bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increasing the Usability of Climate Models through the Use of Consumer-Report-Style Resources for Decision-Making
Authors: Briley Laura , Kelly Rachel , Blackmer Emily D. , Troncoso Andrea Vega , Rood Richard B. , Andresen Jeffrey , Lemos Maria Carmen 
Published: May 2020

AbstractConsumers of climate model information face difficulty in assessing which models and projections are best for their particular needs. This difficulty stems from the abundance of climate information, as well as the relative inaccessibility or unavailability of information concerning a given model’s quality, trade-offs, and suitability for a particular geographic region or decision-making application. Consumer reports have traditionally provided potential consumers with background knowledge and a review of available products and services to help to make decisions. As a knowledge broker for climate information in the Great Lakes region, the Great Lakes Integrated Sciences and Assessments (GLISA) team has developed a suite of climate model consumer-report-style documents to help climate information consumers make decisions when selecting models and projections for their work. To develop the reports, GLISA reviewed examples of consumer reports from other sectors, relied on the feedback and advice of our ongoing Practitioner Working Group composed of real-world consumers, and incorporated otherwise-unavailable information from model developers. Due to close, continuing partnership with our Practitioner Working Group, the content and the formatting of our climate model consumer reports respond directly to the needs of consumers. Our reports therefore evolve based on needs of the practitioners as well as with the knowledge generated by our research in usability of climate knowledge. We pose that climate model consumer reports, especially when developed in the context of trusted user–knowledge broker relationships, contribute to making climate information more relevant to and usable by practitioners.
A Statistical–Dynamical Methodology to Downscale Regional Climate Projections to Urban Scale
Authors: DuchÊne François , Van Schaeybroeck Bert , Caluwaerts Steven , De Troch Rozemien , Hamdi Rafiq , Termonia Piet 
Published: May 2020

AbstractThe demand of city planners for quantitative information on the impact of climate change on the urban environment is increasing. However, such information is usually extracted from decadelong climate projections generated with global or regional climate models (RCMs). Because of their coarse resolution and unsuitable physical parameterization, however, their model output is not adequate to be used at city scale. A full dynamical downscaling to city level, on the other hand, is computationally too expensive for climatological time scales. A statistical–dynamical computationally inexpensive method is therefore proposed that approximates well the behavior of the full dynamical downscaling approach. The approach downscales RCM simulations using the combination of an RCM at high resolution (H-RES) and a land surface model (LSM). The method involves the setup of a database of urban signatures by running an H-RES RCM with and without urban parameterization for a relatively short period. Using an analog approach, these signatures are first selectively added to the long-term RCM data, which are then used as forcing for an LSM using an urban parameterization in a stand-alone mode. A comparison with a full dynamical downscaling approach is presented for the city of Brussels, Belgium, for 30 summers with the combined ALADIN–AROME model (ALARO-0) coupled to the Surface Externalisée model (SURFEX) as H-RES RCM and SURFEX as LSM. The average bias of the nocturnal urban heat island during heat waves is vanishingly small, and the RMSE is strongly reduced. Not only is the statistical–dynamical approach able to correct the heat-wave number and intensities, it can also improve intervariable correlations and multivariate and temporally correlated indices, such as Humidex.
Human Flourishing in Christ: A Journey of Hope in the Christian Community
Authors: Perkins Ignatius 
Published: May 2020

Promoting human flourishing among the sick and the dying as the spiritual goal of life—union with Christ—presents one of the most challenging experiences for patients, families, clinicians, and the Christian community in today’s healthcare environment. This article will present a framework and the important Catholic moral principles that can help guide and facilitate ethical decisions in end-of-life care that promotes and protects human dignity, freedom, and human flourishing in Christ as the telos of the journey of hope in the Christian community. Summary: As members of the Christian Community we have been called to bring the healing message of salvation and hope to one another. This ministry calls each of us to reach beyond ourselves and to touch our loved ones, our neighbors, those made vulnerable by the circumstances of their illness and to protect and defend human dignity, freedom and promote human flourishing. As Jesus did in his own time, each of us is called to help bring healing and wholeness to the sick and the dying in our world. How we can respond to our obligation to care for the sick and dying at the end-of-life, grounded in the principles of the Catholic moral tradition that govern our care and treatment decisions, is the focus of this paper.
The Whole Lateral Type of the Sphenoethmoidal Cell and Its Relevance to Endoscopic Sinus Surgery
Authors: Liu Jinfeng , Yuan Jingjing , Dai Jinsheng , Wang Ningyu 
Published: May 2020

Background: The sphenoethmoidal cell and the sphenoid sinus (SS) show great similarity in endoscopy and imaging. Hence, it is important to accurately identify the sphenoethmoidal cell preoperatively to prevent injury of the nerve and artery during endoscopic surgery. The aim of the present study was to investigate a special type of sphenoethmoidal cell. Methods: A total of 365 inpatients whose paranasal sinus computed tomography (CT) was collected and reviewed from May 2018 to September 2019 were included. The anatomical imaging characteristics of the sphenoethmoidal cell were observed. Results: A special type of the sphenoethmoidal cell was found on 9 sides in 730 sides (1.3%), according to its extension to the SS. Unlike Onodi cell (49.6%) and Jinfeng cell (1.3%), this cell simultaneously extends toward the superolateral, lateral, and inferolateral regions of the SS and is simultaneously closely attached to the optic canal and the maxillary nerve. Presently, this cell is named as the whole lateral type of the sphenoethmoidal cell, and the SS is located at the medial or inferomedial of it. Conclusions: When evaluating the paranasal sinus CT preoperatively, attention must be paid to the possibility of the whole lateral type of sphenoethmoidal cell appearing, not just Onodi cell, extending into the SS.
Changes in Pharyngeal Baseline Impedance in Patients With Laryngopharyngeal Reflux
Authors: Doo Jeon Gang , Kim Su Il , Park Jung Min , Kwon Oh Eun , Lee Young Chan , Eun Young‐Gyu 
Published: May 2020

ObjectiveFew studies have investigated pharyngeal intraluminal baseline impedance (BI) levels in patients with laryngopharyngeal reflux (LPR). The aim of this study was to compare intraluminal BI levels between patients with LPR and healthy controls.Study DesignRetrospective case series.SettingTertiary care medical center.Subjects and MethodsWe conducted a retrospective analysis of 24‐hour multichannel intraluminal impedance (MII)–pH monitoring results from patients with suspected LPR complaining of reflux symptoms. Patients with suspected LPR were divided into 2 groups according to the 24‐hour MII‐pH monitoring (LPR group: patients with symptoms with reflux events ≥1, symptom but no reflux [SNR] group: patients with symptoms but no reflux event). Healthy controls were recruited and also underwent 24‐hour MII‐pH monitoring. We compared the esophageal and pharyngeal BI levels and ratios between 3 groups.ResultsPharyngeal BI levels in the LPR group were significantly higher than in the healthy controls. In addition, the pharyngeal BI levels in the SNR group were significantly higher than in the healthy controls. All ratios of pharyngeal to distal esophageal BI levels in the LPR and SNR group were significantly higher than in the healthy controls. However, there were no significant differences in esophageal BI levels and ratios between the 3 groups.ConclusionWe found that the pharyngeal BI levels were higher in patients with LPR than in healthy controls. In addition, the pharyngeal BI levels measured by 24‐hour MII‐pH monitoring in patients with LPR symptoms, but without a reflux episode, were higher than in the healthy controls.
Budesonide vs Saline Nasal Irrigation in Allergic Rhinitis: A Randomized Placebo‐Controlled Trial
Authors: Periasamy Nikitha , Pujary Kailesh , Bhandarkar Ajay M. , Bhandarkar Naveen D. , Ramaswamy Balakrishnan 
Published: May 2020

ObjectivesBudesonide nasal irrigation is currently widely used in the treatment of chronic sinusitis typically following endoscopic sinus surgery to improve inflammatory control. Its application in treatment of allergic rhinitis has not been previously studied. This study assesses the subjective and clinical response to budesonide buffered hypertonic saline nasal irrigation and hypertonic saline nasal irrigation in patients with allergic rhinitis.Study DesignThis is a prospective, single‐center, double‐blind, randomized placebo‐controlled trial.SettingTertiary care hospital.Subjects and MethodsFifty‐two patients diagnosed with allergic rhinitis were randomized into 2 groups to receive either buffered hypertonic saline nasal irrigation with a placebo respule or buffered hypertonic saline nasal irrigation with a budesonide respule. Patients were assessed at baseline and 4 weeks subjectively using the Sino‐Nasal Outcome Test–22 (SNOT‐22) questionnaire and visual analog scale (VAS). Clinical assessment was done using the modified Lund‐Kennedy score.ResultsThe average SNOT‐22, VAS, and modified Lund‐Kennedy scores improved in both groups (P <. 001). The budesonide irrigation group was found to have significantly better improvement than the saline nasal irrigation group with the SNOT‐22 scores (P =. 012) and VAS scores (P =. 007). However, the difference in the clinical response between the 2 groups was not significant (P =. 268).ConclusionThis study adds evidence to the use of saline nasal irrigation in allergic rhinitis but also demonstrates efficacy of the addition of budesonide to irrigations. Budesonide nasal irrigation thus appears to be a viable treatment option for allergic rhinitis.
The ties that bind: Cancer history, communication, and screening intention associations among diverse families
Authors: Nolan Timiya S , Tan Alai , Williams Karen Patricia 
Published: May 2020

Objective Breast and cervical cancers are screen-detectable; yet, challenges exist with ensuring uptake of mammography and Pap smear. Family, a central factor in developing knowledge to carry out health promotion behaviors, may be an asset to improving intention to screen among non-adherent women from underrepresented minority groups. We explored familial cancer; communication; and breast and cervical screening intention among non-adherent Black, Latina, and Arab women in the United States who participated in a randomized controlled trial of the Kin KeeperSM Cancer Prevention Intervention study. The intervention was a culturally-targeted breast and cervical cancer literacy tool for Black, Latina, and Arab women, consisting of two family-focused education sessions on the cancers, their screening guidelines, and risk-reducing health-related behaviors. Methods For this secondary analysis, we assessed family cancer history, family communication, and screening intention for breast and cervical cancer in age-eligible, non-adherent participants. Descriptive statistics examined sample characteristics of the intervention and control groups. Odds ratios were estimated from logistic regression modeling to assess the intervention and sample characteristic effects on screening intention. Results Of the 516 participants, 123 and 98 were non-adherent to breast and cervical cancer screening, respectively. The intervention (OR = 1.95 for mammography; OR = 1.62 for Pap smear) and highly communicative (OR = 2.57 for mammography; OR = 3.68 for Pap smear) families reported greater screening intention. Family history of cancer only increased screening intention for mammography (OR = 2.25). Conclusion Family-focused approaches supporting communication may increase breast and cervical cancer screening intention among non-adherent, underrepresented minority groups.
Plasma 25-Hydroxyvitamin D Level at Admission Predicts Unfavorable Outcome in Intensive Care Unit Patients
Authors: Maamer Dhouha , Trifi Ahlem , Ben Fradj Mohamed Kacem , Daly Foued , Hammami Mohamed Bassem , Abdellatif Sami , Feki Moncef , Ben Lakhal Salah 
Published: May 2020

Introduction: Patients in intensive care units (ICUs) are at high risk of unfavorable outcomes. Considering the role of vitamin D (Vit D) in cardiovascular and immune functions, Vit D deficiency could affect ICU patients’ outcomes. This study aimed to evaluate Vit D status and its predictive value for outcome in ICU patients. Patients and Methods: A total of 169 ICU patients were followed during ICU stay. Primary outcome was the occurrence of at least one major adverse event; secondary outcomes were organ failure, septic shock, ICU-acquired infection, other adverse events, and ICU mortality. Plasma 25-hydroxyvitamin D (25(OH)D) was assessed by immunoassay. Multivariate Cox regression analyses were performed to test the associations of low 25(OH)D levels with poor outcomes. Results: Around 75% of patients had 25(OH)D levels <12 ng/ml. During their ICU stay, 114 patients experienced a major adverse event, 85 patients presented an ICU-acquired infection, and 22 patients died. Plasma 25(OH)D levels <12 ng/ml were associated with higher risk of major adverse events, Hazard ratio [95% CI], 4.47 [1.77, 11.3], p = .020, and ICU-acquired infection, 2.67 [1.01, 7.42], p = .049, but not with increased risk of ICU mortality. Conclusions: Hypovitaminosis D is very common in ICU patients. Results of the present study show that low plasma 25(OH)D levels are associated with increased risk of unfavorable outcomes in these patients. Additional research is needed to investigate the impact of Vit D status and effect of Vit D supplementation in ICU patients.
The Cascade device – In vitro tests to assess coil protrusion into the parent vessel
Authors: Bhogal P , Wong K , Makalanda HLD 
Published: May 2020

Background Balloon and stent-assisted coiling of aneurysms have increased the number of aneurysms available for endovascular treatment. Newer devices that allow flow within the parent vessel but coverage at the neck have recently entered the market. The Cascade is a new non-occlusive fully retrievable neck-bridging support device that has been designed to provide temporary support during coil embolisation of intracranial aneurysms. Methods Using a silicone aneurysm model three different aneurysms were catheterised with the coiling microcatheter placed in three different positions within each aneurysm – at the neck, centrally, and looped within the aneurysm. Multiple different coils were then deployed within each aneurysm with the Cascade device deployed across the neck to provide protection. In total 480 attempted coilings were performed. Aneurysm flow was used to calculate the change in intra-aneurysmal flow with the Cascade device deployed across the neck of the aneurysm. Results We did not observe a single episode of coil protrusion through the Cascade mesh nor did we observe any coil protrusion into the parent vessel when the Cascade was deployed across the neck. There was an average flow velocity reduction of 23% with the Cascade device deployed across the neck of the aneurysm. Conclusion The Cascade device offers robust protection of the aneurysmal neck and parent vessel as well as inducing significant intra-aneurysmal flow velocity reduction.
Safety and efficacy of delayed-release dimethyl fumarate in patients with relapsing-remitting multiple sclerosis: 9 years’ follow-up of DEFINE, CONFIRM, and ENDORSE
Authors: Gold Ralf , Arnold Douglas L. , Bar-Or Amit , Fox Robert J. , Kappos Ludwig , Chen Chongshu , Parks Becky , Miller Catherine 
Published: May 2020

Introduction: We report safety and efficacy in patients treated with dimethyl fumarate (DMF) for ~9 years in ENDORSE. Lymphocyte analysis data are also reported. Methods: Incidence of serious adverse events (SAEs), discontinuations due to adverse events (AEs), annualized relapse rate (ARR) and Expanded Disability Status Scale (EDSS) score were assessed. Patients were treated with DMF 240 mg twice daily (BID): placebo (PBO)/DMF (PBO for years 0–2 /DMF for years 3–9) or continuous (DMF/DMF) treatment; newly diagnosed patients were included. Annual magnetic resonance imaging (MRI) was evaluated in patients from the MRI cohort of DEFINE/CONFIRM. For the lymphocyte analysis, data from first DMF exposure were analyzed. Results: Of 2079 DEFINE/CONFIRM completers, 1736 enrolled and received ⩾1 dose of DMF. The MRI cohort included 530 patients. In the overall population, 527 (30%) patients experienced SAEs; most were fall and urinary tract infection. Over 9 years on DMF treatment, adjusted ARR remained low (⩽0.20). In patients treated with PBO in years 0–2, decreased ARR was apparent as early as year 3. Of DMF/DMF and PBO/DMF patients, 73% and 74%, respectively, had no 24-week confirmed disability progression. Most patients (~70%) had no new T1 or new/newly enlarging T2 lesions compared with previous MRI scans after 7 years treatment with DMF; the annual number of new T1 hypointense lesions and new/newly enlarging T2 hyperintense lesions were 0.6–0.8 and 0.9–2.0, respectively. Mean percentage brain volume change from ENDORSE baseline (6 years treatment in ENDORSE) was −1.32% (range −1.60% to −1.05%). Of the 2513 patients with lymphocyte assessments, 2470 had ⩾1 post-baseline measurement, 53 developed severe prolonged lymphopenia and were followed for up to 11 years; incidence of serious infection was not higher than in patients with absolute lymphocyte count (ALC) always ⩾ lower limit of normal (LLN). In patients with lymphopenia while on DMF and ALC < 0.91 × 109/L at discontinuation ( n = 138), median time to ALC ⩾ LLN was 7 weeks post-discontinuation. Conclusions: Sustained safety and efficacy of DMF was observed in patients continuing on treatment for up to 11 years, supporting DMF as a long-term treatment option for patients with RRMS. Trial registration: ClinicalTrials.gov identifiers, NCT00835770 (ENDORSE); NCT00420212 (DEFINE); NCT00451451 (CONFIRM).
FGFR aberrations increase the risk of brain metastases and predict poor prognosis in metastatic breast cancer patients
Authors: Xie Ning , Tian Can , Wu Hui , Yang Xiaohong , liu Liping , Li Jing , Xiao Huawu , Gao Jianxiang , Lu Jun , Hu Xuming , Cao Min , Shui Zhengrong , Tang Yu , Wang Xiao , Yang Jianbo , Hu Zhe-Yu , Ouyang Quchang 
Published: May 2020

Background: The survival status of patients with breast cancer and brain metastasis (BCBM) receiving current treatments is poor. Method: We designed a real-world study to investigate using patients’ clinical and genetic aberrations to forecast the prognoses of BCBM patients. We recruited 146 BCBM patients and analyzed their clinical features to evaluate the overall survival (OS). For genetic testing, 30 BCBM and 165 non-brain-metastatic (BM) metastatic breast cancer (MBC) patients from Hunan Cancer Hospital, and 86 BCBM and 1416 non-BM MBC patients from the Geneplus database who received circulating tumor DNA testing, were compared and analyzed. Results: Ki67 >14% and >3 metastatic brain tumors were significant risk factors associated with poor OS, while chemotherapy and brain radiotherapy were beneficial factors for better OS. Compared with non-BM MBC patients, BCBM patients had more fibroblast growth factor receptor ( FGFR) aberrations. The combination of FGFR, TP53 and FLT1 aberrations plus immunohistochemistry HER2-positive were associated with an increased risk of brain metastasis (AUC = 77.13%). FGFR aberration alone was not only a predictive factor (AUC = 67.90%), but also a significant risk factor for poor progression-free survival (Logrank p = 0.029). FGFR1 aberration was more frequent than other FGFR family genes in BCBM patients, and FGFR1 aberration was significantly higher in BCBM patients than non-BM MBC patients. Most FGFR1-amplified MBC patients progressed within 3 months of the late-line (>2 lines) treatment. Conclusion: A group of genetic events, including FGFR, TP53 and FLT1 genetic aberrations, and HER2-positivity, forecasted the occurrence of BM in breast cancers. FGFR genetic aberration alone predicted poor prognosis.
The benefits and harms of therapeutic exercise on physical and psychosocial outcomes in people with multimorbidity: Protocol for a systematic review
Authors: Bricca Alessio , Harris Lasse K , Saracutu Madalina , Smith Susan M , Juhl Carsten B , Skou Søren T 
Published: May 2020

Aim:The aim of this study is to investigate the benefits and harms of therapeutic exercise in people with multimorbidity defined as the combination of two or more of the following conditions: knee and hip osteoarthritis, hypertension, diabetes type 2, depression, heart failure, ischaemic heart disease and chronic obstructive pulmonary disease, by performing a systematic review of randomized controlled trials (RCTs).Methods:This study will be performed according to the recommendations from the Cochrane Collaboration and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We will search for RCTs investigating the effect of therapeutic exercise in multimorbidity, as defined above, in MEDLINE, EMBASE, CENTRAL and CINAHL from 1990. Cochrane reviews on the effect of therapeutic exercise for each of the aforementioned conditions and references of the included studies will be checked for eligible studies and citation tracking will be performed in Web of Science. We will assess the risk of bias of the included studies using the Cochrane ‘Risk of Bias Tool’ 2.0 and the Grading of Recommendations Assessment, Development and Evaluation assessment for judging the overall quality of evidence. Meta-analyses will be performed, if possible, using a random-effects model as heterogeneity is expected due to differences in interventions and participant characteristics and outcome measures. Subgroup and meta-regression analyses will be performed to explore potential predictors of outcomes.Dissemination:The results of this systematic review will be published in a peer-review journal, presented at national and international conferences and made available to end users via infographics, podcasts, press releases and videos.