bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of Tornado Events and Warnings in the Southeastern United States
Authors: Anderson-Frey Alexandra K. , Richardson Yvette P. , Dean Andrew R. , Thompson Richard L. , Smith Bryan T. 
Published: June 2019

Abstract
The southeastern United States has become a prime area of focus in tornado-related literature due, in part, to the abundance of tornadoes occurring in high-shear low-CAPE (HSLC) environments. Through this analysis of 4133 tornado events and 16 429 tornado warnings in the southeastern United States, we find that tornadoes in the Southeast do indeed have, on average, higher shear and lower CAPE than tornadoes elsewhere in the contiguous United States (CONUS). We also examine tornado warning skill in the form of probability of detection (POD; percent of tornadoes receiving warning prior to tornado occurrence) and false alarm ratio (FAR; percent of tornado warnings for which no corresponding tornado is detected), and find that, on average, POD is better and FAR is worse for tornadoes in the Southeast than for the CONUS as a whole. These measures of warning skill remain consistent even when we consider only HSLC tornadoes. The Southeast also has nearly double the CONUS percentage of deadly tornadoes, with the highest percentage of these deadly tornadoes occurring during the spring, the winter, and around local sunset. On average, however, the tornadoes with the lowest POD also tend to be those that are weakest and least likely to be deadly; for the most part, the most dangerous storms are indeed being successfully warned.
Long‐term Efficacy of Uvulopalatopharyngoplasty among Adult Patients with Obstructive Sleep Apnea: A Systematic Review and Meta‐analysis
Authors: He Mu , Yin Guoping , Zhan Siyan , Xu Jinkun , Cao Xin , Li Jingjing , Ye Jingying 
Published: June 2019

ObjectivesTo evaluate the long‐term efficacy and potential predictors of uvulopalatopharyngoplasty (UPPP) among adult patients with obstructive sleep apnea (OSA).Data SourcesA systematic search was conducted through PubMed/Medline, Embase, Web of Science, and the Cochrane Library until December 2018.Review MethodsFull‐text articles were selected that studied adult patients who underwent single‐level UPPP or its modification for OSA and had a long‐term follow‐up (at least 34 months) with objective sleep study results. Studies that had no objective outcomes or performed other surgical procedures for OSA were excluded.ResultsOf 2600 studies, 11 were included. Meta‐analysis comparing long‐term post‐ and preoperative outcomes showed significant improvements, with an 15.4 event/h (46.1%) decrease of apnea‐hypopnea index. Compared with the short‐term outcomes (3‐12 months), the long‐term outcomes were less effective, with apnea‐hypopnea index increasing 12.3 events/h (63.8%) and the surgical response decreasing from 67.3% to 44.35%. Subanalysis of individual patient data showed significant correlations of baseline body mass index, lowest arterial oxygen saturation, and proportion of sleep time with oxygen saturation <90% with long‐term surgical response.ConclusionsDespite the surgical efficacy decreasing over time, UPPP and its modification are an effective surgical method for adult OSA in both the short term and the long term after the surgery. Baseline body mass index, lowest arterial oxygen saturation, and proportion of sleep time with oxygen saturation <90% were potentially predictive for long‐term surgical response. Case‐control studies of the long‐term surgical effect of OSA are needed.
An acceptance, role transition, and couple dynamics-based program for caregivers: A qualitative study of the experience of spouses of persons with young-onset dementia
Authors: Larochette Clotilde , Wawrziczny Emilie , Papo David , Pasquier Florence , Antoine Pascal 
Published: June 2019

Objective In this study, we assessed a support program based on acceptance, role transition, and couple dynamics for spouses of people with young-onset dementia. The qualitative feedback from the caregivers’ experience is analyzed. The goal was to explore how this home-based support program is perceived and to appraise the impact of the different approaches that were offered. Design A thematic analysis was conducted on the answers to the end-of-session questionnaires and the follow-up semistructured interviews. Results Five themes emerged from the analyses. They highlighted caregivers’ ability to overcome their emotional struggle as well as the control of their loved one’s behaviors. The results also showed the possibility for caregivers to access new ways to support their loved ones and to maintain the quality of their relationship. Conclusion These findings represent preliminary evidence of this program’s efficacy for caregivers.
Proton Pump Inhibitor Use Affects Pseudarthrosis Rates and Influences Patient-Reported Outcomes
Authors: Mangan John J. , Divi Srikanth N. , McKenzie James C. , Stull Justin D. , Conaway William , Casper David S. , Goyal Dhruv K. C. , Nicholson Kristen J. , Galetta Matthew S. , Wagner Scott C. , Kaye I. David , Kurd Mark F. , Woods Barrett I. , Radcliff Kristen E. , Rihn Jeffery A. , Anderson D. Greg , Hilibrand Alan S. , Vaccaro Alexander R. , Schroeder Gregory D. , Kepler Christopher K. 
Published: June 2019

Study Design: Retrospective cohort review Objectives: Cervical pseudarthrosis is a frequent cause of need for revision anterior cervical discectomy and fusion (ACDF) and may lead to worse patient-reported outcomes. The effect of proton pump inhibitors on cervical fusion rates are unknown. The purpose of this study was to determine if patients taking PPIs have higher rates of nonunion after ACDF. Methods: A retrospective cohort review was performed to compare patients who were taking PPIs preoperatively with those not taking PPIs prior to ACDF. Patients younger than 18 years of age, those with less than 1-year follow-up, and those undergoing surgery for trauma, tumor, infection, or revision were excluded. The rates of clinically diagnosed pseudarthrosis and radiographic pseudarthrosis were compared between PPI groups. Patient outcomes, pseudarthrosis rates, and revision rates were compared between PPI groups using either multiple linear or logistic regression analysis, controlling for demographic and operative variables. Results: Out of 264 patients, 58 patients were in the PPI group and 206 were in the non-PPI group. A total of 23 (8.71%) patients were clinically diagnosed with pseudarthrosis with a significant difference between PPI and non-PPI groups ( P = .009). Using multiple linear regression, PPI use was not found to significantly affect any patient-reported outcome measure. However, based on logistic regression, PPI use was found to increase the odds of clinically diagnosed pseudarthrosis (odds ratio 3.552, P = .014). Additionally, clinically diagnosed pseudarthrosis negatively influenced improvement in PCS-12 scores ( P = .022). Conclusions: PPI use was found to be a significant predictor of clinically diagnosed pseudarthrosis following ACDF surgery. Furthermore, clinically diagnosed pseudarthrosis negatively influenced improvement in PCS-12 scores.
Long-term outcomes of Wagner self-locking stem with bone allograft for Paprosky type II and III bone defects in revision total hip arthroplasty: A mean 15.7-year follow-up
Authors: Zang Junting , Uchiyama Katsufumi , Moriya Mitsutoshi , Fukushima Kensuke , Takahira Naonobu , Takaso Masashi 
Published: June 2019

Purpose: Massive bone defects represent a challenge in revision total hip arthroplasty (THA). Wagner self-locking (SL) stem is a favorable option for this technique; however, its long-term outcomes with bone allograft have rarely been reported. The purpose of this study was to investigate the long-term outcomes of this stem with bone allograft for Paprosky type II and III bone defects in revision THA. Methods: A total of 38 patients (40 hips) who underwent revision THA with the Wagner SL stem were retrospectively reviewed. Bone allograft was placed in every patient. Clinical outcomes were determined using the Japanese Orthopedic Association’s hip scoring system (JOA hip score). Stem subsidence, stem fixation, and remodeling of the grafted bone were assessed radiographically. The survival rate of the stem was assessed by Kaplan–Meier survival analysis. Results: The mean JOA hip score at the latest follow-up was 75.3 points. Stem subsidence of ≥10 mm was observed in four hips (10.0%). Moreover, 67.5% (27/40) of hips were stable, and 27.5% (11/40) had fibrous fixation. Bone restoration was observed in 25 hips (62.5%). At a mean follow-up of 15.7 years, the cumulative stem survival rates were 96.6%and 91.7% with “stem re-revision for loosening” and “stem re-revision for any reason” as the end points, respectively. Conclusion: The Wagner SL stem with bone allograft for proximal femoral bone defects in revision THA is a clinically beneficial procedure.
High rate of durable complete remission in follicular lymphoma after CD19 CAR-T cell immunotherapy
Authors: Hirayama Alexandre V. , Gauthier Jordan , Hay Kevin A. , Voutsinas Jenna M. , Wu Qian , Pender Barbara S. , Hawkins Reed M. , Vakil Aesha , Steinmetz Rachel N. , Riddell Stanley R. , Maloney David G. , Turtle Cameron J. 
Published: June 2019

Abstract
Patients with follicular lymphoma (FL) with early relapse after initial chemoimmunotherapy, refractory disease, or histologic transformation (tFL) have limited progression-free and overall survival. We report efficacy and long-term follow-up of 21 patients with relapsed/refractory (R/R) FL (n = 8) and tFL (n = 13) treated on a phase 1/2 clinical trial with cyclophosphamide and fludarabine lymphodepletion followed by infusion of 2 × 106 CD19-directed chimeric antigen receptor–modified T (CAR-T) cells per kilogram. The complete remission (CR) rates by the Lugano criteria were 88% and 46% for patients with FL and tFL, respectively. All patients with FL who achieved CR remained in remission at a median follow-up of 24 months. The median duration of response for patients with tFL was 10.2 months at a median follow-up of 38 months. Cytokine release syndrome occurred in 50% and 39%, and neurotoxicity in 50% and 23% of patients with FL and tFL, respectively, with no severe adverse events (grade ≥3). No significant differences in CAR-T cell in vivo expansion/persistence were observed between FL and tFL patients. CD19 CAR-T cell immunotherapy is highly effective in adults with clinically aggressive R/R FL with or without transformation, with durable remission in a high proportion of FL patients. This trial was registered at clinicaltrials.gov as #NCT01865617.
Adoptive T-cell therapy for pediatric cytomegalovirus-associated retinitis
Authors: Seo Shiney , Smith Corey , Fraser Christopher , Patheja Rajan , Shah Shaheen P. , Rehan Sweera , Crooks Pauline , Neller Michelle A. , Khanna Rajiv 
Published: June 2019

Key Points
TCRαβ+/CD19+-depleted haploidentical HSCT was used to restore immunity in a pediatric patient with combined immunodeficiency syndrome. Posttransplant drug-resistant CMV retinitis was successfully treated with T cells expanded from a haploidentical HSCT donor.
Genome-wide identification, phylogeny, evolutionary expansion and expression analyses of bZIP transcription factor family in tartary buckwheat
Authors: Liu Moyang , Wen Yongdi , Sun Wenjun , Ma Zhaotang , Huang Li , Wu Qi , Tang Zizhong , Bu Tongliang , Li Chenglei , Chen Hui 
Published: June 2019

Abstract
Background
In reported plants, the bZIP family is one of the largest transcription factor families. bZIP genes play roles in the light signal, seed maturation, flower development, cell elongation, seed accumulation protein, abiotic and biological stress and other biological processes. While, no detailed identification and genome-wide analysis of bZIP family genes in Fagopyum talaricum (tartary buckwheat) has previously been published. The recently reported genome sequence of tartary buckwheat provides theoretical basis for us to study and discuss the characteristics and expression of bZIP genes in tartary buckwheat based on the whole genome.

Results
In this study, 96 FtbZIP genes named from FtbZIP1 to FtbZIP96 were identified and divided into 11 subfamilies according to their genetic relationship with 70 bZIPs of A. thaliana. FtbZIP genes are not evenly distributed on the chromosomes, and we found tandem and segmental duplication events of FtbZIP genes on 8 tartary buckwheat chromosomes. According to the results of gene and motif composition, FtbZIP located in the same group contained analogous intron/exon organizations and motif composition. By qRT-PCR, we quantified the expression of FtbZIP members in stem, root, leaf, fruit, and flower and during fruit development. Exogenous ABA treatment increased the weight of tartary buckwheat fruit and changed the expressions of FtbZIP genes in group A.

Conclusions
Through our study, we identified 96 FtbZIP genes in tartary buckwheat and synthetically further analyzed the structure composition, evolution analysis and expression pattern of FtbZIP proteins. The expression pattern indicates that FtbZIP is important in the course of plant growth and development of tartary buckwheat. Through comprehensively analyzing fruit weight and FtbZIP genes expression after ABA treatment and endogenous ABA content of tartary buckwheat fruit, ABA may regulate downstream gene expression by regulating the expression of FtPinG0003523300.01 and FtPinG0003196200.01, thus indirectly affecting the fruit development of tartary buckwheat. This will help us to further study the function of FtbZIP genes in the tartary buckwheat growth and improve the fruit of tartary buckwheat.
BET protein inhibition regulates cytokine production and promotes neuroprotection after spinal cord injury
Authors: Sánchez-Ventura Judith , Amo-Aparicio Jesús , Navarro Xavier , Penas Clara 
Published: June 2019

AbstractBackgroundSpinal cord injury (SCI) usually causes a devastating lifelong disability for patients. After a traumatic lesion, disruption of the blood-spinal cord barrier induces the infiltration of macrophages into the lesion site and the activation of resident glial cells, which release cytokines and chemokines. These events result in a persistent inflammation, which has both detrimental and beneficial effects, but eventually limits functional recovery and contributes to the appearance of neuropathic pain. Bromodomain and extra-terminal domain (BET) proteins are epigenetic readers that regulate the expression of inflammatory genes by interacting with acetylated lysine residues. While BET inhibitors are a promising therapeutic strategy for cancer, little is known about their implication after SCI. Thus, the current study was aimed to investigate the anti-inflammatory role of BET inhibitors in this pathologic condition.MethodsWe evaluated the effectiveness of the BET inhibitor JQ1 to modify macrophage reactivity in vitro and to modulate inflammation in a SCI mice model. We analyzed the effects of BET inhibition in pro-inflammatory and anti-inflammatory cytokine production in vitro and in vivo. We determined the effectiveness of BET inhibition in tissue sparing, inflammation, neuronal protection, and behavioral outcome after SCI.ResultsWe have found that the BET inhibitor JQ1 reduced the levels of pro-inflammatory mediators and increased the expression of anti-inflammatory cytokines. A prolonged treatment with JQ1 also decreased reactivity of microglia/macrophages, enhanced neuroprotection and functional recovery, and acutely reduced neuropathic pain after SCI.ConclusionsBET protein inhibition is an effective treatment to regulate cytokine production and promote neuroprotection after SCI. These novel results demonstrate for the first time that targeting BET proteins is an encouraging approach for SCI repair and a potential strategy to treat other inflammatory pathologies.
Significant and Distinctive n-Grams in Oncology Notes: A Text-Mining Method to Analyze the Effect of OpenNotes on Clinical Documentation
Authors: Rahimian Maryam , Warner Jeremy L. , Jain Sandeep K. , Davis Roger B. , Zerillo Jessica A. , Joyce Robin M. 
Published: June 2019

PURPOSE OpenNotes is a national movement established in 2010 that gives patients access to their visit notes through online patient portals, and its goal is to improve transparency and communication. To determine whether granting patients access to their medical notes will have a measurable effect on provider behavior, we developed novel methods to quantify changes in the length and frequency of use of n-grams (sets of words used in exact sequence) in the notes. METHODS We analyzed 102,135 notes of 36 hematology/oncology clinicians before and after the OpenNotes debut at Beth Israel Deaconess Medical Center. We applied methods to quantify changes in the length and frequency of use of sequential co-occurrence of words ( n-grams) in the unstructured content of the notes by unsupervised hierarchical clustering and proportional analysis of n-grams. RESULTS The number of significant n-grams averaged over all providers did not change, but for individual providers, there were significant changes. That is, all significant observed changes were provider specific. We identified eight providers who were late note signers. This group significantly reduced its late signing behavior after OpenNotes implementation. CONCLUSION Although the number of significant n-grams averaged over all providers did not change, our text-mining method detected major content changes in specific providers’ documentation at the n-gram level. The method successfully identified a group of providers who decreased their late note signing behavior.
Impact of Travel Time on Health Care Costs and Resource Use by Phase of Care for Older Patients With Cancer
Authors: Rocque Gabrielle B. , Williams Courtney P. , Miller Harold D. , Azuero Andres , Wheeler Stephanie B. , Pisu Maria , Hull Olivia , Rocconi Rodney P. , Kenzik Kelly M. 
Published: June 2019

PURPOSE Many community cancer clinics closed between 2008 and 2016, with additional closings potentially expected. Limited data exist on the impact of travel time on health care costs and resource use. METHODS This retrospective cohort study (2012 to 2015) evaluated travel time to cancer care site for Medicare beneficiaries age 65 years or older in the southeastern United States. The primary outcome was Medicare spending by phase of care (ie, initial, survivorship, end of life). Secondary outcomes included patient cost responsibility and resource use measured by hospitalization rates, intensive care unit admissions, and chemotherapy-related hospitalization rates. Hierarchical linear models with patients clustered within cancer care site (CCS) were used to determine the effects of travel time on average monthly phase-specific Medicare spending and patient cost responsibility. RESULTS Median travel time was 32 (interquartile range, 18-59) minutes for the 23,382 included Medicare beneficiaries, with 24% of patients traveling longer than 1 hour to their CCS. During the initial phase of care, Medicare spending was 14% higher and patient cost responsibility was 10% higher for patients traveling longer than 1 hour than those traveling 30 minutes or less. Hospitalization rates were 4% to 13% higher for patients traveling longer than 1 hour versus 30 minutes or less in the initial (61 v 54), survivorship (27 v 26), and end-of-life (310 v 286) phases of care (all P < .05). Most patients traveling longer than 1 hour were hospitalized at a local hospital rather than at their CCS, whereas the converse was true for patients traveling 30 minutes or less. CONCLUSION As health care locations close, patients living farther from treatment sites may experience more limited access to care, and health care spending could increase for patients and Medicare.
Quantitative contrast-enhanced perfusion kinetics in multiparametric MRI in differentiating prostate cancer from chronic prostatitis: results from a pilot study
Authors: Sureka Binit , Elhence Poonam , Khera Pushpinder Singh , Choudhary Gautam Ram , Pandey Himanshu , Garg Pawan Kumar , Yadav Kuldeep , Goel Akhil 
Published: June 2019

Objective:
The objectives of the study were to analyze the apparent diffusion coefficient (ADC), ktrans, kep metrics in dynamic contrast-enhanced multiparametric MRI (DCE-mpMRI) in biopsy proven cases of prostate cancer (PCa) and prostatitis and to establish “cut-off” values for various pharmacokinetic parameters that may distinguish PCa from chronic prostatitis.

Methods:
A retrospective review of all cases of PCa and chronic prostatitis patients, who underwent DCE-mpMRI in our institute was done from July 2017 to January 2019. Mean ADC, ktrans , kep for lesion “L” (ADCL, ktrans L , kepL) and normal prostate tissue “N” (ADCN, ktrans N , kepN ,) were calculated for each region of interest. Different ratios ADC ratio (defined as ADCL/ ADCN), ktrans ratio (ktrans L/ ktrans N), kepratio (kepL/kepN) were calculated to differentiate PCa from chronic prostatitis.

Results:
Total of biopsy proven 14 cases of PCa and 18 cases of chronic prostatitis were included in the study. For ktrans ratio, the optimal cut-off was at 1.49 units where sensitivity was 85.7%, specificity was 61.1 % and Youden’s index was 0.468 %. Similarly, optimal cut-offs determined for kep lesion was 0.86 (sensitivity 85.7%, specificity 66.7%, J = 0.524) and for kep ratio was 1.34 units (sensitivity 78.6%, specificity 66.7%, J = 0.543).

Conclusion:
DCE-mpMRI metrics could differentiate between PCa and chronic prostatitis with good specificity and sensitivity, while ProstateImaging Reporting and Data System v. 2 alone, did not differentiate between these patterns.

Advances in knowledge:
ktrans ratio, kep lesion and kep ratio can differentiate PCa from chronic prostatitis.
Examining the role of funders in ensuring value and reducing waste in research: An organizational case-study of the Patient-Centered Outcomes Research Institute
Authors: Whitlock Evelyn P. , Selby Joe V. , Dunham Kelly M. , Fernandez Alicia , Forsythe Laura P. , Norquist Grayson 
Published: June 2019

International experts have recommended actions that funders can take to improve the value of research investments. They state that self-assessment and public sharing are the basis for accountability and improvement. We examined our policies and practice to determine the extent to which the Patient-Centered Outcomes Research Institute’s (PCORI) policies and practices as a research funder align with international best practice recommendations. A self-audit of current policies and practice against 17 recommendations and 35 sub-recommendations representing five major stages of research production, based on adapted methods used for self-assessment by another funder, was performed. Fit of existing PCORI policies and practices with 35 sub-recommendations, qualitative assessment of adequacy (area of strength; area of partial strength; area of growth; not applicable) for 17 recommendations for five stages of research production was assessed. Of the 17 recommendations, 15 were applicable to PCORI’s research mission and focus. PCORI has policies and practices in place for all elements of six recommendations (“area of strength”) and policies that address each element but with some still in active development for three (“area of partial strength”). PCORI is partially addressing six of the 15 relevant recommendations (“area of growth”). Areas for growth include making study protocols publicly available, improving policies on data sharing, and enhancing collaboration with other funders to reduce redundant funding. A voluntary consortium of international funders is underway to encourage further progress, including additional self-assessment and public sharing for accountability. These findings indicate PCORI has undertaken efforts to align its funding practices with international recommendations to ensure the value of public dollars invested in research. Further efforts will likely require additional coordination and collaboration between funders and stakeholders.