bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Influence of a Lake-to-Lake Connection from Lake Huron on the Lake-Effect Snowfall in the Vicinity of Lake Ontario
Authors: Lang Carrie E. , McDonald Jessica M. , Gaudet Lauriana , Doeblin Dylan , Jones Erin A. , Laird Neil F. 
Published: May 2018

AbstractLake-effect storms (LES) produce substantial snowfall in the vicinity of the downwind shores of the Great Lakes. These storms may take many forms; one type of LES event, lake to lake (L2L), occurs when LES clouds/snowbands develop over an upstream lake (e.g., Lake Huron), extend across an intervening landmass, and continue over a downstream lake (e.g., Lake Ontario). The current study examined LES snowfall in the vicinity of Lake Ontario and the atmospheric conditions during Lake Huron-to-Lake Ontario L2L days as compared with LES days on which an L2L connection was not present [i.e., only Lake Ontario (OLO)] for the cold seasons (October–March) from 2003/04 through 2013/14. Analyses of snowfall demonstrate that, on average, significantly greater LES snowfall totals occur downstream of Lake Ontario on L2L days than on OLO days. The difference in mean snowfall between L2L and OLO days approaches 200% in some areas near the Tug Hill Plateau and central New York State. Analyses of atmospheric conditions found more-favorable LES environments on L2L days relative to OLO days that included greater instability over the upwind lake, more near-surface moisture available, faster wind speeds, and larger surface heat fluxes over the upstream lake. Last, despite significant snowfalls on L2L days, their average contribution to the annual accumulated LES snowfall in the vicinity of Lake Ontario was found to be small (i.e., 25%–30%) because of the relatively infrequent occurrence of L2L days.
Are coffee’s alleged health protective effects real or artifact? The enduring disjunction between relevant experimental and observational evidence
Authors: James Jack E 
Published: May 2018

Background: There is a large corpus of observational evidence claiming that coffee is health protective and a similarly large corpus of experimental psychopharmacological evidence to suggest that habitual caffeine consumption may be harmful to health. Aim: The purpose of this study was to examine the disjunction between observational and experimental findings with specific reference to the implications of coffee/caffeine consumption for elevated blood pressure, cardiovascular disease, type 2 diabetes and neurodegenerative disease. Method: Illustrative recent major reviews alleging health protective effects from coffee consumption were examined in light of findings from relevant experimental studies of caffeine. Findings: Decades-long coffee consumption is but one of countless lifestyle variables that may benefit or harm health. Contradictions concerning the implications of coffee/caffeine consumption for health between observational and experimental research are attributable mostly to poor control over potential confounders in observational studies. Conclusion: When considered in the context of experimental evidence concerning caffeine’s known pharmacological actions, there is reason to be sceptical about observational findings alleging health-protective effects from coffee consumption. Long-term randomised trials are needed to end the enduring interpretative disjunction between observational and experimental evidence concerning coffee/caffeine consumption and health.
From the Field: Improving Fetal and Infant Growth in Vulnerable Populations
Authors: Adu-Afarwuah Seth 
Published: May 2018

Background: This article summarizes a presentation given at the 2017 Dairy for Global Nutrition Conference in Boise, Idaho. Objective: To give an overview of the pattern of early growth faltering in developing countries and examine the implications of the iLiNS-DYAD randomized trial in Ghana. Methods: The pattern of growth faltering in developing countries was outlined. In Ghana, 1320 women ≤ 20 weeks of pregnancy were assigned to 20 g/d small-quantity lipid-based nutrient supplement (SQ-LNS; LNS group) or multiple micronutrients (MMNs) containing 22 and 18 vitamins and minerals, respectively, until 6 months postpartum, or iron and folic acid (IFA) until delivery, and thereafter placebo until 6 months postpartum. Infants in the LNS group were assigned to SQ-LNS from 6 to 18 months of age. Results: Mean anthropometric z-scores for infants in developing countries start below the World Health Organization standard at 1 month of age, and generally decline until about age of 24 months. In the Ghana trial, mean (SD) birth weight (g) was greater ( P = .044) for the LNS group (3030 [414]) than the IFA group (2945 [442]) but not the MMN group (3005 [435]). Among primiparous mothers, the LNS group had significantly greater mean birth length, weight, and head circumference than the IFA or MMN group. By 18 months of age, the mean length (95% confidence interval) for the LNS group was +0.6 (0.1-1.1) cm greater than for the IFA group and +0.6 (0.1-1.2) cm greater than for the MMN group. Conclusion: Pre- and post-natal SQ-LNS consumption may improve fetal and infant growth in similar populations.
Clozapine toxicity in a CYP2D6 poor metaboliser: Additive effects of haloperidol and valproate on clozapine metabolism
Authors: Reznik Robert , Chen Rena Yuan Yuan , Stanford Phoebe 
Published: May 2018

Objective: To illustrate the complexities of clozapine metabolism with the use of therapeutic drug monitoring. Methods: We describe a case of clozapine toxicity in a patient with schizophrenia treated with the combination of clozapine, valproate and haloperidol. Results: A 24-year-old CYP2D6 poor metaboliser developed clozapine toxicity corresponding to the additive effects of haloperidol, and increasing clozapine and valproate doses. Saturation of metabolism, evidenced by a high clozapine/norclozapine ratio, was present at this time. Conclusions: Clozapine metabolism is complex and influenced by multiple factors, including interactions with hepatic P450 enzyme inducers/inhibitors, genetic polymorphisms and the potential for saturation of the N-demethylation metabolic pathway.
Neuro-reciprocity and vicarious trauma in psychiatrists
Authors: Isobel Sophie , Angus-Leppan Gavin 
Published: May 2018

Objectives: This paper aims to briefly overview the processes of neuro-reciprocity relevant to vicarious traumatization of psychiatrists through their clinical roles. Conclusions: High rates of trauma in mental health service users, understanding of the effects of trauma on the brain and mechanisms of neuro-reciprocity in empathic attunement suggest that psychiatrists are at high risk of vicarious trauma. Preventing vicarious trauma at an organizational level through trauma-informed approaches is of paramount importance.
Changing characteristics of a Psychiatric Emergency Care Centre. An eight year follow-up study
Authors: Seymour Joanne , Chapman Tristan , Starcevic Vladan , Viswasam Kirupamani , Brakoulias Vlasios 
Published: May 2018

Objective: The objective of this study was to report changes in characteristics of admissions to an established Psychiatric Emergency Care Centre (PECC) eight years after its opening. Method: Key clinical characteristics of admissions to the PECC were documented for 327 patients in 2015 and compared with the 477 patients in 2007, which is when the centre first opened. The characteristics of admission were evaluated using an audit of medical records from June to December in both 2007 and 2015. Results: Statistically significant differences ( p<0.05) between 2007 and 2015 were: a reduction in the numbers of patients admitted with depression; a reduction in the numbers of patients diagnosed with adjustment disorder; an increase in the numbers of patients diagnosed with borderline personality disorder; a reduction in pro re nata (prn) use, including a reduction in the need for chemical restraint with midazolam and a decrease in the length of admission in the PECC. Conclusions: The significant reduction in aggression, the use of prn medication and the number of people with longer stays within the PECC support the usefulness of PECCs in relation to patient satisfaction and adherence to admission criteria policy. These factors may be considered as indicators of the efficiency of a PECC.
The Optimal Cutoff Point for Expressing Revised Edmonton Symptom Assessment System Scores as Binary Data Indicating the Presence or Absence of Symptoms
Authors: Kako Jun , Kobayashi Masamitsu , Kanno Yusuke , Ogawa Asao , Miura Tomofumi , Matsumoto Yoshihisa 
Published: May 2018

Context: Terminally ill patients with cancer experience various physical and emotional symptoms that have a negative impact on quality of life and activities of daily living. Recently, revised Edmonton Symptom Assessment System (ESAS-r) scores have been proposed for assessing symptoms in terminally ill patients with cancer. Objective: To determine the optimal cutoff point for expressing ESAS-r scores as binary data, indicating the presence or absence of symptoms. Methods: We conducted a retrospective study of patients hospitalized in the palliative care unit of our hospital between September 1, 2014 and May 31, 2015. To determine the optimal cutoff point for expressing ESAS-r scores as binary data, indicating the presence or absence of 6 physical symptoms (“pain,” “tiredness,” “drowsiness,” “nausea,” “lack of appetite,” and “dyspnea”), the sensitivity and specificity of each measurement were calculated. Cutoff points were estimated using receiver operating characteristic curve analysis. Results: Data from 157 patients who performed the self-assessment in ESAS-r scores were analyzed. The mean age was 66.5 years. Approximately 60.0% of patients were male. The optimal cutoff point for pain, tiredness, drowsiness, nausea, lack of appetite, and dyspnea was 4, 4, 4, 2, 5, and 4, respectively. The area under the curve for tiredness, nausea, and dyspnea was >0.70, followed in order by pain, lack of appetite, and drowsiness. The area under the curve for drowsiness was 0.55. Conclusion: Our results suggest that physical symptoms other than drowsiness could potentially predict ESAS-r score severity.
TGFβ3, MSX1, and MMP3 as Candidates for NSCL±P in an Indian Population
Authors: Kumari Priyanka , Singh Subodh Kumar , Raman Rajiva 
Published: May 2018

Objective: To evaluate the association of transforming growth factor β3 ( TGFβ3), muscle segment homeobox 1 ( MSX1), Metalloproteinases 3 ( MMP3), and MMP9 genes as candidates for nonsyndromic cleft lip and/or palate in an Indian population. Design: Case–control association study, mutational screening, and functional evaluation of obtained mutations. Setting: Mutational screening of the developmental genes, TGFβ3 and MSX1, along with functional evaluation and association of promoter region SNPs—one each in MMP3 and MMP9. Patients, Participants: Two hundred forty five NSCL±P cases from G. S. Memorial Plastic Surgery Hospital and Trauma Center, Varanasi and 201 healthy controls without a family history of congenital malformations from nearby schools, primary health centers, and the university hospital. Main Outcome Measure(s): Sequencing, SSCP, and PCR-RFLP were used for candidate gene screening. MatInspector and electrophoretic mobility shift assay (EMSA) were used to check the differential transcription factor binding of the variants at promoter region. Luciferase assay was used to test the transcriptional potential of the variant, and evaluation of the alternative splice site was carried out using exon-trapping experiment. Results: Metalloproteinases3 −1171 5A/6A was associated with NSCL±P, whereas MMP9 −1562 C/T did not show association. A rare variant in the promoter region of TGFβ3 (rs117462711) creates a differential binding site, confirmed by EMSA. Luciferase assay showed 3.7-fold increased expression level in mutant construct. A synonymous change in MSX1 (rs34165410) showed association with NSCL±P, which may create an alternative splice site or lead to low codon usage. Exon-trapping experiment failed to confirm alternative splicing, indicating low codon usage frequency of the mutant affecting the gene function. Conclusions: TGFβ3, MSX1, and MMP3 are candidates for NSCL±P.
Hip resurfacing with a highly cross-linked polyethylene acetabular liner and a titanium nitride-coated femoral component
Authors: Pritchett James W 
Published: May 2018

Aims: This study evaluated a specific hip resurfacing system to determine the: (1) function and complications, (2) implant survivorship, (3) acetabular bone conservation and joint biomechanics and (4) osteolysis and polyethylene wear. Methods: I performed 234 resurfacing procedures (192 patients) using a two-piece titanium acetabular component with a 4 mm highly cross-linked polyethylene liner and a cementless titanium nitride-coated titanium femoral component. Function was assessed with Harris Hip, WOMAC, SF-12, and UCLA scores. Radiography and CT scans were used to evaluate bone retention, component position, joint biomechanics, and osteolysis. Retrieved polyethylene liners were analyzed for wear. Results: Median follow-up was 8 years and patients averaged 48 years of age at surgery. The mean Harris Hip Score was 96 and all scores improved significantly. Kaplan-Meier survivorship was 97%. The mean medial acetabular thickness was 9 mm postoperatively versus 14 mm preoperatively ( p = 0.019). Femoral bone conservation (head:neck ratio) was 1.36 postoperatively versus 1.42 preoperatively ( p = 0.02). There was no polyethylene wear through or osteolysis. Eight polyethylene retrievals had a mean wear of 0.05 mm/yr. Conclusions: Resurfacing with a highly cross-linked polyethylene acetabular component and a titanium nitride-coated titanium cementless femoral component is a reliable and bone-conserving procedure at mid-term.
Cerebral Microbleeds in Advanced Dementia: Clinical and Pathological Correlates
Authors: Boyano Inmaculada , Ramos Ana , López-Alvarez Jorge , Mendoza-Rebolledo Carolina , Osa-Ruiz Emma , Rodríguez Irene , Pérez Almudena , Alfayate Eva , González Belén , Fernández Laura , Agüera-Ortiz Luis , Rábano Alberto , Olazarán Javier 
Published: May 2018

Objective: We conducted a longitudinal study to explore the clinical and pathological correlates of cerebral microbleeds (CMBs) in institutionalized patients with dementia. Methods: Clinical and magnetic resonance imaging (MRI) data were extracted from 182 nursing home patients (mean age [standard deviation]: 81.3 [6.9], 78.0% female, and 83.4% moderate to severe dementia), which were divided according to the CMBs number and location. One-year follow-up data were obtained from 153 patients, and postmortem pathological diagnosis was available in 40 patients. Results: Cerebral microbleeds were observed in 42.9% of patients and were associated with MRI ischemic lesions ( P < .0005). In the adjusted analysis, lobar CMB predicted worsening of parkinsonism (standardized β: 0.43) and gait (standardized β: 0.24). A pathological diagnosis of Alzheimer’s disease was less frequent in the brains of patients with lobar and deep CMB (33.3% vs 85.3%; P < .05). Conclusion: Cerebral microbleeds were linked to cerebrovascular disease and predicted motor deterioration in institutionalized people with advanced dementia.
Real-world outcomes in patients with chronic obstructive pulmonary disease initiating long-acting mono bronchodilator therapy
Authors: Bengtson Lindsay G.S. , DePietro Michael , McPheeters Jeffrey , Fox Kathleen M. 
Published: May 2018

Background: Randomized clinical trials have shown long-acting mono bronchodilator therapy to be efficacious in improving lung function and dyspnea, while reducing exacerbations; however, less is known regarding the effectiveness in routine clinical practice. This study examined treatment patterns, rescue medication use, healthcare resource utilization and costs, and exacerbations in patients with chronic obstructive pulmonary disease (COPD) who initiated long-acting mono bronchodilator therapy in real-world settings. Methods: This retrospective study used US claims data from adult patients with COPD initiating long-acting mono bronchodilator therapy between 1 January 2008 and 31 January 2015. Patients were required to have continuous health plan enrollment 12 months prior to (baseline period) and 12 months following therapy initiation (follow-up period). Outcomes, including treatment patterns, rescue medication use, exacerbations, and healthcare utilization and costs, were measured until the earliest of treatment augmentation or discontinuation, death, health plan disenrollment, or the end of the study period. Results were analyzed descriptively for all measures. Baseline and follow-up measures of all-cause and COPD-related healthcare costs and exacerbations [per patient per month (PPPM)] were compared using paired t tests. Results: Among 27,394 patients with a mean follow up of 6.3 months, 18.2% augmented, 74.2% discontinued, and 7.6% continued long-acting mono bronchodilator therapy. Rescue medication use was prevalent during the follow-up period, with an average of 1.0 short-acting β agonist (SABA) fills/month and 0.8 short-acting muscarinic antagonist (SAMA) fills/month, among patients with at least one fill for the medication of interest. PPPM mean number of exacerbations was more than triple (0.17 versus 0.05, p < 0.001) and PPPM exacerbation-related costs were more than double over the follow-up period compared with baseline ($1070 versus $485). COPD-related costs accounted for 50% of all-cause costs during the follow-up period and were significantly higher compared with baseline ($1206 versus $592, p < 0.001). Conclusions: Patients initiating long-acting mono bronchodilator therapy had high rates of medication discontinuation or augmentation. Patients used more rescue medications and experienced significantly more COPD exacerbations with higher healthcare costs compared with baseline. Further research is warranted to determine whether more aggressive initial therapy would result in symptom improvement.
Oral care after stroke: Where are we now?
Authors: Lyons Mary , Smith Craig , Boaden Elizabeth , Brady Marian C , Brocklehurst Paul , Dickinson Hazel , Hamdy Shaheen , Higham Susan , Langhorne Peter , Lightbody Catherine , McCracken Giles , Medina-Lara Antonieta , Sproson Lise , Walls Angus , Watkins Dame Caroline 
Published: May 2018

Purpose There appears to be an association between poor oral hygiene and increased risk of aspiration pneumonia – a leading cause of mortality post-stroke. We aim to synthesise what is known about oral care after stroke, identify knowledge gaps and outline priorities for research that will provide evidence to inform best practice. Methods A narrative review from a multidisciplinary perspective, drawing on evidence from systematic reviews, literature, expert and lay opinion to scrutinise current practice in oral care after a stroke and seek consensus on research priorities. Findings: Oral care tends to be of poor quality and delegated to the least qualified members of the caring team. Nursing staff often work in a pressured environment where other aspects of clinical care take priority. Guidelines that exist are based on weak evidence and lack detail about how best to provide oral care. Discussion Oral health after a stroke is important from a social as well as physical health perspective, yet tends to be neglected. Multidisciplinary research is needed to improve understanding of the complexities associated with delivering good oral care for stroke patients. Also to provide the evidence for practice that will improve wellbeing and may reduce risk of aspiration pneumonia and other serious sequelae. Conclusion Although there is evidence of an association, there is only weak evidence about whether improving oral care reduces risk of pneumonia or mortality after a stroke. Clinically relevant, feasible, cost-effective, evidence-based oral care interventions to improve patient outcomes in stroke care are urgently needed.
Health-related quality of life in adults with relapsed/refractory acute lymphoblastic leukemia treated with blinatumomab
Authors: Topp Max S. , Zimmerman Zachary , Cannell Paul , Dombret Hervé , Maertens Johan , Stein Anthony , Franklin Janet , Tran Qui , Cong Ze , Schuh Andre C. 
Published: May 2018

Key Points
Blinatumomab delays deterioration in HRQL in adults with R/R ALL.
Towards the elimination of paediatric tuberculosis in high-income, immigrant-receiving countries: a 25-year conventional and molecular epidemiological case study
Authors: Dhawan Vivek , Bown Jennifer , Lau Angela , Langlois-Klassen Deanne , Kunimoto Dennis , Bhargava Ravi , Chui Linda , Collin Simon M. , Long Richard 
Published: May 2018

The epidemiology of tuberculosis (TB) in high-income countries is increasingly dictated by immigration. The influence of this trend on paediatric TB and TB elimination are not well defined.We undertook a 25-year conventional and molecular epidemiologic study of paediatric TB in Alberta, one of four major immigrant-receiving provinces in Canada. All isolates ofMycobacterium tuberculosiswere DNA fingerprinted using standard methodology.Between 1990 and 2014, 176 children aged 0–14 years were diagnosed with TB. Foreign-born children or Canadian-born children of foreign-born parents accounted for an increasingly large proportion of total cases during the study period (from 32.1% to 89.5%). Of the 78 culture-positive cases, 35 (44.9%) had a putative source case identified by conventional epidemiology, with 34 (97.1%) having a concordant molecular profile. Of the remaining 43 culture-positive cases, molecular profiling identified spatially and temporally related sources in six cases (14.0%). These six children, along with four other children whose source cases were discovered through reverse-contact tracing, had a high morbidity and mortality.The increasing burden of paediatric TB in both foreign-born children and Canadian-born children of foreign-born parents calls for more timely diagnosis of source cases and more targeted screening for latent TB infection.
Preeclampsia and gestational weight gain in the Norwegian Fit for Delivery trial
Authors: Hillesund E. R. , Seland S. , Bere E. , Sagedal L. R. , Torstveit M. K. , Lohne-Seiler H. , Vistad I. , Øverby N. C. 
Published: May 2018

Abstract
Objective
Excessive gestational weight gain is linked to risk of preeclampsia, but it is not clear whether the association is causal. The purpose of this paper was to examine gestational weight gain in the Norwegian Fit for Delivery study among women who developed preeclampsia compared to those who did not, and to further explore associations between weight gain and preeclampsia by including data on body composition (bioimpedance) assessed in the last trimester of pregnancy.

Results
A total of 550 women were eligible for the study. Women who developed preeclampsia gained more weight than women who did not (difference 3.7 kg, p = 0.004), with a 3.5 kg difference in total body water observed in week 36 (p = 0.040). Adjusted for age, education, pre-pregnancy body mass index (BMI), randomization, and fat mass, a one kg increase in GWG was associated with 1.3 times higher odds of preeclampsia (OR: 1.31, 95% CI 1.15–1.49, p < 0.001). An independent inverse association between fat mass in week 36 and odds of preeclampsia was observed (OR: 0.79, 95% CI 0.68–0.92, p = 0.002). Given the observed difference in total body water, these findings point to excess fluid as the component driving the association between gestational weight gain and preeclampsia in the present study.
Trial registration The NFFD trial has the Clinical Trials registration: clinicaltrial.gov NCT0100168