bluuebunny/crossref_metadata_2025_split huggingface dataset:
Renal Safety of Multimodal Brain Imaging Followed by Endovascular Therapy
Authors: Cereda Carlo W. , Mlynash Michael , Cippà Pietro E. , Kemp Stephanie , Heit Jeremy J. , Marks Michael P. , Lansberg Maarten G. , Albers Gregory W. 
Published: November 2020

Background and Purpose:
Contrast-enhanced noninvasive angiography and perfusion imaging are recommended to identify eligible patients for endovascular therapy (EVT) in extended time windows (>6 hours or wake-up). If eligible, additional intraarterial contrast exposure will occur during EVT. We aimed to study the renal safety in the DEFUSE 3 (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke) population, selected with contrast-enhanced multimodal Imaging and randomized to EVT versus medical management.

Methods:
In the randomized DEFUSE 3 trial population, we compared changes in serum creatinine between baseline (before randomization) and 24 hours later. The primary outcome was the relative change in creatinine level between baseline and 24 hours in the EVT versus medical arm. The secondary outcome was a comparison between computed tomography (CT) versus magnetic resonance imaging selection in the EVT arm. The safety outcome was a comparison of the proportion of patients with criteria for contrast-associated kidney injury in the EVT versus medical arm and a comparison between CT versus magnetic resonance imaging selection in the EVT arm.

Results:

In the DEFUSE 3 population (n=182, age 69±13, 51% female), mean creatinine decreased from a baseline of 0.98±0.33 mg/dL to 0.88±0.28 mg/dL at 24 hours (
P
<0.001). There was no difference in change between treatment groups: relative to baseline, there was a 6.3% reduction in the EVT group versus 9.2% in the medical group,
P
=0.294. Absolute decrease −0.08±0.18 in EVT versus −0.12±0.18 in medical,
P
=0.135; Among patients treated with EVT, there was no difference in 24-hour creatinine level changes between patients who were selected with CT angiography/CT perfusion (−0.08±0.18) versus magnetic resonance imaging (−0.07±0.19),
P
=0.808 or 6.8% reduction versus 4.8%,
P
=0.696. In the EVT arm, contrast-associated kidney injury was encountered in 4 out of 91 (4.4%) versus 2/90 (2.2%) in the medical arm
P
=0.682. In the EVT arm, contrast-associated kidney injury was evenly distributed between magnetic resonance imaging (1/22, 4.6%) versus CT 3 out of 69 (4.4%),
P
=1.0.

Conclusions:
Perfusion imaging before EVT was not associated with evidence of decline in renal function.

Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02586415.
Observations of Clouds, Aerosols, Precipitation, and Surface Radiation over the Southern Ocean: An Overview of CAPRICORN, MARCUS, MICRE, and SOCRATES
Authors: McFarquhar Greg M. , Bretherton Christopher S. , Marchand Roger , Protat Alain , DeMott Paul J. , Alexander Simon P. , Roberts Greg C. , Twohy Cynthia H. , Toohey Darin , Siems Steve , Huang Yi , Wood Robert , Rauber Robert M. , Lasher-Trapp Sonia , Jensen Jorgen , Stith Jeffrey L. , Mace Jay , Um Junshik , Järvinen Emma , Schnaiter Martin , Gettelman Andrew , Sanchez Kevin J. , McCluskey Christina S. , Russell Lynn M. , McCoy Isabel L. , Atlas Rachel L. , Bardeen Charles G. , Moore Kathryn A. , Hill Thomas C. J. , Humphries Ruhi S. , Keywood Melita D. , Ristovski Zoran , Cravigan Luke , Schofield Robyn , Fairall Chris , Mallet Marc D. , Kreidenweis Sonia M. , Rainwater Bryan , D’Alessandro John , Wang Yang , Wu Wei , Saliba Georges , Levin Ezra J. T. , Ding Saisai , Lang Francisco , Truong Son C. H. , Wolff Cory , Haggerty Julie , Harvey Mike J. , Klekociuk Andrew R. , McDonald Adrian 
Published: November 2020

AbstractWeather and climate models are challenged by uncertainties and biases in simulating Southern Ocean (SO) radiative fluxes that trace to a poor understanding of cloud, aerosol, precipitation, and radiative processes, and their interactions. Projects between 2016 and 2018 used in situ probes, radar, lidar, and other instruments to make comprehensive measurements of thermodynamics, surface radiation, cloud, precipitation, aerosol, cloud condensation nuclei (CCN), and ice nucleating particles over the SO cold waters, and in ubiquitous liquid and mixed-phase clouds common to this pristine environment. Data including soundings were collected from the NSF–NCAR G-V aircraft flying north–south gradients south of Tasmania, at Macquarie Island, and on the R/V Investigator and RSV Aurora Australis. Synergistically these data characterize boundary layer and free troposphere environmental properties, and represent the most comprehensive data of this type available south of the oceanic polar front, in the cold sector of SO cyclones, and across seasons. Results show largely pristine environments with numerous small and few large aerosols above cloud, suggesting new particle formation and limited long-range transport from continents, high variability in CCN and cloud droplet concentrations, and ubiquitous supercooled water in thin, multilayered clouds, often with small-scale generating cells near cloud top. These observations demonstrate how cloud properties depend on aerosols while highlighting the importance of dynamics and turbulence that likely drive heterogeneity of cloud phase. Satellite retrievals confirmed low clouds were responsible for radiation biases. The combination of models and observations is examining how aerosols and meteorology couple to control SO water and energy budgets.
Intensification and Maintenance of a Double Warm-Core Structure in Typhoon Lan (2017) Simulated by a Cloud-Resolving Model
Authors: Tsujino Satoki , Tsuboki Kazuhisa , Yamada Hiroyuki , Ohigashi Tadayasu , Ito Kosuke , Nagahama Norio 
Published: November 2020

AbstractKnowledge of the development and maintenance processes of double warm cores in tropical cyclones is important for full understanding of the dynamics of storm intensity changes. During its mature stage, Typhoon Lan (2017) had a clear double warm-core structure, which was observed by dropsondes. In this study, to investigate the intensification and maintenance of the double warm-core structure, a numerical simulation of the storm is performed with a cloud-resolving model and verified by dropsonde and satellite observations. A potential temperature budget and backward trajectories are diagnosed to examine intensification and maintenance processes in the simulated eye. The budget analysis indicates that, during the most rapidly intensifying stage, a double warm core is enhanced by axisymmetric subsidence warming in the eye. In the mature stage, upper-core warming is mostly canceled by ventilation due to vertical wind shear, but the lower core continues to warm by asymmetric advection, possibly associated with dynamical instability in the eyewall. The results raise a topic of interest: it is difficult to fully explain the axisymmetric subsidence warming process during the most rapidly intensifying stage by the dynamical response in an axisymmetric balanced vortex. The back-trajectory analysis indicates that the air mass associated with the subsidence is partly induced by inward acceleration in subgradient regions (unbalanced processes) in the eyewall.
The Effect of Anthropogenic Aerosols on the Aleutian Low
Authors: Dow William J. , Maycock Amanda C. , Lofverstrom Marcus , Smith Christopher J. 
Published: November 2020

AbstractPast studies have suggested that regional trends in anthropogenic aerosols can influence the Pacific decadal oscillation (PDO) through modulation of the Aleutian low. However, the robustness of this connection is debated. This study analyzes changes to the Aleutian low in an ensemble of climate models forced with large, idealized global and regional black carbon (BC) and sulfate aerosol perturbations. To isolate the role of ocean feedbacks, the experiments are performed with an interactive ocean and with prescribed sea surface temperatures. The results show a robust weakening of the Aleutian low forced by a global tenfold increase in BC in both experiment configurations. A linearized steady-state primitive equation model is forced with diabatic heating anomalies to investigate the mechanisms through which heating from BC emissions influences the Aleutian low. The heating from BC absorption over India and East Asia generates Rossby wave trains that propagate into the North Pacific sector, forming an upper-tropospheric ridge. Sources of BC outside of East Asia enhance the weakening of the Aleutian low. The responses to a global fivefold and regional tenfold increase in sulfate aerosols over Asia show poor consistency across climate models, with a multimodel mean response that does not project strongly onto the Aleutian low. These findings for a large, idealized step increase in regional sulfate aerosol differ from previous studies that suggest the transient increase in sulfate aerosols over Asia during the early twenty-first century weakened the Aleutian low and induced a transition to a negative PDO phase.
Are Storm Characteristics the Same When Viewed Using Merged Surface Radars or a Merged Satellite Product?
Authors: Ayat Hooman , Evans Jason P. , Sherwood Steven , Behrangi Ali 
Published: November 2020

AbstractHigh-resolution datasets offer the potential to improve our understanding of spatial and temporal precipitation patterns and storm structures. The goal of this study is to evaluate the similarities and differences of object-based storm characteristics as observed using space- or land-based sensors. The Method of Object-based Diagnostic Evaluation (MODE) Time Domain (MTD) is used to identify and track storm objects in two high-resolution merged datasets: the Integrated Multisatellite Retrievals for Global Precipitation Measurement (IMERG) final product V06B and gauge-corrected ground-radar-based Multi-Radar Multi-Sensor (MRMS) quantitative precipitation estimations. Characteristics associated with landfalling hurricanes were also examined as a separate category of storm. The results reveal that IMERG and MRMS agree reasonably well across many object-based storm characteristics. However, there are some discrepancies that are statistically significant. MRMS storms are more concentrated, with smaller areas and higher peak intensities, which implies higher flash flood risks associated with the storms. On the other hand, IMERG storms can travel longer distances with a higher volume of precipitation, which implies higher risk of riverine flooding. Agreement between the datasets is higher for faster-moving hurricanes in terms of the averaged intensity. Finally, MRMS indicates a higher average precipitation intensity during the hurricane’s lifetime. However, in non-hurricanes, the opposite result was observed. This is likely related to MRMS having higher resolution; monitoring the hurricanes from many viewing angles, leading to different signal saturation properties compared to IMERG; and/or the dominance of droplet aggregation effects over evaporation effects at lower altitudes.
Risk factors for acute pulmonary embolism in patients with off-pump coronary artery bypass grafting: implications for nursing
Authors: Zhou Jinli , Cao Xiuhong , Du Yeping , Shi Yan , Pan Weiwei , Jia Suhong 
Published: November 2020

Objective Acute pulmonary embolism (APE) is a serious complication after off-pump coronary artery bypass grafting (OPCABG). We aimed to analyze the risk factors for APE in patients with OPCABG. Methods In this retrospective, observational study, patients with OPCABG who were treated in our hospital from 1 January 2018 to 31 March 2020 were included. The basic characteristics of patients and results of preoperative laboratory examinations were collected and analyzed. Results A total of 707 patients with OPCABG were included and the incidence of APE was 3.21%. Left ventricular ejection fraction (LVEF), a history of smoking, number of bypass grafting, duration of surgery, and age were significant risk factors for APE in patients with OPCABG. The areas under the curves of LVEF, number of bypass grafting, duration of surgery, and age were 0.773, 0.759, 0.738, and 0.723, respectively. The cutoff values of LVEF, number of bypass grafting, duration of surgery, and age were 59.84, 3.18, 237.42, and 73.28, respectively. Conclusions LVEF, a history of smoking, number of bypass grafting, duration of surgery, and age may be risk factors for APE in patients with OPCABG. Early measures should be taken to target these risks to prevent APE.
Frequent co-reactivation of Epstein–Barr virus in patients with cytomegalovirus viremia under immunosuppressive therapy and/or chemotherapy
Authors: Hatayama Yuki , Hashimoto Yuki , Motokura Toru 
Published: November 2020

Objective Co-reactivation of cytomegalovirus (CMV) and Epstein–Barr virus (EBV) occurs in iatrogenically immunosuppressed patients, but the clinical relevance of this is unknown. We aimed to determine the frequency of EBV reactivation in patients with CMV viremia and to explore its clinical significance. Methods Serum or plasma CMV and EBV DNA was detected by quantitative real-time PCR in 82 patients who received immunosuppressive therapy and/or chemotherapy and underwent CMV antigenemia tests. Results CMV DNA was positive in 55 patients, with EBV reactivation being found in 29 of these (52.7%). EBV co-reactivation was significantly associated with aging (>64 years vs. ≤64 years, odds ratio 4.07, 95% confidence interval 1.06–15.6). When older patients were divided into two groups according to age, EBV co-reactivation occurred more frequently in early-old patients (aged 65–74 years) than in late-old patients (aged ≥75 years) (100.0% vs. 53.3%, respectively). Steroid pulse treatment was administered significantly more often in the early-old group than in those aged ≤64 years and ≥75 years (72.7% vs 27.6% vs 14.3%, respectively). Conclusions Co-reactivation of EBV in patients with CMV viremia highlighted early-old patients and may reflect treatment intensity as well as immunosenescence.
Embedded English verbs in Arabic-English code-switching in Egypt
Authors: Kniaź Małgorzata , Zawrotna Magdalena 
Published: November 2020

Aims: This study provides new insights into Arabic-English code-switching with particular reference to verb insertion. It aims to identify (1) patterns of English verb insertion into Arabic; (2) factors affecting them. We offer an alternative to previous studies’ conclusions regarding a supposed lack of English verbs integrated morphologically into Arabic, which is claimed to result from incongruence between Arabic and English verb systems. Methodology: We employ the Matrix Language Frame (MLF) model and the 4-M model. Data and analysis: The data comprise 14,414 clauses obtained from interviews with students at the American University in Cairo. Data were analyzed quantitatively. Findings: Most (80.17%) of inserted verbs were inflected with Arabic tense, gender, and number prefixes showing morphological integration into Arabic. We distinguished four recurrent patterns in verb insertion: (1) complete morphological integration in the present tense; (2) incomplete assimilation of forms requiring the use of the plural suffix -u; (3) lack of morphological integration in the past tense; and (4) lack of suffixation of Arabic clitics to English verbs. Originality: This is the first study focusing on verb insertion in Arabic-English code-switching based on empirical data collected in Egypt. It offers different findings on verb patterns and their explanation compared with other quantitative studies based on the MLF model. We propose to look beyond incongruence between Arabic and English as a factor determining verb patterns to include linguistic convention. Thus, we hypothesize that verb insertion might be controlled by linguistic norms accepted and perpetuated in a given speech community. Significance: Contrary to previous claims, our results show that patterns of verb insertion in Arabic-English code-switching are consistent with the MLF model. Hence, the study contributes evidence for the MLF model and its explanatory value.
Rationing health and social goods during pandemics: Guidance for Ghanaian decision makers
Authors: Laar Amos , DeBruin Debra , Ofori-Asenso Richard , Laar Matilda Essandoh , Redman Barbara , Caplan Arthur 
Published: November 2020

Healthcare rationing during pandemics has been widely discussed in global bioethics literature. However, existing scenarios and analyses have focused on high income countries, except for very few disease areas such as HIV treatment where some analyses related to African countries exist. We argue that the lack of scholastic discourse, and by extension, professional and democratic engagement on the subject constitute an unacceptable ethical omission. Not only have African governments failed to develop robust ethical plans for pandemics, ethicists in this region have been unable to ignite public discourse on rationing. Therefore, we aim to initiate a debate on how rationing health and social goods could be done ethically in Ghana during the current and future pandemics. The paper discusses and critiques some moral considerations (utilitarian, equity, equal worth, urgent need, and the prioritarian principles) for rationing and their relevance in the Ghanaian context. This contribution may facilitate ethical decision-making during the current (COVID-19) pandemic - in Ghana and other African settings where hardly any rationing guidelines exist
Assessment of nurses’ ethical performance from the perspective of mothers and nurses in pediatric wards of beast hospital, Hamadan, 2019
Authors: Shadi Danial , Bashiri Saba , Mezerji Naser Mohammad Gholi , Tehrani Tayebeh Hasan 
Published: November 2020

Background and aim Difficult moral situations assume more critical importance in pediatric wards since children are more vulnerable than adults. Given that professional ethics is a substantial part of children treatment, the present study was conducted to determine the ethical performance of nurses from the perspective of mothers and nurses in the pediatric wards of Be'esat Hospital in Hamadan. Materials and methods The present descriptive-analytical study was conducted on 58 nurses and 263 mothers of children referred to the pediatric wards of Be'esat Hospital in Hamadan in 2019. The study samples were randomly selected. Data collection tools included the demographic form and Ethical Performance Assessment Questionnaire developed by Beykmirza et al. The obtained data were analyzed in SPSS software version 23using descriptive and inferential statistics. Results As evidenced by the obtained results, the mean ethical performance of nurses from the perspective of nurses and mothers were reported as 86.72 ± 6.397 and 69.92 ± 18.09. From the mothers' viewpoint, 27%, 39.2%, and 33.8% of nurses had weak, moderate and good levels of performance, respectively. On the other hand, from the nurses' perspective, 24.6% and 75.4% of nurses had moderate and good levels of performance, respectively. The obtained results were indicative of a statistically significant difference between the performance score as reported by mothers and nurses (P < 0.001). Conclusion Considering that the majority of mothers rated the ethical performance of nurses as weak and moderate, it is suggested that professional ethical principles be implemented in the form of Retraining programs in an attempt to improve the ethical performance of nurses.
Use of the TIDieR checklist to describe an online structured education programme for type 2 diabetes
Authors: Poduval Shoba , Ross Jamie , Pal Kingshuk , Newhouse Nicola , Hamilton Fiona , Murray Elizabeth 
Published: November 2020

Objectives The aim of structured education for type 2 diabetes is to improve knowledge, skills and confidence in self-management. It is recommended in the UK for everyone who is newly diagnosed with type 2 diabetes. We developed an on-line programme called HeLP-Diabetes: Starting Out to address poor uptake of face-to-face structured education. The aim of this paper is to describe the intervention in line with the Template for Intervention Description and Replication guide, which calls for better reporting of interventions. Methods The Template for Intervention Description and Replication guide provided the item headings for the description. These included the theoretical underpinning, materials, procedures, providers, and mode of delivery. Results The programme was developed to meet NICE requirements for structured education and therefore followed a structured curriculum with four sessions covering content such as what diabetes is and how it is treated, possible complications, and how lifestyle changes can improve health. Content was delivered in text, images and video, and behaviour change techniques, self-assessment and feedback were used to help people target key health behaviours. The programme was delivered entirely online, but the team were available for support via telephone. Email feedback and reminders were sent. Conclusions The TIDieR checklist allowed us to provide a clear structure for the description of the intervention. However, it could not capture the full complexity of the programme, and intervention developers considering using it in the future may find that it needs to be adapted to make it more specific to their intervention.
What are the knowledge, attitudes and beliefs regarding concussion of primary care physicians and family resident physicians in rural communities?
Authors: Galbraith Heather , Quesnele Jairus , Kenrick-Rochon Shannon , Grenier Sylvain , Baldisera Tara 
Published: November 2020

Background Primary care physicians and family medicine resident physicians report continued gaps in knowledge when diagnosing and managing pediatric patients with concussion. Methods A cross-sectional electronic survey of 130 primary care physicians and family medicine resident physicians in the Northeastern Ontario Local Health Integration Network (LHIN). Descriptive statistics, chi-squared Fisher exact tests, were used to compare physicians versus resident physicians with two-tailed p < 0.05 (with 95% confidence intervals). Results With a 48% response rate, when treating concussions 44% of providers either did not use any specific clinical practice guideline, standardized assessment tool, could not recall the source of a specific tool/guideline or omitted answering the question. However, 61% of all respondents would refer some or all concussion patients to a specialist for treatment. At least 41% of providers indicated they lacked access to a ‘Provider Decision Support Tool’ specific to concussion, and 88% of the 25 providers were without access to discharge instructions. Conclusion Similar to other jurisdictions, Northeastern Ontario primary care physicians and family medicine resident physicians report gaps in knowledge for both diagnosis and management of pediatric concussion. Consequently, they did not use current guidelines or best practices to guide management.