bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiological study of emergency ambulance activation in the British Eastern Sovereign Base Area of Cyprus, September 2013 to August 2016
Authors: Jefferys Sophie , Martin-Bates A J , Harold A , Withnall R 
Published: August 2018

ObjectivesTo record the activation and use of the Eastern Sovereign Base Area (ESBA) emergency ambulance service of British Forces Cyprus between 1 September 2013 and 31 August 2016. To reflect on these findings in light of data from 1995 to 1998 to identify current treads and areas of development.MethodRetrospective epidemiological study of all activations of the ESBA emergency ambulance service within the study period.Results812 patients were treated over 3 years, an 80% increase in workload, of which 41% were entitled personnel. Forty-two per cent of activations were for medical complaints compared with 41% for trauma. The number of deaths remained static (n=15). Road traffic incidents (RTI) remain the top activation by type, but accounting for a smaller proportion of workload. RTI mortality has declined by 50%.ConclusionThe ESBA emergency ambulance service responded to double the activations, when compared with 18 years ago, with a significant shift to medical cases over trauma. This ESBA emergency ambulance provides a varied and vital service for the local community that also benefits Defence Medical Services personnel interested in the Pre-Hospital Emergency Medicine environment in order to maintain clinical skills and currency for the benefit of future deployments, both humanitarian and kinetic in nature.
Risk screening assessment for ranking historic coastal landfills by pollution risk
Authors: Brand James H. , Spencer Kate L. 
Published: August 2018

Abstract
Globally there are significant numbers of historic landfills, and in England alone there are over 1200 in low-lying coastal areas. Approximately one-third of these historic coastal landfills are near designated ecological sites, and without intervention, 10% are expected to start eroding within 40 years. Indeed, some sites are already eroding and releasing waste, and erosion is likely to become more common with the anticipated effects of climate change. Mitigating the pollution risk from all historic coastal landfills under threat of erosion would be prohibitively expensive; consequently, it is necessary to understand which sites pose the greatest pollution risk to prioritise management resources. This paper proposes a new risk screening assessment that can support coastal managers in identifying which historic coastal landfills pose the greatest pollution risk at a national scale for minimal cost using existing datasets. The proposed method determines an overall risk index for each site by considering the risk of pollution from eroding historic coastal landfills in two stages: the first stage assesses the risk of waste being released (waste release index), and the second assesses the risk to various receptors (pollution index). The highest risk sites can then be prioritised for further investigation or remediation.
Answering FO+MOD Queries under Updates on Bounded Degree Databases
Authors: Berkholz Christoph , Keppeler Jens , Schweikardt Nicole 
Published: August 2018

We investigate the query evaluation problem for fixed queries over fully dynamic databases, where tuples can be inserted or deleted. The task is to design a dynamic algorithm that immediately reports the new result of a fixed query after every database update.
We consider queries in first-order logic (FO) and its extension with modulo-counting quantifiers (FO+MOD) and show that they can be efficiently evaluated under updates, provided that the dynamic database does not exceed a certain degree bound.
In particular, we construct a data structure that allows us to answer a Boolean FO+MOD query and to compute the size of the result of a non-Boolean query within constant time after every database update. Furthermore, after every database update, we can update the data structure in constant time such that afterwards we are able to test within constant time for a given tuple whether or not it belongs to the query result, to enumerate all tuples in the new query result, and to enumerate the difference between the old and the new query result with constant delay between the output tuples. The preprocessing time needed to build the data structure is linear in the size of the database.
Our results extend earlier work on the evaluation of first-order queries on static databases of bounded degree and rely on an effective Hanf normal form for FO+MOD recently obtained by Heimberg, Kuske, and Schweikardt (LICS 2016).
Comparison of methods of chemical loop gain measurement during tidal ventilation in awake healthy subjects
Authors: Bokov Plamen , Matrot Boris , Gallego Jorge , Delclaux Christophe 
Published: August 2018

The loop gain (LG) is defined as the ratio of a ventilatory response over the perturbation in ventilation, and it is used to analyze ventilatory control stability. The LG can be derived from minute ventilation (V̇e), end-tidal Pco2([Formula: see text]), and end-tidal Po2([Formula: see text]) values. Several methods of LG assessment have been developed, which have never been compared. We evaluated the computability, the short-term repeatability, and the agreement of six published (or slightly modified) models for LG determination. These models included three unconstrained autoregressive models, univariate (V̇e), bivariate (V̇e, [Formula: see text]), and trivariate (V̇e, [Formula: see text], and [Formula: see text]), and three analytical transfer function constrained models based on V̇e, V̇e and CO2-sensitivity, and V̇e and central and peripheral CO2sensitivities, respectively. The models were tested with tidal breathing data in 37 awake healthy subjects (median age 35 yr; 23 women, 14 men). Modeling failed in 11, 0, and 0 subjects for the three unconstrained models, respectively, and 4, 1, and 9 subjects for the three constrained models, respectively. Bland and Altman analyses of the LG values in the medium frequency range of two separate recordings demonstrated good repeatability for four models, excluding univariate and trivariate unconstrained models. The four repeatable models gave LG values that were in agreement (medium frequency LG, median 0.100–0.210), although the constrained model based on V̇e systematically overestimated LG values. The variances explained by these models were ∼20%. In conclusion, model-based analyses of tidal breathing were performed with different approaches that gave comparable results for chemical LG and explained variance.NEW & NOTEWORTHY Several methods of chemical loop gain measurement have been published but never compared. We show that a better repeatability is obtained with analytical constrained models compared with autoregressive unconstrained models and that the repeatable models gave comparable results of loop gain, even if the calculation based on ventilation-only recording gave higher values than those obtained with both ventilation and end-tidal Pco2recording. The explained variance of ventilation was similar whatever the model.
Hemodynamic characteristics of postural hyperventilation: POTS with hyperventilation versus panic versus voluntary hyperventilation
Authors: Stewart Julian M. , Pianosi Paul , Shaban Mohamed A. , Terilli Courtney , Svistunova Maria , Visintainer Paul , Medow Marvin S. 
Published: August 2018

Upright hyperventilation occurs in ~25% of our patients with postural tachycardia syndrome (POTS). Poikilocapnic hyperventilation alone causes tachycardia. Here, we examined changes in respiration and hemodynamics comprising cardiac output (CO), systemic vascular resistance (SVR), and blood pressure (BP) measured during head-up tilt (HUT) in three groups: patients with POTS and hyperventilation (POTS-HV), patients with panic disorder who hyperventilate (Panic), and healthy controls performing voluntary upright hyperpnea (Voluntary-HV). Though all were comparably tachycardic during hyperventilation, POTS-HV manifested hyperpnea, decreased CO, increased SVR, and increased BP during HUT; Panic patients showed both hyperpnea and tachypnea, increased CO, and increased SVR as BP increased during HUT; and Voluntary-HV were hyperpneic by design and had increased CO, decreased SVR, and decreased BP during upright hyperventilation. Mechanisms of hyperventilation and hemodynamic changes differed among POTS-HV, Panic, and Voluntary-HV subjects. We hypothesize that the hyperventilation in POTS is caused by a mechanism involving peripheral chemoreflex sensitization by intermittent ischemic hypoxia. NEW & NOTEWORTHY Hyperventilation is common in postural tachycardia syndrome (POTS) and has distinctive cardiovascular characteristics when compared with hyperventilation in panic disorder or with voluntary hyperventilation. Hyperventilation in POTS is hyperpnea only, distinct from panic in which tachypnea also occurs. Cardiac output is decreased in POTS, whereas peripheral resistance and blood pressure (BP) are increased. This is distinct from voluntary hyperventilation where cardiac output is increased and resistance and BP are decreased and from panic where they are all increased.
Effects of hypoxia-ischemia and inotropes on expression of cardiac adrenoceptors in the preterm fetal sheep
Authors: Hutchinson Dana S. , Brew Nadine , Vu Teresa , Merlin Jon , Hale Nadia , Walker David W. , Wong Flora Y. 
Published: August 2018

Preterm infants frequently suffer cardiovascular compromise, with hypotension and/or low systemic blood flow, leading to tissue hypoxia-ischemia (HI). Many preterm infants respond inadequately to inotropic treatments using adrenergic agonists such as dobutamine (DB) or dopamine (DA). This may be because of altered cardiac adrenoceptor expression because of tissue HI or prolonged exposure to adrenergic agonists. We assessed the effects of severe HI with and without DB/DA treatment on cardiac adrenoceptor expression in preterm fetal sheep. Fetal sheep (93–95 days) exposed to sham surgery or severe HI induced by umbilical cord occlusion received intravenous DB or saline for 74 h (HI + DB, HI, Sham + DB, Sham). The HI groups were also compared with fetal sheep exposed to HI and DA. Fetal hearts were collected to determine β-adrenoceptor numbers using [125I]-cyanopindolol binding and mRNA expression of β1-, β2-, α1A-, α2A-, or α2B-adrenoceptors. The HI group had increased β-adrenoceptor numbers compared with all other groups in all four heart chambers ( P < 0.05). This increase in β-adrenoceptor numbers in the HI group was significantly reduced by DB infusion in all four heart chambers, but DA infusion in the HI group only reduced β-adrenoceptor numbers in the left atria and ventricle. DB alone did not affect β-adrenoceptor numbers in the sham animals. Changes in β1-adrenoceptor mRNA levels trended to parallel the binding results. We conclude that HI upregulates preterm fetal cardiac β-adrenoceptors, but prolonged exposure to adrenergic agonists downregulates adrenoceptors in the preterm heart exposed to HI and may underpin the frequent failure of inotropic therapy in preterm infants. NEW & NOTEWORTHY This is the first study, to our knowledge, on the effects of hypoxia-ischemia and adrenergic agonists on adrenoceptors in the preterm heart. In fetal sheep, we demonstrate that hypoxia-ischemia increases cardiac β-adrenoceptor numbers. However, exposure to both hypoxia-ischemia and adrenergic agonists (dobutamine or dopamine) reduces the increase in β-adrenoceptor numbers, which may underpin the inadequate response in human preterm infants to inotropic therapy using adrenergic agonists. Dobutamine alone does not affect the cardiac adrenoceptors in the sham animals.
Peak Troponin I Levels Are Associated with Functional Outcome in Intracerebral Hemorrhage
Authors: Gerner Stefan T. , Auerbeck Katrin , Sprügel Maximilian I. , Sembill Jochen A. , Madžar Dominik  , Gölitz Philipp , Hoelter Philip , Kuramatsu Joji B. , Schwab Stefan , Huttner Hagen B. 
Published: August 2018

<b><i>Background:</i></b> Troponin I is a widely used and reliable marker of myocardial damage and its levels are routinely measured in acute stroke care. So far, the influence of troponin I elevations during hospital stay on functional outcome in patients with atraumatic intracerebral hemorrhage (ICH) is unknown. <b><i>Methods:</i></b> Observational single-center study including conservatively treated ICH patients over a 9-year period. Patients were categorized according to peak troponin I level during hospital stay (≤0.040, 0.041–0.500, &#x3e; 0.500 ng/mL) and compared regarding baseline and hematoma characteristics. Multivariable analyses were performed to investigate independent associations of troponin levels during hospital stay with functional outcome – assessed using the modified Rankin Scale (mRS; favorable 0–3/unfavorable 4–6) – and mortality after 3 and 12 months. To account for possible confounding propensity score (PS)-matching (1: 1; caliper 0.1) was performed accounting for imbalances in baseline characteristics to investigate the impact of troponin I values on outcome. <b><i>Results:</i></b> Troponin elevations (&#x3e; 0.040 ng/mL) during hospital stay were observed in 308 out of 745 (41.3%) patients and associated with poorer status on admission (Glasgow Coma Scale/National Institute of Health Stroke Scale). Multivariable analysis revealed troponin I levels during hospital stay to be independently associated with unfavorable outcome after 12 months (risk ratio [95% CI]: 1.030 [1.009–1.051] per increment of 1.0 ng/mL; <i>p</i> = 0.005), but not with mortality. After PS-matching, patients with troponin I elevation (≥0.040 ng/mL) versus those without had a significant higher rate of ­unfavorable outcome after 3 and 12 months (mRS 4–6 at 3 months: &#x3c; 0.04 ng/mL: 159/265 [60.0%] versus ≥0.04 ng/mL: 199/266 [74.8%]; <i>p</i> &#x3c; 0.001; at 12 months: &#x3c; 0.04 ng/mL: 141/248 [56.9%] versus ≥0.04 ng/mL: 179/251 [71.3%]; <i>p</i> = 0.001). <b><i>Conclusions:</i></b> Troponin I elevations during hospital stay occur frequently in ICH patients and are independently associated with functional outcome after 3 and 12 months but not with mortality.
Steinernema kandii n. sp. (Rhabditida: Steinernematidae), a new entomopathogenic nematode from northern Benin
Authors: Godjo Anique , Afouda Leonard , Baimey Hugues , Couvreur Marjolein , Zadji Lionel , Houssou Gladys , Bert Wim , Willems Anne , Decraemer Wilfrida 
Published: August 2018

SummaryTwo nematode isolates from the genusSteinernemawere collected in northern Benin. Morphological, morphometric, molecular and cross-hybridisation studies placed these nematodes into a new species,Steinernema kandiin. sp., within thebicornutum-group. Phylogenetic analyses based on both ITS and D2-D3 regions of 28S rDNA revealed thatS. kandiin. sp. is different from all knownSteinernemaspecies and sister toS. abbasi(97.3-97.6% ITS nucleotide similarity) andS. bifurcatum(98.3-98.4% D2-D3 similarity).Steinernema kandiin. sp. can be separated from other members of thebicornutum-group by the greater infective juvenile (IJ) max. body diam. of 35 (27-48)μm (type isolate). It differs fromS. abbasiby the greater IJ body length 707 (632-833)μm (type isolate), EP distance 55 (52-60)μm (type isolate), spicule length 67 (57-75)μm (type isolate) and the occurrence of one pair of genital papillae at the cloacal aperture.
A New Model to Downscale Urban and Rural Surface and Air Temperatures Evaluated in Shanghai, China
Authors: Liu Dongwei , Grimmond C. S. B. , Tan Jianguo , Ao Xiangyu , Peng Jie , Cui Linli , Ma Bingxin , Hu Yan , Du Mingbin 
Published: August 2018

AbstractA simple model, the Surface Temperature and Near-Surface Air Temperature (at 2 m) Model (TsT2m), is developed to downscale numerical model output (such as from ECMWF) to obtain higher-temporal- and higher-spatial-resolution surface and near-surface air temperature. It is evaluated in Shanghai, China. Surface temperature (Ts) and near-surface air temperature (Ta) submodels account for variations in land cover and their different thermal properties, resulting in spatial variations of surface and air temperature. The net all-wave radiation parameterization (NARP) scheme is used to compute net wave radiation for the surface temperature submodel, the objective hysteresis model (OHM) is used to calculate the net storage heat fluxes, and the surface temperature is obtained by the force-restore method. The near-surface air temperature submodel considers the horizontal and vertical energy changes for a column of well-mixed air above the surface. Modeled surface temperatures reproduce the general pattern of MODIS images well, while providing more detailed patterns of the surface urban heat island. However, the simulated surface temperatures capture the warmer urban land cover and are 10.3°C warmer on average than those derived from the coarser MODIS data. For other land-cover types, values are more similar. Downscaled, higher-temporal- and higher-spatial-resolution air temperatures are compared to observations at 110 automatic weather stations across Shanghai. After downscaling with TsT2m, the average forecast accuracy of near-surface air temperature is improved by about 20%. The scheme developed has considerable potential for prediction and mitigation of urban climate conditions, particularly for weather and climate services related to heat stress.
Selecting Time Series Length to Moderate the Impact of Nonstationarity in Extreme Rainfall Analyses
Authors: DeGaetano Arthur T. , Castellano Christopher 
Published: August 2018

AbstractObserved and projected increases in the frequency of extreme rainfall complicate the extreme value analyses of precipitation that are used to guide engineering design specifications, because conventional methods assume stationarity. Uncertainty in the magnitude of the trend in future years precludes directly accounting for the trend in these analyses. While previous extreme value analyses have sought to use as long a record as possible, it is shown using stochastically generated time series that this practice exacerbates the potential error introduced by long-term trends. For extreme precipitation series characterized by a trend in the location parameter exceeding approximately 0.005% yr−1, limiting the record length to fewer than 70 years is recommended. The use of longer time periods results in partial-duration series that are significantly different from their stationary counterparts and a greater percentage of rainfall extremes that exceed the 90% confidence interval corresponding to a stationary distribution. The effect is most pronounced on the shortest (i.e., 2 yr) recurrence intervals and generally becomes undetectable for recurrence intervals of more than 25 years. The analyses also indicate that the practice of including stations with records of limited length that end several decades prior to the present should be avoided. Distributions having a stationary location parameter but trended scale parameter do not exhibit this behavior.
Migrant health literacy in the European Union: A systematic literature review
Authors: Ward Markia , Kristiansen Maria , Sørensen Kristine 
Published: August 2018

Objective: The European Union (EU) has experienced an increasing intake of migrants in recent years. As its population diversifies, new challenges present themselves for healthcare delivery due to communication, cultural differences and health literacy of migrants. In the light of this, this systematic literature review examines the state of the art of migrant health literacy research within the EU. Methods: Based on PRISMA guidelines, a systematic literature review was conducted in 2013, 2016 and 2018 using the following databases: PubMed, Web of Science, CINAHL, MEDLINE and PsychINFO. Results: A total of 21 articles were selected for inclusion. EU-related migrant health literacy research dated from 2009, but only a small number of the EU member states were represented. Eight general research themes were identifiable. Definitions of migrants varied, however, or could not be identified within a particular study, which may hamper the further dissemination of research, policy and capacity building. Conclusion: The review shows the evolution of migrant health literacy research in the EU. More research is needed however to support health system responses, to increase the health literacy of migrants and to improve the quality of healthcare in the EU.
Periorbital erythema and swelling as a presenting sign of lupus erythematosus in tertiary referral centers and literature review
Authors: Wu MY , Wang CH , Ng CY , Kuo TT , Chang YC , Yang CH , Lin JY , Ho HC , Chung WH , Chen CB 
Published: August 2018

Background Cutaneous lupus erythematosus (CLE) includes a broad range of dermatologic manifestations. Periorbital involvement, however, is a relatively rare clinical presentation of CLE. Objectives This clinical study aimed to investigate the characteristics of this unique presentation of CLE in tertiary medical centers. Methods We enrolled patients with periorbital erythema and swelling as the presenting sign of lupus erythematosus, from January 2003 to November 2017, using the data of 553 pathologically proven CLE cases from the registration database of the Chang Gung Memorial Hospitals in Taiwan. Results We enrolled a total of 25 patients. The mean age was 46.7 years and 68% of the patients were female. Most of the patients (84.0%) presented with unilateral involvement, with the left orbit involved in 15 patients (60%); the upper eyelid was the most frequently involved (72%). Mean duration between the onset of clinical manifestations and the diagnosis of CLE was approximately 59 weeks. Nineteen patients had been previously misdiagnosed. All patients had features compatible with CLE on histopathological examination. In contrast, laboratory analysis of the autoimmune profile often revealed negative results, including those for antinuclear antibodies (25%). Notably, anti-SSA/SSB (45.5%) showed the highest positive rate. During follow-up, six patients developed systemic lupus erythematosus (SLE) and two patients developed Sjögren syndrome. Conclusions The diagnosis of CLE presenting as periorbital erythema and swelling is often delayed because of clinical mimicry and the high proportion of negative results on autoantibody tests. Increased clinical suspicion and prompt histopathological examination are crucial for early diagnosis. Moreover, one-fourth of the patients ultimately developed SLE, which highlights the importance of clinical awareness.