bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can We Constrain CMIP5 Rainfall Projections in the Tropical Pacific Based on Surface Warming Patterns?*
Authors: Grose Michael R. , Bhend Jonas , Narsey Sugata , Gupta Alex Sen , Brown Josephine R. 
Published: September 2014

Abstract
Climate warming has large implications for rainfall patterns, and identifying the most plausible pattern of rainfall change over the next century among various model projections would be valuable for future planning. The spatial pattern of projected sea surface temperature change has a key influence on rainfall changes in the tropical Pacific Ocean. Here it is shown that simple indices of the size of the equatorial peak in the spatial pattern of warming and to a lesser extent the hemispheric asymmetry in warming are useful for classifying the surface temperature change in different models from phase 5 of the Coupled Model Intercomparison Project (CMIP5). Models with a more pronounced equatorial warming show a fairly distinct rainfall response compared to those with more uniform warming, including a greater “warmer-get-wetter” or dynamical response, whereby rainfall increases follow the surface warming anomaly. Models with a more uniform warming pattern project a smaller rainfall increase at the equator and a rainfall increase in the southern tropical Pacific, a pattern that is distinct from the multimodel mean of CMIP5. Thus, the magnitude of enhanced equatorial warming and to some extent the hemispheric asymmetry in warming provides a useful framework for constraining rainfall projections. While there is not a simple emergent constraint for enhanced equatorial warming in models in terms of past trends or bias in the current climate, further understanding of the various feedbacks involved in these features could lead to a useful constraint of rainfall for the Pacific region.
School nurses’ descriptions of concerns arising during pupils’ health check-ups: A qualitative study
Authors: Poutiainen Hannele , Holopainen Arja , Hakulinen-Viitanen Tuovi , Laatikainen Tiina 
Published: September 2014

Objective: To describe the concerns and modes of action of Finnish school nurses during pupils’ health check-ups. Methods: Focus group interviews with 17 school nurses were performed in 2011 and again in 2013. Data were analysed using inductive content analysis. Results: School nurses’ concerns were mostly associated with the psychosocial development of pupils and with problems in the family, for example, the loss of a parental role. With regard to physical health, school nurses were particularly concerned with obesity among pupils. The new phenomenon of cyberbullying also caused concern. School nurses were able to identify the causes for their concern at school health check-ups, but they were uncertain regarding how they should act and finding the right mode of action and sufficient multidisciplinary support when pupils had problems. Conclusion: The concern of school nurses at health check-ups was mainly associated with pupils’ health habits, their psychosocial development and family characteristics, and with addressing the need to taking the health behaviours and well-being of the entire family into consideration during health check-ups. Linked-up processes in school health care and multidisciplinary collaboration within schools are of primary importance in supporting the work of nurses and in promoting pupils’ well-being and health.
Effects of Task Precision Demands on Behavioral and Physiological Changes During a Repetitive Asymmetric Lifting Activity
Authors: Mehta Jay P. , Lavender Steven A. , Jagacinski Richard J. , Sommerich Carolyn M. 
Published: September 2014

Objective: This study investigated the effects of task precision demands on behavioral and physiological changes during repetitive asymmetric lifting. Background: Repetitive lifting encountered in manual material handling leads to muscle fatigue and is a documented risk factor for low back disorder. Method: A total of 17 healthy volunteers performed repetitive asymmetric lifting for 60 min (10 lifts/min). Task precision demands were imposed by varying the entry width onto the destination conveyor. Physiological changes were assessed using near-infrared spectroscopy obtained from the erector spinae muscles. Three-dimensional spine kinematics and moment responses were quantified to understand behavioral changes during the lifting activity. Results: Task precision demands showed no effect on erector spinae muscle oxygenation levels. Behavioral changes associated with repetitive lifting included increases in the overall lift duration, peak forward bending motion, and three-dimensional movement velocities of the spine, along with a decrease in the lateral bending moment. Relative to low precision demands, high precision demands resulted in 20% longer placement periods, which, in turn, resulted in a 12% increase in the time-integrated twisting postures and a 10% increase in the time-integrated lateral bending moments during load placement. Conclusion: The elevated risk of low back injury when lifting under greater precision demands is likely due to the sustained spine twisting and the sustained lateral bending moment on the spine in the final phase of these lifts. Application: Understanding behavioral changes to repetitive asymmetric lifting, especially for tasks requiring greater precision can be used to support injury prevention efforts.
Comparison of rehospitalization rates in France and the United States
Authors: Gusmano Michael , Rodwin Victor , Weisz Daniel , Cottenet Jonathan , Quantin Catherine 
Published: September 2014

Objective To compare rates of 30-day all-cause rehospitalization in France and the US among patients aged 65 years and older and explain any difference between the countries. Methods To calculate rehospitalization rates in France, we use an individual identifying variable in the national hospital administrative dataset to track unique individuals aged 65 years or more hospitalized in France in 2010. To calculate the proportion of rehospitalized patients (65+) who received outpatient visits between the time of initial discharge and rehospitalization, we linked the hospital database with a database that includes all medical and surgical admissions. We used step by step regression models to predict rehospitalization. Results Rates of rehospitalization in France (14.7%) are lower than among Medicare beneficiaries in the US (20%). We find that age, sex, patient morbidity and the ownership status of the hospital are all correlated with rehospitalization in France. Conclusions Lower rates of rehospitalization in France appear to be due to a combination of better access to primary care, better health among the older French population, longer lengths of stay in French hospitals and the fact that French nursing homes do not face the same financial incentive to rehospitalize residents.
Gray platelet syndrome: proinflammatory megakaryocytes and α-granule loss cause myelofibrosis and confer metastasis resistance in mice
Authors: Guerrero Jose A. , Bennett Cavan , van der Weyden Louise , McKinney Harriet , Chin Melody , Nurden Paquita , McIntyre Zoe , Cambridge Emma L. , Estabel Jeanne , Wardle-Jones Hannah , Speak Anneliese O. , Erber Wendy N. , Rendon Augusto , Ouwehand Willem H. , Ghevaert Cedric 
Published: September 2014

Key Points
Proinflammatory MKs from mice with GPS drive the extension of myelofibrosis, splenomegaly, and emperipolesis. The lack of preformed α-granules in Nbeal2−/− platelets leads to protection against cancer metastasis.
Endothelial dysfunction and renal fibrosis in endotoxemia-induced oliguric kidney injury: possible role of LPS-binding protein
Authors: Castellano Giuseppe , Stasi Alessandra , Intini Angelica , Gigante Margherita , Di Palma Anna Maria , Divella Chiara , Netti Giuseppe Stefano , Prattichizzo Clelia , Pontrelli Paola , Crovace Antonio , Staffieri Francesco , Fiaccadori Enrico , Brienza Nicola , Grandaliano Giuseppe , Pertosa Giovanni , Gesualdo Loreto 
Published: September 2014

Abstract
Introduction
The pathophysiology of endotoxemia-induced acute kidney injury (AKI) is characterized by an intense activation of the host immune system and renal resident cells by lipopolysaccharide (LPS) and derived proinflammatory products. However, the occurrence of renal fibrosis in this setting has been poorly investigated. The aim of the present study was to investigate the possible association between endothelial dysfunction and acute development of tissue fibrosis in a swine model of LPS-induced AKI. Moreover, we studied the possible effects of coupled plasma filtration adsorption (CPFA) in this setting.

Methods
After 9 hours from LPS infusion and 6 hours of CPFA treatment, histologic and biochemical changes were analyzed in pigs. Apoptosis and endothelial dysfunction were assessed on renal biopsies. The levels of LPS-binding protein (LBP) were quantified with enzyme-linked immunosorbent assay (ELISA). Endothelial cells (ECs) were stimulated in vitro with LPS and cultured in the presence of swine sera and were analyzed with FACS and real-time RT-PCR.

Results
In a swine model of LPS-induced AKI, we observed that acute tubulointerstitial fibrosis occurred within 9 hours from LPS injection. Acute fibrosis was associated with dysfunctional alpha-smooth muscle actin (α-SMA)+ ECs characterized by active proliferation (Ki-67+) without apoptosis (caspase-3-). LPS led to EC dysfunction in vitro with significant vimentin and N-cadherin expression and increased collagen I mRNA synthesis. Therapeutic intervention by citrate-based CPFA significantly prevented acute fibrosis in endotoxemic animals, by preserving the EC phenotype in both peritubular capillaries and renal arteries. We found that the removal of LBP from plasma was crucial to eliminate the effects of LPS on EC dysfunction, by blocking LPS-induced collagen I production.

Conclusions
Our data indicate that EC dysfunction might be pivotal in the acute development of tubulointerstitial fibrosis in LPS-induced AKI. Selective removal of the LPS adaptor protein LBP might represent a future therapeutic option to prevent EC dysfunction and tissue fibrosis in endotoxemia-induced AKI.
Prognostic implications of conversion from nonshockable to shockable rhythms in out-of-hospital cardiac arrest
Authors: Goto Yoshikazu , Maeda Tetsuo , Nakatsu-Goto Yumiko 
Published: September 2014

Abstract
Introduction
The prognostic significance of conversion from nonshockable to shockable rhythms in patients with initial nonshockable rhythms who experience out-of-hospital cardiac arrest (OHCA) remains unclear. We hypothesized that the neurological outcomes in those patients would improve with subsequent shock delivery following conversion to shockable rhythms and that the time from initiation of cardiopulmonary resuscitation by emergency medical services personnel to the first defibrillation (shock delivery time) would influence those outcomes.

Methods
We analyzed the data of 569,937 OHCA adults with initial nonshockable rhythms. The data were collected in a nationwide Utstein-style Japanese database between 2005 and 2010. Patients were divided into subsequently shocked (n =21,944) and subsequently not-shocked (n =547,993) cohorts. The primary study endpoint was 1-month favorable neurological outcome (Cerebral Performance Categories scale, category 1 or 2).

Results
In the subsequently shocked cohort, the ratio of 1-month favorable neurological outcome was significantly higher than that in the subsequently not-shocked cohort (1.79% versus 0.60%, P <0.001). Multivariate logistic regression analysis for 11 prehospital variables revealed that when the shock delivery time was less than 20 minutes, subsequent shock delivery was significantly associated with increased odds of 1-month favorable neurological outcomes (adjusted odds ratios (95% confidence interval), 6.55 (5.21 to 8.22) and 2.97 (2.58 to 3.43) for shock delivery times less than 10 minutes and from 10 to 19 minutes, respectively). However, when the shock delivery time was more than or equal to 20 minutes, subsequent shock delivery was not associated with increased odds of 1-month favorable neurological outcomes.

Conclusions
In patients with an initial nonshockable rhythm after OHCA, subsequent conversion to shockable rhythms during emergency medical services resuscitation efforts was associated with increased odds of 1-month favorable neurological outcomes when the shock delivery time was less than 20 minutes.
Don’t miss the diagnosis of sepsis!
Authors: Marik Paul E 
Published: September 2014

AbstractThe early detection and treatment of sepsis are the most important factors in improving the outcome of patients with this condition. However, many patients admitted to hospital experience a long delay in the diagnosis of sepsis. Furthermore, it is not uncommon for febrile patients to be sent home from the Emergency Department or the physician’s office with the diagnosis of ‘flu’ only to return hours or days later in overt septic shock. The early diagnosis of sepsis may be challenging as many of the signs and symptoms are non-specific. Clinical studies suggest that early diagnosis of sepsis requires a high index of suspicion and comprehensive clinical evaluation together with laboratory tests, including a complete blood count with differential, lactate and procalcitonin levels.
Prehospital intravenous access and fluid resuscitation in severe sepsis: an observational cohort study
Authors: Seymour Christopher W , Cooke Colin R , Heckbert Susan R , Spertus John A , Callaway Clifton W , Martin-Gill Christian , Yealy Donald M , Rea Thomas D , Angus Derek C 
Published: September 2014

Abstract
Introduction
Prompt treatment of severe sepsis in the Emergency Department reduces deaths, but the role of prehospital fluid resuscitation is unknown. We sought to determine the risk-adjusted association between prehospital fluid administration and hospital mortality among emergency medical services (EMS) patients admitted with severe sepsis.

Methods
We performed a prospective, observational study of patients hospitalized with severe sepsis on admission among 45,394 adult EMS encounters taken to 15 hospitals from 11/2009 to 12/2010 by a two-tier EMS system in King County, Washington. The region mandated recording of prehospital intravenous catheter and fluid administration in prehospital records, along with detailed demographic, incident, physiologic, and hospital adjustment variables. We determined the effect of prehospital intravenous catheter or fluid versus no catheter or fluid on all-cause mortality using multivariable logistic regression.

Results
Of all encounters, 1,350 met criteria for severe sepsis on admission, of whom 205 (15%) died by hospital discharge, 312 (23%) received prehospital intravenous fluid, 90 (7%) received a prehospital catheter alone and 948 (70%) did not receive catheter or fluid. EMS administered a median prehospital fluid volume of 500 mL (interquartile range (IQR): 200, 1000 mL). In adjusted models, the administration of any prehospital fluid was associated with reduced hospital mortality (Odds ratio =0.46; 95% Confidence interval: 0.23, 0.88; P =0.02) compared to no prehospital fluid. The odds of hospital mortality were also lower among severe sepsis patients treated with prehospital intravenous catheter alone (Odds ratio =0.3; 95% Confidence interval: 0.17 to 0.57; P <0.01).

Conclusions
In a population-based study, the administration of prehospital fluid and placement of intravenous access were associated with decreased odds of hospital mortality compared with no prehospital catheter or fluid.
The lower limit of intensity to control uremia during continuous renal replacement therapy
Authors: Yasuda Hideto , Uchino Shigehiko , Uji Makiko , Ohnuma Tetsu , Namba Yoshitomo , Katayama Shinshu , Kawarazaki Hiroo , Toki Noriyoshi , Takeda Kenta , Izawa Junichi , Tokuhira Natsuko , Nagata Isao ,   JSEPTIC Clinical Trial Group
Published: September 2014

Abstract
Introduction
The recommended lower limit of intensity during continuous renal replacement therapy (CRRT) is 20 or 25 mL/kg/h. However, limited information is available to support this threshold. We aimed to evaluate the impact of different intensities of CRRT on the clearance of creatinine and urea in critically ill patients with severe acute kidney injury (AKI).

Methods
This is a multicenter retrospective study conducted in 14 Japanese ICUs in 12 centers. All patients older than 18 years and treated with CRRT due to AKI were eligible. We evaluated the effect of CRRT intensity by two different definitions: daily intensity (the mean intensity over each 24-h period) and average intensity (the mean of daily intensity during the period while CRRT was performed). To study the effect of different CRRT intensity on clearance of urea and creatinine, all patients/daily observations were arbitrarily allocated to one of 4 groups based on the average intensity and daily intensity: <10, 10-15, 15-20, and >20 mL/kg/h.

Results
Total 316 patients were included and divided into the four groups according to average CRRT intensity. The groups comprised 64 (20.3%), 138 (43.7%), 68 (21.5%), and 46 patients (14.6%), respectively. Decreases in creatinine and urea increased as the average intensity increased over the first 7 days of CRRT. The relative changes of serum creatinine and urea levels remained close to 1 over the 7 days in the “<10” group. Total 1,101 daily observations were included and divided into the four groups according to daily CRRT intensity. The groups comprised 254 (23.1%), 470 (42.7%), 239 (21.7%), and 138 observations (12.5%), respectively. Creatinine and urea increased (negative daily change) only in the “<10“ group and decreased with the increasing daily intensity in the other groups.

Conclusions
The lower limit of delivered intensity to control uremia during CRRT was approximately between 10 and 15 mL/kg/h in our cohort. A prescribed intensity of approximately 15 mL/kg/h might be adequate to control uremia for patients with severe AKI in the ICU. However, considering the limitations due to the retrospective nature of this study, prospective studies are required to confirm our findings.
Perioperative blood transfusion is associated with a gene transcription profile characteristic of immunosuppression: a prospective cohort study
Authors: Fragkou Paraskevi C , Torrance Hew D , Pearse Rupert M , Ackland Gareth L , Prowle John R , Owen Helen C , Hinds Charles J , O’Dwyer Michael J 
Published: September 2014

Abstract
Introduction
Blood transfusion in the perioperative period has frequently been associated with an excess of nosocomial infections. Whilst transfused whole blood induces specific host immune alteration that may predispose to nosocomial infections, the immunomodulating properties associated with leukodepleted blood remain incompletely understood. In this study, we explore the hypothesis that the transfusion of leukodepleted allogeneic blood during or following major gastrointestinal surgery is associated with an immunosuppressed phenotype, which may in turn predispose to postoperative infectious complications.

Methods
Patients aged over 45 years undergoing scheduled inpatient major gastrointestinal surgery were recruited. Gene expression profiles of specific inflammatory genes were assayed from blood collected preoperatively, at 24 and at 48 hours after surgery. Genes were selected based on their ability to represent specific immune pathways. Gene expression was quantified using quantitative real-time polymerase chain reaction (qRT-PCR) to measure messenger RNA (mRNA) levels. Postoperative infections were documented using predefined criteria.

Results
One hundred and nineteen patients were recruited. Fifteen (13%) patients required blood transfusion within 24 hours of surgery, 44 (37%) patients developed infections and 3 (2%) patients died prior to discharge. Patients receiving a blood transfusion were more likely to develop postoperative infections (P =0.02) and to have lower tumour necrosis factor alpha (TNFα), interleukin (IL)-12, IL-23 and RAR-related orphan receptor gamma T (RORγt) gene expression in the postoperative period (P <0.05). The TNFα/IL-10 mRNA ratio at 24 hours (P =0.0006) and at 48 hours (P =0.01) was lower in patients receiving a blood transfusion over this period. Multivariable analysis confirmed that these observations were independent of the severity of the surgical insult.

Conclusions
An association between an immunosuppressive pattern of gene expression and blood transfusion following major elective gastrointestinal surgery is described. This gene expression profile includes a reduction in the activity of innate immunity and T helper cell type 1 (Th1) and T helper cell type 17 (Th17) pathways in those patients receiving a blood transfusion. Blood transfusion was also associated with an excess of infectious complications in this cohort. A mechanistic link is suggested but not proven.
Lack of replication of interactions between polymorphisms in rheumatoid arthritis susceptibility: case–control study
Authors: Ferreiro-Iglesias Aida , Calaza Manuel , Perez-Pampin Eva , Lopez Longo Francisco J , Marenco Jose L , Blanco Francisco J , Narvaez Javier , Navarro Federico , Cañete Juan D , de la Serna Arturo R , Gonzalez-Alvaro Isidoro , Herrero-Beaumont Gabriel , Pablos Jose L , Balsa Alejandro , Fernandez-Gutierrez Benjamin , Caliz Rafael , Gomez-Reino Juan J , Gonzalez Antonio 
Published: September 2014

Abstract
Introduction
Approximately 100 loci have been definitively associated with rheumatoid arthritis (RA) susceptibility. However, they explain only a fraction of RA heritability. Interactions between polymorphisms could explain part of the remaining heritability. Multiple interactions have been reported, but only the shared epitope (SE) × protein tyrosine phosphatase nonreceptor type 22 (PTPN22) interaction has been replicated convincingly. Two recent studies deserve attention because of their quality, including their replication in a second sample collection. In one of them, researchers identified interactions between PTPN22 and seven single-nucleotide polymorphisms (SNPs). The other showed interactions between the SE and the null genotype of glutathione S-transferase Mu 1 (GSTM1) in the anti–cyclic citrullinated peptide–positive (anti-CCP+) patients. In the present study, we aimed to replicate association with RA susceptibility of interactions described in these two high-quality studies.

Methods
A total of 1,744 patients with RA and 1,650 healthy controls of Spanish ancestry were studied. Polymorphisms were genotyped by single-base extension. SE genotypes of 736 patients were available from previous studies. Interaction analysis was done using multiple methods, including those originally reported and the most powerful methods described.

Results
Genotypes of one of the SNPs (rs4695888) failed quality control tests. The call rate for the other eight polymorphisms was 99.9%. The frequencies of the polymorphisms were similar in RA patients and controls, except for PTPN22 SNP. None of the interactions between PTPN22 SNPs and the six SNPs that met quality control tests was replicated as a significant interaction term—the originally reported finding—or with any of the other methods. Nor was the interaction between GSTM1 and the SE replicated as a departure from additivity in anti-CCP+ patients or with any of the other methods.

Conclusions
None of the interactions tested were replicated in spite of sufficient power and assessment with different assays. These negative results indicate that whether interactions are significant contributors to RA susceptibility remains unknown and that strict standards need to be applied to claim that an interaction exists.