bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining the Impacts of Great Lakes Temperature Perturbations on Simulated Precipitation in the Northeastern United States
Authors: Hanrahan Janel , Langlois Jessica , Cornell Lauren , Huang Huanping , Winter Jonathan M. , Clemins Patrick J. , Beckage Brian , Bruyère Cindy 
Published: June 2021

AbstractMost inland water bodies are not resolved by general circulation models, requiring that lake surface temperatures be estimated. Given the large spatial and temporal variability of the surface temperatures of the North American Great Lakes, such estimations can introduce errors when used as lower boundary conditions for dynamical downscaling. Lake surface temperatures (LSTs) influence moisture and heat fluxes, thus impacting precipitation within the immediate region and potentially in regions downwind of the lakes. For this study, the Advanced Research version of the Weather Research and Forecasting Model (WRF-ARW) was used to simulate precipitation over the six New England states during a 5-yr historical period. The model simulation was repeated with perturbed LSTs, ranging from 10°C below to 10°C above baseline values obtained from reanalysis data, to determine whether the inclusion of erroneous LST values has an impact on simulated precipitation and synoptic-scale features. Results show that simulated precipitation in New England is statistically correlated with LST perturbations, but this region falls on a wet–dry line of a larger bimodal distribution. Wetter conditions occur to the north and drier conditions occur to the south with increasing LSTs, particularly during the warm season. The precipitation differences coincide with large-scale anomalous temperature, pressure, and moisture patterns. Care must therefore be taken to ensure reasonably accurate Great Lakes surface temperatures when simulating precipitation, especially in southeastern Canada, Maine, and the mid-Atlantic region.
Rainfall spatio-temporal correlation and intermittency structure from micro-γ to meso-β scale in the Netherlands
Authors: van Leth Thomas C. , Leijnse Hidde , Overeem Aart , Uijlenhoet Remko 
Published: June 2021

AbstractWe investigate the spatio-temporal structure of rainfall at spatial scales from 7m to over 200 km in the Netherlands. We used data from two networks of laser disdrometers with complementary interstation distances in two Dutch cities (comprising five and six disdrometers, respectively) and a Dutch nationwide network of 31 automatic rain gauges. The smallest aggregation interval for which raindrop size distributions were collected by the disdrometers was 30 s, while the automatic rain gauges provided 10-min rainfall sums. This study aims to supplement other micro-γ investigations (usually performed in the context of spatial rainfall variability within a weather radar pixel) with new data, while characterizing the correlation structure across an extended range of scales. To quantify the spatio-temporal variability, we employ a two-parameter exponential model fitted to the spatial correlograms and characterize the parameters of the model as a function of the temporal aggregation interval. This widely used method allows for a meaningful comparison with seven other studies across contrasting climatic settings all around the world. We also separately analyzed the intermittency of the rainfall observations. We show that a single parameterization, consisting of a two-parameter exponential spatial model as a function of interstation distance combined with a power-law model for decorrelation distance as a function of aggregation interval, can coherently describe rainfall variability (both spatial correlation and intermittency) across a wide range of scales. Limiting the range of scales to those typically found in micro-γ variability studies (including four of the seven studies to which we compare our results) skews the parameterization and reduces its applicability to larger scales.
Time to abandon the old dictum of delayed laparoscopic cholecystectomy after acute cholecystitis has settled in Caribbean practice
Authors: Cawich Shamir O , Mahabir Avidesh H , Griffith Sahle , FaSiOen Patrick , Naraynsingh Vijay 
Published: June 2021

Although laparoscopic cholecystectomy is the gold standard treatment for acute cholecystitis, many Caribbean surgeons are reluctant to operate during the acute attack. We collected data for all consecutive patients who underwent laparoscopic cholecystectomy for acute cholecystitis from January 1 to 31 December 2018. Delayed cholecystectomy was done >6 weeks after acute cholecystitis settled. We compared data between early and delayed groups. Delayed laparoscopic cholecystectomy was performed in 54 patients, and 42 had early laparoscopic cholecystectomy. Delayed surgery resulted in significantly more complications requiring readmission (39% vs 0), longer operations (2.27 vs 0.94 h) and lengthier post-operative hospitalisation (1.84 vs 1.1 days). Caribbean hospitals should abandon the practice of delayed surgery after cholecystitis has settled. Early laparoscopic cholecystectomy would be financially advantageous for our institutions, and it would save patients recurrent attacks of gallstone disease.
A prospective, observational study of fidaxomicin use for Clostridioides difficile infection in France
Authors: Guery Benoit , Berger Pierre , Gauzit Remy , Gourdon Magali , Barbut Frédéric ,   for the DAFNE study group, DAFNE study group:  , Bémer Pascale , Bessède Emilie , Camou Fabrice , Cattoir Vincent , Couzigou Carine , Descamps Dominique , Dinh Aurélien , Laurans Caroline , Lavigne Jean-Philippe , Lechiche Catherine , Leflon-Guibout Véronique , Le Monnier Alban , Levast Marion , Mootien Joy Yoganaden , N’Guyen Yohan , Piroth Lionel , Prazuck Thierry , Rogeaux Olivier , Roux Anne-Laure , Vachée Anne , Vernet Garnier Véronique , Wallet Frédéric 
Published: June 2021

Objective To describe the characteristics, management and outcomes of hospitalised patients with Clostridioides difficile infection (CDI) treated with and without fidaxomicin. Methods This prospective, multicentre, observational study (DAFNE) enrolled hospitalised patients with CDI, including 294 patients treated with fidaxomicin (outcomes recorded over a 3-month period) and 150 patients treated with other CDI therapies during three 1-month periods. The primary endpoint was baseline and CDI characteristics of fidaxomicin-treated patients. Results At baseline, the fidaxomicin-treated population included immunocompromised patients (39.1%) and patients with severe (59.2%) and recurrent (36.4%) CDI. Fidaxomicin was associated with a high rate of clinical cure (92.2%) and low CDI recurrence (16.3% within 3 months). Clinical cure rates were ≥90% in patients aged ≥65 years, those receiving concomitant antibiotics and those with prior or severe CDI. There were 121/296 (40.9%) patients with adverse events (AEs), 5.4% with fidaxomicin-related AEs and 1.0% with serious fidaxomicin-related AEs. No fidaxomicin-related deaths were reported. Conclusions Fidaxomicin is an effective and well-tolerated CDI treatment in a real-world setting in France, which included patients at high risk of adverse outcomes. Trial registration: Description of the use of fidaxomicin in hospitalised patients with documented Clostridium difficile infection and the management of these patients (DAFNE), NCT02214771, www.ClinicalTrials.gov.
Application of a second opinion ultrasound in Breast Imaging Reporting and Data System 4A cases: can immediate biopsy be avoided?
Authors: Cai Yantao , Zhu Chenfang , Chen Qianqian , Zhao Feng , Guo Shanyu 
Published: June 2021

Objective The probability of malignancy in women who are diagnosed with a Breast Imaging Reporting and Data System (BI-RADS) 4A score is low. Application of a second opinion ultrasound (SOUS), which is low in cost and minimally invasive, may lower the biopsy rate for patients who fall into this category. This study aimed to apply SOUS to patients with a BI-RADS score of 4A and predict the pathological results of a biopsy. Methods One hundred seventy-eight patients were analyzed. Univariate and multivariate analyses were performed to screen for predictive factors that are associated with malignancy. Categorical alteration of downgraded, unchanged, or upgraded was made after SOUS results. Changes in category were compared with biopsies to determine their predictive value of benignancy or malignancy. Results Independent factors associated with malignancy were age (>50 years), tumor size (≥20 mm), margin (not circumscribed), orientation (not parallel), and peripheral location, and an upgraded categorical alteration from SOUS. Downgraded categorical alterations were associated with benignancy. Conclusions In BI-RADS 4A cases, a biopsy is recommended when independent factors are associated with malignancy. A downgraded result from an SOUS examination is a protective factor, supporting the likelihood of benignancy in these patients.
What Surrogates Understand (and Don’t Understand) About Patients’ Wishes After Engaging Advance Care Planning: A Qualitative Analysis
Authors: Simmons David B. , Levi Benjamin H. , Green Michael J. , La In Seo , Lipnick Daniella , Smith Theresa J. , Thiede Elizabeth R. , Wiegand Debra L. , Van Scoy Lauren 
Published: June 2021

Background: The goal of advance care planning (ACP) is to improve end-of-life decision-making for patients and their spokespersons, but multiple studies have failed to show substantial or consistent benefit from ACP. Understanding how and why ACP under-performs in the setting of complex medical decision-making is key to optimizing current, or designing new, ACP interventions. Aim: To explore how ACP did or did not contribute to a spokespersons’ understanding of patient wishes after engaging in ACP. Design: Thematic analysis of 200 purposively sampled interviews from a randomized control trial of an ACP decision aid. Setting/Participants: 200 dyads consisting of patients 18 years or older with advanced serious illness and their spokesperson at 2 tertiary care centers in Hershey, PA and Boston, MA. Participants were interviewed 1 month after completing ACP. Results: ACP helped participants: 1) express clear end-of-life wishes, 2) clarify values, and 3) recognize challenges associated with applying those wishes in complex situations. Shortcomings of ACP included 1) unknown prognostic information or quality-of-life outcomes to inform decision-making, 2) skepticism about patients’ wishes, and 3) complicated emotions impacting end-of-life discussions. Conclusions: Helping patients and their spokespersons better anticipate decision-making in the face of prognostic and informational uncertainty as well as the emotional complexities of making medical decisions may improve the efficacy of ACP interventions.
Reduced emergency room visits and improved medication adherence of an integrated oncology pharmaceutical care practice in China
Authors: Qi Huijie , Zhu Lili , Chen Lu , Zhang Wenxin , Wang Tianxiao , Chen Haifei , Wu Qian , Zhan Qiong , Le Tianji , Zhang Liudi , Zhong Mingkang , Shi Xiaojin , Li Qunyi 
Published: June 2021

Objective We described our initial experience of a new integrated oncology phamaceutical care practice to enhance the quality of pharmacy service and patient care in Huashan hospital. Data sources: A retrospective study was performed from August 2019 to September 2020. Patients were described as integrated pharmacy service group and routine care group. Medication adherence of patients in integrated pharmacy service group was recorded by the online management system. Patient satisfaction and the cumulative incidence of emergency room (ER) and outpatient visit were evaluated between two groups. Data summary: In total, 323 patients received the integrating oncology pharmacy service. The percentage of the patients missing administration every day was reduced from 29.7% to 0.3% within a 40-day monitoring and intervention period. There was a significant difference on patient satisfaction with pharmacy service in two groups ( P < 0.05). Fewer patients in the integrated pharmacy service group visited clinic and ER compared with routine care group (33.1% vs. 59.2%; P < 0.05). Conclusions As a new practice model, the integrated program is adopted to provide patient care and ongoing monitoring for cancer patients. The practice model delivers high continuity of care for cancer patients and improves communication and collaboration between healthcare professionals and oncology patients. The practice also provides the potential of developing hospital pharmaceutical service and optimizing disease prevention and treatment strategies.
Visceral segment aortic thrombus is associated with proximal aortic degeneration after infrarenal abdominal aortic aneurysm repair
Authors: Steenberge Sean P , Clair Daniel G , Eagleton Matthew J , Caputo Francis J , Smolock Christopher J , Lyden Sean P 
Published: June 2021

Objective To identify predictors of aortic aneurysm formation at or above an infrarenal abdominal aortic aneurysm repair. Methods A total of 881 infrarenal abdominal aortic aneurysm repairs were identified at a single institution from 2004 to 2008; 187 of the repairs were identified that had pre-operative and post-operative computed tomography imaging at least one year or greater to evaluate for aortic degeneration following repair. Aortic diameters at the celiac, superior mesenteric, and renal arteries were measured on all available computed tomographic scans. Aortic thrombus and calcification volumes in the visceral and infrarenal abdominal aortic segments were calculated. Multivariable modeling was used with log transformed variables to determine potential predictors of future aortic aneurysm development after infrarenal abdominal aortic aneurysm repair. Results Of the 187 patients in the cohort, 100 had an open abdominal aortic aneurysm repair while 87 were treated with endovascular repair. Proximal aortic aneurysms developed in 26% ( n = 49) of the cohort during an average of 72 ± 34.2 months of follow-up. After multivariable modeling, visceral segment aortic thrombus on pre-operative computed tomography imaging increased the risk of aortic aneurysm development above the infrarenal abdominal aortic aneurysm repair within both the open abdominal aortic aneurysm (hazard ratio 2.04, p = 0.033) and endovascular repair (hazard ratio 3.31, p = 0.004) cohorts. Endovascular repair was independently associated with a higher risk of future aortic aneurysm development after infrarenal abdominal aortic aneurysm repair when compared to open abdominal aortic aneurysm (hazard ratio 2.19, p = 0.025). Conclusions Visceral aortic thrombus present prior to abdominal aortic aneurysm repair and endovascular repair are both associated with an increased risk of future proximal aortic degeneration after infrarenal abdominal aortic aneurysm repair. These factors may predict patients at higher risk of developing proximal aortic aneurysms that may require complex aortic repairs.
The anatomy of CUSMA’s patent: Does it still reflect an equipoise?
Authors: Boru Zeleke Temesgen 
Published: June 2021

The Protocol of Amendment to the Agreement between the United States of America, Canada and the United Mexican States erased many of the TRIPS-plus provisions inserted earlier into the Canada- United States of America-Mexico Agreement (hereafter, CUSMA) signed on 30 November 2018. While the erasure of the provisions shows the contributions made to promote access to medicines, the Agreement still retains TRIPS-plus provisions, including the provisions on patent term extensions. Thus seen, irrespective of the changes introduced by the Protocol of Amendment, patent term extensions may have a negative implication on access to cost-cutting medicines (biosimilars and generics). Against this backdrop, this paper focuses on patent term extensions, as contained in the CUSMA’s Intellectual Property Rights (IPRs) chapter. The paper investigates if & how the patent term extension has the potential to impede access to affordable medicines (biologics and chemically synthesized medicines). In so doing, the paper provides possible responses to the question, do the provisions on patent term extensions hinder the timely access to affordable medicines? As such, the first part of the paper succinctly looks at CUSMA. Section “Patent protection under the TRIPS agreement” examines the TRIPS patent regime. While “The CUSMA’s rules on patent term extension” section discusses the nature of obligations included in the CUSMA’s IPRs chapter, the Section “The CUSMA’s rules on patent term extension vis-à-vis access to medicines” analyzes the potential implications of patent term extensions on access to affordable medicines. The final section concludes the paper.
Malignant middle cerebral artery syndrome with thrombotic thrombocytopenia following vaccination against SARS-CoV-2
Authors: Jacob Carmen , Rani Khairil Amir , Holton Patrick James , Boyce Sara Rosalind , Weir Nicolas Ulrick , Griffith Colin Roderick , Eynon Colin Andrew 
Published: June 2021

Cases of thromboses at unusual sites with thrombocytopenia have been reported following vaccination against Sars-CoV-2. This new syndrome, christened vaccine-induced thrombotic thrombocytopenia (VITT), mainly results in venous thromboses. We report the case of a young woman with a right middle cerebral artery stroke following vaccination with ChAdOx1 nCoV-19. A diagnosis of VITT was made and platelet counts began to recover shortly after commencing treatment with argatroban, intravenous immunoglobulins and corticosteroids. On day 6 following admission, the patient deteriorated neurologically and decision made to proceed with decompressive hemicraniectomy. There were no perioperative complications and anticoagulation with argatroban was reinitiated on the first postoperative day. VITT is a rare condition resembling auto-immune heparin-induced thrombocytopenia. All critical care staff should be aware of the rare link between vaccination against SARS-CoV-2 and VITT and the need to rapidly commence both anticoagulation, using heparin alternatives, and immunomodulation.
Evaluation of the short-term efficacy of local analgesic (lidocaine) and opioid analgesic (sufentanil) on patients with centrally mediated abdominal pain syndrome: a randomized controlled trial
Authors: Yang Hang , Chen Honglin , Hu Bing 
Published: June 2021

Background: Centrally mediated abdominal pain syndrome (CAPS) is characterized by continuous or frequently recurring abdominal pain and can result in functional loss across several life domains. The efficacy of the present management methods has not been established yet. We performed a prospective randomized controlled trial to explore the short-term efficacy of local analgesic (lidocaine) and opioid analgesic (sufentanil) in patients with CAPS. Methods: We consecutively enrolled 130 patients who met the Rome IV CAPS criteria and divided them into the sufentanil + lidocaine (S + L) group and sufentanil (S) group. Patients completed the pain rating scales, including the numeric rating scale (NRS) and verbal rating scale (VRS), 60 min before colonoscopy. All the patients were initially administered sufentanil. In the S + L group, we sprayed a 5 ml solution of lidocaine on the surface of ascending, transverse, descending, and sigmoid colon during colonoscope withdrawal, while 5 ml saline was sprayed in the S group. Follow up was performed 1 day, 3 days, 1 week, 2 weeks, 1 month, and 3 months after colonoscopy, to complete the pain scaling. Results: A comparison of the NRS and VRS showed that there were no significant differences between the S + L and S groups and within each group ( p > 0.05). Conclusions: Local analgesic lidocaine and opioid analgesic sufentanil showed negative efficacy during short-term observation. The opioid receptor blocker sufentanil did not worsen symptoms in patients with CAPS after colonoscopy under general anesthesia in the short term. [chictr.org.cn, Chinese Clinical Trial Identifier, ChiCTR-IOR-16008187]
Health-Related Quality of Life in Ankle Osteoarthritis: A Case-Control Study
Authors: Paget Liam D.A. , Tol Johannes L. , Kerkhoffs Gino M.M.J. , Reurink Gustaaf 
Published: June 2021

Objective Ankle osteoarthritis (OA) has a prevalence of 3.4% in the general population of which 70% to 78% is posttraumatic, affecting younger patients with a longer projected life span compared with hip and knee OA. The current literature reports the physical and mental quality of life (QoL) of patients with ankle OA, to be similar to end-stage hip OA, end-stage kidney disease and digestive heart failure. However, the QoL of ankle OA patients has not yet been determined compared with a matched control group representing the general population. Our aim is to determine the physical and mental QoL compared with a matched control group. Design The Physical and Mental Component Summaries of the Short Form–36 of 100 patients with ankle OA were compared with 91 age- and gender-matched controls. This case-control study is a substudy of the PRIMA trial, in which the efficacy of platelet-rich plasma injections for ankle OA is determined. Results A clinically relevant difference was found for both the Physical ( P=0.003; 95% CI −6.7 to −1.3) and Mental Component Summary scores ( P < 0.001; 95% CI −10 to −6). Patients with ankle OA had a median of 45 points (matched controls 52 points) and 43 points (matched controls 53 points) for the Physical and Mental Component summary scores, respectively. Conclusions Patients with ankle OA had a clinically relevant poorer mental and physical QoL compared with matched controls from the general population. Furthermore, the physical QoL of patients with ankle OA from younger age categories was affected more than those in older age categories.
Neglected cardiovascular risk factors: Relationship of anxiety and depression with percutaneous coronary angioplasty
Authors: Hadi Mohd Firdaus bin , Siew Kelvin Shenq Woei , Mohd Firdaus Mohd Al-Baqlish , Mohammad Aidid Edre bin , Kong Sylvia Wei Wei , Zainal Abidin Imran Bin 
Published: June 2021

Introduction: Coronary artery disease (CAD) is the leading cause of mortality in Malaysia. Psychological risk factors are associated with detrimental outcomes in CAD. Our study aimed to evaluate procedural anxiety and depression levels among subjects who underwent coronary angioplasty. Methods: A single-centre prospective cohort study was conducted on patients electively admitted to a tertiary hospital in Malaysia for percutaneous coronary intervention (PCI) over a half-year period. The Hospital Anxiety and Depression Scale (HADS) and the EuroQol-5 Dimension (EQ5D) Health Questionnaire were used to evaluate subjects’ psychological statuses. The EQ Visual Analogue Scale was used for the global assessment of their health. Results: The analysis included 65 patients with a mean age of 63 years from a predominately educated population ( n=54; 83.1%). Before the PCI procedure, female sex was found to be protective against depression, with an odds ratio (ORs) of 0.29 (95% confidence interval (CI) 0.08–1.03). A high level of education was protective against anxiety (OR=0.21; 95% CI 0.06–0.83). After the PCI, females were more likely to be depressed (OR=3.89; 95% CI 1.13–13.37), and those of Malay ethnicity were more likely to be anxious (OR=4.2; 95% CI 1.03–17.07). Using the HADS, subjects were significantly less anxious and depressed (pre-PCI: median (IQR) score=4 (7.0)); post-PCI: median (IQR) score=3 (5.0), p=0.02), measured by the HADS. Using the EQ5D, subjects had an improved mean VAS score (post-PCI: 75±14.9; pre-PCI: 68±12.6; p<0.05). Conclusions: PCI may predispose patients with CAD to psychological stressors. Female patients and those of Malay ethnicity are more likely to experience psychological stress. Being highly educated is protective against such stress.