bluuebunny/crossref_metadata_2025_split huggingface dataset:
Australian children undergoing selective dorsal rhizotomy: protocol for a national registry of multidimensional outcomes
Authors: Lewis Jennifer , Bear Natasha , Baker Felicity , Fowler Adam , Lee Olivia , McLennan Kim , Richardson Emma , Scheinberg Adam , Smith Nadine , Thomason Pam , Tidemann Andrew , Wynter Meredith , Paget Simon 
Published: May 2019

IntroductionSelective dorsal rhizotomy (SDR) is a neurosurgical intervention intended to permanently reduce spasticity in the lower limbs and improve mobility in selected children with cerebral palsy (CP). Despite SDR having been performed worldwide for the past 30 years, there is moderate quality of evidence that SDR is effective in reducing spasticity with low to very low evidence of its effectiveness in improving gait, function and participation, using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system. Published studies have described outcomes for groups that differ in selection, surgical technique and postoperative rehabilitation making it difficult for clinicians to use this information to advise families on best management. There is substantial community interest in SDR. A small number of children with CP undergo SDR in Australia each year and some families seek the intervention at international sites. Capturing clinical outcomes and adverse event (AE) data for Australian children undergoing SDR will provide clinicians with information to help guide families considering SDR.Methods and analysisThe Australian SDR Research Registry is a national registry of multidimensional outcomes for Australian children undergoing SDR in an Australian or overseas centre. Data will be collected for up to 10 years following the surgery, to include surgery and admission details, surgical and long-term AEs, and outcome measures across the body structure and functions, activity and participation domains of the International Classification of Functioning, Disability and Health. Data will be collected at baseline, during inpatient admission and at 1, 2, 5 and 10 years post. The aim of collecting these data is to improve understanding of short-, medium- and long-term outcomes and adverse effects of the intervention.Ethics and disseminationThis study was approved by the individual Human Research and Ethics committees at the five Australian tertiary hospitals involved. Results will be disseminated via peer-reviewed publications and conference presentations.Trial registration numberACTRN12618000985280; Pre-results.
Diabetes & Women’s Health (DWH) Study: an observational study of long-term health consequences of gestational diabetes, their determinants and underlying mechanisms in the USA and Denmark
Authors: Zhang Cuilin , Olsen Sjurdur F , Hinkle Stefanie N , Gore-Langton Robert E , Vaag Allan , Grunnet Louise Groth , Yeung Edwina H , Bao Wei , Bowers Katherine , Liu Aiyi , Mills James L , Sherman Seth , Gaskins Audrey J , Ley Sylvia H , Madsen Camilla M , Chavarro Jorge E , Hu Frank B 
Published: May 2019

PurposeWomen who experience gestational diabetes mellitus (GDM) are at exceptionally high-risk of developing type 2 diabetes (T2DM) later in life. However, limited information is available about genetic and environmental factors that are implicated in the progression from GDM to T2DM.ParticipantsThe Diabetes & Women’s Health (DWH) Study applied a hybrid design, which combined new prospective data collection with existing data in two prospective cohorts, the Danish National Birth Cohort (DNBC) and the Nurses’ Health Study II (NHS II). In total, the DWH Study identified 7759 women with a GDM diagnosis from both cohorts; 4457 women participated in the DWH Study data collection, which included two cycles of follow-up from 2012 to 2014 and 2014 to 2016.Findings to dateProgression from GDM to T2DM was high. In the NHS II group, by 2013, 23.1% (n=846/3667) developed T2DM. In the DNBC group, at cycle 1 (2012–2014), the progression rate was even higher: 27.2% (n=215/790) had developed T2DM. Furthermore, we have shown that women who had GDM experienced a significantly greater risk of hypertension and cardiovascular diseases, as well as early stages of glomerular hyperfiltration and renal damage. Moreover, the DWH Study findings have shown that healthful diet and lifestyle factors and weight control were related to a lower risk of T2DM, hypertension and cardiovascular diseases.Future plansPrimary data collection for the DWH Study is complete and investigators are currently investigating interactions of the abovementioned modifiable factors with T2DM genetic susceptibility in determining the risk of progression from GDM to T2DM. Findings from ongoing work will provide further insights for identifying more precise prevention strategies for T2DM and comorbidities in this high-risk population. Future work will examine novel biomarkers of health and disease in this cohort.
Effects of tolvaptan add-on therapy in patients with acute heart failure: meta-analysis on randomised controlled trials
Authors: Ma Guang , Ma Xixi , Wang Guoliang , Teng Wei , Hui Xuezhi 
Published: May 2019

ObjectivesTreating acute decompensated heartfailure (ADHF) for improving congestion with diuretics may cause worsening renal function (WRF), but the clinical efficacy of tolvaptan add-on therapy on reducing WRF in ADHF patients is inconsistent. This analysis is to evaluate the effects of tolvaptan add-on therapy on reducing WRF in ADHF patients.MethodsMeta-analysis of randomised trials of tolvaptan add-on therapy on reducing WRF in ADHF patients. The MEDLINE, Embase and Cochrane Central Register of Controlled Trials databases were searched for relevant articles from their inception to 31 October, 2017. Two reviewers filtrated the documents on WRF, short-term all-cause mortality, body weight decreased, elevated sodium level for calculating pooled relatives risks, weighted mean difference and associated 95% CIs. We used fixed-effects or random-effects models according to I2statistics.AchievementsSeven random controlled trials with 937 patients were included for analysis. Compared with the control, tolvaptan add-on therapy did not improve incidence of worsening renal function (RR 0.78, 95% CI 0.48 to 1.26, p=0.31, I2=66%) and short-term all-cause mortality (RR 0.85, 95% CI 0.47 to 1.56, p=0.61, I2=0%). On subgroup analyses, there was a suggestion of possible effect modification by dose of tolvaptan, in which benefit was observed in low-dose (≤15 mg/day) group (RR 0.48, 95% CI 0.23 to 1.02, p=0.05, I2=54%), but not with high-dose (30 mg) group (RR 1.33, 95% CI 0.99 to 1.78, p=0.05, I2=0%). However, tolvaptan add-on therapy reduced body weight in 2 days (standardised mean difference −0.49, 95% CI −0.64 to −0.34, p<0.00001, I2=0%), increased sodium level (mean difference 1.56, 95% CI 0.04 to 3.07, p=0.04, I2=0%).ConclusionThe result suggests that comparing with the standard diuretic therapy, tolvaptan add-on therapy did not reduce the incidence of WRF and short-term mortality, however, it can decrease body weight and increase the sodium level in patients who are with ADHF. Further researches are still required for confirmation.
Attitudes and beliefs of Spanish families regarding their family members aged 75 years and over who live alone: a qualitative study
Authors: Molina-Mula Jesús , Gallo-Estrada Julia , Miquel-Novajra Alexandre 
Published: May 2019

ObjectiveThis study aimed to assess the attitudes and beliefs of Spanish families regarding their elderly family members aged 75 years and over who live alone, with consideration of gender and educational differences among the family members.MethodsThis qualitative study was based on the critical social paradigm, the theory of constructivist structuralism and Bourdieu’s theory of sociology of action. Four discussion groups were created with the following distribution of family members based on their gender and educational level: women with higher education, women with basic or secondary education, men with higher education and men with basic or secondary education. Participants were selected using purposive and snowball sampling. Announcements inviting voluntary participation were posted at primary health care facilities, social centres and neighbourhood associations in Mallorca, Spain.ResultsAnalyses of the group discussions and a field journal revealed that families believe that elderly individuals prefer to live alone to retain their freedom and individual identities.ConclusionsFamilies held two main views regarding elderly individuals living alone: a more traditional one in which elderly care is considered a moral duty associated with women, and a more modern view in which elderly care is considered a personal option that can be delegated. Sociomedical resources were considered insufficient and not easily accessible.
Importance of personal and professional experience for hospital staff in person-centred dementia care: a cross-sectional interview study using freelisting in a UK hospital ward
Authors: Petty Stephanie , Dening Tom , Griffiths Amanda , Coleston Donna Maria 
Published: May 2019

ObjectiveTo detail how hospital staff with differing personal and professional caregiving experiences approach the care of patients with dementia, in order to make practical recommendations for practice.DesignCross-sectional qualitative interviews.SettingA UK hospital ward providing dementia care.ParticipantsA complete hospital ward staff team, constituting 47 hospital staff from 10 professions.MethodsHospital staff were asked to list their approaches to emotion-focused care in individual, ethnographic freelisting interviews. Cultural consensus analysis was used to detail variations in approaches to dementia care between staff subgroups.Main outcome measuresThe most salient listed descriptions of care emphasised by staff members with personal experience of dementia caregiving when compared with staff members without such experience, and descriptions from staff newer to the profession compared with staff with more years of professional dementia caregiving experience.ResultsSubgroups of hospital staff showed different patterns of responses both in how they noticed the emotional distress of patients with dementia, and in prioritised responses that they deemed to work. Hospital staff with professional experience of dementia caregiving and staff with fewer years of professional experience prioritised mutual communication and getting to know each patient.ConclusionsSubgroups of hospital staff with personal caregiving experiences and fewer years of professional care experience were more likely to describe person-centred care as their routine ways of working with patients with dementia. It is recommended that personal experience and the novice curiosity of hospital staff be considered as valuable resources that exist within multidisciplinary staff teams that could enhance staff training to improve the hospital care for patients with dementia.
Effect of preoperative bicarbonate infusion on maternal and perinatal outcomes of obstructed labour in Mbale Regional Referral Hospital: a study protocol for a randomised controlled trial
Authors: Musaba Milton W , Barageine Justus K , Ndeezi Grace , Wandabwa Julius N , Weeks Andrew 
Published: May 2019

IntroductionTo improve maternal and fetal outcomes among patients with obstructed labour (OL) in low-resource settings, the associated electrolyte and metabolic derangements must be adequately corrected. Oral fluid intake during labour and preoperative intravenous fluid replacement following OL corrects the associated dehydration and electrolyte changes, but it does not completely reverse the metabolic acidosis, that is, a cause of intrapartum birth asphyxia and a risk factor for primary postpartum haemorrhage due to uterine atony. Sodium bicarbonate is a safe, effective, cheap and readily available acid buffer, that is widely used by sportspeople to improve performance. It also appears to improve fetal and maternal outcomes in abnormally progressing labour. However, its effects on maternal and fetal outcomes among patients with OL is unknown. We aim at establishing the effect of a single-dose preoperative infusion of sodium bicarbonate on maternal and fetal lactate levels and clinical outcomes among patients with OL.Methods and analysisThis will be a double blind, randomised controlled clinical phase IIb trial. We will randomise 478 patients with OL to receive either 50 mL of placebo with standard preoperative infusion of normal saline (1.5 L) or 4.2 g of sodium bicarbonate solution (50 mL of 50 mmol/L) with the preoperative infusion of normal saline (1.5 L). The primary outcome will be mean lactate levels in maternal capillary blood at 1 hour after study drug administration and in the arterial cord blood at birth. We will use the intention-to-treat analysis approach. Secondary outcomes will include safety, maternal and fetal morbidity and mortality up to 14 days postpartum.Ethics and disseminationMakerere University School of Medicine Research and Ethics Committee and Uganda National Council for Science and Technology have approved the protocol. Each participant will give informed consent at enrollment.Trial registration numberPACTR201805003364421
Propensity-matched study of enhanced primary care on contact with the criminal justice system among individuals recently released from prison to New Haven
Authors: Wang Emily A , Lin Hsiu-ju , Aminawung Jenerius A , Busch Susan H , Gallagher Colleen , Maurer Kathleen , Puglisi Lisa , Shavit Shira , Frisman Linda 
Published: May 2019

BackgroundHealth systems can be integral to addressing population health, including persons with incarceration exposure. Few studies have comprehensively integrated state-wide data to assess how the primary care system can impact criminal justice outcomes. We examined whether enhanced primary care can decrease future contact with the criminal justice system among individuals just released from prison.MethodsWe linked administrative data (2013–2016) of Connecticut Department of Correction, Department of Mental Health and Addiction Services, Department of Social Service, Court Support Services Division, and Department of Public Health to conduct a quasi-experimental study using propensity score matching of 94 participants who received enhanced primary care in Transitions Clinic to 94 controls not exposed to the programme. The propensity score included 23 variables, which encompassed participants’ medical and incarceration history and service utilisation. The main outcomes were reincarceration rates and days incarcerated in the first year from the index date, which was either enrolment in the Transitions Clinic programme or release from prison in the control group.ResultsThe odds of reincarceration, including arrests and new convictions, were similar for the two groups, but Transitions Clinic participants had lower odds of returning to prison for a parole or probation technical violation (adjusted OR: 0.38; 95% CI 0.16 to 0.93) compared with the control group. Further, Transitions Clinic participants had fewer incarceration days (incidence rate ratio: 0.55; 95% CI 0.35 to 0.84) compared with the control group.ConclusionsEnhanced primary care for individuals just released from prison can reduce reincarceration for technical violations and shorten time spent within correctional facilities. This study shows how community health systems may play a role in current strategies to reduce prison populations.
Wind turbine wake effect visualization and LiDAR measurement techniques
Authors: McKinnon Michael , Johnson David A. 
Published: May 2019

The expansion of wind energy development has resulted in larger wind farms and closer placement of turbines to utilize the space available. Each turbine produces a wake that affects downstream turbines, which causes issues such as production loss, blade loading, and fluctuating electrical output. To minimize this impact, the wake produced by turbines must first be understood. Experimental methods were used in the exploration of the wake effects of wind turbines. Smoke visualization inside the University of Waterloo Wind Generation Facility was used to determine the helical vortex wake distribution behind a 3.3 m diameter turbine as well as the tip vortex shedding from the blade. Wind Doppler Light Detection and Ranging (LiDAR) measurement devices were modified and used to measure wind turbine wake velocities. The University of Waterloo Wind Energy Group has a ZephIR z150 LiDAR to use in this study. The LiDAR was verified under normal operation for accuracy against a cup and vane anemometer. The LiDAR was then verified for accuracy and to determine the position of measurements after modifications necessary for future wake measurement experiments.
Targeting Mitochondrial Structure Sensitizes Acute Myeloid Leukemia to Venetoclax Treatment
Authors: Chen Xufeng , Glytsou Christina , Zhou Hua , Narang Sonali , Reyna Denis E. , Lopez Andrea , Sakellaropoulos Theodore , Gong Yixiao , Kloetgen Andreas , Yap Yoon Sing , Wang Eric , Gavathiotis Evripidis , Tsirigos Aristotelis , Tibes Raoul , Aifantis Iannis 
Published: May 2019

AbstractThe BCL2 family plays important roles in acute myeloid leukemia (AML). Venetoclax, a selective BCL2 inhibitor, has received FDA approval for the treatment of AML. However, drug resistance ensues after prolonged treatment, highlighting the need for a greater understanding of the underlying mechanisms. Using a genome-wide CRISPR/Cas9 screen in human AML, we identified genes whose inactivation sensitizes AML blasts to venetoclax. Genes involved in mitochondrial organization and function were significantly depleted throughout our screen, including the mitochondrial chaperonin CLPB. We demonstrated that CLPB is upregulated in human AML, it is further induced upon acquisition of venetoclax resistance, and its ablation sensitizes AML to venetoclax. Mechanistically, CLPB maintains the mitochondrial cristae structure via its interaction with the cristae-shaping protein OPA1, whereas its loss promotes apoptosis by inducing cristae remodeling and mitochondrial stress responses. Overall, our data suggest that targeting mitochondrial architecture may provide a promising approach to circumvent venetoclax resistance.Significance:A genome-wide CRISPR/Cas9 screen reveals genes involved in mitochondrial biological processes participate in the acquisition of venetoclax resistance. Loss of the mitochondrial protein CLPB leads to structural and functional defects of mitochondria, hence sensitizing AML cells to apoptosis. Targeting CLPB synergizes with venetoclax and the venetoclax/azacitidine combination in AML in a p53-independent manner.See related commentary by Savona and Rathmell, p. 831.This article is highlighted in the In This Issue feature, p. 813
Predictability of Idealized Thunderstorms in Buoyancy–Shear Space
Authors: Lawson John R. 
Published: May 2019

Abstract
Thunderstorms are difficult to predict because of their small length scale and fast predictability destruction. A cell’s predictability is constrained by properties of the flow in which it is embedded (e.g., vertical wind shear), and associated instabilities (e.g., convective available potential energy). To assess how predictability of thunderstorms changes with environment, two groups of 780 idealized simulations (each using a different microphysics scheme) were performed over a range of buoyancy and shear profiles. Results were not sensitive to the scheme chosen. The gradient in diagnostics (updraft speed, storm speed, etc.) across shear–buoyancy phase space represents sensitivity to small changes in initial conditions: a proxy for inherent predictability. Storm evolution is split into two groups, separated by a U-shaped bifurcation in phase space, comprising 1) cells that continue strengthening after 1 h versus 2) those that weaken. Ensemble forecasts in regimes near this bifurcation are hence expected to have larger uncertainty, and adequate dispersion and reliability is essential. Predictability loss takes two forms: (i) chaotic error growth from the largest and most powerful storms, and (ii) tipping points at the U-shaped perimeter of the stronger storms. The former is associated with traditional forecast error between corresponding grid points, and is here counterintuitive; the latter is associated with object-based error, and matches the mental filtering performed by human forecasters for the convective scale.
Dry and Semidry Tropical Cyclones
Authors: Cronin Timothy W. , Chavas Daniel R. 
Published: May 2019

AbstractIt is widely believed that tropical cyclones are an intrinsically moist phenomenon, requiring evaporation and latent heat release in cumulus convection. Recent numerical modeling by Mrowiec et al., however, challenged this conventional wisdom by finding the formation of axisymmetric dry tropical cyclones in dry radiative–convective equilibrium (RCE). This paper addresses ensuing questions about the stability of dry tropical cyclones in 3D, the moist–dry vortex transition, and whether existing theories for intensity, size, and structure apply to dry cyclones. A convection-permitting model is used to simulate rotating 3D RCE, with surface wetness (0–1) and surface temperature (240–300 K) smoothly varying between dry and moist states. Tropical cyclones spontaneously form and persist for tens of days in both moist and dry/cold states, as well as part of the relatively moist/warm intermediate parameter space. As the surface is dried or cooled, cyclones weaken, both in absolute terms and relative to their potential intensities. Dry and semidry cyclones have smaller outer radii but similar-sized or larger convective centers compared to moist cyclones, consistent with existing structural theory. Strikingly, spontaneous cyclogenesis fails to occur at moderately low surface wetness values and intermediate surface temperatures of 250–270 K. Simulations with time-varying surface moisture and sea surface temperatures indicate this range of parameter space is a barrier to spontaneous genesis but not cyclone existence. Dry and semidry tropical cyclones in rotating RCE provide a compelling model system to further our understanding of real moist tropical cyclones.
Turbulent Transport of Spray Droplets in the Vicinity of Moving Surface Waves
Authors: Richter David H. , Dempsey Anne E. , Sullivan Peter P. 
Published: May 2019

AbstractA common technique for estimating the sea surface generation functions of spray and aerosols is the so-called flux–profile method, where fixed-height concentration measurements are used to infer fluxes at the surface by assuming a form of the concentration profile. At its simplest, this method assumes a balance between spray emission and deposition, and under these conditions the concentration profile follows a power-law shape. It is the purpose of this work to evaluate the influence of waves on this power-law theory, as well as investigate its applicability over a range of droplet sizes. Large-eddy simulations combined with Lagrangian droplet tracking are used to resolve the turbulent transport of spray droplets over moving, monochromatic waves at the lower surface. The wave age and the droplet diameter are varied, and it is found that droplets are highly influenced both by their inertia (i.e., their inability to travel exactly with fluid streamlines) and the wave-induced turbulence. Deviations of the vertical concentration profiles from the power-law theory are found at all wave ages and for large droplets. The dynamics of droplets within the wave boundary layer alter their net vertical fluxes, and as a result, estimates of surface emission based on the flux–profile method can yield significant errors. In practice, the resulting implication is that the flux–profile method may unsuitable for large droplets, and the combined effect of inertia and wave-induced turbulence is responsible for the continued spread in their surface source estimates.