bluuebunny/crossref_metadata_2025_split huggingface dataset:
Equine infectious keratitis in Finland: Associated microbial isolates and susceptibility profiles
Authors: Mustikka Minna P. , Grönthal Thomas S. C. , Pietilä Elina M. 
Published: July 2019

AbstractObjectiveTo retrospectively describe laboratory findings, treatment, and outcome associated with equine infectious keratitis in Finland.Animals and proceduresMedical records of horses diagnosed with infectious keratitis in University of Helsinki Equine Hospital from January 2007 to June 2018 were reviewed.ResultsForty‐seven cases were included. Keratomycosis was diagnosed in 27 eyes and bacterial keratitis in 20 eyes.Aspergillus flavuswas the most frequent fungal isolate (9/17, 53%), followed byCylindrocarponsp. (3/17, 18%) andAspergillus fumigatus(2/17, 12%). Susceptibility was tested for 10/11Aspergillussp. isolates; all were susceptible to voriconazole while only two were susceptible to amphotericin B.Cylindrocarponsp. isolates were resistant to both agents.Streptococcus equisubsp.zooepidemicuswas the most frequent bacterial isolate (9/19, 47%), followed by other streptococci (4/19, 21%). All 13Streptococcussp. isolates were susceptible to penicillin, and all tested isolates (n = 11) were also susceptible to chloramphenicol. Mean duration of medical treatment was longer in fungal keratitis (38 days) than in bacterial keratitis (25 days) (P < .001). Twenty‐six of the eyes underwent globe‐sparing surgery in addition to medical therapy. Recovery was achieved in 66% (31/47) of all cases and in 59% (16/27) and 75% (15/20) (P = .264) of cases with keratomycosis and bacterial keratitis, respectively.ConclusionsAlthoughAspergillussp. andS zooepidemicuswere the most frequently encountered isolates, cytology, culture, and susceptibility testing are essential to differentiate bacterial and fungal keratitis and guide the clinician to choose the most efficient treatment.
Tofacitinib for the treatment of moderately to severely active ulcerative colitis: a systematic review, network meta-analysis and economic evaluation
Authors: Lohan Christoph , Diamantopoulos Alex , LeReun Corinne , Wright Emily , Bohm Natalie , Sawyer Laura Marie 
Published: July 2019

Background and aimsIn the UK, treatments for patients with moderately to severely active ulcerative colitis who have an inadequate response to conventional therapies comprise four biological therapies—the tumour necrosis factor inhibitor (TNFi) agents adalimumab, golimumab and infliximab and the anti-integrin vedolizumab—and an orally administered small molecule therapy, tofacitinib. However, there have been few head-to-head studies of these therapies. This study aimed to compare the clinical and cost-effectiveness of tofacitinib with biological therapies.MethodsA systematic literature review was conducted to identify all relevant randomised controlled trial (RCT) evidence. Clinical response, clinical remission and serious infection rates were synthesised using network meta-analysis (NMA). The results were used to compare the cost-effectiveness of tofacitinib and biologics with conventional therapy, using a Markov model, which incorporated lifetime costs and consequences of treatment from a UK National Health Service perspective. Analyses were conducted separately for TNFi-naïve and TNFi-exposed populations.ResultsSeventeen RCTs were used in the NMAs. There were no statistically significant differences among biological therapies and tofacitinib for either TNFi-naïve or TNFi-exposed patients. In TNFi-naïve patients, all therapies were more efficacious than placebo. In TNFi-exposed patients, only tofacitinib was significantly more efficacious than placebo as induction therapy, and only tofacitinib and vedolizumab were significantly more efficacious than placebo as maintenance therapies. There were no significant differences in serious infection rates among therapies. The incremental cost-effectiveness ratios for tofacitinib versus conventional therapy were £21 338 and £22 816 per quality-adjusted life year (QALY) in the TNFi-naïve and TNFi-exposed populations, respectively. TNFi therapies were dominated or extendedly dominated in both populations. Compared with vedolizumab, tofacitinib was associated with a similar number of QALYs, at a lower cost.ConclusionTofacitinib is an efficacious treatment for moderately to severely active ulcerative colitis and is likely to be a cost-effective use of NHS resources.
Acupuncture for chronic neck pain with sensitive points: study protocol for a multicentre randomised controlled trial
Authors: Sun Mingsheng , Geng Guoyan , Chen Jiao , Ma Xingsha , Yan Mingxi , Liu Xiaojia , Du Jiarong , Cai Dingjun , Zheng Hui , Zhao Ling , Liang Fan-rong 
Published: July 2019

IntroductionChronic neck pain is a challenging condition to treat in clinical practice and has a considerable impact on quality of life and disability. According to the theory of traditional Chinese medicine, acupoints and tender points may become sensitised when the body is in a diseased state. Stimulation of such sensitive points may lead to disease improvement and improved clinical efficacy. This study aims to evaluate the efficacy and safety of needling at sensitive acupoints in providing pain relief, improvement of cervical vertebral function and quality of life in patients with chronic neck pain.Methods and analysisThis multicentre, randomised controlled, explanatory and parallel clinical trial will include 716 patients with chronic neck pain. Study participants will be randomly assigned in a 1:1:1:1 ratio to four treatment groups: the highly sensitive acupoints group, low/non-sensitive acupoints group, sham acupuncture group and waiting-list control group. The primary outcome will be the change in the visual analogue scale score for neck pain from baseline to 4 weeks. Secondary outcomes will be the Northwick Park Neck Pain Questionnaire and McGill pain questionnaire, 12-item Short-Form health survey, Neck Disability Index, changes in the pressure pain threshold, range of cervical motion, Self-Rating Anxiety Scale, Self-Rating Depression Scale and adverse events before treatment, post-treatment, and at 4, 8, 12, 16 and 20 weeks post-treatment. The intention-to-treat approach will be used in the statistical analysis. Group comparisons will be undertaken using χ2tests for categorical characteristics, and analysis of variance for continuous variables to analyse whether acupuncture in the highly sensitive acupoints group achieves better treatment outcomes than in each of the other three groups.Ethics and disseminationEthical approval of this study has been granted by the local Institutional Review Board (ID: 2017 KL-038). The outcomes of the trial will be disseminated through peer-reviewed publications.Trial registration numberChiCTR1800016371; Pre-results.
Prevalence and factors associated with underweight children: a population-based subnational analysis from Pakistan
Authors: Kumar Ramesh , Abbas Faisal , Mahmood Tahir , Somrongthong Ratana 
Published: July 2019

ObjectivesThis study aims to determine the prevalence of and factors associated with underweight children under the age of 5 in Punjab, Pakistan.DesignWe analysed cross-sectional household-level subnationally representative Multiple Indicator Cluster Survey.SettingsPunjab province, Pakistan.Participants24 042 children under 5 years of age.Data analysisMultilevel multivariate logistic regression analysis.ResultsPrevalence of moderately and severely underweight children was found to be (33.3% and 11.3%, respectively). Multivariate multilevel logistic regression results show that as the child grows older the likelihood of the child being underweight increases significantly (eg, children between 12 and 23 months are one and half times more likely to be underweight, whereas children between the ages of 36 and 47 months are two and a half times more likely to be underweight). Gender was found to be another significant factor contributing to underweight prevalence among children under the age of 5. The likelihood of a girl child being underweight is more than that of a boy child being underweight (OR 0.92, 95% CI 0.8 to 1.0). Similarly, a child whose birth order is three or more is two times more likely to be underweight (OR 1.96, 95% CI 1.5 to 2.5) relative to a child of a lower birth order. Moreover, diarrhoea also significantly increases the likelihood of the child being underweight (OR 1.31, 95% CI 1.1 to 1.5). Child size is another determinant for underweight prevalence among children under 5, for example, a child with a size smaller than average at the time of birth is 2.7 times more likely to be moderately underweight than a child with an average or larger than average size at the time of birth.ConclusionRigorous community-based interventions should be developed and executed throughout the province to improve this grave situation of underweight prevalence in Punjab. Mother’s education should be uplifted by providing them formal education and providing awareness about the importance of proper nutrition for children.
Patients’ perspectives on integrated oral healthcare in a northern Quebec Indigenous primary health care organisation: a qualitative study
Authors: Shrivastava Richa , Couturier Yves , Kadoch Naomi , Girard Felix , Bedos Christophe , Macdonald Mary Ellen , Torrie Jill , Emami Elham 
Published: July 2019

ObjectivePatient-centred care is considered to be an important element in the evaluation of integrated healthcare and has been effective in addressing oral health disparities. This study explored the patients’ perspectives of patient-centred integrated care in oral health services integrated into a primary healthcare organisation serving a northern Quebec Cree population.DesignThis study used a multiple case study design within a qualitative approach and developmental evaluation methodology. Two theoretical models, Picker’s Principles of Patient-Centred Care and Valentijn’s Rainbow Model of Integrated Care, guided data collection and data analysis. The thematic analysis included transcription, debriefing, codification, data display and interpretation.SettingThis study was conducted in purposefully selected four Cree communities of Northern Quebec.ParticipantsAdult patients in need of oral healthcare and who attended the local dental clinic were identified and recruited by maximum variation sampling and snowball techniques.Outcome measuresPatients’ perspectives of patient-centred integrated oral healthcare.ResultsData analysis generated six major themes: enhanced accessibility, creating supportive environment, building trust through shared decision making, appreciation of public health programmes, raising oral health awareness and growing cultural humility among healthcare providers. Patients identified the integration of dental care into primary healthcare with respect to co-location, provision of free oral healthcare services, care coordination and continuity of care, referral services, developing supportive environment, shared decision making, oral health promotion and culturally competent care.ConclusionThese results confirmed that patient-centred care is an important element of integrated care. Patients valued the use of this concept in all domains and levels of integration. They recommended to further strengthen the clinical integration by involving parents in oral health promotion as well as optimising care coordination and empowering a supportive environment in organisational integration.
Bias Correction of Gauge Data and its Effect on Precipitation Climatology over Mainland China
Authors: Zhang Yingxian , Ren Yuyu , Ren Guoyu , Wang Guofu 
Published: July 2019

AbstractTypical rain gauge measurements have long been recognized to underestimate actual precipitation. Long-term daily precipitation records during 1961–2013 from a dense national network of 2379 gauges were corrected to remove systematic errors caused by trace precipitation, wetting losses, and wind-induced undercatch. The corrected percentage was higher in cold seasons and lower in warm seasons. Both trace precipitation and wetting loss corrections were more important in arid regions than in wet regions. A greater correction percentage for wind-induced error could be found in cold and arid regions, as well as high wind speed areas. Generally, the annual precipitation amounts as well as the annual precipitation intensity increased to varying degrees after bias correction with the maximum percentage being about 35%. More importantly, the bias-corrected snowfall amount as well as the rainstorm amount increased remarkably by percentages of more than 50% and 18%, respectively. Remarkably, the total number of actual rainstorm events during the past 53 years could be 90 days more than the observed rainstorm events in some coastal areas of China. Therefore, the actual amounts of precipitation, snowfall, and intense rainfall were much higher than previously measured over China. Bias correction is thus needed to obtain accurate estimates of precipitation amounts and precipitation intensity.
Nonlocal Transport and Implied Viscosity and Diffusivity throughout the Boundary Layer in LES of the Southern Ocean with Surface Waves
Authors: Large William G. , Patton Edward G. , Sullivan Peter P. 
Published: July 2019

AbstractObservations from the Southern Ocean Flux Station provide a wide range of wind, buoyancy, and wave (Stokes) forcing for large-eddy simulation (LES) of deep Southern Ocean boundary layers. Almost everywhere there is a nonzero angle Ω between the shear and the stress vectors. Also, with unstable forcing there is usually a depth where there is stable stratification, but zero buoyancy flux and often a number of depths above where there is positive flux, but neutral stratification. These features allow nonlocal transports of buoyancy and of momentum to be diagnosed, using either the Eulerian or Lagrangian shear. The resulting profiles of nonlocal diffusivity and viscosity are quite similar when scaled according to Monin–Obukhov similarity theory in the surface layer, provided the Eulerian shear is used. Therefore, a composite shape function is constructed that may be generally applicable. In contrast, the deeper boundary layer appears to be too decoupled from the Stokes component of the Lagrangian shear. The nonlocal transports can be dominant. The diagnosed across-shear momentum flux is entirely nonlocal and is highly negatively correlated with the across-shear component of the wind stress, just as nonlocal and surface buoyancy fluxes are related. Furthermore, in the convective limit the scaling coefficients become essentially identical, with some consistency with atmospheric experience. The nonlocal contribution to the along-shear momentum flux is proportional to (1 − cosΩ) and is always countergradient, but is unrelated to the aligned wind stress component.
Origin of Strong Winds in an Explosive Mediterranean Extratropical Cyclone
Authors: Brâncuş Mihaela , Schultz David M. , Antonescu Bogdan , Dearden Christopher , Ştefan Sabina 
Published: July 2019

AbstractDuring 2–3 December 2012, the Black Sea and east coast of Romania were affected by a rapidly deepening Mediterranean cyclone. The cyclone developed a bent-back front along which short-lived (2–4 h) strong winds up to 38 m s−1 were recorded equatorward of the cyclone center. A mesoscale model simulation was used to analyze the evolution of the wind field, to investigate the physical processes that were responsible for the strong winds and their acceleration, and to investigate the relative importance of the stability of the boundary layer to those strong winds. The origin of the air in the wind maximum equatorward of the cyclone center was twofold. The first was associated with a sting jet, a descending airstream from the midlevels of the cloud head and the lower part of the cyclonic branch of the warm conveyor belt. The sting jet started to descend west of the cyclone center, ending at the frontolytic tip of the bent-back front. The second was a low-level airstream associated with the cold conveyor belt that originated northeast of the cyclone center and traveled below 900 hPa along the cold side of the bent-back front, ending behind the cold front. Both airstreams were accelerated by the along-flow pressure gradient force, with the largest accelerations acting on the sting-jet air before entering into the near-surface strong-wind area. The sensible heat fluxes destabilized the boundary layer to near-neutral conditions south of the cyclone center, facilitating downward mixing and allowing the descending air to reach the surface. Mesoscale instabilities appeared to be unimportant in the sting-jet formation.
Influence of the distribution of bone cement along the fracture line on the curative effect of vertebral augmentation
Authors: Xu Kai , Li Ya-Ling , Song Fei , Liu Hua-Wei , Yang Hua-Dong , Xiao Song-Hua 
Published: July 2019

Objective The present study was performed to evaluate the effect of different bone cement distributions along the fracture line on clinical and imaging outcomes of vertebral augmentation. Methods In total, 84 patients who underwent vertebral augmentation for a single osteoporotic vertebral compression fracture from January 2016 to August 2018 were retrospectively reviewed. These patients were divided into two groups according to the relationship between the bone cement distribution and the fracture line: the unilateral group (n = 23) and the bilateral group (n = 61). Postoperative clinical and imaging parameters were compared between the two groups. Results Statistical analyses showed no significant difference in postoperative pain relief, bone cement leakage, nerve injury, or new vertebral fracture between the two groups. Significant recovery from vertebral compression was observed in the bilateral group after surgery, but there was no significant difference in vertebral compression after surgery in the unilateral group. Conclusions Pain relief was similar for different types of cement distributions along the fracture line, but a bilateral cement distribution exhibited better recovery from vertebral compression and did not increase bone cement leakage in the vertebral augmentation procedure.
Human papillomavirus (HPV) DNA and mRNA primary cervical cancer screening: Evaluation and triaging options for HPV-positive women
Authors: Sangrajrang Suleeporn , Laowahutanont Piyawat , Wongsena Metee , Muwonge Richard , Imsamran Weerawut , Ploysawang Pattama , Basu Partha 
Published: July 2019

Objective Cervical cancer is the second most common cancer in Thai women; human papillomavirus (HPV) is the main cause. This study aimed to determine the clinical performance of HPV mRNA compared with HPV DNA testing. Methods Cervical specimens were collected from women aged 35 to 60 who attended the routine organized screening programme. We compared accuracy parameters of standalone HPV mRNA and HPV DNA tests, and those of triaging with liquid-based cytology or HPV genotyping and liquid-based cytology for those positive only for the less oncogenic HPV types. Test accuracy parameters were estimated using latent class analysis using Bayesian models. Results Of the 5046 women enrolled, 174 (3.4%) were HPV DNA positive and 141 (2.8%) HPV mRNA positive. Colposcopy compliance was 95.4% ( n = 166) among HPV DNA-positive women and 94.3% ( n = 133) among those HPV mRNA positive. The estimated sensitivity, specificity, and positive predictive value for detection of CIN2 or worse were 67.4%, 97.1%, 12.1% for HPV DNA testing, and 73.1%, 97.8%, 16.3% for HPV mRNA testing. These estimates for triaging of HPV DNA-positive women with liquid-based cytology were 64.4%, 98.8%, and 19.0%, respectively, and slightly better for liquid-based cytology triage of HPV mRNA-positive women, at 71.8%, 98.9%, and 22.1%. Conclusion A triaging strategy based on HPV genotyping and liquid-based cytology for those positive only for the less oncogenic HPV types had test characteristics comparable with that of liquid-based cytology triage. The HPV mRNA detection-based strategies had non-significant advantages over the HPV DNA detection-based strategies.
Validation of the failure to maturation equation and proposal for a novel scoring system for arteriovenous fistula maturation in multiethnic Asian haemodialysis patients
Authors: Tng Alvin Ren Kwang , Lee Kian Guan , Tan Ru Yu , Pang Suh Chien , Foo Marjorie Wai Yin , Choong Hui Lin , Li Hui Hua , Goh Nicholette , Shaam Achudan , Tan Yi Liang , Chong Tze Tec , Tan Chieh Suai 
Published: July 2019

Introduction: A successful arteriovenous fistula is essential for effective haemodialysis. We aim to validate the existing failure to maturation equation and to propose a new clinical scoring system by evaluating arteriovenous fistula success predictors. Methods: Data of end-stage renal disease patients initiated on haemodialysis from January 2010 to December 2012 were retrospectively obtained from medical records with follow-up until 1 January 2014. Application of the failure to maturation equation was evaluated. A nomogram was developed using arteriovenous fistula success predictors and was calibrated with a bootstrapping technique. Results: A total of 694 patients were included with mean duration of follow-up of 2.3 years. Arteriovenous fistula maturation was achieved by 542 patients (78%). Comparing our cohort with the failure to maturation cohort, there were statistically significant differences in mean age, ethnicity and presence of diabetes mellitus. The failure to maturation equation failed to predict arteriovenous fistula outcomes with area under the curve performance of 0.519 on a receiver operating characteristic curve. Multivariate logistic regression showed that Malay patients (odds ratio = 0.628; 95% confidence interval = 0.403–0.978; p < 0.05) and patients requiring preoperative vein mapping (odds ratio = 0.601; 95% confidence interval = 0.410–0.883; p < 0.01) had a lower chance of arteriovenous fistula success, whereas male gender (odds ratio = 1.526; 95% confidence interval = 1.040–2.241; p < 0.05) and presence of postoperative good thrill (odds ratio = 3.137; 95% confidence interval = 2.127–4.625; p < 0.0001) had a higher chance of arteriovenous fistula success. The derived nomogram predicted arteriovenous fistula success (odds ratio = 1.030; 95% confidence interval = 1.022–1.038; p < 0.0001) with the area under the curve of 0.695 on a receiver operating characteristic curve and an adequacy index of 99.86% ( p < 0.0001). Conclusion: The failure to maturation equation was not validated in our cohort. The clinical utility of our proposed arteriovenous fistula scoring system requires external validation in larger studies.