bluuebunny/crossref_metadata_2025_split huggingface dataset:
Seasonal Covariability of Dryness or Wetness in China and Global Sea Surface Temperature
Authors: Li Chunxiang , Wang Chunzai , Zhao Tianbao 
Published: October 2019

AbstractSeasonal covariability of the dryness/wetness in China and global sea surface temperature (SST) is investigated by using the monthly self-calibrated Palmer drought severity index (PDSI) data and other data from 1950 to 2014. The singular value decomposition (SVD) analysis shows two recurring PDSI–SST coupled modes. The first SVD mode of PDSI is associated with the warm phases of the eastern Pacific–type El Niño–Southern Oscillation (ENSO), the interdecadal Pacific oscillation (IPO) or Pacific decadal oscillation (PDO), the Indian Ocean basin mode (IOBM) in the autumn and winter, and the cold phase of the IOBM in the spring. Meanwhile, the Atlantic multidecadal oscillation (AMO) pattern appears in every season except the autumn. The second SVD mode of PDSI is accompanied by a central Pacific–type El Niño developing from the winter to autumn over the tropical Pacific and a positive phase of IPO or PDO from the winter to summer. Moreover, an AMO pattern is observed in all seasons except the summer, whereas the SST over the tropical Indian Ocean shows negligible variations. The further analyses suggest that AMO remote forcing may be a primary factor influencing interdecadal variability of PDSI in China, and interannual to interdecadal variability of PDSI seems to be closely associated with the ENSO-related events. Meanwhile, the IOBM may be a crucial factor in interannual variability of PDSI during its mature phase in the spring. In general, the SST-related dryness/wetness anomalies can be explained by the associated atmospheric circulation changes.
Neutrophil extracellular traps are a source of extracellular HMGB1 in lupus nephritis: associations with clinical and histopathological features
Authors: Whittall-García L P , Torres-Ruiz J , Zentella-Dehesa A , Tapia-Rodríguez M , Alcocer-Varela J , Mendez-Huerta N , Gómez-Martín D 
Published: October 2019

Objective This study aimed to analyze the expression of the high mobility group box-1 (HMGB1) protein in neutrophil extracellular traps (NETs) of patients with lupus nephritis (LN) and its association with clinical and histopathological features of the disease. Methods Twenty-three patients with biopsy-confirmed LN and 14 systemic lupus erythematosus (SLE) patients with active disease (SLE Disease Activity Index (SLEDAI) score ≥ 6) and no evidence of LN were included. Clinical and laboratory features were recorded. NETs and the expression of HMGB1 were assessed by confocal microscopy, and serum HMGB1 levels were measured by ELISA. Results In comparison to patients without kidney disease, patients with LN had a higher expression of HMGB1 in spontaneous (57 vs. 30.4; p = 0.027) and lipopolysaccharide (LPS)-induced (55.8 vs. 24.9; p = 0.005) NETs. We found a positive correlation between serum HMGB1 and the expression of HMGB1 in LPS-induced NETs ( r = 0.447, p = 0.017). The expression of HMGB1 in spontaneous NETs correlated with SLEDAI score ( r = 0.514, p = 0.001), anti-dsDNA antibodies ( r = 0.467, p = 0.004), the rate of glomerular filtration descent ( r = 0.543, p = 0.001), and diverse histopathological components of active nephritis in the kidney biopsy, such as the activity index ( r = 0.581, p = 0.004), fibrinoid necrosis ( r = 0.603, p = 0.002), and cellular crescents ( r = 0.486, p = 0.019). Conclusions In patients with SLE, NETs are a source of extracellular HMGB1. The expression of HMGB1 in NETs is higher among patients with LN, which correlates with clinical and histopathological features of active nephritis and suggest a possible role of this alarmin in the pathophysiology of kidney damage in SLE.
Nonlocality of one-dimensional bilinear hardening–softening elastoplastic axial lattices
Authors: Picandet Vincent , Challamel Noël 
Published: October 2019

The static behaviour of an elastoplastic axial lattice is studied in this paper through both discrete and nonlocal continuum analyses. The elastoplastic lattice system is composed of piecewise linear hardening–softening elastoplastic springs connected between each other via nodes, loaded by concentrated tension forces. This inelastic lattice evolution problem is ruled by some difference equations, which are shown to be equivalent to the finite difference formulation of a continuous elastoplastic bar problem under distributed tension load. Exact solutions of this inelastic discrete problem are obtained from the resolution of this piecewise linear difference equations system. Localization of plastic strain in the first elastoplastic spring, connected to the fixed end, is observed in the softening range. A continuous nonlocal elastoplastic theory is then built from the lattice difference equations using a continualization process, based on a rational asymptotic expansion of the associated pseudo-differential operators. The continualized lattice-based model is equivalent to a distributed nonlocal continuous elastoplastic theory coupled to a cohesive elastoplastic model, which is shown to capture efficiently the scale effects of the reference axial lattice. The hardening–softening localization process of the nonlocal elastoplastic continuous model strongly depends on the lattice spacing, which controls the size of the nonlocal length scales. An analogy with the one-dimensional lattice system in bending is also shown. The considered microstructured elastoplastic beam is a Hencky bar-chain connected by elastoplastic rotational springs. It is shown that the length scale calibration of the nonlocal model strongly depends on the degree of the difference equations of each lattice model (namely axial or bending lattice). These preliminary results valid for one-dimensional systems allow possible future developments of new nonlocal elastoplastic models, including two- or even three-dimensional elastoplastic interactions.
Granulomatous Appendicitis in the Pediatric Population
Authors: Wu Hao , Fuller Maren Y , Pogoriler Jennifer 
Published: October 2019

Background The clinical significance of a diagnosis of granulomatous appendicitis (GA) is not well established in the pediatric population. Methods Retrospective review of the etiology and histopathology of pediatric GA at 2 large pediatric institutions. Results Forty-three (0.4%) patients had GA at a median age of 12.1 years. Twenty-two (51%) had perforated appendicitis that was medically managed prior to interval appendectomy. Sixteen of 21 noninterval appendectomies were performed for clinically suspected acute appendicitis. Among them, 1 had Crohn’s disease identified during surgery. None of the other patients had a subsequent diagnosis of inflammatory bowel disease (median follow-up of 4 weeks). There were significantly more cases with mucosal-only granulomas as well as fewer serosal granulomas in the noninterval appendectomy specimens than the interval specimens ( P = .014). When performed, special stains for microorganisms did not contribute to clinical care. In the same time period, GA was seen in 6 (6%) of 94 bowel resections for Crohn’s disease. Conclusion GA is rare in pediatric patients, with interval appendectomy being the most common etiology and only rarely associated with Crohn’s disease. Granulomas in interval appendectomies tend to be serosal-based. Special stains for infectious organisms in GA are of low diagnostic yield and have little impact on clinical management.
Helical stent (SUPERA™) and drug-coated balloon (Passeo–18 Lux™) for recurrent cephalic arch stenosis: Rationale and design of arch V SUPERA–LUX Study
Authors: Tang TY , Tan CS , Yap CJQ , Tan RY , Tay HH , Choke ETC , Chong TT 
Published: October 2019

Background: The treatment options for cephalic arch stenosis are limited and standard of care remains at crossroads – none are ideal and there is currently no gold standard. Endovascular techniques are now the preferred primary therapeutic option because they are minimally invasive and better tolerated by haemodialysis patients who have multiple comorbidities. However, conventional plain old balloon angioplasty, bare metal stenting and stent grafts all have their limitations. The aim of this trial is to evaluate whether the helical SUPERA™ stent (Abbott Vascular, Santa Clara, CA, USA), which has a higher degree of flexibility and resistance to compressive forces compared to traditionally laser-cut nitinol stents, combined with a drug-coated balloon (Biotronik Passeo-18 Lux™) to minimize the neointimal hyperplasia effect, can improve patency and reduce reintervention rates. Methods and results: Arch V SUPERA-LUX is a pilot investigator-initiated single-centre, single-arm prospective study. Twenty patients with a brachiocephalic fistula within 6 months of initial plain old balloon angioplasty for significant cephalic arch stenosis will be recruited for treatment with SUPERA and drug-coated balloon. The primary objectives are immediate angiographic and procedural success, primary patency and functional fistula at 1 week, 8 weeks, 6 and 12 months. The results from eight patients treated prospectively as proof of concept have shown primary patency of 83.3% at 1 year with 100% technical and procedural success rates. Enrolment for the Arch V SUPERA-LUX study is expected to be completed at the end of 2019. Conclusion: The Arch V SUPERA-LUX study is the first trial to evaluate whether SUPERA stent implantation and drug-coated balloon use can provide superior protection against restenosis compared to traditional angioplasty, bare metal stents and stent grafts in recurrent cephalic arch stenosis. Initial pilot results are encouraging but longer follow-up is required to truly test this technique. Trial registration: This study is registered on ClinicalTrials.gov NCT03891693.
MOG-IgG myelitis coexisting with systemic lupus erythematosus in the post-partum setting
Authors: Bilodeau Philippe A , Kumar Vinayak , Rodriguez Andrew E , Li Clarence T , Sanchez-Alvarez Catalina , Thanarajasingam Uma , Zalewski Nicholas L , Flanagan Eoin P 
Published: October 2019

Background: Longitudinally extensive transverse myelitis (LETM) accompanying systemic lupus erythematosus (SLE) is often due to coexisting aquaporin-4-IgG seropositive neuromyelitis optica spectrum disorder but has not been associated with myelin oligodendrocyte glycoprotein-IgG (MOG-IgG). Objective and methods: Case report at an academic medical center. Results: A 32-year-old woman developed severe transverse myelitis (paraplegia) shortly after SLE onset in the post-partum period. Magnetic resonance imaging (MRI) revealed an LETM, cerebrospinal fluid showed marked inflammation, and testing for infections was negative. Serum live-cell-based assay for MOG-IgG was positive but aquaporin-4-IgG was negative. Conclusion: In patients with SLE and LETM, MOG-IgG testing should be considered, in addition to AQP4-IgG.
Coping with diabetes stress among adults in rural Dominican Republic: “I don’t think about it”
Authors: Sadeghzadeh Claire , Wallace Deshira D. , Gonzalez Rodriguez Humberto , Barrington Clare 
Published: October 2019

Objectives As type 2 diabetes prevalence increases across Latin America, understanding local approaches to coping with diabetes stress is essential to providing care that incorporates patients’ values and preferences. This study explored a local phenomenon, “ no le doy mente” (I don’t think about it), used by adults with type 2 diabetes in the Dominican Republic to cope with diabetes stress. Methods We conducted 19 qualitative in-depth interviews with adults with type 2 diabetes (10 men, 9 women) recruited from one rural clinic. Using an inductive analytic approach including iterative coding, memos, and matrices, we identified reasons, strategies, and perceived benefits of not thinking about type 2 diabetes among participants. Results Participants described not thinking about diabetes as an active process to maintain a sense of normalcy despite significant life changes following diagnosis. They avoided thinking about diabetes by staying busy, proactively managing type 2 diabetes through diet and medication, and turning to their faith. Participants perceived that enacting no le doy mente helped to protect their overall health and well-being. Discussion Future research should investigate provider perceptions of no le doy mente to align patient and provider communication and mindfulness-based stress reduction as a way to support people with type 2 diabetes avoid dwelling on negative thoughts about diabetes.
Development of a Modular Cadaveric Endoscopic Orbital Surgery Model
Authors: Banks Catherine , Husain Qasim , Sacks Raymond , Freitag Suzanne K. , Bleier Benjamin S. 
Published: October 2019

Introduction Endoscopic orbital surgery requires the acquisition of unique skill set including endoscopic bimanual dissection of intra/extraconal lesions adherent to orbital fat and neurovascular structures. Our goal was to develop a modular cadaveric model used to train surgeons to resect orbital pathology within any desired orbital compartment. Methods Expansile superabsorbent polymer (SAP) beads (2 mm) were soaked in Omnipaque™ (Iohexol) solution for 15 minutes prior to transcaruncular orbital implantation using 10-gauge angiocath. Insertion depth was designed to implant beads in predetermined intraconal compartments corresponding to established orbital tumor stages. Beads were left to expand in situ over a period of 1 to 5 hours. Computed tomography scans were performed using the FUSION image guidance protocol. Model utility and learning curves were assessed by quantifying resection time over 8 sequential attempts. Results All 24 beads were successfully implanted in 8 orbits corresponding to CHEER stage II to IV lesions (n = 3 per orbit). Beads expanded from 2 mm to an average of 5.2 mm within 1 hour. During expansion, the beads interpolated into the adjacent fascia similar to in vivo tumors. Average insertion time was 5:53 minutes per orbit (range, 3:24–10:33 min) and average time to bead identification was 10:47 minutes. Across all beads, dissection times decreased in a nonsignificant manner over 8 consecutive attempts. Conclusion The directed implantation of expansile SAP beads in this cadaveric model accurately replicates the approach, identification, and resection of isolated orbital lesions. This orbital model can assist the endoscopic surgical team to develop further knowledge and technical skill sets to approach orbital lesions. Further ongoing studies to validate this model are currently underway.
The influence of personal values and patient intoxication on nurses concerns about opioids: results of a prospective cross-sectional multi-centre study
Authors: Heckroth Antje , Pludra Vanessa , Johannssen Christian , Guest Charlotte , Wiedermann Frauke , Bantel Carsten 
Published: October 2019

Background: Nurses are the main administrators of opioids in hospitals and enjoy some autonomy when using them to manage pain. Nevertheless evidence suggests they exercise this freedom restrictively with the reasons for this self-limitation remaining unclear. Nurses are influenced by personal and professional values and by patients’ attributes. Intoxicated patients pose a particular challenge. This study therefore investigated whether cautious attitudes towards opioids were aggravated in intoxicated patients and influenced by personal values. Methods: A two-version questionnaire was developed. Each presented a case vignette describing a patient in acute pain who was either intoxicated or not intoxicated. Questionnaires contained identical case statements inquiring about concerns regarding opioids, preferred analgesics and statements about opioids and personal values. They were distributed prospectively in a cross-sectional, multi-centre design. Equal distribution of both questionnaires was achieved through randomization of wards. Regression analysis was employed to determine predictors for responses to the case statements. Results: In total, n = 374 (26%) nurses returned questionnaires, 85% were female, 39% worked in surgery and 64% had >10 years experience. A total of 78% were concerned using opioids in the intoxicated patient and 70% preferred non-opioids instead. Most nurses agreed familiarity with an opioid gives them more confidence and they were more concerned in patients with a history of drug abuse. They neither associated opioids with helping patients to die nor with drug abuse. The majority endorsed value statements representing ‘universalism’, ‘hedonism’ and ‘benevolence’ while disagreeing with ‘power’ and ‘stimulation’. Nurses concerns were predicted by values indicating ‘conformity’ and ‘achievement’. Conclusion: Nurses were concerned giving opioids to intoxicated patients and preferred non-opioids instead. These concerns were predicted by personal values representing ‘Conservation’ (‘conformity’) and ‘Self-Enhancement’ (‘achievement’). Therefore, stigmatizing mental models likely contribute to nurses’ reluctance to use opioids. Interestingly, personal ambition might protect nurses from discriminatory thoughts and practice.
Evaluation of the Metastatic Spine Disease Multidisciplinary Working Group Algorithms as Part of a Multidisciplinary Spine Tumor Conference
Authors: Rudra Soumon , Lauman Mary K. , Stowe Hayley , Henke Lauren E. , Wallace Adam N. , Roach Michael C. , Huang Jiayi , Tsien Christina I. , Bradley Jeffrey D. , Santiago Paul , Buchowski Jacob M. , Jennings Jack W. , Robinson Clifford G. 
Published: October 2019

Study Design: Retrospective cohort study. Objective: The Metastatic Spine Disease Multidisciplinary Working Group Algorithms are evidence and expert opinion–based strategies for utilizing radiation therapy, interventional radiology procedures, and surgery to treat 5 types of spine metastases: asymptomatic spinal metastases, uncomplicated spinal metastases, stable vertebral compression fractures (VCF), unstable VCF, and metastatic epidural spinal cord compression (MESCC). Evaluation of this set of algorithms in a clinical setting is lacking. The authors aimed to identify rate of treatment adherence to the Working Group Algorithms and, subsequently, update these algorithms based on actual patient management decisions made at a single-institution, multidisciplinary, spine tumor conference. Methods: Patients with metastatic spine disease from primary non-hematologic malignancies discussed at an institutional spine tumor conference from 2013 to 2016 were evaluated. Rates of Working Group Algorithms adherence were calculated for each type of metastasis. Based on the reasons for algorithm nonadherence, and patient outcomes in such cases, updated Working Group Algorithms recommendations were proposed. Results: In total, 154 eligible patients with 171 spine metastases were evaluated. Rates of algorithm adherence were as follows: asymptomatic (67%), uncomplicated (73%), stable VCF (20%), unstable VCF (32%), and MESCC (41%). The most common deviation from the Working Group Algorithms was surgery for MESCC despite poor prognostic factors, but this treatment strategy was supported based on median survival surpassing 6 months in these patients. Conclusions: Adherence to the Working Group Algorithm was lowest for MESCC and VCF patients, but many nonadherent treatments were supported by patient survival outcomes. We proposed updates to the Working Group Algorithm based on these findings.
Personalizing Decision-Making for Patients Choosing Contralateral Prophylactic Mastectomy: A Utility Analysis of Genetic Factors and the Relative Risk of Breast Cancer
Authors: Campwala Insiyah , Yoo June , Gupta Subhas 
Published: October 2019

Introduction: There has been an increasing trend of patients with breast cancer electing to undergo contralateral prophylactic mastectomy (CPM), despite the lack of evidence showing long-term survival benefit. We aim to quantify the tiered amount of genetic and surgical complication risk deemed necessary to justify CPM. Methods: A review of breast cancer–affiliated genetic mutations and morbidity rates of breast cancer surgery from a single institution was compiled. A survey using a utility analysis was created. Severity of breast cancer genetic risk and morbidity risk warranting CPM was quantified and evaluated. Results: A total of 143 surveys were submitted by women of the general population. Data analysis confirmed previous predictions that at a hypothetical increased risk of contralateral breast cancer (CBC), about twice the proportion of women will elect CPM. With over 10 times the baseline risk and no surgical complications, 98.6% of women chose CPM. There was a decrease in affirmative responses with increasing morbidity. This decrease was least prominent at higher genetic risk, illustrating that when women are at a higher risk of CBC, the surgical morbidity rate has less of an impact on their decision for CPM. Conclusion: At increased risk of CBC, women are likely to elect for CPM. We anticipate that these findings will encourage the growing use of personalized medicine, with the potential to tailor breast cancer treatment plans for each patient’s personal genetic profile.
Osteochondral Autologous Transplantation for Treating Patellar High-Grade Chondral Defects: A Systematic Review
Authors: Donoso Rodrigo , Figueroa David , Espinoza Jaime , Yañez Claudio , Saavedra Jamil 
Published: October 2019

Background: Patellar cartilage defects account for 34.6% of defects found during routine arthroscopy. These defects pose a challenge in orthopaedic surgery because they have been associated with worse outcomes after surgical repair compared with other chondral lesions within the knee. Purpose: To systematically review the literature for evidence on results of osteochondral autologous transplantation (OAT) for the management of isolated patellar cartilage high-grade defects (International Cartilage Repair Society [ICRS] grade 3-4). Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the literature was performed to find studies that addressed outcomes regarding OAT to treat patellar high-grade cartilage defects (ICRS grade 3-4). Studies addressing patient-reported outcomes, return to sports, or magnetic resonance imaging (MRI) at follow-up after isolated OAT procedures for patellar cartilage defects were included. Results: A total of 5 studies were included in this review. We were not able to perform a meta-analysis as no studies had available data. A total of 102 patients who received an isolated OAT for a patellar chondral defect were included in these 5 studies. All patients showed significant improvement at final follow-up based on the following patient-reported outcome scores: Lysholm, International Knee Documentation Committee, Kujala, Tegner, and 36-Item Short Form Health Survey. We found that 4 studies used MRI during the first postoperative year to assess osteochondral plug integration and positioning. The results demonstrated that most plugs were integrated and correctly positioned when evaluated at follow-up, conducted on average after 12 months. Whether patients were able to return to sports was queried in 2 of the included studies, revealing that patients could return to their previous level in most cases (Tegner score, 5-9 at 2 years after surgery). Conclusion: Results indicate that OAT is a safe and reliable technique to treat patellar high-grade osteochondral defects, allowing for significant improvement in patient-reported outcomes and return to sports.