bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hookah venue employees’ knowledge and perceptions of hookah tobacco smoking
Authors: Crape Byron Lawrence , Yakhiyayeva Tansholpan , Kadyrzhanuly Kainar , Gusmanov Arnur , Sadykova Dzhamilya 
Published: April 2020

BackgroundRecent years showed sharp proliferation of hookah bars worldwide with scarcity of workplace safety regulations. Hookah server employees are at high risk for elevated harm. This study reported hookah smoke exposure, assessed acute problems and evaluated factors related to knowledge of hookah-smoking harm and toxicity among high-risk hookah servers.MethodsA mixed methods design was employed. A self-reported questionnaire was distributed online, and semistructured in-depth interviews were used. Hookah server employees were recruited using snowball sampling, with 52 participants included in quantitative analyses and 10 participating in semistructured interviews.ResultsHookah server employees took a median 389 hookah puffs per workday compared with 169–170 per session for customers. Servers were limited in knowledge of potential hookah harms and smoke toxicant exposure. Almost all believed that hookah water bowls filtered out toxicants. Smoking with family members (p=0.012) was associated with lower knowledge scores for hookah harms and exposure. Hookah server employees reported carbon monoxide-poisoning symptoms of dizziness, headaches and fainting during work but believed their bodies would adapt. Home remedies were taken to alleviate symptoms. Work environment and salary attracted hookah server employees to their position and none considered quitting for reasons of harm.ConclusionFindings demonstrate need for workplace policies and regulations to protect hookah server employees and provide targets for educational interventions for high-risk hookah server employees.
High mortality in a sheep flock caused by coinfection of louping ill virus and Anaplasma phagocytophilum
Authors: Daniel Roger , Hopkins Beverley Ann Mary , Rocchi Mara S , Wessels Mark , Floyd Tobias 
Published: April 2020

Fifty‐three of a mixed flock of 180 one‐year‐old lambs (hoggs) and older, barren ewes (ewes that were non‐pregnant or had not lambed that spring) died in May 2019 following introduction to 30 acres of unimproved hill pasture. The flock was moved onto this pasture in early May, and clinical signs and deaths were observed 14 days later. Clinical signs included dyspnoea, lethargy, and sternal and lateral recumbency; the majority were found dead. The flock was removed from the hill the day after the first deaths were discovered. Deaths continued for a further 14 days until a total of 53 animals had died. Three hoggs were submitted for postmortem examination to the Wales Veterinary Science Centre. Anaplasma phagocytophilum, the causal organism of tickborne fever, was detected by PCR testing. Coinfection with louping ill virus was also suspected and later confirmed. The laboratory findings are described, and the risk of these diseases to grazing sheep in upland areas is discussed, as well as the measures being taken to reduce the risk of infection.
Glioblastoma-mediated Immune Dysfunction Limits CMV-specific T Cells and Therapeutic Responses: Results from a Phase I/II Trial
Authors: Weathers Shiao-Pei , Penas-Prado Marta , Pei Be-Lian , Ling Xiaoyang , Kassab Cynthia , Banerjee Pinaki , Bdiwi Mustafa , Shaim Hila , Alsuliman Abdullah , Shanley Mayra , de Groot John F. , O'Brien Barbara J. , Harrison Rebecca , Majd Nazanin , Kamiya-Matsuoka Carlos , Fuller Gregory N. , Huse Jason T. , Chi Linda , Rao Ganesh , Weinberg Jeffrey S. , Lang Frederick F. , Sawaya Raymond , Shpall Elizabeth J. , Rezvani Katayoun , Heimberger Amy B. 
Published: April 2020

Abstract

Purpose:
Cytomegalovirus (CMV) antigens occur in glioblastoma but not in normal brains, making them desirable immunologic targets.

Patients and Methods:
Highly functional autologous polyclonal CMV pp65-specific T cells from patients with glioblastoma were numerically expanded under good manufacturing practice compliant conditions and administered after 3 weeks of lymphodepleting dose-dense temozolomide (100 mg/m2) treatment. The phase I component used a 3+3 design, ascending through four dose levels (5 × 106–1 × 108 cells). Treatment occurred every 6 weeks for four cycles. In vivo persistence and effector function of CMV-specific T cells was determined by dextramer staining and multiparameter flow cytometry in serially sampled peripheral blood and in the tumor microenvironment.

Results:
We screened 65 patients; 41 were seropositive for CMV; 25 underwent leukapheresis; and 20 completed ≥1 cycle. No dose-limiting toxicities were observed. Radiographic response was complete in 1 patient, partial in 2. Median progression-free survival (PFS) time was 1.3 months [95% confidence interval (CI), 0–8.3 months]; 6-month PFS was 19% (95% CI, 7%–52%); and median overall survival time was 12 months (95% CI, 6 months to not reached). Repeated infusions of CMV-T cells paralleled significant increases in circulating CMV+ CD8+ T cells, but cytokine production showing effector activity was suppressed, especially from T cells obtained directly from glioblastomas.

Conclusions:
Adoptive infusion of CMV-specific T cells after lymphodepletion with dose-dense temozolomide was well tolerated. But apparently CMV seropositivity does not guarantee tumor susceptibility to CMV-specific T cells, suggesting heterogeneity in CMV antigen expression. Moreover, effector function of these T cells was attenuated, indicating a requirement for further T-cell modulation to prevent their dysfunction before conducting large-scale clinical studies.
Multiplexed Evaluation of Microdosed Antineoplastic Agents In Situ in the Tumor Microenvironment of Patients with Soft Tissue Sarcoma
Authors: Gundle Kenneth R. , Deutsch Gary B. , Goodman Howard J. , Pollack Seth M. , Thompson Matthew J. , Davis Jessica L. , Lee Mee-Young , Ramirez Daniel C. , Kerwin William , Bertout Jessica A. , Grenley Marc O. , Sottero Kimberly H.W. , Beirne Emily , Frazier Jason , Dey Joyoti , Ellison Micah , Klinghoffer Richard A. , Maki Robert G. 
Published: April 2020

Abstract

Purpose:
A persistent issue in cancer drug development is the discordance between robust antitumor drug activity observed in laboratory models and the limited benefit frequently observed when patients are treated with the same agents in clinical trials. Difficulties in accurately modeling the complexities of human tumors may underlie this problem. To address this issue, we developed Comparative In Vivo Oncology (CIVO), which enables in situ investigation of multiple microdosed drugs simultaneously in a patient's tumor. This study was designed to test CIVO's safety and feasibility in patients with soft tissue sarcoma (STS).

Patients and Methods:
We conducted a single arm, prospective, 13-patient pilot study. Patients scheduled for incisional biopsy or tumor resection were CIVO-injected 1 to 3 days prior to surgery. Saline or microdoses of anticancer agents were percutaneously injected into the tumor in a columnar fashion through each of eight needles. Following excision, drug responses were evaluated in the injected tissue.

Results:
The primary objective was met, establishing CIVO's feasibility and safety. Device-related adverse events were limited to transient grade 1 nonserious events. In addition, biomarker evaluation of localized tumor response to CIVO microinjected drugs by IHC or with NanoString GeoMx Digital Spatial Profiler demonstrated consistency with known mechanisms of action of each drug, impact on the tumor microenvironment, and historic clinical activity.

Conclusions:
These results are an advance toward use of CIVO as a translational research tool for early evaluation of investigational agents and drug combinations in a novel approach to phase 0 trials.
See related commentary by Sleijfer and Lolkema, p. 3897
Acute Neurological Deterioration in Large Vessel Occlusions and Mild Symptoms Managed Medically
Authors: Saleem Yasir , Nogueira Raul G. , Rodrigues Gabriel M. , Kim Song , Sharashidze Vera , Frankel Michael , Al-Bayati Alhamza , Bianchi Nicolas , Haussen Diogo C. 
Published: April 2020

Background and Purpose—
It is unclear which factors predict acute neurological deterioration in patients with large vessel occlusion and mild symptoms. We aim to evaluate the frequency, timing, and potential predictors of acute neurological deterioration ≥4 National Institutes of Health Stroke Scale (NIHSS) points in medically managed patients with large vessel occlusion and mild presentation.

Methods—
Single-center retrospective study of patients with consecutive minor stroke (defined as NIHSS score of ≤5 on presentation) and large vessel occlusion from January 2014 to December 2017. Primary outcome was acute neurological deterioration ≥4 NIHSS points during the hospitalization. Secondary outcomes included ΔNIHSS (defined as discharge minus admission NIHSS score).

Results—

Among 1133 patients with acute minor strokes, 122 (10.6%) had visible occlusions on computed tomography angiography/magnetic resonance angiography. Twenty-four (19.7%) patients had ≥4 points deterioration on NIHSS at a median of 3.6 (1–16) hours from arrival. No clinical or radiological predictors of acute neurological deterioration ≥4 NIHSS points were observed on multivariable analysis. Rescue endovascular thrombectomy was performed more often in the ones with acute neurological deterioration ≥4 NIHSS points compared with patients with no deterioration (54% versus 0%;
P
<0.001). Acute neurological deterioration ≥4 NIHSS points was associated with ΔNIHSS ≥4 points (33% versus 4.9%;
P
<0.01) and a trend toward lower independence rates at discharge (50% versus 70%;
P
=0.06) compared with the group with no deterioration. In patients with any degree of neurological worsening, patients who underwent rescue thrombectomy were more likely to be independent at discharge (73% versus 38%;
P
=0.02) and to have a favorable ΔNIHSS (−2 [−3 to 0] versus 0 [−1 to 6];
P
=0.05) compared with the ones not offered rescue thrombectomy.

Conclusions—
Acute neurological deterioration ≥4 NIHSS points was observed in a fifth of patients with large vessel occlusion and mild symptoms, occurred very early in the hospital course, impacted functional outcomes, and could not be predicted by any of the studied clinical and radiological variables. Rescue thrombectomy was associated with improved clinical outcomes at discharge in patients with neurological deterioration.
<p><strong><em>Passiflora nana</em></strong><strong>, a new species in <em>Passiflora</em> section <em>Decaloba</em> (Passifloraceae) from northern Peru</strong></p>
Authors: MACDOUGAL JOHN M. , ESQUERRE-IBAÑEZ BORIS 
Published: April 2020

A new species of Passiflora L. endemic to cloud forest in northern Peru, P. nana, is described and illustrated from living and herbarium material. The new species is similar to the Colombian P. erythrophylla in flower and Ecuadorian P. hirtiflora in vestiture. The indument is pilose to hispidulous throughout with long straight white trichomes, and the plant is short, less than 2.5 m long, with a very small flower ca. 1.5 cm diam. It is placed in subgenus Decaloba supersection Decaloba section Decaloba.
Severe Historical Droughts Carved on Rock in the Yangtze
Authors: Qin Jun , Shi Ailin , Ren Guoyu , Chen Zhenghong , Yang Yuda , Zou Xukai , Zhang Panfeng 
Published: April 2020

AbstractThe White Crane Ridge (WCR) Rock Fish, now submerged under the backwater of the Three Gorges Reservoir in the Yangtze River, are affirmed as one of the earliest hydrologic observations ever made in any large river in the world. The usually in-water monument provides highly valuable historical records of severe droughts in the upper Yangtze over the last 1,200 years. This article updated the historical drought chronology previously developed based on the WCR inscriptions, which can be applied in assessment of extreme climatic and hydrological risks, and also made a preliminary analysis of changes of the severe drought frequency during the last thousand years in the upper Yangtze. The analysis shows that the severe droughts occurred more frequently during the Medieval Climate Anomaly (MCA), relatively less so during the Little Ice Age (LIA), and once again more often under the background of modern global warming. It was suggested that a generally warmer Euro-Asian continent during the MCA was in favor of the stronger East Asian summer monsoon, and the resulting less precipitation and more severe droughts of the Yangtze and the lower water level at the Three Gorges area on the centennial scale, and vice versa for the period of the LIA. The results would help in understanding the causes and mechanisms of the regional climate change and variability, and also in taking measures in the fields of the watershed management to cope with the long-term change in climatic and hydrologic droughts.
Toward Monitoring Short-Term Droughts Using a Novel Daily Scale, Standardized Antecedent Precipitation Evapotranspiration Index
Authors: Li Jun , Wang Zhaoli , Wu Xushu , Xu Chong-Yu , Guo Shenglian , Chen Xiaohong 
Published: April 2020

AbstractRecent events across many regions around the world have shown that short-term droughts (i.e., daily or weekly) with sudden occurrence can lead to huge losses to a wide array of environmental and societal sectors. However, the most commonly used drought indices can only identify drought at the monthly scale. Here, we introduced a daily scale drought index, that is, the standardized antecedent precipitation evapotranspiration index (SAPEI) that utilizes precipitation and potential evapotranspiration and also considers the effect of early water balance on dry/wet conditions on the current day. The robustness of SAPEI is first assessed through comparison with two typical monthly indices [Palmer drought severity index (PDSI) and standardized precipitation evapotranspiration index (SPEI)] and soil moisture, and then applied to tracking short-term droughts during 1961–2015 for the Pearl River basin in south China. It is demonstrated that SAPEI performs as well as SPEI/self-calibrating PDSI at the monthly scale but outperforms SPEI at the weekly scale. Moreover, SAPEI is capable of revealing daily drought conditions, fairly consistent with soil moisture changes. Results also show that many of the historical short-term droughts over the Pearl River basin have multiple peaks in terms of severity, affected area, and intensity. The daily scale SAPEI provides an effective way of exploring drought initiation, development, and decay, which could be conducive for decision-makers and stakeholders to make early and timely warnings.
Sensitivities of the WRF Lightning Forecasting Algorithm to Parameterized Microphysics and Boundary Layer Schemes
Authors: McCaul Eugene W. , Priftis Georgios , Case Jonathan L. , Chronis Themis , Gatlin Patrick N. , Goodman Steven J. , Kong Fanyou 
Published: April 2020

AbstractThe Lightning Forecasting Algorithm (LFA), a simple empirical procedure that transforms kinematic and microphysical fields from explicit-convection numerical models into mapped fields of estimated total lightning flash origin density, has been incorporated into operational forecast models in recent years. While several changes designed to improve LFA accuracy and reliability have been implemented, the basic linear relationship between model proxy amplitudes and diagnosed total lightning flash rate densities remains unchanged. The LFA has also been added to many models configured with microphysics and boundary layer parameterizations different from those used in the original study, suggesting the need for checks of the LFA calibration factors. To assist users, quantitative comparisons of LFA output for some commonly used model physics choices are performed. Results are reported here from a 12-member ensemble that combines four microphysics with three boundary layer schemes, to provide insight into the extent of LFA output variability. Data from spring 2018 in Nepal–Bangladesh–India show that across the ensemble of forecasts in the entire three-month period, the LFA peak flash rate densities all fell within a factor of 1.21 of well-calibrated LFA-equipped codes, with most schemes failing to show differences that are statistically significant. Sensitivities of threat areal coverage are, however, larger, suggesting substantial variation in the amounts of ice species produced in storm anvils by the various microphysics schemes. Current explicit-convection operational models in the United States employ schemes that are among those exhibiting the larger biases. For users seeking optimum performance, we present recommended methods for recalibrating the LFA.
Clozapine use – has practice changed?
Authors: Rowntree Roberta , Murray Sean , Fanning Felicity , Keating Dolores , Szigeti Atilla , Doyle Roisin , McWilliams Stephen , Clarke Mary 
Published: April 2020

Background: One-third of individuals with schizophrenia have treatment-resistant illness. Of these, up to 60% will respond to clozapine treatment. Aims: This study retrospectively examined clozapine prescribing patterns against National Institute for Health and Care Excellence (NICE) guidelines as treatment-resistant illness emerged in a first-episode psychosis cohort. Methods: A total of 339 individuals with a first-episode psychosis were included in the study. Clozapine prescribing patterns were compared against the NICE guidelines and the impact of clozapine use on one index of service utilisation (hospitalisation) was assessed. Results: A total of 32 individuals (9.4%) from the cohort were prescribed clozapine. The mean time to clozapine trial was 2.1 years (SD 1.95; range 0.17–6.25). The mean number of adequate trials of antipsychotic prior to starting clozapine was 2.74 (SD 1.13; range 1–5). Following clozapine initiation, mean hospital admissions per year reduced from 2.3 to 0.3 ( p=0.00). Mean hospital days pre- and post-clozapine also reduced (147 vs. 53; p=0.00). In total, 18 patients discontinued clozapine use during follow-up – 5 temporarily and 13 permanently. Conclusions: Patients are being prescribed clozapine earlier than previously demonstrated, though delays are still evident, and many patients discontinue treatment. More work needs to be undertaken to understand and address factors which lead to its discontinuation.
Increased neck muscle stiffness in migraine patients with ictal neck pain: A shear wave elastography study
Authors: Hvedstrup Jeppe , Kolding Lærke Tørring , Ashina Messoud , Schytz Henrik Winther 
Published: April 2020

Background Ictal neck pain is a frequent symptom reported by half of migraine patients. It is unknown if neck pain is caused by peripheral or central mechanisms. Neck muscle stiffness can be investigated with ultrasound shear wave elastography. Objectives To determine if migraine patients with ictal neck pain have stiffer neck muscles interictally compared with patients without ictal neck pain and controls. Methods This was a cross-sectional study investigating neck muscle stiffness, pressure pain thresholds and neck pain symptoms in 100 migraine patients recruited from a tertiary headache center and 46 controls. Results Patients with ictal neck pain had increased mean neck muscle stiffness interictally compared to both migraine patients without ictal neck pain ( p = 0.018) and controls ( p = 0.036). Muscle stiffness was negatively correlated with pressure pain thresholds in the neck in migraine patients with ictal neck pain (r = −0.292, p = 0.042). There were no differences in mean pressure pain thresholds between migraine subgroups. Conclusions Migraine patients with ictal neck pain have stiffer neck muscles interictally compared with migraine patients without ictal neck pain and controls measured with ultrasound shear wave elastography. The increased stiffness could be due to local alterations in the neck muscles. Trial registration: clinical-trials.gov, identifier: NCT03626805
Paroxysmal headache with extracephalic irradiation: Proposal for a new variant of epicrania fugax in a series of five patients
Authors: Gutiérrez-Sánchez María , García-Azorín David , Gutiérrez-Viedma Álvaro , González-García Nuria , Horga Alejandro , Martín Susana , Guerrero Ángel L , Cuadrado María-Luz 
Published: April 2020

Background Epicrania fugax consists of brief paroxysms of pain, which radiate in a line or in zigzag trajectory across the surface of the scalp or the face. Methods A prospective, descriptive study was performed in five patients presenting with an epicrania fugax-type pain with extracephalic irradiation. Results All patients were women, and the mean age at onset was 59.8 (standard deviation, 10.9). They had unilateral paroxysms of electrical pain starting at a particular point in the head (parietal, n = 3; vertex, n = 1; frontal, n = 1) and rapidly radiating downwards in a lineal trajectory to reach extracephalic regions (ipsilateral limbs, n = 2; shoulder, n = 2; low neck, n = 1) in 1–3 seconds. Pain intensity was moderate or severe. Three patients had nummular headache at the point where the paroxysms originated. One patient had spontaneous remission, and four patients achieved complete or almost complete response with therapy (onabotulinumtoxinA, n = 2; indomethacin, n = 1; amitriptyline, n = 1; lamotrigine, n = 1). Conclusion The spectrum of epicrania fugax may include paroxysms with extracephalic irradiation. The propagation of pain beyond the head and the face supports the involvement of central mechanisms in the pathophysiology of this entity.
Tear Completion Versus In Situ Repair for 50% Partial-Thickness Bursal-Side Rotator Cuff Tears: A Biomechanical and Histological Study in an Animal Model
Authors: Pulatkan Anil , Anwar Wasim , Ayık Omer , Bozdag Ergun , Yildirim Ayse Nur , Kapicioglu Mehmet , Tuncay Ibrahim , Bilsel Kerem 
Published: April 2020

Background: Tear completion followed by repair (TCR) and in situ repair (ISR) have been widely used for bursal-side partial-thickness rotator cuff tears (PTRCTs). Both techniques have shown favorable results; however, controversy continues in terms of the best management. Purpose: To compare the histological and biomechanical outcomes of these 2 techniques for 50% partial-thickness bursal-side rotator cuff tear repair in a rabbit model. Study Design: Controlled laboratory study. Methods: A total of 27 rabbits were used in this experimental study. Seven rabbits were sacrificed at the beginning of the study to form an intact tendon control group. A chronic 50% partial-thickness bursal-side tear model was created in 20 rabbits, and 5 rabbits were sacrificed for biomechanical testing of chronic partial-thickness tears (control group) without repair. In 15 rabbits, partial-thickness tears were repaired after 8 weeks. Partial-thickness tears in the right shoulders were completed to full thickness and repaired; in contrast, left shoulders were repaired in situ. All rabbits were euthanized 8 weeks after the repair. The tendons were tested biomechanically for ultimate failure, linear stiffness, and displacement. Histological evaluations of tendon-to-bone healing were performed via the modified Watkins score. Results: Macroscopically, all repaired tendons were attached to the greater tuberosity. The TCR group had a higher failure load than the ISR group, with mean values of 140.4 ± 13.8 N and 108.1 ± 16.6 N, respectively ( P = .001). The modified Watkins score was significantly higher in the TCR group (23.5; range, 22-27) than in the ISR group (19.5; range, 16-22) ( P = .009). Conclusion: Both repair techniques are effective for 50% partial-thickness bursal-side rotator cuff tears; however, TCR yields significantly superior biomechanical and histological characteristics compared with ISR. Clinical Relevance: Tear completion and repair technique may increase tendon-to-bone healing and thereby reduce re-rupture rate in the partial thickness bursal side rotator cuff tears.