bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence, predictive factors and clinical significance of development of portal vein thrombosis in cirrhosis: A prospective study
Authors: Noronha Ferreira Carlos , Marinho Rui T. , Cortez‐Pinto Helena , Ferreira Paula , Dias Margarida S. , Vasconcelos Mariana , Alexandrino Paula , Serejo Fátima , Pedro Ana Júlia , Gonçalves Afonso , Palma Sónia , Leite Inês , Reis Daniela , Damião Filipe , Valente Ana , Xavier Brito Leonor , Baldaia Cilenia , Fatela Narcisa , Ramalho Fernando , Velosa José 
Published: April 2019

AbstractBackground and aimsThe role of portal vein thrombosis (PVT) in the natural history of cirrhosis is controversial. There are few prospective studies validating risk factors for development of PVT. We analysed the incidence, factors associated with PVT development and its influence on cirrhosis decompensations and orthotopic liver transplant (OLT)‐free survival.MethodsIn this prospective observational study between January 2014 and March 2019, 445 consecutive patients with chronic liver disease were screened and finally 241 with cirrhosis included. Factors associated with PVT development and its influence on cirrhosis decompensations and OLT‐free survival by time dependent covariate coding were analysed.ResultsMajority of patients belonged to Child‐Pugh class A 184 (76.3%) and the average MELD score was 10 ± 5. Previous cirrhosis decompensations occurred in 125 (52.1%), 63 (26.1%) were on NSBB and 59 (27.2%) had undergone banding for bleeding prophylaxis. Median follow‐up was 29 (1‐58) months. Cumulative incidence of PVT was 3.7% and 7.6% at 1 and 3 years. Previous decompensation of cirrhosis and low platelet counts but not NSBB independently predicted the development of PVT. During follow‐up, 82/236 (34.7%) patients developed cirrhosis decompensations. OLT‐free survival was 100% and 82.8% at 3 years, with and without PVT respectively. MELD score, but not PVT, independently predicted cirrhosis decompensations (HR 1.14; 95%CI:1.09‐1.19) and OLT‐free survival (HR 1.16;95%CI:1.11‐1.21).ConclusionPrevious decompensations of cirrhosis and thrombocytopenia predict PVT development in cirrhosis suggesting a pathophysiologic role for severity of portal hypertension. PVT development did not independently predict cirrhosis decompensations or lower OLT‐free survival.
Adoption of Individual Flood Damage Mitigation Measures in New York City: An Extension of Protection Motivation Theory
Authors: Botzen W. J. Wouter , Kunreuther Howard , Czajkowski Jeffrey , de Moel Hans 
Published: April 2019

AbstractThis study offers insights into factors of influence on the implementation of flood damage mitigation measures by more than 1,000 homeowners who live in flood‐prone areas in New York City. Our theoretical basis for explaining flood preparedness decisions is protection motivation theory, which we extend using a variety of other variables that can have an important influence on individual decision making under risk, such as risk attitudes, time preferences, social norms, trust, and local flood risk management policies. Our results in relation to our main hypothesis are as follows. Individuals who live in high flood risk zones take more flood‐proofing measures in their home than individuals in low‐risk zones, which suggests the former group has a high threat appraisal. With regard to coping appraisal variables, we find that a high response efficacy and a high self‐efficacy play an important role in taking flood damage mitigation measures, while perceived response cost does not. In addition, a variety of behavioral characteristics influence individual decisions to flood‐proof homes, such as risk attitudes, time preferences, and private values of being well prepared for flooding. Investments in elevating one's home are mainly influenced by building code regulations and are negatively related with expectations of receiving federal disaster relief. We discuss a variety of policy recommendations to improve individual flood preparedness decisions, including incentives for risk reduction through flood insurance, and communication campaigns focused on coping appraisals and informing people about flood risk they face over long time horizons.
Evaluation of wound fluid biomarkers to determine healing in adults with venous leg ulcers: A prospective study
Authors: Stacey Michael C. , Phillips Steven A. , Farrokhyar Forough , Swaine Jillian M. 
Published: April 2019

AbstractClinical practice guidelines recommend using repeated wound surface area measurements to determine if a chronic ulcer is healing. This results in delays in determining the healing status. This study aimed to evaluate whether any of a panel of biomarkers can determine the healing status of chronic venous leg ulcers. Forty‐two patients with chronic venous leg ulcers had their wound measured and wound fluid collected at weekly time points for 13 weeks. Wound fluid was analyzed using multiplex enzyme‐linked immunosorbent assay to determine the concentration of biomarkers in the wound fluid at each weekly time point. Healing status was determined by examining the change in wound size at the previous and subsequent weeks. Predictive accuracy with 95% confidence intervals (CI) is reported. Of 42 patients, 105 evaluable weekly time points were obtained, with 32 classified as healing, 27 as nonhealing, and 46 as indeterminate. Thirteen biomarkers significantly differed between healing and nonhealing wounds (p < 0.1) and were included in a multivariate logistic regression model. Granulocyte macrophage‐colony stimulating factor (p < 0.001) and matrix metalloprotease‐13 (p = 0.004) were the best predictors of wound healing. Receiver operating characteristic curves indicated 92% accuracy (95% CI: 85%,100%) for granulocyte macrophage‐colony stimulating factor, and 78% accuracy (95% CI: 65%,90%) for matrix metalloprotease‐13 in discriminating between healing and nonhealing wounds. This study found that two biomarkers from wound fluid can predict healing status in chronic venous leg ulcers. These findings may lead to the ability to determine the future trajectory of a wound and the ability to modify treatment accordingly.
Relationship of Depression Scores and Ranges in Women Who Suffer From Fibromyalgia by Age Distribution: A Case‐Control Study
Authors: Palomo‐López Patricia , Becerro‐de‐Bengoa‐Vallejo Ricardo , Elena‐Losa‐Iglesias Marta , López‐López Daniel , Rodríguez‐Sanz David , Cáceres‐León Macarena , Calvo‐Lobo César 
Published: April 2019

AbstractBackgroundFibromyalgia may be defined as a chronic widespread pain condition that generates a functional impairment with various symptoms, such as depression.PurposeThe main aim of this research was to compare the Beck Depression Inventory (BDI) scores and depression ranges in women who suffered from fibromyalgia with respect to healthy controls, overall and by age distributions.MethodsA case–control observational study was performed. Two hundred women with a mean age of 58.61 ± 15.65 years old were recruited. The women were divided into case (women with fibromyalgia) and control (healthy women) groups. The BDI scores and depression ranges were collected.ResultsThe depression ranges and BDI scores mean ± SD showed statistically significant differences (p < .001) between participants with fibromyalgia (19.30 ± 11.21 points; moderate depression) and healthy controls (6.37 ± 5.35 points; no depression). Regarding the age distributions, statistically significant differences were shown between fibromyalgia and control groups for adults (p < .001; 19.06 ± 6.55 vs. 4.69 ± 4.48 points) and older adults (p = .001; 20.25 ± 13.79 vs. 7.63 ± 5.47 points), respectively. ANOVA of the BDI scores with two factors and interaction (fibromyalgia presence and age distribution) determined no interaction between the two factors (p = .534) and statistically significant differences of BDI scores for fibromyalgia presence (p < .001; R2 = 35.50%), but not for age distribution (p = .144).Linking Evidence to ActionMeasurable differences in higher BDI scores and depression ranges were shown in women who suffered from fibromyalgia with respect to healthy controls, regardless of age distribution. Greater probabilities (odds ratio = 15.88) of suffering from some level of depression (according to BDI scores) were found in women with fibromyalgia in comparison with healthy women. Although these findings did not seem to be influenced by age distribution, interventions targeting depression in practice, research, policy, management, or education must equally include adult and older adult women who suffer from fibromyalgia.
Geomorphic change and biogeomorphic feedbacks in a dryland river: The Little Colorado River, Arizona, USA
Authors: Dean D.J. , Topping D.J. 
Published: April 2019

AbstractThe Little Colorado River in Arizona, United States, has undergone substantial geomorphic change since the late 1800s and early 1900s, consisting of sediment accumulation following an earlier period of likely widespread sediment evacuation. We analyzed hydrologic and geomorphic data at different spatial and temporal scales to determine the primary mechanisms responsible for these changes, and to provide context for periods of sediment evacuation and accumulation in other rivers.Peak-flow magnitude has progressively declined since the 1920s despite the occurrence of four alternating periods of high and low total annual flow. Largely coincident with this hydrologic change, the channel has narrowed between 72% and 88% in some reaches since the 1930s, with increases in sinuosity in wide alluvial valleys causing ∼21%–32% reductions in channel slope. Dense stands of vegetation colonized, and thus stabilized, the newly deposited floodplains. Although large, long-duration floods caused some channel widening, these floods have been too infrequent to offset the progressive narrowing. Channel narrowing, increases in sinuosity, decreases in slope, and increases in vegetative roughness appear to have caused biogeomorphic feedbacks, thereby exacerbating sediment deposition, disrupting flood conveyance, and contributing to decreases in peak-flow magnitude and in sediment transport. The progressive increase in water development in parts of the basin has also likely contributed to progressive declines in peak flow. These results show that biogeomorphic feedback processes combined with human water development may be as important as, if not more important than, changes in climate in driving hydrologic, geomorphic, and sediment-load change in dryland river environments.
Geology of a Neoarchean suture: Evidence from the Zunhua ophiolitic mélange of the Eastern Hebei Province, North China Craton
Authors: Wang Junpeng , Li Xiawen , Ning Wenbin , Kusky Timothy , Wang Lu , Polat Ali , Deng Hao 
Published: April 2019

AbstractMélanges characterize Phanerozoic convergent plate boundaries, but have rarely been reported from Archean orogens. In this paper, we document a Neoarchean ophiolitic mélange in the Eastern Hebei Province of the North China Craton. The Zunhua ophiolitic mélange is composed of a structural mixture of metapelites, ortho- and para-gneisses, and magnetite-quartzite mixed with exotic tectonic mafic blocks of metabasalts, metagabbroic rocks, and metadiabases, along with ultramafic blocks of serpentinized peridotites and podiform chromitites. The Zunhua ophiolitic mélange shows typical “block in matrix” structures. All units of the mélange have been intruded by granitic dikes and quartz veins that clearly cross-cut the foliation of blocks and matrix of the mélange. Laser-ablation–inductively coupled plasma–mass spectrometry zircon U-Pb dating of detrital zircons from the meta-sedimentary mélange matrix and intruding granitic dikes constrains the formation time of the Zunhua mélange to be between 2.52 and 2.46 Ga. Metamorphic rims on zircons from meta-sedimentary mélange matrix have ages of 2467 ± 27 Ma, confirming metamorphism of the mélange occurred at ca. 2.47 Ga. High-precision (scale 1:20 and 1:50) litho-structural mapping, along with detailed structural observations along several transects documents the internal fabrics and kinematics of the mélange, revealing a northwest to southeast directed transportation. The asymmetric structures in the mélange with folding and faulting events in the Zunhua mélange record kinematic information and are similar to the tectonic style of an accretionary wedge. Field relationships and geochemical analysis of various mafic blocks show that these blocks formed in an arc-related subduction tectonic environment. We suggest that the Zunhua mélange marks the suture zone of a Neoarchean arc-continent collisional event in the Central Orogenic Belt of the North China Craton. Combined with our previous studies, we demonstrate that a ca. 2.5 Ga tectonic suture exists between an arc/accretionary prism terrane in the Central Orogenic Belt and the Eastern Block of the North China Craton. We correlate this segment of the suture with other similar zones along strike, for >1000 km, including sections of the ca. 2.5 Ga in Dengfeng greenstone belt in the southern margin of the Central Orogenic Belt, and the ca. 2.5 Ga Zanhuang ophiolitic mélange in the center of the orogen. These relationships demonstrate that tectonic processes in the late Archean included subduction/accretion at convergent margins, and the horizontal movement of plates, in a style similar to modern-day accretionary convergent margins.
Predictive models for short-term and long-term improvement in women under physiotherapy for chronic disabling neck pain: a longitudinal cohort study
Authors: Bohman Tony , Bottai Matteo , Björklund Martin 
Published: April 2019

ObjectivesTo develop predictive models for short-term and long-term clinically important improvement in women with non-specific chronic disabling neck pain during the clinical course of physiotherapy.DesignLongitudinal cohort study based on data from a randomised controlled trial evaluating short-term and long-term effects on sensorimotor function over 11 weeks of physiotherapy.Participants and settingsEighty-nine women aged 31–65 years with non-specific chronic disabling neck pain from Gävle, Sweden.MeasuresThe outcome, clinically important improvement, was measured with the Patient Global Impression of Change Scale (PGICS) and the Neck Disability Index (NDI), assessed by self-administered questionnaires at 3, 9 and 15 months from the start of the interventions (baseline). Twelve baseline prognostic factors were considered in the analyses. The predictive models were built using random-effects logistic regression. The predictive ability of the models was measured by the area under the receiver operating characteristic curve (AUC). Internal validity was assessed with cross-validation using the bootstrap resampling technique.ResultsFactors included in the final PGICS model were neck disability and age, and in the NDI model, neck disability, depression and catastrophising. In both models, the odds for short-term and long-term improvement increased with higher baseline neck disability, while the odds decreased with increasing age (PGICS model), and with increasing level of depression (NDI model). In the NDI model, higher baseline levels of catastrophising indicated increased odds for short-term improvement and decreased odds for long-term improvement. Both models showed acceptable predictive validity with an AUC of 0.64 (95% CI 0.55 to 0.73) and 0.67 (95% CI 0.59 to 0.75), respectively.ConclusionAge, neck disability and psychological factors seem to be important predictors of improvement, and may inform clinical decisions about physiotherapy in women with chronic neck pain. Before using the developed predictive models in clinical practice, however, they should be validated in other populations and tested in clinical settings.
Drug use at the end of life in older adults
Authors: Chuang Hsien-Yeh , Wen Yu-Wen , Chen Liang-Kung , Hsiao Fei-Yuan 
Published: April 2019

ObjectiveTo investigate symptom-relief and comorbid drug uses at the end of life for older people with different dying trajectories (cancer, organ failure, frailty and sudden death) in Taiwan.MethodsIn a retrospective observational study of older people aged 65 years and older who died in hospitals between 2008 and 2012, we used NHIRD to measure numbers, incremental changes and determinants of symptom-relief and comorbid drug use in the last month of outpatient care and last hospitalisation before death.ResultsWe included 59 407 older adults (cancer 37%, organ failure 26%, frailty 35% and sudden death 2%) who died in hospitals for this study. In the last hospitalisation before death, individuals who died of cancer received greatest number of symptom-relief drugs (mean: 4.65, [SD 2.77]) and increased most the average change in the number of symptom-relief drug use (+1.60; SD 3.36). However, individuals who died of organ failure received the highest number of comorbid drugs (mean 2.88, [SD 1.95]) and also increased most the average change in the number of comorbid drug use (+0.17; SD 2.28) at last hospitalisation. Different dying trajectories were key determinants of receiving symptom-relief and comorbid drugs in our study.ConclusionsOur study suggests that the drug use of older adults at the end of life in the cancer group is different from that in the organ failure and frailty groups. Policymakers and health professionals should consider the different strategies to optimise drug use for older people with different dying trajectories near their end of life.
Left ventricular vortex formation time in elite athletes: novel predictor of myocardial performance
Authors: Poh Kian Keong , Ngiam Nicholas , Wood Malissa J 
Published: April 2019

BackgroundEfficient transportation of blood through the left ventricle (LV) during diastole depends on vortex formation. Vortex formation time (VFT) can be measured by echocardiography as a dimensionless index. As elite athletes have supranormal diastolic LV function, we aim to assess resting and post-exercise VFT in these athletes and hypothesised that VFT may predict myocardial performance immediately post-exercise.MethodSubjects were world class speedskaters training for the Winter Olympic Games. Echocardiographic measurements were obtained before and immediately after 3000 m of racing. VFT was computed as 4×(1−β)/π×α³×left ventricle ejection fraction where β is the fraction of diastolic stroke volume contributed by atrial contraction, α is the biplane end diastolic volume (EDV)1/3 divided by mitral annular diameter during early diastole.ResultsBaseline VFT was 2.6±0.7 (n=24, age 22±3 years, 67% males). Post-exercise, heart rates increased (64±10 vs 89±12 beats/min, p<0.01); however, VFT was unchanged (2.9±1.0, p>0.05). VFT at rest correlated modestly with post-exertion early diastolic mitral in-flow velocity (E; r=0.59, p=0.01), tissue Doppler-derived early mitral annular velocity (E′; septal and lateral, both r=0.59, p=0.01) and systolic annular velocity (S′; septal: r=0.46, p=0.02 and lateral: r=0.48, p=0.02) but not late diastolic mitral in-flow velocity (A; r=0.06, p>0.05) or annular velocity (A′; septal: r=0.34, p=NS and lateral: r=0.35, p>0.05).ConclusionThere was no significant difference between VFT at rest and immediately post-exercise. However, VFT at rest correlated with immediate post-exercise augmented systolic and early diastolic tissue Doppler indicators of myocardial performance in elite athletes.
Pain and depression are associated with both physical and mental fatigue independently of comorbidities and medications in primary Sjögren’s syndrome
Authors: Hackett Kate L , Davies Kristen , Tarn Jessica , Bragg Rebecca , Hargreaves Ben , Miyamoto Samira , McMeekin Peter , Mitchell Sheryl , Bowman Simon , Price Elizabeth J , Pease Colin , Emery Paul , Andrews Jacqueline , Lanyon Peter , Hunter John , Gupta Monica , Bombardieri Michele , Sutcliffe Nurhan , Pitzalis Costantino , McLaren John , Cooper Annie , Regan Marian , Giles Ian , Isenberg David , Vadivelu Saravan , Coady David , Dasgupta Bhaskar , McHugh Neil , Young-Min Steven , Moots Robert , Gendi Nagui , Akil Mohammed , Griffiths Bridget , Lendrem Dennis W , Ng Wan-Fai 
Published: April 2019

ObjectivesTo report on fatigue in patients from the United Kingdom primary Sjögren’s syndrome (pSS) registry identifying factors associated with fatigue and robust to assignable causes such as comorbidities and medications associated with drowsiness.MethodsFrom our cohort (n = 608), we identified those with comorbidities associated with fatigue, and those taking medications associated with drowsiness. We constructed dummy variables, permitting the contribution of these potentially assignable causes of fatigue to be assessed. Using multiple regression analysis, we modelled the relationship between Profile of Fatigue and Discomfort physical and mental fatigue scores and potentially related variables.ResultsPain, depression and daytime sleepiness scores were closely associated with both physical and mental fatigue (all p ≤ 0.0001). In addition, dryness was strongly associated with physical fatigue (p ≤ 0.0001). These effects were observed even after adjustment for comorbidities associated with fatigue or medications associated with drowsiness.ConclusionsThese findings support further research and clinical interventions targeting pain, dryness, depression and sleep to improve fatigue in patients with pSS.This finding is robust to both the effect of other comorbidities associated with fatigue and medications associated with drowsiness.
Reduction in morbidity and mortality of dairy calves from an injectable trace mineral supplement
Authors: Bates Andrew , Wells Matt , Laven Richard Anthony , Simpson Meg 
Published: April 2019

The effect of a multimineral preparation on the health and growth of spring born, dairy calves was investigated on four New Zealand pastoral farms. Calves were randomly allocated injections within 24 hours of birth, 35 days and 70 days after birth. Injections contained 40 mg zinc, 10 mg manganese, 5 mg selenium, 15 mg copper and 5 mg chromium per ml (Multimin+Se+ Cu+Cr Cattle, Virbac South Africa) at 1 ml/50 kg body weight. Morbidity, mortality from natural challenge and growth rates were recorded for 140 days. There were no differences in morbidity and mortality within 48 hours of birth for treated calves compared with controls, P=0.192. Morbidity and mortality were highest at 3–35 days (7.5 per cent [95 per cent CI 5.00 to 9.99] treated calves sick and 15.6 per cent [95 per cent CI 12.48 to 18.73] controls sick, P<0.001). For this period, mortality was lower at 4.4 per cent (95 per cent CI 2.49 to 6.41) treated calves and 10.4 per cent (95 per cent CI 7.78 to 13.03) controls, P<0.001. Allowing for potential confounders, the adjusted OR of treated calves scouring between 3 and 35 days was 0.44 (95 per cent CI 0.24 to 0.82, P=0.009). Allowing for potential confounders, from 0 to 140 days a second model predicted treatment approximately halved the probability of morbidity and mortality (P<0.001). There was no difference in the daily rate of gain (0.67 kg/day [95 per cent CI 0.66 to 0.67] for treated calves).