bluuebunny/crossref_metadata_2025_split huggingface dataset:
Palynological analysis of faecal matter in African Forest Elephants Loxodonta cyclotis (Mammalia: Proboscidea: Elephantidae) at Omo Forest Reserve, Nigeria
Authors: Walter Okwong John , Adekanmbi Olusola Helen , Clifford Omonu 
Published: August 2019

The factors affecting African Forest Elephants include food availability, demand for ivory and changes in land-use. In order to survive, they tend to traverse considerable distances in search of food; on such occasions they are trapped and killed for their ivory. This present study is aimed at assessing the faecal matter of elephants, and at providing information on the season of ingestion and foraging preferences of these elephants. Faecal matter was collected at nine different locations for one year before being processed and subjected to standard palynological laboratory procedures. The analyses showed that the samples had moderately abundant and diversified palynomorphs. A total of 27 palynomorphs belonging to 22 families with a total count of 2,895 accounting for 94.34% were found to be eaten, while other plant fragments (epidermal cells, xylem vessel elements, and seeds) accounted for 5.66%. The wet and dry seasons accounted for 73.26% and 26.74% respectively. Epidermal cells and xylem vessel elements recorded (70.76%) and (29.2%) during the dry and wet seasons, respectively. In the palynological analysis, pollen of Balanites wilsoniana, Desplatsia subericarpa, Chrysophyllum albidum, among others were recovered in the faecal matter. Pollen analysis of faecal matters provided no information about the quantitative composition of the natural vegetation of elephants, but rather valuable information about their diet. It is recommended that these preferentially foraged parent plants should be cultivated on a large scale. This would potentially reduce competition for food and movement of these animals to other greener areas, consequently leading to poaching.
Does Large Vessel Size Justify Use of Bare-Metal Stents in Primary Percutaneous Coronary Intervention?
Authors: Costa Francesco , Brugaletta Salvatore , Pernigotti Alberto , Flores-Ulmanzor Eduardo , Ortega-Paz Luis , Cequier Angel , Iniguez Andres , Serra Antoni , Jiménez-Quevedo Pilar , Mainar Vicente , Campo Gianluca , Tespili Maurizio , den Heijer Peter , Bethencourt Armando , Vazquez Nicolás , van Es Gerrit Anne , Backx Bianca , Valgimigli Marco , Serruys Patrick , Sabaté Manel 
Published: August 2019

Background:
Drug-eluting stents (DES) showed improved efficacy and safety compared with bare-metal stents (BMS), and international guidelines recommend their use as first line treatment. Yet, BMS are still widely used in practice, especially in large coronary vessels. We aimed to compare efficacy and safety of second-generation DES over BMS in large coronary culprit ST-segment elevated myocardial infarction lesions.

Methods:
We evaluated impact of large coronary stents (maximum size ≥3.50 mm) or smaller stents (<3.50 mm), among 1498 patients with ST-segment elevated myocardial infarction undergoing primary percutaneous coronary intervention, randomly allocated to everolimus-eluting DES or to an equivalent BMS platform in the EXAMINATION trial (Clinical Evaluation of the Xience-V Stent in Acute Myocardial Infarction Trial). Clinical events up to 5 years of follow-up were evaluated.

Results:

Large coronary stents were used in 683 patients (45.9%). At 5-year follow-up, the crude rate of the primary end point, a composite of all-cause death, any myocardial infarction, or any revascularization, was similar among patients treated with large or smaller coronary stents. The impact of DES versus BMS implantation was consistent irrespective of the stent size both for the primary end point (
P
int
=0.82) and other secondary ischemic end points. Within patients treated with bigger stents, DES implantation was associated to a trend toward a reduction of target lesion (hazard ratio, 0.53; 95% CI, 0.27–1.02;
P
=0.05) and target vessel revascularization (hazard ratio, 0.60; 95% CI, 0.34–1.03;
P
=0.066).

Conclusions:
Our results do not support the preferential use of BMS for patients with large coronary vessels. DES may warrant improved efficacy irrespective of stent size among patients undergoing primary percutaneous coronary intervention.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT00828087.
Is Plato an Innatist in the Meno?
Authors: Bronstein David , Schwab Whitney 
Published: August 2019

AbstractPlato in the Meno is standardly interpreted as committed to condition innatism: human beings are born with latent innate states of knowledge. Against this view, Gail Fine has argued for prenatalism: human souls possess knowledge in a disembodied state but lose it upon being embodied. We argue against both views and in favor of content innatism: human beings are born with innate cognitive contents that can be, but do not exist innately in the soul as, the contents of states of knowledge. Content innatism has strong textual support and constitutes a philosophically interesting theory.
Climatological Features of the Weakly and Very Stably Stratified Nocturnal Boundary Layers. Part II: Regime Occupation and Transition Statistics and the Influence of External Drivers
Authors: Abraham Carsten , Monahan Adam H. 
Published: August 2019

Abstract
In a companion paper hidden Markov model (HMM) analyses have been conducted to classify the nocturnal stably stratified boundary layer (SBL) into weakly stable (wSBL) and very stable (vSBL) conditions at different tower sites on the basis of long-term Reynolds-averaged mean data. The resulting HMM regime sequences allow analysis of long-term (climatological) SBL regime statistics. In particular, statistical features of very persistent wSBL and vSBL nights, in which a single regime lasts for the entire night, are contrasted with those of nights with SBL regime transitions. The occurrence of very persistent nights is seasonally dependent and more likely in homogeneous surroundings than in regions with complex terrain. When transitions occur, their timing is not seasonally dependent, but transitions are enhanced close to sunset (for land-based sites). The regime event durations depict remarkably similar distributions across all stations with peaks in transition likelihood approximately 1–2 h after a preceding transition. At Cabauw in the Netherlands, very persistent wSBL and vSBL nights are usually accompanied by overcast conditions with strong geostrophic winds Ugeo or clear-sky conditions with weak Ugeo, respectively. In contrast, SBL regime transitions can neither be linked to magnitudes in Ugeo and cloud coverage nor to specific tendencies in Ugeo. However, regime transitions can be initiated by changes in low-level cloud cover.
Swell Propagation through Submesoscale Turbulence
Authors: Smit Pieter B. , Janssen Tim T. 
Published: August 2019

AbstractThe propagation of ocean swells from generating regions to remote coastlines is affected by submesoscale turbulence in the surface flow field. The presence of submesoscale velocity variations results in random scattering of wave rays. While the interactions with these flow fields are weak, cumulative effects over oceanic scales are significant and result in observable changes in the wave field. Using geometrical optics and statistical mechanics we derive a framework to express these scattering effects on the mean wave statistics directly in terms of the variance spectrum of the submesoscale current field. The theoretical results are presented in Lagrangian and Eulerian forms, where the latter takes the form of a radiative transport equation augmented with a diffusive term in directional space. The theoretical results are verified through Monte Carlo simulations with a geometrical optics model. We show that including submesoscale scattering on ocean wave evolution can explain observed delays in swell arrivals, accelerated wave height decay, and much larger directional spreading of the wave field than predicted by geometrical spreading alone.
Climatology of Flood-Producing Storms and Their Associated Rainfall Characteristics in the United States
Authors: Dougherty Erin , Rasmussen Kristen L. 
Published: August 2019

Abstract
Floods are one of the deadliest weather-related natural disasters in the continental United States (CONUS). Given that rainfall intensity and the amount of CONUS population exposed to floods is expected to increase in the future, it is critical to understand flood characteristics across the CONUS. Therefore, the purpose of this study is to develop a flood-producing storm climatology over the CONUS from 2002 to 2013 to better understand rainfall characteristics of these storms and spatiotemporal differences across the country. Flood reports from the NCEI Storm Events Database are grouped by causative meteorological event and are merged with a database of stream-gauge-indicated floods to provide a robust indication of significant hydrologic events with a meteorological linkage. High-resolution Stage IV rainfall data were matched to 5559 flood episodes across the CONUS to identify rainfall characteristics of flood-producing storms in a variety of environments. This storm climatology indicates that flash flood–producing storms frequently occur with high rainfall accumulations in the summer east of the Rockies. Slow-rise flood-producing storms frequently occur in the spring–early summer (winter), with high rainfall accumulations over the northern and central CONUS (Pacific Northwest) due to rain-on-snowmelt, synoptic systems, and mesoscale convective systems (atmospheric rivers). Hybrid flood-producing storms, sharing characteristics of flash and slow-rise floods, frequently occur in spring–summer and have high rainfall accumulations in the central CONUS, Northeast, and mid-Atlantic. Results from this climatology may provide useful for emergency managers, city planners, and policy makers seeking efforts to protect their communities against risks associated with flood-producing storms.
Geostationary Lightning Mapper Flash Characteristics of Electrified Snowfall Events
Authors: Harkema Sebastian S. , Schultz Christopher J. , Berndt Emily B. , Bitzer Phillip M. 
Published: August 2019

Abstract
This study examines characteristics of lightning in snowfall events (i.e., thundersnow, TSSN) from the perspective of the Geostationary Lightning Mapper (GLM) and the National Environmental Satellite Data and Information Service (NESDIS) merged Snowfall Rate (mSFR) product. A thundersnow detection algorithm (TDA) was derived from the GLM and mSFR that resulted in a probability of detection (POD) of 66.7% when compared to the aviation routine weather report (METAR) reports of TSSN. However, using the TDA an additional 2175 lightning flashes within detected snowfall were identified that were not observed by the METAR reports, indicating that TSSN has been under reported in previous literature. TSSN flashes observed by GLM have mean flash areas, durations, and total optical energy outputs of 754 km2, 402 ms, and 1342 fJ, which are between the 50th and 99th percentile values for all flashes within the GLM field of view. A comparison with data from the National Lightning Detection Network (NLDN) indicated that the NLDN had at least one cloud or ground flash detection in 1709 of the 2214 flashes observed by GLM in snowfall. An average of 5.85 NLDN flashes was assigned to a single GLM flash when the NLDN flash data were constrained by the GLM flash duration and spatial footprint. Statistically significant (p &lt; 0.01) differences in flash area and flash energy were found between flashes that were observed by the NLDN and those that were not. Additionally, when GLM was combined with the NLDN, at least 11.1% of flashes involved a tall human-made object like an antenna or wind turbine.
Quantitative susceptibility mapping in spinocerebellar ataxia type 3/Machado–Joseph disease (SCA3/MJD)
Authors: Xie Fangfang , Weihua Liao , Lirong Ouyang , Wang Xiaoyi , Xing Wu 
Published: August 2019

Background The deep nuclei, brainstem, and anterior central gyrus are important sites of spinocerebellar ataxia type3/Machado–Joseph Disease (SCA3/MJD) involvement. These locations were the common iron deposition areas. We hypothesized that iron deposition changes occur in SCA3/MJD patients and are associated with disease progression. Purpose Quantitative susceptibility mapping was used to quantitatively analyze changes in iron levels in SCA3/MJD patients. Material and Methods Eighteen symptomatic SCA3/MJD patients and 18 age-matched normal controls (group 1; NC1), and 12 asymptomatic mutation carriers (pre-SCA3/MJD) and 16 age-matched normal controls (group 2; NC2) were examined by enhanced gradient echo T2*-weighted angiography. Data were processed to obtain the quantitative susceptibility mapping values. Independent sample t-tests were conducted to compare the differences in the quantitative susceptibility mapping values. Results In the red nuclei and substantia nigra, the quantitative susceptibility mapping values of the symptomatic SCA3/MJD group were significantly higher than those of NC1 ( P < 0.05). The quantitative susceptibility mapping values of the symptomatic SCA3/MJD group were higher than those of NC1 in the globus pallidus, but it was not statistically significant ( P = 0.056). No significant difference in quantitative susceptibility mapping values was found between the pre-SCA3/MJD and NC2. No significant correlation was found between the International Cooperative Ataxia Rating Scale and the Scale for the Assessment and Rating of Ataxia and the quantitative susceptibility mapping values. Conclusion The results clearly demonstrated the quantitative susceptibility mapping value increase in the globus pallidus, red nuclei, and substantia nigra of the symptomatic SCA3/MJD group, indicating iron overload in these nuclei, suggesting that iron deposition is associated with disease onset.
Prognostic role of primary tumor, nodal neck, and retropharyngeal GTVs for unresectable sinonasal cancers treated with IMRT and chemotherapy
Authors: Ferella Letizia , Cavallo Anna , Miceli Rosalba , Iacovelli Nicola Alessandro , Giandini Tommaso , Pignoli Emanuele , Calareso Giuseppina , Bossi Paolo , Resteghini Carlo , Gravina Giovanni Luca , Nicolai Piero , Castelnuovo Paolo , Piazza Cesare , Licitra Lisa , Fallai Carlo , Orlandi Ester 
Published: August 2019

Background: We evaluated the prognostic role of gross tumor volumes (GTVs) of primary tumor and positive lymph nodes on overall survival (OS) and progression-free survival (PFS) in locally advanced unresectable sinonasal cancer (SNC) treated with definitive intensity-modulated radiotherapy (IMRT) with or without chemotherapy. Methods: Primary tumor GTV (GTV-T), pathologic neck nodes GTV (GTV-N), and positive retropharyngeal nodes GTV (GTV-RPN) of 34 patients with epithelial nonglandular SNC receiving IMRT with or without chemotherapy were retrospectively measured. The GTV variables were analyzed in relation with OS and PFS. Survival curves were estimated using the Kaplan-Meier method and compared with the log-rank test. We also estimated the crude cumulative incidence of locoregional relapses only. The optimal volume cutoff value was determined using an outcome-oriented method among the observed values. Results: GTV-T was significantly associated with decreased OS ( P=0.003) and PFS ( P=0.003). Moreover, patients with disease total volumes (GTV) smaller than 149.44 cm³ had better OS and PFS than patients with higher volumes ( P<0.0001 for both). Neck nodal metastasis impacted on OS and PFS ( P=0.030 and P=0.033, respectively), but GTV-N did not ( P=0.961; P=0.958). Retropharyngeal nodes metastasis was not associated with prognosis (OS: P=0.400; PFS: P=0.104). When GTV-RPN was added to GTV-N (GTV-TN), a relation with PFS ( P=0.041) and a trend toward significance for OS ( P=0.075) were found. Conclusions: Our results show that tumor volume is a powerful predictor of outcome in SNC. This could be useful to identify patients with worse prognosis deserving different treatment strategies.
Heterogeneous risk profiles among B3 breast lesions of uncertain malignant potential
Authors: Orsaria Paolo , Grasso Antonella , Carino Rita , Caredda Emanuele , Sammarra Matteo , Altomare Carlo , Rabitti Carla , Gullotta Gabriella , Perrone Giuseppe , Pantano Francesco , Buonomo Oreste Claudio , Altomare Vittorio 
Published: August 2019

Background: Most cases of breast lesions of uncertain malignant potential (B3) undergo surgical intervention. We aimed to analyze the outcome of B3 lesion subtypes in a large series of screen-detected cases. Methods: We screened 2,986 core needle biopsies to classify B3 lesions. Positive predictive values (PPVs) for malignancy were calculated for a comprehensive risk characterization according to clinicopathologic and morphologic variables. Results: B3 lesions comprised 35% atypical ductal hyperplasia (PPV = 20%), 16.7% flat epithelial atypia (PPV = 12%), 22.7% lobular neoplasia (PPV = 16.2%), 9% papillary lesion (PPV = 18.5%), 8.6% phyllodes tumor (PPV = 3.8%), and 8% radial scars (PPV = 4.1%) based on histopathologic diagnosis. Upgrade rates were 15.9% for calcifications, 13.7% for mass lesions, and 16.7% for architectural deformities, with 8.3% of malignant lesions classified as ductal carcinoma in situ and 6.7% as invasive cancers (PPV = 15%). Conclusion: B3 lesions entail a heterogeneous risk of malignancy, and careful radiologic–pathologic correlation is required for optimal treatment.
A randomized trial of telemedicine for migraine management
Authors: Friedman Deborah I , Rajan Balaraman , Seidmann Abraham 
Published: August 2019

Objective To determine whether synchronous video-based telemedicine visits with specialists are feasible and to evaluate clinical effectiveness, patient perceptions, and other benefits of telemedicine visits for follow-up migraine care in a tertiary headache center. Design A one-year, randomized clinical trial. Results Fifty patients were screened and 45 entered the study (43 women, two men). Out of 96 scheduled visits, 89 were successfully conducted using telemedicine. Eighteen patients (out of 22) in the telemedicine cohort and 12 patients (out of 23) in the in-office cohort completed the study. In this small study, clinical outcomes, namely improvement in MIDAS, number of headache days, and average severity at 12 months for participants in the telemedicine group, were not different from those in the in-office group. Convenience was rated higher and visit times were shorter in the telemedicine group. Conclusions In this cohort of patients with severe migraine-related disability, telemedicine was a feasible mode of treatment and an effective alternative to in-office visits for follow-up migraine care. Physician productivity could be higher with telemedicine, and patients may get better access because of its convenience. Trial Registration This study is listed on ClinicalTrials.gov (NCT01706003).
Posteromedial Ligament Repair of the Knee With Suture Tape Augmentation: A Biomechanical Study
Authors: Mehl Julian T. , Kia Cameron , Murphy Matthew , Obopilwe Elifho , Cote Mark , Imhoff Florian B. , Imhoff Andreas B. , Arciero Robert A. , Beitzel Knut , Otto Alexander 
Published: August 2019

Background: In cases of acute combined posteromedial and anterior cruciate ligament (ACL) injuries, primary repair of the superficial medial collateral ligament (sMCL) and posterior oblique ligament (POL) with suture tape augmentation may be a reasonable alternative to standard tendon reconstruction techniques. Purpose/Hypothesis: The purpose was to examine the rotational and valgus laxity with ACL strain following sMCL and POL repair with suture tape augmentation at various degrees of knee flexion. It was hypothesized that this technique would restore knee laxity and kinematics comparable with those of the intact state. Study Design: Controlled laboratory study. Methods: Ten cadaveric knee specimens (mean ± SD, 57.9 ± 5.9 years) were obtained. Specimens were tested with the tibia fixed and the femur mobile on an X-Y table. Each specimen was tested in 4 conditions according to the state of the sMCL and POL: native, deficient, repaired with suture tape augmentation, and reconstructed with tendon allografts. Valgus laxity was tested with 40-N force applied in the lateral direction of the femur, and rotational motion was tested with 5-N torque applied to the tibia. ACL strain during valgus stress was also measured. Each condition was tested in 0°, 15°, 30°, 45°, and 60° of knee flexion. Results: Dissection of the sMCL and POL led to significantly increased valgus laxity in all flexion angles, with a significant increase in ACL strain at 30° ( P < .001) and 45° ( P < .001). Ligament repair with suture tape augmentation demonstrated similar valgus and rotational laxity as compared with intact specimens, with the exception of increased internal rotation at 30° ( P = .005). Ligament reconstruction resulted in significantly increased valgus opening at 45° ( P = .048) and significantly increased internal rotation at 30° ( P < .001) as compared with the native state. Direct comparison between surgical techniques showed no significant differences. Conclusion: At time zero, ligament repair of the posteromedial knee with suture tape augmentation restored close-to-native valgus and rotatory laxity, as well as native ACL strain for cases of complete sMCL and POL avulsion. Clinical Relevance: Ligament repair of the sMCL and POL with suture tape augmentation may be a reasonable alternative to tendon reconstruction techniques in cases of acute combined posteromedial and ACL injuries with valgus and rotatory instability.
Efavirenz-Induced Vanishing Bile Duct Syndrome: A Case Report
Authors: Nwaesei Angela Shogbon , Moye-Dickerson Pamela M. , Dretler Robin Henry 
Published: August 2019

Background: Efavirenz (Sustiva®) is used for the treatment of human immunodeficiency virus (HIV) type 1 infection. Hepatoxicity is a known potential adverse drug event with efavirenz; however, to our knowledge, vanishing bile duct syndrome (VBDS), a type of liver injury, has not been reported with this therapy. Case Presentation: We report the case of a 48-year-old male with HIV and VBDS secondary to antiretroviral therapy. The patient was started on efavirenz, emtricitabine, and tenofovir disoproxil fumarate (Atripla®). Four weeks later, the patient presented with complaints of poor appetite, nausea with emesis, dark urine, and malaise. Labs obtained supported the diagnosis of acute hepatitis, and a liver biopsy confirmed a diagnosis of VBDS. The Naranjo adverse drug reaction probability scale showed that it was probable (score of 7) that the VBDS was related to drug therapy. Efavirenz was assessed to be the most likely cause of VBDS, end-stage liver disease, and the eventual need for liver transplantation. Conclusion: To our knowledge, this is the first reported case of probable efavirenz-induced VBDS in a patient living with HIV. Recognition and awareness of this adverse drug reaction by clinicians for quick diagnosis, discontinuation of therapy, and management are important in patients receiving this regimen.