bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Nature of Eddy Kinetic Energy in the Labrador Sea: Different Types of Mesoscale Eddies, Their Temporal Variability, and Impact on Deep Convection
Authors: Rieck Jan K. , Böning Claus W. , Getzlaff Klaus 
Published: June 2019

AbstractOceanic eddies are an important component in preconditioning the central Labrador Sea (LS) for deep convection and in restratifying the convected water. This study investigates the different sources and impacts of eddy kinetic energy (EKE) and its temporal variability in the LS with the help of a 52-yr-long hindcast simulation of a 1/20° ocean model. Irminger Rings (IR) are generated in the West Greenland Current (WGC) between 60° and 62°N, mainly affect preconditioning, and limit the northward extent of the convection area. The IR exhibit a seasonal cycle and decadal variations linked to the WGC strength, varying with the circulation of the subpolar gyre. The mean and temporal variations of IR generation can be attributed to changes in deep ocean baroclinic and upper-ocean barotropic instabilities at comparable magnitudes. The main source of EKE and restratification in the central LS are convective eddies (CE). They are generated by baroclinic instabilities near the bottom of the mixed layer during and after convection. The CE have a middepth core and reflect the hydrographic properties of the convected water mass with a distinct minimum in potential vorticity. Their seasonal to decadal variability is tightly connected to the local atmospheric forcing and the associated air–sea heat fluxes. A third class of eddies in the LS are the boundary current eddies shed from the Labrador Current (LC). Since they are mostly confined to the vicinity of the LC, these eddies appear to exert only minor influence on preconditioning and restratification.
Forecast Sensitivity Observation Impact in the 4DVAR and Hybrid-4DVAR Data Assimilation Systems
Authors: Kim Sung-Min , Kim Hyun Mee 
Published: June 2019

AbstractIn this study, the observation impacts on 24-h forecast error reduction (FER), based on the adjoint method in the four-dimensional variational (4DVAR) data assimilation (DA) and hybrid-4DVAR DA systems coupled with the Unified Model, were evaluated from 0000 UTC 5 August to 1800 UTC 26 August 2014. The nonlinear FER in hybrid-4DVAR was 12.2% greater than that in 4DVAR due to the use of flow-dependent background error covariance (BEC), which was a weighted combination of the static BEC and the ensemble BEC based on ensemble forecasts. In hybrid-4DVAR, the observation impacts (i.e., the approximated nonlinear FER) for most observation types increase compared to those in 4DVAR. The increased observation impact from using hybrid-4DVAR instead of 4DVAR changes depending on the analysis time and regions. To calculate the ensemble BEC in hybrid-4DVAR, analyses at 0600 and 1800 UTC (0000 and 1200 UTC) used 3-h (9-h) ensemble forecasts. Greater observation impact was obtained when 3-h ensemble forecasts were used for the ensemble BEC at 0600 and 1800 UTC, than with 9-h ensemble forecasts at 0000 and 1200 UTC. Different from other observations, the atmospheric motion vectors (AMVs) deduced from geostationary satellite are more frequently observed in the same area. When the ensemble forecasts with longer integration times were used for the ensemble BEC in hybrid-4DVAR, the observation impact of the AMVs decreased the most in East Asia. This implies that the observation impact of AMVs in East Asia shows the highest sensitivity to the integration time of the ensemble members used for deducing the flow-dependent BEC in hybrid-4DVAR.
Reports and Victims of Sex and Labor Trafficking in a Major Midwest Metropolitan Area, 2008-2017
Authors: Koegler Erica , Mohl Amanda , Preble Kathleen , Teti Michelle 
Published: June 2019

Objective: The objective of this study was to determine the number, risk factors, and demographic characteristics of potential human trafficking victims from tips reported to a social services agency in a major Midwest metropolitan area from 2008 through 2017. Methods: The agency, comprising 90 employees serving more than 10 000 persons annually, received federal funding to raise awareness about trafficking and to identify and support persons who are at risk for trafficking through training, coalition building, direct outreach and service, and case management. We, the authors, counted the numbers of tips and potential victims reported to the agency by year, type of trafficking, economic sector, sex, region of origin, and age and looked for new risk factors for trafficking. Results: Data were available for 213 tips received from September 1, 2008, through June 30, 2017, and for 82 potential victims identified from July 1, 2011, through June 30, 2017. Labor trafficking (126 tips, 57 potential victims) was more common than sex trafficking (59 tips, 17 potential victims). The number of tips varied during the study period. Tips and potential victims were diverse and included male and female children and adults. Most victims were from Mexico (n = 68), the United States (n = 47), Asia (n = 31), and Central and South America (n = 23). Potential victims were exploited in several industries including agriculture, construction, commercial sex, and landscaping. New risk factors for trafficking were exploitation within marriage and work in the sales industry. Conclusions: Domestic and foreign-born men, women, and children are all at risk for labor and sex trafficking. Direct outreach to foreign-born victims should be a priority. The new risk factors should be explored.
Associations of lymphocyte percentage and red blood cell distribution width with risk of lung cancer
Authors: Ma Cong , Wang Xiaoyan , Zhao Rui 
Published: June 2019

Objective There is ample evidence to indicate that inflammation is involved in tumorigenesis. Lymphocyte percentage (LYM%) and red blood cell distribution width (RDW) are easily measured indicators of systemic inflammation. This study aimed to investigate the associations between LYM% and RDW and the risk of lung cancer. Methods We retrospectively reviewed the records of 430 patients with lung cancer and 158 healthy individuals (control group). Twenty clinical characteristics were analyzed, including LYM% and RDW. Significant laboratory indices were determined by univariate analysis and logistic regression was conducted to identify independent predictors of lung cancer risk. Results Patients with lung cancer had significantly lower LYM% and higher RDW levels compared with healthy controls. LYM% and RDW were confirmed to be independent predictors of lung cancer risk. LYM% also differed significantly among different histological subtypes of lung cancer. Conclusion A high risk of lung cancer was closely correlated with low LYM% and high RDW. LYM% and RDW are easily measured and may therefore aid the assessment and timely screening of lung cancer risk.
Memory clinic survey in New Zealand: a second look
Authors: Stone Constance , Copeland Bronwyn , Collier Cheryl , Cheung Gary 
Published: June 2019

Objective: To investigate the changes in publicly funded memory clinics in New Zealand’s since the last survey in 2008. Method: We conducted an online survey of the 20 District Health Boards (DHBs) and gathered information on the recently discontinued or established memory clinics. Results: We found dedicated memory clinics in the seven DHBs that have the largest older persons populations in New Zealand. Those DHBs that had discontinued their memory clinics did so because they opted for a more integrated approach using their primary care based dementia care pathway. Increased waiting times, low staffing ratios, variance in cognitive screening tests and patient demographics were reported. Conclusions: There is significant variability in the structure of memory clinics in New Zealand. These clinics could benefit from collaboration and bench-marking of their services.
Serum Chemerin Levels Correlate With Determinants of Metabolic Syndrome in Obese Children and Adolescents
Authors: Ba Hong-Jun , Xu Ling-Ling , Qin You-Zhen , Chen Hong-Shan 
Published: June 2019

Objectives: This study aimed to investigate serum chemerin concentrations in obese children and adolescents and to investigate the associations of chemerin with body mass index (BMI), lipid levels, and insulin sensitivity. Methods: Forty-eight obese and 40 nonobese Chinese children and adolescents were included in the study. BMI and levels of chemerin, lipids, glucose, and insulin were measured following an overnight fast. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and BMI standard deviation score (BMI-SDS) were determined for all participants. Results: Serum chemerin levels were found to be significantly higher in obese children and adolescents than in control group members (94.83 ± 5.99 ng/mL vs 56.43 ± 4.16 ng/mL, P < .001). There were significant correlations between chemerin and age, BMI, BMI-SDS, total triglyceride (TG) levels, insulin levels, and HOMA-IR. After controlling for age, we found that chemerin levels were also significantly correlated with BMI-SDS (r =+ 0.284, P = .008) and HOMA-IR (r =+ 0.241, P = .034). In a stepwise multiple regression analysis, we observed only BMI-SDS to be an important determinant of chemerin level. Conclusions: In our sample of Chinese children and adolescents, chemerin levels were significantly higher in the obese group than in the control group. Chemerin levels were positively correlated with BMI-SDS and HOMA-IR and negatively correlated with age. We thus believe that further study is necessary to investigate the risk of metabolic abnormalities in young obese children and adolescents.
Barriers to post-diagnostic care and support in minority ethnic communities: A survey of Danish primary care dementia coordinators
Authors: Nielsen T Rune , Nielsen Dorthe S , Waldemar Gunhild 
Published: June 2019

Background People from minority ethnic groups are under-represented in dementia diagnosis, treatment, and care. The aim of this study was to examine barriers to accessing post-diagnostic care and support in minority ethnic communities from the perspective of primary care dementia coordinators in Denmark. Method A survey questionnaire investigating issues related to provision of care and support services in minority ethnic communities was conducted among 41 primary care dementia coordinators representing all Danish geographic regions. Responses were primarily based on five-point Likert scales. Results from geographic regions with different rates of people from minority ethnic communities with dementia were compared. Results Among the surveyed dementia coordinators, 95% generally thought that providing dementia care and support services to minority ethnic service users was challenging. Strategies for overcoming cultural and linguistic barriers were generally sparse. Uptake of most post-diagnostic services was perceived to be influenced by service users’ minority ethnic background. Communication difficulties, poor knowledge about dementia among minority ethnic service users, inadequate cultural sensitivity of care workers, and a lack of suitable dementia services for minority ethnic communities were highlighted as some of the main barriers. Not surprisingly, 97% generally found minority ethnic families to be more involved in provision of personal care and support compared to ethnic Danish families. Conclusion There is a need to develop methods and models for post-diagnostic care and support that include cultural awareness and diversity for interacting with different cultural communities.
Modifiable Risk Factors for Delayed Graft Function After Deceased Donor Kidney Transplantation
Authors: Kaufmann Kai B. , Baar Wolfgang , Silbach Kai , Knörlein Julian , Jänigen Bernd , Kalbhenn Johannes , Heinrich Sebastian , Pisarski Przemyslaw , Buerkle Hartmut , Göbel Ulrich 
Published: June 2019

Purpose: Delayed graft function is a major complication after kidney transplantation affecting patients’ long-term outcome. The aim of this study was to identify modifiable risk factors for delayed graft function after deceased donor kidney transplantation. Methods: This is a single-center retrospective cohort study of a university transplantation center. Univariate and multivariate step-wise logistic regression analysis of patient-specific and procedural risk factors were conducted. Results: We analyzed 380 deceased donor kidney transplantation patients between October 30, 2008 and December 30, 2017. The incidence of delayed graft function was 15% (58/380). Among the patient-specific risk factors recipient diabetes (2.8 [1.4-5.9] odds ratio [OR] [95% confidence interval [CI]]), American Society of Anesthesiologist score of 4 (2.7 [1.2-6.5] OR [95% CI]), cold ischemic time >13 hours (2.8 [1.5-5.3] OR [95% CI]) and donor age >55 years (1.9 [1.01-3.6] OR [95% CI]) revealed significance. The significant intraoperative, procedural risk factors included the use of colloids (3.9 [1.4-11.3] OR [95% CI]), albumin (3.0 [1.2-7.5] OR [95% CI]), crystalloids >3000 mL (3.1 [1.2-7.5] OR [95% CI]) and mean arterial pressure <80 mm Hg at the time of reperfusion (2.4 [1.2-4.8] OR [95% CI]). Conclusion: Patients undergoing deceased donor kidney transplantation with a mean arterial pressure >80 mm Hg at the time of transplant reperfusion without requiring excessive fluid therapy in terms of colloids, albumin or crystalloids >3000 mL are less likely to develop delayed graft function.
Bilateral iliac vein stenting reduces great and small saphenous venous reflux
Authors: Chait Jesse , Kibrik Pavel , Kenney Kevin , Alsheekh Ahmad , Ostrozhynskyy Yuriy , Marks Natalie , Hingorani Anil , Rajaee Sareh , Ascher Enrico 
Published: June 2019

Objective Iliac vein stenting has been an evolving treatment option in the management of CVI secondary to iliac vein obstruction. Historically, treatment of CVI has been focused on the elimination of saphenous vein disease; however, the effect of reduction of iliac vein obstruction on superficial venous reflux remains largely unknown. This study aimed to identify the effect of iliac vein stenting on saphenous vein reflux. Methods In this retrospective study spanning course of five years, we performed 2681 venograms with venoplasties and stenting of the iliac veins. Pre-operative and post-operative venous mapping was performed via duplex ultrasonography. Patients who received any lower extremity vascular intervention between “pre-” and “post-stenting” duplex ultrasonography examination, other than iliac vein stenting, were excluded from analysis. Results One thousand six hundred forty-five patients, of which 63.2% were female, underwent iliac vein stenting; 1033 patients received bilateral intervention, whereas 356 and 259 patients received unilateral left and right stenting, respectively. The average age of the patient cohort was 66 (range 22–100; SD ± 13.9). The distribution CEAP scores of each limb at the time of intervention were: C2 (1%), C3 (25%), C4 (51%), C5 (5%), and C6 (18%). Bilateral iliac vein stenting significantly reduced reflux in the bilateral great saphenous and small saphenous veins by 363.8 ms ( p < 0.0001) and 345.4 ms ( p < 0.0002), respectively, but had no effect on ASV reflux. Unilateral stenting did not produce significant reductions in reflux, besides an average reduction of 573.2 ms ( p = 0.004) in the left great saphenous vein. Conclusion Bilateral iliac vein stenting decreased great saphenous vein and small saphenous vein reflux. Unilateral stenting did not demonstrate a significant reduction in saphenous reflux. Bilateral reduction in stenosis of the iliac veins may influence superficial venous reflux.
Outcomes of patients with single-bone-forearm surgery: a clinical assessment and three-dimensional motion analysis
Authors: Schachinger Florian , Pobatschnig Barbara , Kranzl Andreas , Stauffer Alexandra , Farr Sebastian 
Published: June 2019

The creation of a single-bone-forearm is a salvage procedure to stabilize the forearm. The purpose of this study was to investigate clinical outcomes and how these patients compensate for the lack of forearm rotation. We evaluated four patients (three children, one adult) who had undergone single-bone-forearm surgery. Patients were examined clinically and with three-dimensional motion analysis. We found these patients are generally capable to perform important activities of daily living (e.g. glass jug pouring), which would normally need forearm rotation. Motion analysis revealed remarkable compensatory motion at other joints during these activities. We conclude that patients with a single-bone-forearm can maintain a certain level of daily activities by using compensatory motions at other joints, although the time needed to complete the tasks may be longer. Level of evidence: IV
Rates of Comorbid Anxiety and Depression in Patients With Age-Related Macular Degeneration
Authors: Olson Daniel , Zhang Xinxin , Ward Michael F. , Le Patrick , Ismail Omar M. , Poole Zachary B. , Donaldson Jared C. , Van Buren Eric , Lin Feng-Chang , Ulrich Jan N. , Davis Richard M. 
Published: June 2019

Purpose: The purpose of this article is to investigate how age-related macular degeneration (AMD) is associated with anxiety and depression. Methods: An online repository of deidentified patient data was queried to identify and retrospectively analyze patients with AMD, depression, or anxiety via ICD-9 and ICD-10 codes. Odds ratios were calculated between AMD and anxiety and depression, respectively. Results: Of the 51 019 patients analyzed in this study, 11 681 (22.9%) had depression, 8727 (17.1%) had anxiety, and 2752 (5.4%) had AMD. The prevalence of anxiety among AMD patients was 18.2%, and the prevalence of depression among AMD patients was 25.0%. The odds of a patient with AMD carrying a diagnosis of anxiety are 1.3 (95% CI 1.2, 1.5) times higher than a patient without AMD, and the odds of carrying a diagnosis of depression are also 1.3 (95% CI 1.1, 1.4) times more likely. Conclusions: Patients with AMD have increased odds of suffering from comorbid anxiety and depression. Ophthalmologists should consider mental health screens and appropriate referrals as new diagnoses of AMD are made or as the disease progresses.
Combined inhibition of Bcl-2 and NFκB synergistically induces cell death in cutaneous T-cell lymphoma
Authors: Froehlich Tabea C. , Müller-Decker Karin , Braun Jana D. , Albrecht Thomas , Schroeder Anne , Gülow Karsten , Goerdt Sergij , Krammer Peter H. , Nicolay Jan P. 
Published: June 2019

AbstractTherapeutic options for cutaneous T-cell lymphoma (CTCL) are limited and curative treatment regimens are not available. Thus, new targeted and well-tolerated therapeutic approaches are urgently needed. In this respect, we have recently shown that dimethyl fumerate (DMF) inhibits NF-κB acting as a survival factor in CTCL. Similarly, inhibition of the antiapoptotic protein B-cell lymphoma 2 (Bcl-2) has been shown to induce cell death in CTCL especially when combined with histone deacetylase inhibitors. Therefore, we hypothesized that inhibition of Bcl-2 should potentiate NF-κB inhibition in a novel combination treatment of CTCL. We show that, in vitro, the Bcl-2 inhibitors ABT-199 and ABT-263 induced specific cell death in primary CD4+ cells from CTCL patients as well as in the CTCL cell line SeAx, but not in T cells of healthy donors nor in the CTCL cell line HH, which lacks Bcl-2. Combined treatment with ABT-199 and DMF caused synergistic cell death specifically in CTCL cells engaging 2 independent signaling pathways. To verify these findings in vivo, we performed combined ABT-199 and DMF treatment in a xenograft mouse model for CTCL. The combined treatment effectively reduced tumor growth and increased overall survival via synergistic induction of CTCL cell death and suppression of tumor cell proliferation. Essentially, the combination treatment was superior to ABT-199 monotherapy with respect to both efficacy and tolerability. To sum up, our data provide proof of principle for the therapeutic potential of combining Bcl-2 and NF-κB inhibitors in treating CTCL. Next, this potential should be explored further in a clinical study.
Process evaluation of the Healthy Primary School of the Future: the key learning points
Authors: Bartelink N. H. M. , van Assema P. , Jansen M. W. J. , Savelberg H. H. C. M. , Moore G. F. , Hawkins J. , Kremers S. P. J. 
Published: June 2019

Abstract

Background
While schools have potential to contribute to children’s health and healthy behaviour, embedding health promotion within complex school systems is challenging. The ‘Healthy Primary School of the Future’ (HPSF) is an initiative that aims to integrate health and well-being into school systems. Central to HPSF are two top-down changes that are hypothesized as being positively disruptive to the Dutch school system: daily free healthy lunches and structured physical activity sessions. These changes are expected to create momentum for bottom-up processes leading to additional health-promoting changes. Using a programme theory, this paper explores the processes through which HPSF and the school context adapt to one another. The aim is to generate and share knowledge and experiences on how to implement changes in the complex school system to integrate school health promotion.

Methods
The current study involved a mixed methods process evaluation with a contextual action-oriented research approach. The processes of change were investigated in four Dutch primary schools during the development year (2014–2015) and the first two years of implementation (2015–2017) of HPSF. The schools (each with 15–26 teachers and 233–389 children) were in low socio-economic status areas. Measurements included interviews, questionnaires, observations, and analysis of minutes of meetings.

Results
Top-down advice, combined with bottom-up involvement and external practical support were key facilitators in embedding HPSF within the schools’ contexts. Sufficient coordination and communication at the school level, team cohesion, and feedback loops enhanced implementation of the changes. Implementation of the healthy lunch appeared to be disruptive and create momentum for additional health-promoting changes.

Conclusions
Initiating highly visible positive disruptions to improve school health can act as a catalyst for wider school health promotion efforts. Conditions to create a positive disruption are enough time, and sufficient bottom-up involvement, external support, team cohesion and coordination. The focus should be on each specific school, as each school has their own starting point and process of change.

Trial registration
The study was retrospectively registered in the ClinicalTrials.gov database on 14 June 2016 (NCT02800616).