bluuebunny/crossref_metadata_2025_split huggingface dataset:
When the bi-directional Glenn is an unfavourable option: primary extracardiac inferior cavopulmonary connection as an alternative palliation
Authors: Dodge-Khatami Ali , Aggarwal Avichal , Taylor Mary B. , Maposa Douglas , Salazar Jorge D. 
Published: April 2015

AbstractThe superior cavopulmonary anastomosis – bi-directional Glenn – is the standard palliation for single ventricle physiology. When upper body systemic venous anatomic concerns such as superior caval vein stenosis, hypoplasia, or inadequate collateral tributaries are present, a Glenn may be precluded or have a high risk of poor outcome. A primary inferior cavopulmonary connection with an extracardiac conduit is an alternative palliation that provides a generous pathway for pulmonary blood flow, with the additional benefit of including hepatic venous return. We report a case of primary extracardiac inferior cavopulmonary connection in a patient unsuitable for Glenn, with successful post-operative outcome and early follow-up.
Metagenomic and network analysis reveal wide distribution and co-occurrence of environmental antibiotic resistance genes
Authors: Li Bing , Yang Ying , Ma Liping , Ju Feng , Guo Feng , Tiedje James M , Zhang Tong 
Published: April 2015

Abstract
A metagenomic approach and network analysis was used to investigate the wide-spectrum profiles of antibiotic resistance genes (ARGs) and their co-occurrence patterns in 50 samples from 10 typical environments. In total, 260 ARG subtypes belonging to 18 ARG types were detected with an abundance range of 5.4 × 10−6–2.2 × 10−1 copy of ARG per copy of 16S-rRNA gene. The trend of the total ARG abundances in environments matched well with the levels of anthropogenic impacts on these environments. From the less impacted environments to the seriously impacted environments, the total ARG abundances increased up to three orders of magnitude, that is, from 3.2 × 10−3 to 3.1 × 100 copy of ARG per copy of 16S-rRNA gene. The abundant ARGs were associated with aminoglycoside, bacitracin, β-lactam, chloramphenicol, macrolide-lincosamide-streptogramin, quinolone, sulphonamide and tetracycline, in agreement with the antibiotics extensively used in human medicine or veterinary medicine/promoters. The widespread occurrences and abundance variation trend of vancomycin resistance genes in different environments might imply the spread of vancomycin resistance genes because of the selective pressure resulting from vancomycin use. The simultaneous enrichment of 12 ARG types in adult chicken faeces suggests the coselection of multiple ARGs in this production system. Non-metric multidimensional scaling analysis revealed that samples belonging to the same environment generally possessed similar ARG compositions. Based on the co-occurrence pattern revealed by network analysis, tetM and aminoglycoside resistance protein, the hubs of the ARG network, are proposed to be indicators to quantitatively estimate the abundance of 23 other co-occurring ARG subtypes by power functions.
Metagenomic and lipid analyses reveal a diel cycle in a hypersaline microbial ecosystem
Authors: Andrade Karen , Logemann Jörn , Heidelberg Karla B , Emerson Joanne B , Comolli Luis R , Hug Laura A , Probst Alexander J , Keillar Angus , Thomas Brian C , Miller Christopher S , Allen Eric E , Moreau John W , Brocks Jochen J , Banfield Jillian F 
Published: April 2015

AbstractMarine microbial communities experience daily fluctuations in light and temperature that can have important ramifications for carbon and nutrient cycling. Elucidation of such short time scale community-wide dynamics is hindered by system complexity. Hypersaline aquatic environments have lower species richness than marine environments and can be well-defined spatially, hence they provide a model system for diel cycle analysis. We conducted a 3-day time series experiment in a well-defined pool in hypersaline Lake Tyrrell, Australia. Microbial communities were tracked by combining cultivation-independent lipidomic, metagenomic and microscopy methods. The ratio of total bacterial to archaeal core lipids in the planktonic community increased by up to 58% during daylight hours and decreased by up to 32% overnight. However, total organism abundances remained relatively consistent over 3 days. Metagenomic analysis of the planktonic community composition, resolved at the genome level, showed dominance by Haloquadratum species and six uncultured members of the Halobacteriaceae. The post 0.8 μm filtrate contained six different nanohaloarchaeal types, three of which have not been identified previously, and cryo-transmission electron microscopy imaging confirmed the presence of small cells. Notably, these nano-sized archaea showed a strong diel cycle, with a pronounced increase in relative abundance over the night periods. We detected no eukaryotic algae or other photosynthetic primary producers, suggesting that carbon resources may derive from patchily distributed microbial mats at the sediment-water interface or from surrounding land. Results show the operation of a strong community-level diel cycle, probably driven by interconnected temperature, light abundance, dissolved oxygen concentration and nutrient flux effects.
Hyperdominance in Amazonian forest carbon cycling
Authors: Fauset Sophie , Johnson Michelle O. , Gloor Manuel , Baker Timothy R. , Monteagudo M. Abel , Brienen Roel J.W. , Feldpausch Ted R. , Lopez-Gonzalez Gabriela , Malhi Yadvinder , ter Steege Hans , Pitman Nigel C.A. , Baraloto Christopher , Engel Julien , Pétronelli Pascal , Andrade Ana , Camargo José Luís C. , Laurance Susan G.W. , Laurance William F. , Chave Jerôme , Allie Elodie , Vargas Percy Núñez , Terborgh John W. , Ruokolainen Kalle , Silveira Marcos , Aymard C. Gerardo A. , Arroyo Luzmila , Bonal Damien , Ramirez-Angulo Hirma , Araujo-Murakami Alejandro , Neill David , Hérault Bruno , Dourdain Aurélie , Torres-Lezama Armando , Marimon Beatriz S. , Salomão Rafael P. , Comiskey James A. , Réjou-Méchain Maxime , Toledo Marisol , Licona Juan Carlos , Alarcón Alfredo , Prieto Adriana , Rudas Agustín , van der Meer Peter J. , Killeen Timothy J. , Marimon Junior Ben-Hur , Poorter Lourens , Boot Rene G.A. , Stergios Basil , Torre Emilio Vilanova , Costa Flávia R.C. , Levis Carolina , Schietti Juliana , Souza Priscila , Groot Nikée , Arets Eric , Moscoso Victor Chama , Castro Wendeson , Coronado Euridice N. Honorio , Peña-Claros Marielos , Stahl Clement , Barroso Jorcely , Talbot Joey , Vieira Ima Célia Guimarães , van der Heijden Geertje , Thomas Raquel , Vos Vincent A. , Almeida Everton C. , Davila Esteban Álvarez , Aragão Luiz E.O.C. , Erwin Terry L. , Morandi Paulo S. , de Oliveira Edmar Almeida , Valadão Marco B.X. , Zagt Roderick J. , van der Hout Peter , Loayza Patricia Alvarez , Pipoly John J. , Wang Ophelia , Alexiades Miguel , Cerón Carlos E. , Huamantupa-Chuquimaco Isau , Di Fiore Anthony , Peacock Julie , Camacho Nadir C. Pallqui , Umetsu Ricardo K. , de Camargo Plínio Barbosa , Burnham Robyn J. , Herrera Rafael , Quesada Carlos A. , Stropp Juliana , Vieira Simone A. , Steininger Marc , Rodríguez Carlos Reynel , Restrepo Zorayda , Muelbert Adriane Esquivel , Lewis Simon L. , Pickavance Georgia C. , Phillips Oliver L. 
Published: April 2015

AbstractWhile Amazonian forests are extraordinarily diverse, the abundance of trees is skewed strongly towards relatively few ‘hyperdominant’ species. In addition to their diversity, Amazonian trees are a key component of the global carbon cycle, assimilating and storing more carbon than any other ecosystem on Earth. Here we ask, using a unique data set of 530 forest plots, if the functions of storing and producing woody carbon are concentrated in a small number of tree species, whether the most abundant species also dominate carbon cycling, and whether dominant species are characterized by specific functional traits. We find that dominance of forest function is even more concentrated in a few species than is dominance of tree abundance, with only ≈1% of Amazon tree species responsible for 50% of carbon storage and productivity. Although those species that contribute most to biomass and productivity are often abundant, species maximum size is also influential, while the identity and ranking of dominant species varies by function and by region.
Diffusivity of the uncinate fasciculus in heroin users relates to their levels of anxiety
Authors: Wong N M L , Cheung S-H , Chan C C H , Zeng H , Liu Y-P , So K-F , Lee T M C 
Published: April 2015

AbstractHeroin use is closely associated with emotional dysregulation, which may explain its high comorbidity with disorders such as anxiety and depression. However, the understanding of the neurobiological etiology of the association between heroin use and emotional dysregulation is limited. Previous studies have suggested an impact of heroin on diffusivity in white matter involving the emotional regulatory system, but the specificity of this finding remains to be determined. Therefore, this study investigated the association between heroin use and diffusivity of white matter tracts in heroin users and examined whether the tracts were associated with their elevated anxiety and depression levels. A sample of 26 right-handed male abstinent heroin users (25 to 42 years of age) and 32 matched healthy controls (19 to 55 years of age) was recruited for this study. Diffusion tensor imaging data were collected, and their levels of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Our findings indicated that heroin users exhibited higher levels of anxiety and depression, but the heroin use-associated left uncinate fasciculus was only related to their anxiety level, suggesting that association between heroin and anxiety has an incremental organic basis but that for depression could be a threshold issue. This finding improves our understanding of heroin addiction and its comorbid affective disorder and facilitates future therapeutic development.
Control strategy without phase‐locked loop based on coordinate transformation for three‐phase AC/DC converter
Authors: Zheng Xinxin , Xiao Lan , Wang Zilong , Lei Yun , Wang Chuyang 
Published: April 2015

A novel control strategy without phase‐locked loop (PLL) for the three‐phase AC/DC converter is proposed in this study. There is no need to detect the phase angle of the grid and the defect of inaccurate phase‐locking can be remedied. The frequency of the grid can be detected by a frequency tracking method. A linear changed angle from −π to π with the detected grid frequency is generated by the DSP controller to take part in the coordinate transformation. The grid frequency tracking method is realised by negative feedback of reactive power. It can ensure that the frequency of the linear changed angle is the same as the grid frequency. The principle of the proposed control strategy is analysed in details. Compared with the control strategy with PLL, the proposed control strategy does not need complex PLL and it can realise high power factor and low total harmonic distortion in the non‐ideal grid. The structure of the proposed grid frequency tracking method is established and the parameters of it are designed. An 18 kW DSP‐based bidirectional three‐phase AC/DC converter is established. Simulation and experimental results verify theoretical analysis.
Krankenhauskosten ambulant-sensitiver Krankenhausfälle in Deutschland
Authors: Fischbach D. 
Published: April 2015

ZusammenfassungAls ambulant-sensitive Krankenhausfälle (ASK) werden diejenigen Krankenhausfälle definiert, die durch eine besser zugängliche oder bessere Ergebnisse erzielende ambulante Versorgung hätten vermieden werden können. Als solche werden sie von einigen Gesundheitssystemen als Qualitätsindikator für die ambulante Versorgung verwendet. Welche Krankheiten als ambulant-sensitiv definiert werden, variiert von Land zu Land. Krankheitskataloge von ASK wurden bereits in Ländern wie den USA, England, Neuseeland und Kanada zusammengestellt und evaluiert. Für Deutschland existiert jedoch noch kein Katalog. Ziel der Studie ist es daher, anhand des Krankheitskatalogs aus dem englischen Gesundheitssektor die Kosten für ASK in Deutschland abzuschätzen, um so zur weiteren Erforschung dieses Instruments beizutragen. Für die Berechnung dieser Kosten wurde für den Zeitraum von 2003 bis 2010 ein Modell auf Basis der Datenveröffentlichungen gemäß § 21 Krankenhausentgeltgesetz (KHEntgG) der German-Diagnosis Related Groups (G-DRG)-Browser des Instituts für das Entgeltsystem im Krankenhaus (InEK) aufgesetzt. Hierzu wurden alle relevanten DRG-ICD Kombinationen extrahiert, die Anzahl der Fälle pro Kombination mit ihrer jeweiligen Bewertungsrelation und dem durchschnittlichen Zahl-Basisfallwert multipliziert und zuletzt die Produkte in ihre jeweiligen ICD-Gruppen und in die definierten Krankheiten aggregiert, um die Kosten pro Krankheit und die Gesamtkosten zu berechnen. Fallzahlen und errechnete Kosten wurden mit einer weiteren Quelle verglichen. Hieraus ergaben sich für das Jahr 2010 11,7 Millionen Fälle, von denen 10,7% als ASK definiert wurden. Im betrachteten Zeitraum wuchs die Anzahl der ASK um durchschnittlich 0,9% jährlich und 6% insgesamt. Die Gesamtkosten betrugen 37,6 Milliarden Euro (EUR), wobei der Anteil an ASK 3,4 Milliarden EUR ausmachte. 3 der 19 ambulant-sensitiven Krankheiten verantworteten circa 60% der Kosten. Diese ASK-Kosten bilden eine solide Grundlage, um die Erforschung dieses Qualitätsindikators für den deutschen ambulanten Sektor weiter anzutreiben.
Modified Early Warning Score and VitalPac Early Warning Score in geriatric patients admitted to emergency department
Authors: Dundar Zerrin Defne , Ergin Mehmet , Karamercan Mehmet A. , Ayranci Kursat , Colak Tamer , Tuncar Alpay , Cander Basar , Gul Mehmet 
Published: April 2015

Objective
The aim of this study was to evaluate the value of the Modified Early Warning Score (MEWS) and the VitalPac Early Warning Score (VIEWS) in predicting hospitalization and in-hospital mortality in geriatric emergency department (ED) patients.

Patients and methods
This prospective, single-centered observational study was carried out over 1 month at the ED of a university hospital in patients 65 years of age and older presenting to the ED. The vital parameters of the patients measured on admission to ED were recorded. The MEWS and VIEWS were calculated using the recorded physiological parameters of the patients. Hospitalization and in-hospital mortality were used as the primary outcomes.

Results
A total of 671 patients included in the study. The median age of the patients was 75 (11) years, and 375 (55.9%) were men. The MEWS is effective for discriminating patient groups that have been discharged from ED, admitted to a ward and admitted to ICU [1 (2) vs. 1 (1) vs. 3 (3), respectively, P<0.001]. The VIEWS is also effective for discriminating patient groups that have been discharged from ED, admitted to a ward, and admitted to ICU [2 (3) vs. 5 (5) vs. 8 (8), respectively, P<0.001]. The AUCs of the MEWS and VIEWS were 0.727 [95% confidence interval (CI) 0.689–0.765] and 0.756 (95% CI 0.720–0.792) in predicting hospitalization, respectively. The AUCs of the MEWS and VIEWS were 0.891 (95% CI 0.844–0.937) and 0.900 (95% CI 0.860–0.941) in predicting in-hospital mortality, respectively.

Conclusion
The MEWS and VIEWS are powerful scoring systems that are easy-to-use for predicting the hospitalization and in-hospital mortality of geriatric ED patients.
Intravenous dexamethasone in acute management of vestibular neuritis: a randomized, placebo-controlled, single-blind trial
Authors: Adamec Ivan , Krbot Skorić Magdalena , Gabelić Tereza , Barun Barbara , Ljevak Josip , Bujan Kovač Andreja , Jurjević Ivana , Habek Mario 
Published: April 2015

Introduction
The aim of the present study was to evaluate the role of intravenous dexamethasone in relieving the symptoms and signs of vestibular neuritis in the emergency department setting.

Patients and methods
This was a randomized, placebo-controlled, superiority, single-blind study. Patients were randomized either to intravenous dexamethasone (group A) or to placebo (group B), with all patients receiving symptomatic therapy. The primary outcome was defined as necessity to hospitalize patients who present with vestibular neuritis in the emergency department. The secondary outcomes were (a) improvement in nystagmus, (b) improvement in postural instability, (c) lessening of nausea, (d) lessening of vomiting, and (e) recovery of subjective symptoms.

Results
Altogether, 100 patients were randomized, 51 into group A and 49 into group B. There was no difference in the hospitalization rate between groups (P=0.284). In both groups, there was a statistically significant difference in the values of all measured variables 2 h after therapy intervention compared with the baseline values. In group A, significantly fewer patients had third-degree nystagmus 2 h after therapy intervention whereas the difference in group B did not reach statistical significance. After therapy, more patients had first-degree nystagmus in group A as well as in group B than before the intervention. There was a significantly greater absolute difference in European Evaluation of Vertigo scale results in group A compared with group B.

Conclusion
The value of dexamethasone cannot be established, given the small sample and limitations of the present study. Some observations consistent with clinical improvement cannot exclude a true treatment effect, and further study is still warranted.
Developing the elements of information integration in the real estate and user services
Authors: Sillanpää Elina , Sillanpää Ilkka 
Published: April 2015

Purpose
– The purpose of the study is to formulate a model for the information integration development. The service supply chain is managed with information; therefore, the functionality of the flow of information is an essential part of service business. The aim of this study is to address this issue by looking into the meaning and development of the elements of information integration in real estate and user services.

Design/methodology/approach
– This paper is a qualitative research into elements of information integration and developing them in real estate and user services. Collecting the data for the study consisted of three stages: a workshop and two rounds of interviews.

Findings
– The finding of the study is a model for developing information integration in a real estate and user services. The model presents the meanings of the six elements which integration consists of and which need to be developed to increase information integration.

Research limitations/implications
– In services, the supply chain is typically shorter than in production. This study is limited to analyse the supply chain between a customer and a service provider since these are the most significant and often the only parties in the supply chain of real estate and user services.

Practical implications
– The results can be utilized when developing information integration in the service supply chain and developing service providers operations.

Originality/value
– The research results bring additional value to the previous studies regarding elements of information integration by developing a model for the sequence of development of these elements.
Risk ranking and analysis in PPP water supply infrastructure projects
Authors: Ameyaw Ernest Effah , Chan Albert P.C 
Published: April 2015

Purpose
– This paper aims to identify and evaluate the most significant risk factors that strongly affect the implementation of public–private partnership (PPP) water supply projects. PPP for water supply infrastructure services has seen continued growth over the past two decades, following public sector’s budgetary constraints and inability to provide infrastructure-based water services efficiently and cost effectively. However, these projects are often subjected to major risks leading to failures.

Design/methodology/approach
– Following extensive literature review and case study analyses, an international questionnaire survey was conducted with practicing and experienced PPP experts to establish the significant risks in PPP water projects. Both the probability of occurrence and severity of 40 risks were evaluated by the expert panel to determine their significance and impact on water projects procured under the PPP arrangement.

Findings
– The paper presents a derived risk factor list, ranks the factors and describes the “top-ranked” risk factors as: poor contract design, water pricing and tariff review uncertainty, political interference, public resistance to PPP, construction time and cost overrun, non-payment of bills, lack of PPP experience, financing risk, faulty demand forecasting, high operational costs and conflict between partners.

Originality/value
– This factor list broadens PPP stakeholders’ view of important project risks, rather than relying on culture-dependent studies – an area that has received less attention in PPP risk management research. The identified risk factors would provide governments and investors a useful tool in implementing constructive water PPPs by facilitating the development of risk mitigation strategies, particularly for developing countries with poor risk management practices.
Innovations in inpatient flow and bed management
Authors: Waring Teresa S. , Alexander Martin 
Published: April 2015

Purpose– The purpose of this paper is to address a gap in operations management empirical research through the use of diffusion of innovation (DOI) theory to develop further insight into patient flow and bed management, a problem that has been taxing healthcare organizations across the world.Design/methodology/approach– The study used an action research (AR) approach and was conducted over an 18-month period within an acute hospital in the north east of England. Data were generated through enacting AR cycles, interviews, participant observation, document analysis, diaries, meetings, questionnaires and statistical analysis.Findings– The research conducted within this study has not only led to practical outcomes for the hospital in terms of the successful adoption of a new patient flow system but has also led to new knowledge about the determinants of diffusion for technological and process innovations in healthcare organizations which are complex and highly political.Research limitations/implications– AR is not suited to all organizations and is most appropriate within those that are culturally attuned to participative and democratic ways of working. The results from this study are not generalizable but some similar organizations may see merits in this approach.Social implications– The AR approach has supported the hospital in adopting the new system, PFMS. This system is helping to improve the quality of patient care, providing facilities to support the work of clinicians, aiding timely discharge of well patients back into the community and saving the hospital money in terms of not needing to open emergency “winter” wards.Originality/value– From an operations management perspective this work has demonstrated the potential to bring theory, in this case DOI theory, and practice closer together as well as show how academic research can impact organizations. Local-H intends to continue developing its AR approach and take it into other systems projects.