bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical predictors of progression and clearance of low‐level CMV DNAemia in solid organ transplant recipients
Authors: Natori Yoichiro , Alghamdi Ali , Husain Shahid , Rotstein Coleman , Selzner Nazia , Tikkanen Jussi , Schiff Jeffrey , Humar Atul , Kumar Deepali 
Published: November 2019

AbstractBackgroundLow‐level CMV DNAemia is common and in the absence of treatment may either progress to higher viral loads that require therapy, or may spontaneously resolve. The clinical predictors of progression and spontaneous viral clearance are not well defined.MethodsWe performed a retrospective cohort study of organ transplant recipients who had untreated low‐level CMV DNAemia (<1000 IU/mL). Outcomes were evaluated for 8 weeks after initial viral detection, and progression to CMV high viral load was defined as CMV viral load ≥1000 IU/mL. CMV DNAemia doubling time was calculated for a subset of patients with sufficient viral load timepoints.ResultsOf the 297 patients analyzed, 118/297 (39.7%) patients progressed to a high viral load and the remaining cleared DNAemia spontaneously (46.8%) or remained at low level (13.4%). In multivariate analysis, progression was significantly more likely in lung transplant recipients (odds ratio 3.09) and less likely in those with an episode of previously treated CMV infection (odds ratio 0.081). In a subset of 27 patients with progression, the doubling time for CMV DNAemia was a median of 6.1 days (range 2.4‐21.8).ConclusionWe found that previous CMV infection significantly decreased the likelihood of low‐level DNAemia progression suggesting that CMV immunity plays a role in progression vs spontaneous clearance.
Linking water relations and hydraulics with photosynthesis
Authors: Xiong Dongliang , Nadal Miquel 
Published: November 2019

SummaryFor land plants, water is the principal governor of growth. Photosynthetic performance is highly dependent on the stable and suitable water status of leaves, which is balanced by the water transport capacity, the water loss rate as well as the water capacitance of the plant. This review discusses the links between leaf water status and photosynthesis, specifically focussing on the coordination of CO2 and water transport within leaves, and the potential role of leaf capacitance and elasticity on CO2 and water transport.
Responses of river discharge and sediment load to climate change in the transboundary Mekong River Basin
Authors: Khoi Dao Nguyen , Nguyen Van Thinh , Sam Truong Thao , Ky Phung Nguyen , Thi Bay Nguyen 
Published: November 2019

AbstractClimate change is expected to alter streamflow and sediment load in the transboundary Mekong River Basin (MRB), thereby affecting aquatic ecosystem and people’s livelihoods. Thus, future decisions on sustainable management of water resources in the basin should take climate change impact into consideration. In this study, the responses of river discharge and sediment (total suspended sediment [TSS]) load to future climate change in the transboundary MRB have been investigated. The Soil and Water Assessment Tool (SWAT) model is used as a simulation tool, which has been carefully calibrated and validated against the observation data in the period of 1982–2005 before applying to evaluate the impact of climate change scenarios for the near‐future period of 2016–2040. The climate change scenarios, which are acquired from four different Regional Climate Models (RCMs) downscaled from the Hadley Centre Global Environmental Model version 2‐Atmosphere (HadGEM2‐AO), are applied in the present study. In regard to the effect of changing climate, the annual river discharge and TSS load are forecasted to rise from 3.35 to 9.13% and from 7.45 to 13.15%, respectively. Generally, the TSS loading projection varies larger than the streamflow projection concerning changing climate. The findings here are also agreed with the conclusions of previous investigations on the future impacts of changing climate in the MRB.
A study of the Resilience Analysis Grid method and its applicability to the water sector in England and Wales
Authors: Rodríguez Mayra , Lawson Elizabeth , Butler David 
Published: November 2019

AbstractThis paper presents an adaptation of the Resilience Analysis Grid (RAG) method framed on the Resilience Engineering theory as a proposal for tackling the lack of organisational resilience metrics in the water sector of England and Wales. The method was adapted to the sector by selecting 16 indicators and the addition of a ‘Resilience Ethos’ section to the grid. Its applicability was tested by analysing the evolution of resilience in Ofwat’s Price Reviews 2009 (PR09), 2014 (PR14) and 2019 (PR19). Key conclusions obtained were that: (I) PR14 acts as a pivot between PR09 and PR19, as it installs a new regulatory approach; (II) the sector has advanced significantly towards greater consideration of resilience and its management in PR19; and (III) the PRs lack instruments for in‐period performance assessment. The RAG method proved to be simple and flexible to use, delivering clear and straightforward graphical results.
Effects of Sports On Social Anxiety and Subjective Well-Being Levels of University Students
Authors: Tunç Aygül Çağlayan , Akandere Mehibe 
Published: November 2019

The aim of this study is to examine the effects of social anxiety and subjective well-being levels of university students. Totally 600 students from the University of Konya, Konya, Turkey. Social Anxiety and subjective well-being tests are applied on participants. The statistical package program Spss 16.0 is used in order to analyze the data. The t test and variance analyzer (ANOVA) is used for independent groups while Tukey's test was used as multiple comparison tests for differences. The relationship between consistent data is being tested via pearson. Well-being scores of male or female students who do not do sports (P <0.05). Being criticized scores of men are not doing sports (P <0.05). Social avoidance scores were higher than boys (P <0.05). Consequently, it is seen as a self-being level.
Semi‐automatic methods for tracking the medial gastrocnemius muscle–tendon junction using ultrasound: a validation study
Authors: Cenni Francesco , Bar‐On Lynn , Monari Davide , Schless Simon‐Henri , Kalkman Barbara M. , Aertbeliën Erwin , Desloovere Kaat , Bruyninckx Herman 
Published: November 2019

New Findings
What is the central question of this study?
Is the proposed semi‐automatic algorithm suitable for tracking the medial gastrocnemius muscle–tendon junction in ultrasound images collected during passive and active conditions?

What is the main finding and its importance?
The validation of a method allowing efficient tracking of the muscle–tendon junction in both passive and active conditions, in healthy as well as in pathological conditions. This method was tested in common acquisition conditions and the developed software made freely available.

AbstractClinically relevant information can be extracted from ultrasound (US) images by tracking the displacement of the junction between muscle and tendon. This paper validated automatic methods for tracking the location of muscle–tendon junction (MTJ) between the medial gastrocnemius and the Achilles tendon during passive slow and fast stretches, and active ankle rotations while walking on a treadmill. First, an automatic algorithm based on an optical flow approach was applied on collected US images. Second, results of the automatic algorithm were evaluated and corrected using a quality measure that indicated which critical images need to be manually corrected. US images from 12 typically developed (TD) children, 12 children with spastic cerebral palsy (SCP) and eight healthy adults were analysed. Automatic and semi‐automatic tracking methods were compared to manual tracking using root mean square errors (RMSE). For the automatic tracking, RMSE was less than 3.1 mm for the slow stretch and 5.2 mm for the fast stretch, the worst case being for SCP. The tracking results in the fast stretch condition were improved (especially in SCP) by using the semi‐automatic approach, with an RMSE reduction of about 30%. During walking, the semi‐automatic method also reduced errors, with a final RMSE of 3.6 mm. In all cases, data processing was considerably shorter using the semi‐automatic method (2 min) compared to manual tracking (20 min). A quick manual correction considerably improves tracking of the MTJ during gait and allows to achieve results suitable for further analyses. The proposed algorithm is freely available.
The impact of hypoxaemia on vascular function in lowlanders and high altitude indigenous populations
Authors: Tymko Michael M. , Tremblay Joshua C. , Bailey Damian M. , Green Daniel J. , Ainslie Philip N. 
Published: November 2019

AbstractExposure to hypoxia elicits widespread physiological responses that are critical for successful acclimatization; however, these responses may induce apparent maladaptive consequences. For example, recent studies conducted in both the laboratory and the field (e.g. at high altitude) have demonstrated that endothelial function is reduced in hypoxia. Herein, we review the several proposed mechanism(s) pertaining to the observed reduction in endothelial function in hypoxia including: (i) changes in blood flow patterns (i.e. shear stress), (ii) increased inflammation and production of reactive oxygen species (i.e. oxidative stress), (iii) heightened sympathetic nerve activity, and (iv) increased red blood cell concentration and mass leading to elevated nitric oxide scavenging. Although some of these mechanism(s) have been examined in lowlanders, less in known about endothelial function in indigenous populations that have chronically adapted to environmental hypoxia for millennia (e.g. the Peruvian, Tibetan and Ethiopian highlanders). There is some evidence indicating that healthy Tibetan and Peruvian (i.e. Andean) highlanders have preserved endothelial function at high altitude, but less is known about the Ethiopian highlanders. However, Andean highlanders suffering from chronic mountain sickness, which is characterized by an excessive production of red blood cells, have markedly reduced endothelial function. This review will provide a framework and mechanistic model for vascular endothelial adaptation to hypoxia in lowlanders and highlanders. Elucidating the pathways responsible for vascular adaption/maladaptation to hypoxia has potential clinical implications for disease featuring low oxygen delivery (e.g. heart failure, pulmonary disease). In addition, a greater understanding of vascular function at high altitude will clinically benefit the global estimated 85 million high altitude residents.
image
Antidiabetic medication use during pregnancy: an international utilization study
Authors: Cesta Carolyn E , Cohen Jacqueline M , Pazzagli Laura , Bateman Brian T , Bröms Gabriella , Einarsdóttir Kristjana , Furu Kari , Havard Alys , Heino Anna , Hernandez-Diaz Sonia , Huybrechts Krista F , Karlstad Øystein , Kieler Helle , Li Jiong , Leinonen Maarit K , Gulseth Hanne L , Tran Duong , Yu Yongfu , Zoega Helga , Odsbu Ingvild 
Published: November 2019

ObjectiveDiabetes in pregnancy and consequently the need for treatment with antidiabetic medication (ADM) has become increasingly prevalent. The prevalence and patterns of use of ADM in pregnancy from 2006 onward in seven different countries was assessed.Research design and methodsData sources included individually linked data from the nationwide health registers in Denmark (2006–2016), Finland (2006–2016), Iceland (2006–2012), Norway (2006–2015), Sweden (2006–2015), state-wide administrative and claims data for New South Wales, Australia (2006–2012) and two US insurance databases: Medicaid Analytic eXtract (MAX; 2006–2012, public) and IBM MarketScan (2012–2015, private). The prevalence of ADM use was calculated as the proportion of pregnancies with at least one filled prescription of an ADM in the 90 days before pregnancy or within the three trimesters of pregnancy.ResultsPrevalence of any ADM use in 5 279 231 pregnancies was 3% (n=147 999) and varied from under 2% (Denmark, Norway, and Sweden) to above 5% (Australia and US). Insulin was the most used ADM, and metformin was the most used oral hypoglycemic agent with increasing use over time in all countries. In 11.4%–62.5% of pregnancies with prepregnancy use, ADM (primarily metformin) was discontinued. When ADM treatment was initiated in late pregnancy for treatment of gestational diabetes mellitus, insulin was most often dispensed, except in the US, where glibenclamide was most often used.ConclusionsPrevalence and patterns of use of ADM classes varied between countries and over time. While insulin remained the most common ADM used in pregnancy, metformin use increased significantly over the study period.
Performance of externally validated enhanced computer-aided versions of the National Early Warning Score in predicting mortality following an emergency admission to hospital in England: a cross-sectional study
Authors: Faisal Muhammad , Richardson Donald , Scally Andy , Howes Robin , Beatson Kevin , Mohammed Mohammed 
Published: November 2019

ObjectivesIn the English National Health Service, the patient’s vital signs are monitored and summarised into a National Early Warning Score (NEWS) to support clinical decision making, but it does not provide an estimate of the patient’s risk of death. We examine the extent to which the accuracy of NEWS for predicting mortality could be improved by enhanced computer versions of NEWS (cNEWS).DesignLogistic regression model development and external validation study.SettingTwo acute hospitals (YH—York Hospital for model development; NH—Northern Lincolnshire and Goole Hospital for external model validation).ParticipantsAdult (≥16 years) medical admissions discharged over a 24-month period with electronic NEWS (eNEWS) recorded on admission are used to predict mortality at four time points (in-hospital, 24 hours, 48 hours and 72 hours) using the first electronically recorded NEWS (model M0) versus a cNEWS model which included age+sex (model M1) +subcomponents of NEWS (including diastolic blood pressure) (model M2).ResultsThe risk of dying in-hospital following emergency medical admission was 5.8% (YH: 2080/35 807) and 5.4% (NH: 1900/35 161). The c-statistics for model M2 in YH for predicting mortality (in-hospital=0.82, 24 hours=0.91, 48 hours=0.88 and 72 hours=0.88) was higher than model M0 (in-hospital=0.74, 24 hours=0.89, 48 hours=0.86 and 72 hours=0.85) with higher Positive Predictive Value (PPVs) for in-hospital mortality (M2 19.3% and M0 16.6%). Similar findings were seen in NH. Model M2 performed better than M0 in almost all major disease subgroups.ConclusionsAn externally validated enhanced computer-aided NEWS model (cNEWS) incrementally improves on the performance of a NEWS only model. Since cNEWS places no additional data collection burden on clinicians and is readily automated, it may now be carefully introduced and evaluated to determine if it can improve care in hospitals that have eNEWS systems.
Measurement of coverage, compliance and determinants of uptake in a publicly funded rotavirus vaccination programme: a retrospective cohort study
Authors: Rafferty Ellen , Guo Xiaoyan , McDonald Bruce , Svenson Lawrence W , MacDonald Shannon Elizabeth 
Published: November 2019

ObjectivesIn June 2015, Alberta, Canada instituted a universal publicly funded rotavirus vaccination programme (Rotarix, RV1), with vaccine doses scheduled for 2 and 4 months of age. Vaccination was restricted so that infants were only allowed to receive first dose between 6 and 20 weeks of age, and second dose before eight calendar months of age. We assessed the coverage and schedule non-compliance of rotavirus vaccination for babies born between June 2015 and August 2016, that is, since the inception of the publicly funded rotavirus vaccination programme, and determined factors associated with rotavirus vaccine uptake.DesignRetrospective cohort study using linked administrative health data.SettingAlberta, Canada.ParticipantsCohort of 66 689 children.Primary and secondary outcome measures(1) First and second dose rotavirus vaccination coverage, (2) percent of children non-compliant with recommended vaccine schedule and (3) adjusted ORs for factors associated with vaccination status.ResultsFor the 66 689 children included in the study, coverage levels for one-dose and two-dose rotavirus vaccination were 87% and 83%, respectively. In comparison, two-dose diphtheria-tetanus-pertussis-polio-Haemophilus influenzae type bvaccine coverage was 92%, despite having the same dosing schedule. Schedule non-compliance during the publicly funded programme was very low. We observed socioeconomic disparities in the uptake of the vaccine, with income, location of residence and number of children in the household all contributing to the odds of a child being vaccinated with rotavirus.ConclusionsCompliance to the recommended rotavirus schedule was very high, suggesting that even with the restrictive rotavirus vaccine schedule, the vaccine can be delivered on-time. However, rotavirus vaccine coverage remained lower than DTaP, a similarly scheduled childhood vaccination. We also observed socioeconomic disparities in vaccine uptake. These findings raise concerns about rotavirus protection in the groups at highest risk for gastrointestinal illness, including low-income and rural populations.
Volume and in-hospital mortality after emergency abdominal surgery: a national population-based study
Authors: Nally Deirdre M , Sørensen Jan , Valentelyte Gintare , Hammond Laura , McNamara Deborah , Kavanagh Dara O , Mealy Ken 
Published: November 2019

​ObjectivesEmergency abdominal surgery (EAS) refers to high-risk intra-abdominal surgical procedures undertaken for acute gastrointestinal pathology. The relationship between hospital or surgeon volume and mortality of patients undergoing EAS is poorly understood. This study examined this relationship at the national level.​DesignThis is a national population-based study using a full administrative inpatient dataset (National Quality Assurance Improvement System) from publicly funded hospitals in Ireland.​Setting24 public hospitals providing EAS services.​Participants and InterventionsPatients undergoing EAS as identified by primary procedure codes during the period 2014–2018.​Main outcome measuresThe main outcome measure was adjusted in-hospital mortality following EAS in publicly funded Irish hospitals. Mortality rates were adjusted for sex, age, admission source, Charlson Comorbidity Index, procedure complexity, organ system and primary diagnosis. Differences in overall, 7-day and 30-day in-hospital mortality for hospitals with low (<250), medium (250–449) and high (450+) volume and surgical teams with low (<30), medium (30–59) and high (60+) volume during the study period were also estimated.​ResultsThe study included 10 344 EAS episodes. 798 in-hospital deaths occurred, giving an overall in-hospital mortality rate of 77 per 1000 episodes. There was no statistically significant difference in adjusted mortality rate between low and high volume hospitals. Low volume surgical teams had a higher adjusted mortality rate (85.4 deaths/1000 episodes) compared with high volume teams (54.7 deaths/1000 episodes), a difference that persisted among low volume surgeons practising in high volume hospitals.​ConclusionPatients undergoing EAS managed by high volume surgeons have better survival outcomes. These findings contribute to the ongoing discussion regarding configuration of emergency surgery services and emphasise the need for effective clinical governance regarding observed variation in outcomes within and between institutions.
Associations between adolescent experiences, parent experiences and HbA1c: results following two surveys based on the Norwegian Childhood Diabetes Registry (NCDR)
Authors: Iversen Hilde Hestad , Bjertnaes Oyvind , Skrivarhaug Torild 
Published: November 2019

ObjectiveThe aim of the current study was to determine the association between the experiences of adolescents and their parents with paediatric diabetes care at hospital outpatient departments and the association between these experiences and the Hemoglobin A1c (HbA1c) levels of adolescents.DesignCross-sectional survey.SettingPaediatric diabetes care at hospital outpatient departments in Norway.ParticipantsParents of all outpatients registered in the Norwegian Childhood Diabetes Registry and patients in the same registry aged 12–17 years.Intervention1399 parents participated in a national pilot survey and 335 patients aged 12–17 years from the four largest paediatric outpatient departments in Norway responded in another pilot study. 181 paired parental and patient questionnaires were analysed.Main outcome measuresThe correlations between single items, indicator scores and overall scores were explored, as was that between indicator scores and HbA1c levels.ResultsThere was a moderate but significant correlation between the responses of the patients and parents. For 40 of the 42 associations the correlations were significant, ranging from 0.16 to 0.42. A weak but significant negative correlation was found between the indicator scores of parents and the HbA1c levels of the adolescents. The strongest correlations were between HbA1c level and nurse contact and organisation, both with a correlation coefficient of 0.21 (p<0.01). There was no significant correlation between HbA1c level and patient indicator scores.ConclusionsThese results highlight the need to obtain information from both parents and adolescents, and indicate that the views of adolescents are not always mirrored by their parents. Three of the seven parent experience indicators were significantly related to the HbA1c levels of adolescents, but replication in future research with larger sample sizes is warranted.
Pregnancy outcome in women with atrial septal defect: associated with in vitro fertilisation and pre-eclampsia
Authors: Udholm Sebastian , Udholm Louise , Nyboe Camilla , Kesmodel Ulrik Schiøler , Hjortdal Vibeke Elisabeth 
Published: November 2019

ObjectiveTo investigate in vitro fertilisation (IVF) in women with atrial septal defect (ASD), and to examine the maternal characteristics and outcome of pregnancy, as well as the fetal outcome of infants born by women with ASD.MethodsWe used population-based registries in this nationwide cohort study, including Danish individuals born before 1994 who received an ASD diagnosis between 1959 and 2014. Patients were compared with a random reference sample (ratio of 10 citizens per patient) matched by sex and age. The Danish Medical Birth Register (DMBR) contains data on all pregnancies and births in Denmark from 1977 to present. Risk of IVF treatment as well as maternal, pregnancy and fetal outcomes were compared.ResultsA total of 2277 Danish patients had a validated ASD diagnosis. Of these, 310 women were identified in the DMBR. Women with ASD had an increased risk of receiving IVF treatment (HR 3.14, 95% CI 2.1 to 4.7, p<0.0001), and a higher proportion of patients received IVF treatment when compared with the reference cohort (10.6% vs 3.2%; p<0.001). Furthermore, patients had more multiple births. Looking at singleton pregnancies (n=519), pre-eclampsia occurred more frequently in patients with ASD during pregnancy (6.7% vs 2.3%; p<0.001). Infants from mothers with ASD were found to have perinatal outcomes comparable to those of infants from the reference group.ConclusionWomen with ASD had an increased risk of and received more IVF treatment than the reference group. The outcome of pregnancy in these patients were generally uneventful, however, we did confirm that pre-eclampsia occurred more frequently.