bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of dry mouth in screening sleep apnea
Authors: Zhang Cheng , Shen Yane , Liping Feng , Ma Jing , wang guang-fa 
Published: September 2020

ABSTRACTPurpose of the studyEffective screening questionnaires are essential for early detection of obstructive sleep apnea (OSA). The STOP-Bang questionnaire has high sensitivity but low specificity. Dry mouth is a typical clinical sign of OSA. We hypothesised that adding dry mouth in the STOP-Bang questionnaire would improve its specificity.Study designA survey of the incidence of dry mouth was performed in a general population group and suspected sleep apnea clinical population group. Patients with suspected OSA were assessed by laboratory polysomnography and STOP-Bang questionnaire was performed. Adding the option of dry mouth to the OSA screening questionnaire resulted in a new quesionnaire, where cut-off value, diagnostic efficacy and the predictive parameters (sensitivity, specificity, positive predictive value and negative predictive value) were explored.Results(In the 912 general population group, the incidence of dry mouth in the snoring group (54.0%) was much higher than that in the non-snoring group (30.5%) (p&lt;0.05). In 207 patients with suspected OSA, the incidence of dry mouth in the OSA group was much higher than that in the non-OSA group (p&lt;0.05). The sensitivity and specificity of the STOP-Bang questionnaire were 88.8% and 23.7% for identifying OSA, and 92.2% and 23.1% for identifying moderate and severe OSA, respectively. Adding the option of dry mouth (dry mouth every morning) to the STOP-Bang questionare resulted in a new questionnaire (STOP-Bang-dry-mouth questionnarie) with 9 items. Its sensitivity and specificity were 81.70% and 42.10% for identifying OSA, and 89.10% and 42.30% for identifying moderate and severe OSA, respectively.ConclusionsThe dry mouth symptom correlated with snoring and sleep apnea. The specificity of the STOP-Bang questionnaire can be improved by integrating dry mouth. The diagnostic accuracy of the STOP-Bang-dry mouth questionnaire is yet to be further verified in prospective studies.
Mycoplasma genitaliumcoinfection in men with symptomatic gonococcal urethritis
Authors: Richardson Daniel , Lewis David A , Jeoffreys Neisha J , Couldwell Deborah L 
Published: September 2020

ObjectivesInternational guidelines recommendMycoplasma genitaliumtesting, preferably using an assay to detect macrolide resistance-associated mutations, for men presenting with non-gonococcal urethritis, but there is no specific guidance on such testing for men with gonococcal urethritis.MethodsThis study aimed to estimate the proportion of men with gonococcal urethritis who have coinfection withM. genitaliumthrough a retrospective analysis of cases of symptomatic urethral gonorrhoea at Western Sydney Sexual Health Centre in 2017 and 2018.ResultsFourteen of 184 (7.6%, 95% CI 3.7 to 11.5) men with gonococcal urethritis hadM. genitaliumdetected in the urine at the time of presentation. No demographic or behavioural factors predictedM. genitaliumcoinfection. Coinfection with urethralChlamydia trachomatiswas detected in 29 of 184 (15.8%, 95% CI 10.5 to 21.1). All five men with macrolide-resistantM. genitaliumdetected returned for treatment with moxifloxacin at a median of 8 days (range 5–16 days) after presentation and treatment of gonorrhoea; three of five were documented to remain symptomatic at this visit.ConclusionAlthoughM. genitaliumcoinfection is less common than chlamydia among men with symptomatic gonococcal urethritis,M. genitaliumtesting, using an assay to detect macrolide resistance, will potentially reduce symptom duration particularly for men with macrolide-resistant infections, but may not be justifiable on cost-benefit analysis.
Reliability of diaphragm voluntary activation measurements in healthy adults
Authors: Ramsook Andrew H. , Molgat-Seon Yannick , Boyle Kyle G. , Mitchell Reid A. , Puyat Joseph H. , Koehle Michael S. , Sheel A. William , Guenette Jordan A. 
Published: September 2020

Voluntary activation can be used to assess central fatigue of the diaphragm after tasks such as exercise or inspiratory muscle loading. Cervical magnetic stimulation (CMS) of the phrenic nerves elicits an involuntary contraction, or twitch, of the diaphragm. This twitch is quantified based on a measure of transdiaphragmatic pressure and can be used to evaluate diaphragm contractile function and diaphragm voluntary activation (diaphragm-VA). The test–retest reliability of diaphragm-VA using CMS is currently unknown. Thirteen participants (4 male, 9 female; aged 25 ± 3 years) performed a series of interpolated twitch manoeuvres, which included a maximal inspiratory effort against a semi-occluded mouthpiece and 2 CMS-stimuli, 1 during the inspiratory manoeuvre and 1 after when the participant returned to functional residual capacity to quantify diaphragm-VA. Intraclass correlation coefficients (ICCs) and standard error of measurement (SEM) measured between-day and within-session reliability of diaphragm-VA, respectively. Maximal diaphragm-VA values were 91% (SD: 6; SEM: 3.9) and 92% (SD: 5; SEM: 2.2) during visits 1 and 2 (p = 0.68), respectively, and displayed “good” between-day reliability (ICC: 0.88; 95% confidence interval: 0.67–0.95; SEM: 2.7). Our results suggest that assessing diaphragm-VA using CMS is reliable in young healthy adults. Measuring diaphragm-VA may provide additional insight into the consequences and mechanisms of diaphragm fatigue. Novelty: Magnetic stimulation of the phrenic nerves can reliably measure voluntary activation of the diaphragm. Diaphragm voluntary activation can be used to provide additional insight into fatigability of the diaphragm.
GLOSS
Authors: Herriot Robert G. 
Published: September 2020

A program of a high level language can be executed either by applying a suitable high level machine to the program or by translating the program to an equivalent program in another language for which a machine exists. Constructing a high level machine for each language is an interesting solution, but such a solution requires the construction of many machines and also does not enable the semanticist to compare programming languages. Using an existing conventional machine whose machine language is the target language of a translator provides an un-interesting solution which also does not allow the semanticist to easily compare programming languages.
If we use a high level machine, such as GLOSS, whose machine language is the target language of a translator, then we can write a translator which merely rearranges syntax and does not lose any semantics. Such a solution is interesting to the semanticist if a large class of programming languages can be translated into this high level machine by syntax rearrangement because the high level machine can serve as a medium of programming language comparison.
Gene Networks Constructed Through Simulated Treatment Learning can Predict Proteasome Inhibitor Benefit in Multiple Myeloma
Authors: Ubels Joske , Sonneveld Pieter , van Vliet Martin H. , de Ridder Jeroen 
Published: September 2020

AbstractPurpose:Proteasome inhibitors are widely used in treating multiple myeloma, but can cause serious side effects and response varies among patients. It is, therefore, important to gain more insight into which patients will benefit from proteasome inhibitors.Experimental Design:We introduce simulated treatment learned signatures (STLsig), a machine learning method to identify predictive gene expression signatures. STLsig uses genetically similar patients who have received an alternative treatment to model which patients will benefit more from proteasome inhibitors than from an alternative treatment. STLsig constructs gene networks by linking genes that are synergistic in their ability to predict benefit.Results:In a dataset of 910 patients with multiple myeloma, STLsig identified two gene networks that together can predict benefit to the proteasome inhibitor, bortezomib. In class “benefit,” we found an HR of 0.47 (P = 0.04) in favor of bortezomib, while in class “no benefit,” the HR was 0.91 (P = 0.68). Importantly, we observed a similar performance (HR class benefit, 0.46; P = 0.04) in an independent patient cohort. Moreover, this signature also predicts benefit for the proteasome inhibitor, carfilzomib, indicating it is not specific to bortezomib. No equivalent signature can be found when the genes in the signature are excluded from the analysis, indicating that they are essential. Multiple genes in the signature are linked to working mechanisms of proteasome inhibitors or multiple myeloma disease progression.Conclusions:STLsig can identify gene signatures that could aid in treatment decisions for patients with multiple myeloma and provide insight into the biological mechanism behind treatment benefit.
COVID-19 in the Healthy Patient Population
Authors: Ronderos Botero Diana Maria , Omar Alaa Mabrouk Salem , Sun Haozhe Keith , Mantri Nikhitha , Fortuzi Ked , Choi Yongsub , Adrish Muhammad , Nicu Marin , Bella Jonathan N. , Chilimuri Sridhar 
Published: September 2020

Objective:
Coronavirus disease 2019 (COVID-19) can infect patients in any age group including those with no comorbid conditions. Understanding the demographic, clinical, and laboratory characteristics of these patients is important toward developing successful treatment strategies.

Approach and Results:

In a retrospective study design, consecutive patients without baseline comorbidities hospitalized with confirmed COVID-19 were included. Patients were subdivided into ≤55 and >55 years of age. Predictors of in-hospital mortality or mechanical ventilation were analyzed in this patient population, as well as subgroups. Stable parameters in overall and subgroup models were used to construct a cluster model for phenotyping of patients. Of 1207 COVID-19–positive patients, 157 met the study criteria (80≤55 and 77>55 years of age). Most reliable predictors of outcomes overall and in subgroups were age, initial and follow-up
d
-dimer, and LDH (lactate dehydrogenase) levels. Their predictive cutoff values were used to construct a cluster model that produced 3 main clusters. Cluster 1 was a low-risk cluster and was characterized by younger patients who had low thrombotic and inflammatory features. Cluster 2 was intermediate risk that also consisted of younger population that had moderate level of thrombosis, higher inflammatory cells, and inflammatory markers. Cluster 3 was a high-risk cluster that had the most aggressive thrombotic and inflammatory feature.

Conclusions:
In healthy patient population, COVID-19 remains significantly associated with morbidity and mortality. While age remains the most important predictor of in-hospital outcomes, thromboinflammatory interactions are also associated with worse clinical outcomes regardless of age in healthy patients.
Improved Estimates of Changes in Upper Ocean Salinity and the Hydrological Cycle
Authors: Cheng Lijing , Trenberth Kevin E. , Gruber Nicolas , Abraham John P. , Fasullo John T. , Li Guancheng , Mann Michael E. , Zhao Xuanming , Zhu Jiang 
Published: September 2020

AbstractOcean salinity records the hydrological cycle and its changes, but data scarcity and the large changes in sampling make the reconstructions of long-term salinity changes challenging. Here, we present a new observational estimate of changes in ocean salinity since 1960 from the surface to 2000 m. We overcome some of the inconsistencies present in existing salinity reconstructions by using an interpolation technique that uses information on the spatiotemporal covariability of salinity taken from model simulations. The interpolation technique is comprehensively evaluated using recent Argo-dominated observations through subsample tests. The new product strengthens previous findings that ocean surface and subsurface salinity contrasts have increased (i.e., the existing salinity pattern has amplified). We quantify this contrast by assessing the difference between the salinity in regions of high and low salinity averaged over the top 2000 m, a metric we refer to as SC2000. The increase in SC2000 is highly distinguishable from the sampling error and less affected by interannual variability and sampling error than if this metric was computed just for the surface. SC2000 increased by 1.9% ± 0.6% from 1960 to 1990 and by 3.3% ± 0.4% from 1991 to 2017 (5.2% ± 0.4% for 1960–2017), indicating an acceleration of the pattern amplification in recent decades. Combining this estimate with model simulations, we show that the change in SC2000 since 1960 emerges clearly as an anthropogenic signal from the natural variability. Based on the salinity-contrast metrics and model simulations, we find a water cycle amplification of 2.6% ± 4.4% K−1since 1960, with the larger error than salinity metric mainly being due to model uncertainty.
Evaluation of Simulated Winter Precipitation Using WRF-ARW during the ICE-POP 2018 Field Campaign
Authors: Sunny Lim Kyo-Sun , Chang Eun-Chul , Sun Ruiyu , Kim Kwonil , Tapiador Francisco J. , Lee GyuWon 
Published: September 2020

AbstractThis study evaluates the performance of several cloud microphysics parameterizations in simulating surface precipitation for two snowstorm cases during the International Collaborative Experiment held at the PyeongChang 2018 Olympics and Winter Paralympic Games (ICE-POP 2018) field campaign. We compared four different schemes in the Weather Research and Forecasting (WRF) Model, namely the double-moment 6-class (WDM6), the WRF single-moment 6-class (WSM6), and Thompson and Morrison parameterizations. Both WSM6 and WDM6 overestimated the precipitation amount for the shallow precipitation system because of the substantial amount of cloud ice, mostly generated by the deposition process. The simulated precipitation amount and distribution for the deep precipitation system showed no noticeable differences in the different cloud microphysics parameterizations. However, the simulated hydrometeor type at the surface using WSM6 and WDM6 showed good agreement with observations for all cases. The accuracy of the mean mass-weighted terminal velocity of cloud ice applied in WSM6 and WDM6 is ±20%. The number concentration of cloud ice and the ice microphysics processes are newly retrieved with 1.2 times increased . For the shallow snowstorm, the precipitation amount was reduced by approximately 8% because of the inefficient deposition and its effects on the subsequent ice microphysical processes, such as the accretion of cloud ice by snow and the conversion from cloud ice to snow.
Verification of Solid Precipitation Forecasts from Numerical Weather Prediction Models in Norway
Authors: Køltzow Morten , Casati Barbara , Haiden Thomas , Valkonen Teresa 
Published: September 2020

AbstractAssessing the quality of precipitation forecasts requires observations, but all precipitation observations have associated uncertainties making it difficult to quantify the true forecast quality. One of the largest uncertainties is due to the wind-induced undercatch of solid precipitation gauge measurements. This study discusses how this impacts the verification of precipitation forecasts for Norway for one global model [the high-resolution version of the ECMWF Integrated Forecasting System (IFS-HRES)], and one high-resolution, limited-area model [Applications of Research to Operations at Mesoscale (MEPS)]. First, the forecasts are compared with high-quality reference measurements (less undercatch) and with more simple measurement equipment commonly available (substantial undercatch) at the Haukeliseter observation site. Then the verification is extended to include all Norwegian observation sites: 1) stratified by wind speed, since calm (windy) conditions experience less (more) undercatch; and 2) by applying transfer functions, which convert measured precipitation to what would have been measured with high-quality equipment with less undercatch, before the forecast–observation comparison is performed. Results show that the wind-induced undercatch of solid precipitation has a substantial impact on verification results. Furthermore, applying transfer functions to adjust for wind-induced undercatch of solid precipitation gives a more realistic picture of true forecast capabilities. In particular, estimates of systematic forecast biases are improved, and to a lesser degree, verification scores like correlation, RMSE, ETS, and stable equitable error in probability space (SEEPS). However, uncertainties associated with applying transfer functions are substantial and need to be taken into account in the verification process. Precipitation forecast verification for liquid and solid precipitation should be done separately whenever possible.
Perioperative and Long-Term Outcomes of Robot-Assisted Partial Nephrectomy: A Systematic Review
Authors: Tang Amber B. , Lamaina Margherita , Childers Christopher P. , Mak Selene S. , Ruan Qiao , Begashaw Meron M. , Bergman Jonathan , Booth Marika S. , Shekelle Paul G. , Wilson Mark , Gunnar William , Maggard-Gibbons Melinda , Girgis Mark D. 
Published: September 2020

Background Adoption of the robotic surgical platform for small renal cancers has rapidly expanded, but its utility compared to other approaches has not been established. The objective of this review is to assess perioperative and long-term oncologic and functional outcomes of robot-assisted partial nephrectomy (RAPN) compared to laparoscopic partial nephrectomy (LPN) and open partial nephrectomy (OPN). Methods A search in PubMed, Embase, and Cochrane (2010-2019) was conducted. Of 3877 articles screened, 7 observational studies were included. Results RAPN was associated with 24-50 mL less intraoperative blood loss compared to LPN and 39-84 mL less than OPN. RAPN also demonstrated trends of other postoperative benefits, such as shorter length of stay and fewer major complications. Several studies reported better long-term functional kidney outcomes, but these findings were inconsistent. Recurrence and cancer-specific survival (CSS) were similar across groups. While RAPN had a 5-year CSS of 90.1%-97.9%, LPN and OPN had survival rates of 85.9%-86.9% and 88.5-96.3% respectively. Conclusions RAPN may be associated with a lower estimated blood loss and comparable long-term outcomes when compared to other surgical approaches. However, additional randomized or propensity matched studies are warranted to fully assess long-term functional kidney and oncologic outcomes.
The Impact of Hospital/University Affiliation on Research Productivity Among US-Based Authors in the Fields of Trauma, Surgical Critical Care, Acute Care, and Emergency General Surgery
Authors: Baroutjian Amanda , Sutherland Mason , Hoff John J. , Bean Tyler , Sanchez Carol , McKenney Mark , Elkbuli Adel 
Published: September 2020

Background Research productivity is critical to academic surgery and essential for advancing surgical knowledge and evidence-based practice. We aim to determine if surgeon affiliation with top US universities/hospitals (TOPS) is associated with increased research productivity measured by numbers of peer-reviewed publications in PubMed (PMIDs). Methods A bibliometric analysis was performed for PMIDs. Affiliated authors who published in trauma surgery (TS), surgical critical care (SCC), acute care surgery (ACS), and emergency general surgery (EGS) were evaluated for publications between 2015 and 2019, and lifetime productivity. Our analysis included 3443 authors from 443 different institutions. Our main outcome was PMIDs of first author (FA) and senior author (SA) in each field (2015-2019) and total lifetime publications. Results Significant differences exist between PMIDs from TOPS vs non-TOPS in FA-TS (1.34 vs 1.23, P = .001), SA-TS (1.71 vs 1.46, P < .001), total SA-PMIDs (44.10 vs 26.61, P < .001), and SA-lifetime PMIDs (90.55 vs 59.03, P < .001). There were no significant differences in PMIDs for FA or SA-SCC, FA or SA-ACS, FA or SA-EGS, FA-total PMIDs 2015-2019, or FA-lifetime PMIDs ( P > .05 for all). Conclusion There were significantly higher TS PMIDs among FAs and SAs affiliated with top US institutions in 2015-2019, along with higher total PMIDs (2015-2019) and lifetime PMIDs. These findings are of significance to future graduate medical applicants and academic surgeons who need to make decisions about training and future career opportunities.
Timing of Prophylactic Inferior Vena Cava Filter Placement and Trauma Outcomes
Authors: Elkbuli Adel , Ehrhardt John D. , Kinslow Kyle , McKenney Mark 
Published: September 2020

Background Prophylactic inferior vena cava filters (IVCFs) are often placed in trauma patients who cannot receive prophylactic anticoagulation. IVCFs are utilized in an effort to reduce the risk of acute pulmonary embolism (PE) and mortality. This study aims to investigate whether time-to-filter placement is associated with differences in trauma outcomes. Methods We conducted a single-center retrospective review of adult trauma patients who underwent prophylactic IVCF placement. Patients were divided into 2 groups based on time-to-filter: 0-48 hours and >48 hours. Outcome measures included post-filter deep vein thrombosis (DVT), post-filter PE, in-hospital mortality, and ICU length of stay (ICU-LOS). Significance was defined as P < .05. Results During the 6-year study period, 513 patients underwent prophylactic IVCF placement. Both groups were similar with respect to injury severity score (ISS) ( P = .540), percent of patients on home anticoagulation (38% and 39%, P = .845), abbreviated injury scale (AIS) by anatomic region ( P = .899), and traumatic brain injury (TBI) prevalence ( P = .182). Time-to-filter was not associated with significant differences in DVT, PE, or in-hospital mortality ( P > .05 for all). Filter placement in the first 48 hours was associated with shorter ICU-LOS and hospital-LOS. Conclusions Currently, there are no investigations in the trauma literature looking at the impact of time-to-filter on complications related to venous thromboembolism and potential survival benefit. Results of this investigation showed that IVCF placement within the first 48 hours was significantly associated with shorter ICU- and hospital- LOS.
A First Nations Voice: Institutionalising Political Listening
Authors: Appleby Gabrielle , Synot Eddie 
Published: September 2020

AbstractThe Uluru Statement from the Heart offers an opportunity to reorder the Australian constitutional hierarchy as it relates to First Nations. The proposal for a First Nations Voice provides a tailored, structural response to the experiences of Aboriginal and Torres Strait Islander people under the Australian state. For the First Nations Voice to meet this potential, it will require more than careful design of the Voice as a new constitutional institution; it will require existing constitutional institutions within the legislature and executive to learn to ‘listen’. This article draws on the political and democratic listening literature to examine how political listening might be practised at the interface between the First Nations Voice and existing constitutional institutions. We suggest five principles to guide this cross-institutional relationship together with ways these principles might be incorporated into governance structures.