bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving communication lines: quality improvement project moving a department away from outdated paging
Authors: Jones Neil John , Shah Sachi , Robati Shibby , Thilagarajah Michael 
Published: December 2019

IntroductionPaging systems in Hospitals have been established for some time, but they are now outdated and unreliable. This opinion is shared by the UK government, which has given the NHS until 2021 to become free of these technologies. Given this new mandate, we wanted to implement a change in the way other Healthcare Professionals can contact Orthopaedic Senior House Officer Doctors (SHOs), at Darent Valley Hospital, a District General Hospital in Kent, England.MethodsUsing the Plan, Do, Study, Act (PDSA) cycle model for quality improvement projects, the authors demonstrate two successful cycles improving the way in which HCPs can establish communication with Orthopaedic Junior Doctors. PDSA cycle 1 introduced a ward doctor to be stationed on the orthopaedic wards and to carry a mobile phone. The mobile phone worked well, but there were limitations to having to stay on the wards. PDSA cycle 2 introduced mobile phones for all Orthopaedic Doctor Teams. Impact of changes made was measured using staff questionnaires distributed to a range of Healthcare Professionals.ResultsAfter PDSA Cycle 1, 100% of the 36 asked agreed that having a ward doctor had saved time in their day. 72% said they page an Orthopaedic Doctor zero to two times with no reply, compared with 9% before the change was implemented. After PDSA cycle 2, 100% of the 31 asked agreed that using mobile phones was an effective way of communicating with the Orthopaedic Doctors, and 90% said that, on average, they would spend less than 2 min trying to contact an Orthopaedic Doctor, compared with 33% after PDSA cycle 1 intervention.ConclusionThis cycle has clearly improved communication in our orthopaedic department. If used in the right way, mobile phone technology can surely improve our clinical environments.
Trauma Embolic Scoring System in military trauma: a sensitive predictor of venous thromboembolism
Authors: Walker Patrick F , Schobel Seth , Caruso Joseph D , Rodriguez Carlos J , Bradley Matthew J , Elster Eric A , Oh John S 
Published: December 2019

IntroductionClinical decision support tools capable of predicting which patients are at highest risk for venous thromboembolism (VTE) can assist in guiding surveillance and prophylaxis decisions. The Trauma Embolic Scoring System (TESS) has been shown to model VTE risk in civilian trauma patients. No such support tools have yet been described in combat casualties, who have a high incidence of VTE. The purpose of this study was to evaluate the utility of TESS in predicting VTE in military trauma patients.MethodsA retrospective cohort study of 549 combat casualties from October 2010 to November 2012 admitted to a military treatment facility in the USA was performed. TESS scores were calculated through data obtained from the Department of Defense Trauma Registry and chart reviews. Univariate analysis and multivariate logistic regression were performed to evaluate risk factors for VTE. Receiver operating characteristic (ROC) curve analysis of TESS in military trauma patients was also performed.ResultsThe incidence of VTE was 21.7% (119/549). The median TESS for patients without VTE was 8 (IQR 4–9), and the median TESS for those with VTE was 10 (IQR 9–11). On multivariate analysis, Injury Severity Score (ISS) (OR 1.03, p=0.007), ventilator days (OR 1.05, p=0.02), and administration of tranexamic acid (TXA) (OR 1.89, p=0.03) were found to be independent risk factors for development of VTE. On ROC analysis, an optimal high-risk cut-off value for TESS was ≥7 with a sensitivity of 0.92 and a specificity of 0.53 (area under the curve 0.76, 95% CI 0.72 to 0.80, p<0.0001).ConclusionsWhen used to predict VTE in military trauma, TESS shows moderate discrimination and is well calibrated. An optimal high-risk cut-off value of ≥7 demonstrates high sensitivity in predicting VTE. In addition to ISS and ventilator days, TXA administration is an independent risk factor for VTE development.Level of evidenceLevel III.
Microstructure and mechanical properties of cold metal transfer welded galvanized steel/magnesium alloy dissimilar joints
Authors: Zhang Chao , Wu Mingfang , Wang Yuxin , Pu Juan 
Published: December 2019

The joining of magnesium alloy to galvanized steel was realized by cold metal transfer method with AZ31 magnesium alloy welding wire. Weld appearance, microstructure and tensile properties of Mg–steel joints under various welding parameters were investigated with different welding heat inputs. The results showed that magnesium alloy-steel brazed joints had good weld appearance. When the welding heat input was 141 J/mm, Zn elements were enriched in the Zn-rich zone (ZRZ), and the interface layer was composed of a large portion of Mg–Zn phases and minor Mg–Al phases. With the increase of welding heat input, Zn elements in the ZRZ gradually decreased, Fe/Al phase appeared in the interface layer, and the strength of welding joint increased. When the welding heat input was 159 J/mm, the tensile strength of welding joint reached the maximum value of 198 MPa. However, when the welding input was increased to 181 J/mm, Zn element in the ZRZ was burnt and volatilized seriously, resulting in poor wetting and spreading properties of liquid phase at the interface zone of the steel.
Integrin β4–Targeted Cancer Immunotherapies Inhibit Tumor Growth and Decrease Metastasis
Authors: Ruan Shasha , Lin Ming , Zhu Yong , Lum Lawrence , Thakur Archana , Jin Runming , Shao Wenlong , Zhang Yalei , Hu Yangyang , Huang Shiang , Hurt Elaine M. , Chang Alfred E. , Wicha Max S. , Li Qiao 
Published: December 2019

AbstractIntegrin β4 (ITGB4) has been shown to play an important role in the regulation of cancer stem cells (CSC). Immune targeting of ITGB4 represents a novel approach to target this cell population, with potential clinical benefit. We developed two immunologic strategies to target ITGB4: ITGB4 protein–pulsed dendritic cells (ITGB4-DC) for vaccination and adoptive transfer of anti-CD3/anti-ITGB4 bispecific antibody (ITGB4 BiAb)–armed tumor-draining lymph node T cells. Two immunocompetent mouse models were utilized to assess the efficacy of these immunotherapies in targeting both CSCs and bulk tumor populations: 4T1 mammary tumors and SCC7 head and neck squamous carcinoma cell line. Immunologic targeting of ITGB4 utilizing either ITGB4-DC or ITGB4 BiAb-T cells significantly inhibited local tumor growth and metastases in both the 4T1 and SCC7 tumor models. Furthermore, the efficacy of both of these ITGB4-targeted immunotherapies was significantly enhanced by the addition of anti–PD-L1. Both ITGB4-targeted immunotherapies induced endogenous T-cell cytotoxicity directed at CSCs as well as non-CSCs, which expressed ITGB4, and immune plasma–mediated killing of CSCs. As a result, ITGB4-targeted immunotherapy reduced not only the number of ITGB4high CSCs in residual 4T1 and SCC7 tumors but also their tumor-initiating capacity in secondary mouse implants. In addition, treated mice demonstrated no apparent toxicity. The specificity of these treatments was demonstrated by the lack of effects observed using ITGB4 knockout 4T1 or ITGB4-negative CT26 colon carcinoma cells. Because ITGB4 is expressed by CSCs across a variety of tumor types, these results support immunologic targeting of ITGB4 as a promising therapeutic strategy.Significance: This study identifies a novel mechanism of resistance to anti–PD-1/PD-L1 immunotherapy mediated by HPV E5, which can be exploited using the HPV E5 inhibitor rimantadine to improve outcomes for head and neck cancer patients.
Catechol‐O‐Methyltransferase and Cardiovascular Disease: MESA
Authors: Hall Kathryn T. , Battinelli Elisabeth , Chasman Daniel I. , Ridker Paul M , Psaty Bruce M. , Rotter Jerome I. , Kaptchuk Ted J. , Tracy Russell P. , Wassel Christina L. , Mukamal Kenneth J. 
Published: December 2019

Background

Genetic variation in catechol‐O‐methyltransferase (

COMT

), a key enzyme in estrogen and catecholamine metabolism, has plausible physiological links to cardiovascular disease (
CVD
) and its risk factors. In
WHS
(Women's Health Study),

COMT

variants rs4818 and rs4680 were associated with a lower risk of
CVD
among women receiving placebo but not aspirin, suggesting a possible role of

COMT

in thrombosis.

Methods and Results

To evaluate potential pathways linking

COMT

with
CVD
, and

COMT

effect modification of aspirin in prevention, we examined

COMT

association with
CVD
risk and subclinical measures, coronary artery calcium, and carotid intima‐media thickness in MESA (Multi‐Ethnic Study of Atherosclerosis). In 65 957 person‐years of follow‐up, during which 498 events occurred,

COMT

rs4818 was associated with lower
CVD
risk (hazard ratio, 0.85; 95% CI, 0.74–0.97 [
P
=0.02]). This association remained virtually unchanged after adjusting for common
CVD
risk factors. Fibrinogen was the only risk factor associated with rs4818 (β, −3.65;
SE
, 1.35 mg/
dL
[
P
=0.007]). Results were directionally similar but not significant for rs4680. Adjusted hazard ratios for

COMT

rs4818
CVD
association were 0.79 (95% CI, 0.65–0.95;
P
=0.02) among individuals who used aspirin <3 days per week and 0.89 (95% CI, 0.71–1.13;
P
=0.34) among more frequent users (
P
interaction
=0.39). Neither intima‐media thickness nor coronary artery calcium was associated with

COMT

.

Conclusions

In a multiethnic prospective cohort of men and women, the

COMT

rs4818G allele was associated with lower
CVD
risk and lower fibrinogen levels but not with radiographic measures of subclinical atherosclerosis. These results suggest a plausible role of

COMT

in the latter stages of
CVD
.
Police Presence, Rapid Response Rates, and Crime Prevention
Authors: Weisburd Sarit 
Published: December 2019

AbstractThis paper estimates the impact of police presence on crime using a unique database that tracks the exact location of Dallas Police Department patrol cars throughout 2009. To address the concern that officer location is often driven by crime, my instrument exploits police responses to calls outside their allocated coverage beat. This variable provides a plausible shift in police presence within the abandoned beat that is driven by the police goal of minimizing response times. I find that a 10% decrease in police presence at that location results in a 7% increase in crime. This result sheds light on the black box of policing and crime and suggests that routine changes in police patrol can have a significant impact on criminal behavior.
The Potential Vorticity Structure and Dynamics of African Easterly Waves
Authors: Russell James O. H. , Aiyyer Anantha 
Published: December 2019

Abstract
The dynamics of African easterly waves (AEWs) are investigated from the perspective of potential vorticity (PV) using data from global reanalysis projects. To a leading order, AEW evolution is governed by four processes: advection of the wave-scale PV by background flow, advection of background PV by the AEW, diabatic forcing due to wave-scale moist convection, and coupling between the wave and background diabatic forcing. Moist convection contributes significantly to the growth of AEWs in the midtroposphere, and to both growth and propagation of AEWs near the surface. The former is associated with stratiform clouds while the latter with deep convection. Moist convection helps maintain a more upright AEW PV column against the background shear, which makes the wave structure conducive for tropical cyclogenesis. It is also argued that—contrary to the hypothesis in some prior studies—the canonical diabatic Rossby wave model is likely not applicable to AEWs.
The Importance of Past MJO Activity in Determining the Future State of the Midlatitude Circulation
Authors: Tseng Kai-Chih , Barnes Elizabeth A. , Maloney Eric 
Published: December 2019

AbstractThe Madden–Julian oscillation (MJO) is one of the most important sources of predictability on subseasonal to seasonal (S2S) time scales. Many previous studies have explored the impact of the present state of the MJO on the future evolution and predictability of extratropical weather patterns. What is still unclear, however, is the importance of the accumulated influence of past MJO activity on these results. In this study, the importance of past MJO activity in determining the future state of extratropical circulations is examined by using a linear baroclinic model (LBM) and one of the simplest machine learning algorithms: logistic regression. By increasing the complexity of the logistic regression model with additional information about the past activity of the MJO, it is demonstrated that the past 15 days play a dominant role in determining the state of MJO teleconnections more than 15 days into the future. This conclusion is supported by numerical LBM simulations. It is further shown that the past 15 days of additional information are only important for some MJO phases/lead times and not others, and the physical basis for this result is explored.
Assimilation of Low-Peaking Satellite Observations Using the Coupled Interface Framework
Authors: Frolov Sergey , Campbell William , Ruston Benjamin , Bishop Craig H. , Kuhl David , Flatau Maria , McLay Justin 
Published: December 2019

Abstract
Coupled data assimilation (DA) provides a consistent framework for assimilating satellite observations that are sensitive to several components of the Earth system. In this paper, we focus on low-peaking infrared satellite channels that are sensitive to the lower atmosphere and Earth surface temperature (EST) over both ocean and land. Our atmospheric hybrid-4DVAR system [the Navy Global Environmental Model (NAVGEM)] is extended to include the following: 1) variability in the sea surface temperature (both diurnal variability and climatological perturbations to the ensemble members), 2) the coupled Jacobians of the radiative transfer model for the infrared sensors, and 3) the coupled covariances between the EST and the atmosphere. Our coupling approach is found to improve forecast accuracy and to provide corrections to the EST that are in balance with the atmospheric analysis. The largest impact of the coupling is found on near-surface atmospheric temperature and humidity in the tropics, but the impact extends all the way to the stratosphere. The role of each coupling element on the performance of the global atmospheric circulation model is investigated. Inclusion of variability in the sea surface temperature has the strongest positive impact on the forecast quality. Additional inclusion of the coupled Jacobian and ensemble-based coupled covariances led to further improvements in scores and to modification of the corrections to the ocean boundary layer. Coupled DA had significant impact on latent and sensible heat fluxes over land, locations of western boundary currents, and along the ice edge.
Springtime Onset of Isolated Convection Precipitation across the Southeastern United States: Framework and Regional Evolution
Authors: Rickenbach Thomas M. , Ferreira Rosana Nieto , Wells Hannah 
Published: December 2019

Abstract
This study examines the geographic and temporal characteristics of the springtime transition to the summer precipitation regime of isolated convection in the southeastern (SE) United States during 2009–12, using a high-resolution surface radar-based precipitation dataset. Isolated convection refers herein to isolated elements or small clusters of precipitation in radar imagery less than 100 km in horizontal dimension. Though the SE United States does not have a monsoon climate, it is useful to apply the established framework of monsoon onset to study the timing and regional variation of the onset of the summer isolated convection regime. Overall, isolated convection rain onset in the SE U.S. domain occurs in late May. Onset begins in south Florida in mid-April, continuing nearly simultaneously across the southeastern coastal plain in early to mid-May. In the northern domain, from Virginia to the Ohio Valley, onset generally occurs much later (mid-June to early July) with more variable onset timing. The sharpness of onset timing is most evident in the coastal plain and Florida. Results suggest the hypothesis, to be examined in a forthcoming study, that the timing of isolated convection onset in the spring may be triggered by specific synoptic-scale events within gradual seasonal changes in atmospheric conditions including extratropical cyclone tracks, convective instability, and the westward migration of the North Atlantic subtropical high. This approach may offer a useful framework for evaluating long-term changes in precipitation for subtropical regimes in an observational and modeling context.
Psychoeducation through digital video for Olympic and Paralympic athletic career transition
Authors: Burrows Emma , McArdle Siobhain 
Published: December 2019

Objective: Prior research has noted Olympic and Paralympic athletes are often unaware and unprepared for upcoming career transitions, resulting in experiences of psychological distress. The purpose of this study was to explore the use of digital video as a delivery method for psychoeducation about an upcoming career transition. Design: Post-survey design. Method: Video development was guided by entertainment-education theory. Participants were shown the video at a centralised training location and asked to fill in questionnaires following viewing and again within 72 hours of viewing. Specifically, subjective and objective recall of the intended learning points was assessed. In addition, participants’ appreciation of the content and design was measured. Analysis was descriptive in nature. Results: Participants included 168 Olympic/Paralympic athletes ( N = 116), coaches ( N = 10) and athlete support providers ( N = 42). Immediately following viewing, participants could accurately recall between one and three learning points, but at 72 hours post-viewing, this range had fallen to one to two learning points. Participants indicated they enjoyed the video, identified with the narrators and found it informative and personally relevant. Conclusion: The results of this study suggest a digital video 2 minutes 35 seconds in length is a useful psychoeducation tool for up to three learning points. The results support the development of video psychoeducation resources using education-entertainment theory and the social validity of video as a psychoeducation tool in Olympic and Paralympic sport.
Deep cervical and paratracheal drainage for descending necrotizing mediastinitis
Authors: Sakai Takashi , Matsutani Noriyuki , Ito Ken , Mochiki Masato , Mineda Joji , Shirai Suguru , Kanaoka Rie , Yamauchi Yoshikane , Saito Yuichi , Sakao Yukinori , Kawamura Masafumi 
Published: December 2019

Background Descending necrotizing mediastinitis is life-threatening and extends into the deep cervical fascia including the pretracheal, perivascular and retrovisceral, and prevertebral spaces. Deep cervical and paratracheal drainage via a transcervical approach prevents the spread of infection into the deep mediastinum. It is effective for local neck drainage and important in the primary treatment of descending necrotizing mediastinitis. Transthoracic mediastinal drainage is also effective for treating this condition. Methods Nine patients with descending necrotizing mediastinitis were treated by deep cervical and paratracheal drainage via a transcervical approach at our institution from April 2007 to December 2017. Four patients with diagnoses of extensive descending necrotizing mediastinitis had progressive extension of abscesses into the lower mediastinum, below the level of the carina. The other five had localized descending necrotizing mediastinitis with infection in the upper mediastinum above the level of the carina. Results All 9 patients (4 with extensive and 5 with localized descending necrotizing mediastinitis) initially underwent deep cervical and paratracheal drainage via a transcervical approach, and all recovered. Two of the patients with extensive infection required no additional surgical intervention. Conclusions Fluid collections in the deep cervical fascia must be drained urgently. Deep cervical and paratracheal drainage via a transcervical approach effectively controls all types of descending necrotizing mediastinitis, and it is less invasive than transthoracic approaches via thoracotomy. However, a thoracotomy for mediastinal drainage must be considered if infection is not controlled by transcervical drainage. Thoracic surgeons and otolaryngologists must plan efficacious treatment before surgical procedures for descending necrotizing mediastinitis.
Clinical outcomes of patients with nasopharyngeal carcinoma treated with antibiotics for radiation-induced mucositis: a retrospective study
Authors: Weng JingJin , Wei Jiazhang , Li Min , Lu Jinlong , Qin Yangda , Liu Fei , Xiong Weiming , Qu Shenhong 
Published: December 2019

Objective To examine the effects of antibiotic administration on radiation-induced oral and oropharyngeal mucositis, and on the prognosis of patients with nasopharyngeal carcinoma (NPC). Methods We retrospectively analyzed data for patients with NPC with grade 1/2 or 3/4 mucositis. Forty-two patients with grade 3/4 mucositis received antibiotics. Univariate survival analysis was assessed by Kaplan–Meier survival curves, survival curves were compared using log-rank tests, and multivariate analysis was carried out by Cox regression. Results A total of 463 patients with NPC were included in the study (194 grade 1/2 mucositis, 269 grade 3/4 mucositis). Univariate analyses identified T-stage, N-stage, clinical stage, type of treatment, and antibiotic use as factors affecting overall and disease-free survival. Multivariate analysis also determined that T-stage, N-stage stage, type of treatment, and antibiotic usage were independent factors affecting overall and disease-free survival. Mucositis improved in 32 of the 42 patients who received antibiotics (76.19%). However, red blood cell count and hemoglobin levels decreased in all patients after antibiotic treatment. Conclusions Antibiotics may be effective for the treatment of severe radiation-induced mucositis (grade 3/4) during chemoradiotherapy, but may potentially adversely affect the prognosis of patients with NPC.
Behavioral and dietary risk factors of recurrent urinary tract infection in Chinese postmenopausal women: a case–control study
Authors: Zhu Meifeng , Wang Shenju , Zhu Ying , Wang Zhixia , Zhao Min , Chen Dai , Zhou Chunxiang 
Published: December 2019

Objective The present study aimed to examine the behavioral and dietary risk factors of recurrent urinary tract infection (RUTI) in postmenopausal patients in China. Methods We performed a population-based case–control study with 193 postmenopausal women with RUTI and 193 age-matched healthy female controls with no history of RUTI. The study was conducted between January 2016 and June 2018 in Changzhou, China. Data were collected using an interviewer-based questionnaire, including information on demographics, lifestyle behavior, and habitual diet. Conditional logistic regression analysis was conducted to examine the risk factors associated with RUTI. Results Wiping from back to front after toilet use, sedentary behavior >6 hours/day, delayed voiding, and chronic constipation were associated with an increased risk of RUTI. Drinking more than three cups of green tea per month showed an inverse association with RUTI. However, there was no evidence of dose dependency for overall consumption. Additionally, the three-cup association involved a small proportion of cases and may reflect statistical artifact. Conclusions Wiping from back to front after toilet use, sedentary behavior, delayed voiding, and chronic constipation are associated with an increased risk of RUTI in postmenopausal women.