bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical effectiveness of a patient decision aid to improve decision quality and glycaemic control in people with diabetes making treatment choices: a cluster randomised controlled trial (PANDAs) in general practice
Authors: Mathers Nigel , Ng Chirk Jenn , Campbell Michael Joseph , Colwell Brigitte , Brown Ian , Bradley Alastair 
Published: November 2012

ObjectiveTo determine the effectiveness of a patient decision aid (PDA) to improve decision quality and glycaemic control in people with diabetes making treatment choices using a cluster randomised controlled trial (RCT).DesignA cluster RCT.Setting49 general practices in UK randomised into intervention (n=25) and control (n=24).ParticipantsGeneral practicesInclusion criteria: >4 medical partners; list size >7000; and a diabetes register with >1% of practice population. 191 practices assessed for eligibility, and 49 practices randomised and completed the study.PatientsPeople with type 2 diabetes mellitus (T2DM) taking at least two oral glucose-lowering drugs with maximum tolerated dose with a glycosolated haemoglobin (HbA1c) greater than 7.4% (IFCC HbA1c >57 mmol/mol) or advised in the preceeding 6 months to add or consider changing to insulin therapy. Exclusion criteria: currently using insulin therapy; difficulty reading or understanding English; difficulty in understanding the purpose of the study; visual or cognitive impairment or mentally ill. A total of 182 assessed for eligibility, 175 randomised to 95 intervention and 80 controls, and 167 completion and analysis.InterventionBrief training of clinicians and use of PDA with patients in single consultation.Primary outcomesDecision quality (Decisional Conflict Scores, knowledge, realistic expectations and autonomy) and glycaemic control (glycosolated haemoglobin, HbA1c).Secondary outcomesKnowledge and realistic expectations of the risks and benefits of insulin therapy and diabetic complications.ResultsIntervention group: lower total Decisional Conflict Scores (17.4 vs 25.2, p<0.001); better knowledge (51.6% vs 28.8%, p<0.001); realistic expectations (risk of ‘hypo’, ‘weight gain’, ‘complications’; 81.0% vs 5.2%, 70.5% vs 5.3%, 26.3% vs 5.0% respectively, p<0.001); and were more autonomous in decision-making (64.1% vs 42.9%, p=0.012). No significant difference in the glycaemic control between the two groups.ConclusionsUse of the PANDAs decision aid reduces decisional conflict, improves knowledge, promotes realistic expectations and autonomy in people with diabetes making treatment choices in general practice.ISRCTN Trials Register Number14842077.
Blood pressure in different ethnic groups (BP-Eth): a mixed methods study
Authors: Wood Sally , Martin Una , Gill Paramjit , Greenfield Sheila M , Haque M Sayeed , Mant Jonathan , Mohammed Mohammed A , Heer Gurdip , Johal Amanpreet , Kaur Ramandeep , Schwartz Claire , McManus Richard J 
Published: November 2012

IntroductionPeople of South Asian, African-Caribbean and Irish ethnicity are known to have worse cardiovascular outcomes than those from the white British group. While the reasons underpinning this are complex, the effect of hypertension is both significant and modifiable. In recent years, there has been increasing interest in and uptake of ‘out-of-office’ methods for blood pressure (BP) monitoring. However, guidance in this area has been largely based on research among the white population. This study aims to answer the following questions: (1) How often and in what ways does blood pressure (BP) monitoring occur and how does this differ between white and the above minority ethnic populations. (2) Are the thresholds for diagnosis of hypertension, and treatment targets in hypertension comparable for white British and minority ethnic populations using different measurement modalities: office blood pressure, ambulatory BP monitoring and home monitoring? (3) What preferences for BP measurement do people from white and minority ethnic populations have?Methods and analysisA mixed methods approach will be used including the following: (1) A postal survey sent to 8000 hypertensive and not-known-to-be-hypertensive people from all four ethnic groups will determine current patterns of BP monitoring. (2) A validation study will compare BP measurement by ambulatory monitoring with office standard measurement, office research measurement and home monitoring in 200 people from each of the ethnic groups concerned. (3) Focus groups organised by ethnicity and gender will gather qualitative data regarding patient preferences for and experiences of BP measurement in each of the given modalities.The data collected from these phases will be analysed appropriately in order to answer the above research questions.Ethics and disseminationEthical approval has been gained from the Black Country Research Ethics Committee: Ref 09/H1202/114. The results of this work will be disseminated via journal publication and conference presentation.
Restless legs syndrome and all-cause mortality in four prospective cohort studies
Authors: Szentkirályi András , Winter Anke C , Schürks Markus , Völzke Henry , Hoffmann Wolfgang , E Buring Julie , Gaziano J Michael , Kurth Tobias , Berger Klaus 
Published: November 2012

ObjectivesTo evaluate the association between restless legs syndrome (RLS) and all-cause mortality.DesignFour prospective cohort studies.SettingThe Dortmund Health Study (DHS) and the Study of Health in Pomerania (SHIP) from Germany. The Women's Health Study (WHS) and the Physicians’ Health Study (PHS) from the USA.ParticipantsIn DHS: a random sample (n=1 299) from the population of Dortmund; in SHIP: a sample (n=4 291) from residents living in West Pomerania were drawn by multistage random sampling design; in WHS: female healthcare professionals (n=31 370); in PHS: male physicians (n=22 926)Main outcome measuresAll-cause mortality.ResultsThe prevalence of RLS ranged between 7.4% and 11.9% at baseline. During follow-up (ranging between 6 and 11 years) RLS was not associated with increased risk of all-cause mortality in any of the four cohorts. The multivariable-adjusted HRs (95% CI) for all-cause mortality ranged from 0.21 (0.03 to 1.53) to 1.07 (0.93 to 1.23) across the four studies. The HRs for all-cause mortality did not differ according to gender.ConclusionsIn these four independently conducted large prospective cohort studies from Germany and the USA, RLS did not increase the risk of all-cause mortality. These findings do not support the hypothesis that RLS is a risk factor for mortality of any cause.
DEFECT PREDICTION USING CASE-BASED REASONING: AN ATTRIBUTE WEIGHTING TECHNIQUE BASED UPON SENSITIVITY ANALYSIS IN NEURAL NETWORKS
Authors: PAIKARI ELHAM , RICHTER MICHAEL M. , RUHE GUENTHER 
Published: November 2012

Software defect prediction is an acknowledged approach used to achieve better product quality and to better utilize resources needed for that purpose. One known method for predicting the number of defects is to apply case-based reasoning (CBR). In this paper, different attribute weighting techniques for CBR-based defect prediction are analyzed. One of the weighting techniques used in this work, Sensitivity Analysis based on Neural Networks (SANN), is based on sensitivity analysis of the impact of attributes as part of neural network analysis. Neural networks are applicable when there are non-linear and complicated relationships among the attributes. Since weighting plays a key role in the CBR model, using an efficient weight calculation method can change the results. The results of SANN are compared with applying uniform weights and weights gained from Multiple Linear Regression (MLR).Evaluation of the accuracy of the overall method for applying the three different weighting techniques is done over five data sets, comprising about 5000 modules from NASA. Two quality measures are applied: Average Absolute Error (AAE) and Average Relative Error (ARE). In addition to the variation of weighting techniques, the impact of varying the number of nearest neighbors is studied.The three main results of the empirical analysis are: (i) In the majority of cases, SANN achieves the most accurate results; (ii) uniform weighting performs better than the MLR-based weighting heuristic; and (iii) there is no significant preference pattern for defining the number of similar objects used for prediction in CBR.
Inhibition of mTOR Suppresses UVB-Induced Keratinocyte Proliferation and Survival
Authors: Carr Theresa D. , DiGiovanni John , Lynch Christopher J. , Shantz Lisa M. 
Published: November 2012

AbstractUV radiation is the major risk factor for developing skin cancer, the most prevalent cancer worldwide. Several studies indicate that mTOR signaling is activated by UVB and may play an important role in skin tumorigenesis. mTOR exists in two functionally and compositionally distinct protein complexes: the rapamycin-sensitive mTOR complex 1 (mTORC1) and the rapamycin-resistant mTOR complex 2 (mTORC2). The purpose of these studies was to investigate the roles of the two mTOR complexes in UVB-mediated proliferation and apoptosis in the skin. We used rapamycin, a pharmacologic inhibitor of mTORC1, and an inducible mTOR-deficient (K5-CreERT2;mTORfl/fl) mouse model that allows epidermal-specific disruption of mTOR following topical treatment with 4-hydroxytamoxifen (4OHT). Rapamycin blocked UVB-induced phosphorylation of S6K, the downstream target of mTORC1, and significantly reduced UVB-stimulated epidermal proliferation and cell-cycle progression, but had no effect on cell death. In contrast, mTOR deletion, which attenuated UVB-induced phosphorylation of both S6K and the mTORC2 target AKTSer473, significantly increased apoptosis both in vivo and in keratinocyte cultures, in addition to reducing hyperproliferation following UVB irradiation. The role of mTORC2 in UVB-induced prosurvival signaling was verified in Rictor−/− mouse embryo fibroblasts, which lack functional mTORC2 and were more sensitive to UVB-induced apoptosis than controls. These studies show that mTORC1 and mTORC2 play unique but complementary roles in controlling proliferation and apoptosis in the skin. Our findings underscore the importance of both mTOR complexes in mediating UVB-induced signaling in keratinocytes and provide new insight into the pathogenesis of skin cancer. Cancer Prev Res; 5(12); 1394–404. ©2012 AACR.
The Buoyancy Budget with a Nonlinear Equation of State
Authors: Hieronymus Magnus , Nycander Jonas 
Published: November 2012

Abstract
The nonlinear equation of state of seawater introduces a sink or source of buoyancy when water parcels of unequal salinities and temperatures are mixed. This article contains quantitative estimates of these nonlinear effects on the buoyancy budget of the global ocean. It is shown that the interior buoyancy sink can be determined from surface buoyancy fluxes. These surface buoyancy fluxes are calculated using two surface heat flux climatologies, one based on in situ measurements and the other on a reanalysis, in both cases using a nonlinear equation of state. It is also found that the buoyancy budget in the ocean general circulation model Nucleus for European Modeling of the Ocean (NEMO) is in good agreement with the buoyancy budgets based on the heat flux climatologies. Moreover, an examination of the vertically resolved buoyancy budget in NEMO shows that in large parts of the ocean the nonlinear buoyancy sink gives the largest contribution to this budget.
A Spectral Aging Model for the Meteosat-7 Visible Band
Authors: Decoster I. , Clerbaux N. , Baudrez E. , Dewitte S. , Ipe A. , Nevens S. , Velazquez Blazquez A. , Cornelis J. 
Published: November 2012

Abstract
For more than 30 years, the Meteosat satellites have been in a geostationary orbit around the earth. Because of the high temporal frequency of the data and the long time period, this database is an excellent candidate for fundamental climate data records (FCDRs). One of the prerequisites to create FCDRs is an accurate and stable calibration over the full data period. Because of the presence of contamination on the instrument in space, a degradation of the visible band of the instruments has been observed. Previous work on the Meteosat First Generation satellites, together with results from other spaceborne instruments, led to the idea that there is a spectral component to this degradation. This paper describes the model that was created to correct the Meteosat-7 visible (VIS) channel for these spectral aging effects. The model assumes an exponential temporal decay for the gray part of the degradation and a linear temporal decay for the wavelength-dependent part. The effect of these two parts of the model is tuned according to three parameters; 253 clear-sky stable earth targets with different surface types are used together with deep convective cloud measurements to fit these parameters. The validation of the model leads to an overall stability of the Meteosat-7 reflected solar radiation data record of about 0.66 W m−2 decade−1.
Drop-Size Distributions in Thunderstorms Measured by Optical Disdrometers during VORTEX2
Authors: Friedrich Katja , Kalina Evan A. , Masters Forrest J. , Lopez Carlos R. 
Published: November 2012

Abstract
When studying the influence of microphysics on the near-surface buoyancy tendency in convective thunderstorms, in situ measurements of microphysics near the surface are essential and those are currently not provided by most weather radars. In this study, the deployment of mobile microphysical probes in convective thunderstorms during the second Verification of the Origins of Rotation in Tornadoes Experiment (VORTEX2) is examined. Microphysical probes consist of an optical Ott Particle Size and Velocity (PARSIVEL) disdrometer that measures particle size and fall velocity distributions and a surface observation station that measures wind, temperature, and humidity. The mobile probe deployment allows for targeted observations within various areas of the storm and coordinated observations with ground-based mobile radars. Quality control schemes necessary for providing reliable observations in severe environments with strong winds and high rainfall rates and particle discrimination schemes for distinguishing between hail, rain, and graupel are discussed. It is demonstrated how raindrop-size distributions for selected cases can be applied to study size-sorting and microphysical processes. The study revealed that the raindrop-size distribution changes rapidly in time and space in convective thunderstorms. Graupel, hailstones, and large raindrops were primarily observed close to the updraft region of thunderstorms in the forward- and rear-flank downdrafts and in the reflectivity hook appendage. Close to the updraft, large raindrops were usually accompanied by an increase in small-sized raindrops, which mainly occurred when the wind speed and standard deviation of the wind speed increased. This increase in small drops could be an indicator of raindrop breakup.
A randomized controlled trial of surface neuromuscular electrical stimulation applied early after acute stroke: effects on wrist pain, spasticity and contractures
Authors: Malhotra Shweta , Rosewilliam Sheeba , Hermens Hermie , Roffe Christine , Jones Peter , Pandyan Anand David 
Published: November 2012

Objectives: To investigate effects of surface neuromuscular electrical stimulation applied early after stroke to the wrist and finger extensor muscles on upper limb pain, spasticity and contractures in patients with no functional arm movement. Design: Secondary analysis from a Phase II, randomized, controlled, single-blind study. Setting: An acute hospital stroke unit. Subjects: Patients with no useful arm function within six weeks of a first stroke. Intervention: Patients were randomized to treatment (30-minute sessions of surface neuromuscular stimulation to wrist and finger extensors and 45 minutes of physiotherapy) or control (45 minutes of physiotherapy) groups. All patients had access to routine care. Treatment was given for six weeks from recruitment. Results: Ninety patients (49% male, median age 74 years (range 32–98), median time since stroke onset three weeks (range one to six weeks)) were included. Treatment compliance was variable (mean 28%). The treatment prevented the development of pain (mean difference in rate of change 0.4 units/week, 95% confidence interval (CI) 0.09 to 0.6). Treatment may have prevented a deterioration in contractures (quantified by measuring passive range of movement) in severely disabled patients (mean rate of deterioration −0.5 deg/week; 95% CI −0.9 to −0.06). There were no significant changes in stiffness and spasticity. Conclusion: Surface neuromuscular electrical stimulation reduces pain in stroke patients with a non-functional arm. There was some evidence that treatment with electrical stimulation was beneficial in reducing contractures. Treatment had no effect on spasticity.
Effects of motor imagery training on balance and gait abilities in post-stroke patients: a randomized controlled trial
Authors: Cho Hwi-young , Kim June-sun , Lee Gyu-Chang 
Published: November 2012

Objectives: To investigate the effects of motor imagery training on the balance and gait abilities of post-stroke patients. Design: Randomized controlled trial. Setting: Outpatient rehabilitation centre. Subjects: Twenty-eight individuals with chronic stroke. Interventions: The experimental group ( n = 15) performed motor imagery training involving imagining normal gait movement for 15 minutes embedded in gait training for 30 minutes (45 minutes/day, 3 times/week); the control group ( n = 13) performed gait training only (30 minutes/day, 3 times/week). Main measures: Balance and gait abilities were measured by the Functional Reach Test, Timed Up-and-Go Test, 10-m Walk Test and Fugl-Meyer assessment before and after interventions. Results: All measurements improved significantly compared with baseline values in the experimental group. In the control group, there were significant improvements in all parameters except the Fugl-Meyer assessment. All parameters of the experimental group increased significantly compared to those of the control group as follows: Functional Reach Test (control vs. experimental: 28.1 ± 3.1 vs. 37.51 ± 3.0), Timed Up-and-Go Test (20.7 ± 4.0 vs. 13.2 ± 2.2), 10-m Walk Test (17.4 ± 4.6 vs. 16.0 ± 2.7) and Fugl-Meyer assessment (12.0 ± 2.9 vs. 17.6 ± 1.3). Conclusions: Gait training with motor imagery training improves the balance and gait abilities of chronic stroke patients significantly better than gait training alone.
Preferences for end-of-life care: A nominal group study of people with dementia and their family carers
Authors: Dening Karen H , Jones Louise , Sampson Elizabeth L 
Published: November 2012

Background: The wishes and preferences of people with dementia should inform decisions on future care. However, such decisions are often left to family carers and may not reflect those the person with dementia would have made for themselves. We know little about what influences agreement between people with dementia and their carers. Aim: To explore whether people with dementia and their carers were able to generate and prioritise preferences for end-of-life care. We examined whether carers influenced the choices made by the persons with dementia. Design: Nominal group technique. Setting/participants: People with dementia ( n = 6), carers ( n = 5) and dyads of people with dementia and carers ( n = 6) attending memory assessment services. Methods: Three modified nominal group technique groups were conducted in five stages: (1) silent generation of ideas, (2) discussion, (3) further generation of ideas, (4) discussion and themeing and (5) ranking. The discussions were recorded, transcribed and analysed for thematic content using NVIVO8. Results: Quality of care, family contact, dignity and respect were ranked as significant themes by all groups. The analysis of transcripts revealed three main themes: quality of care, independence and control and carer burden. People with dementia had difficulty considering their future selves. Carers wanted much control at the end of life, raising issues of assisted dying and euthanasia. Conclusions: Wishes and preferences of people with dementia and their family carers may differ. To ensure the wishes of people with dementia are respected, their views should be ascertained early in the disease before their ability to consider the future is compromised.
Translating new knowledge into practices: reconceptualising stroke as an emergency condition
Authors: Snow Stephanie J 
Published: November 2012

Objectives To examine how the new concept of stroke as an emergency condition led to the development of new clinical pathways for stroke patients in Newcastle Upon Tyne, implemented through protocols which were then rapidly adopted across the UK and further afield. Methods Historical analysis using health policy documents, published papers and correspondence on stroke alongside 17 interviews with stroke clinicians and managers in the UK and the US. Results The challenges of implementation stemmed from organisational and professional barriers rather than scientific or technological difficulties. Stroke’s historical status as a non-treatable illness was a barrier to the adoption of acute treatments. Building new pathways for stroke patients by developing protocols for paramedics and emergency room staff originated as a local solution to a local problem but were taken up widely. Discussion Understanding the clinical response to the reconceptualisation of stroke as a treatable disease contributes to our understandings of the relations between clinical research and practice. These findings have implications for how we understand the translation of new knowledge into practice and its transfer across different clinical communities and settings. Protocols are shown to be a particularly valuable tool, bridging knowledge between communities and manifesting a new identity for stroke.
Comparison of the relative comparator and k0neutron activation analysis techniques for the determination of trace-element concentrations in pyrite
Authors: Osborne O. D. , Pring A. , Popelka-Filcoff R. S. , Bennett J. W. , Stopic A. , Glascock M. D. , Lenehan C. E. 
Published: November 2012

AbstractThirty pyrite samples from a wide range of localities were analysed using relative comparator and k0neutron activation analysis (NAA) techniques at the University of Missouri Research Reactor, Columbia, Missouri, USA (MURR) and the Australian Nuclear Science and Technology Organisation, Lucas Heights, NSW, Australia (ANSTO), respectively. Statistical analyses of the trace-element data produced by the two methods showed a generally good correlation, with the majority of elemental concentrations of paired data reported by MURR and ANSTO being indistinguishable at a 0.05 significance level. Trace-element analyses of pyrite from Navajún in Spain by both techniques compare well with published data. There is evidence for contamination by Al, Na and Ti in one set of samples, this is likely to have been introduced by contact with a plastic used in sample preparation.