bluuebunny/crossref_metadata_2025_split huggingface dataset:
Toward the Improvement of High-Impact Probabilistic Forecasts with a Sensitivity-Based Convective-Scale Ensemble Subsetting Technique
Authors: Coleman Austin , Ancell Brian 
Published: October 2020

AbstractEnsemble sensitivity analysis (ESA) is a useful and computationally inexpensive tool for analyzing how features in the flow at early forecast times affect different relevant forecast features later in the forecast. Given the frequency of observations measured between model initialization times that remain unused, ensemble sensitivity may be used to increase predictability and forecast accuracy through an objective ensemble subsetting technique. This technique identifies ensemble members with the smallest errors in regions of high sensitivity to produce a smaller, more accurate ensemble subset. Ensemble subsets can significantly reduce synoptic-scale forecast errors, but applying this strategy to convective-scale forecasts presents additional challenges. Objective verification of the sensitivity-based ensemble subsetting technique is conducted for ensemble forecasts of 2–5-km updraft helicity (UH) and simulated reflectivity. Many degrees of freedom are varied to identify the lead times, subset sizes, forecast thresholds, and atmospheric predictors that provide most forecast benefit. Subsets vastly reduce error of UH forecasts in an idealized framework but tend to degrade fractions skill scores and reliability in a real-world framework. Results reveal this discrepancy is a result of verifying probabilistic UH forecasts with storm-report-based observations, which effectively dampens technique performance. The potential of ensemble subsetting and likely other postprocessing techniques is limited by tuning UH forecasts to predict severe reports. Additional diagnostic ideas to improve postprocessing tool optimization for convection-allowing models are discussed.
Reflective testing – A randomized controlled trial in primary care patients
Authors: Oosterhuis Wytze P , Venne Wilhelmine PHG Verboeket-van de , Deursen Cees TBM van , Stoffers Henri EJH , Acker Bernadette AC van , Bossuyt Patrick MM 
Published: October 2020

Background Reflective testing, i.e. interpreting, commenting on and, if necessary, adding tests in order to aid the diagnostic process in a meaningful and efficient manner, is an extra service provided by laboratory medicine. However, there have been no prospective randomized controlled trials investigating the value of reflective testing in patient management. Methods In this trial, primary care patients were randomly allocated to an intervention group, where general practitioners received laboratory tests results as requested as well as add-on test results with interpretative comments where considered appropriate by the laboratory specialist, or to a control group, where general practitioners only received the laboratory test results requested. Patients’ medical records were evaluated with a follow-up period of six months. For both groups, the primary outcome measures, i.e. both intended action and actual management action, were blindly assessed by an independent expert panel as adequate, neutral or inadequate. Results In 226 of the 270 cases (84%), reflective testing was considered to be useful for the patient. In the intervention group ( n = 148), actual management by the general practitioner was scored as adequate ( n = 104; 70%), neutral ( n = 29; 20%) or not adequate ( n = 15; 10%). In the control group ( n = 122), these numbers were 57 (47%), 37 (30%) and 28 (23%). This difference was statistically significant ( P < 0.001). Conclusion This randomized controlled trial showed a positive effect of reflective testing in primary care patients on the adequacy of their management, as documented in medical records.
Inappropriate Adults? A Review of the Current Use of Appropriate Adults in the Criminal Justice System
Authors: Dent Nick , O’Beirne Sean 
Published: October 2020

Appropriate Adults (AAs) are an important procedural safeguard for young and vulnerable people in a criminal investigation. The significance of their role is recognised by Parliament in the Police and Criminal Evidence Act 1984 (PACE) and the appending Codes of Practice, most notably Code C. However, the ability of AAs as to perform their role is being impeded by a lack of clarity around their status and the rules that they are governed by. Often at the behest of lawyers, AAs are excluded from the conversations which lawyers have with their clients as a pragmatic solution to the uncertainty in the status of AAs. This means that AAs are rarely able to properly perform their vital role. Consequently, vulnerable people are not receiving the meaningful support they should receive. This represents a missed opportunity to protect the rights and interests of vulnerable people in the criminal justice system. When AAs are deployed effectively and appropriately, they can empower young or vulnerable suspects in an adversarial criminal justice system which, in turn, can help recalibrate the scales of justice to allow for a fairer outcome. This article will examine and critique the state of the current law, clarify the law on Legal Professional Privilege (LPP) and how that relates to Aas and propose a modest incremental extension to the principles of confidentiality to cover confidential discussions between AAs and young or vulnerable people in the criminal justice system.
Montgomery Salivary Bypass Tube in Head and Neck Cancer: The Experience of Our Otolaryngology Clinic
Authors: Minni Antonio , Ralli Massimo , Di Cianni Simone , Cialente Fabrizio , Candelori Francesca , Colizza Andrea , Cambria Francesca , de Vincentiis Marco 
Published: October 2020

Introduction: One of the most common complications in the immediate and late postoperative period following total laryngectomy or pharyngolaryngectomy is pharyngocutaneous fistulae (PCF) formation and pharyngoesophageal stenosis (PES), causing significant mortality and morbidity. Since 1978, Montgomery salivary bypass tube (MSBT) has been used to reduce the incidence of PCF and PES. The aim of this retrospective study was to analyze the outcomes of using MSBT both as a tool to prevent PCF and PES and to treat these complications in the postoperative period. Methods: Between January 2013 and December 2019, we inserted 109 MSBT in 87 patients with laryngeal/hypopharyngeal cancer treated in the Unit of Otolaryngology of our University Hospital. Results: Sixty (86.9%) patients healed from complications with primary and secondary placement of MSBT. Seven patients presented a persistence of PCF and 2 presented a recurrence of PES. Secondary placement of MSBT allowed treating successfully 15 (83%) of 18 patients. Only 3 of them presented a PCF at the end of the follow-up period. Conclusion: According to our experience, the MSBT is an affordable, easy to apply and well-tolerated tool. Although it is generally used for PCF treatment, it can also be used intraoperatively for PCF and PES prevention.
High-intensity functional exercise in older adults with dementia: A systematic review and meta-analysis
Authors: Yeh Shu-Wei , Lin Li-Fong , Chen Hung-Chou , Huang Li-Kai , Hu Chaur-Jong , Tam Ka-Wai , Kuan Yi-Chun , Hong Chien-Hsiung 
Published: October 2020

Objective: This study aimed to investigate the efficacy of high-intensity functional exercise among older adults with dementia. Methods: In this systematic review and meta-analysis of randomized controlled trials, we collected articles published before August 2020 from PubMed, Embase, and the Cochrane Library to evaluate the effect of high-intensity functional exercise on older adults with dementia. Primary outcomes included improvements in balance function and gait performance (speed, cadence, and stride length). The secondary outcomes included lower limb strength, activities of daily living, psychiatric well-being, depression, and cognition. Furthermore, we performed subgroup analysis with two high-intensity functional exercise programs: the Umeå program and Hauer’s program. Results: We identified 15 articles describing six trials including older adults with dementia undergoing high-intensity functional exercise or control activity. The meta-analysis indicated that high-intensity functional exercise, both in Hauer’s program and in the Umeå program, significantly improved balance function (pooled standardized mean difference 0.57, 95% confidence interval 0.31–0.83). Hauer’s program significantly improved gait speed, cadence, stride length, and lower limb strength. Beneficial effects on speed, cadence, and lower limb strength were retained for several months. The Umeå program facilitated activities of daily living and psychiatric well-being, with effects on activities of daily living lasting several months. In the only eligible trial, no effects on cognition were observed. Adverse effects of high-intensity functional exercise were minimal to none. Conclusions: High-intensity functional exercise is generally safe and is recommended for older individuals with mild or moderate dementia to provide benefits in motor performance and daily functioning.
A smartphone application to facilitate adherence to home-based exercise after flexor tendon repair: A randomised controlled trial
Authors: Svingen Jonas , Rosengren Jenny , Turesson Christina , Arner Marianne 
Published: October 2020

Objective: Evaluate the effect of a smartphone application on exercise adherence, range of motion and self-efficacy compared to standard rehabilitation after repair of the flexor digitorum profundus tendon. Design: Prospective multi-centre randomised controlled trial. Setting: Four hand surgery departments in Sweden. Subjects: A total of 101 patients (35 women) (mean age 37.5 ± 12.8) were randomised to control ( n = 49) or intervention group ( n = 52). Intervention: A smartphone application to facilitate rehabilitation. Main outcome measures: Adherence assessed with the Sport Injury Rehabilitation Adherence Scale at two and six weeks (primary outcome). Secondary outcomes were self-reported adherence in three domains assessed at two and six weeks, self-efficacy assessed with Athlete Injury Self-Efficacy Questionnaire at baseline, two and six weeks. Range of motion and perceived satisfaction with rehabilitation and information were assessed at 12 weeks. Results: Twenty-five patients were lost to follow-up. There was no significant between group difference in Sport Injury Rehabilitation Adherence Scale at two or six weeks, mean scores (confidence interval, CI 95%) 12.5 (CI 11.8–13.3), 11.8 (CI 11.0–12.8) for the intervention group, and 13.3 (CI 12.6–14.0), 12.8 (CI 12.0–13.7) for the control group. Self-reported adherence for exercise frequency at six weeks was significantly better for the intervention group, 93.2 (CI 86.9–99.5) compared to the controls 82.9 (CI 76.9–88.8) ( P = 0.02). There were no differences in range of motion, self-efficacy or satisfaction. Conclusion: The smartphone application used in this study did not improve adherence, self-efficacy or range of motion compared to standard rehabilitation for flexor tendon injuries. Further research regarding smartphone applications is needed. Level of evidence: I. Randomised controlled trial
The effect of an integrated multidisciplinary rehabilitation programme for patients with chronic low back pain: Long-term follow up of a randomised controlled trial
Authors: Schmidt Anne Mette , Laurberg Trine Bay , Moll Line Thorndal , Schiøttz-Christensen Berit , Maribo Thomas 
Published: October 2020

Objective: To compare the long-term effectiveness of an integrated rehabilitation programme with an existing rehabilitation programme, in terms of back-specific disability, in patients with chronic low back pain. Design: A single-centre, pragmatic, two-arm parallel, randomised controlled trial. Setting: A rheumatology rehabilitation centre in Denmark. Subjects: A total of 165 adults (aged ⩾ 18 years) with chronic low back pain. Interventions: An integrated programme (a pre-admission day, two weeks at home, two weeks inpatient followed by home-based activities, plus two 2-day inpatient booster sessions, and six-month follow-up visit) was compared with an existing programme (four-week inpatient, and six-month follow-up visit). Main measure: The primary outcome was disability measured using the Oswestry Disability Index after one year. Secondary outcomes included pain intensity (Numerical Rating Scale), pain self-efficacy (Pain Self-Efficacy Questionnaire), health-related quality of life (EuroQol-5 Domain 5-level (EQ-5D)), and depression (Major Depression Inventory). Analysis was by intention-to-treat, using linear mixed models. Results: 303 patients were assessed for eligibility of whom 165 patients (mean age 50 years (SD 13) with a mean Oswestry Disability Index score of 42 (SD 11)) were randomly allocated (1:1 ratio) to the integrated programme ( n = 82) or the existing programme ( n = 83). The mean difference (integrated programme minus existing programme) in disability was –0.53 (95% CI –4.08 to 3.02); p = 0.770). No statistically significant differences were found in the secondary outcomes. Conclusion: The integrated programme was not more effective in reducing long-term disability in patients with chronic low back pain than the existing programme.
Telomerase reverse transcriptase rs2736098 polymorphism is associated with lung cancer: A meta-analysis
Authors: Wang Meihua , Sun Yaping 
Published: October 2020

Background A meta-analysis was conducted to determine whether telomerase reverse transcriptase (TERT) rs2736098 polymorphism was related to the incidence of lung cancer. Methods We systematically searched the following three electronic databases: PubMed, Embase, and China National Knowledge Infrastructure (CNKI), for relevant articles. Statistical analysis was performed using the odds ratio (OR) and the corresponding 95% confidence interval (CI). Results Seven articles involving 3836 healthy controls and 3637 patients were included in this meta-analysis. TERT rs2736098 polymorphism was significantly related to lung cancer incidence (AA vs. GG: OR=1.83, 95% CI=1.58–2.12; AG vs. GG: OR=1.21, 95% CI=1.10–1.34; Dominant model: OR=1.33, 95% CI=1.22–1.46; Recessive model: OR=1.66, 95% CI=1.44–1.90). Moreover, this polymorphism was found to be correlated with the susceptibility to lung cancer when studies were stratified based on the sample size and the Hardy–Weinberg equilibrium. Conclusion The present findings indicate that the TERT rs2736098 polymorphism may be a risk factor for the development of lung cancer.
Association between umbilical cord vitamin D levels and adverse neonatal outcomes
Authors: Treiber M. , Mujezinović F. , Pečovnik Balon B. , Gorenjak M. , Maver U. , Dovnik A. 
Published: October 2020

Objective We investigated the associations between cord blood concentration of 25-hydroxyvitamin D [25(OH)D], neonatal outcomes, and the risk of hospitalization during the first year of life. Methods A total of 402 newborn infants and their mothers were prospectively enrolled and divided in four groups according to season of the year. We determined 25(OH)D serum concentrations from maternal–neonatal pairs at delivery by electrochemiluminescence immunoassay. Cut-offs at 25, 50, and 75 nmol/L defined vitamin D status, corresponding to deficiency, insufficiency, and sufficiency, respectively. Crude odds ratio (cOR) and 95% confidence intervals (CI) were estimated using logistic regression. Results Vitamin D severe deficiency (i.e., <25 nmol/L) was present in 18% of newborns. Cord blood severe deficiency was associated with an increased risk of preterm birth (cOR 3.6, 95% CI: 1.1–12.2), neonatal respiratory distress syndrome (cOR 5.9, 95% CI: 1.1–33.2), and increased risk of hospitalization during the first year of life because of acute respiratory infection (cOR 3.9, 95% CI: 1.4–10.6) or acute gastroenterocolitis (cOR 5.2, 95% CI: 1.4–19.1). Conclusion Cord blood vitamin D deficiency is associated with increased risk of preterm birth, neonatal respiratory distress syndrome, and hospitalization during the first year of life.
Method for evaluating the human bioequivalence of acarbose based on pharmacodynamic parameters
Authors: Xu Su-Mei , Xu Yu-Ying , Yan Juan , Zhang Yi-Fei , Li Dai , Li Dan , Li Xiao-Min , Guo Jie , Xu Ping-Sheng 
Published: October 2020

Objective To explore a method for evaluating the bioequivalence of acarbose based on pharmacodynamic parameters using a single-dose, randomized-sequence, three-way crossover study of acarbose test (T) and reference (R) formulations. Methods Baseline-adjusted, pre-dose value deduction, and direct comparison methods were used to evaluate the geometric T/R ratios and 90% confidence intervals (CIs) of the ln-transformed pharmacodynamic parameters to identify the most suitable evaluation system. Twelve participants were randomly divided into three groups to receive treatment in the following sequences: TRR, RTR, and RRT, each including a 7-day washout period between treatment periods. The serum glucose concentration (baseline) was determined. Pharmacodynamic parameters, including the maximum reduction in serum glucose concentrations (ΔCSG,max) and difference of the AUC of glucose between before and after acarbose exposure (ΔAUEC), were tested. Results Using the direct comparison method, the geometric mean ratios of CSG,max, AUEC(0-2h), and AUEC(0-4h) were 94.13%, 97.82% and 99.76%, respectively. The 90% CIs of the geometric T/R ratios for CSG,max, AUEC(0-2h), and AUEC(0-4h) all fell between 80% and 125%. Conversely, ΔCSG,max and ΔAUEC(0-4h) were less reliable measures of acarbose bioequivalence. Conclusions Pre-dose value deduction and direct comparison methods can be initially considered suitable for assessing acarbose bioequivalence.
Serum oestradiol levels are inversely associated with C-reactive protein levels in premenopausal women, but not postmenopausal women
Authors: Park Jae-Min , Lee Yong-Jae 
Published: October 2020

Objective Epidemiological studies on the association of serum oestradiol levels and inflammatory markers have reported inconsistent and conflicting results. Therefore, we investigated the association between serum oestradiol and high-sensitivity C-reactive protein (CRP) levels in women on the basis of their menopausal status. Methods This cross-sectional study examined the association between serum oestradiol and CRP levels on the basis of menopausal status in 151 premenopausal women aged 42.7 ± 6.7 years and 394 postmenopausal women aged 58.1 ± 6.7 years who participated in a health examination program. Multiple linear regression analysis was conducted using CRP levels as the dependent variable. Results Multiple linear regression analysis showed that serum oestradiol levels were inversely associated with CRP levels in premenopausal women (β coefficient = −0.298) after adjusting for age, body mass index, smoking, mean arterial pressure, and levels of fasting plasma glucose, triglycerides, high-density lipoprotein cholesterol, aspartate aminotransferase, and alanine aminotransferase. However, this association was not found in postmenopausal women after adjusting for the same confounding factors. Conclusions Serum oestradiol levels are inversely associated with CRP levels in premenopausal women, but not in postmenopausal women. Lower oestrogenic activity may at least partly contribute to the pathogenesis of chronic inflammation, particularly in premenopausal women.
Safety and oncological outcomes for large (stage ≥T2b) and locally advanced renal cell carcinoma: comparison between laparoscopic and modified hand-assisted laparoscopic radical nephrectomy
Authors: Guo Xudong , Wang Hanbo , Xiang Yuzhu , Jin Xunbo , Jiang Shaobo 
Published: October 2020

Objective To compare the operative and oncologic outcomes between hand-assisted laparoscopic radical nephrectomy (HALRN) and laparoscopic radical nephrectomy (LRN) for large (stage ≥T2b) and locally advanced renal cell carcinoma. Methods We retrospectively collected data from patients who underwent HALRN or LRN for stage ≥T2b renal cell carcinoma from January 2011 to January 2018 in our institution. The patients’ demographics, perioperative parameters, and postoperative follow-up data were compared between the two groups. The survival outcome was estimated using the Kaplan–Meier method. Results The HALRN group comprised 78 patients, and the LRN group comprised 63 patients. The median operative duration was significantly shorter in the HALRN than LRN group. The two groups were equivalent in terms of the incision length, blood loss, complication rate, and duration of hospitalization. In the HALRN and LRN groups, the 5-year overall survival rates were 69.4% and 73.1%, the 5-year cancer-specific survival rates were 80.0% and 83.3%, and the 5-year progression-free survival rates were 66.4% and 74.7%, respectively, with no significant differences. Conclusions Compared with LRN, HALRN may offer a shorter operative duration and equivalent surgical outcomes without sacrificing oncological efficacy. In addition, HALRN has specific advantages for extremely large and complicated renal tumors.
Association Between Mandibular Prognathism and MATRILIN-1 Gene in Central India Population: A Cross-sectional Study
Authors: Kulkarni Shilpa Devdatt , Bhad Wasundhara A , Doshi Umal H 
Published: October 2020

Introduction: Mandibular prognathism (MP) is known to be an inherited trait. Secondary condylar cartilage is the postnatal growth site of the mandible. Chromosome location 1p36 contains MATRILIN-1, which is related to cartilage matrix formation. The aim of this article is to find out relation between mutation in gene encoding MATRILIN-1 at 1p36 and MP. Material and Methods: This case control study included 35 skeletal class III patients with MP (18 males and 17 females in the age range from 6 years to 63 years; mean age was 21.74 ± 12.87 years) and 30 control individuals with orthognathic skeletal relation (17 males, 13 females in the age range from 19 years to 25 years, mean age of 21.57 ± 2.59 years) without any family history of MP. DNA was extracted from venous blood and genotyped. Two loci on chromosome 1p36 (rs20566 and rs1065755) encoding MATRILIN-1 were studied for mutation. Results: Single-nucleotide polymorphism (SNP) at rs20566 and frameshift mutation at rs1065755 had a significantly greater frequency in MP cases than in control. Conclusions: Mutation at both the sites can be attributed to increased risk of developing MP.
Activity participation patterns of community mental health consumers
Authors: Jennings Courtney , Lhuede Kate , Bradley Gail , Pepin Genevieve , Hitch Danielle 
Published: October 2020

Introduction Previous international research indicates that people with severe mental illness often experience lower levels of activity participation and may therefore be marginalized from occupational opportunities that support recovery. This study aimed to describe activity and participation patterns of consumers of mental health services living in the community and identify significant relationships with demographic characteristics. Method A cross-sectional observational study design was utilized, via data mining of the Activity and Participation Questionnaires completed while receiving services from an area mental health service. Data for 282 consumers, who submitted 333 questionnaires, were included. Results Consumers were mostly engaged in home-based and unpaid work, and their participation in these tasks significantly increased over time. Significant relationships were found between activity participation and age, gender and primary language. Consumers who were older were less likely to participate in employment, education and physical activity, while female and culturally and linguistically diverse consumers were less likely to engage in activities in the community. Conclusion Demographic factors may have a significant impact on the ability of consumers to participate in activities. This may require targeted approaches to activity and participation interventions for specific groups of consumers.