bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Unexplained Left Ventricular Hypertrophy by Cardiac Magnetic Resonance Imaging in MESA
Authors: Massera Daniele , McClelland Robyn L. , Ambale‐Venkatesh Bharath , Gomes Antoinette S. , Hundley W. Gregory , Kawel‐Boehm Nadine , Yoneyama Kihei , Owens David S. , Garcia Mario J. , Sherrid Mark V. , Kizer Jorge R. , Lima Joao A. C. , Bluemke David A. 
Published: April 2019

Background

Hypertrophic cardiomyopathy is defined as unexplained left ventricular (
LV
) hypertrophy (wall thickness ≥15 mm) and is prevalent in 0.2% of adults (1:500) in population‐based studies using echocardiography. Cardiac magnetic resonance imaging (
MRI
) allows for more accurate wall thickness measurement across the entire ventricle than echocardiography. The prevalence of unexplained
LV
hypertrophy by cardiac
MRI
is unknown.
MESA
(Multi‐Ethnic Study of Atherosclerosis) recruited individuals without overt cardiovascular disease 45 to 84 years of age.

Methods and Results

We studied 4972 individuals who underwent measurement of regional
LV
wall thickness by cardiac
MRI
as part of the
MESA
baseline exam. American Heart Association criteria were used to define
LV
segments. We excluded participants with hypertension,
LV
dilation (≥95% predicted end‐diastolic volume) or dysfunction (ejection fraction ≤50%), moderate‐to‐severe left‐sided valve lesions by cardiac
MRI
, severe aortic valve calcification by cardiac computed tomography (aortic valve Agatston calcium score >1200 in women or >2000 in men), obesity (body mass index >35 kg/m
2
), diabetes mellitus, and current smoking. Sixty‐seven participants (aged 64±10 years, 9% female) had unexplained
LV
hypertrophy (wall thickness ≥15 mm in at least 2 adjacent
LV
segments), representing 1.4% (1 in 74) participants, 2.6% of men and 0.2% of women. Prevalence was similar across categories of race/ethnicity. Hypertrophy was focal in 17 (25.4%), intermediate in 44 (65.7%), and diffuse in 5 (7.5%) participants.

Conclusions

The prevalence of unexplained
LV
hypertrophy in a population‐based cohort using cardiac
MRI
was 1.4%. This may have implications for the diagnosis of patients with hypertrophic cardiomyopathy and will require further study.
Impact of Dry Midlevel Air on the Tropical Cyclone Outer Circulation
Authors: Wang Shuai , Toumi Ralf 
Published: April 2019

AbstractThe impact of dry midlevel air on the outer circulation of tropical cyclones is investigated in idealized simulations with and without a moist envelope protecting the inner core. It is found that a dry midlevel layer away from the cyclone center can broaden the outer primary circulation and thus the overall destructive potential at both developing and mature stages. The midlevel outer drying enhances the horizontal gradient of latent heating in the rainbands and drives the expansion of the outer circulation. The moist convection at large radii is suppressed rapidly after the midlevel air is dried in the outer rainbands. An enhanced horizontal gradient of latent heating initiates a radial–vertical overturning circulation anomaly in the rainbands. This anomalous overturning circulation accelerates the radial inflow of the main secondary circulation, increases the angular momentum import, and thus increases the cyclone size. The dry air, mixed into the boundary layer from the midtroposphere, is “recharged” by high enthalpy fluxes because of the increased thermodynamical disequilibrium above the sea surface. This recharge process protects the eyewall convection from the environmental dry-air ventilation. The proposed mechanism may explain the continuous expansion in the tropical cyclone outer circulation after maturity, as found in observations.
Improving Satellite-Based Subhourly Surface Rain Estimates Using Vertical Rain Profile Information
Authors: Utsumi Nobuyuki , Kim Hyungjun , Turk F. Joseph , Haddad Ziad. S. 
Published: April 2019

Abstract
Quantifying time-averaged rain rate, or rain accumulation, on subhourly time scales is essential for various application studies requiring rain estimates. This study proposes a novel idea to estimate subhourly time-averaged surface rain rate based on the instantaneous vertical rain profile observed from low-Earth-orbiting satellites. Instantaneous rain estimates from the Tropical Rainfall Measuring Mission (TRMM) Precipitation Radar (PR) are compared with 1-min surface rain gauges in North America and Kwajalein atoll for the warm seasons of 2005–14. Time-lagged correlation analysis between PR rain rates at various height levels and surface rain gauge data shows that the peak of the correlations tends to be delayed for PR rain at higher levels up to around 6-km altitude. PR estimates for low to middle height levels have better correlations with time-delayed surface gauge data than the PR’s estimated surface rain rate product. This implies that rain estimates for lower to middle heights may have skill to estimate the eventual surface rain rate that occurs 1–30 min later. Therefore, in this study, the vertical profiles of TRMM PR instantaneous rain estimates are averaged between the surface and various heights above the surface to represent time-averaged surface rain rate. It was shown that vertically averaged PR estimates up to middle heights (~4.5 km) exhibit better skill, compared to the PR estimated instantaneous surface rain product, to represent subhourly (~30 min) time-averaged surface rain rate. These findings highlight the merit of additional consideration of vertical rain profiles, not only instantaneous surface rain rate, to improve subhourly surface estimates of satellite-based rain products.
Dynamics on Seasonal Variability of EKE Associated with TIWs in the Eastern Equatorial Pacific Ocean
Authors: Wang Minyang , Du Yan , Qiu Bo , Xie Shang-Ping , Feng Ming 
Published: April 2019

AbstractEnergetic mesoscale eddies (vortices) associated with tropical instability waves (TIWs) exist in the eastern equatorial Pacific Ocean between 0° and 8°N. This study examines the seasonal variations in eddy kinetic energy (EKE) of TIWs using in situ and satellite observations and elucidates the underlying dynamical mechanisms. The results reveal that the cross-equatorial southerly winds are key to sustaining the high-level EKE (up to ~600 cm2 s−2) from boreal summer to winter in 0°–6°N and 155°–110°W. Because of the β effect and the surface wind divergence, the southerly winds generate anticyclonic wind curls north of the equator that intensify the sea surface temperature (SST) fronts and force the downwelling annual Rossby waves. The resultant sea surface height ridge induces strong horizontal current shears between 0° and 5°N. The intensified current shears and SST fronts generate EKE via barotropic and baroclinic instabilities, respectively. To the extent that the seasonal migration of a northward-displaced intertropical convergence zone intensifies the southerly winds north of, but not south of, the equator, our study suggests that the climatic asymmetry is important for the oceanic eddy generations in the eastern equatorial Pacific Ocean—a result with important implications for coupled climate simulation/prediction.
Mastoid Surgery under Local Anesthesia for Medically Unfit Patients: Techniques and Outcome
Authors: Neumann Codruta , Yung Jennifer , Carroll Paul H. 
Published: April 2019

Objectives We present the surgical techniques and outcomes of mastoid surgery under local anesthesia in patients who were unfit for general anesthesia. Methods Five tertiary-referred patients with multiple comorbidities and failed conservative treatment for chronic otitis media were operated on under local anesthesia. No sedation was administered. The principles of cholesteatoma surgery were observed, but the technique was adapted to keep surgical time to a minimum. Results None of the patients had perioperative problems, and all have dry, waterproof ears with preservation of hearing after surgery. So far, none of the patients have had recurrent or residual disease. Conclusions Cholesteatoma surgery can be successfully performed with a local anesthetic in patients who are medically unfit for general anesthesia. Surgery requires a good coordination of the operating team in order to shorten the operating time. Otologists should develop and maintain their skills by performing ear surgery with local anesthetic on a regular basis.
Antisecretory Factor–Inducing Therapy Improves Patient-Reported Functional Levels in Meniere's Disease
Authors: Leong Samuel C. , Narayan Surya , Lesser Tristram H. 
Published: April 2019

Objectives The aim of this study was to evaluate the effectiveness of specially processed cereal (SPC) as a suitable adjunctive treatment for Meniere's disease. Methods We performed a randomized double-blinded, placebo-controlled, crossover study in a tertiary referral center of patients who had a diagnosis of Meniere's disease based on the guidelines of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS). The main outcome measure was the AAO-HNS Functional Level Scale (FLS). Results Thirty-nine patients completed the study without any reported complications. The mean pretreatment FLS score for the entire study cohort was 3.8 (median, 4; range, 1 to 6). The overall FLS score improved significantly (p < 0.001), to 2.8 (median, 3), after SPC treatment. No patients showed worsening on the FLS during SPC or placebo treatment. Of the 39 patients, 23 showed improvement on the FLS, and no change was observed in the remaining 16. The median improvement on the FLS in these 23 patients was 2 points (mean, 1.7; range, 1 to 4). The mean FLS score after placebo cereal treatment was not significantly different from baseline (p = 0.452), but was significantly higher than that after SPC treatment (mean, 3.7; p < 0.001). The marginal difference observed between the baseline FLS score and the placebo FLS score was due to the fact that 5 patients reported 1-point improvements on the FLS after placebo treatment. Nevertheless, significantly fewer patients improved on placebo than on SPC (p < 0.001). Conclusions Treatment with SPC appears to be well tolerated by most patients (91%) without any complications. More than half (59%) of the study cohort reported subjective improvement in functional level.
Parathyroid Computed Tomography Angiography: Early Experience with a Novel Imaging Technique in Primary Hyperparathyroidism
Authors: Schwartz Isaac E. , Capra Gregory G. , Mullin David P. , Johnson Terence E. , Boswell Gilbert E. 
Published: April 2019

ObjectivesTo describe parathyroid computed tomography angiography (PCTA), determine its accuracy, and, as a secondary objective, calculate its mean radiation dosimetry.Study DesignRetrospective chart review of patients who underwent parathyroidectomy for primary hyperparathyroidism from 2007 to 2015.SettingSingle‐center tertiary care academic military hospital.Subjects and MethodsPCTA is a 2‐phase computed tomography imaging technique that uses individualized timing of contrast infusion and novel patient positioning to accurately identify parathyroid adenomas. Consecutive patients who underwent parathyroidectomy for primary hyperparathyroidism from 2007 to 2015 were reviewed; 55% of patients were women. The mean age was 50.9 years (range, 26‐68 years). Sensitivity and specificity were calculated as well as mean radiation dosimetry and timing of contrast.ResultsA total of 108 procedures were performed during the study period. Twenty‐one patients undergoing 22 PCTAs after prior sestamibi scans were nonlocalizing or equivocal. In this group, there were 15 true‐positive, 3 false‐positive, 4 true‐negative, and 0 false‐negative PCTAs. This represents a sensitivity of 100% (95% CI, 74.7%‐100%) and a specificity of 57% (95% CI, 20%‐88%). The mean calculated radiation dose was 5.15 mSv. In the most recent studies, a mean dose of 4.1 mSv was calculated. The ideal time of image acquisition contrast administration varied from 20 to 30 seconds after contrast infusion.ConclusionsPCTA is a new technique in anatomic imaging for hyperparathyroidism. In a single‐center, single‐radiologist retrospective study, it demonstrates excellent accuracy for patients with parathyroid adenomas that are otherwise difficult to localize preoperatively. Preliminary experience suggests that its use may be indicated as a primary imaging modality in the future.
Pattern of Drug Use by Advanced Cancer Patients Followed at Home
Authors: Mercadante Sebastiano , Fulfaro Fabio , Casuccio Alessandra 
Published: April 2019

The aim of this study was to document the drugs most commonly prescribed to control symptoms in advanced cancer patients being followed at home. We analyzed data for 128 patients admitted to a home palliative care program from January 1993 to January 1995. All patients were followed at home until death by a team consisting of doctors and nurses, and were given two or three medical examinations a week. The most frequently prescribed drugs were analgesics and drugs commonly used to prevent NSAID-induced gastric toxicity. Slow-release morphine was the analgesic used most often. Most patients received more than four drugs. Younger people received morphine more often than did older patients. Conclusions Drug monitoring is a useful audit tool for verifying the quality and quantity of drugs prescribed for advanced cancer patients being followed at home. Pharmacological usage should be reviewed periodically and should reflect evidence-based practice.
Computerized Quality-of-Life Screening in a Cancer Pain Clinic
Authors: Carlson Linda E. , Speca Michael , Hagen Neil , Taenzer Paul 
Published: April 2019

Methods To determine the utility and acceptability to patients and staff of a computerized quality-of-life (QOL) screening program in a tertiary ambulatory cancer pain clinic, patients were administered the computerized EORTC-QLQ-C30 questionnaire. A report summarizing this QOL information was given to clinic staff prior to each patient's appointment. Both the patient and the clinical staff were surveyed afterwards. Results Although more than half of the 46 patients had never used a computer before, almost all reported that the program was easy to use and understand, enjoyable, helpful, and quick. Their attitudes toward computers significantly improved from pre- to post-assessment. Staff found the QOL information to be appropriate and useful. Conclusions The computerized questionnaire was readily used by patients and was helpful to pain clinic staff, making it an appropriate tool for identifying important QOL problems and issues in busy clinical settings, even for inexperienced computer users with significant functional impairment.
Religiousness and Major Depression among Bereaved Family Caregivers: A 13–Month Follow-Up Study
Authors: Fenix J.B. , Cherlin Emily J. , Prigerson Holly G. , Johnson-Hurzeler Rosemary , Kasl Stanislav V. , Bradley Elizabeth H. 
Published: April 2019

Objective To examine the association between a multi-item measure of religiousness and major depressive disorder (MDD) in bereaved family caregivers of patients with cancer. Design A prospective longitudinal study of primary caregivers of consecutive patients (n=175) with cancer enrolled in the largest hospice in Connecticut. Results Caregivers with a high religiousness summary score were significantly less likely to have MDD at the 13–month follow-up interview (OR=0.79, 95% CI: 0.68–0.91). This finding remained significant (OR=0.74, 95% CI: 0.59–0.91) after adjustment for caregiver MDD at baseline, caregiver age, caregiver burden, and number of activities restricted due to caregiving roles. Conclusions Family caregivers who reported greater religiousness at baseline had lower rates of depression in the 13–month follow up after their loss. Collaboration with religious support groups or community groups during bereavement could offer an effective mechanism for speeding the process of recovery for some caregivers.
Is Courage the Counterpoint of Demoralization?
Authors: Wein Simon 
Published: April 2019

Objective To consider the role courage plays in our ability to cope with threat and adversity, especially the role of courage in understanding demoralization and dignity. Method By exploring standard psychiatric texts and Aristotle's concept of courage and virtue. A review of Medline and PsyclNFO provided few relevant documents, reflecting the paucity of research on the concept of courage in psychiatry, palliative care, and psycho-oncology. Results and conclusions Courage is an important precursor to maintaining morale and therefore may play a critical causative role in demoralization. Courage is also intimately related to the concepts of self-esteem, free will, and personal values in life. The utility of the concept of courage is that it enables a response to a difficult circumstance. The main drawback of courage in a therapeutic sense is that it is often linked with cowardice, which has a pejorative connotation and is notoriously difficult to diagnose.
Unique Calendar Effects in the Indian Stock Market: Evidence and Explanations
Authors: Harshita  , Singh Shveta , Yadav Surendra S. 
Published: April 2019

Covering 20 years (1995–2015), the article ascertains the presence of the month-of-the-year effect in the Indian stock market, for the raw returns series as well as after adjusting for non-linearities of the market. Whether the effect is the same for portfolios of different sizes and values is also ascertained. The threshold generalised autoregressive conditionally heteroskedastic (TGARCH) model is employed to address non-linearity. The results suggest the presence of higher returns in November/December at the index level. Further, only firms with a size smaller than the average exhibit seasonality in the form of the April/May and November/December effect. The value-sorted portfolios exhibit weaker evidence of the December effect. Tax-loss selling, window dressing and behavioural aspects seem to provide the explanation. JEL Classification: C58, G14
National gambling policies and the containment of the EU’s politico-legal influence
Authors: Selin Jani 
Published: April 2019

Aims: Research has shown that the EU’s politico-legal influence over member states is contained through two political strategies: contained compliance and anticipatory obedience. Previous studies on gambling policies in the EU have quite uncritically presumed that the EU is capable of inducing changes, or even forcing changes, in national gambling policies. In this article, the objective was to investigate whether member states have adopted the two strategies allowing a containment of the EU’s influence on their national gambling policies. Design: The politico-legal influence of the Court of Justice of the European Union (CJEU) and the European Commission on national gambling policy is analysed in the case of Finnish monopoly-based gambling policy. The analysis is based on case law and policy documents. Results: The results indicate that Finland has adopted both anticipatory obedience and contained compliance when striving to safeguard its gambling monopoly system. Contained compliance was adopted during the early period of Finland’s accession (1995–2001). Anticipatory obedience was exercised between the years 2004 and 2013, a period characterised by several critical legal cases and the infringement procedure commenced by the European Commission against Finland. During the third period (2014- 2017 ), when the merger of three monopoly operators into a single state-owned company was on the agenda, neither strategy was adopted, indicating little EU influence (despite public justifications of the same). Conclusion: The EU’s opportunities to induce changes in the gambling policies of member states should not be overemphasised because member states are able to contain the EU’s politico-legal influence. Future analyses of national gambling policies in the EU would benefit from taking the interaction between member states and the EU into account.
Validation of the COAST score for predicting acute traumatic coagulopathy: A retrospective single-centre cohort study
Authors: Thorn Sophie , Tonglet Martin , Maegele Marc , Gruen Russell , Mitra Biswadev 
Published: April 2019

Purpose Early identification of trauma patients at risk of developing acute traumatic coagulopathy is important in initiating appropriate, coagulopathy-focused treatment. A clinical acute traumatic coagulopathy prediction tool is a quick, simple method to evaluate risk. The COAST score was developed in Australia and we hypothesised that it could predict coagulopathy and bleeding-related adverse outcomes in other advanced trauma systems. We validated COAST on a single-centre cohort of trauma patients from a trauma centre in Belgium. Methods The COAST score was modified to suit available data; we used entrapment, blood pressure, temperature, major chest injury and abdominal injury to calculate the score. Acute traumatic coagulopathy was defined as international normalised ratio >1.5 or activated partial thromboplastin time >60 s upon arrival of the patient to the hospital. Data were extracted from the local trauma registry on patients that presented between 1 January and 31 December 2015. Results In all, 133 patients met the inclusion criteria (>16 years old, available COAST and outcome data) for analysis. The COAST score had an area under the receiver operating characteristics curve of 0.941 (95% CI: 0.884–0.999) and at COAST ≥3, it had 80% sensitivity and 96% specificity. The score also identified patients with higher rates of mortality, blood transfusion and emergent surgery. Conclusion This retrospective cohort study demonstrated the utility of the COAST score in identifying trauma patients who are likely to have bleeding-related poor outcomes. The early identification of these patients will facilitate timely, appropriate treatment for acute traumatic coagulopathy and minimise the risk of over-treatment. It can also be used to select patients with acute traumatic coagulopathy for trials involving therapeutic agents targeted at acute traumatic coagulopathy.
Genome-Wide Profiling of the Toxic Effect of Bortezomib on Human Esophageal Carcinoma Epithelial Cells
Authors: Ao Nannan , Dai Yingchu , Chen Qianping , Feng Yang , Yu Jingping , Wang Chang , Liu Fenju , Li Ming , Liu Geng 
Published: April 2019

Objectives: Bortezomib has been widely used to treat multiple myeloma and other hematological malignancies. However, not much is known about its effect on solid tumors. The aim of this study was to study the effect of Bortezomib on human esophageal cancer cell lines and investigate the potential target pathways. Methods: Two human esophageal cancer cell lines, TE-1 and KYSE-150, were used in this study. Cell viability, cell cycle distribution, and apoptosis after Bortezomib treatment was detected by Cell Counting Kit-8, flow cytometry, and Annexin V/propidium iodide staining, respectively. The genes targeted by Bortezomib were analyzed at the messenger RNA level by microarray chips and quantitative real-time polymerase chain reaction. Results: The proliferation of human esophageal cancer cell lines was inhibited by Bortezomib in a dose- and time-dependent manner. Bortezomib treatment led to G2/M arrest and apoptosis. Microarray chips revealed multiple signaling pathways targeted by Bortezomib, including proteasome, endoplasmic reticulum, Wnt-, and calcium-mediated pathway. The expression patterns of 4 representative genes UBD, CUL3, HDAC6, and GADD45A were verified by quantitative real-time polymerase chain reaction and showed consistency with the microarray assay. Conclusion: Bortezomib could suppress cell viability, cause G2/M arrest, and induce apoptosis in human esophageal cancer cells, with possible targets including UBD, CUL3, HDAC6, and GADD45A.