bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Extremes in Global Precipitation Products: How Reliable Are They?
Authors: Rajulapati Chandra Rupa , Papalexiou Simon Michael , Clark Martyn P. , Razavi Saman , Tang Guoqiang , Pomeroy John W. 
Published: October 2020

AbstractGlobal gridded precipitation products have proven essential for many applications ranging from hydrological modeling and climate model validation to natural hazard risk assessment. They provide a global picture of how precipitation varies across time and space, specifically in regions where ground-based observations are scarce. While the application of global precipitation products has become widespread, there is limited knowledge on how well these products represent the magnitude and frequency of extreme precipitation—the key features in triggering flood hazards. Here, five global precipitation datasets (MSWEP, CFSR, CPC, PERSIANN-CDR, and WFDEI) are compared to each other and to surface observations. The spatial variability of relatively high precipitation events (tail heaviness) and the resulting discrepancy among datasets in the predicted precipitation return levels were evaluated for the time period 1979–2017. The analysis shows that 1) these products do not provide a consistent representation of the behavior of extremes as quantified by the tail heaviness, 2) there is strong spatial variability in the tail index, 3) the spatial patterns of the tail heaviness generally match the Köppen–Geiger climate classification, and 4) the predicted return levels for 100 and 1000 years differ significantly among the gridded products. More generally, our findings reveal shortcomings of global precipitation products in representing extremes and highlight that there is no single global product that performs best for all regions and climates.
Food and nutrient provision in preschools: Comparison of public and private preschools
Authors: Yen Chin-En 
Published: October 2020

Background: A balanced diet is important for ensuring health and development in childhood. As preschool is the main place of childcare, the meals that they provide have a critical influence on children’s dietary intake. Aim: The objectives of this study were to evaluate the nutrition status of preschool meals and to compare the food and nutrient content in public and private preschool meals. Methods: This was a cross-sectional study of 12 randomly sampled, public and private preschools in Taichung City, Taiwan. The background questionnaires, which included the meal budget and provision status of preschool meals, were completed either by the principals or supervisors of the preschools. The food and nutrition levels of preschool meals were assessed by weighing the actual food provided to the preschool children. In addition, preschool menus were collected to evaluate the meals and food served. Results: Overall, the mean calcium provision of preschools was lower than half the daily dietary reference intake (DRI), and the mean sodium was higher than half the DRI. The mean energy, carbohydrate, protein, fat, iron and vitamins B1, B2 and C supplied by the public preschools were significantly higher than those in the private preschools. In addition, the whole grains, meat, vegetables, fruits, oil and nuts supplied in public preschools were significantly higher than those found in private preschools. Conclusions: The mean energy and macronutrient provision of public preschools were significantly higher than those found in private preschools. Meal quality and nutrient levels offered in public preschools were generally higher than those found in private preschools.
A comparative evaluation of telehealth and direct assessment when screening for spasticity in residents of two long-term care facilities
Authors: Harper Kelly A , Butler Emily C , Hacker Mallory L , Naik Aaditi , Eoff Bryan R , Phibbs Fenna T , Isaacs David A , Gallion Stephen J , Thomas Esmeralda P , Scott Jim L , Ploucher Shelby , Meystedt Jacqueline C , McLeod Megan E , Charles Philip David 
Published: October 2020

Objective: To evaluate the performance of telehealth as a screening tool for spasticity compared to direct patient assessment in the long-term care setting. Design: Cross-sectional, observational study. Setting: Two long-term care facilities: a 140-bed veterans’ home and a 44-bed state home for individuals with intellectual and developmental disabilities. Subjects: Sixty-one adult residents of two long-term care facilities (aged 70.1 ± 16.2 years) were included in this analysis. Spasticity was identified in 43% of subjects (Modified Ashworth Scale rating mode = 2). Contributing diagnoses included traumatic brain injury, spinal cord injury, birth trauma, stroke, cerebral palsy, and multiple sclerosis. Main measures: Movement disorders neurologists conducted in-person examinations to determine whether spasticity was present (reference standard) and also evaluated subjects with spasticity using the Modified Ashworth Scale. Telehealth screening examinations, facilitated by a bedside nurse, were conducted remotely by two teleneurologists using a three-question screening tool. Telehealth screening determinations of spasticity were compared to the reference standard determination to calculate sensitivity, specificity, and the area under the curve (AUC) in receiver operating characteristics. Teleneurologist agreement was evaluated using Cohen’s kappa. Results: Teleneurologist 1 had a specificity of 89% and sensitivity of 65% to identify the likely presence of spasticity ( n = 61; AUC = 0.770). Teleneurologist 2 showed 100% specificity and 82% sensitivity ( n = 16; AUC = 0.909). There was almost perfect agreement between the two examiners at 94% (kappa = 0.875, 95% CI: 0.640–1.000). Conclusion: Telehealth may provide a useful, efficient method of identifying residents of long-term care facilities that likely need referral for spasticity evaluation.
Can the early use of botulinum toxin in post stroke spasticity reduce contracture development? A randomised controlled trial
Authors: Lindsay Cameron , Ispoglou Sissi , Helliwell Brinton , Hicklin Dawn , Sturman Steve , Pandyan Anand 
Published: October 2020

Objective: Does early treatment of spasticity with botulinum-toxin (BoNTA), in (hyper)acute stroke patients without arm-function, reduce contractures and improve function. Design: Randomised placebo-controlled-trial Setting: Specialised stroke-unit. Participants & Intervention: Patients with an Action Research Arm Test (ARAT) grasp-score⩽2 who developed spasticity within six-weeks of a first stroke were randomised to receive injections of: 0.9%sodium-chloride solution (placebo) or onabotulinumtoxin-A (treatment). Outcome-Measures: Spasticity, contractures, splint use and arm function (ARAT) were taken at baseline, 12-weeks post-injection and six-months after stroke. Additionally, spasticity and contractures were measured at weeks-two, four and six post-injection. Results: Ninety three patients were randomised. Mean time to intervention was 18-days (standard deviation = 9.3). Spasticity was lower in the treatment group with difference being significant between week-2 to 12 (elbow) and week-2 to 6 (wrist). Mean-difference (MD) varied between –8.5(95% CI –17 to 0) to –9.4(95% CI –14 to –5) µV. Contracture formation was slower in the treatment group. Passive range of motion was higher in the treatment group and was significant at week-12 (elbow MD6.6 (95% CI –0.7 to –12.6)) and week-6 (wrist MD11.8 (95% CI 3.8 to 19.8)). The use of splints was lower in the treatment group odds ratio was 7.2 (95% CI 1.5 to 34.1) and 4.2 (95% CI 1.3 to 14.0) at week-12 and month-6 respectively. Arm-function was not significantly different between the groups MD2.4 (95% CI –5.3 to 10.1) and 2.9 (95% CI –5.8 to 11.6) at week-12 and month-6 respectively. Conclusion: BoNTA reduced spasticity and contractures after stroke and effects lasted for approximately 12-weeks. BoNTA reduced the need for concomitant contracture treatment and did not interfere with recovery of arm function. Trial Registration: EudraCT (2010-021257-39) and ClinicalTrials.gov-Identifier: NCT01882556.
Marker-less assessment of the geometric error of fused cone-beam computed tomography images of the foot constructed using stitching software
Authors: Wellenberg Ruud HH , Dobbe Johannes GG , Erkkilä Jukka , Maas Mario , Streekstra Geert J 
Published: October 2020

Background Image noise, object repositioning, initial manual image alignment, and stitching of different volumes, i.e. anatomical regions may all affect the stitching error of fused cone-beam computed tomography (CBCT) images. Purpose To determine the geometric error of fused CBCT images of the hindfoot, lower leg, and forefoot after using stitching software, based on a marker-less validation method. Material and Methods CBCT images of the hindfoot, lower leg, and forefoot were acquired multiple times on a Planmed Verity scanner with and without repositioning the leg between acquisitions. Prototype stitching software was used to stitch hindfoot–forefoot volumes and hindfoot–lower leg volumes. Stitching error was determined via registration and by calculating the displacement of the tibia, first metatarsal, or proximal phalanges, with respect to the calcaneus, compared to their position on conventional CT. Results Overall total translation and rotation errors were 1.22 ± 0.62 mm (range 0.43–3.07 mm) and 1.27° ± 0.53° (range 0.29°–2.88°). Lower leg translation was smaller compared to forefoot translation ( P < 0.001). No statistical difference was observed between lower leg and forefoot rotation errors ( P = 0.186). Cadaver repositioning between acquisitions resulted in larger rotation errors ( P < 0.05). Cadaver repositioning did not affect translation errors ( P = 0.768). Conclusion Geometric error of fused CBCT images can be quantified using a marker-less validation method. Stitching of hindfoot volumes with forefoot and lower leg volumes induces translation and rotation errors of up to approximately 3 mm and 3°. Translation errors are larger in hindfoot–forefoot stitches compared to hindfoot–lower leg stitches.
Imaging of bioluminescent Klebsiella pneumoniae induced pulmonary infection in an immunosuppressed mouse model
Authors: Hu Xing , Cai Yun , Wang Yuhang , Wang Rui , Wang Jin , Zhang Bo 
Published: October 2020

Objective To establish a mouse model of bioluminescent Klebsiella pneumoniae-induced lung infection, under different infection states after pretreatment with various dosages of cyclophosphamide (CTX). Methods A K. pneumoniae strain carrying the luxCDABE operon was used to infect immunocompetent mice (intraperitoneal injection of saline at 4 days and 1 day prior to experimental lung infection) and immunodeficient mice (50 mg/kg CTX at 4 days and 50 mg/kg CTX at 1 day prior to lung infection; or 150 mg/kg CTX at 4 days and 100 mg/kg CTX at 1 day prior to lung infection). Disease progression was monitored in living mice using a bioluminescence imaging system. The bioluminescent images, bacterial loads in lungs, blood cytological changes and histopathology of lungs were analysed. Results K. pneumoniae-induced lung infection models were established in mice pretreated with CTX. Different doses of CTX led to different severities of lung infection. Mice pretreated with 150/100 mg/kg CTX were more suitable for real-time monitoring as they had more typical bioluminescent images of lung infection, more obvious changes in the bioluminescent intensity values, more bacterial colonies in the lungs and more distinct pulmonary pathological changes. Conclusions A stable bioluminescent K. pneumonia-induced lung infection model was successfully established in mice pretreated with CTX, which can be semi-quantitatively monitored in real-time.
Risk factors for early postoperative recurrence in single and small hepatitis B virus-associated primary hepatocellular carcinoma
Authors: Jin Hongmei , Wang Hui , Li Guanghao , Hou Qingshun , Wu Wei , Liu Fuhui 
Published: October 2020

Objective To investigate the risk factors of early postoperative recurrence in patients with single and small (≤3 cm) hepatitis B virus-associated primary hepatocellular carcinoma (HBV-HCC). Methods This retrospective study analyzed patients with single and small HBV-HCC. All patients were followed up for 1 year after surgery. Results Among 182 patients, 54 patients had early recurrence within 1 year. The recurrence group had higher proportions of men, drinking history, Child–Turcotte–Pugh (CTP) class C, patients who underwent transarterial chemoembolization (TACE), and serum alpha-fetoprotein (AFP) >10 ng/mL as well as higher gamma-glutamyl transpeptidase (GGT) levels and lower total protein (TP) and CD8+ T lymphocyte levels than the no recurrence group. Cox multivariate regression analysis demonstrated that drinking history (HR, 1.312; 95% CI, 1.042–1.652), CTP class C (HR, 1.236; 95% CI, 1.037–1.473), TACE treatment (HR, 1.241; 95% CI, 1.026–1.501), GGT (HR, 1.138; 95% CI, 1.042–1.243), TP (HR, 0.729; 95% CI, 0.555–0.957), and AFP (HR, 2.519; 95% CI, 1.343–4.726) were independently associated with early postoperative recurrence. Conclusion Drinking history, CTP class C, TACE, serum AFP, GGT, and TP levels were independently associated with early postoperative recurrence in patients with single and small HBV-HCC.
Cardiac contractility modulation attenuates structural and electrical remodeling in a chronic heart failure rabbit model
Authors: Ning Bin , Zhang Feifei , Song Xuelian , Hao Qingqing , Li Yingxiao , Li Rong , Dang Yi 
Published: October 2020

Background Cardiac contractility modulation (CCM) is non-excitatory electrical stimulation for improving cardiac function. This study aimed to evaluate the effects of CCM on structural and electrical remodeling in a rabbit model of chronic heart failure (CHF). Methods Thirty rabbits were randomly divided into the sham, CHF, and CCM groups. The CHF model was induced 12 weeks after trans-aortic constriction by pressure unloading and CCM was delivered to the myocardium for 4 weeks. Corrected QT intervals, the ventricular effective refractory period, and inducibility of ventricular tachycardia were measured by an electrophysiological examination. Connective tissue growth factor, galectin-3, Kv4.3, KCNQ1, KCNH2, and connexin 43 protein levels were measured by western blotting. Results The CHF group had a significantly prolonged corrected QT interval and ventricular effective refractory period, and increased inducibility of ventricular tachycardia. Prominent myocardial fibrosis and increased hydroxyproline content were observed in the CHF group, but these were suppressed in the CCM group. Kv4.3, KCNQ1, KCNH2, and connexin 43 protein levels were significantly lower in the CHF group, but treatment with CCM partially restored their levels. Conclusions CCM attenuates myocardial structural and electrical remodeling during CHF. These findings provide evidence for clinical use of CCM in treating CHF.
Melanopsin hypersensitivity dominates interictal photophobia in migraine
Authors: Zele Andrew J , Dey Ashim , Adhikari Prakash , Feigl Beatrix 
Published: October 2020

Purpose To define the melanopsin and cone luminance retinogeniculate pathway contributions to photophobia in healthy controls and migraineurs. Methods Healthy controls and migraineurs were categorized according to the International Classification of Headache Disorders criteria. Photophobia was measured under full-field illumination using electromyography in response to narrowband lights spanning the melanopsin and cone luminance action spectra. Migraineurs were tested during their interictal headache-free period. Melanopsin-mediated post-illumination pupil responses quantified intrinsically photosensitive Retinal Ganglion Cell (ipRGC) function. Results A model combining the melanopsin and cone luminance action spectra best described photophobia thresholds in controls and migraineurs; melanopsin contributions were ∼1.5× greater than cone luminance. In the illumination range causing photophobia, migraineurs had lower photophobia thresholds (∼0.55 log units; p < 0.001) and higher post-illumination pupil response amplitudes ( p = 0.03) than controls. Conclusion Photophobia is driven by melanopsin and cone luminance inputs to the cortex via the retino-thalamocortical pathway. In migraineurs, lower photophobia thresholds reflect hypersensitivity of ipRGC and cone luminance pathways, with the larger and prolonged post-illumination pupil response amplitude indicative of a supranormal melanopsin response. Our findings inform artificial lighting strategies incorporating luminaires with low melanopsin excitation and photopic luminance to limit the lighting conditions leading to photophobia.
A Point-Based Risk Calculator Predicting Mortality in Patients That Developed Postoperative Sepsis
Authors: Gabriel Rodney A. , Trivedi Suraj , Schmidt Ulrich H. 
Published: October 2020

Background: Predicting the mortality from post-operative sepsis remains a continuing problem. We built a statistical model using national data to predict mortality in patients who developed post-operative sepsis. Methods: This is a retrospective study using the American College of Surgeons National Quality Surgical Improvement Program database, in which we gathered data from adult patients between 2011 and 2016 who experienced postoperative sepsis. We designed a predictive model using multivariable logistic regression on a training set and validated the model on a separate test set. Results: There were 128,325 patients included in the final dataset, in which 18,499 (14.4%) died within 30-days of surgery. The model consisted of 10 covariates: American Society of Anesthesiologists Physical Status classification score, preoperative sepsis, age, chronic obstructive pulmonary disease, postoperative myocardial infarction, postoperative stroke, postoperative acute renal failure, transfusion requirement, and infection type. A point-based risk calculator was developed, which had an area under the receiver operating characteristics curve of 0.819 (95% confidence interval 0.814-0.823). Conclusion: Although further work is needed to confirm and validate our model on external datasets, our scoring system provides a novel way to measure mortality in septic post-operative patients.
Acceptability of pharmacist-led interventions to resolve drug-related problems in patients with chronic myeloid leukaemia
Authors: Tan Bee Kim , Chua Siew Siang , Chen Li-Chia , Chang Kian Meng , Balashanker Sharmini , Bee Ping Chong 
Published: October 2020

Purpose Chronic myeloid leukaemia (CML) patients on long-term tyrosine kinase inhibitor (TKI) therapy are susceptible to drug-related problems (DRPs). This study aimed to evaluate the acceptability and outcomes of pharmacist-led interventions on DRPs encountered by CML patients. Methods This study included participants from the intervention arm of a randomised controlled trial which was conducted to evaluate the effects of pharmacist-led interventions on CML patients treated with TKIs. Participants were recruited and followed up in the haematology clinics of two hospitals in Malaysia from March 2017 to January 2019. A pharmacist identified DRPs and helped to resolve them. Patients were followed-up for six months, and their DRPs were assessed based on the Pharmaceutical Care Network Europe Classification for DRP v7.0. The identified DRPs, the pharmacist’s interventions, and the acceptance and outcomes of the interventions were recorded. A Poisson multivariable regression model was used to analyse factors associated with the number of identified DRPs per participant. Results A total of 198 DRPs were identified from 65 CML patients. The median number of DRPs per participants was 3 (interquartile range: 2, 4). Most participants (97%) had at least one DRP, which included adverse drug events (45.5%), treatment ineffectiveness (31.5%) and patients’ treatment concerns or dissatisfaction (23%). The 228 causes of DRPs identified comprised the following: lack of disease or treatment information, or outcome monitoring (47.8%), inappropriate drug use processes (23.2%), inappropriate patient behaviour (19.9%), suboptimal drug selection (6.1%), suboptimal dose selection (2.6%) and logistic issues in dispensing (0.4%). The number of concomitant medications was significantly associated with the number of DRPs (adjusted Odds Ratio: 1.100; 95% CI: 1.005, 1.205; p = 0.040). Overall, 233 interventions were made. These included providing patient education on disease states or TKI-related side effects (75.1%) and recommending appropriate instructions for taking medications (7.7%). Of the 233 interventions, 94.4% were accepted and 83.7% were implemented by the prescriber or patient. A total of 154 DRPs (77.3%) were resolved. Conclusions The pharmacist-led interventions among CML patients managed to identify various DRPs, were well accepted by both TKI prescribers and patients, and had a high success rate of resolving the DRPs.
Clinical outcomes of open hip abductor tendon repair with minimum two-year follow-up
Authors: Balazs George C , Dooley Matt , Wang Dean , O’Sullivan Eilish , Kelly Bryan T 
Published: October 2020

Background: The results of open hip abductor tendon repair remains poorly defined. We sought to present the results and complications of this procedure using modern suture anchor fixation. Materials and Methods: Our prospective institutional hip preservation registry was queried for all patients who underwent open hip abductor tendon repair with minimum 2-year follow-up were identified. Demographic, clinical, intraoperative, and functional outcome details were recorded. Patient-reported outcome scores (PROs) including the modified Harris Hip Score (mHHS), HOS-ADL, HOS-S, and iHOT-33 were collected for the preoperative and final postoperative state. Risk factors for lower final mHHS and change in mHHS were analysed using a multiple regression model. Results: A total of 21 patients with mean 48 months clinical follow-up (range 24–84 months). Median mHHS improved from 49.50 preoperatively to 82.50 postoperatively ( p < 0.001), median HOS-ADL improved from 60.29 to 82.35 ( p = 0.001), median HOS-S improved from 37.50 to 60.00 ( p = 0.04), and median iHOT-33 improved from 29.81 to 70.15 ( p = 0.001). All patients had +4 or +5 hip abductor strength at final in-person examination at mean 17 months postoperatively. All patients with a preoperative Trendelenburg gait had complete resolution at final examination. There 2 complications, and no patient had re-tear or revision surgery. LCEA < 25° and a history of prior ipsilateral hip surgery were independently predictive of smaller improvement in mHHS at final follow-up. Conclusions: Open abductor tendon repair is a safe and effective procedure that provides sustained symptomatic and functional improvements at mid-term follow-up.