bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spengelidae (Hemichordata: Enteropneusta) from the Eastern Pacific including a new species, Schizocardium californicum, from California
Authors: CAMERON C. B. , PEREZ M. 
Published: May 2019

Twenty one enteropneusts have been described from the west coast of North America, but those reports include no Spengelidae. Here we describe two species of acorn worms in the genus Schizocardium (S. californicum and S. peruvianum) on the basis of morphology. The former represent the first spengelid worm described from North American waters. The latter is a previously described species, and here we expand on its morphological description and extend its geographic range north from Peru to California. Notes on the habit and localization of each species, as well as a dichotomous key to the genera of the family Spengelidae are provided. Based on morphology, spengelids appears to represent an intermediate between the enteropneust families Harrimaniidae and Ptychoderidae, and Schizocardium is sister taxon to the ptychoderids. The disjunct and widely distributed populations of S. peruvianum and S. brasiliense, with populations in South American and North America, but none between, could represent the relict populations of formerly wide spread species, or the two extremes of ranges.
New genera and species of Neotropical Rhinotragini (Coleoptera, Cerambycidae, Cerambycinae)
Authors: SANTOS-SILVA ANTONIO , BEZARK LARRY G. , MARTINS UBIRAJARA R. 
Published: May 2019

Giesberteclipta and Thomasella, two new genera of Rhinotragini Thomson, 1861 (Coleoptera: Cerambycidae: Cerambycinae), are described and illustrated. Six new species are also described and illustrated: Acyphoderes violaceus from Costa Rica; Ischasioides giesberti from Ecuador, and Oxylymma pallida, Pseudagaone williamsi, Stultutragus tippmanni and S. ventriguttatus from Brazil. Keys are provided for the known species of Pseudagaone Tippmann, 1960, Giesberteclipta, and Oxylymma Pascoe, 1859 and for parts of Ischasioides Tavakilian & Peñaherrera-Leiva, 2003 and Stultutragus Clarke, 2010. The following new combinations are proposed: Giesberteclipta costipennis (Giesbert, 1991); G. monteverdensis (Giesbert, 1991); Thomasella igniventris (Giesbert, 1991), and Stultutragus romani (Aurivillius, 1919). The following three new country records are reported: Oxylymma durantoni Peñaherrera-Leiva & Tavakilian, 2003 (Brazil), Oxylymma sudrei Peñaherrera-Leiva & Tavakilian, 2003 (Brazil), and Ommata (Eclipta) faurei Peñaherrera-Leiva & Tavakilian, 2003, all from Brazil.
Surface Control of the Frequency of Stratospheric Sudden Warming Events
Authors: Wu Zheng , Reichler Thomas 
Published: May 2019

AbstractThe frequency of stratospheric sudden warming events (SSWs) is an important characteristic of the coupled stratosphere–troposphere system. However, many modern climate models are unable to reproduce the observed SSW frequency. A previous study suggested that one of the reasons could be the momentum damping at the surface. The goal of the present study is to understand what determines the climatological SSW frequency and how the surface damping comes into play. To this end, we conduct a parameter sweep with an idealized model, using a wide range of values for the surface damping. It is found that the SSW frequency is a strong and nonlinear function of the surface damping. Various tropospheric and stratospheric factors are identified to link the surface damping to the SSW frequency. The factors include the magnitude of the surface winds, the meridional and vertical wind shear, the synoptic eddy activity in the troposphere, the transient wave activity flux at the lower stratosphere, and the strength of the stratospheric polar vortex. Mathematical–statistical modeling, informed by the parameter sweep, is used to quantify how the different factors relate to each other. This successfully reproduces the complex variations of the SSW frequency with the surface damping seen in the parameter sweep. The results may help in explaining some of the difficulties that climate models have in simulating the observed SSW frequency.
A Deficit of Seasonal Temperature Forecast Skill over West Coast Regions in NMME
Authors: Zhang Zhenhai , Pierce David W. , Cayan Daniel R. 
Published: May 2019

Abstract
This study investigates the forecast skill of seasonal-mean near-surface (2 m) air temperature in the North American Multimodel Ensemble (NMME) Phase 2, with a focus on the West Coast of the United States. Overall, 1-month lead time NMME forecasts exhibit skill superior or similar to persistence forecasts over many continental regions, and skill is generally higher over the ocean than the continent. However, forecast skill along most West Coast regions is markedly lower than in the adjacent ocean and interior, especially during the warm seasons. Results indicate that the poor forecast skill along the West Coast of the United States reflects deficiencies in their representation of multiple relevant physical processes. Analyses focusing on California find that summer forecast errors are spatially coherent over the coastal region and the inland region individually, but the correlation of forecast errors between the two regions is low. Variation in forecast performance over the coastal California region is associated with anomalous geopotential height over the lower middle latitudes and subtropics of the eastern Pacific, North America, and the western Atlantic. In contrast, variation in forecast performance over the inland California region is associated with the atmospheric circulation over the western United States. Further, it is found that forecast errors along the California coast are linked to anomalies of low cloudiness (stratus clouds) along the coastal region.
Impact of anticoagulation strategy and agents on extracorporeal membrane oxygenation therapy
Authors: Macielak Shea , Burcham Pamela , Whitson Bryan , Abdel-Rasoul Mahmoud , Rozycki Alan 
Published: May 2019

Introduction: Extracorporeal membrane oxygenation mandates balancing the risk of thromboembolic complications with bleeding. We aimed to evaluate pragmatic anticoagulation regimens during extracorporeal membrane oxygenation and compare thromboembolic and bleeding outcomes. Methods: This retrospective, single-center study reviewed patients on venovenous or venoarterial extracorporeal membrane oxygenation for a minimum of 24 hours over a 5-year period. The primary outcome was composite thromboembolic events per day of extracorporeal membrane oxygenation. Secondary outcomes included composite bleeding complications, percent of measured activated partial thromboplastin times in goal range, and comparing events with therapeutic anticoagulation for the majority of the extracorporeal membrane oxygenation run (>50% of time on extracorporeal membrane oxygenation) versus non-therapeutic anticoagulation (therapeutic anticoagulation <50% of time). Results: For the primary analysis, 100 patients received heparin, 10 received bivalirudin, and 43 were transitioned between heparin and bivalirudin. No significant differences were identified comparing the heparin group to the bivalirudin (RR = 0.427, p = 0.156) or transitioned group (RR = 1.274, p = 0.325). There were no differences in the rate of bleeding events when comparing the heparin group to the bivalirudin (RR = 0.626, p = 0.250) or transitioned group (RR = 0.742, p = 0.116). An increased number of adjustments to the anticoagulants was associated with a statistically higher rate of bleeding events per day (p = 0.006). Conclusion: There were no differences in thromboembolic or bleeding events when comparing different anticoagulant regimens. Adjustments to the anticoagulants are more likely to occur when bleeding is observed. Due to variability in anticoagulation, there is a need to standardize anticoagulation with extracorporeal membrane oxygenation.
Palliative care for people with dementia living at home: A systematic review of interventions
Authors: Miranda Rose , Bunn Frances , Lynch Jennifer , Van den Block Lieve , Goodman Claire 
Published: May 2019

Background: The European Association for Palliative Care White Paper defined optimal palliative care in dementia based on evidence and expert consensus. Yet, we know little on how to achieve this for people with dementia living and dying at home. Aims: To examine evidence on home palliative care interventions in dementia, in terms of their effectiveness on end-of-life care outcomes, factors influencing implementation, the extent to which they address the European Association for Palliative Care palliative care domains and evidence gaps. Design: A systematic review of home palliative care interventions in dementia. Data sources: The review adhered to the PRISMA guidelines and the protocol was registered with PROSPERO (CRD42018093607). We searched four electronic databases up to April 2018 (PubMed, Scopus, Cochrane library and CINAHL) and conducted lateral searches. Results: We retrieved eight relevant studies, none of which was of high quality. The evidence, albeit of generally weak quality, showed the potential benefits of the interventions in improving end-of-life care outcomes, for example, behavioural disturbances. The interventions most commonly focused on optimal symptom management, continuity of care and psychosocial support. Other European Association for Palliative Care domains identified as important in palliative care for people with dementia, for example, prognostication of dying or avoidance of burdensome interventions were under-reported. No direct evidence on facilitators and barriers to implementation was found. Conclusions: The review highlights the paucity of high-quality dementia-specific research in this area and recommends key areas for future work, for example, the need for process evaluation to identify facilitators and barriers to implementing interventions.
Food Insecurity and Associated Factors Among University Students
Authors: Ukegbu Patricia , Nwofia Blessing , Ndudiri Uchechi , Uwakwe Nnenna , Uwaegbute Ada 
Published: May 2019

Background: Food insecurity is a growing public health issue and a barrier to students achieving adequate nutrition. Data regarding food insecurity among university students in Nigeria are scarce. Objective: The study assessed the prevalence of food insecurity and associated factors among university students, southeast Nigeria. Methods: A cross-sectional survey of 398 randomly selected students recruited from 2 universities in southeast Nigeria was conducted. Food security status was assessed using the 10-item US Household Food Security Scale Module. Anthropometric measurements and sociodemographic data were collected. Multivariate logistic regression was used to identify factors associated with food insecurity. Results: A majority of the students were categorized as food insecure. Of this, about 35.7% and 45.0% were considered to have low and very low food insecurity, respectively. Food insecurity was significantly associated with monthly allowance, daily amount spent on food, and source of income. The odds of food insecurity was significantly higher for students whose fathers were farmers (4.6, 95% confidence interval [CI]: 1.453-14.737), but lower for those whose mothers were farmers (0.18, 95% CI: 0.059-0.564). Conclusion: The result provides an insight into the food security status of university students in Nigeria. The prevalence of food insecurity was high among the students. Therefore, further studies involving different urban and rural (and/or public and private) universities in Nigeria are suggested in order to have a deeper understanding of the magnitude and contributing factors among this population group.
Clinical Outcomes of Total Ankle Arthroplasty With Total Talar Prosthesis
Authors: Kanzaki Noriyuki , Chinzei Nobuaki , Yamamoto Tetsuya , Yamashita Takahiro , Ibaraki Kazuyuki , Kuroda Ryosuke 
Published: May 2019

Background: Total ankle arthroplasty (TAA) has been developed to treat patients with end-stage ankle osteoarthritis (OA). However, there is often difficulty in treating complicated pathologies such as ankle OA with subtalar joint OA and severe talar collapse. Therefore, this study aimed to explore the short-term results and complications of TAA with total talar prosthesis, known as combined TAA, as the new techniques to treat such complicated pathology. Methods: We examined postoperative results including ankle range of motion, Japanese Society for Surgery of the Foot (JSSF) scale, and complications. There were 22 patients (15 women), with mean follow-up of 34.9 (range, 24–53 months), and the mean age was 72 (range, 62–80) years. The main indications for combined TAA included osteoarthritis (18 patients), rheumatoid arthritis (3 patients), and talar osteonecrosis with osteoarthritis (one patient). Results: The mean range of motion improved from 4.0 to 14.4 degrees in dorsiflexion and from 23.8 to 32.0 degrees in plantarflexion. The JSSF scale improved from 50.5 to 91.5 points. Prolonged wound healing occurred in 3 patients, and medial malleolus fracture occurred in 4 patients. Conclusion: Combined TAA was a reliable procedure for the treatment of not only ankle OA following avascular necrosis of talus but also of degeneration of both ankle and subtalar joints. Level of Evidence: Level IV, case series.
Hemodialysis vascular accesses in patients on chronic hemodialysis at the Kenyatta National Hospital in Kenya
Authors: Kabinga Samuel K , Kayima Joshua K , McLigeyo Seth O , Ndungu John N 
Published: May 2019

Introduction: The objective of our study was to document the level of preparedness for renal replacement therapy assessed by incident hemodialysis vascular access and the access at least 3 months after initiation of hemodialysis at Kenyatta National Hospital, Nairobi. Methods: Between June and July 2018, we carried out a cross-sectional descriptive study on the preparedness for hemodialysis by patients who were on chronic hemodialysis in the Kenyatta National Hospital Renal Department. Sociodemographic, medical history, duration of follow-up, and state of preparedness parameters were obtained through interview and entered into the questionnaire. The data were entered in preprogrammed format in the Statistical Package for the Social Sciences (SPSS) version 20.0 for analyses. Results: Eighty-two patients were enrolled. Males were 50% (41). The mean age was 45.39 ± 15.96 years but females were 5 years younger than their male counterparts. About 85.4% of the patients were drawn from the hypertension and diabetes clinics, and the mean, mode, and median of the duration of follow-up were 41, 0, and 0 months, respectively, in these clinics. Almost three in every four patients (74.4%) were initiated on hemodialysis as emergency (p value < 0.001). About 80% were initiated hemodialysis via acute catheters placed in the jugular and subclavian veins (p value < 0.001). At least 3 months later, 40% still had acute catheters on the same veins (p value < 0.001). Acute venous catheters in the femoral veins were in 9.2% at initiation and 6.6% of the patients at least 3 months later. Less than 2% of the patients had arteriovenous fistulae at initiation, which rose to 14.5% in 3 months. Tunneled catheters were placed in 11.8% initially and at least 3 months, were almost in 40% of the patients. Conclusion: In conclusion, our young hemodialysis population mainly drawn from hypertension and diabetes clinic requires more input in hemodialysis vascular access planning. Focused individualized follow-up and early referrals to nephrologists are required. Uptake of arteriovenous grafts for hemodialysis might reduce the prevalence of hemodialysis catheters. As it is, this population is threatened with iterative vascular accesses complications as well as real danger of exhaustion of their vascular capital. There is real danger of increase in mortality from access complications.
Severe rebound after cessation of fingolimod treated with ocrelizumab with coincidental transient aggravation: report of two cases
Authors: Schmidt Stephan , Schulten Thomas 
Published: May 2019

Background: Fingolimod (FTY), an oral treatment for patients with relapsing-remitting multiple sclerosis (RRMS), has been associated with a significant rebound of disease activity after cessation of therapy. Methods: We present the clinical and radiological findings of two patients with severe rebound after FTY withdrawal, which was further aggravated by the initiation of treatment with the B cell-depleting monoclonal antibody, ocrelizumab. Results: Both patients exhibited significant Expanded Disability Status Scale progression after administration of ocrelizumab despite immune reconstitution more than 3 months after FTY withdrawal. Conclusions: Although the observed effect may be coincidental, ocrelizumab may complicate recovery of rebound after cessation of FTY. Further studies are warranted to better understand and predict the clinical and immunological consequences of sequential immunosuppressive and immunomodulatory treatments in patients with highly active RRMS.
Posterior spinal fusion using a unilateral C1 posterior arch screw and a C2 laminar screw for atlantoaxial fracture dislocation
Authors: Ono Yuichi , Miyakoshi Naohisa , Hongo Michio , Kasukawa Yuji , Ishikawa Yoshinori , Kudo Daisuke , Kimura Ryota , Iida Jumpei , Shimada Yoichi 
Published: May 2019

Introduction: C1 lateral mass screws and C2 pedicle screws are usually chosen to fix atlantoaxial (C1–C2) instability. However, there are a few situations in which these screws are difficult to use, such as in a case with a fracture line at the screw insertion point and bleeding from the fracture site. A new technique using a unilateral C1 posterior arch screw and a C2 laminar screw combined with a contralateral C1 lateral mass screws–C2 pedicle screws procedure for upper cervical fixation is reported. Case Report: A 24-year-old woman had an irreducible C1–C2 anterior dislocation with a type III odontoid fracture on the right side due to a traffic accident. The patient underwent open reduction and posterior C1–C2 fixation. On the left side, a C1 lateral mass screws and a C2 pedicle screws were placed. Because there was bleeding from the fracture site and a high-riding vertebral artery was seen on the right side, a C1 posterior arch screw and a C2 laminar screw were chosen. Eight months after the surgery, computed tomography scans showed healing of the odontoid fracture with anatomically correct alignment. Conclusions: Although there have been few comparable studies, fixation with unilateral C1 posterior arch screw–C2 laminar screw could be a beneficial choice for surgeries involving the upper cervical region in patients with fracture dislocation or arterial abnormalities.
The Impact of Frailty on Short-Term Outcomes After Elective Hip and Knee Arthroplasty in Older Adults: A Systematic Review
Authors: Schmucker Abigail M. , Hupert Nathaniel , Mandl Lisa A. 
Published: May 2019

Introduction: This systematic literature review evaluates (1) frailty in older adults as a risk factor for short-term adverse events and suboptimal clinical outcomes after total joint arthroplasty and (2) interventions to improve arthroplasty outcomes in these frail patients. Methods: PubMed, EMBASE, Cochrane Register of Controlled Trials, SCOPUS, AgeLine, and Web of Science were searched from database inception to November 22, 2017; gray literature and references were also searched. Studies including adults ≥65 years of age undergoing hip or knee arthroplasty and measuring preoperative frailty and postoperative adverse events or clinical outcomes within 90 days of surgery were included. Two investigators independently screened all abstracts and extracted data; disagreements were adjudicated by a third reviewer. Risk of bias was assessed using the Newcastle–Ottawa scale for cohort studies and the Cochrane Risk of Bias tool for randomized controlled trials. Study quality was assessed using a 5-point scale modified from the Oxford Centre for Evidence-Based Medicine tool. Results: Of 1913 abstracts identified, 82 full texts were reviewed, and 13 met inclusion criteria: 5 prospective cohort studies, 6 retrospective cohort studies, and 2 randomized controlled trials covering 382 763 total patients. These studies used 13 frailty instruments and assessed 32 distinct outcomes. Substantial heterogeneity precluded valid meta-analysis; results were qualitatively summarized by study design, frailty instrument, and outcome type. Of the 11 cohort studies, 10 found significant associations between frailty and poor postoperative outcomes. Trials of preoperative frailty-modifying interventions found no association between interventions and improved outcomes. Discussion: Standardizing frailty measurement would improve generalizability, permitting the assessment of associations with patient-reported and functional outcome measures, as well as the efficacy of interventions to improve outcomes, in frail patients undergoing arthroplasty. Conclusions: Frailty is associated with higher rates of short-term adverse events and worse clinical outcomes after elective hip and knee arthroplasty.
The cullin4A is up-regulated in chronic obstructive pulmonary disease patient and contributes to epithelial-mesenchymal transition in small airway epithelium
Authors: Ren Yidan , Zhang Yi , Fan Lixia , Jiao Qinlian , Wang Yunshan , Wang Qin 
Published: May 2019

Abstract
Background
Chronic obstructive pulmonary disease (COPD) is a common respiratory disease with high morbidity and mortality. The most important pathophysiological change of COPD is airway obstruction. Airway obstruction can cause airflow restriction and obstructive ventilation dysfunction. Currently, many studies have shown that there is EMT phenomenon in the process of airway remodeling of COPD. Cullin4A (CUL4A) is an E3 ubiquitin ligase that interacts with other factors to form the E3 complex. Studies have shown that CLU4A is associated with EMT in non-small cell lung cancer and other cancers. However, its relationship with EMT in COPD has not been reported systematically. In this study, we detected the expression of CUL4A in lung epithelium of COPD patients. In addition, the regulatory effect and mechanism of CUL4A on EMT in COPD were clarified in small airway epithelial cells.

Methods
The expression of CUL4A was assessed by immunohistochemistry in lung epithelium specimens from smokers, non-smokers and patients with chronic obstructive pulmonary disease. The role of CUL4A on cigarette smoke extract (CSE)-induced epithelial-mesenchymal transition (EMT) in human small airway epithelial cells (HSAEpiCs) was assessed by silencing or overexpression CUL4A in vitro. Cigarette smoke is recognized as a high-risk factor in the induction of COPD, and its damage to the airway involves airway damage, airway inflammation and airway remodeling.

Results
The results shown that CUL4A expression in small airway epithelium was significantly increased in patients with COPD. We also observed a significant negative association between CUL4A and FEV1%, a useful clinical marker for the diagnosis and evaluation of COPD severity, in small airway epithelial cells. In vitro, CSE-induced EMT is associated with high expression of CUL4A, and targeted silencing of CUL4A with shRNA inhibits CSE-induced EMT in human small airway epithelial cells.

Conclusions
Our results showed that CUL4A was overexpressed in lung epithelium of COPD patients, and CUL4A could regulate EMT of human small airway epithelium, which revealed a new mechanism of remodeling of small airway epithelium of COPD patients.