bluuebunny/crossref_metadata_2025_split huggingface dataset:
Artificial neural network‐based modeling of snow properties using field data and hyperspectral imagery
Authors: Haq Mohd Anul , Ghosh Abhijit , Rahaman Gazi , Baral Prashant 
Published: July 2019

AbstractThis study attempts to model snow wetness and snow density of Himalayan snow cover using a combination of Hyperspectral image processing and Artificial Neural Network (ANN). Initially, a total of 300 spectral signature measurements, synchronized with snow wetness and snow density, were collected in the field. The spectral reflectance of snow was then modeled as a function of snow properties using ANN. Four snow wetness and three snow density models were developed. A strong correlation was observed in near‐infrared and shortwave‐infrared region. The correlation analysis of ANN modeled snow density and snow wetness showed a strong linear relationship with field‐based data values ranging from 0.87–0.90 and 0.88–0.91, respectively. Our results indicate that an Artificial Intelligence (AI) approach, using a combination of Hyperspectral image processing and ANN, can be efficiently used to predict snow properties (wetness and density) in the Himalayan region.Recommendations for resource managers

Snow properties, such as snow wetness and snow density are mainly investigated through field‐based survey but rugged terrains, difficult weather conditions, and logistics management issues establish remote sensing as an efficient alternative to monitor snow properties, especially in the mountain environment.
Although Hyperspectral remote sensing is a powerful tool to conduct the quantitative analysis of the physical properties of snow, only a few studies have used hyperspectral data for the estimation of snow density and wetness in the Himalayan region. This could be because of the lack of synchronized snow properties data with field‐based spectral acquisitions.
In combination with Hyperspectral image processing, Artificial Neural Network (ANN) can be a useful tool for effective snow modeling because of its ability to capture and represent complex input‐output relationships.
Further research into understanding the applicability of neural networks to determine snow properties is required to obtain results from large snow cover areas of the Himalayan region.
Delayed recognition of childhood arterial ischemic stroke
Authors: Hori Ikumi , Tsuji Takeshi , Miyake Misa , Ueda Kazuto , Kataoka Erina , Suzuki Michio , Kobayashi Satoru , Kurahashi Hirokazu , Takahashi Yoshiyuki , Okumura Akihisa , Yoshikawa Tetsushi , Saitoh Shinji , Natsume Jun 
Published: July 2019

AbstractBackgroundFew population‐based surveys of childhood arterial ischemic stroke (AIS) have been conducted in Asian countries. The aim of this study was to investigate the clinical features, time to diagnosis, and prognosis of childhood AIS in a population‐based cohort in Japan.MethodsChildren aged 29 days–15 years 11 months old, residing in the Aichi Prefecture of Japan with radiologically confirmed AIS during 2010–2014, were identified retrospectively through questionnaires. We analyzed 40 children (23 boys, 17 girls; median age, 7 years 3 months), and collected time interval information of 26 patients. The time from clinical onset to first physician assessment and the time to AIS diagnosis were calculated.ResultsThe most common presentation was paralysis or paresis in 27 patients (71%). No underlying disorders or possible trigger factors were identified in 14 patients (35%). The median time from symptom onset to first physician assessment was 2.9 h. The median time from symptom onset to the confirmed AIS diagnosis was 27.0 h. The diagnosis of AIS was made in the first 6 h after onset of symptoms in 27% of patients for whom the time was available. Radiological diagnosis took longer than 24 h in 54% of these patients.ConclusionsLong in‐hospital delays exist in the diagnosis of AIS in children, likely due to lack of awareness of stroke by doctors. Further efforts to increase public and physician awareness of childhood stroke are needed to ensure early diagnosis and treatment.
A systematic review: Current trends and take rates of cultured epithelial autografts in the treatment of patients with burn injuries
Authors: Lo Cheng H. , Chong Elaine , Akbarzadeh Shiva , Brown Wendy A. , Cleland Heather 
Published: July 2019

ABSTRACTSeveral issues persist in clinical translation and application of cultured epithelial autografts during treatment of patients with massive burn injuries. The aim of this systematic review is to determine (1) current practice and trends in clinical application and (2) clinical efficacy of cultured epithelial autografts. A structured literature search was performed in Ovid MEDLINE from 1946 and Ovid EMBASE from 1974 until present. All published peer‐reviewed randomized or non‐randomized clinical studies, cohort studies, prospective, or retrospective series involving human application of cultured epithelial autografts in the setting of burn injury were included. From 7,267 studies initially identified, 77 studies were included in the analysis. In 96% (74/77) of these series, the sample size was less than 100 patients. In 76.6% (59/77) publications, average burn treated exceeded 40% total body surface area. Overall, cultured epithelial autograft take rates reported in the literature were inconsistent and varied significantly from 0 to 100%. There was a recent trend for co‐application of cultured grafts with autologous skin grafts, achieving relatively high and consistent take rates of 73–96%. Results from cultured epithelial autograft application remained unpredictable. This technology remains an adjunct or biological dressing, and not an alternative to conventional split skin graft. However, it has contributed to wound closure and it has been life saving in selected circumstances. Skin tissue engineering should continue as the clinical need for skin replacement is foreseeable into the future.
Professionals’ accounts of genetic testing in adoption: a qualitative study
Authors: Arribas-Ayllon Michael , Clarke Angus , Shelton Katherine 
Published: July 2019

ObjectiveTo explore social workers’ and medical advisors’ accounts of genetic testing in adoption.MethodsA qualitative study using semi-structured interviews to gather in-depth accounts of retrospective cases. Data were analysed thematically to identify professionals’ knowledge and expectations.ResultsTwenty professionals working in adoption services (including 8 medical advisors and 12 social workers) participated in this study. Social workers adopted an essentialist (single-gene) model to discuss genetic testing in relation to past cases. They assumed that testing was a generic procedure for detecting the presence or absence of a specific aetiology, the results of which were believed to be definitive and mutually exclusive. By contrast, medical advisors were circumspect and agnostic about the meaning of results, especially in relation to chromosomal microarray testing. Whereas social workers believed that genetic testing provided clarity in assessment and therefore assisted adoption, medical advisors emphasised the uncertainties of testing and the possibility that prospective adopters might be misled. Medical advisors also reported inappropriate requests to test children where there was a family history of a genetic condition, or to confirm or exclude a diagnosis of fetal alcohol spectrum disorder in children presenting with non-specific dysmorphic features.ConclusionRecent advances in genetic technologies are changing the ways in which professionals understand and tolerate uncertainty in adoption. Social workers and medical advisors have different understandings and expectations about the clinical utility of genetic testing. These findings have implications for social work training about genetic testing and enabling effective communication between professional groups.
Sugary drink consumption and risk of cancer: results from NutriNet-Santé prospective cohort
Authors: Chazelas Eloi , Srour Bernard , Desmetz Elisa , Kesse-Guyot Emmanuelle , Julia Chantal , Deschamps Valérie , Druesne-Pecollo Nathalie , Galan Pilar , Hercberg Serge , Latino-Martel Paule , Deschasaux Mélanie , Touvier Mathilde 
Published: July 2019

AbstractObjectiveTo assess the associations between the consumption of sugary drinks (such as sugar sweetened beverages and 100% fruit juices), artificially sweetened beverages, and the risk of cancer.DesignPopulation based prospective cohort study.Setting and participantsOverall, 101 257 participants aged 18 and over (mean age 42.2, SD 14.4; median follow-up time 5.1 years) from the French NutriNet-Santé cohort (2009-2017) were included. Consumptions of sugary drinks and artificially sweetened beverages were assessed by using repeated 24 hour dietary records, which were designed to register participants’ usual consumption for 3300 different food and beverage items.Main outcome measuresProspective associations between beverage consumption and the risk of overall, breast, prostate, and colorectal cancer were assessed by multi-adjusted Fine and Gray hazard models, accounting for competing risks. Subdistribution hazard ratios were computed.ResultsThe consumption of sugary drinks was significantly associated with the risk of overall cancer (n=2193 cases, subdistribution hazard ratio for a 100mL/d increase 1.18, 95% confidence interval 1.10 to 1.27, P<0.0001) and breast cancer (693, 1.22, 1.07 to 1.39, P=0.004). The consumption of artificially sweetened beverages was not associated with the risk of cancer. In specific subanalyses, the consumption of 100% fruit juice was significantly associated with the risk of overall cancer (2193, 1.12, 1.03 to 1.23, P=0.007).ConclusionsIn this large prospective study, the consumption of sugary drinks was positively associated with the risk of overall cancer and breast cancer. 100% fruit juices were also positively associated with the risk of overall cancer. These results need replication in other large scale prospective studies. They suggest that sugary drinks, which are widely consumed in Western countries, might represent a modifiable risk factor for cancer prevention.Study registrationClinicalTrials.govNCT03335644.
Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy: retrospective cohort study
Authors: Walsh Laura K , Donelle Jessy , Dodds Linda , Hawken Steven , Wilson Kumanan , Benchimol Eric I , Chakraborty Pranesh , Guttmann Astrid , Kwong Jeffrey C , MacDonald Noni E , Ortiz Justin R , Sprague Ann E , Top Karina A , Walker Mark C , Wen Shi Wu , Fell Deshayne B 
Published: July 2019

Abstract

Objective
To determine whether any association exists between exposure to 2009 pandemic H1N1 (pH1N1) influenza vaccination during pregnancy and negative health outcomes in early childhood.

Design
Retrospective cohort study.

Setting
Population based birth registry linked with health administrative databases in the province of Ontario, Canada.

Participants
All live births from November 2009 through October 2010 (n=104 249) were included, and children were followed until 5 years of age to ascertain study outcomes.

Main outcome measures
Rates of immune related (infectious diseases, asthma), non-immune related (neoplasms, sensory disorders), and non-specific morbidity outcomes (urgent or inpatient health services use, pediatric complex chronic conditions) were evaluated from birth to 5 years of age; under-5 childhood mortality was also assessed. Propensity score weighting was used to adjust hazard ratios, incidence rate ratios, and risk ratios for potential confounding.

Results
Of 104 249 live births, 31 295 (30%) were exposed to pH1N1 influenza vaccination in utero. No significant associations were found with upper or lower respiratory infections, otitis media, any infectious diseases, neoplasms, sensory disorders, urgent and inpatient health services use, pediatric complex chronic conditions, or mortality. A weak association was observed between prenatal pH1N1 vaccination and increased risk of asthma (adjusted hazard ratio 1.05, 95% confidence interval 1.02 to 1.09) and decreased rates of gastrointestinal infections (adjusted incidence rate ratio 0.94, 0.91 to 0.98). These results were unchanged in sensitivity analyses accounting for any potential differential healthcare seeking behavior or access between exposure groups.

Conclusions
No associations were observed between exposure to pH1N1 influenza vaccine during pregnancy and most five year pediatric health outcomes. Residual confounding may explain the small associations observed with increased asthma and reduced gastrointestinal infections. These outcomes should be assessed in future studies.
Understanding safety differently: developing a model of resilience in the use of intravenous insulin infusions in hospital in-patients—a feasibility study protocol
Authors: Iflaifel Mais Hasan , Lim Rosemary , Ryan Kath , Crowley Clare , Iedema Rick 
Published: July 2019

BackgroundIntravenous insulin infusions are considered the treatment of choice for critically ill patients and non-critically ill patients with persistent raised blood glucose who are unable to eat, to achieve optimal blood glucose levels. The benefits of using intravenous insulin infusions as well as the problems experienced are well described in the scientific literature. Traditional approaches for improving patient safety have focused on identifying errors, understanding their causes and designing solutions to prevent them. Such approaches do not take into account the complex nature of healthcare systems, which cannot be controlled solely by following standards. An emerging approach called Resilient Healthcare proposes that, to improve safety, it is necessary to focus on how work can be performed successfully as well as how work has failed.Methods and analysisThe study will be conducted at Oxford University Hospitals NHS Foundation Trust and will involve three phases. Phase I: explore how work is imagined by analysing intravenous insulin infusion guidelines and conducting focus group discussions with guidelines developers, managers and healthcare practitioners. Phase II: explore the interplay between how work is imagined and how work is performed using mixed methods. Quantitative data will include blood glucose levels, insulin infusion rates, number of hypoglycaemic and hyperglycaemic events from patients’ electronic records. Qualitative data will include video reflexive ethnography: video recording healthcare practitioners using intravenous insulin infusions and then conducting reflexive meetings with them to discuss selected video footage. Phase III: compare findings from phase I and phase II to develop a model for using intravenous insulin infusions.Ethics and disseminationEthical approvals have been granted by the South Central—Oxford C Research Ethics Committee, Oxford University Hospitals NHS Foundation Trust and University of Reading. The results will be disseminated through presentations at appropriate conferences and meetings, and publications in peer-reviewed journals.
How does clinical space utilisation impact patient flow?
Authors: von Guionneau Alexandra , Burford Charlotte M 
Published: July 2019

BackgroundLong waiting times in accident and emergency (A&E) departments remain one of the largest barriers to the timely assessment of critically unwell patients. In order to reduce the burden on A&Es, some trusts have introduced ambulatory care areas (ACAs) which provide acute assessment for general practitioner referrals. However, ACAs are often based on already busy acute medical wards and the availability of clinical space for clerking patients means that these patients often face long waiting times too. A cheap and sustainable method to reducing waiting times is to evaluate current space utilisation with the view to making use of underutilised workspace. The aim of this quality improvement project was to improve accessibility to pre-existing clinical spaces, and in doing so, reduce waiting times in acute admissions.MethodsData were collected retrospectively from electronic systems and used to establish a baseline wait time from arrival to having blood taken (primary outcome). Quality improvement methods were used to identify potential implementations to reduce waiting time, by increasing access to clinical space, with serial measurements of the primary outcome being used to monitor change.ResultsData were collected over 54 consecutive days. The median wait time increased by 55 min during the project period. However, this difference in waiting time was not deemed significant between the three PDSA cycles (p=0.419, p=0.270 and p=0.350, Mann-Whitney U). Run chart analysis confirmed no significant changes occurred.ConclusionIn acute services, one limiting factor to seeing patients quickly is room availability. Quality improvement projects, such as this, should consider facilitating better use of available space and creating new clinical workspaces. This offers the possibility of reducing waiting times for both staff and patients alike. We recommend future projects focus efforts on integration of their interventions to generate significant improvements.
Medical oncologists’ and palliative care physicians’ opinions towards thromboprophylaxis for inpatients with advanced cancer: a cross-sectional study
Authors: Hannon Breffni , Taback Nathan , Zimmermann Camilla , Granton John , Krzyzanowska Monika 
Published: July 2019

BackgroundPatients with advanced cancer are increasingly discharged from inpatient settings following focused symptom management admissions. Thromboprophylaxis (TP) is recommended for patients with cancer admitted to acute care settings; less is known about TP use in palliative care (PC) settings. This study explored the opinions of Canadian medical oncologists (MO) and PC physicians regarding the use of TP for inpatients with advanced cancer.MethodsA fractional factorial survey designed to evaluate the impact of patient factors (age, clinical setting, reason for admission, pre-admission performance status (Eastern Cooperative Oncology Group; ECOG), and risk of bleeding on anticoagulation) and physician demographics on recommending TP was administered by email to Canadian MO and PC physicians. Each respondent received eight vignettes randomly selected from a set of 32. Hierarchical regression was used to evaluate the odds of prescribing TP adjusted for patient factors.Results606 MO and 491 PC physicians were surveyed; response rates were 11.1% and 15.0%, respectively. MO were predominantly male (59.7%); PC female (60.3%); most worked in academic environments (90.3% MO; 73.9% PC). Multivariable hierarchical logistic regression demonstrated that all patient factors except age were associated with prescribing TP (ORs range: from 1.34 (95% CI 1.01 to 1.77) for good ECOG, to 2.53 (95% CI 1.9 to 3.37), for reversible reason for admission). Controlling for these factors, medical specialty was independently associated with recommending TP (OR for MO 2.09 (95% CI 1.56 to 2.8)).ConclusionsMO have higher odds of recommending TP for inpatients with advanced cancer than PC physicians. Further research exploring the drivers of these differing practices is warranted.
Anti-inflammatory diet and risk of abdominal aortic aneurysm in two Swedish cohorts
Authors: Kaluza Joanna , Stackelberg Otto , Harris Holly Ruth , Björck Martin , Wolk Alicja 
Published: July 2019

ObjectiveThe relationship between dietary patterns and development of abdominal aortic aneurysm (AAA) is not well understood. Thus, we prospectively evaluated the association between the anti-inflammatory potential of diet and risk of AAA.MethodsThe study population included the Cohort of Swedish Men (45 072 men) and the Swedish Mammography Cohort (36 633 women), aged 45–83 years at baseline. The anti-inflammatory potential of diet was estimated using Anti-inflammatory Diet Index (AIDI) based on 11 foods with anti-inflammatory potential and 5 with proinflammatory potential (maximum 16 points) that was validated againsthigh sensitivity C reactive protein (hsCRP). Cox proportional hazard regression models were used to estimate HRs and 95% CIs. During the 14.9 years of follow-up (1 217 263 person-years), 1528 AAA cases (277 (18%) ruptured, 1251 non-ruptured) were ascertained via the Swedish Inpatient Register, the National Cause of Death Register and the Register for Vascular Surgery (Swedvasc).ResultsWe observed an inverse association between the AIDI and AAA risk in women and men; HRs between extreme quartiles of the AIDI (≥8 vs ≤5 points) were 0.55 (95% CI 0.36 to 0.83) in women and 0.81 (95% CI 0.68 to 0.98) in men. The AIDI was inversely associated with both ruptured and non-ruptured AAA incidence; the HR of participants in the highest quartile of AIDI compared with those in the lowest quartile was 0.61 (95% CI 0.41 to 0.90) for ruptured AAA and 0.79 (95% CI 0.65 to 0.95) for non-ruptured AAA.ConclusionAdherence to diet with a high anti-inflammatory potential was associated with a reduced AAA risk, an association that was even more pronounced for AAA rupture.
WEB embolization versus stent-assisted coiling: comparison of complication rates and angiographic outcomes
Authors: Kabbasch Christoph , Goertz Lukas , Siebert Eberhard , Herzberg Moriz , Borggrefe Jan , Krischek Boris , Stavrinou Pantelis , Dorn Franziska , Liebig Thomas 
Published: July 2019

BackgroundIntrasaccular flow disruption represents a new paradigm in endovascular treatment of wide-necked bifurcation aneurysms.ObjectiveTo perform a matched case–control study comparing complications and angiographic outcome using the Woven Endobridge (WEB) device and stent-assisted coiling (SAC).MethodsSixty-six patients treated with the WEB at three German tertiary care centers were included and matched with 66 patients treated with SAC based on aneurysm location and unruptured/ruptured aneurysm status. Parameters were retrospectively analysed and compared between the treatment groups using inverse probability of treatment weighting (IPTW) with propensity scores.ResultsProcedural complication rates were 12.1% in the WEB group and 21.2% in the SAC group, which was statistically significant after IPTW adjustment (OR=2.2, 95% CI 1.08 to 4.4, p=0.03). Favourable outcome (modified Rankin scale score ≤2) was achieved by 57/66 (86.4%) in the WEB group and 57/66 (86.4%) in the SAC group (p=1.0). At mid-term follow-up, a similar number of aneurysms achieved adequate occlusion (complete occlusion or neck remnant) in the WEB group (93.9%) and in the SAC group (93.9%, p=1.0). Re-treatment was performed in 10.6% after WEB embolization and 12.1% after SAC (p=1.0).ConclusionsThe WEB provides similar mid-term aneurysm occlusion rates to those of SAC, with no additional morbidity and potentially lower complication rates. Long-term outcome analysis will provide a definite conclusion on the use of WEB for intracranial aneurysms.
Insula stroke: the weird and the worrisome
Authors: Raghu Ashley Laurence Bharat , Parker Tariq , van Wyk André , Green Alexander Laurence 
Published: July 2019

AbstractInfarction of the insula is a common scenario with large tissue-volume strokes in the middle cerebral artery territory. Considered to be part of the central autonomic network, infarction of this region is associated with autonomic disturbances, in particular cardiovascular dysregulation. Risk of aspiration following stroke is also associated with involvement of the insula, consistent with its purported participation in complex functions of the mouth and pharynx. Strokes restricted to the insula are rare and present with a broad range of symptoms that offer a window of insight into the diverse functionality of the insular cortex. Chemosensory, autonomic, vestibular, auditory, somatosensory, language and oropharyngeal functional deficits are all recognised, among others. Long-term sequelae are unknown but profound symptoms, such as hemiparesis, are usually transient. Understanding the patterns of dysfunction highlighted provides the basis for future strategies to optimise stroke management on the discovery of insula involvement.