluate combination therapy against these targets in PNETs. Patients and Methods We conducted a two-stage single-arm phase II trial of the mTOR inhibitor temsirolimus 25 mg intravenously (IV) once per week and the VEGF-A monoclonal antibody bevacizumab 10 mg/kg IV once every 2 weeks in patients with well or moderately differentiated PNETs and progressive disease by RECIST within 7 months of study entry. Coprimary end points were tumor response rate and 6-month PFS. Results A total of 58 patients were enrolled, and 56 patients were eligible for response assessment. Confirmed response rate (RR) was 41% (23 of 56 patients). PFS at 6 months was 79% (44 of 56). Median PFS was 13.2 months (95% CI, 11.2 to 16.6). Median overall survival was 34 months (95% CI, 27.1 to not reached). For evaluable patients, the most common grade 3 to 4 adverse events attributed to therapy were hypertension (21%), fatigue (16%), lymphopenia (14%), and hyperglycemia (14%). Conclusion The combination of temsirolimus and bevacizumab had substantial activity and reasonable tolerability in a multicenter phase II trial, with RR of 41%, well in excess of single targeted agents in patients with progressive PNETs. Six-month PFS was a notable 79% in a population of patients with disease progression by RECIST criteria within 7 months of study entry. On the basis of this trial, continued evaluation of combination mTOR and VEGF pathway inhibitors is warranted.
Institutional Clinical Trial Accrual Volume and Survival of Patients With Head and Neck Cancer
Authors: Wuthrick Evan J. , Zhang Qiang , Machtay Mitchell , Rosenthal David I. , Nguyen-Tan Phuc Felix , Fortin André , Silverman Craig L. , Raben Adam , Kim Harold E. , Horwitz Eric M. , Read Nancy E. , Harris Jonathan , Wu Qian , Le Quynh-Thu , Gillison Maura L. 
Published: December 2014

Purpose National Comprehensive Cancer Network guidelines recommend patients with head and neck cancer (HNC) receive treatment at centers with expertise, but whether provider experience affects survival is unknown. Patients and Methods The effect of institutional experience on overall survival (OS) in patients with stage III or IV HNC was investigated within a randomized trial of the Radiation Therapy Oncology Group (RTOG 0129), which compared cisplatin concurrent with standard versus accelerated fractionation radiotherapy. As a surrogate for experience, institutions were classified as historically low- (HLACs) or high-accruing centers (HHACs) based on accrual to 21 RTOG HNC trials (1997 to 2002). The effect of accrual volume on OS was estimated by Cox proportional hazards models. Results Median RTOG accrual (1997 to 2002) at HLACs was four versus 65 patients at HHACs. Analysis included 471 patients in RTOG 0129 (2002 to 2005) with known human papillomavirus and smoking status. Patients at HLACs versus HHACs had better performance status (0: 62% v 52%; P = .04) and lower T stage (T4: 26.5% v 35.3%; P = .002) but were otherwise similar. Radiotherapy protocol deviations were higher at HLACs versus HHACs (18% v 6%; P < .001). When compared with HHACs, patients at HLACs had worse OS (5 years: 51.0% v 69.1%; P = .002). Treatment at HLACs was associated with increased death risk of 91% (hazard ratio [HR], 1.91; 95% CI, 1.37 to 2.65) after adjustment for prognostic factors and 72% (HR, 1.72; 95% CI, 1.23 to 2.40) after radiotherapy compliance adjustment. Conclusion OS is worse for patients with HNC treated at HLACs versus HHACs to cooperative group trials after accounting for radiotherapy protocol deviations. Institutional experience substantially influences survival in locally advanced HNC.
Pre- and Postdiagnosis Physical Activity, Television Viewing, and Mortality Among Patients With Colorectal Cancer in the National Institutes of Health–AARP Diet and Health Study
Authors: Arem Hannah , Pfeiffer Ruth M. , Engels Eric A. , Alfano Catherine M. , Hollenbeck Albert , Park Yikyung , Matthews Charles E. 
Published: December 2014

Purpose Physical inactivity has been associated with higher mortality risk among survivors of colorectal cancer (CRC), but the independent effects of pre- versus postdiagnosis activity are unclear, and the association between watching television (TV) and mortality in survivors of CRC is previously undefined. Methods We analyzed the associations between prediagnosis (n = 3,797) and postdiagnosis (n = 1,759) leisure time physical activity (LTPA) and TV watching and overall and disease-specific mortality among patients with CRC. We used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% CIs, adjusting for known mortality risk factors. Results Comparing survivors of CRC reporting more than 7 hours per week (h/wk) of prediagnosis LTPA with those reporting no LTPA, we found a 20% lower risk of all-cause mortality (HR, 0.80; 95% CI, 0.68 to 0.95; P for trend = .021). Postdiagnosis LTPA of ≥ 7 h/wk, compared with none, was associated with a 31% lower all-cause mortality risk (HR, 0.69; 95% CI, 0.49 to 0.98; P for trend = .006), independent of prediagnosis activity. Compared with 0 to 2 TV hours per day (h/d) before diagnosis, those reporting ≥ 5 h/d of TV before diagnosis had a 22% increased all-cause mortality risk (HR, 1.22; 95% CI, 1.06 to 1.41; P trend = .002), and more postdiagnosis TV watching was associated with a nonsignificant 25% increase in all-cause mortality risk (HR, 1.25; 95% CI, 0.93 to 1.67; P for trend = .126). Conclusion LTPA was inversely associated with all-cause mortality, whereas more TV watching was associated with increased mortality risk. For both LTPA and TV watching, postdiagnosis measures independently explained the association with mortality. Clinicians should promote both minimizing TV time and increasing physical activity for longevity among survivors of CRC, regardless of previous behaviors.