bluuebunny/crossref_metadata_2025_split huggingface dataset:
Twenty‐Year Trends in the American Heart Association Cardiovascular Health Score and Impact on Subclinical and Clinical Cardiovascular Disease: The Framingham Offspring Study
Authors: Enserro Danielle M. , Vasan Ramachandran S. , Xanthakis Vanessa 
Published: May 2018

Background

Data on the temporal trends in ideal cardiovascular health (
CVH
) as well as on their association with subclinical/overt cardiovascular disease (
CVD
) and death are limited.

Methods and Results

This study included 3460 participants attending ≥1 of 4 consecutive exams of the Framingham Heart Study (1991–2008, mean age 55.4 years,
CVH
score ranged 0–14). We created 4 groups describing changes in
CVH
score between examination cycles 5 and 8, using first and last exams attended (high‐high: starting
CVH
score ≥8, last score of ≥8, referent; high‐low: ≥8 start and ≤7 last; low‐high: ≤7 start and ≥8 last; and low‐low: ≤7 start and ≤7 last) and related them to subclinical
CVD
cross‐sectionally, and incident
CVD
and death. Fewer people have ideal
CVH
scores over the past 20 years (8.5% for 1991–1995, 5.9% for 2005–2008,
P
=0.002), because of decreases in those with ideal status of body mass index, blood glucose, and serum cholesterol levels (
P
<0.05 for all). The odds of subclinical disease and risk of
CVD
and death were higher for all compared with the high‐high group (428
CVD
and 367 death events, median follow‐up 5.1 years, hazard ratios for
CVD
: 1.39, 1.73, 1.9 and death: 1.12, 1.57, 1.4 and odds ratios for subclinical disease: 1.61, 1.98, 2.86 for high‐low, low‐high, and low‐low, respectively).

Conclusions

The decreased presence of ideal
CVH
scores over the past 20 years resulted in increasing odds of subclinical disease and risk of
CVD
and death, emphasizing the importance of maintaining ideal
CVH
over the life course.
Revisiting the taxonomy of Justicia beddomei (Acanthaceae)
Authors: PRABHUKUMAR KONICKAL MAMBETTA , BEEGAM FARSANA , GEORGE SATHEESH , BALACHANDRAN INDIRA 
Published: May 2018

Taxonomic history and occurrence of Justicia beddomei in India is discussed. Detailed description, photographs, conservation assessment, ecology and distributional notes are provided along with a comparison of the closely allied species J. adhatoda. The paper also discusses the identity of the raw drug ‘Vasa’ in Indian Systems of Medicine-Ayurveda.
Interpreting Results from the NARCCAP and NA-CORDEX Ensembles in the Context of Uncertainty in Regional Climate Change Projections
Authors: Karmalkar Ambarish V. 
Published: May 2018

AbstractTwo ensembles of dynamically downscaled climate simulations for North America—the North American Regional Climate Change Assessment Program (NARCCAP) and the Coordinated Regional Climate Downscaling Experiment (CORDEX) featuring simulations for North America (NA-CORDEX)—are analyzed to assess the impact of using a small set of global general circulation models (GCMs) and regional climate models (RCMs) on representing uncertainty in regional projections. Selecting GCMs for downscaling based on their equilibrium climate sensitivities is a reasonable strategy, but there are regions where the uncertainty is not fully captured. For instance, the six NA-CORDEX GCMs fail to span the full ranges produced by models in phase 5 of the Coupled Model Intercomparison Project (CMIP5) in summer temperature projections in the western and winter precipitation projections in the eastern United States. Similarly, the four NARCCAP GCMs are overall poor at spanning the full CMIP3 ranges in seasonal temperatures. For the Southeast, the NA-CORDEX GCMs capture the uncertainty in summer but not in winter projections, highlighting one consequence of downscaling a subset of GCMs. Ranges produced by the RCMs are often wider than their driving GCMs but are sensitive to the experimental design. For example, the downscaled projections of summer precipitation are of opposite polarity in two RCM ensembles in some regions. Additionally, the ability of the RCMs to simulate observed temperature trends is affected by the internal variability characteristics of both the RCMs and driving GCMs, and is not systematically related to their historical performance. This has implications for adequately sampling the impact of internal variability on regional trends and for using model performance to identify credible projections. These findings suggest that a multimodel perspective on uncertainties in regional projections is integral to the interpretation of RCM results.
A Role for the Equatorial Undercurrent in the Ocean Dynamical Thermostat
Authors: Coats S. , Karnauskas K. B. 
Published: May 2018

AbstractReconstructions of sea surface temperature (SST) based on instrumental observations suggest that the equatorial Pacific zonal SST gradient has increased over the twentieth century. While this increase is suggestive of the ocean dynamical thermostat mechanism of Clement et al., observations of a concurrent weakening of the zonal atmospheric (Walker) circulation are not. Here we show, using heat and momentum budget calculations on an ocean reanalysis dataset, that a seasonal weakening of the zonal atmospheric circulation is in fact consistent with cooling in the eastern equatorial Pacific (EEP) and thus an increase in the zonal SST gradient. This cooling is driven by a strengthening Equatorial Undercurrent (EUC) in response to decreased upper-ocean westward momentum associated with weakening equatorial zonal wind stress. This process can help to reconcile the seemingly contradictory twentieth-century trends in the tropical Pacific atmosphere and ocean. Moreover, it is shown that coupled general circulation models (CGCMs) do not correctly simulate this process; we identify a systematic bias in the relationship between changes in equatorial surface zonal wind stress in the EEP and EUC strength that may help to explain why observations and CGCMs have opposing trends in the zonal SST gradient over the twentieth century.
El Niño–Southern Oscillation and Associated Climatic Conditions around the World during the Latter Half of the Twenty-First Century
Authors: Power Scott B. , Delage François P. D. 
Published: May 2018

AbstractIncreases in greenhouse gas emissions are expected to cause changes both in climatic variability in the Pacific linked to El Niño–Southern Oscillation (ENSO) and in long-term average climate. While mean state and variability changes have been studied separately, much less is known about their combined impact or relative importance. Additionally, studies of projected changes in ENSO have tended to focus on changes in, or adjacent to, the Pacific. Here we examine projected changes in climatic conditions during El Niño years and in ENSO-driven precipitation variability in 36 CMIP5 models. The models are forced according to the RCP8.5 scenario in which there are large, unmitigated increases in greenhouse gas concentrations during the twenty-first century. We examine changes over much of the globe, including 25 widely spread regions defined in the IPCC special report Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation (SREX). We confirm that precipitation variability associated with ENSO is projected to increase in the tropical Pacific, consistent with earlier research. We also find that the enhanced tropical Pacific variability drives ENSO-related variability increases in 19 SREX regions during DJF and in 18 during JJA. This externally forced increase in ENSO-driven precipitation variability around the world is on the order of 15%–20%. An increase of this size, although substantial, is easily masked at the regional level by internally generated multidecadal variability in individual runs. The projected changes in El Niño–driven precipitation variability are typically much smaller than projected changes in both mean state and ENSO neutral conditions in nearly all regions.
Inverse Cascades of Kinetic Energy as a Source of Intrinsic Variability: A Global OGCM Study
Authors: Sérazin Guillaume , Penduff Thierry , Barnier Bernard , Molines Jean-Marc , Arbic Brian K. , Müller Malte , Terray Laurent 
Published: May 2018

AbstractA seasonally forced 1/12° global ocean/sea ice simulation is used to characterize the spatiotemporal inverse cascade of kinetic energy (KE). Nonlinear scale interactions associated with relative vorticity advection are evaluated using cross-spectral analysis in the frequency–wavenumber domain from sea level anomaly (SLA) time series. This analysis is applied within four eddy-active midlatitude regions having large intrinsic variability spread over a wide range of scales. Over these four regions, mesoscale surface KE is shown to spontaneously cascade toward larger spatial scales—between the deformation scale and the Rhines scale—and longer time scales (possibly exceeding 10 years). Other nonlinear processes might have to be invoked to explain the longer time scales of intrinsic variability, which have a substantial surface imprint at midlatitudes. The analysis of a fully forced 1/12° hindcast shows that low-frequency and synoptic atmospheric forcing barely affects this inverse KE cascade. The inverse cascade is also at work in a 1/4° simulation, albeit with a weaker intensity, consistent with the weaker intrinsic variability found at this coarser resolution. In the midlatitude North Pacific, the spatiotemporal cascade transfers KE from high-frequency frontal Rossby waves (FRWs), probably generated by baroclinic instability, toward the lower-frequency, westward-propagating mesoscale eddy (WME) field. The WMEs provide local gradients of potential vorticity that support these short Doppler-shifted FRWs. FRWs have periods shorter than 2 months and might be subsampled by altimetric observations, perhaps explaining why the temporal inverse cascade deduced from high-resolution models and mapped altimeter products can be quite different. The nature of the nonlinear interactions between FRWs and WMEs remains unclear but might involve wave turbulence processes.
A Simple and Effective Method for Separating Meteorological from Nonmeteorological Targets Using Dual-Polarization Data
Authors: Kilambi Alamelu , Fabry Frédéric , Meunier Véronique 
Published: May 2018

AbstractTo satisfy the needs of the meteorological and aeroecological communities wanting a simple but effective way of flagging each other’s unwanted echo for a variety of different operational radar systems, we evaluated the ability of an estimate of depolarization ratio (DR) based on differential reflectivity (ZDR) and copolar correlation coefficient (ρHV) measurements to separate both types of echoes. The method was tested with data collected by S- and C-band radars used in the United States and Canada. The DR-based method that does not require training achieved 96% separation between weather and biological echoes. Since the misclassifications are typically caused by isolated pixels in the melting layer or at the edge of echo patterns, the addition of a despeckling algorithm considerably reduces further these false alarms, resulting in an increase in correct identification approaching 99% on test cases.
Application of Multivariate Sensitivity Analysis Techniques to AGCM-Simulated Tropical Cyclones
Authors: He Fei , Posselt Derek J. , Narisetty Naveen N. , Zarzycki Colin M. , Nair Vijayan N. 
Published: May 2018

AbstractThis work demonstrates the use of Sobol’s sensitivity analysis framework to examine multivariate input–output relationships in dynamical systems. The methodology allows simultaneous exploration of the effect of changes in multiple inputs, and accommodates nonlinear interaction effects among parameters in a computationally affordable way. The concept is illustrated via computation of the sensitivities of atmospheric general circulation model (AGCM)-simulated tropical cyclones to changes in model initial conditions. Specifically, Sobol’s variance-based sensitivity analysis is used to examine the response of cyclone intensity, cloud radiative forcing, cloud content, and precipitation rate to changes in initial conditions in an idealized AGCM-simulated tropical cyclone (TC). Control factors of interest include the following: initial vortex size and intensity, environmental sea surface temperature, vertical lapse rate, and midlevel relative humidity. The sensitivity analysis demonstrates systematic increases in TC intensity with increasing sea surface temperature and atmospheric temperature lapse rates, consistent with many previous studies. However, there are nonlinear interactions among control factors that affect the response of the precipitation rate, cloud content, and radiative forcing. In addition, sensitivities to control factors differ significantly when the model is run at different resolution, and coarse-resolution simulations are unable to produce a realistic TC. The results demonstrate the effectiveness of a quantitative sensitivity analysis framework for the exploration of dynamic system responses to perturbations, and have implications for the generation of ensembles.
Advanced stage breast cancer is associated with catheter-tip thrombus formation following implantable central venous port placement
Authors: Makary Mina S , Lionberg Alexander , Khayat Mamdouh , Lustberg Maryam B , AlTaani Jamal , Pan Xueliang J , Layman Richard R , Raman Subha V , Layman Rachel M , Dowell Joshua D 
Published: May 2018

Purpose Catheter-tip associated thrombosis is not uncommon in patients with implantable central venous ports; however, the prevalence and clinical impact of this complication on patient management is unclear. This study aims to identify risk factors for thrombus formation in a large population receiving serial echocardiograms (echo) following port placement. Methods A total of 396 female breast cancer patients underwent internal jugular vein chest port placement between 2007 and 2013 and received echo studies every third month. Catheter tip position was measured from chest radiography and catheter associated thrombus was identified by echo. Results Sixteen out of 396 patients (4%) had catheter-tip thrombus. No patients were symptomatic or prophylactically anticoagulated. Patients with thrombus were significantly younger than those without (46.4 years versus 53.4 years, respectively, p = 0.02) and had higher stage breast cancer with 75% versus 44.7% having stage III or IV cancer ( p = 0.017). Thrombus was identified after a median of 91 days. No significant difference was identified in anatomic ( p = 0.1) or measured ( p = 0.15) tip position, port laterality ( p = 0.86), or number of port lumens ( p = 0.65). Conclusions In this large cohort, younger patients and those with more advanced stage breast cancer were more associated with catheter-tip-related thrombus after port placement.
Ultrasonographic optic nerve sheath diameter to detect increased intracranial pressure in adults: a meta-analysis
Authors: Kim Sung-Eun , Hong Eun Pyo , Kim Heung Cheol , Lee Si Un , Jeon Jin Pyeong 
Published: May 2018

Background The optimal optic nerve sheath diameter (ONSD) cut-off for identifying increased intracranial pressure (IICP) remains unclear in adult patients. Purpose To validate the diagnostic accuracy of ultrasonographic (US) ONSD > 5.0 mm as a cut-off for detecting IICP by computed tomographic (CT) through a meta-analysis. Material and Methods A systemic literature review was performed of online databases from January 1990 to September 2017. A bivariate random-effects model was used to estimate pooled sensitivity, specificity, and diagnostic odds ratio (DOR) with 95% confidence intervals (CIs). A summary receiver operating characteristic (SROC) graph was used to provide summary points for sensitivity and specificity. Meta-regression tests were performed to estimate the influence of the study characteristics on DOR. Publication bias was assessed using Deeks' funnel plot asymmetry test. Results Six studies with 352 patients were included in the meta-analysis. US ONSD > 5.0 mm revealed pooled sensitivity of 99% (95% CI = 96–100) and specificity of 73% (95% CI = 65–80) for IICP detection. DOR was 178. The area under the SROC curve was 0.981, indicating a good level of accuracy. Meta-regression studies showed no significant associations between DOR and study characteristics such as probe mode (relative DOR [RDOR] = 0.60; P = 0.78), study quality (RDOR = 0.52; P = 0.67), IICP prevalence (RDOR = 0.04; P = 0.17), or pathology at admission (RDOR = 1.30; P = 0.87). Conclusion US ONSD > 5.0 mm can be used to rapidly detect IICP in adults in emergency departments and intensive care units. Further meta-analysis based on individual patient-level databases is needed to confirm these results.
Automated daily quality control analysis for mammography in a multi-unit imaging center
Authors: Sundell Veli-Matti , Mäkelä Teemu , Meaney Alexander , Kaasalainen Touko , Savolainen Sauli 
Published: May 2018

Background The high requirements for mammography image quality necessitate a systematic quality assurance process. Digital imaging allows automation of the image quality analysis, which can potentially improve repeatability and objectivity compared to a visual evaluation made by the users. Purpose To develop an automatic image quality analysis software for daily mammography quality control in a multi-unit imaging center. Material and Methods An automated image quality analysis software using the discrete wavelet transform and multiresolution analysis was developed for the American College of Radiology accreditation phantom. The software was validated by analyzing 60 randomly selected phantom images from six mammography systems and 20 phantom images with different dose levels from one mammography system. The results were compared to a visual analysis made by four reviewers. Additionally, long-term image quality trends of a full-field digital mammography system and a computed radiography mammography system were investigated. Results The automated software produced feature detection levels comparable to visual analysis. The agreement was good in the case of fibers, while the software detected somewhat more microcalcifications and characteristic masses. Long-term follow-up via a quality assurance web portal demonstrated the feasibility of using the software for monitoring the performance of mammography systems in a multi-unit imaging center. Conclusion Automated image quality analysis enables monitoring the performance of digital mammography systems in an efficient, centralized manner.
Double-blind placebo-controlled randomized clinical trial of ginger (Zingiber officinale Rosc.) addition in migraine acute treatment
Authors: Martins Laís Bhering , Rodrigues Ana Maria dos Santos , Rodrigues Débora Fernandes , dos Santos Luana Caroline , Teixeira Antônio Lúcio , Ferreira Adaliene Versiani Matos 
Published: May 2018

Background Previous studies have demonstrated the analgesic effects of ginger in different conditions, but evidence about its efficacy in migraine treatment is scarce. Objective This study aimed to evaluate the potential of ginger to improve acute migraine as an add-on strategy to standard treatment. Methods A double-blind placebo-controlled randomized clinical trial in the emergency room of a general hospital was conducted. Patients who sought medical care at the time of migraine attack were enrolled in this study. Only adults with episodic migraine (one to six migraine attacks per month) with or without aura were included. Sixty participants were randomized into two groups in which they received 400 mg of ginger extract (5% active ingredient) or placebo (cellulose), in addition to an intravenous drug (100 mg of ketoprofen) to treat the migraine attack. Patients filled a headache diary before, 0.5 h, 1 h, 1.5 h and 2 h after the medication. Pain severity, functional status, migraine symptoms and treatment satisfaction were also recorded. Results Patients treated with ginger showed significantly better clinical response after 1 h ( p = 0.04), 1.5 h ( p = 0.01) and 2 h ( p = 0.04). Furthermore, ginger treatment promoted reduction in pain and improvement on functional status at all times assessed. Conclusions The addition of ginger to non-steroidal anti-inflammatory drugs may contribute to the treatment of migraine attack. This trial is registered at ClinicalTrials.gov (NCT02568644)
Hamstring and Ankle Flexibility Deficits Are Weak Risk Factors for Hamstring Injury in Professional Soccer Players: A Prospective Cohort Study of 438 Players Including 78 Injuries
Authors: van Dyk Nicol , Farooq Abdulaziz , Bahr Roald , Witvrouw Erik 
Published: May 2018

Background: Hamstring injuries remain a significant injury burden in sports such as soccer that involve high-speed running. It has repeatedly been identified as the most common noncontact injury in elite male soccer, representing 12% of all injuries. As the incidence of hamstring injuries remains high, investigations are aimed at better understanding how to prevent hamstring injuries. Stretching to improve flexibility is commonly used in elite-level sports, but risk factor studies have reported contradicting results, leading to unclear conclusions regarding flexibility as a risk factor for hamstring injuries. Purpose: To investigate the association of lower limb flexibility with the risk of hamstring injuries in professional soccer players. Study Design: Cohort study; Level of evidence, 2. Methods: All teams (n = 18) eligible to compete in the premier soccer league in Qatar (Qatar Stars League [QSL]) underwent a comprehensive musculoskeletal assessment during their annual periodic health evaluation at Aspetar Orthopaedic and Sports Medicine Hospital in Doha, Qatar. Variables included passive knee extension and ankle dorsiflexion range of motion. A clustered multivariate Cox regression analysis was used to identify associations with the risk of hamstring injuries. Receiver operating characteristic (ROC) curves were calculated to determine sensitivity and specificity. Results: A total of 438 unique players (72.4% of all QSL players) competed for 601 player-seasons (148 players competed both seasons) and sustained 78 hamstring injuries. Passive knee extension range of motion (hazard ratio [HR], 0.97 [95% CI, 0.95-0.99]; P = .008) and ankle dorsiflexion range of motion (HR, 0.93 [95% CI, 0.88-0.99]; P = .02) were independently associated with the injury risk. The absolute differences between the injured and uninjured players were 1.8° and 1.4 cm, respectively, with small effect sizes ( d < 0.2). The ROC curve analyses showed an area under the curve of 0.52 for passive knee extension and 0.61 for ankle dorsiflexion, indicating failed to poor combined sensitivity and specificity of the 2 strength variables identified in the multivariate Cox regression analysis. Conclusion: This study identified deficits in passive hamstring and ankle dorsiflexion range of motion as weak risk factors for a hamstring injury. These findings have little clinical value in predicting the risk of future hamstring injuries, and test results must therefore be interpreted cautiously in athletic screening.