bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness and Safety of Non–Vitamin K Antagonist Oral Anticoagulant and Warfarin in Cirrhotic Patients With Nonvalvular Atrial Fibrillation
Authors: Lee Hsin‐Fu , Chan Yi‐Hsin , Chang Shang‐Hung , Tu Hui‐Tzu , Chen Shao‐Wei , Yeh Yung‐Hsin , Wu Lung‐Sheng , Kuo Chang‐Fu , Kuo Chi‐Tai , See Lai‐Chu 
Published: March 2019

Background

Liver cirrhotic patients with nonvalvular atrial fibrillation have been excluded from randomized clinical studies regarding oral anticoagulants for stroke prevention. Whether non–vitamin K antagonist oral anticoagulants (
NOAC
s) are superior to warfarin for these patients remains unclear.

Methods and Results

This nationwide retrospective cohort study, with data collected from the Taiwan National Health Insurance Research Database, enrolled 2428 liver cirrhotic patients with nonvalvular atrial fibrillation taking apixaban (n=171), dabigatran (n=535), rivaroxaban (n=732), or warfarin (n=990) from June 1, 2012, to December 31, 2016. We used propensity score–based stabilized weights to balance covariates across study groups. Patients were followed until the occurrence of an event or the end date of study. The
NOAC
group (n=1438) showed risk of ischemic stroke/systemic embolism and intracranial hemorrhage comparable to that of the warfarin group (n=990) after adjustment. The
NOAC
group showed significantly lower risk of gastrointestinal bleeding (hazard ratio: 0.51 [95% CI, 0.32–0.79];
P
=0.0030) and all major bleeding (hazard ratio: 0.51 [95% CI, 0.32–0.74];
P
=0.0003) compared with warfarin group. Overall, 90% (n=1290) of patients were taking a low‐dose
NOAC
(apixaban 2.5 mg twice daily, rivaroxaban 10–15 mg daily, or dabigatran 110 mg twice daily). The subgroup analysis indicated that both dabigatran and rivaroxaban showed lower risk of all major bleeding than warfarin. The advantage of lower gastrointestinal and all major bleeding with
NOACs
over warfarin is contributed by those subgroups with either nonalcoholic or nonadvanced liver cirrhosis.

Conclusions

NOACs have
a risk of thromboembolism comparable to that of warfarin and a lower risk of major bleeding among liver cirrhotic Asian patients with nonvalvular atrial fibrillation. Consequently, thromboprophylaxis with low‐dose
NOAC
s may be considered for such patients.
Determinants of In‐Hospital Mortality After Percutaneous Coronary Intervention: A Machine Learning Approach
Authors: Al'Aref Subhi J. , Singh Gurpreet , van Rosendael Alexander R. , Kolli Kranthi K. , Ma Xiaoyue , Maliakal Gabriel , Pandey Mohit , Lee Bejamin C. , Wang Jing , Xu Zhuoran , Zhang Yiye , Min James K. , Wong S. Chiu , Minutello Robert M. 
Published: March 2019

Background
The ability to accurately predict the occurrence of in‐hospital death after percutaneous coronary intervention is important for clinical decision‐making. We sought to utilize the New York Percutaneous Coronary Intervention Reporting System in order to elucidate the determinants of in‐hospital mortality in patients undergoing percutaneous coronary intervention across New York State.

Methods and Results

We examined 479 804 patients undergoing percutaneous coronary intervention between 2004 and 2012, utilizing traditional and advanced machine learning algorithms to determine the most significant predictors of in‐hospital mortality. The entire data were randomly split into a training (80%) and a testing set (20%). Tuned hyperparameters were used to generate a trained model while the performance of the model was independently evaluated on the testing set after plotting a receiver‐operator characteristic curve and using the output measure of the area under the curve (
AUC
) and the associated 95% CIs. Mean age was 65.2±11.9 years and 68.5% were women. There were 2549 in‐hospital deaths within the patient population. A boosted ensemble algorithm (AdaBoost) had optimal discrimination with
AUC
of 0.927 (95%
CI
0.923–0.929) compared with
AUC
of 0.913 for
XGB
oost (95%
CI
0.906–0.919,
P
=0.02),
AUC
of 0.892 for Random Forest (95%
CI
0.889–0.896,
P
<0.01), and
AUC
of 0.908 for logistic regression (95%
CI
0.907–0.910,
P
<0.01). The 2 most significant predictors were age and ejection fraction.

Conclusions
A big data approach that utilizes advanced machine learning algorithms identifies new associations among risk factors and provides high accuracy for the prediction of in‐hospital mortality in patients undergoing percutaneous coronary intervention.
The Dogma of Dingoes—Taxonomic status of the dingo: A reply to Smith et al.
Authors: JACKSON STEPHEN M. , FLEMING PETER J.S. , ELDRIDGE MARK D.B. , INGLEBY SANDY , FLANNERY TIM , JOHNSON REBECCA N. , COOPER STEVEN J.B. , MITCHELL KIEREN J. , SOUILMI YASSINE , COOPER ALAN , WILSON DON E. , HELGEN KRISTOFER M. 
Published: March 2019

Adopting the name Canis dingo for the Dingo to explicitly denote a species-level taxon separate from other canids was suggested by Crowther et al. (2014) as a means to eliminate taxonomic instability and contention. However, Jackson et al. (2017), using standard taxonomic and nomenclatural approaches and principles, called instead for continued use of the nomen C. familiaris for all domestic dogs and their derivatives, including the Dingo. (This name, C. familiaris, is applied to all dogs that derive from the domesticated version of the Gray Wolf, Canis lupus, based on nomenclatural convention.) The primary reasons for this call by Jackson et al. (2017) were: (1) a lack of evidence to show that recognizing multiple species amongst the dog, including the Dingo and New Guinea Singing Dog, was necessary taxonomically, and (2) the principle of nomenclatural priority (the name familiaris Linnaeus, 1758, antedates dingo Meyer, 1793). Overwhelming current evidence from archaeology and genomics indicates that the Dingo is of recent origin in Australia and shares immediate ancestry with other domestic dogs as evidenced by patterns of genetic and morphological variation. Accordingly, for Smith et al. (2019) to recognise Canis dingo as a distinct species, the onus was on them to overturn current interpretations of available archaeological, genomic, and morphological datasets and instead show that Dingoes have a deeply divergent evolutionary history that distinguishes them from other named forms of Canis (including C. lupus and its domesticated version, C. familiaris). A recent paper by Koepfli et al. (2015) demonstrates exactly how this can be done in a compelling way within the genus Canis—by demonstrating deep evolutionary divergence between taxa, on the order of hundreds of thousands of years, using data from multiple genetic systems. Smith et al. (2019) have not done this; instead they have misrepresented the content and conclusions of Jackson et al. (2017), and contributed extraneous arguments that are not relevant to taxonomic decisions. Here we dissect Smith et al. (2019), identifying misrepresentations, to show that ecological, behavioural and morphological evidence is insufficient to recognise Dingoes as a separate species from other domestic dogs. We reiterate: the correct binomial name for the taxon derived from Gray Wolves (C. lupus) by passive and active domestication, including Dingoes and other domestic dogs, is Canis familiaris. We are strongly sympathetic to arguments about the historical, ecological, cultural, or other significance of the Dingo, but these are issues that will have to be considered outside of the more narrow scope of taxonomy and nomenclature.
Modeling the Transient Response of Tropical Convection to Mesoscale SST Variations
Authors: Skyllingstad Eric D. , de Szoeke Simon P. , O’Neill Larry W. 
Published: March 2019

AbstractA cloud-resolving model coupled to a mixed layer ocean with an initial 500-km-wide, +3-K sea surface temperature (SST) patch is used to demonstrate the relationship between tropical mesoscale SST gradients and convection under different wind speeds. On these scales, boundary layer convergence toward hydrostatic low surface pressure is partially responsible for triggering convection, but convection subsequently organizes into cells and squall lines that propagate away from the patch. For strong wind (12 m s−1), enhanced convection is shifted downstream from the patch and consists of relatively small cells that are enhanced from increased moist static energy (MSE) flux over the patch. Convection for weak wind (6 m s−1) develops directly over the patch, merging in larger-scale coherent squall-line systems that propagate away from the patch. Squall lines decay after approximately 1 day, and convection redevelops over the patch region after 2 days. Decreasing patch SST from ocean mixing in the coupled simulations affects the overall strength of the convection, but does not qualitatively alter the convective behavior in comparison with cases with a fixed 3-K SST anomaly. In all cases, increased fluxes of heat and moisture, along with latent heating from shallow convection, initially generate lower pressure over the patch and convergence of the boundary layer winds. Within about 1 day, secondary convective circulations, such as surface cold pools, act to spread the effects of the convection over the model domain and overwhelm the effect of low pressure. SST anomalies (1 and 0.5 K) generate enhanced convection only for winds below 6 m s−1.
Decadal Variations of the East Asian Summer Monsoon Forced by the 11-Year Insolation Cycle
Authors: Jin Chunhan , Liu Jian , Wang Bin , Yan Mi , Ning Liang 
Published: March 2019

AbstractStatistical evidence suggests that solar activity may affect the atmospheric circulation over East Asia (EA), but the way in which the 11-yr solar radiation cycle affects the East Asian summer monsoon (EASM) remains unexplained. Based on one control experiment and four solar-only forcing experiments performed during the Community Earth System Model–Last Millennium Ensemble (CESM-LME) model project, we explore the potential impacts of the 11-yr solar cycle on EASM variability and the physical processes through which solar forcing influences EASM decadal variability. The model results show that the warm season [May–September (MJJAS)] mean precipitation over EA exhibits significant decadal variation with a “northern wet–southern dry” pattern during peak years in the strong 11-yr solar cycle epoch (AD 900–1285), which is in contrast to the absence of decadal signals during the weak 11-yr solar cycle epoch (AD 1400–1535). For the four-member ensemble averaged solar-only forcing experiment, the summer mean precipitation over northern EA is significantly correlated with the solar forcing (r = 0.414, n = 68, p < 0.05) on a decadal time scale during the strong cycle epoch, whereas there is no statistical link between the EASM and solar activity during the weak cycle epoch (r = 0.002, n = 24). A strong, 11-yr solar cycle is also shown to excite an anomalous sea surface temperature (SST) pattern that resembles a cool Pacific decadal oscillation (PDO) phase, which has a significant 11-yr periodicity. The associated anomalous North Pacific anticyclone dominates the entire extratropical North Pacific and enhances the southerly monsoon over EA, which results in abundant rainfall over northern EA. We argue that the 11-yr solar cycle affects the EASM decadal variation through excitation of a coupled decadal mode in the Asia–North Pacific region.
Evaluation of Gridded and In Situ Precipitation Datasets on Modeled Glacio-Hydrologic Response of a Small Glacierized Himalayan Catchment
Authors: Mimeau Louise , Esteves Michel , Jacobi Hans-Werner , Zin Isabella 
Published: March 2019

Abstract
Reliable precipitation data in the Himalayas are essential for the study of the water resources, the evolution of glaciers, and the present and future climate. Although several types of precipitation datasets are available for the Himalayan region, all of them have limitations, which hamper the quantification of the precipitation fluxes at high elevations. This study compares different types of precipitation datasets issued from (i) in situ data, (ii) satellite-based data [TRMM, Climate Hazards Group Infrared Precipitation with Station Data (CHIRPS)], and (iii) a reanalysis product [High Asia Refined analysis (HAR)] for a small headwater catchment at high elevations (Upper Dudh Koshi, Nepal) and assesses the impact of the precipitation uncertainty on the result of the modeling of the glacio-hydrological system. During the analyzed period from 2010 to 2015, large differences between the precipitation datasets occur regarding annual amounts (ranging from 410 to 1190 mm yr−1) as well as in seasonal and diurnal cycles. The simulations with the glacio-hydrological model Distributed Hydrological Soil Vegetation Model–Glaciers Dynamics Model (DHSVM-GDM) show that the choice of a given precipitation dataset greatly impacts the simulated snow cover dynamics and glacier mass balances as well as the annual, seasonal, and diurnal streamflows. Due to the uncertainty in the precipitation, the simulated contribution of the ice melt to the annual outflow also remains uncertain and simulated fractions range from 29% to 76% for the 2012–13 glaciological year.
Improvement of Mountain-Wave Turbulence Forecasts in NOAA’s Rapid Refresh (RAP) Model with the Hybrid Vertical Coordinate System
Authors: Kim Jung-Hoon , Sharman Robert D. , Benjamin Stanley G. , Brown John M. , Park Sang-Hun , Klemp Joseph B. 
Published: March 2019

Abstract
Spurious mountain-wave features have been reported as false alarms of light-or-stronger numerical weather prediction (NWP)-based cruise level turbulence forecasts especially over the western mountainous region of North America. To reduce this problem, a hybrid sigma–pressure vertical coordinate system was implemented in NOAA’s operational Rapid Refresh model, version 4 (RAPv4), which has been running in parallel with the conventional terrain-following coordinate system of RAP version 3 (RAPv3). Direct comparison of vertical velocity |w| fields from the RAPv4 and RAPv3 models shows that the new RAPv4 model significantly reduces small-scale spurious vertical velocities induced by the conventional terrain-following coordinate system in the RAPv3. For aircraft-scale turbulence forecasts, |w| and |w|/Richardson number (|w|/Ri) derived from both the RAPv4 and RAPv3 models are converted into energy dissipation rate (EDR) estimates. Then, those EDR-scaled indices are evaluated using more than 1.2 million in situ EDR turbulence reports from commercial aircraft for 4 months (September–December 2017). Scores of the area under receiver operating characteristic curves for the |w|- and |w|/Ri-based EDR forecasts from the RAPv4 are 0.69 and 0.83, which is statistically significantly improved over the RAPv3 of 0.63 and 0.77, respectively. The new RAPv4 became operational on 12 July 2018 and provides better guidance for operational turbulence forecasting over North America.
Validated liquid chromatography coupled to tandem mass spectrometry method for simultaneous quantitation of tolvaptan and its five major metabolites in human plasma
Authors: Hoshikawa Kohei , Naito Takafumi , Saotome Masao , Maekawa Yuichiro , Kawakami Junichi 
Published: March 2019

Background Tolvaptan is converted to major metabolites including three monohydroxylates (DM-4110, DM-4111 and DM-4119), an oxidate (MOP-21826) and a carboxylate (DM-4103) in humans. This study developed a simultaneous quantitative method for tolvaptan and its five major metabolites in human plasma using liquid chromatography coupled to tandem mass spectrometry. Methods Deproteinized plasma specimens using acetonitrile were separated using a 3- μm particle size octadecylsilyl column with 250 mm length and a simple linear gradient program at a flow rate of 0.3 mL/min with a total run time of 15 min. This method was applied to the determination of plasma samples collected from 20 heart failure patients treated with 3.75–15 mg tolvaptan. Results No interfering peak was found in drug-free plasma specimens. The calibration curves of tolvaptan, DM-4110, DM-4111, DM-4119, MOP-21826 and DM-4103 were linear over the concentration ranges of 3.125–1000, 0.3125–100, 1.25–400, 0.625–200, 0.125–40 and 31.25–10,000 ng/mL, respectively. Their pretreatment recovery rates and matrix factors were 94.1–113.9% and 86.9–108.0%, respectively. The intra- and inter-day accuracies and imprecisions were 91.6–106.5% and 0.9–10.9%, respectively, for all analytes. The plasma concentration ranges of tolvaptan, DM-4110, DM-4111, DM-4119, MOP-21826 and DM-4103 were 9.37–280, 1.91–16.3, 3.43–88.9, 1.43–10.4, 0.160–1.01 and 40.2–1471 ng/mL, respectively, in heart failure patients. Conclusions This validated method with acceptable analytical performance can be utilized for evaluating the pharmacokinetics of oral tolvaptan, including the determination of its major metabolites, in heart failure patients.
Analysis of the Influence of Standard Time Variability on the Reliability of the Simulation of Assembly Operations in Manufacturing Systems
Authors: Machado Rafaela Heloisa Carvalho , Helleno André Luis , de Oliveira Maria Célia , Santos Mário Sérgio Corrêa dos , Dias Renan Meireles da Costa 
Published: March 2019

Objective: The aim of this article is to analyze the influence of the variability of the standard time in the simulation of the assembly operations of manufacturing systems. Background: Discrete event simulation (DES) has been used to provide efficient analysis during the design of a process or scenario. However, the modeling activities of new configurations face the problem of data availability and reliability when it comes to seeking standard times that are effective in representing the actual process under analysis, especially when the process cannot be monitored. Method: The methods-time measurement (MTM) is used as a source of standard times for simulation. Assembly activities were performed at a Learning Factory facility, which provided the necessary structure for simulating real production processes. Simulation performances using different variability of standard times were analyzed to define the impact of data characteristics. Results: The MTM standard time presented an error of approximately 5%. The definition of the data variability of standard times and the statistical distribution impacts were shown in the simulation results, with errors above 6% being observed, interfering with the model reliability. Conclusion: Based on the study, to increase the adherence of a simulation to represent a real process, it is recommended to use triangular distributions with central values greater than those established via the MTM for the representation of the standard times of new assembly processes or scenarios using DES. Application: The study contributions can be applied in assembly line design, providing a reliable model representing real processes and scenarios.
Opioids, (Non)-medical Marijuana, and the Cult of the Body
Authors: Schimmoeller Ethan 
Published: March 2019

Ohio’s first medical marijuana dispensaries will open in the fall of 2018, so physicians, then, must decide whether they will participate. But is medical marijuana really medical? No, at best, it is an unproven botanical. Medicine today is progressively moving away from traditional understandings of health according to formal and final causation and toward wellness as an expanding, subjective ideal. Whereas patients are healthy if the doctor says so, patients are well if they say so. Pitched as a wellness product, cannabis presents itself as an existential palliative, part of an imminent cult of the body. Consequently, people often use cannabis to escape reality according to a new age mythos. Physicians can play their part by choosing not to certify for “medical” marijuana and seek to rediscover the body as more than mere dead matter in motion rather than insulating ourselves from the difficult questions of suffering, meaning, and purpose. Summary: Despite state-level legality, medical marijuana is not medical. Rather, it is often touted as part of a cult of the body to escape suffering and death.
A Randomized Single‐Blinded Trial of Ibuprofen‐ versus Opioid‐Based Primary Analgesic Therapy in Outpatient Otolaryngology Surgery
Authors: Nguyen Khanh K. , Liu Yuan F. , Chang Crystal , Park Jaimie J. , Kim Cherine H. , Hondorp Brian , Vuong Christopher , Xu Helen , Crawley Brianna K. , Simental Alfred A. , Church Christopher A. , Inman Jared C. 
Published: March 2019

ObjectiveTo compare the efficacy of pain control and opioid consumption between patients who receive opioid as primary analgesic therapy and those who receive ibuprofen.Study DesignProspective randomized trial.SettingTertiary care academic hospital.Subject and MethodsAdult patients undergoing outpatient otolaryngology surgery were assigned to take hydrocodone/acetaminophen or ibuprofen for postoperative analgesia. Patient‐recorded pain scores and analgesic consumption were analyzed.ResultsOut of 185 recruits, 108 (58%) completed responses. Fifty‐six patients (52%) received opioid medication for primary analgesic treatment versus 52 (48%) who received ibuprofen. There was no difference in reported pain scores between the treatment groups. Those who received ibuprofen as primary therapy reported a significantly lower consumption of opioid medication at 2.04 tablets/pills (95% CI, 0.9‐3.1) versus 4.86 (3.6‐6.1; P =. 001). Based on multivariate analysis, male sex and older age exhibited lower reported pain scores, while older age and use of ibuprofen as primary therapy exhibited lower opioid requirements.ConclusionFor postoperative pain management in outpatient otolaryngology procedures, ibuprofen as primary therapy can provide equally effective pain control as compared with hydrocodone/acetaminophen while decreasing overall opioid requirement. Prescription pill counts are further described to help guide physician practices in the era of an opioid epidemic.
Role of preoperative blood markers as prognostic factors for lung cancer surgery
Authors: Hamid Umar Imran , Al-Saudi Reza , Paul Ian , Graham Alastair 
Published: March 2019

Objective This study was undertaken to assess the potential value of preoperative blood components as prognostic markers of outcome after lung cancer resection, and hence their potential to aid in the selection of patients for curative surgery. Methods This was a single-center study on 313 patients who underwent surgery for non-small-cell lung cancer from 2006 to 2008. Data were analyzed retrospectively from a prospectively maintained thoracic database. Preoperative blood results including plasma fibrinogen levels, serum C-reactive protein, hemoglobin concentration, and platelet count were included in the analysis. Results The mean age was 75 years, and 40% of the patients were females. The most common resection was lobectomy in 68% of patients, followed by pneumonectomy, wedge resection, and segmentectomy in 18%, 10%, and 1.6%, respectively. Patients with abnormal C-reactive protein, fibrinogen, and hemoglobin levels had a worse overall survival. Large tumor size and nodal metastasis on clinical staging was also associated with poor survival. However, on Cox regression analysis, plasma fibrinogen and nodal metastasis were the only independent predictors of survival after lung resection. Conclusions Among the different blood markers, elevated preoperative plasma fibrinogen was an independent marker of reduced survival in patients with resected non-small-cell lung cancer, and its value in selecting patients who may benefit from surgery needs further investigation.