bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dog Ownership and Survival After a Major Cardiovascular Event
Authors: Mubanga Mwenya , Byberg Liisa , Egenvall Agneta , Ingelsson Erik , Fall Tove 
Published: October 2019

Background:
Dog ownership is associated with increased physical activity levels and increased social support, both of which could improve the outcome after a major cardiovascular event. Dog ownership may be particularly important in single-occupancy households where ownership provides substitutive companionship and motivation for physical activity.

Methods and Results:
We used the Swedish National Patient Register to identify all patients aged 40 to 85 presenting with an acute myocardial infarction (n=181 696; 5.7% dog ownership) or ischemic stroke (n=154 617; 4.8% dog ownership) between January 1, 2001 and December 31, 2012. Individual information was linked across registers for cause of death, sociodemographic, and dog ownership data. We evaluated all-cause mortality and risk of recurrent hospitalization for the same cause until December 31, 2012. Models were adjusted for socioeconomic, health, and demographic factors at study inclusion such as age, marital status, the presence of children in the home, area of residence, and income, as well as all registered comorbidities and hospitalization for cardiovascular disease in the past 5 years. Dog owners had a lower risk of death after hospitalization for acute myocardial infarction during the full follow-up period of 804 137 person-years, with an adjusted hazard ratio (HR) of 0.67 (95% CI, 0.61 to 0.75) for those who lived alone, and HR of 0.85 (95% CI, 0.80 to 0.90) for those living with a partner or a child. Similarly, after an ischemic stroke, dog owners were at lower risk of death during the full follow-up of 638 219 person-years adjusted HR of 0.73 (95% CI, 0.66 to 0.80) for those who lived alone and HR of 0.88 (95% CI, 0.83 to 0.93) for those living with a partner or a child. We further found an association of dog ownership with reduced risk of hospitalization for recurrent myocardial infarction (HR, 0.93; 95% CI, 0.87 to 0.99).

Conclusions:
We found evidence of an association of dog ownership with a better outcome after a major cardiovascular event. Although our models are adjusted for many potential confounders, there are also unmeasured confounders such as smoking that prevent us from drawing conclusions regarding a possible causal effect.
North Atlantic Integrated Water Vapor Transport—From 850 to 2100 CE: Impacts on Western European Rainfall
Authors: Sousa Pedro M. , Ramos Alexandre M. , Raible Christoph C. , Messmer M. , Tomé Ricardo , Pinto Joaquim G. , Trigo Ricardo M. 
Published: October 2019

AbstractMoisture transport over the northeastern Atlantic Ocean is an important process governing precipitation distribution and variability over western Europe. To assess its long-term variability, the vertically integrated horizontal water vapor transport (IVT) from a long-term climate simulation spanning the period 850–2100 CE was used. Results show a steady increase in moisture transport toward western Europe since the late-nineteenth century that is projected to expand during the twenty-first century under the RCP8.5 scenario. The projected IVT for 2070–99 significantly exceeds the range given by interannual–interdecadal variability of the last millennium. Changes in IVT are in line with significant increases in tropospheric moisture content, driven by the concurrent rise in surface temperatures associated with the anthropogenic climate trend. On regional scales, recent and projected precipitation changes over the British Isles follow the global positive IVT trend, whereas a robust precipitation decrease over Iberia is identified in the twenty-first century, particularly during autumn. This indicates a possible extension of stable and dry summer conditions and a decoupling between moisture availability and dynamical forcing. The investigation of circulation features reveals a mean poleward shift of moisture corridors and associated atmospheric rivers. In particular, in Iberia, a significant increase in the frequency of dry weather types is observed, accompanied by a decrease in the frequency of wet types. An opposite response is observed over the British Isles. These changes imply a stronger meridional north–south dipole in terms of pressure and precipitation distributions, enhancing the transport toward central Europe rather than to Iberia.
An Investigation of Large Along-Track Errors in Extratropical Transitioning North Atlantic Tropical Cyclones in the ECMWF Ensemble
Authors: Leonardo Nicholas M. , Colle Brian A. 
Published: October 2019

AbstractThe synoptic evolution and mechanisms for the largest medium-range (72–120 h) along-track errors of tropical cyclones (TC) are investigated. The mean along-track errors (ATEs) of the 51-member European Centre for Medium-Range Weather Forecasts (ECMWF) ensemble are evaluated for 393 forecasts (85 TCs) during the 2008 to 2016 North Atlantic seasons. The 27 unique forecasts within the upper quintile of most negative ATEs (i.e., slow bias greater than 500 km by 72 h) are inherently fast-moving TCs that undergo extratropical transition as they recurve and interact with a 300-hPa upstream trough and a downstream ridge. Both the trough and ridge are underamplified by only 5–10 m ~60 h before the time of largest ATE. The height errors then grow rapidly due to underpredicted 300–200-hPa potential vorticity advection by both the nondivergent wind and the irrotational wind from the TC’s outflow. Both wind components are underpredicted and result in weak biases in the trough’s developing potential vorticity gradient and associated jet streak. The underamplification of the upstream trough is exacerbated by underpredicted 700-hPa cold advection extending from beneath the trough into the TC at 48–36 h before the largest ATE. Standardized differences are consistent with the mean errors and reveal that weaker divergent outflow is driven by underpredicted near-TC precipitation, which corresponds to underpredicted 700-hPa moisture fluxes near the TC at ~108 h before the largest ATE. The ensemble member ATEs at 72–120 h generally show little correlation with their ATEs before 36 h, suggesting that initial position uncertainty is not the primary source of ATE variability later in the forecast.
Moxetumomab pasudotox for hairy cell leukemia: preclinical development to FDA approval
Authors: Lin Adam Yuh , Dinner Shira Naomi 
Published: October 2019

AbstractMoxetumomab pasudotox (MP) is an immunotoxin that recently received US Food and Drug Administration (FDA) approval for the treatment of hairy cell leukemia (HCL) that has failed at least 2 prior lines of therapy, including a purine analog. MP is a recombinant immunotoxin that consists of an anti-CD22 immunoglobulin variable domain genetically joined to Pseudomonas exotoxin (PE38). Unlike most antibody-drug conjugates, which use a chemical linker, recombinant DNA techniques are used to produce MP. MP and its predecessor, BL22, were initially developed to treat non-Hodgkin lymphoma, acute lymphoblastic leukemia, and HCL. However, MP was found to be particularly effective in HCL due to the high level of CD22 cell-surface expression. The recent pivotal phase 3 trial of MP in relapsed/refractory HCL demonstrated a durable complete remission rate of 30%, and 85% of complete responders achieved minimal residual disease negativity, which is associated with improved disease-free survival outcomes in HCL. In addition to an exceptional depth of response, MP appears to be less immunosuppressive than purine analogs. MP is generally well tolerated but has unique toxicities, including capillary leak syndrome and hemolytic uremic syndrome, which are poorly understood. This review will encompass the preclinical and clinical development of MP, with particular attention to its current indication in HCL.
An updated phytoplankton check-list for the Helgoland Roads time series station with eleven new records of diatoms and dinoflagellates
Authors: Kraberg Alexandra , Kieb Ute , Peters Silvia , Wiltshire Karen Helen 
Published: October 2019

Abstract
The Helgoland Roads time series is one of the longest and most detailed time series in the world. It comprises daily phytoplankton counts accompanied by physico-chemical measurements. As such, it provides valuable long-term record of changes and their underlying causes in the phytoplankton community around Helgoland. This work provides an updated check-list of the phytoplankton species encountered at the Helgoland Roads LTER station with additional taxonomic assessments from live net samples and scanning electron microscope surveys. Since the last check-list was published 11 additional taxa have been recorded for the first time comprising 9 diatom and 2 dinoflagellate species. Of the 9 diatom species 3 were Chaetoceros species: Chaetoceros anastomosans, C. pseudocurvisetus and C. lorenzianus (the latter identified by their resting cysts) which were all first recognised in September 2009. The toxic dinoflagellate Dinophysis tripos, and the bipolar centric diatom Odontella longicruris both were first observed in September 2015. The latest new record is the potentially toxic dinoflagellate Alexandrium ostenfeldii, first recorded in August 2017. All of the first records (with the exception of Dinophysis tripos) were first observed in semi-quantitative surveys based on live samples and SEM demonstrating that adding less frequent but very detailed assessments can complement high frequency counts of fixed samples as long as these data of different origin are linked efficiently to the individual sampling event and all metadata including representative pictorial metadata are recorded in a consistent manner. In this manner the enhanced checklist serves as a baseline against which long-term changes in phytoplankton potentially related to ecosystem state can be addressed.
Heterogeneous BCR-ABL1 signal patterns identified by fluorescence in situ hybridization are associated with leukemic clonal evolution and poorer prognosis in BCR-ABL1 positive leukemia
Authors: Zhang Zhanglin , Chen Zhiwei , Jiang Mei , Liu Shuyuan , Guo Yang , Wan Lagen , Li Fei 
Published: October 2019

Abstract

Background
Although extensive use of tyrosine kinase inhibitors has resulted in high and durable response rate and prolonged survival time in patients with BCR-ABL1 positive chronic myeloid leukemia (CML) and acute leukemia, relapse and drug resistance still remain big challenges for clinicians. Monitoring the expression of BCR-ABL1 fusion gene and identifying ABL kinase mutations are effective means to predict disease relapse and resistance. However, the prognostic impact of BCR-ABL1 signal patterns detected by fluorescence in situ hybridization (FISH) remains largely unaddressed.

Methods
BCR-ABL1 signal patterns were analyzed using FISH in 243 CML-chronic phase (CML-CP), 17 CML-blast phase (CML-BP) and 52 BCR-ABL1 positive acute lymphoblastic leukemia (ALL) patients.

Results
The patterns of BCR-ABL1 signals presented complexity and diversity. A total of 12 BCR-ABL1 signals were observed in this cohort, including 1R1G2F, 1R1G1F, 2R1G1F, 1R2G1F, 2R2G1F, 1R2G2F, 1R1G3F, 1G3F, 2G3F, 1G4F, 1R1G4F and 1R4F. Complex BCR-ABL1 signal patterns (≥ two types of signal patterns) were observed in 52.9% (n = 9) of the CML-BP patients, followed by 30.8% (n = 16) of the ALL patients and only 2.1% (n = 5) of the CML-CP patients. More importantly, five clonal evolution patterns related to disease progression and relapse were observed, and patients with complex BCR-ABL1 signal patterns had a poorer overall survival (OS) time compared with those with single patterns (5.0 vs.15.0 months, p = 0.006).

Conclusions
Our data showed that complex BCR-ABL1 signal patterns were associated with leukemic clonal evolution and poorer prognosis in BCR-ABL1 positive leukemia. Monitoring BCR-ABL1 signal patterns might be an effective means to provide prognostic guidance and treatment choices for these patients.
Imaging of shoulder arthroplasties and their complications: a pictorial review
Authors: Combes Damien , Lancigu Romain , Desbordes de Cepoy Patrick , Caporilli-Razza Filippo , Hubert Laurent , Rony Louis , Aubé Christophe 
Published: October 2019

Abstract
Currently, an increasing number of patients benefit from shoulder prosthesis implantation. Radiologists are therefore more often confronted with imaging examinations involving shoulder arthroplasty, whether during a dedicated examination or incidentally. Standard radiography is the first-line imaging modality in the follow-up of these implants, before the possible use of cross-sectional imaging modalities (computed tomography and magnetic resonance imaging), ultrasound, or nuclear medicine examinations. Shoulder arthroplasties are divided into three categories: reverse shoulder arthroplasty, total shoulder arthroplasty, and partial shoulder joint replacement (including humeral hemiarthroplasty and humeral head resurfacing arthroplasty). Each of these prostheses can present complications, either shared by all types of arthroplasty or specific to each. Infection, periprosthetic fractures, humeral component loosening, heterotopic ossification, implant failure, and nerve injury can affect all types of prostheses. Instability, scapular notching, and acromial fractures can be identified after reverse shoulder arthroplasty implantation. Glenoid component loosening and rotator cuff tear are specific complications of total shoulder arthroplasty. Progressive wear of the native glenoid is the only specific complication observed in partial shoulder joint replacement. Knowledge of different types of shoulder prostheses and their complications’ radiological signs is crucial for the radiologist to initiate prompt and adequate management.
Agreement between simulated patients and faculty: Assessment of communication skills during objective structured clinical examination
Authors: Yousuf Farheen , Yousuf Naveed 
Published: October 2019

Objective: Ensuring competence in communication skills amongst trainees is essential in health professions education. Involving faculty members for the same is a challenge in Obstetrics and Gynecology (OBGYN) due to their clinical commitments. The present study compares scores of OBGYN faculty, non-OBGYN faculty and simulated patients (SPs) on communication skills of postgraduate trainees during formative Objective Structured Clinical Examination (OSCE).
Methods: This is a psychometric study conducted in Feburary 2017 at the Aga Khan University Medical College (AKU-MC). All thirty-two postgraduate trainees of OBGYN gave consent. Each trainee was assessed by OBGYN faculty, non-OBGYN faculty and SP on communication skills at six stations using nine-point itemized rating-scale during formative OBGYN OSCE. The scores were reviewed using descriptive statistics, reliability was calculated using Cronbach’s alpha and inter-rater reliability was analyzed using Pearson correlation and intra-class correlation coefficient.
Results: The score reliability of each of the examiners was >0.7. The mean scores showed that OBGYN faculty were most stringent while SPs were lenient examiners, however, non-OBGYN faculty scored in between. The inter-rater reliability among any two of the OBGYN, non-OBGYN and SP examiner was >0.84 using Pearson correlation and >0.9 using intra-class correlation.Conclusion: The SPs and non-OBGYN clinical faculty can also be used to assess communication and counseling skills on OBGYN OSCEs after required training as examiners.
doi: https://doi.org/10.12669/pjms.35.6.1000
How to cite this:Yousuf F, Yousuf N. Agreement between simulated patients and faculty: Assessment of communication skills during objective structured clinical examination. Pak J Med Sci. 2019;35(6):1570-1574. doi: https://doi.org/10.12669/pjms.35.6.1000
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Presentation, diagnosis and management of locally advanced breast cancer: Is it different in low/middle income countries?
Authors: Manzoor Shahneela , Anwer Mariyah , Soomro Salim , Kumar Dileep 
Published: October 2019

Background and Objective: Breast cancer incidence is increasing and it is highest in low income countries. The main challenge is regarding awareness, screening, late presentation and its management in a third-world country. Our objective was to share the experience faced in various presentations, diagnosis and management of locally advanced breast cancer (LABC) in a third world country and discuss if they are different with respect to developed countries.
Methods: It is a retrospective case series study performed at Jinnah Postgraduate Medical Centre Karachi, from January 2015 to December 2017, over period of three years. Data was collected from the record maintained by authors about patients presenting in breast clinic. Patients of breast cancer were managed in breast clinic over 3 years. Our study included patients who presented with LABC based on their clinical presentation confirmed by histopathological diagnosis and followed by surgical management. Statistical analysis for students t-test was performed using SPSS (version 20.0). A p-value less than 0.05 was considered statistically significant.
Results: One hundred twelve patients presented with LABC over period of 3 years. All but two were female. Mean age was 52 years (range 26-78 years), SD 18.96. On presentation size of tumor was 5cm & more in 103 (91.9%) patients. Involvement of axilla was in 86 (76.7%). Chest wall was involved in 22 (19.6%). Total T3 and T4 were 71 (63.3%) and 41 (36.6%) respectively Diagnosis of all patients was confirmed by histopathology. Neoadjuvant was given to all patients to downstage the tumor. ER/PR was positive in 46(41.1%), HER-2/neu positive in 31 (27.6%). On staging breast carcinoma was metastatic in 13(11.6%) with liver, lung and bone in 4 (3.5%), 3 (2.7%) and 6 (5.3%) respectively. Breast conservation was done in 6 (6.1%) patients, Modified Radical Mastectomy was done in 86 (86.9%), Radical Mastectomy in 3 (3.03%), Toilet Mastectomy in 4 (4.045) and 13 (11.6%) patients were not operated.
Conclusion: In our series 65% of all breast cancers are LABC at presentation. In low/middle income countries high percentage of LABC at presentation result in high metastatic disease, poor prognosis and limits conservation of breast. Awareness and education can improve outcomes.
doi: https://doi.org/10.12669/pjms.35.6.165
How to cite this:Manzoor S, Anwer M, Soomro S, Kumar D. Presentation, diagnosis and management of locally advanced breast cancer: Is it different in low/middle income countries (LMICs)?. Pak J Med Sci. 2019;35(6):1554-1557. doi: https://doi.org/10.12669/pjms.35.6.165
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Employees’ opinions on critical success factors and performance criteria in disaster and emergency management
Authors: Şahinöz Saime , Yaprak Ünal , Şahinöz Turgut 
Published: October 2019

Objective: To evaluate the critical success factors at disaster and emergency management and to analyse their impact on performance to guide the managers and decision makers.
Methods: This was a cross-sectional study. It included all staff working in the fire brigade, 112 Emergency, Disaster and Emergency Management Authority and Red Crescent institutions serving in emergency situations in five provinces (Rize, Artvin, Trabzon, Gümüşhane, Bayburt) in the Eastern Black Sea region of Turkey. One province (Gümüşhane) was selected by cluster sampling method. Questionnaire which is the data collection method in the study was applied between 08/01/2016 - 02/02/2016 to all of the staff working in the fire brigade, 112 Emergency, Disaster and Emergency Management Authority and Red Crescent institutions serving in emergency situations in Gümüşhane province.
Results: It has been found out that there is a significant and positive relationship between all of the critical success factors, planning, response and recovery criteria, and performance variance.
Conclusions: The presence of well-planned emergency aid systems in the institutions or organizations involved in this area is an element of success. For this reason, this factor should be given more importance.
doi: https://doi.org/10.12669/pjms.35.6.778
How to cite this:Sahinoz S, Yaprak U, Sahinoz T. Employees’ opinions on critical success factors and performance criteria in disaster and emergency management. Pak J Med Sci. 2019;35(6):1636-1641. doi: https://doi.org/10.12669/pjms.35.6.778
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Evidence-based Clinical Decision Support Systems for the prediction and detection of three disease states in critical care: A systematic literature review
Authors: Medic Goran , Kosaner Kließ Melodi , Atallah Louis , Weichert Jochen , Panda Saswat , Postma Maarten , EL-Kerdi Amer 
Published: October 2019

Background:Clinical decision support (CDS) systems have emerged as tools providing intelligent decision making to address challenges of critical care. CDS systems can be based on existing guidelines or best practices; and can also utilize machine learning to provide a diagnosis, recommendation, or therapy course.Methods:This research aimed to identify evidence-based study designs and outcome measures to determine the clinical effectiveness of clinical decision support systems in the detection and prediction of hemodynamic instability, respiratory distress, and infection within critical care settings. PubMed, ClinicalTrials.gov and Cochrane Database of Systematic Reviews were systematically searched to identify primary research published in English between 2013 and 2018. Studies conducted in the USA, Canada, UK, Germany and France with more than 10 participants per arm were included.Results:In studies on hemodynamic instability, the prediction and management of septic shock were the most researched topics followed by the early prediction of heart failure. For respiratory distress, the most popular topics were pneumonia detection and prediction followed by pulmonary embolisms. Given the importance of imaging and clinical notes, this area combined Machine Learning with image analysis and natural language processing. In studies on infection, the most researched areas were the detection, prediction, and management of sepsis, surgical site infections, as well as acute kidney injury. Overall, a variety of Machine Learning algorithms were utilized frequently, particularly support vector machines, boosting techniques, random forest classifiers and neural networks. Sensitivity, specificity, and ROC AUC were the most frequently reported performance measures.Conclusion:This review showed an increasing use of Machine Learning for CDS in all three areas. Large datasets are required for training these algorithms; making it imperative to appropriately address, challenges such as class imbalance, correct labelling of data and missing data. Recommendations are formulated for the development and successful adoption of CDS systems.