bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association Between Periodontal Disease and Breast Cancer in a Prospective Cohort Study
Authors: Jia Mengmeng , Wu Zeni , Vogtmann Emily , O'Brien Katie M. , Weinberg Clarice R. , Sandler Dale P. , Gierach Gretchen L. 
Published: July 2020

Abstract
Periodontal disease may be associated with increased breast cancer risk, but studies have not considered invasive breast cancer and ductal carcinoma in situ (DCIS) separately in the same population. We assessed the relationship between periodontal disease and breast cancer in a large prospective cohort study. The Sister Study followed women without prior breast cancer ages 35 to 74 years from 2003 to 2017 (N = 49,968). Baseline periodontal disease was self-reported, and incident breast cancer was ascertained over a mean follow-up of 9.3 years. We estimated hazard ratios (HR) and 95% confidence intervals (CI) using Cox proportional hazards regression, adjusting for multiple potential confounders, including smoking status. Heterogeneity in risk for invasive breast cancer versus DCIS was also estimated. About 22% of participants reported a history of periodontal disease at baseline. A total of 3,339 incident breast cancers (2,607 invasive breast cancer, 732 DCIS) were identified. There was no clear association between periodontal disease and overall breast cancer risk (HR = 1.02; 95% CI, 0.94–1.11). However, we observed a nonstatistically significant suggestive increased risk of invasive breast cancer (HR = 1.07; 95% CI, 0.97–1.17) and decreased risk of DCIS (HR = 0.86; 95% CI, 0.72–1.04) associated with periodontal disease, with evidence for heterogeneity in the risk associations (relative HR for invasive breast cancer versus DCIS = 1.24; 95% CI, 1.01–1.52). A case-only analysis for etiologic heterogeneity confirmed this difference. We observed no clear association between periodontal disease and overall breast cancer risk. The heterogeneity in risk associations for invasive breast cancer versus DCIS warrants further exploration.
Ischemic Preconditioning Improves Microvascular Endothelial Function in Remote Vasculature by Enhanced Prostacyclin Production
Authors: Rytter Nicolai , Carter Howard , Piil Peter , Sørensen Henrik , Ehlers Thomas , Holmegaard Frederik , Tuxen Christoffer , Jones Helen , Thijssen Dick , Gliemann Lasse , Hellsten Ylva 
Published: July 2020

BACKGROUND
The mechanisms underlying the effect of preconditioning on remote microvasculature remains undisclosed. The primary objective was to document the remote effect of ischemic preconditioning on microvascular function in humans. The secondary objective was to test if exercise also induces remote microvascular effects.

METHODS AND RESULTS

A total of 12 healthy young men and women participated in 2 experimental days in a random counterbalanced order. On one day the participants underwent 4×5 minutes of forearm ischemic preconditioning, and on the other day they completed 4×5 minutes of hand‐grip exercise. On both days, catheters were placed in the brachial and femoral artery and vein for infusion of acetylcholine, sodium nitroprusside, and epoprostenol. Vascular conductance was calculated from blood flow measurements with ultrasound Doppler and arterial and venous blood pressures. Ischemic preconditioning enhanced (
P
<0.05) the remote vasodilator response to intra‐arterial acetylcholine in the leg at 5 and 90 minutes after application. The enhanced response was associated with a 6‐fold increase (
P
<0.05) in femoral venous plasma prostacyclin levels and with a transient increase (
P
<0.05) in arterial plasma levels of brain‐derived neurotrophic factor and vascular endothelial growth factor. In contrast, hand‐grip exercise did not influence remote microvascular function.

CONCLUSIONS
These findings demonstrate that ischemic preconditioning of the forearm improves remote microvascular endothelial function and suggest that one of the underlying mechanisms is a humoral‐mediated potentiation of prostacyclin formation.
Disparities in Premature Cardiac Death Among US Counties From 1999–2017: Temporal Trends and Key Drivers
Authors: Jin Yinzi , Song Suhang , Zhang Lin , Trisolini Michael G. , Labresh Kenneth A. , Smith Sidney C. , Zheng Zhi‐Jie 
Published: July 2020

Background
Disparities in premature cardiac death (PCD) might stagnate the progress toward the reduction of PCD in the United States and worldwide. We estimated disparities across US counties in PCD rates and investigated county‐level factors related to the disparities.

Methods and Results

We used US mortality data for cause‐of‐death and demographic data from death certificates and county‐level characteristics data from multiple databases. PCD was defined as any death that occurred at an age between 35 and 74 years with an underlying cause of death caused by cardiac disease based on
International Classification of Diseases, Tenth Revision
(
ICD‐10
), codes. Of the 1 598 173 PCDs that occurred during 1999–2017, 60.9% were out of hospital. Although the PCD rates declined from 1999–2017, the proportion of out‐of‐hospital PCDs among all cardiac deaths increased from 58.3% to 61.5%. The geographic disparities in PCD rates across counties widened from 1999 (Theil index=0.10) to 2017 (Theil index=0.23), and within‐state differences accounted for the majority of disparities (57.4% in 2017). The disparities in out‐of‐hospital PCD rates (and in‐hospital PCD rates) associated with demographic composition were 36.51% (and 37.51%), socioeconomic features were 18.64% (and 18.36%), healthcare environment were 18.64% (and 13.90%), and population health status were 23.73% (and 30.23%).

Conclusions
Disparities in PCD rates exist across US counties, which may be related to the decelerated trend of decline in the rates among middle‐aged adults. The slower declines in out‐of‐hospital rates warrants more precision targeting and sustained efforts to ensure progress at better levels of health (with lower PCD rates) against PCD.
<p><strong>The nomenclature and taxonomy of <em>Kalanchoe nyikae</em> (Crassulaceae subfam. Kalanchooideae), a little-known species from East Africa</strong></p>
Authors: SMITH GIDEON F. , FIGUEIREDO ESTRELA 
Published: July 2020

From the 1950s to the 1980s the East African taxa of Kalanchoe Adanson (1763: 248) (Crassulaceae subfam. Kalanchooideae) received taxonomic attention in a series of papers by Cufodontis (1957, 1958, 1965, 1967, 1969), Raadts (1977, 1979, 1984, 1985, 1989), and Wickens (1982, 1987) that culminated in the treatment of the genus by Wickens (1987: 30–58) for the Flora of Tropical East Africa (FTEA; Uganda, Kenya, Tanzania). Wickens (1987) recognised 25 Kalanchoe species in the FTEA region, with two species, K. ndorensis Schweinfurth (1892: 865 [as name only in Engler (1892: 232)]) and K. stuhlmannii Engler (1895: 188), treated as imperfectly known.
A New Parameterization of the Accretion of Cloud Water by Snow and Its Evaluation through Simulations of Mesoscale Convective Systems
Authors: Jin Han-Gyul , Baik Jong-Jin 
Published: July 2020

Abstract
A new parameterization of the accretion of cloud water by snow for use in bulk microphysics schemes is derived as an analytic approximation of the stochastic collection equation (SCE), where the theoretical collision efficiency for individual snowflake–cloud droplet pairs is applied. The snowflake shape is assumed to be nonspherical with the mass–size and area–size relations suggested by an observational study. The performance of the new parameterization is compared to two parameterizations based on the continuous collection equation, one with the spherical shape assumption for snowflakes (SPH-CON), and the other with the nonspherical shape assumption employed in the new parameterization (NSP-CON). In box model simulations, only the new parameterization reproduces a relatively slow decrease in the cloud droplet number concentration, which is predicted by the direct SCE solver. This results from considering the preferential collection of cloud droplets depending on their sizes in the new parameterization based on the SCE. In idealized squall-line simulations using a cloud-resolving model, the new parameterization predicts heavier precipitation in the convective core region compared to SPH-CON, and a broader area of the trailing stratiform rain compared to NSP-CON due to the horizontal advection of greater amount of snow in the upper layer. In the real-case simulations of a line-shaped mesoscale convective system that passed over the central Korean Peninsula, the new parameterization predicts higher frequencies of light precipitation rates and lower frequencies of heavy precipitation rates. The relatively large amount of upper-level snow in the new parameterization contributes to a broadening of the area with significant snow water path.
A Study of the Interaction between Typhoon Francisco (2013) and a Cold-Core Eddy. Part II: Boundary Layer Structures
Authors: Ma Zhanhong , Fei Jianfang , Huang Xiaogang , Cheng Xiaoping , Liu Lei 
Published: July 2020

Abstract
In Part II of this study, the influence of an oceanic cold-core eddy on the atmospheric boundary layer structures of Typhoon Francisco (2013) is investigated, as well as a comparison with the cold wake effect. Results show that the eddy induces shallower mixed-layer depth and forms stable boundary layer above and near it. The changes of these features shift from northwest to southeast across the storm eye, following the translation of Francisco over the eddy. Nonetheless, the decrease in mixed-layer depth and formation of stable boundary layer caused by the cold wake are located at right rear of the storm. The sensible heat fluxes at the lowest atmospheric model level are mostly downward over the sea surface cooling region. Due to their different relative locations with Francisco, the diabatic heating in the northwest quadrant of the storm can be more effectively inhibited by the cold-core eddy than by the cold wake. The asymmetric characteristics of surface tangential wind are less sensitive to sea surface cooling than those of surface radial wind, implying a change in surface inflow angle. Different from previous studies, the surface inflow angle is found to be reduced especially above the cold-core eddy and cold wake region. An analysis of radial wind tendency budget indicates that the decrease in radial pressure gradient is dominant in changing the acceleration rate of surface radial wind, rather than the decrease in the Coriolis and centrifugal forces, and therefore more outward surface flow is induced by both the cold-core eddy and cold wake.
Incorporation of Satellite Precipitation Uncertainty in a Landslide Hazard Nowcasting System
Authors: Hartke Samantha H. , Wright Daniel B. , Kirschbaum Dalia B. , Stanley Thomas A. , Li Zhe 
Published: July 2020

AbstractMany existing models that predict landslide hazards utilize ground-based sources of precipitation data. In locations where ground-based precipitation observations are limited (i.e., a vast majority of the globe), or for landslide hazard models that assess regional or global domains, satellite multisensor precipitation products offer a promising near-real-time alternative to ground-based data. NASA’s global Landslide Hazard Assessment for Situational Awareness (LHASA) model uses the Integrated Multisatellite Retrievals for Global Precipitation Measurement (IMERG) product to issue hazard “nowcasts” in near–real time for areas that are currently at risk for landsliding. Satellite-based precipitation estimates, however, can contain considerable systematic bias and random error, especially over mountainous terrain and during extreme rainfall events. This study combines a precipitation error modeling framework with a probabilistic adaptation of LHASA. Compared with the routine version of LHASA, this probabilistic version correctly predicts more of the observed landslides in the study region with fewer false alarms by high hazard nowcasts. This study demonstrates that improvements in landslide hazard prediction can be achieved regardless of whether the IMERG error model is trained using abundant ground-based precipitation observations or using far fewer and more scattered observations, suggesting that the approach is viable in data-limited regions. Results emphasize the importance of accounting for both random error and systematic satellite precipitation bias. The approach provides an example of how environmental prediction models can incorporate satellite precipitation uncertainty. Other applications such as flood and drought monitoring and forecasting could likely benefit from consideration of precipitation uncertainty.
Feedbacks Driving Interdecadal Variability in Southern Ocean Convection in Climate Models: A Coupled Oscillator Mechanism
Authors: Gnanadesikan Anand , Speller Cassidy M. , Ringlein Grace , San Soucie John , Thomas Jordan , Pradal Marie-Aude 
Published: July 2020

AbstractNumerous climate models display large-amplitude, long-period variability associated with quasiperiodic convection in the Southern Ocean, but the mechanisms responsible for producing such oscillatory convection are poorly understood. In this paper we identify three feedbacks that help generate such oscillations within an Earth system model with a particularly regular oscillation. The first feedback involves increased (decreased) upward mixing of warm interior water to the surface, resulting in more (less) evaporation and loss of heat to the atmosphere which produces more (less) mixing. This positive feedback helps explain why temperature anomalies are not damped out by surface forcing. A second key mechanism involves convective (nonconvective) events in the Weddell Sea causing a relaxation (intensification) of westerly winds, which at some later time results in a pattern of currents that reduces (increases) the advection of freshwater out of the Weddell Sea. This allows for the surface to become lighter (denser) which in turn can dampen (trigger) convection—so that the overall feedback is a negative one with a delay—helping to produce a multidecadal oscillation time scale. The decrease (increase) in winds associated with convective (nonconvective) states also results in a decrease (increase) in the upward mixing of salt in the Eastern Weddell Sea, creating a negative (positive) salinity anomaly that propagates into the Western Weddell Sea and dampens (triggers) convection—again producing a negative feedback with a delay. A principal oscillatory pattern analysis yields a reasonable prediction for the period of oscillation. Strengths of the feedbacks are sensitive to parameterization of mesoscale eddies.
High-Performance Trauma Centers in a Single-State Trauma System
Authors: Hatchimonji Justin S. , Kaufman Elinore J. , Young Andrew J. , Smith Brian P. , Xiong Ruiying , Reilly Patrick M. , Holena Daniel N. 
Published: July 2020

Background Trauma centers with low observed:expected (O:E) mortality ratios are considered high performers; however, it is unknown whether improvements in this ratio are due to a small number of unexpected survivors with high mortality risk (big saves) or a larger number of unexpected survivors with moderate mortality risk (marginal gains). We hypothesized that the highest-performing centers achieve that status via larger numbers of unexpected survivors with moderate mortality risk. Methods We calculated O:E ratios for trauma centers in Pennsylvania for 2016 using a risk-adjusted mortality model. We identified high and low performers as centers whose 95% CIs did not cross 1. We visualized differences between these centers by plotting patient-level observed and expected mortality; we then examined differences in a subset of patients with a predicted mortality of ≥10% using the chi-squared test. Results One high performer and 1 low performer were identified. The high performer managed a population with more blunt injuries (97.2% vs 93.6%, P < .001) and a higher median Injury Severity Score (14 vs 11, P < .001). There was no difference in survival between these centers in patients with an expected mortality of <10% (98.0% vs 96.7%, P = .11) or ≥70% (23.5% vs 10.8%, P = .22), but there was a difference in the subset with an expected mortality of ≥10% (77.5% vs 43.1%, P < .001). Conclusions Though patients with very low predicted mortality do equally well in high-performing and low-performing centers, the fact that performance seems determined by outcomes of patients with moderate predicted mortality favors a “marginal gains” theory.
Triage of Patients With Rib Fractures
Authors: Leichtle Stefan W. , Pendleton Audrey , Wang Sarah , Torres Beth , Collins Rachel , Aboutanos Michel B. 
Published: July 2020

Background Most triage guidelines for blunt chest wall trauma focus on advanced age and multiple fractured ribs to indicate a high-risk patient population that should be admitted to an intensive care unit (ICU). Overly sensitive ICU admission criteria, however, may result in overutilization of resources. We revised our rib fracture triage guideline to de-emphasize age and number of rib fractures, hypothesizing that we could lower ICU admission rates without compromising outcomes. Methods Patients admitted to our level 1 trauma center over 9 months after the institution of the revised guideline (N = 248) were compared with those admitted over 6 months following the original guideline (N = 207) using Fisher’s exact and Wilcoxon-Mann-Whitney tests, as appropriate. Univariate followed by multivariate analyses were performed to determine risk factors for complications. Results The ICU admission rate significantly decreased from 73% to 63% ( P = .02) after the institution of the revised guideline, despite an increase in the patient’s age and injury acuity of the cohort. There was no significant difference in respiratory complications, unplanned ICU admission rates, and overall mortality. Poor incentive spirometer effort (750 mL or less) and dyspnea in the trauma bay were the strongest predictors of an adverse composite outcome and prolonged hospital length of stay. Discussion A revised rib fracture triage guideline with less emphasis on the patient’s age and the number of fractured ribs safely lowered ICU admission rates. Poor functional status rather than age and anatomy was the strongest predictor of complications and prolonged hospital stay.
Mental health in biological disasters: From SARS to COVID-19
Authors: Hsieh Kuan-Ying , Kao Wei-Tsung , Li Dian-Jeng , Lu Wan-Chun , Tsai Kuan-Yi , Chen Wei-Jen , Chou Li-Shiu , Huang Joh-Jong , Hsu Su-Ting , Chou Frank Huang-Chih 
Published: July 2020

Background: The outbreak of coronavirus disease 2019 (COVID-19), like severe acute respiratory syndrome (SARS), provokes fear, anxiety and depression in the public, which further affects mental health issues. Taiwan has used their experience of the SARS epidemic for the management of foreseeable problems in COVID-19 endemic. Aim/Objective: This review summarizes issues concerning mental health problems related to infectious diseases from current literatures. Results: In suspected cases under quarantine, confirmed cases in isolation and their families, health care professionals, and the general population and related effective strategies to reduce these mental health issues, such as helping to identify stressors and normalizing their impact at all levels of response as well as public information and communication messages by electronic devices. The importance of community resilience was also addressed. Psychological first aid, psychological debriefing, mental health intervention and psychoeducation were also discussed. Issues concerning cultures and religions are also emphasized in the management plans. Conclusion: Biological disaster like SARS and COVID-19 not only has strong impact on mental health in those being infected and their family, friends, and coworkers, but also affect wellbeing in general public. There are evidenced that clear and timely psychoeducation, psychological first aid and psychological debriefing could amileorate negative impact of disaster, thus might also be helpful amid COVID-19 pandemic.
UK primary care survey of venous leg ulceration management and referral – Post-EVRA trial
Authors: Heatley Francine , Saghdaoui Layla B , Salim Safa , Onida Sarah , Gohel Manj S , Davies Alun H 
Published: July 2020

Objective Determine standards of referral and management of patients with venous leg ulceration in primary care after the release of the EVRA (A Randomized Trial of Early Endovenous Ablation in Venous Ulceration) study results. Methods An online questionnaire was disseminated over four months to professionals working within primary care. Results The survey received 643 responses. Of respondents, 90 (14%) had heard of the EVRA trial and 51 (8%) were familiar with the results. Of those who answered the following questions, 410 (69.1%) stated that referral to a vascular specialist must be made by the General Practitioner and 13 (2.2%) reported that they would always refer patients for secondary care assessment before the publication of EVRA. Considering the EVRA results, 128 (29%) reported that they would change practice regarding referral and would experience no barriers and 198 (45%) reported that they would like to refer earlier but is not their decision. Barriers to changing practice included local referral policies, training and time restrictions, 266 (59%) had heard of the NICE guideline (CG168) and 194 (43%) were aware of the recommendations for referral to a vascular service within two weeks for patients with an open or healed ulcer. Conclusion There is a considerable variation in local referral pathways for venous leg ulceration, and despite clinicians wanting to refer promptly, many primary care professionals are unable to. Unfortunately, the EVRA study alone may not change the overall practice, and work is needed to overcome barriers faced by primary care professionals.
Comparison of the effects of the Feldenkrais method versus core stability exercise in the management of chronic low back pain: a randomised control trial
Authors: Ahmadi Hanieh , Adib Hanieh , Selk-Ghaffari Maryam , Shafizad Misagh , Moradi Siavash , Madani Zahra , Partovi Gholamreza , Mahmoodi Aliakbar 
Published: July 2020

Objective: To investigate the effect of the Feldenkrais method versus core stability exercises on pain, disability, quality of life and interoceptive awareness in patients with chronic non-specific low back pain. Design: A single-blinded, randomised, controlled trial. Setting: Outpatient, sports medicine clinic of Mazandaran medical university. Participants: Sixty patients with chronic non-specific low back pain randomised equally into the Feldenkrais method versus core stability exercises groups. Intervention: Intervention group received Feldenkrais method consisting of training theoretical content and supervised exercise therapy two sessions per week for five weeks. Control group received educational programme and home-based core stability exercises for five weeks. Outcome measures: All patients were examined by World Health Organization’s Quality of life Questionnaire, McGill Pain Questionnaire, Oswestry Disability Questionnaire and Multidimensional Assessment of Interoceptive Awareness Questionnaire. All outcomes were measured at baseline and the end of the intervention Results: There were statistically significant differences between groups for quality of life ( P = 0.006, from 45.51 to 60.49), interoceptive awareness ( P > 0.001, from 2.74 to 4.06) and disability ( P = 0.021, from 27.17 to 14.5) in favour of the Feldenkrais method. McGill pain score significantly decreased in both the Feldenkrais (from 15.33 to 3.63) and control groups (from 13.17 to 4.17), but there were no between-groups differences ( P = 0.16). Conclusion: Feldenkrais method intervention gave increased benefits in improving quality of life, improving interoceptive awareness and reducing disability index.