bluuebunny/crossref_metadata_2025_split huggingface dataset:
Growth differentiation factor-15 as candidate predictor for mortality in adults with pulmonary hypertension
Authors: Geenen Laurie W , Baggen Vivan J M , Kauling Robert M , Koudstaal Thomas , Boomars Karin A , Boersma Eric , Roos-Hesselink Jolien W , van den Bosch Annemien E 
Published: September 2019

ObjectiveDespite its predictive value for mortality in various diseases, the relevance of growth differentiation factor-15 (GDF-15) as prognostic biomarker in pulmonary hypertension (PH) remains unclear. This study investigated the association between GDF-15 and outcomes in adults with PH.MethodsThis is a single-centre prospective observational cohort study. All adults with PH were included at the day of their diagnostic right heart catheterisation between 2012 and 2016. PH due to left heart disease was excluded. Venous blood sampling was performed and included GDF-15 and N-terminal pro-B-type natriuretic peptide (NT-proBNP) measurements. Kaplan-Meier curves and Cox regression analysis were used to investigate the association between GDF-15 and a composite endpoint of death or lung transplantation. We adjusted for age and NT-proBNP in multivariable analysis. Reference values were established by GDF-15 measurements in healthy controls.ResultsGDF-15 was measured in 103 patients (median age 59.2 years, 65% women, 51% pulmonary arterial hypertension). GDF-15 was elevated in 76 patients (74%). After a median follow-up of 3.4 (IQR 2.3–4.6) years, 32 patients (31.1%) reached the primary endpoint. Event-free survival 2 years after diagnosis was 100% in patients with normal GDF-15 versus 72.4% in patients with elevated GDF-15 (p=0.007). A significant association was found between GDF-15 and the primary endpoint (HR per twofold higher value 1.77, 95% CI 1.39 to 2.27, p<0.001), also after adjustment for age and NT-proBNP (HR 1.41, 95% CI 1.02 to 1.94, p=0.038).ConclusionsHigh GDF-15 levels are associated with an increased risk of death or transplant in adults with PH, independent of age and NT-proBNP. As non-specific biomarker, GDF-15 could particularly be useful to detect low-risk patients.
Differences in public support for handgun purchaser licensing
Authors: Crifasi Cassandra K , Stone Elizabeth M , McGinty Beth , Vernick Jon S , Barry Colleen L , Webster Daniel W 
Published: September 2019

ObjectiveTo assess whether there are differences in support for handgun purchaser licensing.MethodsWe used data from four waves of online, national polling on gun policy. To estimate differences in support for licensing across groups, we categorised respondents by whether they personally owned a gun, lived in a state with handgun purchaser licensing or lived in a state regulating private sales without a licensing system.ResultsEighty-four per cent of adults living in states with licensing supported the policy compared with 74% in states without the law (p<0.001). Seventy-seven per cent of gun owners living in states with licensing supported the policy vs 59% of gun owners in states without licensing (p<0.001).ConclusionsSupport for licensing among gun owners living in states with these laws, many of whom have presumably gone through the process, was much higher than gun owners in states without such laws.
Waterpipe tobacco smoke toxicity: the impact of waterpipe size
Authors: Hauser Cindy DeForest , Mailig Ronnae , Stadtler Hannah , Reed Jenna , Chen Shi , Uffman Emilie , Bernd Karen 
Published: September 2019

IntroductionWaterpipe tobacco smoking continues to show increasing popularity, especially among individuals between 18 and 22 years old. Waterpipe tobacco smoke (WTS) is a mixture of particulates and gases formed from the combustion of the charcoal and volatilisation and humidification of the tobacco+humectant+flavouring substrate known as shisha or mu’assel. As such, variation in the configuration of the waterpipe may affect the particles produced. Our study focuses on the effects of waterpipe size on the physical properties and cytotoxicity of the smoke produced.MethodsShisha type and headspace volume were held constant and a modified Beirut puff protocol was followed while the size of the waterpipe was varied. Particle concentrations and size distributions were measured using a TSI Engine Exhaust Particle Sizer. Type II alveolar cells were exposed to smoke at the air-liquid interface and two metrics of cell health analysed.ResultsIn a 30 min session, we observed a decrease in total particle concentration (1014–1013) and mass (10 000–2800 mg/m3) and an increase in particle size (125–170 nm) as pipe height increases from 22 to 55 cm and bowl size from 300 to 1250 mL. Smoke from all pipe sizes caused decreases in lysosomal function (>40%) and membrane integrity (>60%) 24 hours post 57 min exposure, and meet the National Institutes of Health definition of a cytotoxic agent (≥30% decrease in cell viability).ConclusionSmoke from waterpipes of all sizes causes significant alveolar cellular harm, indicating that this device needs regulation as a hazard to human health.
Trajectory-state theory of the Klein-Gordon field
Authors: Holland Peter 
Published: September 2019

Abstract.
We develop a trajectory construction of solutions to the massless wave equation in n + 1 dimensions and hence show that the quantum state of a massive relativistic system in 3 + 1 dimensions may be represented by a stand-alone four-dimensional congruence comprising a continuum of 3-trajectories coupled to an internal scalar time coordinate. A real Klein-Gordon amplitude is the current density generated by the temporal gradient of the internal time. Complex amplitudes are generated by a two-phase flow. The Lorentz covariance of the trajectory model is established.
Keep It Simple
Authors: Jacobs Jochen , Wang Xi , Alexa Marc 
Published: September 2019

Head-mounted displays cause discomfort. This is commonly attributed to conflicting depth cues, most prominently between vergence, which is consistent with object depth, and accommodation, which is adjusted to the near eye displays.
It is possible to adjust the camera parameters, specifically interocular distance and vergence angles, for rendering the virtual environment to minimize this conflict. This requires dynamic adjustment of the parameters based on object depth. In an experiment based on a visual search task, we evaluate how dynamic adjustment affects visual comfort compared to fixed camera parameters. We collect objective as well as subjective data. Results show that dynamic adjustment decreases common objective measures of visual comfort such as pupil diameter and blink rate by a statistically significant margin. The subjective evaluation of categories such as fatigue or eye irritation shows a similar trend but was inconclusive. This suggests that rendering with fixed camera parameters is the better choice for head-mounted displays, at least in scenarios similar to the ones used here.
Checklist of oribatid mites (Acari: Oribatida) of Canada and Alaska
Authors: BEHAN-PELLETIER VALERIE M. , LINDO ZOË 
Published: September 2019

This checklist of the oribatid fauna of Canada and Alaska (excluding Astigmata) includes 580 identified species in 249 genera and 96 families. The known fauna of Canada includes 556 identified species in 247 genera, and that of Alaska includes 182 species in 95 genera; 39 of the 42 oribatid superfamilies are represented. We further list ~ 300 species that are currently unidentified, and possibly undescribed. In addition, we list 42 genera that are represented only by unidentified and probably undescribed species. For each species we give combinations and synonymies, specific locations in Alaska and the Provinces and Territories of Canada, habitats, and biogeography. There are 182 identified species known for Alaska, 152 for Yukon, 122 for Northwest Territories, 58 for Nunavut; 210 for British Columbia, 213 for Alberta, 15 for Saskatchewan, 84 for Manitoba, 167 for Ontario, 210 for Québec, 110 for Nova Scotia, 77 for New Brunswick, 84 for Newfoundland and 6 for Prince Edward Island. The known fauna of Canada is smaller than that of Austria, and is approximately equivalent to that of the Czech Republic. As these countries are much smaller in size than Canada and less ecologically diverse, we consider the Canadian and Alaskan fauna are at most 25% known. The paucity of these data reflects the absence of taxonomic and faunistic studies on Oribatida in State, Provinces or Territories, and especially in the Canadian and Alaskan National Park systems and the hundreds of Provincial Parks. Despite the almost 90% increase in described species since the catalogue of Marshall et al. (1987), there is a need for focussed, coordinated research on Oribatida in the natural regions throughout Canada and Alaska, and for monographs on families and genera with large numbers of undescribed species, such as Brachychthoniidae, Damaeidae, Cepheidae, Liacaridae, Oppiidae, Suctobelbidae, Hydrozetidae, Phenopelopidae, Scheloribatidae, Haplozetidae and Galumnidae.
Linking Global Changes of Snowfall and Wet-Bulb Temperature
Authors: Tamang Sagar K. , Ebtehaj Ardeshir M. , Prein Andreas F. , Heymsfield Andrew J. 
Published: September 2019

AbstractSnowfall is one of the primary drivers of the global cryosphere and is declining in many regions of the world with widespread hydrological and ecological consequences. Previous studies have shown that the probability of snowfall occurrence is well described by wet-bulb temperatures below 1°C (1.1°C) over land (ocean). Using this relationship, wet-bulb temperatures from three reanalysis products as well as multisatellite and reanalysis precipitation data are analyzed from 1979 to 2017 to study changes in potential snowfall areas, snowfall-to-rainfall transition latitude, snowfall amount, and snowfall-to-precipitation ratio (SPR). Results are presented at hemispheric scales, as well as for three Köppen–Geiger climate classes and four major mountainous regions including the Alps, the western United States, High Mountain Asia (HMA), and the Andes. In all reanalysis products, while changes in the wet-bulb temperature over the Southern Hemisphere are mostly insignificant, significant positive trends are observed over the Northern Hemisphere (NH). Significant reductions are observed in annual-mean potential snowfall areas over NH land (ocean) by 0.52 (0.34) million km2 decade−1 due to an increase of 0.34°C (0.35°C) decade−1 in wet-bulb temperature. The fastest retreat in NH transition latitudes is observed over Europe and central Asia at 0.7° and 0.45° decade−1. Among mountainous regions, the largest decline in potential snowfall areas is observed over the Alps at 3.64% decade−1 followed by the western United States at 2.81% and HMA at 1.85% decade−1. This maximum decrease over the Alps is associated with significant reductions in annual snowfall of 20 mm decade−1 and SPR of 2% decade−1.
Nephroprotective effect of losartan in IgA model rat
Authors: Xing Li , Song Er Lin , Jia Xi Bei , Ma Jing , Li Bing , Gao Xu 
Published: September 2019

Objective This study was performed to investigate the possible nephroprotective effects of losartan in a rat model of experimental IgA nephropathy (IgAN). Methods Thirty male Sprague–Dawley rats were randomly divided into three groups. The rats in the model group were treated with bovine serum albumin (oral gavage), lipopolysaccharide (tail vein injection), and carbon tetrachloride (subcutaneous injection); rats in the losartan group received treatments similar to those of the model group, and were orally gavaged with losartan; and rats in the control group received phosphate-buffered saline alone (both orally and intravenously). Results Losartan treatment lowered the 24-hour urinary protein, serum blood urea nitrogen, and serum creatinine levels. Proliferating mesangial cells with a variable increase in the mesangial matrix were detected in the model group, whereas injury in the losartan group was significantly attenuated. Immunohistochemistry revealed that the expression levels of transforming growth factor (TGF)-β1 and α-smooth muscle actin were significantly elevated in the model group but reduced in the losartan group. The expression levels of TGF-β1 and monocyte chemoattractant protein-1 were minimal in the control group, significantly increased in the model group, and reduced in the losartan group. Conclusion Losartan has a protective effect against tubulointerstitial injury in IgAN.
ALK or ROS1-rearranged breast metastasis from lung adenocarcinoma: a report of 2 cases
Authors: Wu Xiao , Wang Hong , Fang Mei , Li Chun , Zeng Yun , Wang Kai 
Published: September 2019

Background: Breast metastases from extramammary sites are extremely rare, with an incidence of 0.4%–1.3% reported in the literature. Insufficient knowledge about its pathology and genetic mutation often leads to misdiagnosis and delayed treatment. Case presentation: We present 2 patients with synchronous (case 1) or metachronous (case 2) breast nodules, revealed as atypical breast metastases from pulmonary adenocarcinomas, in which ALK or ROS1 rearrangement were finally detected in breast mass. After they failed sequential treatments with standard chemotherapies for lung and breast cancer, we reexamined breast lump biopsy and found they were all lung adenocarcinoma metastasis to the breast with the presence of an ALK rearrangement in one case and of ROS1 rearrangement in the other. Eventually these 2 patients were treated with crizotinib. Both the primary tumor and the metastasis of these 2 patients were significantly regressed. Conclusion: Whenever a diagnosis of a suspected tumor with sites at more than one organ is made, pathologic as well molecular pathologic examinations designated for organ-specific cancers should be done.
Tai Chi Movements for Wellbeing – evaluation of a British Lung Foundation pilot
Authors: Lewis A , Hopkinson NS 
Published: September 2019

Aims: In breathless individuals with respiratory disease, pulmonary rehabilitation (PR) can improve exercise capacity, symptoms and ability to cope with their condition. However, access is often limited, and adherence can be poor. Thus, there is interest in developing alternative and complementary forms of exercise intervention and tai chi may be effective in this context. Method: The British Lung Foundation worked in collaboration with ‘Tai Chi Movements for Wellbeing’ Training to train leaders to run community-based tai chi groups in the UK. Leaders received funding to run 3 months of once-a-week classes consisting of a 12 movement sequence of tai chi. Participants completed a questionnaire survey to evaluate the service at the start of their first session and again after 3 months. Results: Ten tai chi groups recruited 128 participants, 65% women, mean (standard deviation (SD)) age 70.1 (7.4) years at baseline. Seventy individuals completed the follow-up questionnaire at 3 months. Participants demonstrated an improvement in Medical Research Council (MRC) Dyspnoea Score pre 3 (interquartile range (IQR) = 1.8), post 2 (IQR = 1), p = .013 and disease burden; chronic obstructive pulmonary disease (COPD) assessment test score pre 19.4 (8.7), post 17.9 (9.4), mean change –1.5 (confidence interval (CI): –2.89 to –0.127), p = .033. Those who completed the programme had a worse baseline COPD assessment test (CAT) score and were more likely to have participated in maintenance exercise previously. Qualitative feedback suggested that participants felt the classes had helped with breathlessness and relaxation. Conclusion: Establishing a tai chi for wellbeing programme for people with respiratory disease is feasible, with a reasonable level of compliance, and is perceived to be helpful by participants.
Impact of a Drug Overdose Decedent Toxicology Testing Legislative Mandate on Informing Coroner Death Investigation and Certification Practices
Authors: Quesinberry Dana , Bunn Terry L. , Hargrove Sarah , Slavova Svetla 
Published: September 2019

Objective: To (a) determine the impact of Kentucky’s (KY’s) mandate requiring postmortem toxicology testing of coroner cases; (b) identify the influence of coroner experience and training, jurisdiction size, budget, and location on postmortem testing requests; (c) identify facilitators/barriers for postmortem toxicology testing requests and listing the specific drugs involved in drug-poisoning deaths on death certificates. Methods: A modified Dillman approach was used to deliver the survey to KY’s elected coroners between April and May 2016. Responses stratified by identified influence factors were compared using χ2 tests and Fisher exact tests. Results: Fifty-eight percent of coroners reported that drug overdose investigations had changed since the mandate was enacted. Statistically significant differences in responses were found when stratified. Sixty-three percent of coroners reported always using testing results to complete death certificates. Conclusions: Uptake of the mandate for postmortem toxicology testing of all decedents is not yet complete. Policy Implication: Without uptake of the mandate, surveillance efforts may result in undercounting of drug overdose deaths and the involvement of specific drugs. Mandates for enhanced training and modification of funding structure for medico-legal death investigations could facilitate uptake.
Diabetes Healthcare Professionals Use Multiple Continuous Glucose Monitoring Data Indicators to Assess Glucose Management
Authors: Sheng Tong , Offringa Reid , Kerr David , Clements Mark , Fischer Jerome , Parks Linda , Greenfield Michael 
Published: September 2019

Background: Continuous glucose monitoring (CGM) offers multiple data features that can be leveraged to assess glucose management. However, how diabetes healthcare professionals (HCPs) actually assess CGM data and the extent to which they agree in assessing glycemic management are not well understood. Methods: We asked HCPs to assess ten de-identified CGM datasets (each spanning seven days) and rank order each day by relative glycemic management (from “best” to “worst”). We also asked HCPs to endorse features of CGM data that were important in making such assessments. Results: In the study, 57 HCPs (29 endocrinologists; 28 diabetes educators) participated. Hypoglycemia and glycemic variance were endorsed by nearly all HCPs to be important (91% and 88%, respectively). Time in range and daily lows and highs were endorsed more frequently by educators (all Ps < .05). On average, HCPs endorsed 3.7 of eight data features. Overall, HCPs demonstrated agreement in ranking days by relative glycemic control (Kendall’s W = .52, P < .001). Rankings were similar between endocrinologists and educators ( R2 = .90, Cohen’s kappa = .95, mean absolute error = .4 [all Ps < .05]; Mann-Whitney U = 41, P = .53). Conclusions: Consensus in the endorsement of certain data features and agreement in assessing glycemic management were observed. While some practice-specific differences in feature endorsement were found, no differences between educators and endocrinologists were observed in assessing glycemic management. Overall, HCPs tended to consider CGM data holistically, in alignment with published recommendations, and made converging assessments regardless of practice.
Optimisation of cardiac resynchronisation therapy device selection guided by cardiac magnetic resonance imaging: Cost-effectiveness analysis
Authors: Crespo Carlos , Linhart Markus , Acosta Juan , Soto-Iglesias David , Martínez Mikel , Jáuregui Beatriz , Mira Áurea , Restovic Gabriela , Sagarra Joan , Auricchio Angelo , Fahn Bernhard , Boltyenkov Artem , Lasalvia Luis , Sampietro-Colom Laura , Berruezo Antonio 
Published: September 2019

Background A recent study showed that the presence and characteristics of myocardial scar could independently predict appropriate implantable cardioverter-defibrillator therapies and the risk of sudden cardiac death in patients receiving a de novo cardiac resynchronisation device. Design The aim was to evaluate the cost-effectiveness of cardiac magnetic resonance imaging-based algorithms versus clinical practice in the decision-making process for the implantation of a cardiac resynchronisation device pacemaker versus cardiac resynchronisation device implantable cardioverter-defibrillator device in heart failure patients with indication for cardiac resynchronisation therapy. Methods An incidental Markov model was developed to simulate the lifetime progression of a heart failure patient cohort. Key health variables included in the model were New York Heart Association functional class, hospitalisations, sudden cardiac death and total mortality. The analysis was done from the healthcare system perspective. Costs (€2017), survival and quality-adjusted life years were assessed. Results At 5-year follow-up, algorithm I reduced mortality by 39% in patients with a cardiac resynchronisation device pacemaker who were underprotected due to misclassification by clinical protocol. This approach had the highest quality-adjusted life years (algorithm I 3.257 quality-adjusted life years; algorithm II 3.196 quality-adjusted life years; clinical protocol 3.167 quality-adjusted life years) and the lowest lifetime costs per patient (€20,960, €22,319 and €28,447, respectively). Algorithm I would improve results for three subgroups: non-ischaemic, New York Heart Association class III–IV and ≥65 years old. Furthermore, implementing this approach could generate an estimated €702 million in health system savings annually in European Society of Cardiology countries. Conclusion The application of cardiac magnetic resonance imaging-based algorithms could improve survival and quality-adjusted life years at a lower cost than current clinical practice (dominant strategy) used for assigning cardiac resynchronisation device pacemakers and cardiac resynchronisation device implantable cardioverter-defibrillators to heart failure patients.
Is There a Difference Between the Readabilities of Informed Consent Forms Used for Elective and Emergency Procedures in Turkey?
Authors: Sönmez Mehmet Giray , Öztürk Sönmez Leyla , Kozanhan Betül , Dündar Zerrin Defne 
Published: September 2019

Background:Informed consent is an important aspect of ethical medical practice. In legal terms, making an intervention without informed consent may mean negligence or malpractice and may lead to legal action, maltreatment, and even attack against the doctor. This study aims to evaluate the readability of informed consent forms (ICFs) used for elective (urology and general surgery) and emergency procedures (emergency medicine and intensive care) by comparing through readability formulas.Methods:Elective and emergency ICFs were accessed through the web sites of national health care associations. A total of 387 consent forms were evaluated and the same forms were included only once. A total of 35 consent forms were evaluated for emergency procedures, while a total of 55 consent forms were evaluated for elective procedures. Ateşman and Bezirci-Yılmaz formulas defined for determining the readability level of Turkish texts and Gunning fog and Flesch Kincaid formulas measuring the general readability level were used for calculating the readability level of consent forms.Results:Even though elective ICFs are more readable compared to those of emergency procedures according to Bezirci-Yılmaz formulas, this was statistically insignificant ( P = .54). The readability of elective consent forms was found to be at a significantly more difficult level to read compared to Ateşman, Gunning fog, and Flesch Kincaid formulas ( P = .002, P < .001, P < .001, respectively).Conclusion:Even though the procedure is emergency or elective, a difficult readability level may cause problems for the doctor in legal phases. Readable and understandable consent forms should be available to be able to explain morbidity and mortality and improve prognosis. Education level of our country should also be considered while preparing these consent forms.