bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tornado-Resolving Ensemble and Probabilistic Predictions of the 20 May 2013 Newcastle–Moore EF5 Tornado
Authors: Snook Nathan , Xue Ming , Jung Youngsun 
Published: February 2019

AbstractAn ensemble of 10 forecasts is produced for the 20 May 2013 Newcastle–Moore EF5 tornado and its parent supercell using a horizontal grid spacing of 50 m, nested within ensemble forecasts with 500-m horizontal grid spacing initialized via ensemble Kalman filter data assimilation of surface and radar observations. Tornadic circulations are predicted in all members, though the intensity, track, and longevity of the predicted tornado vary substantially among members. Overall, tornadoes in the ensemble forecasts persisted longer and moved to the northeast faster than the observed tornado. In total, 8 of the 10 ensemble members produce tornadoes with winds corresponding to EF2 intensity or greater, with maximum instantaneous near-surface horizontal wind speeds of up to 130 m s−1 and pressure drops of up to 120 hPa; values similar to those reported in observational studies of intense tornadoes. The predicted intense tornadoes all acquire well-defined two-cell vortex structure, and exhibit features common in observed tornadic storms, including a weak-echo notch and low reflectivity within the mesocyclone. Ensemble-based probabilistic tornado forecasts based upon near-surface wind and/or vorticity fields at 10 m above the surface produce skillful forecasts of the tornado in terms of area under the relative operating characteristic curve, with probability swaths extending along and to the northeast of the observed tornado path. When probabilistic swaths of 0–3- and 2–5-km updraft helicity are compared to the swath of wind at 10 m above the surface exceeding 29 m s−1, a slight northwestward bias is present, although the pathlength, orientation, and the placement of minima and maxima show very strong agreement.
Sensitivities of the NCEP Global Forecast System
Authors: Wang Jih-Wang A. , Sardeshmukh Prashant D. , Compo Gilbert P. , Whitaker Jeffrey S. , Slivinski Laura C. , McColl Chesley M. , Pegion Philip J. 
Published: February 2019

AbstractAn important issue in developing a forecast system is its sensitivity to additional observations for improving initial conditions, to the data assimilation (DA) method used, and to improvements in the forecast model. These sensitivities are investigated here for the Global Forecast System (GFS) of the National Centers for Environmental Prediction (NCEP). Four parallel sets of 7-day ensemble forecasts were generated for 100 forecast cases in mid-January to mid-March 2016. The sets differed in their 1) inclusion or exclusion of additional observations collected over the eastern Pacific during the El Niño Rapid Response (ENRR) field campaign, 2) use of a hybrid 4D–EnVar versus a pure EnKF DA method to prepare the initial conditions, and 3) inclusion or exclusion of stochastic parameterizations in the forecast model. The Control forecast set used the ENRR observations, hybrid DA, and stochastic parameterizations. Errors of the ensemble-mean forecasts in this Control set were compared with those in the other sets, with emphasis on the upper-tropospheric geopotential heights and vorticity, midtropospheric vertical velocity, column-integrated precipitable water, near-surface air temperature, and surface precipitation. In general, the forecast errors were found to be only slightly sensitive to the additional ENRR observations, more sensitive to the DA methods, and most sensitive to the inclusion of stochastic parameterizations in the model, which reduced errors globally in all the variables considered except geopotential heights in the tropical upper troposphere. The reduction in precipitation errors, determined with respect to two independent observational datasets, was particularly striking.
Diabetes Self-Management Behaviors, Health Care Access, and Health Perception in Mexico-US Border States
Authors: McEwen Marylyn M. , Pasvogel Alice , Elizondo-Pereo Rogelio , Meester Irene , Vargas-Villarreal Javier , González-Salazar Francisco 
Published: February 2019

Purpose The purpose of this study was to describe diabetes self-management behaviors, diabetes health care access, and health perception for Mexican adults and Hispanics residing in the Mexico-US border region. Methods This study used data from the Behavior Risk Factor Surveillance System (BRFSS) survey diabetes items (n = 26) to assess characteristics of Hispanics in 4 Arizona border counties (n = 216) and cross-sectional data from a modified BRFSS in a convenience sample of adults residing in Monterrey, Mexico (n = 351). Data were analyzed for descriptive statistics with SPSS. Results The Mexico cohort was younger than the Arizona cohort (59.36 [11.5] vs 65.54 [11.1], respectively) and the mean length of time with type 2 diabetes was similar. Less than 10% (9.7%) of the Arizona cohort reported never monitoring blood glucose compared to 22.5% of the Mexico cohort. The mean (SD) number of times in the past 12 months the Mexico cohort saw their health care provider was 9.09 (6.8) vs 4.49 (8.3) for the Arizona cohort. Despite provider access, there were differences in self-management behaviors between the cohorts. Conclusions Due to environmental and policy factors in the Mexico-US border region, there continues to be a gap in evidence-based practice and uptake of self-management behaviors for adults with diabetes. Resources such as the BRFSS and shared practice guidelines would bridge this gap.
Comparison of two cardiopulmonary bypass strategies with a miniaturized tubing system: a propensity score–based analysis
Authors: Zhang Cheng , Meng Baoying , Wu Keye , Ding Yiqun 
Published: February 2019

Introduction: The existing cardiopulmonary bypass tubing system has already been significantly improved in our hospital by reducing the priming volume; thus, we further employed a new cardiopulmonary bypass strategy in children based on a miniaturized cardiopulmonary bypass circuit. We aimed to compare the effectiveness of new and conventional strategies by analyzing the outcomes after congenital heart surgery. Methods: We performed a database analysis of all patients undergoing congenital heart surgery with cardiopulmonary bypass at Shenzhen Children’s Hospital from 1 May 2015 to 30 June 2017. Propensity score matching was used to adjust for significant covariates, and multivariable regression models and stratified analysis were used to assess the association of cardiopulmonary bypass strategy with outcomes. Results: Of 925 total patients, 55.35% were in the conventional strategy group and 44.65% were in the new strategy group. After propensity score matching, there were 610 patients in total, with 305 patients in each group. In the multivariable regression models, the cardiopulmonary bypass strategy was not significantly associated with successful early extubation (p > 0.05), reintubation (p > 0.05), or nasal continuous positive airway pressure (p > 0.05) rates. The new strategy group had fewer hospital stays (p = 0.04) and intensive care unit stays (p < 0.05) compared with patients who underwent conventional strategy. The difference remained statistically significant (p < 0.05) when The Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery category was <3. Conclusion: The implementation of a new cardiopulmonary bypass strategy, with selective ultrafiltration based on a miniaturized cardiopulmonary bypass circuit system, was safe and effective for children who underwent congenital heart surgery in a Chinese hospital. The new cardiopulmonary bypass strategy was associated with fewer hospital and intensive care unit stays.
Tamoxifen for bipolar disorder: Systematic review and meta-analysis
Authors: Palacios Jorge , Yildiz Ayşegül , Young Allan H , Taylor Matthew J 
Published: February 2019

Background: Tamoxifen is an oral medication that has been proposed as a potential treatment for bipolar disorder. Tamoxifen acts to inhibit the intracellular action of protein kinase C, which is also an action of well-established treatments such as lithium and valproate. Here we aimed to identify randomised controlled trials (RCTs) of tamoxifen in the treatment of bipolar disorder and synthesise their results using meta-analysis. Methods: RCTs were identified by searching of electronic databases and from discussion with experts in the field. Data were extracted, and meta-analyses performed in R. Results: Five placebo-controlled RCTs of tamoxifen in the treatment of acute mania were identified. There were no trials in the treatment of episodes of bipolar depression, or for relapse prevention. The studies of mania treatment were of between three and six weeks duration. Tamoxifen was studied either as monotherapy (two trials) or as augmentation of lithium or valproate (three trials). Change in mania scale scores favoured tamoxifen over placebo: SMD −2.14 (95% CI −3.39 to −0.89; 4 trials), as did endpoint mania scale scores SMD 1.23 (95% CI 0.60–1.87; 5 trials). Response rates were also higher: RR 4.35 (1.99–9.50; 4 trials). Acceptability was similar to placebo: RR 1.03 (0.94–1.13; 5 trials). Conclusions: Tamoxifen appears to be a promising potential treatment for episodes of mania. Future studies could investigate its effects as an adjunct to dopamine antagonists for improved anti-manic efficacy, and establish its longer term effects on mood, particularly depression and relapse.
Incidence and predictors of aorta calcification in patients with systemic lupus erythematosus
Authors: Hu L , Chen Z , Jin Y , Jiang B , Wang X , Yu H , Yang X 
Published: February 2019

Objective Artery calcification, as subclinical atherosclerosis, is attracting attention. The aim of this study was to determine the prevalence and risk factors of artery calcification in patients with systemic lupus erythematosus. Methods 641 patients with systemic lupus erythematosus were enrolled in the study. Demographic, clinical, and laboratory characteristics were collected. Calcification score was quantified from the multi-detector computed tomography scan image using the Agatston Score method. Results The total incidence of artery calcification was 25.9% (166/641), of which the percentages of aorta calcium and coronary artery calcification were 23.1% (148/641) and 8.4% (54/641), respectively. In multivariate models, systemic lupus erythematosus patients with artery calcification had longer disease duration than patients without artery calcification ( p < 0.05). Presence of serositis (OR 2.559, 95%CI 1.414–4.632), pneumonia (OR 2.022, 95%CI 1.102–3.711) and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score (OR 1.049, 95%CI 1.004–1.095) were independently associated with increased risk of aorta calcium, while the duration of corticosteroids use (OR 1.039, 95%CI 1.002–1.078) and cyclophosphamide therapy (OR 8.251, 95%CI 2.496–27.279) were independently associated with increased risk of coronary artery calcification in systemic lupus erythematosus patients. In systemic lupus erythematosus patients, aorta calcium was prone to occur at a younger age compared to coronary artery calcification, and aorta calcium score was positively correlated with age. Conclusions Systemic lupus erythematosus patients had a much earlier onset and higher incidences of aorta calcium than coronary artery calcification. Presence of serositis, pneumonia, and higher SLEDAI score may predict increased risk of aorta calcium.
Peripheral nervous system involvement in systemic lupus erythematosus: a retrospective study on prevalence, associated factors and outcome
Authors: Bortoluzzi A , Piga M , Silvagni E , Chessa E , Mathieu A , Govoni M 
Published: February 2019

Background Despite its potentially significant impact on disease outcome, peripheral nervous system involvement in systemic lupus erythematosus has received little attention. Objective The objective of this study was to assess the prevalence and clinical features of peripheral nervous system involvement in a large cohort of systemic lupus erythematosus patients. Methods The records of systemic lupus erythematosus patients examined at two tertiary referral centres over a period of 14 years (from 2000 to 2014) were analyzed. Peripheral nervous system events were ascertained according to the 1999 American College of Rheumatology case definitions and by using an attribution algorithm for neuropsychiatric events. Prevalence of peripheral nervous system in systemic lupus erythematosus and demographic, clinical and laboratory features were assessed. Patients with peripheral nervous system events were compared with a control group of systemic lupus erythematosus patients without peripheral nervous system involvement. Results In a retrospective cohort of 1224 patients, the overall prevalence of peripheral nervous system involvement was 6.9% (85 patients, 95% confidence interval 0.06–0.08), with 68% of peripheral nervous system events attributable to systemic lupus erythematosus. Polyneuropathy was the most common manifestation observed (38 events, 39.2%), followed by cranial neuropathy in 30 cases (30.9%) and 12 cases of single (12.4%) or multiple (eight events, 8.2%) mononeuritis. The average age of systemic lupus erythematosus onset was significantly higher in patients with peripheral nervous system events than in controls (mean ± standard deviation: 45.9 ± 14.8 vs. 37.1 ± 14.0) and they were more likely to have higher SLEDAI-2K and SLICC/ACR Damage Index scores, as well as hypertension and livedo reticularis. A subgroup analysis of events deemed to be systemic lupus erythematosus-related provided similar results. Conclusion Peripheral nervous system manifestations are a potential complication of systemic lupus erythematosus. Careful neurological assessment should therefore be included in the diagnostic workup of patients with systemic lupus erythematosus, especially in those with later onset and greater damage and disease activity.
Induced expression of Toll-like receptor 9 in peritubular capillary endothelium correlates with the progression of tubulointerstitial lesions in autoimmune disease-prone mice
Authors: Masum M A , Ichii O , ELewa Y H A , Kon Y 
Published: February 2019

Background Toll-like receptor (Tlr) 9 is capable of recognizing exogenous and/or endogenous nucleic acids and plays a crucial role in innate and adaptive immunity. Recently, we showed that Tlr9 is overexpressed in podocytes, a component of the blood–urine barrier (BUB), in glomeruli of autoimmune glomerulonephritis (AGN) model mice. This study investigated the activation of peritubular capillary (PTC) endothelial cells (ECs), a component of the BUB in the tubulointerstitium, through overexpressing Tlr9, and the subsequent development of tubulointerstitial lesions (TILs) in AGN model mice. Methods Lupus-prone BXSB/MpJ-Yaa (Yaa) and BXSB/MpJ (BXSB) mice were used as an AGN model and control, respectively. In addition to histopathological and ultrastructural techniques, protein and mRNA levels were also evaluated. The relationship between Tlr9 and TIL indices was analyzed by statistical correlation analysis. Results Yaa mice developed TILs and showed strong Tlr9 mRNA expression in PTC ECs at 24 weeks (wks) of age. However, BXSB mice showed no TIL but faint expression of Tlr9 mRNA at 8 and 24 wks of age. Tlr9 protein localization on PTC was almost absent in BXSB mice at both ages but intense expression was found in Yaa mice only at 24 wks of age. Relative mRNA expression of Tlr9 and its putative downstream cytokines, including interleukin 1 beta ( Il1b), Il6, interferon gamma ( Ifng), and tumor necrosis factor alpha ( Tnf) was markedly increased in isolated tubulointerstitium from Yaa mice at 24 wks of age. Furthermore, electron microscopy examination revealed PTC injury and TIL in Yaa mice at 24 wks. The expression level of Tlr9 in the tubulointerstitium was correlated with inflammatory cells in TILs, injured PTC, Ilb and Tnf expression, and damaged tubules ( P < 0.05 and 0.01). Conclusion Induced expression of Tlr9 in ECs correlates with PTC injury and the development of TILs in lupus-prone AGN model mice.
Effect of disease-modifying therapies on subcortical gray matter atrophy in multiple sclerosis
Authors: Sotirchos Elias S , Gonzalez-Caldito Natalia , Dewey Blake E , Fitzgerald Kathryn C , Glaister Jeffrey , Filippatou Angeliki , Ogbuokiri Esther , Feldman Sydney , Kwakyi Ohemaa , Risher Hunter , Crainiceanu Ciprian , Pham Dzung L , Van Zijl Peter C , Mowry Ellen M , Reich Daniel S , Prince Jerry L , Calabresi Peter A , Saidha Shiv 
Published: February 2019

Background: The effects of disease-modifying therapies (DMTs) on region-specific brain atrophy in multiple sclerosis (MS) are unclear. Objective: To determine the effects of higher versus lower efficacy DMTs on rates of brain substructure atrophy in MS. Methods: A non-randomized, observational cohort of people with MS followed with annual brain magnetic resonance imaging (MRI) was evaluated retrospectively. Whole brain, subcortical gray matter (GM), cortical GM, and cerebral white matter (WM) volume fractions were obtained. DMTs were categorized as higher (DMT-H: natalizumab and rituximab) or lower (DMT-L: interferon-beta and glatiramer acetate) efficacy. Follow-up epochs were analyzed if participants had been on a DMT for ⩾6 months prior to baseline and had at least one follow-up MRI while on DMTs in the same category. Results: A total of 86 DMT epochs (DMT-H: n = 32; DMT-L: n = 54) from 78 participants fulfilled the study inclusion criteria. Mean follow-up was 2.4 years. Annualized rates of thalamic (−0.15% vs −0.81%; p = 0.001) and putaminal (−0.27% vs −0.73%; p = 0.001) atrophy were slower during DMT-H compared to DMT-L epochs. These results remained significant in multivariate analyses including demographics, clinical characteristics, and T2 lesion volume. Conclusion: DMT-H treatment may be associated with slower rates of subcortical GM atrophy, especially of the thalamus and putamen. Thalamic and putaminal volumes are promising imaging biomarkers in MS.
The efficacy of the modified Story Memory Technique in progressive MS
Authors: Chiaravalloti Nancy D , Moore Nancy B , DeLuca John 
Published: February 2019

Background: Impairments in new learning and memory are common in individuals with multiple sclerosis (MS), negatively impacting everyday life, including occupational and social functioning. Objective: This study examined the efficacy of the modified Story Memory Technique (mSMT) in a progressive multiple sclerosis (PMS) sample through a double-blind, placebo-controlled, randomized clinical trial (RCT). Methods: Thirty (30) individuals with PMS, naïve to the mSMT, were randomized to the treatment or placebo control group. The Treatment Group completed mSMT training twice per week for 5 weeks while the Placebo Group met with the therapist at the same frequency, engaging in non-training-oriented tasks to control for professional contact and disease alterations. Results: The treatment group showed significant improvements in learning compared with the placebo control group, evident on both objective evaluation of new learning and self-report of functioning in daily life. Increased awareness of cognitive deficits was also noted post-treatment. Conclusion: These data provide Class I evidence supporting the efficacy of the mSMT in PMS. A behavioral intervention, targeted to specifically strengthen new learning, can significantly improve memory performance in PMS, and this improvement in memory performance is maintained 3 months later.
Why are acute ischemic stroke patients not receiving thrombolysis in a telestroke network?
Authors: Nalleballe Krishna , Sharma Rohan , Kovvuru Sukanthi , Brown Aliza , Sheng Sen , Gundapaneni Sukumar , Ranabothu Saritha , Veerapaneni Poornachand , Joiner Renee , Kapoor Nidhi , Culp William , Onteddu Sanjeeva 
Published: February 2019

Objective The purpose of this study was to determine reasons for not giving intravenous tissue plasminogen activator to eligible patients with acute ischemic stroke in a telestroke network. Methods We performed a retrospective analysis of prospectively collected data of patients who were seen as a telestroke consultation during 2015 and 2016 with the Arkansas Stroke Assistance through Virtual Emergency Support programme for possible acute ischemic stroke. Results Total consultations seen were 809 in 2015 and 744 in 2016, out of which 238 patients in 2015 and 247 patients in 2016 received intravenous tissue plasminogen activator. In 2015 and 2016, out of the remaining 571 and 497 patients, 294 and 200 patients respectively were thought to be cases of acute stroke based on clinical evaluation. The most common reasons for not being treated in 2015 and 2016, respectively, were; (a) minimal deficits in 42.17% and 49.5% cases, (b) falling out of the 4.5-hour time window in 22.44% and 22% cases, (c) patient/next of kin refusal in 18.02% and 16.5% cases. Less common reasons included limited functional status, abnormal labs (thrombocytopenia, elevated international normalised ratio (INR)/prothrombin time (PT)/partial thromboplastin time (PTT), hypo or hyperglycemia etc), recent surgery and symptoms being too severe etc. Conclusion ‘Minimal deficits’ and ‘out of time window’ continue to be the major causes for not receiving thrombolysis during acute ischemic stroke in both traditional and telestroke systems. Patient/next of kin refusal was high in our telestroke system when compared to traditional practices. Considering the increasing utility of telestroke this needs to be further looked into, along with the ways to address it.
Like in English and como, como que, and like in Spanish in the speech of Southern Arizona bilinguals
Authors: Kern Joseph 
Published: February 2019

Aims and Objectives/Purpose/Research Questions: This study analyzes the use of like in English and como, como que, and like in Spanish in the speech of bilinguals from Southern Arizona to assess the possible influence of like in English on its equivalents in Spanish in a language contact situation in which English is the majority language. Design/Methodology/Approach: Drawing on a discourse-pragmatic variationist approach, this study analyzes the use of like in English and its Spanish equivalents in recorded conversations between nine pairs of young Spanish-English bilingual friends from Southern Arizona. Data and Analysis: 3389 tokens of like in English and its Spanish equivalents from 18 hours of recorded conversations (9 hours in each language) were analyzed quantitatively. The analysis assesses the relative frequencies of these variants and their syntactic positioning as clause-external discourse markers and clause-internal discourse particles. The independent variables of the analysis were the language of the conversation and the sex and language dominance of the participants. Findings/Conclusions: Contact with English did not appear to radically influence the use of como, como que, and like in Spanish in the speech of these bilinguals. In the speech of the same bilinguals, like in English was much more frequent and occurred in many more syntactic positions than its Spanish equivalents. Originality: This is the first study of discourse-pragmatic features in contact to analyze the use of discourse markers and discourse particles in both the donor and the recipient language in the speech of the same bilinguals. Significance/Implications: These results contribute to our knowledge of the limited interaction of linguistic repertoires in the speech of bilinguals at the discourse level even in language contact situations with a majority language. They also underline the ability of bilinguals to both understand and reproduce the subtleties of the use of these features in the two languages they speak.