bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding diagnostic disagreement in angle closure assessment between anterior segment optical coherence tomography and gonioscopy
Authors: Porporato Natalia , Baskaran Mani , Tun Tin A , Sultana Rehena , Tan Marcus , Quah Joanne HuiMin , Allen John C , Perera Shamira , Friedman David S , Cheng Ching Yu , Aung Tin 
Published: September 2019

Background/aimsAlthough being a more objective tool for assessment and follow-up of angle closure, reliability studies have reported a moderate diagnostic performance for anterior segment optical coherence tomography (OCT) technologies when comparing with gonioscopy as the reference standard. We aim to determine factors associated with diagnostic disagreement in angle closure when assessed by anterior segment swept source OCT (SS-OCT, CASIA SS-1000; Tomey, Nagoya, Japan) and gonioscopy.MethodsCross-sectional study. A total of 2027 phakic subjects aged ≥50 years, with no relevant previous ophthalmic history, were consecutively recruited from a community polyclinic in Singapore. Gonioscopy and SS-OCT (128 radial scans) for the entire circumference of the angle were performed for each subject. A two-quadrant closed gonioscopic definition was used. On SS-OCT images, angle closure was defined as iridotrabecular contact (ITC) to the extent of ≥35%, ≥50% and ≥75% of the circumferential angle. Diagnostic disagreements between both methods, that is, false positives or overcalls and false negatives or undercalls were defined, respectively, as gonioscopic open/closed angles inversely assessed as closed/open by SS-OCT.ResultsTwo hundred and seventy-two (14.7%) resulted in overcall results (false positives) when ≥50% of the angle circumference was closed using SS-OCT. These eyes had significantly wider (anterior chamber width, 11.7 vs 11.6 mm, p<0.001) and deeper (anterior chamber depth (ACD), 2.4 vs 2.2 mm, p<0.001) anterior chambers than eyes assessed by both methods as closed (true positives). Deeper ACD (OR 9.31) and lower lens vault (LV) (OR 0.04) were significantly associated with a false positive diagnosis in the multivariate analysis. Most of these cases had short (52.6%) or irregular (39%) ITC in SS-OCT images.ConclusionsWe found that anterior chamber dimensions, determined by ACD and LV, were factors significantly associated with diagnostic disagreement between anterior segment SS-OCT and gonioscopy in angle closure assessment.
Does disallowing body checking in non-elite 13- to 14-year-old ice hockey leagues reduce rates of injury and concussion? A cohort study in two Canadian provinces
Authors: Emery Carolyn , Galarneau Jean-Michel , Palacios-Derflingher Luz , Black Amanda Marie , Eliason Paul , Krolikowski Maciek , Spencer Nicole , Kozak Stacy , Schneider Kathryn J , Babul Shelina , Mrazik Martin , Lebrun Constance M , Goulet Claude , Macpherson Alison , Hagel Brent E 
Published: September 2019

Objective
To compare rates of injury and concussion among non-elite (lowest 60% by division of play) Bantam (ages 13–14 years) ice hockey leagues that disallow body checking to non-elite Bantam leagues that allow body checking.

Methods
In this 2-year cohort study, Bantam non-elite ice hockey players were recruited from leagues where policy allowed body checking in games (Calgary/Edmonton 2014–2015, Edmonton 2015–2016) and where policy disallowed body checking (Kelowna/Vancouver 2014–2015, Calgary 2015–2016). All ice hockey game-related injuries resulting in medical attention, inability to complete a session and/or time loss from hockey were identified using valid injury surveillance methodology. Any player suspected of having concussion was referred to a study physician for diagnosis and management.

Results
49 body checking (608 players) and 33 non-body checking teams (396 players) participated. There were 129 injuries (incidence rate (IR)=5.52/1000 hours) and 54 concussions (IR=2.31/1000 hours) in the body checking teams in games. After policy change, there were 31 injuries (IR=2.50/1000 hours) and 17 concussions (IR=1.37/1000 hours) in games. Policy disallowing body checking was associated with a lower rate of all injury (adjusted incidence rate ratio (IRR)=0.45; 95% CI: 0.27 to 0.76). The point estimate showed a lower rate of concussion (adjusted IRR=0.59; 95% CI: 0.30 to 1.17), but this was not statistically significant.

Conclusion
Policy change disallowing body checking in non-elite Bantam ice hockey resulted in a 55% lower rate of injury. There is growing evidence that disallowing body checking in youth ice hockey is associated with fewer injuries.
Implementing primary palliative care best practices in critical care with the Care and Communication Bundle
Authors: Vuong Cristina , Kittelson Sheri , McCullough Lindsay , Yingwei Yao , Hartjes Tonja 
Published: September 2019

BackgroundClinician–family communication is a central component of medical decision-making in the intensive care unit (ICU) and the quality of this communication has a direct impact on decisions made regarding care for patients who are critically ill.AimThe purpose of the project was to emphasise the need for quality improvement in the medical ICU at the University of Florida Health Hospital in regard to communication between the patients, families and providers.MethodInterventions included development of a more systemic approach to primary palliative care by using the nationally recognised and published Care and Communication Bundle tool. The Bundle is a standardised clinical pathway of palliative care best practices.ResultsDuring the project period, staff satisfaction/engagement increased from tier 3 to tier 1 level, the medical ICU length of stay decreased from 4.97 days in fiscal year (FY) 2016 to 4.22 days in FY2017. Moreover, the number of patients discharged directly to hospice increased from 21 in FY2016 to 42 in FY2017, representing a 100% increase. Additionally, palliative care consults decreased in the medical ICU (FY2016=108, FY2017=82), as a result of an increase in daily primary palliative care interventions. The findings demonstrate an improvement in outcome measures during the project.
Telemedicine is associated with rapid transfer and fewer involuntary holds among patients presenting with suicidal ideation in rural hospitals: a propensity matched cohort study
Authors: Vakkalanka Jayamalathi Priyanka , Harland Karisa K , Wittrock Amy , Schmidt Margaret , Mack Luke , Nipe Matthew , Himadi Elaine , Ward Marcia M , Mohr Nicholas M 
Published: September 2019

ObjectiveThe purpose of this study was to evaluate the impact of telemedicine in clinical management and patient outcomes of patients presenting to rural critical access hospital emergency departments (EDs) with suicidal ideation or attempt.MethodsRetrospective propensity-matched cohort study of patients treated for suicidal attempt and ideation in 13 rural critical access hospital EDs participating in a telemedicine network. Patients for whom telemedicine was used were matched 1:1 to those who did not have telemedicine as an exposure (n=139 TM+, n=139 TM–) using optimal matching of propensity scores based on administrative data. Our primary outcome was ED length-of-stay (LOS), and secondary outcomes included admission proportion, use of chemical or physical restraint, 30 day ED return, involuntary detention orders, treatment/follow-up plan and 6-month mortality. Analyses for multivariable models were conducted using conditional linear and logistic regression clustered on matched pairs with purposeful selection of covariates.ResultsMean ED LOS was not associated with telemedicine consultation among all patients, but was associated with a 29.3% decrease in transferred patients (95% CI 11.1 to 47.5). The adjusted odds of hospital admission (either local or through transfer) was 2.35 (95% CI 1.10 to 5.00) times greater among TM+ patients compared with TM– patients. Involuntary hold placement was lower in those exposed to telemedicine (adjusted odds ratio (aOR): 0.48; 95% CI 0.23 to 0.97). We did not observe significant differences in other outcomes.ConclusionThe role of telemedicine in influencing access, quality and efficiency of care in underserved rural hospitals is critically important as these networks become more prevalent in rural healthcare environments.
Variant type is associated with disease characteristics in SDHB, SDHC and SDHD-linked phaeochromocytoma–paraganglioma
Authors: Bayley Jean Pierre , Bausch Birke , Rijken Johannes Adriaan , van Hulsteijn Leonie Theresia , Jansen Jeroen C , Ascher David , Pires Douglas Eduardo Valente , Hes Frederik J , Hensen Erik F , Corssmit Eleonora P M , Devilee Peter , Neumann Hartmut P H 
Published: September 2019

BackgroundPathogenic germline variants in subunits of succinate dehydrogenase (SDHB, SDHC and SDHD) are broadly associated with disease subtypes of phaeochromocytoma–paraganglioma (PPGL) syndrome. Our objective was to investigate the role of variant type (ie, missense vs truncating) in determining tumour phenotype.MethodsThree independent datasets comprising 950 PPGL and head and neck paraganglioma (HNPGL) patients were analysed for associations of variant type with tumour type and age-related tumour risk. All patients were carriers of pathogenic germline variants in the SDHB, SDHC or SDHD genes.ResultsTruncating SDH variants were significantly over-represented in clinical cases compared with missense variants, and carriers of SDHD truncating variants had a significantly higher risk for PPGL (p<0.001), an earlier age of diagnosis (p<0.0001) and a greater risk for PPGL/HNPGL comorbidity compared with carriers of missense variants. Carriers of SDHB truncating variants displayed a trend towards increased risk of PPGL, and all three SDH genes showed a trend towards over-representation of missense variants in HNPGL cases. Overall, variant types conferred PPGL risk in the (highest-to-lowest) sequence SDHB truncating, SDHB missense, SDHD truncating and SDHD missense, with the opposite pattern apparent for HNPGL (p<0.001).ConclusionsSDHD truncating variants represent a distinct group, with a clinical phenotype reminiscent of but not identical to SDHB. We propose that surveillance and counselling of carriers of SDHD should be tailored by variant type. The clinical impact of truncating SDHx variants is distinct from missense variants and suggests that residual SDH protein subunit function determines risk and site of disease.
Glycaemic control and excess risk of major coronary events in patients with type 2 diabetes: a population-based study
Authors: Tancredi Mauro , Rosengren Annika , Svensson Ann-Marie , Pivodic Aldina , Gudbjörnsdottir Soffia , Wedel Hans , Lind Marcus 
Published: September 2019

ObjectiveThe purpose of the study was to investigate the excess risk of acute myocardial infarction (AMI) and death from coronary artery disease (coronary heart disease, CHD) in relation to age, level of glycaemic control and renal complications in patients with type 2 diabetes.MethodsA total of 431 579 patients with type 2 diabetes mellitus registered in the Swedish National Diabetes Register from 1 January 1998 to 31 December 2012, and 2 173 620 controls from the general population were included. Cox regression was used to study the excess risk of AMI and CHD.ResultsDuring follow-up of 5.1 years in the diabetes group and 5.4 years in the control group, 36 124 (8.4%) and 115 712 (5.3%) CHD events were registered, with corresponding incidence rates/1000 person-years of 14.64 (95% CI 14.49 to 14.79) and 8.73 (95% CI 8.68 to 8.78), respectively. The HR after adjustment for sex and age was 1.67 (1.65–1.69) which was reduced to 1.42 (1.41–1.44) with further adjustment for level of education, country of birth, diabetes duration and comorbidities. The multivariable-adjusted HR for AMI and CHD death with a time-updated glycated haemoglobin level of 6.9% or lower (≤52 mmol/mol) together with normoalbuminuria and estimated glomerular filtration rate ≥60 mL/min for patients with diabetes compared with controls was 0.95 (95% CI 0.92 to 0.98, p<0.001).ConclusionsIn this study, the excess risk of AMI and CHD death was higher for patients with type 2 diabetes compared with controls but converged to that in the general population in patients with on-target HbA1c levels and without renal complications.
Racial disparities and the acute management of severe blunt traumatic brain injury
Authors: Sharma Rohit , Johnson Arianne , Li Jing , DeBoard Zach , Zikakis Isabella , Grotts Jonathan , Kaminski Stephen 
Published: September 2019

BackgroundTraumatic brain injury (TBI) is a significant source of morbidity and mortality. In patients with TBI, racial disparities have been shown to exist in patient outcomes. Identifying where disparities occur along the patient continuum of care will allow for targeted interventions. This study evaluated if racial disparity exists for neuromonitoring and neurointervention rates in patients with severe TBI due to blunt injury.MethodsThe National Trauma Data Bank was used to identify patients aged 18 to 55 years old from 2007 through 2016 with a blunt injury, an initial Glasgow Coma Scale score of 3 to 8, a head Abbreviated Injury Scale score of 3 to 5, and all other anatomic Abbreviated Injury Scale scores less than 3. Coarsened exact matching (CEM) was used to balance covariates between white and non-white patients. Rates of neuromonitoring and neurosurgical interventions were compared between groups. Secondary outcomes were days spent in the intensive care unit (ICU), total hospital length of stay (LOS), and mortality.ResultsA total of 3692 patients with severe isolated TBI due to blunt injury were identified. After applying CEM, 1064 patients were analyzed (644 white, 420 non-white). No differences were observed between white and non-white patient groups for neuromonitoring, neurointervention, mortality, or ICU LOS. White patients had a shorter hospital LOS (8 days vs. 9 days, p<0.05) than non-white patients.DiscussionFor severe isolated blunt TBI, neuromonitoring, neurointervention, and mortality rates were similar for white and non-white patients. Although racial disparities in patient outcomes exist, these differences do not seem to be due to neuromonitoring and neurointervention rates for management of TBI.Level of evidenceLevel III.
The impacts of feeding milk with antibiotics on the fecal microbiome and antibiotic resistance genes in dairy calves
Authors: Feng Xin , Littier Heather M. , Knowlton Katharine F. , Garner Emily , Pruden Amy 
Published: September 2019

The effects of ingestion of antibiotics on the microbiome of the young calf are not well understood. The objective of this study was to evaluate the effect of feeding milk containing pirlimycin on the prevalence of antibiotic resistance genes in the fecal microbiome of dairy calves using a metagenomic approach. In this study calves were assigned to either pasteurized whole milk (control; n = 5) or pasteurized whole milk containing 0.2 mg L−1 of pirlimycin (treatment; n = 5). Fecal samples were collected on days 1, 42, and 84. Functional analysis of DNA via metagenomic rapid annotations using subsystems technology revealed that pirlimycin had no effects on abundance of sequences coding for different cell functions except in the “phage, prophage, and transposable elements” category. Evaluation of the major antibiotic resistance types in samples via annotation against the Comprehensive Antibiotic Resistance Database analysis showed no difference between the two groups. The results of this study will help assess the risk of use of antibiotics in animal agriculture and increase our understanding of how antibiotics present in waste milk affects both calves and their manure, and will lay the groundwork for future research on manure treatment or other strategies to minimize any negative impacts.
Quasi-conformal models and the early
universe
Authors: Salvio Alberto 
Published: September 2019

Abstract
Extensions of the Standard Model and general relativity featuring a UV
fixed point can leave observable implications at accessible energies. Although mass
parameters such as the Planck scale can appear through dimensional transmutation,
all fundamental dimension-4 operators can (at least approximately) respect Weyl
invariance at finite energy. An example is the Weyl-squared term, whose consistency
and observational consequences are studied. This quasi-conformal scenario emerges
from the UV complete quadratic gravity and is a possible framework for inflation. We
find two realizations. In the first one the inflaton is a fundamental scalar with a
quasi-conformal non-minimal coupling to the Ricci scalar. In this case the field
excursion must not exceed the Planck mass by far. An example discussed in detail is
hilltop inflation. In the second realization the inflaton is a pseudo-Goldstone
boson (natural inflation). In this case we show how to obtain an elegant UV
completion within an asymptotically free QCD-like theory, in which the inflaton is a
composite scalar due to new strong dynamics. We also show how efficient reheating
can occur. Unlike the natural inflation based on Einstein gravity, the
tensor-to-scalar ratio is well below the current bound set by Planck. In both
realizations mentioned above, the basic inflationary formulæ are computed
analytically and, therefore, these possibilities can be used as simple benchmark
models.
Toward Improved Cloud-Phase Simulation with a Mineral Dust and Temperature-Dependent Parameterization for Ice Nucleation in Mixed-Phase Clouds
Authors: Fan Songmiao , Ginoux Paul , Seman Charles J. , Silvers Levi G. , Zhao Ming 
Published: September 2019

Abstract
Mixed-phase clouds are frequently observed in the atmosphere. Here we present a parameterization for ice crystal concentration and ice nucleation rate based on parcel model simulations for mixed-phase stratocumulus clouds, as a complement to a previous parameterization for stratus clouds. The parcel model uses a singular (time independent) description for deposition nucleation and a time-dependent description for condensation nucleation and immersion freezing on mineral dust particles. The mineral dust and temperature-dependent parameterizations have been implemented in the Geophysical Fluid Dynamics Laboratory atmosphere model, version 4.0 (AM4.0) (new), while the standard AM4.0 (original) uses a temperature-dependent parameterization. Model simulations with the new and original AM4.0 show significant changes in cloud properties and radiative effects. In comparison to measurements, cloud-phase (i.e., liquid and ice partitioning) simulation appears to be improved in the new AM4.0. More supercooled liquid cloud is predicted in the new model, it is sustained even at temperatures lower than −25°C unlike in the original model. A more accurate accounting of ice nucleating particles and ice crystals is essential for improved cloud-phase simulation in the global atmosphere.
Reproducing Internal Variability with Few Ensemble Runs
Authors: Castruccio Stefano , Hu Ziqing , Sanderson Benjamin , Karspeck Alicia , Hammerling Dorit 
Published: September 2019

Abstract
While large climate model ensembles are invaluable tools for physically consistent climate prediction, they also present a large burden in terms of computational resources and storage requirements. A complementary approach to large initial-condition ensembles is to train a stochastic generator on fewer runs. While simulations from a statistical model cannot capture the complexity of climate model runs, they can address some specific scientific questions of interest, such as sampling the variability of regional trends. We demonstrate this potential by comparing simulations from a large ensemble and a stochastic generator trained with only four runs, and show that the variability of regional temperature trends is almost indistinguishable. Training stochastic generators on fewer runs might prove especially useful in the context of large climate model intercomparison projects where creating large ensembles for each model is not possible.
Warm-Sector Heavy Rainfall in Southern China and Its WRF Simulation Evaluation: A Low-Level-Jet Perspective
Authors: Zhang Murong , Meng Zhiyong 
Published: September 2019

Abstract
Warm-sector heavy rainfall in southern China refers to the heavy rainfall that occurs within the warm sector hundreds of kilometers south of a front or without a front during April–June, characterized by poor predictability and a close relationship with low-level jets (LLJs). Based on 45 warm-sector heavy rainfall episodes in 2013 and 2014 in southern China, this study examines their general characteristics and evaluates the performance of convection-permitting WRF Model simulations from an LLJ perspective. The results show that 64% of the warm-sector heavy rainfall episodes are associated with an LLJ (LLJ type) and 36% are not (no-LLJ type). The LLJ type is distinct from the no-LLJ type, with large rainfall accumulation along the coastal area. It is more common for LLJs to occur at both 800 and 925 hPa in the LLJ type, where there is a wide 800-hPa LLJ west of Guangdong Province and two 925-hPa LLJs over Beibu Gulf and the South China Sea (SCS). The coastal convergence associated with the terminus of the LLJ on 925 hPa is conducive to the coastal rainfall. WRF generally presents lower QPF skill in the LLJ type than in the no-LLJ type, due to the severe underestimation of coastal rainfall. The QPF skill of the LLJ type is significantly correlated with the forecast accuracy of LLJs, especially at 925 hPa. The north bias of the simulated LLJ on 925 hPa over the SCS and the associated overestimation of wind speed below ~900 hPa over the inland region weaken the coastal convergence and eventually lead to the underestimation in coastal precipitation.
Large Hail Incidence and Its Economic and Societal Impacts across Europe
Authors: Púčik Tomáš , Castellano Christopher , Groenemeijer Pieter , Kühne Thilo , Rädler Anja T. , Antonescu Bogdan , Faust Eberhard 
Published: September 2019

Abstract
By 31 December 2018, 39 537 quality-controlled reports of large hail had been submitted to the European Severe Weather Database (ESWD) by volunteers and ESSL. This dataset and the NatCatSERVICE Database of Munich RE jointly allowed us to study the hail hazard and its impacts across Europe over a period spanning multiple decades. We present a spatiotemporal climatology of the ESWD reports, diurnal and annual cycles of large hail, and indicate where and how they may be affected by reporting biases across Europe. We also discuss which hailstorms caused the most injuries and present the only case with hail fatalities in recent times. Additionally, we address our findings on the relation between hail size to the type of impacts that were reported. For instance, the probability of reported hail damage to roofs, windows, and vehicles strongly increases as hail size exceeds 5 cm, while damage to crops, trees, and greenhouses is typically reported with hailstone diameters of 2–3 cm. Injuries to humans are usually reported with hail 4 cm in diameter and larger, and number of injuries increases with increasing hail size. Using the NatCatSERVICE data, we studied economic losses associated with hailstorms occurring in central Europe and looked for long-term changes. The trend in hail losses and the annual number of hail loss days since 1990 to 2018 are compared to that of meteorological conditions favorable for large hail as identified by ESSL’s Additive Regression Convective Hazards model. Both hail loss days and favorable environments show an upward trend, in particular since 2000.