bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of macrolide maintenance therapy and bacterial colonisation on exacerbation frequency and progression of COPD (COLUMBUS): Study protocol for a randomised controlled trial
Authors: Uzun Sevim , Djamin Remco S , Kluytmans JanAJW , Van’t Veer Nils E , Ermens Anton A M , Pelle Aline J , Mulder Paul , van der Eerden Menno M , Aerts JoachimGJV 
Published: June 2012

Abstract

Background
Chronic obstructive pulmonary disease (COPD) is characterised by progressive development of airflow limitation that is poorly reversible. Because of a poor understanding of COPD pathogenesis, treatment is mostly symptomatic and new therapeutic strategies are limited. There is a direct relationship between the severity of the disease and the intensity of the inflammatory response. Besides smoking, one of the hypotheses for the persistent airway inflammation is the presence of recurrent infections. Macrolide antibiotics have bacteriostatic as well as anti-inflammatory properties in patients with cystic fibrosis and other inflammatory pulmonary diseases. There is consistent evidence that macrolide therapy reduces infectious exacerbations, decreases the requirement for additional antibiotics and improves nutritional measures. Because of these positive effects we hypothesised that maintenance macrolide therapy may also have beneficial effects in patients with COPD who have recurrent exacerbations. The effects on development of bacterial resistance to macrolides due to this long-term treatment are unknown. Until now, studies investigating macrolide therapy in COPD are limited. The objective of this study is to assess whether maintenance treatment with macrolide antibiotics in COPD patients with three or more exacerbations in the previous year decreases the exacerbation rate in the year of treatment and to establish microbial resistance due to the long-term treatment.

Methods/design
The study is set up as a prospective randomised double-blind placebo-controlled single-centre trial. A total of 92 patients with COPD who have had at least three exacerbations of COPD in the previous year will be included. Subjects will be randomised to receive either azithromycin 500 mg three times a week or placebo. Our primary endpoint is the reduction in the number of exacerbations of COPD in the year of treatment.

Discussion
We investigate whether long-term therapy with macrolide antibiotics can prevent exacerbations in patients with COPD. Additionally, our study aims to assess the effect of long-term use of macrolide on the development of antimicrobial resistance and on inflammatory parameters related to COPD. We believe this study will provide more data on the effects of macrolide treatment in patients in COPD and will add more knowledge on its working mechanisms.

Trial registration

http://www.clinicaltrials.gov NCT00985244
Endotracheal tube cuff pressure assessment maneuver induces drop of expired tidal volume in the postoperative of coronary artery bypass grafting
Authors: Bolzan Douglas W , Guizilini Solange , Faresin Sonia M , Carvalho Antonio CC , De Paola Angelo AV , Gomes Walter J 
Published: June 2012

Abstract

Background
Previous investigations reported that the cuff pressure (CP) can decrease secondary to the CP evaluation itself. However is not established in literature if this loss of CP is able to generate alterations on expired tidal volume (ETV). Therefore, the aim of this study was to evaluate the potential consequences of the endotracheal CP assessment maneuver on CP levels and ETV in the early postoperative of coronary artery bypass grafting (CABG).

Methods
A total of 488 patients were analyzed. After the operation, the lungs were ventilated in pressure-assist-control mode and the same ventilatory settings were adjusted for all patients. After intensive care unit arrival, the cuff was fully deflated and then progressively inflated by air injection, to promote a minimal volume to occlude the trachea. To assist the cuff inflation and the air leakage identification, the graphical monitoring of the volume-time curve was adopted. After 20 minutes a first cuff pressure evaluation was performed (P1) and a second measurement (P2) was taken after 20 minutes with an analog manometer. ETV was obtained always pre and post P1 measurement.

Results
The CP assessment maneuver promoted a significant drop of P2 in relation to P1 when the manometer was attached to the pilot balloon (p < 0.0001). When compared the moments, pre-P1 versus post-P1, a significant drop of the ETV was also observed (p < 0.0001).

Conclusion
The CP assessment maneuver promoted a significant decrease in CP values and occurrence of air leakage with reduction of ETV in the early postoperative of CABG.
Referring physicians underestimate the extent of abnormalities in final reports from myocardial perfusion imaging
Authors: Trägårdh Elin , Höglund Peter , Ohlsson Mattias , Wieloch Mattias , Edenbrandt Lars 
Published: June 2012

Abstract

Background
It is important that referring physicians and other treating clinicians properly understand the final reports from diagnostic tests. The aim of the study was to investigate whether referring physicians interpret a final report for a myocardial perfusion scintigraphy (MPS) test in the same way that the reading nuclear medicine physician intended.

Methods
After viewing final reports containing only typical clinical verbiage and images, physicians in nuclear medicine and referring physicians (physicians in cardiology, internal medicine, and general practitioners) independently classified 60 MPS tests for the presence versus absence of ischemia/infarction according to objective grades of 1–5 (1 = No ischemia/infarction, 2 = Probably no ischemia/infarction 3 = Equivocal, 4 = Probable ischemia/infarction, and 5 = Certain ischemia/infarction). When ischemia and/or infarction were thought to be present in the left ventricle, all physicians were also asked to mark the involved segments based on the 17-segment model.

Results
There was good diagnostic agreement between physicians in nuclear medicine and referring physicians when assessing the general presence versus absence of both ischemia and infarction (median squared kappa coefficient of 0.92 for both). However, when using the 17-segment model, compared to the physicians in nuclear medicine, 12 of 23 referring physicians underestimated the extent of ischemic area while 6 underestimated and 1 overestimated the extent of infarcted area.

Conclusions
Whereas referring physicians gain a good understanding of the general presence versus absence of ischemia and infarction from MPS test reports, they often underestimate the extent of any ischemic or infarcted areas. This may have adverse clinical consequences and thus the language in final reports from MPS tests might be further improved and standardized.
Multicenter, Randomized, Open-Label, Phase III Trial of Decitabine Versus Patient Choice, With Physician Advice, of Either Supportive Care or Low-Dose Cytarabine for the Treatment of Older Patients With Newly Diagnosed Acute Myeloid Leukemia
Authors: Kantarjian Hagop M. , Thomas Xavier G. , Dmoszynska Anna , Wierzbowska Agnieszka , Mazur Grzegorz , Mayer Jiri , Gau Jyh-Pyng , Chou Wen-Chien , Buckstein Rena , Cermak Jaroslav , Kuo Ching-Yuan , Oriol Albert , Ravandi Farhad , Faderl Stefan , Delaunay Jacques , Lysák Daniel , Minden Mark , Arthur Christopher 
Published: June 2012

Purpose This multicenter, randomized, open-label, phase III trial compared the efficacy and safety of decitabine with treatment choice (TC) in older patients with newly diagnosed acute myeloid leukemia (AML) and poor- or intermediate-risk cytogenetics. Patients and Methods Patients (N = 485) age ≥ 65 years were randomly assigned 1:1 to receive decitabine 20 mg/m2 per day as a 1-hour intravenous infusion for five consecutive days every 4 weeks or TC (supportive care or cytarabine 20 mg/m2 per day as a subcutaneous injection for 10 consecutive days every 4 weeks). The primary end point was overall survival (OS); the secondary end point was the complete remission (CR) rate plus the CR rate without platelet recovery (CRp). Adverse events (AEs) were recorded. Results The primary analysis with 396 deaths (81.6%) showed a nonsignificant increase in median OS with decitabine (7.7 months; 95% CI, 6.2 to 9.2) versus TC (5.0 months; 95% CI, 4.3 to 6.3; P = .108; hazard ratio [HR], 0.85; 95% CI, 0.69 to 1.04). An unplanned analysis with 446 deaths (92%) indicated the same median OS (HR, 0.82; 95% CI, 0.68 to 0.99; nominal P = .037). The CR rate plus CRp was 17.8% with decitabine versus 7.8% with TC (odds ratio, 2.5; 95% CI, 1.4 to 4.8; P = .001). AEs were similar for decitabine and cytarabine, although patients received a median of four cycles of decitabine versus two cycles of TC. The most common drug-related AEs with decitabine were thrombocytopenia (27%) and neutropenia (24%). Conclusion In older patients with AML, decitabine improved response rates compared with standard therapies without major differences in safety. An unplanned survival analysis showed a benefit for decitabine, which was not observed at the time of the primary analysis.
Simulation of the internal temperature in the Passol Laboratory, University of Debrecen
Authors: Csáky I. , Kalmár F. 
Published: June 2012

Abstract
Nowadays the facades of newly built buildings have significant glazed surfaces. The solar gains in these buildings can produce discomfort caused by direct solar radiation on the one hand and by the higher indoor air temperature on the other hand. The amplitude of the indoor air temperature variation depends on the glazed area, orientation of the facade and heat storage capacity of the building. This paper presents the results of a simulation, which were made in the Passol Laboratory of University of Debrecen in order to define the internal temperature variation. The simulation proved that the highest amplitudes of the internal temperature are obtained for East orientation of the facade. The upper acceptable limit of the internal air temperature is exceeded for each analyzed orientation: North, South, East, West. Comparing different building structures, according to the obtained results, in case of the heavy structure more cooling hours are obtained, but the energy consumption for cooling is lower.
Design of a semi-automatic pneumatic opening and closing equipment for gluing and a robotic cell
Authors: Gyurika I. G. , May D. 
Published: June 2012

Abstract
One of the most important manufacturing steps for efficient modules is the encapsulation of the control circuit and the design of the echelon height and convexity value between the casing and the circuit. The paper presents the current manufacturing technology and the development of tools and technology driven by the customers’ requirements. For this reason, a new gluing tool has been developed in the report including a pneumatic open-close machine and special use of plasma technology designed for decreasing the setting time of the glue. The development includes the design of the workplace, working requirements and the optimisation of the expenses. In the paper the results are reported with specific industrial experiences.
Correlation between Controllability of Reset Current and Electrostatic Energy Released from the Self Capacitance of Conducting Bridge Random Access Memory
Authors: Kinoshita Kentaro , Tsuruta Shigeyuki , Hasegawa Sho , Fukuhara Takahiro , Kishida Satoru 
Published: June 2012

ABSTRACTPhysical properties of filaments in Cu/HfO2/Pt conducting-bridge memory (CB-RAM) were investigated basing on direct observation by conducting atomic force microscopy (C-AFM) and energy dispersive X-ray spectroscopy (EDS), R-T characteristics until liquid nitrogen temperature, and I-V characteristics both in air and in vacuum. As a result, physical picture of filaments in Cu/HfO2/Pt structures was revealed. Filaments consist of Cu containing large residual resistance and the cross-sectional area of the filament, Sfila, was roughly proportional to set voltage, Vset, even when current compliance was kept constant. Interestingly, resistivities of filaments are same among all the filaments in different samples and are invariant even after repetitive switching that changes resistance of the filaments. Cu/HfO2/Pt obeyed the universal relation that reset current, Ireset, is proportional to the inverse of resistance in a low resistance state, 1/RLRS, which is known to be applicable to oxygen-migration-based resistive switching memories such as Pt/NiO/Pt. Considering the invariance of resistivity of the filament, this suggests the fact that Ireset is decided dominantly by Sfila. In addition, it was suggested that moisture is necessary for dissolution and migration of Cu to form filaments.
A Reemerging Political Space for Linking Person and Community Through Primary Health Care
Authors: Sweeney Sarah A. , Bazemore Andrew , Phillips Robert L. , Etz Rebecca S. , Stange Kurt C. 
Published: June 2012

Objectives. We sought to understand how national policy key informants perceive the value and changing role of primary care in the context of emerging political opportunities.Methods. We conducted 13 semistructured interviews in May 2011 with leaders of federal agencies, think tanks, nonprofits, and quality standard–defining organizations with influence over health care reform policies and implementation. We recorded the interviews and used an editing and immersion–crystallization analysis approach to identify themes.Results. We identified 4 themes: (1) affirmation of primary care as the foundation of a more effective health care system, (2) the patient-centered medical home as a transitional step to foster practice innovation and payment reform, (3) the urgent need for an increased focus on community and population health in primary care, and (4) the ongoing need for advocacy and research efforts to keep primary care on public and policy agendas.Conclusions. Current efforts to reform primary care are only intermediate steps toward a system with a greater focus on community and population health. Transformed and policy-enabled primary care is an essential link between personalized care and population health.
Public Health Detailing of Primary Care Providers: New York City’s Experience, 2003–2010
Authors: Dresser Michelle G. , Short Leslie , Wedemeyer Laura , Bredow Victoria Lowerson , Sacks Rachel , Larson Kelly , Levy Joslyn , Silver Lynn D. 
Published: June 2012

Objectives. We evaluated the effectiveness of the Public Health Detailing Program in helping primary care providers and their staff to improve patient care on public health challenges. Methods. We analyzed reported changes in clinical practice or behavior by examining providers’ retention and implementation of recommendations for campaigns. Results. During each campaign, 170 to 443 providers and 136 to 221 sites were reached. Among assessed providers who indicated changes in their practice behavior, the following statistically significant increases occurred from baseline to follow-up. Reported screening for clinical preventive services increased, including routinely screening for intimate partner violence (14%–42%). Clinical management increased, such as prescribing longer-lasting supplies of medicine (29%–42%). Lifestyle modification and behavior change, such as recommending increased physical activity to patients with high cholesterol levels, rose from 52% to 73%. Self-management goal setting with patients increased, such as using a clinical checkbook to track hemoglobin A1c goals (28% to 43%). Conclusions. Data suggest that public health detailing can be effective for linking public health agencies and their recommendations to providers and influencing reported changes in clinical practice behavior.
Primary Care and Public Health Activities in Select US Health Centers: Documenting Successes, Barriers, and Lessons Learned
Authors: Lebrun Lydie A. , Shi Leiyu , Chowdhury Joya , Sripipatana Alek , Zhu Jinsheng , Sharma Ravi , Hayashi A. Seiji , Daly Charles A. , Tomoyasu Naomi , Nair Suma , Ngo-Metzger Quyen 
Published: June 2012

Objectives. We examined primary care and public health activities among federally funded health centers, to better understand their successes, the barriers encountered, and the lessons learned.Methods. We used qualitative and quantitative methods to collect data from 9 health centers, stratified by administrative division, urban–rural location, and race/ethnicity of patients served. Descriptive data on patient and institutional characteristics came from the Uniform Data System, which collects data from all health centers annually. We administered questionnaires and conducted phone interviews with key informants.Results. Health centers performed well on primary care coordination and community orientation scales and reported conducting many essential public health activities. We identified specific needs for integrating primary care and public health: (1) more funding for collaborations and for addressing the social determinants of health, (2) strong leadership to champion collaborations, (3) trust building among partners, with shared missions and clear expectations of responsibilities, and (4) alignment and standardization of data collection, analysis, and exchange.Conclusions. Lessons learned from health centers should inform strategies to better integrate public health with primary care.
Comparing the Performance and Recovery Mechanisms for Steam Flooding in Heavy and Light Oil Reservoirs
Authors: Haghighi Mehdi Bagheripour , Ayatollahi Shahab , Shabaninejad Mehdi 
Published: June 2012

Abstract
The concern over fossil energy shortage for the next decade leads to the extensive research activities in the area of enhanced oil recovery. Steam injection as one of well known EOR process has been used for about five decades to improve the oil production rate and recovery efficiency. Steam flooding is applied to heavy and extra-heavy oil reservoirs; however it could be used in light oil reservoirs in which water injection do not work effectively. Regardless of different performances, this method is an efficient EOR process for both heavy and light oil reservoirs.
In this work, two separate numerical models were prepared to investigate steam flooding performance for the recovery of light and heavy oil. The heavy oil model is a Cartesian hypothesis model with properties of Cold Lake heavy oil reservoir in Canada and light oil model is a sector of an Iranian fractured light oil reservoir.
For this purpose, steam flooding was implemented in these two models separately. Then according to software options, all possible recovery mechanisms (viscosity reduction, steam distillation, thermal oil expansion and others) were simulated individually to measure the effectiveness of each recovery mechanism in total recovery of heavy and light oil during steam flooding. Also, operational parameters such as steam quality, steam flow rate and well perforation were optimized for both reservoirs.
Results show that steam flooding performances in heavy and light oil reservoirs are different. Heavy oil reservoirs do not response fast to steam compared to the light oil reservoirs. Furthermore, viscosity reduction is a main recovery mechanism in recovery of heavy oil and contribute to 80% of total recovery, while in recovery of light oil all three main recovery mechanisms have the same contribution to total recovery. It was also found that the optimized operational parameters are different for each reservoir.
Practical Experiences of Improvement of Oil Recovery for SZ Heavy Oil Reservoir in the Stage of High Water-cut
Authors: Su Yanchun , Liu Yingxian , Li Yanlai 
Published: June 2012

Abstract
More than 80% oil reservs is heavy oil in Bohai Bay of China.This paper describes the practice and research for comprehensive adjustment of SZ oil filed which is a large scale multi-layer sandstone heavy oil reservoir in China Offshore.In order to explore the potential of the reservoir, based on the fine geological studies, dynamic data of production and testing, we got water-cut contour of sub-layers by reservoir engineering method. Quantitative description of the remaining oil in the vertical and plane direction was gained by reservoir numerical simulation method, which could be the foundation for deployment of infilling wells and adjustment program of the oilfield. All the above were verified by the pilot well. Based on these studies, we designed infill wells between the edge and corner production wells and the the well network of the oilfield changed from nine-spot pattern to line drive well network. And in the comprehensive adjustment plan we designed 52 wells, the recovery of the oilfield will increase 7.8% compared to basic program.Combined with scaled corning data and the inversion of original resistivity, we established perforating program on the basis of fine numerical model and similar oilfield experiences. Water-cut of the new drilled wells were decreased, the potential productivity of them was fully released, and the effect of the water flooding was improved. Untill Dec 2011, 48 wells have been drilled, and the cumulative oil production of the new wells was about 174 × 104m3, the recovery is expected to be enhanced more than 10.4%.The production performance of the new wells shows that the direction of the adjustment for the heavy oilfield and the method for studying the remaining oil distribution are scientifical and reasonable. The research ideas during this comprehensive adjustment and the method for studying the distribution of remaining oil in the vertical and plane direction of the reservoir can be taken as a reference for similar oilfields, such as JZ and QHD oilfields in Bohai bay.
Laboratory Testing of Addition of Solvents to Steam to Improve SAGD Process
Authors: Ardali M. , Barrufet M. , Mamora D. D. 
Published: June 2012

Abstract
Steam Assisted gravity drainage (SAGD) is demonstrated as a proven technology to unlock heavy oil and bitumen in Canadian reservoirs. One of the long-term concerns with the SAGD process is high energy intensity and related environmental impacts. The addition of suitable hydrocarbon solvents to steam has long been regarded as the simplest and most effective method to increase SAGD performance. Higher oil recovery, accelerated oil production rate, reduced steam to oil ratio and generally more favorable economics is expected from the addition of potential hydrocarbon additives to steam. This paper summarizes experimental results of addition of potential solvents to steam in SAGD process. N-Hexane and n-heptane were co-injected with the steam and the experimental results were compared with pure steam injection. In addition, pure heated n-hexane was injected in one experiment to assess the performance of solvent-based processes. Experiments were conducted using a scaled two-dimensional physical model. Peace River Bitumen samples were used to conduct the experiments at 80 psia.
Experimental results were analyzed to determine the key variables involved in Solvent Assisted SAGD (SA-SAGD) processes. Solvent choice is not solely dependent on mobility improvement capability but also reservoir properties and operational conditions. Co-injection of suitable solvents with the steam led to accelerated oil production rate, higher oil recovery and lower energy to oil ratio. Solvent requirement for pure heated n-hexane injection was considerably high. The vaporized solvent chamber expansion was slow due to low heat content of the solvent and heat losses.