bluuebunny/crossref_metadata_2025_split huggingface dataset:
QBO Influence on MJO Amplitude over the Maritime Continent: Physical Mechanisms and Seasonality
Authors: Densmore Casey R. , Sanabia Elizabeth R. , Barrett Bradford S. 
Published: November 2018

AbstractThe quasi-biennial oscillation (QBO) is stratified by stratospheric zonal wind direction and height into four phase pairs [easterly midstratospheric winds (QBOEM), easterly lower-stratospheric winds, westerly midstratospheric winds (QBOWM), and westerly lower-stratospheric winds] using an empirical orthogonal function analysis of daily stratospheric (100–10 hPa) zonal wind data during 1980–2017. Madden–Julian oscillation (MJO) events in which the MJO convective envelope moved eastward across the Maritime Continent (MC) during 1980–2017 are identified using the Real-time Multivariate MJO (RMM) index and the outgoing longwave radiation (OLR) MJO index (OMI). Comparison of RMM amplitudes by the QBO phase pair over the MC (RMM phases 4 and 5) reveals that boreal winter MJO events have the strongest amplitudes during QBOEM and the weakest amplitudes during QBOWM, which is consistent with QBO-driven differences in upper-tropospheric lower-stratospheric (UTLS) static stability. Additionally, boreal winter RMM events over the MC strengthen during QBOEM and weaken during QBOWM. In the OMI, those amplitude changes generally shift eastward to the eastern MC and western Pacific Ocean, which may result from differences in RMM and OMI index methodologies. During boreal summer, as the northeastward-propagating boreal summer intraseasonal oscillation (BSISO) becomes the dominant mode of intraseasonal variability, these relationships are reversed. Zonal differences in UTLS stability anomalies are consistent with amplitude changes of eastward-propagating MJO events across the MC during boreal winter, and meridional stability differences are consistent with amplitude changes of northeastward-propagating BSISO events during boreal summer. Results remain consistent when stratifying by neutral ENSO phase.
Mechanical Properties and Microstructural Collagen Alignment of the Ulnar Collateral Ligament During Dynamic Loading
Authors: Smith Matthew V. , Castile Ryan M. , Brophy Robert H. , Dewan Ashvin , Bernholt David , Lake Spencer P. 
Published: November 2018

Background: The ulnar collateral ligament (UCL) microstructural organization and collagen fiber realignment in response to load are unknown. Purpose/Hypothesis: The purpose was to describe the real-time microstructural collagen changes in the anterior bundle (AB) and posterior bundle (PB) of the UCL with tensile load. It was hypothesized that the UCL AB is stronger and stiffer with more highly aligned collagen during loading when compared with the UCL PB. Study Design: Descriptive laboratory study. Methods: The AB and PB from 34 fresh cadaveric specimens were longitudinally sectioned to allow uniform light passage for quantitative polarized light imaging. Specimens were secured to a tensile test machine and underwent cyclic preconditioning, a ramp-and-hold stress-relaxation test, and a quasi-static ramp to failure. A division-of-focal-plane polarization camera captured real-time pixelwise microstructural data of each sample during stress-relaxation and at the zero, transition, and linear points of the stress-strain curve. The SD of the angle of polarization determined the deviation of the average direction of collagen fibers in the tissue, while the average degree of linear polarization evaluated the strength of collagen alignment in those directions. Since the data were nonnormally distributed, the median ± interquartile range are presented. Results: The AB has larger elastic moduli than the PB ( P < .0001) in the toe region (median, 2.73 MPa [interquartile range, 1.1-5.6 MPa] vs 0.65 MPa [0.44-1.5 MPa]) and the linear region (13.77 MPa [4.8-40.7 MPa] vs 1.96 MPa [0.58-9.3 MPa]). The AB demonstrated larger stress values, stronger collagen alignment, and more uniform collagen organization during stress-relaxation. PB collagen fibers were more disorganized than the AB during the zero ( P = .046), transitional ( P = .011), and linear ( P = .007) regions of the stress-strain curve. Both UCL bundles exhibited very small changes in collagen alignment (SD of the angle of polarization) with load. Conclusion: The AB of the UCL is stiffer and stronger, with more strongly aligned and more uniformly oriented collagen fibers, than the PB. The small changes in collagen alignment indicate that the UCL response to load is due more to its static collagen organization than to dynamic changes in collagen alignment. Clinical Relevance: The UCL collagen organization may explain its susceptibility to injury with repetitive valgus loads.
Barriers and Facilitators to Food Policy Development in Fiji
Authors: Latu Catherine , Moodie Marj , Coriakula Jeremaia , Waqa Gade , Snowdon Wendy , Bell Colin 
Published: November 2018

Introduction: Policy interventions can encourage healthier dietary choices and help prevent noncommunicable diseases (NCDs). Consequently, governments are seeking to develop and implement food-related policies, but little research on food-related policies is available to guide policy development. Objective: This study aims to provide an in-depth examination of barriers and facilitators to food-related policy development in Fiji. Method: Case studies were undertaken on 7 food-related policies that were recommended for action in 2010. Data were collected in 2015 through 20 key informant interviews with purposely selected officers from relevant government ministries, consumer advocacy groups, and academia as well through document reviews. The interview data were analyzed thematically. Results: Findings were categorized into major themes: leadership, nature of the policy and political environment, and collaboration within and across sectors. Barriers included leaders not being supportive of progressing policy, the content of the policy influencing its adoption, and a lack of consultation with relevant stakeholders. Facilitators included certain leaders’ commitment to driving the policy combined with the support of government at time of deliberation. Good collaboration between government sectors and other stakeholders also facilitated policy endorsement. Conclusion: Attention to leadership, collaboration, policy content, and political environment is likely to enhance the process of developing and implementing food policies targeting NCD prevention in Fiji.
Incidence and predictors of reinfection with trichomoniasis based on nucleic acid amplification testing results in HIV-infected patients
Authors: Muzny Christina A , Tamhane Ashutosh R , Eaton Ellen F , Hudak Kathryn , Burkholder Greer A , Schwebke Jane R 
Published: November 2018

Trichomonas vaginalis infection contributes to HIV transmission. The study objective was to determine the incidence and predictors of T. vaginalis reinfection among HIV-infected women in Birmingham, Alabama. A retrospective cohort study of women at an urban HIV clinic from August 2014 to March 2016 with T. vaginalis by nucleic acid amplification test (NAAT) was conducted. Time to first episode of reinfection was evaluated using Kaplan–Meier survival curves. The association of various predictors was evaluated by univariate and multivariable Cox proportional hazards analyses. Of 612 HIV-infected women at the UAB HIV clinic tested for T. vaginalis by the Aptima TV assay, 110 (18.0%) were identified with prevalent T. vaginalis infection. Overall, 25/110 (22.7%) had a first episode of T. vaginalis reinfection by NAAT with a rate of 3.7 reinfections per 100 person-months (95% confidence interval [CI]: 2.3, 5.2). In univariate analysis, only an HIV viral load (VL) ≥200 copies/ml approached statistical significance (hazard ratio = 2.26; 95% CI: 0.97, 5.29, p = 0.06). After adjusting for age and race, the association of HIV VL ≥200 copies/ml remained strong (adjusted hazard ratio = 2.49; 95% CI: 0.99, 6.27, p = 0.05). T. vaginalis reinfection was high among HIV-infected women in this sample, necessitating enhanced disease control efforts in this high-risk population.
Nivolumab in never-smokers with advanced squamous non-small cell lung cancer: Results from the Italian cohort of an expanded access program
Authors: Garassino Marina Chiara , Crinò Lucio , Catino Annamaria , Ardizzoni Andrea , Cortesi Enrico , Cappuzzo Federico , Bordi Paola , Calabrò Luana , Barbieri Fausto , Santo Antonio , Altavilla Giuseppe , Ambrosio Francesca , Mini Enrico , Vasile Enrico , Morgillo Floriana , Scoppola Alessandro , Bengala Carmelo , Follador Alessandro , Tedde Natale , Giannarelli Diana , Lo Russo Giuseppe , Vitiello Fabiana 
Published: November 2018

Objectives: Never-smokers may be a distinct subgroup among patients with advanced non-small cell lung cancer, appearing to benefit less from immunotherapy than smokers. We report results from never-smokers enrolled in the Italian cohort of the nivolumab expanded access program in pre-treated patients with advanced squamous non-small cell lung cancer. Materials and methods: Nivolumab (3 mg/kg every 2 weeks for ≤24 months) was available on physician request. Efficacy data included objective tumor response, date of progression, and survival information. Safety was monitored. Results: Overall, 371 patients received at least one dose of nivolumab, including 31 never-smokers (8%). Objective response rate, disease-control rate, and median overall survival were 23%, 45%, and 12.1 months (95% confidence interval: 3.7–20.4), respectively, in never-smokers, and 18%, 47%, and 7.9 months (95% confidence interval: 6.2–9.6), respectively, in the overall expanded access program population. Any-grade and grade 3–4 treatment-related adverse events were reported in 12 (39%) and 3 (10%) never-smokers, respectively, and in 109 (29%) and 21 (6%) patients, respectively, in the overall expanded access program population. Grade 3–4 treatment-related adverse events in non-smokers were increased transaminases (n = 2; 6%) and diarrhea (n = 1; 3%). Treatment-related adverse events led to treatment discontinuation in 4 non-smokers (17%) and in 26 patients (9%) overall. Conclusion: Pre-treated never-smokers with advanced squamous non-small cell lung cancer in this Italian expanded access program demonstrated efficacy and safety that were consistent with those in the overall expanded access program population and clinical trials. These results suggest that a proportion of never-smoker patients with squamous non-small cell lung cancer may be responsive to immunotherapy. Other factors, such as the tumor mutational load and the status of programmed death-ligand 1, anaplastic lymphoma kinase, and epidermal growth factor receptor, might play a potential key role.
Single session work: Implementing brief intervention as routine practice in an acute care mental health assessment service.
Authors: Le Gros Jillian , Wyder Marianne , Brunelli Vanessa 
Published: November 2018

Objectives: The study describes the implementation and adaptation of a brief intervention model as routine clinical practice in an acute care service. Methods: An action research process informed the evaluation and design of the intervention. Results: The model’s theoretical framework enhanced clinical practice and benefited consumers, though it was too rigid to be implemented in an acute care setting, so was adapted to suit this environment. Conclusions: This paper highlights the value in realigning practice with fundamental engagement principles to improve practice outcomes.
Carotid surgical cut-down technique for neuroendovascular therapy
Authors: Takano Issei , Matsumoto Yoshiyuki , Fujii Yoshiko , Inoue Yuki , Sugiura Yoshiki , Kawamura Yosuke , Suzuki Ryotaro , Nakae Ryuta , Tanaka Yoshihiro , Nagaishi Masaya , Takigawa Tomoji , Hyodo Akio , Suzuki Kensuke 
Published: November 2018

Background Neuroendovascular therapy is typically performed via the femoral artery, but there are rare cases in which a tortuous upstream angioarchitecture makes it difficult to access the intracranial circulation via this route. Methods In this case series, we describe six cases treated by surgical cut-down in the neck, with puncture of the carotid artery. Antiplatelet and anticoagulation agents were used in all cases. The indications for the technique were postsurgical thoracic aortic aneurysm (two cases), postsurgical abdominal aortic aneurysm (one case), major vessel tortuosity of the common carotid artery (two cases) and aortic arch anomaly (one case). Results The surgical cut-down technique permitted successful neuroendovascular therapy. Although one patient had a small cervical haematoma, he was treated without surgical evacuation. Conclusion Overall, our findings indicate that the surgical cut-down technique is safe and useful for patients in whom the femoral approach is unsuitable.
Oral Administration of a Chemically Modified Curcumin, TRB-N0224, Reduced Inflammatory Cytokines and Cartilage Erosion in a Rabbit ACL Transection Injury Model
Authors: Coury Josephine R. , Nixon Ryan , Collins Melinda , Schwartz John , Chahine Nadeen O. , Grande Daniel A. 
Published: November 2018

Objective To evaluate the effects of TRB-N0224, a chemically modified curcumin (CMC) with zinc binding properties and improved pharmacokinetics, in a rabbit anterior cruciate ligament (ACL) transection injury–induced model of osteoarthritis (OA). Design Thirty-eight skeletally mature New Zealand white rabbits were studied in 4 groups: a sham with arthrotomy ( n = 6), control with ACL transection ( n = 6), and 2 treatment groups with ACL transection and administration of TRB-N0224 at low (25 mg/kg/day) ( n = 13) and high (50 mg/kg/day) ( n = 13) doses. After euthanization at 12 weeks, outcomes were measured by post-necropsy gross morphology, biomechanics, and cartilage and synovium histology. Rabbit blood ELISA quantified cytokine and matrix metalloproteinase (MMP) concentrations at 0, 4, 8, and 12 weeks. Results Both treatment doses had fewer distal femoral condyle erosive defects than the control; the low dose demonstrated a mean 78% decrease ( P < 0.01). Histologically, the low- and high-dose treatment groups had fewer cartilage pathologic changes and less severe synovitis than the control. CMC alone did not have a major effect on the biomechanics of healthy cartilage or cartilage in the ACL transection model, as demonstrated in 5 of the 6 measured properties/regions ( P < 0.05). ELISA results suggested that the key mediators of OA, (interleukin) IL-1β, IL-6, TNFα (tumor necrosis factor-α), MMP-9, and MMP-13, had decreased concentrations with TRB-N0224 treatment at different time points between weeks 4 to 12 ( P < 0.05). Conclusions In the pathogenesis of OA, an imbalance exists between catabolic and anabolic mediators. These results suggest the potential of TRB-N0224 to modulate MMP and cytokine levels, slowing the macroscopic and histopathological progression of OA.
Measuring trainee competence in performing endoscopic retrograde cholangiopancreatography: A systematic review of the literature
Authors: Voiosu Theodor , Bălănescu Paul , Voiosu Andrei , Benguş Andreea , Preda Carmen , Umans Devica S , Bogdan Mateescu Radu , van Hooft Jeanin E 
Published: November 2018

BackgroundCurrent recommendations on training in endoscopic retrograde cholangiopancreatography are predicated on a performance‐centred approach designed to ensure that trainees achieve appropriate skills. We aimed to analyse how competence in endoscopic retrograde cholangiopancreatography is defined in the literature and what proportion of trainees actually reach this threshold.MethodsWe conducted a systematic MEDLINE search for studies reporting on endoscopic retrograde cholangiopancreatography training programmes in a clinical setting. The main outcome measure was threshold for achieving competence in endoscopic retrograde cholangiopancreatography; the secondary outcome measure was assessment of trainee performance. Quality was assessed using the Cochrane Risk of Bias tool and the Methodological Index for Non‐Randomized Studies criteria.ResultsOf 522 initially identified articles, 20 were included in the analysis; most studies showed a high risk of bias. Cannulation rate of the desired duct was the main marker of competence in all studies; however, only 8/20 studies reported on the performance of individual trainees, who achieved their respective standard of competence in only 25.6% of reported cases.ConclusionsCurrent literature identifies cannulation rate of a native papilla to be the most appropriate measure of endoscopic retrograde cholangiopancreatography competence; however, most trainees do not reach predefined competence thresholds. Furthermore, due to the limitations of available studies, the most appropriate competence measure remains subject for debate.
The neutrophil-to-lymphocyte ratio is associated with multiple sclerosis
Authors: Hasselbalch IC , Søndergaard HB , Koch-Henriksen N , Olsson A , Ullum H , Sellebjerg F , Oturai AB 
Published: November 2018

Background Subtypes of white blood cell counts are known biomarkers of systemic inflammation and a high neutrophil-to-lymphocyte ratio (NLR) has been associated with several autoimmune diseases. Few studies have investigated the NLR in multiple sclerosis (MS). Objective To examine the association between NLR, MS and disability measured by the MS severity score (MSSS). Methods Patients were included from the Danish Multiple Sclerosis Biobank. Information on patient NLR was obtained just before their first treatment and clinical information was provided by the Danish Multiple Sclerosis Treatment Register. Information on NLR from controls was collected from the Danish Blood Donor Study. Patients and controls were 1:2 propensity score matched by baseline confounders. Results Propensity score matching left 740 of 743 MS patients and 1420 of 4691 controls for further analyses. Odds-ratio (OR) was 3.64 (95% confidence interval 2.87–4.60, p < 0.001) for MS disease per unit increase of logarithmically transformed NLR (ln-NLR), corresponding to an OR of 2.68 for each doubling of NLR. Mean NLR was 2.12 for patients and 1.72 for controls ( p < 0.001). Ln-NLR correlated weakly with patient MSSS ( R2 = 0.019, p = 0.008). Conclusion Patients with early MS had increased levels of NLR compared to healthy controls and NLR was weakly correlated with MSSS.
Zur Stratizifizierung des wissenschaftlichen Hochschulsystems in der Bundesrepublik Deutschland
Authors: Hummel Thomas R. 
Published: November 2018

Der vorliegende Beitrag diskutiert die Frage, wie vor dem Hintergrund der die Diskussion bestimmenden Schlagworte, Expansion und Wettbewerb im bundesdeutschen Hochschulsystem, die einzelne Hochschule, aber auch die relevanten Abnehmermärkte reagieren werden bzw. können. Aufgrund der beobachtbar real stagnierenden Hochschulbudgets und zu erwartender rückläufiger Studentenzahlen wird allgemein ein sich verschärfender Wettbewerb zwischen den Hochschulen, aber auch innerhalb der Hochschulen, konstatiert. Im Rahmen zweier empirischer Studien wird aufgezeigt, welche Instrumente derzeit den Hochschulen in der Bundesrepublik Deutschland zur Verfügung stehen und wie sie genutzt werden. Implikationen auf der Output-Seite, die insbesondere den entsprechenden Teilarbeitsmarkt tangieren - in diesem Fall die Absolventen wirtschaftswissenschaftlicher Fachbereiche -, werden abschließend aus Sicht der Abnehmer (Personalbereich) aufgezeigt.
Predicting outcomes in rheumatoid arthritis related interstitial lung disease
Authors: Jacob Joseph , Hirani Nikhil , van Moorsel Coline H.M. , Rajagopalan Srinivasan , Murchison John T. , van Es Hendrik W. , Bartholmai Brian J. , van Beek Frouke T. , Struik Marjolijn H.L. , Stewart Gareth A. , Kokosi Maria , Egashira Ryoko , Brun Anne Laure , Cross Gary , Barnett Joseph , Devaraj Anand , Margaritopoulos George , Karwoski Ronald , Renzoni Elisabetta , Maher Toby M. , Wells Athol U. 
Published: November 2018

The aim of this study was to compare radiology-based prediction models in rheumatoid arthritis-related interstitial lung disease (RAILD) to identify patients with a progressive fibrosis phenotype.RAILD patients had computed tomography (CT) scans scored visually and using CALIPER and forced vital capacity (FVC) measurements. Outcomes were evaluated using three techniques, as follows. 1) Scleroderma system evaluating visual interstitial lung disease extent and FVC values; 2) Fleischner Society idiopathic pulmonary fibrosis (IPF) diagnostic guidelines applied to RAILD; and 3) CALIPER scores of vessel-related structures (VRS). Outcomes were compared to IPF patients.On univariable Cox analysis, all three staging systems strongly predicted outcome (scleroderma system hazard ratio (HR) 3.78, p=9×10−5; Fleischner system HR 1.98, p=2×10−3; and 4.4% VRS threshold HR 3.10, p=4×10−4). When the scleroderma and Fleischner systems were combined, termed the progressive fibrotic system (C-statistic 0.71), they identified a patient subset (n=36) with a progressive fibrotic phenotype and similar 4-year survival to IPF. On multivariable analysis, with adjustment for patient age, sex and smoking status, when analysed alongside the progressive fibrotic system, the VRS threshold of 4.4% independently predicted outcome (model C-statistic 0.77).The combination of two visual CT-based staging systems identified 23% of an RAILD cohort with an IPF-like progressive fibrotic phenotype. The addition of a computer-derived VRS threshold further improved outcome prediction and model fit, beyond that encompassed by RAILD measures of disease severity and extent.
Procedure volume and mortality after surgical lung biopsy in interstitial lung disease
Authors: Fisher Jolene H. , Shapera Shane , To Teresa , Marras Theodore K. , Gershon Andrea , Dell Sharon 
Published: November 2018

Surgical volume–outcome relationships are well established but have not been studied in patients with interstitial lung disease (ILD) undergoing surgical lung biopsy (SLB). Our study objective was to determine if hospital SLB volume is associated with post-operative mortality in patients with ILD.A cohort study using administrative, population-based data from Ontario, Canada was performed in adults with ILD who underwent a SLB between 2001 and 2014. The association between yearly hospital SLB volume and 30-day post-operative mortality was assessed using multilevel logistic regression modelling.3057 surgical lung biopsies for ILD were performed during the study period with a median (interquartile range) yearly hospital volume of 73 (34–143) procedures. 30-day mortality was 7.1%, 20.2% and 1.9% in overall, nonelective and elective patients, respectively. Higher yearly hospital SLB volume was associated with lower odds of 30-day post-operative mortality after adjusting for patient characteristics (OR 0.84, 95% CI 0.73–0.97; p=0.02), with the association appearing stronger for nonelectiveversuselective procedures (OR 0.84, 95% CI 0.69–1.02; p=0.08versusOR 0.94, 95% CI 0.74–1.18; p=0.57).Higher yearly hospital SLB volume was associated with lower post-operative mortality in patients with ILD, with the association appearing to be mainly driven by nonelective cases. SLB mortality was significantly higher for nonelective cases.