bluuebunny/crossref_metadata_2025_split huggingface dataset:
What Makes Family Caregivers Happy During the First 2 Years Post Stroke?
Authors: Cameron Jill I. , Stewart Donna E. , Streiner David L. , Coyte Peter C. , Cheung Angela M. 
Published: March 2014

Background and Purpose—
This study aimed to identify aspects of the caregiving situation contributing to family caregivers’ psychological well-being.

Methods—
Longitudinal cohort study with structured quantitative interviews 1, 3, 6, and 12 months post stroke. A subset of participants also completed surveys 18 and 24 months post stroke. Participants included individuals hospitalized for their first stroke and their family caregivers. Psychological well-being was assessed by the Positive Affect Scale.

Results—
A total of 399 stroke survivor, caregiver dyads completed the 1-year follow-up and 80 dyads completed the second year of follow-up. Using mixed effects modeling for longitudinal data, caregivers reported more psychological well-being when they provided more assistance to stroke survivors who had fewer symptoms of depression, better cognitive functioning, and who had more severe strokes. In addition, caregivers who maintained participation in valued activities had more mastery, gained personally providing care, were in better physical health, were older, and were from Quebec reported more psychological well-being. Caregivers followed for a second year post stroke reported better psychological well-being when caring for stroke survivors with fewer symptoms of depression and more severe strokes and when the caregivers had a greater sense of mastery and gained more personally providing care.

Conclusions—
Our findings contribute to the caregiver intervention development literature by identifying aspects of the caregiving situation that are associated with positive outcomes. Incorporating specific aspects, for example, strategies to enhance caregiver mastery into programs and services offered to caregivers may enhance their positive experiences with providing care and ultimately enhance the sustainability of the caregiving situation.
Untangling σαβαχθανι (Matt 27:46 and Mark 15:34)
Authors: Lerner Berel Dov 
Published: March 2014

AbstractThe word σαβαχθανι appearing in Jesus’ cry of despair in Matt 27:46 and Mark 15:34 may be read as the Hebrew סבכתני, “you have tangled me up.” On this reading, Jesus may be expressing his connection with the ram which Abraham sacrificed instead of his son Isaac, since that ram was described as being caught by the horns in a סבך (Gen 22:13).
Der titulus crucis
Authors: Förster Niclas 
Published: March 2014

AbstractThe historical reliability of the titulus crucis as quoted in the Gospel of Mark is substantiated by its unique position in the practice of executions in pagan und Jewish tradition. With its inscription, Pontius Pilate sought to dash messianic expectations for the Jewish kingdom. The threat posed by messianic pretenders to Roman rule is demonstrated by Simon and Athronges, two self-appointed Jewish kings entering into the public sphere around Passover in 4 bce. It is therefore likely that these events coloured Pontius Pilate’s interpretation of Jesus’ entry into Jerusalem as being along the lines of the uprising of the two messianic kings Simon and Athronges.
A Simple Model of the Response of the Atlantic to the North Atlantic Oscillation
Authors: Zhai Xiaoming , Johnson Helen L. , Marshall David P. 
Published: March 2014

Abstract
The response of an idealized Atlantic Ocean to wind and thermohaline forcing associated with the North Atlantic Oscillation (NAO) is investigated both analytically and numerically in the framework of a reduced-gravity model. The NAO-related wind forcing is found to drive a time-dependent “leaky” gyre circulation that integrates basinwide stochastic wind Ekman pumping and initiates low-frequency variability along the western boundary. This is subsequently communicated, together with the stochastic variability induced by thermohaline forcing at high latitudes, to the remainder of the Atlantic via boundary and Rossby waves. At low frequencies, the basinwide ocean heat content changes owing to NAO wind forcing and thermohaline forcing are found to oppose each other. The model further suggests that the recently reported opposing changes of the meridional overturning circulation in the Atlantic subtropical and subpolar gyres between 1950–70 and 1980–2000 may be a generic feature caused by interplay between the NAO wind and thermohaline forcing.
Atmospheric Duct Estimation Using Radar Sea Clutter Returns by the Adjoint Method with Regularization Technique
Authors: Zhao Xiaofeng , Huang Sixun 
Published: March 2014

Abstract
This paper focuses on retrieving the atmospheric duct structure from radar sea clutter returns by the adjoint approach with the regularization technique. The adjoint is derived from the split-step Fourier parabolic equation method, and the regularization term is constructed by the background refractivity field. To ensure successful implementations of the regularization, the L-curve criterion is used to find the optimal regularization parameter. The feasibility of the proposed method is validated by the numerical simulations of different noise-level clutter returns, as well as a real clutter profile measured by the S-Band Space Range Radar located in Wallops Island. In the process of inversions, the refractivity profile is first obtained by genetic algorithm, and then it is used as the background field for the adjoint method. The retrieved results indicate that, with an appropriate regularization parameter, the structure of the background refractivity profile can be improved by the proposed method.
Out of Place
Authors: Carroll Leo , Gonzalez M. Lilliana 
Published: March 2014

Objectives: Test hypotheses drawn from Smith and Alpert’s social conditioning theory that explains biased policing as the result of implicit racial stereotypes. Distinguishing between frisks and searches, we hypothesize that (1) Black drivers are more likely than White drivers to be frisked and searched; (2) racial disparity is greater in frisks than searches; (3) racial disparity in frisks, but not searches, is conditional upon the racial composition of the community; and (4) that drivers’ race is not related to the productivity of searches. Methods: Data are all traffic stops made by the Rhode Island State Police in 2006, exclusive of those in which a search was mandatory. Multinomial and binary logistic regressions are employed to estimate models of frisks, searches, search productivity, and to test the conditional effect of community context. Results: Each of the four hypotheses is supported. Conclusion: Biased policing is largely the product of implicit stereotypes that are activated in contexts in which Black drivers appear out of place and in police actions that require quick decisions providing little time to monitor cognitions. This insight has important implications for police training. Because of limitations in this study, additional research that distinguishes frisks and searches is needed.
The Teaching/Research Trade-Off in Law
Authors: Ginsburg Tom , Miles Thomas J. 
Published: March 2014

Background: There is a long scholarly debate on the trade-off between research and teaching in various fields, but relatively little study of the phenomenon in law. This analysis examines the relationship between the two core academic activities at one particular school, the University of Chicago Law School, which is considered one of the most productive in legal academia. Method: We measure of scholarly productivity with the total number of publications by each professor for each year, and we approximate performance in teaching with course loads and average scores in student evaluations for each course. In OLS regressions, we estimate scholarly output as a function of teaching loads, faculty characteristics, and other controls. We also estimate teaching evaluation scores as a function of scholarly productivity, fixed effects for years and course subject, and faculty characteristics. Result: Net of other factors, we find that, under some specifications, research and teaching are positively correlated. In particular, we find that students’ perceptions of teaching quality rises, but at a decreasing rate, with the total amount of scholarship. We also find that certain personal characteristics correlate with productivity. Conclusion: The recent debate on the mission of American law schools has hinged on the assumption that a trade-off exists between teaching and research, and this article’s analysis, although limited in various ways, casts some doubt on that assumption.
Economic impact analysis of an end-of-life programme for nursing home residents
Authors: Teo W-S Kelvin , Raj Anusha Govinda , Tan Woan Shin , Ng Charis Wei Ling , Heng Bee Hoon , Leong Ian Yi-Onn 
Published: March 2014

Background: Due to limited end-of-life discussions and the absence of palliative care, hospitalisations are frequent at the end of life among nursing home residents in Singapore, resulting in high health-care costs. Aim: Our objective was to evaluate the economic impact of Project Care at the End-of-Life for Residents in homes for the Elderly (CARE) programme on nursing home residents compared to usual end-of-life care. Design and settings/participants: Project CARE was introduced in seven nursing homes to provide advance care planning and palliative care for residents identified to be at risk of dying within 1 year. The cases consisted of nursing home residents enrolled in the Project CARE programme for at least 3 months. A historical group of nursing home residents not in any end-of-life care programme was chosen as the matched controls. Cost differences between the two groups were analysed over the last 3 months and final month of life. Results: The final sample comprised 48 Project CARE cases and 197 controls. Compared to the controls, the cases were older with more comorbidities and higher nursing needs. After risk adjustment, Project CARE cases demonstrated per-resident cost savings of SGD$7129 (confidence interval: SGD$4544–SGD$9714) over the last 3 months of life and SGD$3703 (confidence interval: SGD$1848–SGD$5557) over the last month of life (US$1 = SGD$1.3). Conclusion: This study demonstrated substantial savings associated with an end-of-life programme. With a significant proportion of the population in Singapore requiring nursing home care in the near future, these results could assist policymakers and health-care providers in decision-making on allocation of health-care resources.
The effects of advance care planning on end-of-life care: A systematic review
Authors: Brinkman-Stoppelenburg Arianne , Rietjens Judith AC , van der Heide Agnes 
Published: March 2014

Background: Advance care planning is the process of discussing and recording patient preferences concerning goals of care for patients who may lose capacity or communication ability in the future. Advance care planning could potentially improve end-of-life care, but the methods/tools used are varied and of uncertain benefit. Outcome measures used in existing studies are highly variable. Aim: To present an overview of studies on the effects of advance care planning and gain insight in the effectiveness of different types of advance care planning. Design: Systematic review. Data sources: We systematically searched PubMed, EMBASE and PsycINFO databases for experimental and observational studies on the effects of advance care planning published in 2000–2012. Results: The search yielded 3571 papers, of which 113 were relevant for this review. For each study, the level of evidence was graded. Most studies were observational (95%), originated from the United States (81%) and were performed in hospitals (49%) or nursing homes (32%). Do-not-resuscitate orders (39%) and written advance directives (34%) were most often studied. Advance care planning was often found to decrease life-sustaining treatment, increase use of hospice and palliative care and prevent hospitalisation. Complex advance care planning interventions seem to increase compliance with patients’ end-of-life wishes. Conclusion: The effects of different types of advance care planning have been studied in various settings and populations using different outcome measures. There is evidence that advance care planning positively impacts the quality of end-of-life care. Complex advance care planning interventions may be more effective in meeting patients’ preferences than written documents alone. More studies are needed with an experimental design, in different settings, including the community.
Detection of cell apoptosis in pelvic lymph nodes of patients with cervical cancer after neoadjuvant chemotherapy
Authors: Zhang Haiyan , Peng Wei , Zhang Yangde 
Published: March 2014

Objective To investigate if the administration of neoadjuvant chemotherapy (NACT) reduces pelvic lymph node metastasis by inducing tumour cell apoptosis in patients with cervical cancer. Methods This study enrolled patients with stage Ib2–IIb cervical cancer who underwent surgery with (NACT group) or without (control group) prior cisplatin-based chemotherapy. Immunohistochemical staining of caspase-3 and an in situ terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labelling assay were used to measure the levels of apoptosis in primary tumours and pelvic lymph nodes. Results A total of 185 patients participated in the study: 102 in the NACT group and 83 in the control group. Treatment was considered to be clinically effective in 69.6% (71/102) of the NACT group. The rate of metastasis in the NACT group (20.6%; 21/102) was significantly lower than the control group (42.2%; 35/83). The level of caspase-3 immunostaining and the rate of apoptosis in primary tumours and pelvic lymph nodes in the NACT group were significantly higher than in the control group. Conclusions NACT appeared to limit pelvic node metastasis by inducing tumour cell apoptosis in patients with cervical cancer.
Biochemical changes in the brain of hemiplegic migraine patients measured with 7 tesla 1H-MRS
Authors: Zielman R , Teeuwisse WM , Bakels F , Van der Grond J , Webb A , van Buchem MA , Ferrari MD , Kruit MC , Terwindt GM 
Published: March 2014

Aim The aim of this study was to assess biochemical changes in the brain of patients with hemiplegic migraine in between attacks. Methods Eighteen patients with hemiplegic migraine (M:F, 7:11; age 38 ± 14 years) of whom eight had a known familial hemiplegic migraine (FHM) mutation (five in the CACNA1A gene (FHM1), three in the ATP1A2 gene (FHM2)) and 19 age- and sex-matched healthy controls (M:F, 7:12; mean age 38 ±  12 years) were studied. We used single-voxel 7 tesla 1H-MRS (STEAM, TR/TM/TE = 2000/19/21 ms) to investigate four brain regions in between attacks: cerebellum, hypothalamus, occipital lobe, and pons. Results Patients with hemiplegic migraine showed a significantly lower total N-acetylaspartate/total creatine ratio (tNAA/tCre) in the cerebellum (median 0.73, range 0.59–1.03) than healthy controls (median 0.79, range (0.67–0.95); p = 0.02). In FHM1 patients with a CACNA1A mutation, the tNAA/tCre was lowest. Discussion We found a decreased cerebellar tNAA/tCre ratio that might serve as an early biomarker for neuronal dysfunction and/or loss. This is the first high-spectral resolution 7 tesla 1H-MRS study of interictal biochemical brain changes in hemiplegic migraine patients.
Improving Antibiotic De-Escalation in Suspected Ventilator-Associated Pneumonia
Authors: Oxman David A. , Adams Christopher D. , Deluke Gretchen , Philbrook Lauren , Ireland Peter , Mitani Aya , Panizales Christia , Frendl Gyorgy , Rogers Selwyn O. 
Published: March 2014

Background: Recommendations for treatment of ventilator-associated pneumonia (VAP) emphasize early empiric broad-spectrum antibiotics. However, appropriate antibiotic de-escalation is also critical for optimal patient care. Materials and Methods: We examined how often intensivists in our institution appropriately de-escalated antibiotics in cases of suspected VAP, and whether decision support by intensive care unit pharmacists could improve rates of antibiotic targeting and early antibiotic discontinuation in low-risk patients. Main Results: A total of 92 (observation phase = 50; intervention phase = 42) patients with suspected VAP were identified. During the observation phase, 39 cases yielded positive sputum cultures, but in only 23 (59%) were antibiotics targeted to culture results. This rate improved during the intervention phase when 29 (91%) of 32 cases with positive cultures were targeted ( P value .003). There were 48 cases in which the risk of pneumonia was considered low. Of the 26 low-risk cases in the observation phase, 5 (19%) had antibiotics discontinued early versus 5 (23%) of the 22 cases in the intervention phase. Conclusions: Decision support by clinical pharmacists significantly improved rates of appropriate antibiotic targeting in cases of culture-positive suspected VAP but did not have a significant effect on early antibiotic discontinuation in patients at low risk of true pneumonia.
Endothelial Insulin Resistance Protects the Heart Against Prolonged Ischemia–Reperfusion Injury But Does Not Prevent Insulin Transport Across the Endothelium in a Mouse Langendorff Model
Authors: Sharma Vikram , Kearney Mark T. , Davidson Sean M. , Yellon Derek M. 
Published: March 2014

Aim: The endothelium plays an important role in the maintenance of cardiovascular homeostasis in healthy individuals. Insulin resistance can lead to the development of endothelial dysfunction, which is an important step in the pathogenesis of atherosclerosis. We investigated specifically whether the presence of vascular insulin resistance and endothelial dysfunction has any influence on the myocardial tolerance to ischemia–reperfusion (IR) injury, using Endothelial Specific Mutant Insulin Receptor Over-expressing (ESMIRO) mice, which exhibit vascular insulin resistance and vascular dysfunction. Methods: ESMIRO or wild-type (WT) littermate mouse hearts were isolated and perfused on a Langendorff apparatus. These were subjected to either 35-minute or 45-minute ischemia followed by reperfusion, after which infarct size was determined. The ability of insulin to activate its target kinase pathway, that is, phosphoinositide 3 (PI3) kinase/protein kinase B (AKT) in ESMIRO hearts was also assessed by Western blot analysis. Results: Compared to 35-minute ischemia, the extended 45-minute ischemic protocol significantly exacerbated myocardial infarction in WT mice, (56% ± 4%, n = 6 vs 32% ± 4%, n = 9; P < .01) but not in ESMIRO littermates (34% ± 7%, n = 6 vs 32% ± 3%, n = 9; not significant), suggesting some form of protective phenotype. Insulin treatment was associated with a significant increase in AKT phosphorylation in the myocardium in both the ESMIRO mice and WT littermates, and this was attenuated in both by inhibition of PI3 kinase using LY294002. Thus, insulin was able to directly activate PI3 kinase/AKT in the myocardium despite the absence of functional endothelial insulin receptors in the ESMIRO mice. Conclusion: (1) Insulin at pharmacologic concentrations can be transported across the endothelium independent of vascular insulin receptors and (2) vascular insulin resistance and/or endothelial dysfunction are protective against prolonged IR injury in the Langendorff model.
Sample size considerations in the design of cluster randomized trials of combination HIV prevention
Authors: Wang Rui , Goyal Ravi , Lei Quanhong , Essex M , De Gruttola Victor 
Published: March 2014

Background Cluster randomized trials have been utilized to evaluate the effectiveness of HIV prevention strategies on reducing incidence. Design of such studies must take into account possible correlation of outcomes within randomized units. Purpose To discuss power and sample size considerations for cluster randomized trials of combination HIV prevention, using an HIV prevention study in Botswana as an illustration. Methods We introduce a new agent-based model to simulate the community-level impact of a combination prevention strategy and investigate how correlation structure within a community affects the coefficient of variation – an essential parameter in designing a cluster randomized trial. Results We construct collections of sexual networks and then propagate HIV on them to simulate the disease epidemic. Increasing level of sexual mixing between intervention and standard-of-care (SOC) communities reduces the difference in cumulative incidence in the two sets of communities. Fifteen clusters per arm and 500 incidence cohort members per community provide 95% power to detect the projected difference in cumulative HIV incidence between SOC and intervention communities (3.93% and 2.34%) at the end of the third study year, using a coefficient of variation 0.25. Although available formulas for calculating sample size for cluster randomized trials can be derived by assuming an exchangeable correlation structure within clusters, we show that deviations from this assumption do not generally affect the validity of such formulas. Limitations We construct sexual networks based on data from Likoma Island, Malawi, and base disease progression on longitudinal estimates from an incidence cohort in Botswana and in Durban as well as a household survey in Mochudi, Botswana. Network data from Botswana and larger sample sizes to estimate rates of disease progression would be useful in assessing the robustness of our model results. Conclusion Epidemic modeling plays a critical role in planning and evaluating interventions for prevention. Simulation studies allow us to take into consideration available information on sexual network characteristics, such as mixing within and between communities as well as coverage levels for different prevention modalities in the combination prevention package.
The effects of the Food Dudes Programme on children’s intake of unhealthy foods at lunchtime
Authors: Upton Penney , Taylor Charlotte , Upton Dominic 
Published: March 2014

Aims: Although previous research has shown the Food Dudes Programme increases children’s lunchtime fruit and vegetable consumption, research has seldom evaluated whether the intervention can decrease the consumption of high-fat and high-sugar foods. This study is the first, independent evaluation of the Food Dudes Programme to explore whether the programme could change children’s lunchtime fruit and vegetable consumption and consumption of high-fat and high-sugar foods following the intervention and explore any relationship between these variables. Methods: The Food Dudes Programme was evaluated in 15 primary schools in the West Midlands, United Kingdom ( n = 2,433) at baseline (pre-intervention), and three months and 12 months post-intervention. Consumption was measured across five consecutive days in each school using weighed intake (school-provided meals) and digital photography (home-provided meals). Results: A significant increase in the consumption of lunchtime fruit and vegetables was found at three months for children in the intervention schools, but only for those eating school-supplied lunches. For children consuming school meals, consumption of high-fat and high-sugar foods for children in the intervention and control schools increased over time. No relationship was found between increases in fruit and vegetable consumption and decrease in consumption of high-fat and high-sugar foods following the Food Dudes intervention. Conclusions: The Food Dudes Programme has a limited effect on decreasing consumption of high-fat and high-sugar foods at lunchtime. Targeting unhealthy food consumption in addition to increasing fruit and vegetable consumption may facilitate this. Restricted access to high-fat and high-sugar foods may also reduce intake; however, this needs to be part of a multi-faceted approach to changing children’s dietary patterns involving the whole school community.