bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Influence of Local Feedbacks and Northward Heat Transport on the Equilibrium Arctic Climate Response to Increased Greenhouse Gas Forcing
Authors: Kay Jennifer E. , Holland Marika M. , Bitz Cecilia M. , Blanchard-Wrigglesworth Edward , Gettelman Andrew , Conley Andrew , Bailey David 
Published: March 2012

Abstract
This study uses coupled climate model experiments to identify the influence of atmospheric physics [Community Atmosphere Model, versions 4 and 5 (CAM4; CAM5)] and ocean model complexity (slab ocean, full-depth ocean) on the equilibrium Arctic climate response to an instantaneous CO2 doubling. In slab ocean model (SOM) experiments using CAM4 and CAM5, local radiative feedbacks, not atmospheric heat flux convergence, are the dominant control on the Arctic surface response to increased greenhouse gas forcing. Equilibrium Arctic surface air temperature warming and amplification are greater in the CAM5 SOM experiment than in the equivalent CAM4 SOM experiment. Larger 2 × CO2 radiative forcing, more positive Arctic surface albedo feedbacks, and less negative Arctic shortwave cloud feedbacks all contribute to greater Arctic surface warming and sea ice loss in CAM5 as compared to CAM4. When CAM4 is coupled to an active full-depth ocean model, Arctic Ocean horizontal heat flux convergence increases in response to the instantaneous CO2 doubling. Though this increased ocean northward heat transport slightly enhances Arctic sea ice extent loss, the representation of atmospheric processes (CAM4 versus CAM5) has a larger influence on the equilibrium Arctic surface climate response than the degree of ocean coupling (slab ocean versus full-depth ocean). These findings underscore that local feedbacks can be more important than northward heat transport for explaining the equilibrium Arctic surface climate response and response differences in coupled climate models. That said, the processes explaining the equilibrium climate response differences here may be different than the processes explaining intermodel spread in transient climate projections.
Can Passengers’ Active Head Tilt Decrease the Severity of Carsickness?
Authors: Wada Takahiro , Konno Hiroyuki , Fujisawa Satoru , Doi Shun’ichi 
Published: March 2012

Objective: We investigated the effect of the passenger head-tilt strategy on the severity of carsickness in lateral acceleration situations in automobiles. Background: It is well known that the driver is generally less susceptible to carsickness than are the passengers. However, it is also known that the driver tilts his or her head toward the curve center when negotiating a curve, whereas the passenger’s head moves in the opposite direction. Therefore, we hypothesized that the head-tilt strategy has the effect of reducing the severity of carsickness. Method: A passenger car was driven on a quasi-oval track with a pylon slalom while the participant sat in the navigator seat. The experiment was terminated when either the participant felt the initial symptoms of motion sickness or the car finished 20 laps. In the natural head-tilt condition, the participants were instructed to sit naturally, to relax, and not to oppose the lateral acceleration intentionally. In the active head-tilt condition, the participants were asked to tilt their heads against the centrifugal acceleration, thus imitating the driver’s head tilt. Results: The number of laps achieved in the active condition was significantly greater than that in the natural condition. In addition, the subjective ratings of motion sickness and symptoms in the active condition were significantly lower than those in the natural condition. Conclusion: We suggest that an active head tilt against centrifugal acceleration reduces the severity of motion sickness. Application: Potential applications of this study include development of a methodology to reduce carsickness.
Vascular Effects of Nebivolol Added to Hydrochlorothiazide in African Americans With Hypertension and Echocardiographic Evidence of Diastolic Dysfunction
Authors: Khan Bobby V. , Rahman Syed T. , Haque Tahir , Merchant Nadya , Bhaheetharan Sujan , Harris Junior , Umar Kanwal , Wahi Jessica , Ferdinand Keith C. 
Published: March 2012

Background: African Americans have greater risk of cardiovascular events than comparator populations of white European origin. A potential reason for this is reduced nitric oxide bioavailability in African Americans, resulting in increased prevalence of factors that contribute to ventricular dysfunction. We investigated the effects of nebivolol with the diuretic hydrochlorothiazide (HCTZ) in hypertensive African Americans with echocardiographic evidence of diastolic dysfunction. Methods: A total of 42 African American patients were assigned to nebivolol and HCTZ in an open-label fashion for a 24-week period. Changes in blood pressure (BP), echocardiographic parameters, and success in attaining target BP were determined. As an indirect determinant of endothelial function, serum total nitric oxide (NOx) levels and asymmetric dimethyl arginine (ADMA) levels were performed at baseline and after the treatment period. Results: The systolic BP decreased from 150 ± 13 to 136 ± 16 mm Hg ( P < .005). Diastolic BP decreased from 94 ± 13 to 84 ± 9 mm Hg ( P = .008). Of the patients that completed the study, 77% achieved a combined target BP of systolic BP <140 mm Hg and a diastolic BP <90 mm Hg. Serum NOx increased by 41% and 39% in patients that were treated with 10 mg and 20 mg daily nebivolol, respectively. The ADMA levels decreased by 44% following treatment. The change in systolic BP was strongly correlated to the change in ADMA ( r = .54; P = .024). Furthermore, in comparison to a group of age-matched patients controlled with diuretic therapy only, the ADMA levels were significantly lower in the nebivolol posttreatment group (controlled BP with diuretic: 0.32 ± 0.07μmol/L; nebivolol posttreatment: 0.24 ± 0.06 μmol/L; P < .05). Conclusion: Reduced BP with nebivolol in hypertensive African Americans and echocardiographic evidence of diastolic dysfunction correlates with improved endothelial function. Furthermore, improvement in endothelial function and increased nitric oxide bioavailability suggests a potential mechanism of efficacy of nebivolol in these patients.
Identification of tumor epithelium and stroma in tissue microarrays using texture analysis
Authors: Linder Nina , Konsti Juho , Turkki Riku , Rahtu Esa , Lundin Mikael , Nordling Stig , Haglund Caj , Ahonen Timo , Pietikäinen Matti , Lundin Johan 
Published: March 2012

Abstract

Background
The aim of the study was to assess whether texture analysis is feasible for automated identification of epithelium and stroma in digitized tumor tissue microarrays (TMAs). Texture analysis based on local binary patterns (LBP) has previously been used successfully in applications such as face recognition and industrial machine vision. TMAs with tissue samples from 643 patients with colorectal cancer were digitized using a whole slide scanner and areas representing epithelium and stroma were annotated in the images. Well-defined images of epithelium (n = 41) and stroma (n = 39) were used for training a support vector machine (SVM) classifier with LBP texture features and a contrast measure C (LBP/C) as input. We optimized the classifier on a validation set (n = 576) and then assessed its performance on an independent test set of images (n = 720). Finally, the performance of the LBP/C classifier was evaluated against classifiers based on Haralick texture features and Gabor filtered images.

Results
The proposed approach using LPB/C texture features was able to correctly differentiate epithelium from stroma according to texture: the agreement between the classifier and the human observer was 97 per cent (kappa value = 0.934, P < 0.0001) and the accuracy (area under the ROC curve) of the LBP/C classifier was 0.995 (CI95% 0.991-0.998). The accuracy of the corresponding classifiers based on Haralick features and Gabor-filter images were 0.976 and 0.981 respectively.

Conclusions
The method illustrates the capability of automated segmentation of epithelial and stromal tissue in TMAs based on texture features and an SVM classifier. Applications include tissue specific assessment of gene and protein expression, as well as computerized analysis of the tumor microenvironment.

Virtual slides
The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4123422336534537
The effect of a complementary e-learning course on implementation of a quality improvement project regarding care for elderly patients: a stepped wedge trial
Authors: Van de Steeg Lotte , Langelaan Maaike , Ijkema Roelie , Wagner Cordula 
Published: March 2012

Abstract

Background
Delirium occurs frequently in elderly hospitalised patients and is associated with higher mortality, increased length of hospital stay, functional decline, and admission to long-term care. Healthcare professionals frequently do not recognise delirium, indicating that education can play an important role in improving delirium care for hospitalised elderly. Previous studies have indicated that e-learning can provide an effective way of educating healthcare professionals and improving quality of care, though results are inconsistent.

Methods and design
This stepped wedge cluster randomised trial will assess the effects of a complementary delirium e-learning course on the implementation of quality improvement initiative, which aims to enhance the recognition and management of delirium in elderly patients. The trial will be conducted in 18 Dutch hospitals and last 11 months. Measurements will be taken in all participating wards using monthly record reviews, in order to monitor delivered care. These measurements will include the percentage of elderly patients who were screened for the risk of developing delirium, use of the Delirium Observation Screening scale, use of nursing or medical interventions, and the percentage of elderly patients who were diagnosed with delirium. Data regarding the e-learning course will be gathered as well. These data will include user characteristics, information regarding use of the course, delirium knowledge before and after using the course, and the attitude and intentions of nurses concerning delirium care.

Setting
The study will be conducted in internal medicine and surgical wards of eighteen hospitals that are at the beginning stages of implementing the Frail Elderly Project in the Netherlands.

Discussion
Better recognition of elderly patients at risk for delirium and subsequent care is expected from the introduction of an e-learning course for nurses that is complementary to an existing quality improvement project. This trial has the potential to demonstrate that e-learning can be a vital part of the implementation process, especially for quality improvement projects aimed at complex health issues such as delirium. The study will contribute to a growing body of knowledge concerning e-learning and the effects it can have on knowledge as well as delivered care.

Trial registration
Netherlands Trial Register (NTR): NTR2885
Clinical significance of SOX9 in human non-small cell lung cancer progression and overall patient survival
Authors: Zhou Chun-Hui , Ye Li-Ping , Ye Shi-Xing , Li Yan , Zhang Xin-Yin , Xu Xin-Yu , Gong Li-Yun 
Published: March 2012

Abstract

Background
Sex determining region Y (SRY)-related high mobility groupbox 9 (SOX9) is an important transcription factor required for development, which regulates the expression of target genes in the associated pathway. The aim of this study was to describe the expression of SOX9 in human non-small cell lung cancer (NSCLC) and to investigate the association between SOX9 expression and progression of NSCLC.

Methods
SOX9 protein and mRNA expression in normal human pneumonocytes, lung cancer cell lines, and eight pairs of matched lung cancer tissues and their adjacent normal lung tissues were detected by Western blotting and real-time reverse transcription-polymerase chain reaction (RT-PCR). Immunohistochemistry was used to determine SOX9 protein expression in 142 cases of histologically characterized NSCLC. Statistical analyses were applied to test for prognostic and diagnostic associations.

Results
SOX9 in lung cancer cell lines was upregulated at both mRNA and protein levels, and SOX9 mRNA and protein were also elevated in NSCLC tissues compared with levels in corresponding adjacent non-cancerous lung tissues. Immunohistochemical analysis demonstrated a high expression of SOX9 in 74/142 (52.1%) paraffin-embedded archival lung cancer biopsies. Statistical analysis indicated that upregulation of SOX9 was significantly correlated with the histological stage of NSCLC (P = 0.017) and that patients with a high SOX9 level exhibited a shorter survival time (P < 0.001). Multivariate analysis illustrated that SOX9 upregulation might be an independent prognostic indicator for the survival of patients with NSCLC.

Conclusions
This work shows that SOX9 may serve as a novel and prognostic marker for NSCLC, and play a role during the development and progression of the disease.
The role of immunosuppression of mesenchymal stem cells in tissue repair and tumor growth
Authors: Han Zhipeng , Jing Yingying , Zhang Shanshan , Liu Yan , Shi Yufang , Wei Lixin 
Published: March 2012

AbstractMesenchymal stem cells (MSCs) have acquired great interests for their potential use in the clinical therapy of many diseases because of their functions including multiple lineage differentiation, low immunogenicity and immunosuppression. Many studies suggest that MSCs are strongly immunosuppressivein vitroandin vivo. MSCs exert a profound inhibitory effect on the proliferation of T cells, B cells, dendritic cells and natural killer cells. In addition, several soluble factors have been reported to involved in the immunosuppressive effects by MSCs such as TGF-β, HGF, PGE2, IDO and iNOS. These results suggest that MSCs can be used in the therapy of immune disorder diseases, prevention of organ transplantation rejection and tissue injury. In recent study, we demonstrated that MSCs in tumor inflammatory microenvironment might be elicited of immunosuppressive function. Thus, the application of MSCs in cancer therapy might have negative effect by helping tumor cells escaping from the immune surveillance.
Hypogalactosylation of serum N-glycans fails to predict clinical response to methotrexate and TNF inhibition in rheumatoid arthritis
Authors: Ercan Altan , Cui Jing , Hazen Melissa M , Batliwalla Franak , Royle Louise , Rudd Pauline M , Coblyn Jonathan S , Shadick Nancy , Weinblatt Michael E , Gregersen Peter , Lee David M , Nigrovic Peter A 
Published: March 2012

Abstract
Introduction
Rheumatoid arthritis (RA) is associated with hypogalactosylation of immunoglobulin G (IgG). We examined whether a proxy measure for galactosylation of IgG N-glycans could predict response to therapy or was differentially affected by methotrexate (MTX) or TNF blockade.

Methods
Using a previously defined normal phase high-performance liquid chromatography approach, we ascertained the galactosylation status of whole serum N-glycans in two well-defined RA clinical cohorts: the Autoimmune Biomarkers Collaborative Network (n = 98) and Nested I (n = 64). The ratio of agalactosylated to monogalactosylated N-glycans in serum (sG0/G1) was determined before and during therapy with MTX or TNF inhibition and correlated with anticitrullinated peptide antibody (ACPA) status and clinical response as assessed by 28-joint Disease Activity Score utilizing C-reactive peptide and European League Against Rheumatism response criteria.

Results
RA patients from both cohorts exhibited elevation of sG0/G1 at baseline. Improvement in clinical scores correlated with a reduction in sG0/G1 (Spearman's ρ = 0.31 to 0.37; P < 0.05 for each cohort). However, pretreatment sG0/G1 was not predictive of clinical response. Changes in sG0/G1 were similar in the MTX and TNF inhibitor groups. Corrected for disease activity, ACPA positivity correlated with higher sG0/G1.

Conclusions
Baseline serum N-glycan hypogalactosylation, an index previously correlated with hypogalactosylation of IgG N-glycans, did not distinguish patients with rheumatoid arthritis who were likely to experience a favorable clinical response to MTX or TNF blockade. Clinical improvement was associated with partial glycan normalization. ACPA-positive patients demonstrated enhanced N-glycan aberrancy compared with ACPA-negative patients.
Negative- versus positive-pressure ventilation in intubated patients with acute respiratory distress syndrome
Authors: Raymondos Konstantinos , Molitoris Ulrich , Capewell Marcus , Sander Björn , Dieck Thorben , Ahrens Jörg , Weilbach Christian , Knitsch Wolfgang , Corrado Antonio 
Published: March 2012

Abstract
Introduction
Recent experimental data suggest that continuous external negative-pressure ventilation (CENPV) results in better oxygenation and less lung injury than continuous positive-pressure ventilation (CPPV). The effects of CENPV on patients with acute respiratory distress syndrome (ARDS) remain unknown.

Methods
We compared 2 h CENPV in a tankrespirator ("iron lung") with 2 h CPPV. The six intubated patients developed ARDS after pulmonary thrombectomy (n = 1), aspiration (n = 3), sepsis (n = 1) or both (n = 1). We used a tidal volume of 6 ml/kg predicted body weight and matched lung volumes at end expiration. Haemodynamics were assessed using the pulse contour cardiac output (PiCCO) system, and pressure measurements were referenced to atmospheric pressure.

Results
CENPV resulted in better oxygenation compared to CPPV (median ratio of arterial oxygen pressure to fraction of inspired oxygen of 345 mmHg (minimum-maximum 183 to 438 mmHg) vs 256 mmHg (minimum-maximum 123 to 419 mmHg) (P < 0.05). Tank pressures were -32.5 cmH2O (minimum-maximum -30 to -43) at end inspiration and -15 cmH2O (minimum-maximum -15 to -19 cmH2O) at end expiration. NO Inspiratory transpulmonary pressures decreased (P = 0.04) and airway pressures were considerably lower at inspiration (-1.5 cmH2O (minimum-maximum -3 to 0 cmH2O) vs 34.5 cmH2O (minimum-maximum 30 to 47 cmH2O), P = 0.03) and expiration (4.5 cmH2O (minimum-maximum 2 to 5) vs 16 cmH2O (minimum-maximum 16 to 23), P =0.03). During CENPV, intraabdominal pressures decreased from 20.5 mmHg (12 to 30 mmHg) to 1 mmHg (minimum-maximum -7 to 5 mmHg) (P = 0.03). Arterial pressures decreased by approximately 10 mmHg and central venous pressures by 18 mmHg. Intrathoracic blood volume indices and cardiac indices increased at the initiation of CENPV by 15% and 20% (P < 0.05), respectively. Heart rate and extravascular lung water indices remained unchanged.

Conclusions
CENPV with a tank respirator improved gas exchange in patients with ARDS at lower transpulmonary, airway and intraabdominal pressures and, at least initially improving haemodynamics. Our observations encourage the consideration of further studies on the physiological effects and the clinical effectiveness of CENPV in patients with ARDS.
Reevaluation of the Reactivity of Superoxide Radicals by Consideration of Both the Alkalinity of KO2 and the Superoxide-Scavenging Activity of Xanthine Oxidase
Authors: Mitsuta Keiichi 
Published: March 2012

Abstract
The rate constant, kS, for the reaction of scavengers, obtained from a competitive reaction system in which KO2 was used as a superoxide source, with superoxide has been reevaluated in electron spin resonance (ESR) spin-trapping studies. In consequence, it has been found that the local pH in a reaction field of our KO2 system was 12. As a result, the rate constants for the reaction of xanthine oxidase (XOD) with superoxide at pH 7.8 and 12 were established to be 2.1 × 106 and 8.0 × 105 M−1 s−1, respectively. On the basis of these values, discrepancies between reports in the literature have been examined, and it has been found that systematic errors appearing in values of the rate constant, kT, for the reaction of spin-trapping agents with superoxide due to variations in determination method had originated from omission of the superoxide-scavenging activity of XOD and that the errors could be explained almost completely quantitatively. For this reason, the kT values latterly reported by Allouch et al. are inferior to those formerly reported by Finkelstein et al. as reference values when the kS values are determined by the kinetic competition using these kT values.
Fifteen-Year Follow-Up Results of Presurgical Orthopedics Followed by Primary Correction for Unilateral Cleft Lip Nose in Program SEHATI in Indonesia
Authors: Sulaiman Farida Kamil , Haryanto Inge Gustiningsih , Hak Syafrudin , Nakamura Norifumi , Sasaguri Masaaki , Ohishi Masamichi 
Published: March 2012

Objective To assess long-term effects of nasal correction in infancy on nasal form and growth in patients with unilateral cleft lip, alveolus, and palate (UCLP). Design Retrospective longitudinal study. Patients Seventeen patients with complete UCLP treated in Program SEHATI in Harapan Kita Children and Maternity Hospital, Indonesia, and followed for approximately 15 years were enrolled. Interventions Subjects received presurgical orthopedics using a Hotz's plate and simultaneous primary lip and nose repair in which the lower lateral cartilage was repositioned through a reverse-U incision. Main Outcome Measures Preoperative and postoperative nasal forms, including the nostril height and width ratio, the ratio of the height of the top of the alar groove, and the ratio of nostril surface areas were analyzed using color photos taken serially. One-way analysis of variance was used for statistical analyses. Results The nostril height and width ratio and the height of the alar groove were significantly improved postoperatively and maintained for 15 years. The mean ratio of nostril surface areas was 1.01 ± 0.12 fifteen years postoperatively, and there was no significant difference from the ratio 1 year postoperatively. The major persistent deformities were septal deviation and a small skin web on the nostril rim. Conclusions Our primary cleft lip nose correction has provided an acceptable nose form and absence of disturbance of the nasal growth in patients with UCLP. However, the repositioning of the nasal cartilage at infancy might not eliminate the need for secondary correction after puberty.
Do Managerial Incentives Drive Cost Behavior? Evidence about the Role of the Zero Earnings Benchmark for Labor Cost Behavior in Private Belgian Firms
Authors: Dierynck Bart , Landsman Wayne R. , Renders Annelies 
Published: March 2012

ABSTRACT
This study investigates the influence of managerial incentives to meet or beat the zero earnings benchmark on labor cost behavior of private Belgian firms. We posit that relative to managers of firms reporting healthy profits, managers meeting or beating the zero earnings benchmark will increase labor costs to a smaller extent when activity increases and decrease labor costs to a larger extent when activity decreases. This should take the form of more symmetric labor cost behavior for firms that report a small profit. Our findings are consistent with this prediction. Using detailed employee data, we show that managers of firms reporting a small profit focus on firing employees who are relatively low cost to fire. To protect their reputation in the labor market, managers of other firms, particularly those reporting healthy profits, limit the numbers of dismissals and react to activity changes by changing the number of hours that employees work.
Data Availability: Data are available from the sources referred to in the text.