bluuebunny/crossref_metadata_2025_split huggingface dataset:
Summertime Post-Cold-Frontal Marine Stratocumulus Transition Processes over the Eastern North Atlantic
Authors: kazemirad Melissa , Miller Mark A. 
Published: March 2020

AbstractMarine boundary layer (MBL) cloud morphology associated with two summertime cold fronts over the eastern North Atlantic (ENA) is investigated using high-resolution simulations from the Weather Research and Forecasting (WRF) Model and observations from the Atmospheric Radiation Measurement (ARM) ENA Climate Research Facility. Lagrangian trajectories are used to study the evolution of post-cold-frontal MBL clouds from solid stratocumulus to broken cumulus. Clouds within specified domains in the vicinity of transitions are classified according to their degree of decoupling, and cloud-base and cloud-top breakup processes are evaluated. The Lagrangian derivative of the surface latent heat flux is found to be strongly correlated with that of the cloud fraction at cloud base in the simulations. Cloud-top entrainment instability (CTEI) is shown to operate only in the decoupled MBL. A new indicator of inversion strength at cloud top that employs the vertical gradients of equivalent potential temperature and saturation equivalent potential temperature, which can be computed directly from soundings, is proposed as an alternative to CTEI. Overall, results suggest that the deepening–warming hypothesis suggested by Bretherton and Wyant explains many of the characteristics of the summertime postfrontal MBL evolution of cloud structure over the ENA, thereby widening the phase space over which the hypothesis may be applied. A subset of the deepening–warming hypothesis involving warming initially dominating over moistening is proposed. It is postulated that changes in climate change–induced modifications in cold-frontal structure over the ENA may be accompanied by coincident changes in the location and timing of MBL cloud transitions in the post-cold-frontal environment.
Clinical outcome of severe sepsis and septic shock in critically ill children
Authors: Shah Sachin , Kaul Amita , Jadhav Yogesh , Shiwarkar Ganesh 
Published: March 2020

Information concerning the clinical outcome of severe sepsis and septic shock among the burden of tropical infections in children is limited, particularly in low-income settings.  We conducted a prospective consecutive cohort study in all children aged 1 month to 16 years needing paediatric intensive care between 1 January 2017 and 31 December 2018.  Demographic details, presenting symptoms and duration, associated co-morbidity and organ dysfunction were recorded. Clinical and laboratory parameters discriminating between survivors and non-survivors were evaluated.  Most presented with respiratory or central nervous system derangement along with cardiovascular dysfunction. Haematological involvement was almost invariably found on diagnostic evaluation. Those children with ≥3 systems involved had higher odds of mortality. Dengue was seen in half the patients, being the commonest tropical infection. Not surprisingly, non-survivors were younger, had rapid progression of illness and needed ventilation more often within the first hour of admission. However, in multivariable regression analysis, only procalcitonin levels were associated with increased risk of mortality. We conclude that that tropical infections causing severe sepsis and septic shock are an important cause of mortality. There are, however, no clinical parameters which differentiate reliably between survivors and non-survivors.
Buprenorphine use for pain and suicidal ideation in severely suicidal patients
Authors: Gibbs Hunter M , Price Daniel , Delgado Pedro L , Clothier Jeffrey L , Cáceda Ricardo 
Published: March 2020

Objective Chronic pain is frequently comorbid with opioid abuse and severe depression, a combination that greatly compounds suicide risk. In addition to the therapeutic value of buprenorphine in addiction and analgesia, growing evidence suggests potential use as an antidepressant. Data supporting buprenorphine antisuicidal properties are scarce. We aim to contribute to the discussion of buprenorphine antisuicidal potential in patients with significant psychiatric and medical comorbidity. Methods We performed a chart review of suicidal adult depressed patients with comorbid chronic pain and opioid use disorder who received off-label buprenorphine in outpatient and inpatient settings in a university hospital between 2013 and 2016. Results Four of the patients had an early positive response. However, only three continue to adhere to treatment for six months or longer. Conclusions More severe opioid use disorder seems to more negatively influence clinical outcome, independently of cluster b personality traits. Identification of patients who could benefit from buprenorphine will require further studies.
The association between breast cancer risk factors and background parenchymal enhancement at dynamic contrast-enhanced breast MRI
Authors: Hellgren Roxanna , Saracco Ariel , Strand Fredrik , Eriksson Mikael , Sundbom Ann , Hall Per , Dickman Paul W 
Published: March 2020

Background Background parenchymal enhancement (BPE) of normal tissue at breast magnetic resonance imaging is suggested to be an independent risk factor for breast cancer. Its association with established risk factors for breast cancer is not fully investigated. Purpose To study the association between BPE and risk factors for breast cancer in a healthy, non-high-risk screening population. Material and Methods We measured BPE and mammographic density and used data from self-reported questionnaires in 214 healthy women aged 43–74 years. We estimated odds ratios for the univariable association between BPE and risk factors. We then fitted an adjusted model using logistic regression to evaluate associations between BPE (high vs. low) and risk factors, including mammographic breast density. Results The majority of women had low BPE (84%). In a multivariable model, we found statistically significant associations between BPE and age ( P = 0.002) and BMI ( P = 0.03). We did find a significant association between systemic progesterone medication and BPE, but due to small numbers, the results should be interpreted with caution. The adjusted odds ratio for high BPE was 3.1 among women with density D (compared to B) and 2.1 for density C (compared to B). However, the association between high BPE and density was not statistically significant. We did not find statistically significant associations with any other risk factors. Conclusion Our study confirmed the known association of BPE with age and BMI. Although our results show a higher likelihood for high BPE with increasing levels of mammographic density, the association was not statistically significant.
Vestibular-evoked myogenic potentials in patients with severe obstructive sleep apnea
Authors: Gao Tianxi , Zhang Qing , Hou Jin , Zhu Kang , Sun Bin , Chen Jingguo , Xia Cui , Ren Xiaoyong , Cheng Ying , Wang Zhenghui 
Published: March 2020

Objective Previous studies have shown that patients with obstructive sleep apnea syndrome (OSAS) may have various vestibular abnormalities, and these mainly present as subclinical lesions. In this study, we attempted to combine ocular vestibular-evoked myogenic potentials (VEMPs) and cervical (VEMPs) to investigate vestibular dysfunction in patients with OSAS. Methods Thirty-eight patients with severe OSAS and 42 healthy controls were enrolled and divided into two groups according to results of polysomnography. All parameters of VEMP graphs were analyzed. Results The response rate of ocular VEMPs was significantly lower in patients with severe OSAS (85.5%) than in controls (96.4%). The mean n1 latency of patients with severe OSAS (10.6 ± 1.0 months) was significantly longer than that of controls (10.2 ± 1.1 months). With regard to cervical VEMP, p1-n1 amplitudes were significantly different between the groups. Other VEMP parameters were not significantly different between the groups. Conclusions VEMPs can potentially be used to evaluate vestibular system lesions at the early stage of OSAS, including not only the vestibular nerve, but also the otolith organs involved.
Serum proteomic analysis of Mycobacterium tuberculosis antigens for discriminating active tuberculosis from latent infection
Authors: Peng Zhangli , Chen Ling , Zhang Hong 
Published: March 2020

Objective Serum proteomic analysis of tuberculosis (TB) antigens to identify biomarkers enabling discrimination of active TB (ATB) from latent TB infection (LTBI). Methods Serum samples from patients with ATB, individuals with LTBI and healthy controls (HCs) were used to probe proteome microarrays. Based on signal intensities of IgG and IgM antibodies, 100 TB proteins were selected for fabrication of mini-protein microarrays, which were then used to screen 204 serum samples. Results Proteome microarray analyses showed that 58 IgG or IgM specific antibodies were significantly more abundant in ATB patients than in individuals with LTBI or HCs. Serological evaluation of mini-protein microarrays demonstrated that average levels of 15 specific antibodies were higher in ATB patients than in individuals with LTBI or HCs. This combination of 15 TB serum biomarkers had a sensitivity of 85.4% and specificity of 90.3% in discriminating ATB from LTBI. Conclusion Combinations of serum biomarkers can offer improved diagnostic performance in discriminating ATB from LTBI. Five biomarkers (MT1560.1, Rv0049, Rv0270, Rv1597 and Rv3480c) associated with ATB induced stronger IgM responses in these patients.
Prophylactic application of Bakri balloon tamponade versus uterine gauze packing during cesarean section in patients with placenta previa
Authors: Lin Baohua , Zhou Bei , Chen Juanhua , Yang Jinying 
Published: March 2020

Objective This study was performed to compare the effectiveness of routine Bakri balloon tamponade (BBT) and uterine gauze packing (UGP) during cesarean section in patients with placenta previa. Methods This study involved women with placenta previa who underwent cesarean section with either prophylactic BBT (n = 98) or UGP (n = 64) from January 2016 to December 2018. The clinical variables and pregnancy outcomes were compared between the two groups. Results The estimated intraoperative blood loss was significantly lower in the BBT than UGP group (667 ± 358 vs. 791 ± 360 ml, respectively). Additionally, the proportion of patients who required transfusion was significantly lower in the BBT than UGP group (9/98 vs. 17/64, respectively). The operative duration (97.8 ± 17.7 vs. 108.2 ± 16.9 minutes) and the length of stay (3.79 ± 0.89 vs. 4.12 ± 0.85 days) were significantly shorter in the BBT than UGP group. Conclusions In patients with placenta previa who undergo cesarean section, preventive application of BBT is superior to UGP for decreasing the intraoperative blood loss and transfusion rate. BBT is a more reliable technique to prevent and control postpartum hemorrhage.
Association of body mass index and fasting plasma glucose concentration with post-transplantation diabetes mellitus in Chinese heart transplant recipients
Authors: Zhao Tian , Zhao Yinan , Zong Ailun , Tang Yadi , Shi Xiaopeng , Zhou Yingsheng 
Published: March 2020

Objective Post-transplantation diabetes mellitus (PTDM) is a frequent complication after heart transplantation. We investigated the specific predictors of PTDM in Chinese heart transplant recipients and the prognostic value of these predictors. Methods We retrospectively analyzed 122 adult patients who underwent heart transplantation. Comparisons were made between patients with PTDM (n = 44) and those without PTDM (n = 78). Results During the median follow-up of 44 months, the cumulative incidence of PTDM was 19.7% at 1 year after transplantation and 36.1% at the endpoint. PTDM was associated with a significantly higher preoperative body mass index (BMI) (odds ratio [OR] = 1.349), fasting plasma glucose (FPG) concentration (OR = 2.538), and serum uric acid concentration (OR = 1.005) after transplantation. The area under the receiver operating characteristic curve was 0.708 and 0.763 for the BMI and FPG concentration, respectively. The incidence of acute rejection and infection were higher and the all-cause mortality rate was considerably greater in patients with than without PTDM. Conclusions A higher preoperative BMI (>23 kg/m2), FPG concentration (>5.2 mmol/L), and uric acid concentration could potentially predict PTDM in Chinese heart transplant recipients. PTDM influences long-term survival after heart transplantation.
What Is the Role of Civil Society in Multisectoral Nutrition Governance Systems? A Multicountry Review
Authors: Busse Heidi , Covic Namukolo , Aakesson Ashley , Jogo Wellington 
Published: March 2020

Background: Solutions to create enabling nutrition environments must come from within communities and involve multiple sectors. As vital actors in community mobilization, rights-based advocacy, and accountable public institutions, civil society organizations (CSOs) can help ensure nutrition programs and policies represent and reach all community members to achieve impact. Objectives: To review attributes of civic engagement in multisectoral nutrition governance systems and to provide recommendations to increase CSO participation. Methods: We reviewed 7 national case studies of Civil Society Networks involved with the Scaling Up Nutrition movement and characterized 6 functional attributes of CSOs in multisectoral nutrition governance: identify needs of all community members, mobilize and build civic capacity, advocate for political commitments, inform program design and evaluation, ensure accountability mechanisms in public institutions, and report challenges and successes using broad media campaigns. Results: All studies described government agencies involved with multisectoral nutrition governance systems, at national and subnational levels; however, there was limited evidence of subnational platforms for CSO engagement. Although countries increased investments in public institutions for nutrition, it was unclear whether nutrition service quality improved and none reported corresponding investments in civil society. Conclusion: Our characterization identifies strategies to engage CSOs in multisectoral nutrition governance at multiple ecological levels. We hope future adaptation and application of this characterization will increase community ownership and diverse representation in nutrition governance systems. Both of these are key to enabling national and international entities to address malnutrition’s underlying determinants in ways that align with local contexts, values, and systems change processes.
Eye Lens Dosimetry in Interventional Radiology: Assessment With Dedicated Hp(3) Dosimeters
Authors: Merrachi Nassim-Albert , Bouchard-Bellavance Roxanne , Perreault Pierre , Gilbert Patrick , Soulez Gilles , Bouchard Louis , Oliva Vincent L. , Giroux Marie-France , Normandeau Lysanne , Therasse Eric 
Published: March 2020

Purpose: To quantify eye lens dose in interventional radiology and assess whether neck dosimeter is a good surrogate to evaluate eye lens dosimetry. Methods: Radiation exposure was prospectively measured in 9 interventional radiologists between May and October 2017. Standard Hp(0,07) thermoluminescent dosimeters (TLDs) were worn at the neck outside the lead apron, and 2 dedicated eye lens Hp(3) TLDs were placed just above the eyes, one midline and another at the outer edge of the left eye. Correlations between eye lens and neck TLD doses were assessed with Pearson coefficient, and linear regression was used to predict eye lens dose from neck TLD values. Results: Eye lens dose without eye protection was 0.18 ± 0.11 (mean ± standard deviation; 0.08-0.41) mSv per workday and 35.3 ± 6.6 mSv (16.3-82.9) annually (200 workdays/year). Five (56%) radiologists exceeded the 20 mSv annual eye lens dose limit. Eye lens doses from left and central TLDs were 12.46 ± 3.02 and 9.29 ± 3.38 mSv, respectively ( P = .027). Mean eye lens (left and central) and neck TLD doses were 10.87 ± 2.67 and 16.56 ± 5.67 mSv, respectively ( P = .008). Pearson correlation coefficient between both eye lens TLD and between mean eye lens TLD and neck TLD doses were 0.91 and 0.92, respectively. Average of eye lens dose was 0.0179 + (0.5971 × neck dose). Conclusion: Full-time interventional radiologists are likely to suffer from deterministic radiation effects to the eye lens, especially on the left side. Neck TLD significantly overestimates eye lens dose. However, eye lens doses are highly correlated with neck doses and may be predicted from the neck TLD values.
Student nurses’ ethical views on responses to the severe acute respiratory syndrome outbreak
Authors: Kam Joseph KM , Chan Eric , Lee Albert , Wei Vivian WI , Kwok Kin On , Lui Dominic , Yuen Robert KN 
Published: March 2020

Background Fifteen years have passed since the outbreak of severe acute respiratory syndrome in Hong Kong. At that time, there were reports of heroic acts among professionals who cared for these patients, whose bravery and professionalism were highly praised. However, there are concerns about changes in new generation of nursing professionals. Objective We aimed to examine the attitude of nursing students, should they be faced with severe acute respiratory syndrome patients during their future work. Research design A questionnaire survey was carried out to examine the attitude among final-year nursing students to three ethical areas, namely, duty of care, resource allocation, and collateral damage. Ethical considerations This study was carried out in accordance with the requirements and recommendations of the Central Research and Ethics Committee, School of Health Sciences at Caritas Institute of Higher Education. Findings Complete responses from 102 subjects were analyzed. The overwhelming majority (96.1%) did not agree to participate in the intubation of severe acute respiratory syndrome patients if protective measures, that is, N95 mask and gown, were not available. If there were insufficient N95 masks for all the medical, nursing, and allied health workers in the hospital (resource allocation), 37.3% felt that the distribution of N95 masks should be by casting lot, while the rest disagreed. When asked about collateral damage, more than three-quarters (77.5%) said that severe acute respiratory syndrome patients should be admitted to intensive care unit. There was sex difference in nursing students’ attitude toward severe acute respiratory syndrome care during pregnancy and influence of age in understanding intensive care unit care for these patients. Interestingly, 94.1% felt that there should be a separate intensive care unit for severe acute respiratory syndrome patients. Conclusion As infection control practice and isolation facilities improved over the years, relevant knowledge and nursing ethical issues related to infectious diseases should become part of nursing education and training programs, especially in preparation for outbreaks of infectious diseases or distress.
Elasticities of Gold Demand—An Empirical Analysis Using Cointegration and Error Correction Model
Authors: Immanuvel S. Maria , Lazar D. 
Published: March 2020

This article examines the long-run and the short-run elastic relationships between price, income and gold demand. Four major gold consuming countries in the world, such as India, the USA, Europe and Japan, are included in the analysis. The study period is from January 2000 to December 2017. Using the Cointegration and Error Correction model, we found a long-run relationship between gold demand, price and income of the consumers. Price elasticity is negative and income elasticity is positive in the long run. The speed of error correction is slightly higher for India. Indian gold market takes a shorter time to get back to its equilibrium than the other major gold consuming countries. India’s overall gold consumption is relatively lesser reactive to the fluctuations in the world gold price than the other countries. Consumers in India react expeditiously in the short run and their response to the price changes is stable in the long run. More than 70 per cent of India’s gold consumption is unaffected by the price fluctuations. This behaviour eventually increases the wealth in the country. Hence the study suggests that instead of curbing the demand, new financial products may be developed to monetise the gold lying idle in the households. Various gold monetisation schemes already launched by the government should reach especially the rural section, as most of them may not be aware of these schemes. This may tend to bring a considerable amount of gold into the system. JEL: G14, Q02, Q21
Deliberate corrosive substance attacks – A systematic review
Authors: Moffatt S , Rhimes P 
Published: March 2020

Introduction Deliberate corrosive substance attacks (DCSA) have traditionally been associated with low- and middle-income countries (LMIC). However, the incidence of DCSA in certain geographical locations of the UK has increased in recent years. These attacks have a relatively low mortality rate but cause extensive life-changing injuries and the management from point of wounding to definitive care is challenging for all involved. Methods A systematic review was used to identify literature about DCSA and establish how much evidence about these attacks has been published over the last decade. Victim and perpetrator characteristics, substances used, injury patterns, mortality, pre-hospital and hospital-based management and complications associated with management were areas of interest. The review included any medical literature (case reports, letters, reviews) published within the last 10 years that described DCSA against human victims. Non-English language articles were excluded. Results Eighteen articles containing 762 victims of DCSA were included; seven victims had incomplete data. Articles were mostly from LMIC (Bangladesh, Columbia, Cambodia, India, Iran, Sri Lanka and Pakistan) but there were five articles were from the UK (three ‘Letters to Editors’, one survivor letter and one retrospective review of 21 victims). UK victim and perpetrator characteristics varied from those in LMIC. Seven papers described pre-hospital management and nine described hospital/surgical management. Conclusions The evidence base surrounding DCSA is limited especially in the UK setting. More research into the epidemiology and management of DCSA in the UK is warranted.