bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multistate Model to Predict Heart Failure Hospitalizations and All-Cause Mortality in Outpatients With Heart Failure With Reduced Ejection Fraction
Authors: Upshaw Jenica N. , Konstam Marvin A. , Klaveren David van , Noubary Farzad , Huggins Gordon S. , Kent David M. 
Published: August 2016

Background—
Outpatients with heart failure (HF) who are at high risk for HF hospitalization and death may benefit from early identification. We sought to develop and externally validate a model to predict both HF hospitalization and mortality that accounts for the semicompeting nature of the 2 outcomes and captures the risk associated with the transition from the stable outpatient state to the post-HF hospitalization state.

Methods and Results—
A multistate model to predict HF hospitalization and all-cause mortality was derived using data (n=3834) from the HEAAL study (Heart Failure Endpoint evaluation of Angiotensin II Antagonist Losartan), a multinational randomized trial in symptomatic patients with reduced left ventricular ejection fraction. Twelve easily and reliably obtainable demographic and clinical predictors were prespecified for model inclusion. Model performance was assessed in the SCD-HeFT cohort (Sudden Cardiac Death in Heart Failure Trial; n=2521). At 1 year, the probability of being alive without HF hospitalization was 94% for a typical patient in the lowest risk quintile and 77% for a typical patient in the highest risk quintile and this variability in risk continued through 7 years of follow-up. The model c-index was 0.72 in the derivation cohort, 0.66 in the validation cohort, and 0.69 in the implantable cardiac defibrillator arm of the validation cohort. There was excellent calibration across quintiles of predicted risk.

Conclusions—
Our findings illustrate the advantages of a multistate modeling approach, providing estimates of HF hospitalization and death in the same model, comparison of predictors for the different outcomes and demonstrating the different trajectories of patients based on baseline characteristics and intermediary events.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifiers: NCT00000609 and NCT00090259.
The Course of Ischemic Mitral Regurgitation in Acute Myocardial Infarction After Primary Percutaneous Coronary Intervention
Authors: Nishino Shun , Watanabe Nozomi , Kimura Toshiyuki , Enriquez-Sarano Maurice , Nakama Tatsuya , Furugen Makoto , Koiwaya Hiroshi , Ashikaga Keiichi , Kuriyama Nehiro , Shibata Yoshisato 
Published: August 2016

Background—
Previously published evidence on ischemic mitral regurgitation (IMR) and its adverse prognosis after myocardial infarction has been based on the severity of IMR in the subacute or chronic period of myocardial infarction. However, the state of IMR can vary from the early stage to the chronic stage as a result of various responses of myocardium after primary percutaneous coronary intervention (PCI).

Methods and Results—

Standard echocardiography was serially performed in 546 consecutive patients with first-onset acute myocardial infarction (1) immediately after their arrival (pre-PCI), (2) before discharge (early post-PCI), and (3) 6 to 8 months after PCI (late post-PCI). The course of IMR after primary PCI and the prognostic impact of the IMR in each phase were investigated. IMR was found in 193/546 (35%) patients at the emergency room. In the acute phase after PCI, IMR improved in 63 patients. IMR worsened in 78 patients despite successful PCI. Shorter onset-to-reperfusion time and nontotal occlusion before PCI were the independent predictors of early improvement of IMR. In the chronic phase, IMR improved in 79 patients and worsened in 36 patients. Lower peak creatine kinase–myocardial band was an independent predictor of late improvement of IMR. IMR before PCI worsened 30-day prognosis (
P
=0.02), and persistent IMR in the chronic phase worsened long-term prognosis (
P
=0.04) after primary PCI.

Conclusions—
Degrees of IMR changed in the early and chronic phase after primary PCI for acute myocardial infarction. IMR on arrival and persistent IMR in the chronic phase worsened short-term and long-term prognosis after acute myocardial infarction, respectively.
Morphofunctional Abnormalities of Mitral Annulus and Arrhythmic Mitral Valve Prolapse
Authors: Perazzolo Marra Martina , Basso Cristina , De Lazzari Manuel , Rizzo Stefania , Cipriani Alberto , Giorgi Benedetta , Lacognata Carmelo , Rigato Ilaria , Migliore Federico , Pilichou Kalliopi , Cacciavillani Luisa , Bertaglia Emanuele , Frigo Anna Chiara , Bauce Barbara , Corrado Domenico , Thiene Gaetano , Iliceto Sabino 
Published: August 2016

Background—
Arrhythmic mitral valve prolapse (MVP) is characterized by myxomatous leaflets and left ventricular (LV) fibrosis of papillary muscles and inferobasal wall. We searched for morphofunctional abnormalities of the mitral valve that could explain a regional mechanical myocardial stretch.

Methods and Results—

Thirty-six (27 female patients; median age: 44 years) arrhythmic MVP patients with LV late gadolinium enhancement on cardiac magnetic resonance and no or trivial mitral regurgitation, and 16 (6 female patients; median age: 40 years) MVP patients without LV late gadolinium enhancement were investigated by morphofunctional cardiac magnetic resonance. Mitral annulus disjunction (median: 4.8 versus 1.8 mm;
P
<0.001), end-systolic mitral annular diameters (median: 41.2 versus 31.5;
P
=0.004) and end-diastolic mitral annular diameters (median: 35.5 versus 31.5;
P
=0.042), prevalence of posterior systolic curling (34 [94%] versus 3 [19%];
P
<0.001), and basal to mid LV wall thickness ratio >1.5 (22 [61%] versus 4 [25%];
P
=0.016) were higher in MVP patients with late gadolinium enhancement than in those without. A linear correlation was found between mitral annulus disjunction and curling (
R
=0.85). A higher prevalence of auscultatory midsystolic click (26 [72%] versus 6 [38%];
P
=0.018) was also noted. Histology of the mitral annulus showed a longer mitral annulus disjunction in 50 sudden death patients with MVP and LV fibrosis than in 20 patients without MVP (median: 3 versus 1.5 mm;
P
<0.001).

Conclusions—
Mitral annulus disjunction is a constant feature of arrhythmic MVP with LV fibrosis. The excessive mobility of the leaflets caused by posterior systolic curling accounts for a mechanical stretch of the inferobasal wall and papillary muscles, eventually leading to myocardial hypertrophy and scarring. These mitral annulus abnormalities, together with auscultatory midsystolic click, may identify MVP patients who would need arrhythmic risk stratification.
Characteristics of the Heat Flux in the Unstable Atmospheric Surface Layer
Authors: Sharan Maithili , Srivastava Piyush 
Published: August 2016

AbstractThe behavior of the heat flux H with respect to the stability parameter (=z/L, where z is the height above the ground, and L is the Obukhov length) in the unstable atmospheric surface layer is analyzed within the framework of Monin–Obukhov similarity (MOS) theory. Using MOS equations, H is expressed as a function of and vertical surface-layer potential temperature gradient . A mathematical analysis is carried out to analyze the theoretical nature of heat flux with the stability parameter by considering the vertical potential temperature gradient as (i) a constant and (ii) a power-law function of heat flux. For a given value of H, two values of associated with different stability regimes are found to occur in both the conditions, suggesting the nonuniqueness of MOS equations.Turbulent data over three different sites—(i) Ranchi, India; (ii) the Met Office’s Cardington, United Kingdom, monitoring facility; and (iii) 1999 Cooperative Atmosphere–Surface Exchange Study (CASES-99; United States—are analyzed to compare the observed nature of H with that predicted by MOS. The analysis of observational data over these three sites reveals that the observed variation of H with is consistent with that obtained theoretically from MOS equations when considering the vertical temperature gradient as a power-law function of heat flux having the exponent larger than 2/3. The existence of two different values of the stability parameter for a given value of heat flux suggests that the application of heat flux as a boundary condition involves some intricacies, and it should be applied with caution in convective conditions.
Arctic Sea Ice Seasonal Prediction by a Linear Markov Model
Authors: Yuan Xiaojun , Chen Dake , Li Cuihua , Wang Lei , Wang Wanqiu 
Published: August 2016

Abstract
A linear Markov model has been developed to predict sea ice concentration (SIC) in the pan-Arctic region at intraseasonal to seasonal time scales, which represents an original effort to use a reduced-dimension statistical model in forecasting Arctic sea ice year-round. The model was built to capture covariabilities in the atmosphere–ocean–sea ice system defined by SIC, sea surface temperature, and surface air temperature. Multivariate empirical orthogonal functions of these variables served as building blocks of the model. A series of model experiments were carried out to determine the model’s dimension. The predictive skill of the model was evaluated by anomaly correlation and root-mean-square errors in a cross-validated fashion . On average, the model is superior to the predictions by anomaly persistence, damped anomaly persistence, and climatology. The model shows good skill in predicting SIC anomalies within the Arctic basin during summer and fall. Long-term trends partially contribute to the model skill. However, the model still beats the anomaly persistence for all targeted seasons after linear trends are removed. In winter and spring, the predictability is found only in the seasonal ice zone. The model has higher anomaly correlation in the Atlantic sector than in the Pacific sector. The model predicts well the interannual variability of sea ice extent (SIE) but underestimates its accelerated long-term decline, resulting in a systematic model bias. This model bias can be reduced by the constant or linear regression bias corrections, leading to an improved correlation skill of 0.92 by the regression bias correction for the 2-month-lead September SIE prediction.
Coupled Ocean–Atmosphere Offshore Decay Scale of Cold SST Signals along Upwelling Eastern Boundaries
Authors: Spall Michael A. , Schneider Niklas 
Published: August 2016

AbstractA simple analytic model is developed to represent the offshore decay of cold sea surface temperature (SST) signals that originate from wind-driven upwelling at a coastal boundary. The model couples an oceanic mixed layer to an atmospheric boundary layer through wind stress and air–sea heat exchange. The primary mechanism that controls SST is a balance between Ekman advection and air–sea exchange. The offshore penetration of the cold SST signal decays exponentially with a length scale that is the product of the ocean Ekman velocity and a time scale derived from the air–sea heat flux and the radiative balance in the atmospheric boundary layer. This cold SST signal imprints on the atmosphere in terms of both the boundary layer temperature and surface wind. Nonlinearities due to the feedback between SST and atmospheric wind, baroclinic instability, and thermal wind in the atmospheric boundary layer all slightly modify this linear theory. The decay scales diagnosed from two-dimensional and three-dimensional eddy-resolving numerical ocean models are in close agreement with the theory, demonstrating that the basic physics represented by the theory remain dominant even in these more complete systems. Analysis of climatological SST off the west coast of the United States also shows a decay of the cold SST anomaly with scale roughly in agreement with the theory.
Two-Temperature Nonequilibrium Model of a Marine Boundary Layer Laden with Evaporating Ocean Spray under High-Wind Conditions
Authors: Rastigejev Yevgenii , Suslov Sergey A. 
Published: August 2016

AbstractA nonequilibrium two-temperature multiphase model of the atmospheric boundary layer above wave crests that is laden with evaporating ocean spray in high-wind condition is presented. The governing equations are derived from basic physical principles of conservation of momentum, mass, and thermal energy in multiphase flows. The model derivation uses an Eulerian multifluid approach that considers spray as a continuous medium interacting with the gas phase. The E − ε turbulence closure is used. The developed theoretical framework accounts for the nonuniform ocean spray distribution and the thermal energy exchange between air and spray droplets that, in general, have different temperatures above the wave crest level. Such thermodynamic nonequilibrium conditions are shown to exist when the spray concentration is relatively low and the air humidity is far from saturation. The mechanical and thermodynamic effects of the evaporating spray on airflow and heat transport characteristics are obtained and shown to depend sensitively on the spray concentration.
Systematic review of interventions for Indigenous adults with mental and substance use disorders in Australia, Canada, New Zealand and the United States
Authors: Leske Stuart , Harris Meredith G , Charlson Fiona J , Ferrari Alize J , Baxter Amanda J , Logan Jacquie M , Toombs Maree , Whiteford Harvey 
Published: August 2016

Objective: The aim of this study was to systematically review the evidence-base for the effectiveness of culturally unadapted, culturally adapted and culture-based interventions for Indigenous adults with mental or substance use disorders. Methods: We conducted a systematic search of scientific databases, government websites and web-based Indigenous research repositories. We sought studies using designs comparing an intervention group to a control/comparator group or pre- and post-test designs, published between 2000 and 2015 examining interventions to improve individual-level outcomes (e.g. remission, symptoms, quality of life, functioning) or service-level outcomes (e.g. number of interventions delivered) for Indigenous adults with mental or substance use disorders in Australia, Canada, New Zealand or the United States. Results: A total of 16 studies met inclusion criteria. Virtually all North American studies (6 US and 1 Canadian) evaluated culturally unadapted interventions, all of which were interventions for substance use. Two-thirds of Australian and New Zealand studies evaluated culturally adapted interventions and included samples with mental disorders. Of eight culturally unadapted psychological/psychosocial, pharmacological and educational intervention studies, seven reported significant improvements on at least one measure of psychological well-being, mental health problem severity, or significantly reduced alcohol or illicit drug use. Of seven culturally adapted psychological/psychosocial intervention studies, all reported significant improvement on at least one measure of symptoms of mental illness, functioning, and alcohol use. One culture-based psychological/psychosocial intervention study significantly reduced problem severity in medical and psychiatric domains. Conclusion: There remains inconclusive evidence regarding interventions due to a small and methodologically weak evidence-base. The literature would be enhanced by intervention replication and outcome standardisation, validating the outcome instruments used in Indigenous populations, including sample size calculations and using stronger research designs (e.g. interrupted time-series designs). Robust implementation and outcomes research is needed to further progress evidence-based practice in Indigenous mental health.
Suicidal ideation among MSM in three West African countries: Associations with stigma and social capital
Authors: Stahlman Shauna , Grosso Ashley , Ketende Sosthenes , Pitche Vincent , Kouanda Seni , Ceesay Nuha , Ouedraogo Henri G , Ky-Zerbo Odette , Lougue Marcel , Diouf Daouda , Anato Simplice , Tchalla Jules , Baral Stefan 
Published: August 2016

Background: Suicidal ideation is understudied among men who have sex with men (MSM) across Sub-Saharan Africa. Aims: This study aimed to explore social capital and sexual behavior stigma associated with suicidal ideation among MSM in the West African nations of The Gambia, Burkina Faso and Togo. Methods: Participants were recruited using respondent-driven sampling and snowball sampling across multiple cities ( n = 1555) from July 2011 to August 2013. During a single study visit, participants completed a survey. Logistic regression models were used to assess bivariate and multivariable associations with suicidal ideation. Results: The prevalence of lifetime suicidal ideation was 13% overall and ranged 6%–17% across study sites. After adjusting for potential confounders, MSM who reported stigma as a result of having sex with men were more likely to report suicidal ideation. Physical and sexual violence was strongly associated with suicidal ideation, including being physically harmed (adjusted odds ratio (aOR) = 2.94, 95% confidence interval (CI) = 1.91, 4.52), tortured (aOR = 3.86, 95% CI = 2.17, 6.86) and raped (aOR = 3.07, 95% CI = 2.05, 4.60). In contrast, increasing social participation with the broader community was associated with decreased report of suicidal ideation (aOR = 0.91, 95% CI = 0.85, 0.99). Conclusion: Sexual behavior stigma should be addressed to improve mental health among MSM in Western Sub-Saharan Africa.
The Effect of Observational Practice by a Point-Light Model on Learning a Novel Motor Skill
Authors: Farsi A. , Bahmanbegloo Zeinab H. , Abdoli B. , Ghorbani S. 
Published: August 2016

Purpose The purpose of this study was to investigate the effect of observing point-light and video models and physical practice on learning a crouch start. Method Thirty-two female students were randomly assigned into point-light, video, physical practice, and control groups. They performed 10 trials in pretest, 160 trials in acquisition phase, and 10 trials in 24-hour retention test. Kinematic features and reaction time were measured as dependent variables. Results Results showed that physical practice group performed better than other groups in reaction time and range of motion of trunk and observational groups performed better than control groups in reaction time and range of motion of knee. Conclusion The results confirm the positive effects of observational practice on motor learning.
Estimation of the performance stability of the newly developed topical haemostatic agents based on the chitosan/alginate fibrids
Authors: Struszczyk Marcin H , Wilbik-Hałgas Bożena , Miklas Michał , Cichecka Magdalena , Kucharska Magdalena , Wiśniewska-Wrona Maria , Brzoza-Malczewska Kinga 
Published: August 2016

Designing medical devices requires a wide range of verification steps for estimation of the performance and safety. Designing the research program needs a rational selection of appropriate testing methods (in preclinical and clinical studies) for determination of the risk of potential incompatibilities resulting in adverse events. The significance of the appropriate selection of the testing method is increased in advanced medical devices. The presented research considers the verification of the functional properties of recently developed topical haemostatic agents with the use of the chitosan/alginate fibrids, based on the previously elaborated risk analysis made according to the guidelines of the PN-EN-ISO 14971:2012 and PN-EN ISO 22442-1:2008 standards. The aim of this research was to verify the stability of the performance of the newly developed haemostatic agents during storage. The defined aim of the study arose from the thesis that the appropriate selection of raw materials and a new manner of reprocessing them enabled keeping the usability of the final product for at least two years.
Experiences and perspectives of older people regarding advance care planning: A meta-synthesis of qualitative studies
Authors: Ke Li-Shan , Huang Xiaoyan , Hu Wen-Yu , O’Connor Margaret , Lee Susan 
Published: August 2016

Background: Studies have indicated that family members or health professionals may not know or predict their older relatives’ or patients’ health preferences. Although advance care planning is encouraged for older people to prepare end-of-life care, it is still challenging. Aim: To understand the experiences and perspectives of older people regarding advance care planning. Design: A systematic review of qualitative studies and meta-synthesis was conducted. Data sources: CINAHL, MEDLINE, EMBASE, and PsycINFO databases were searched. Results: A total of 50 articles were critically appraised and a thematic synthesis was undertaken. Four themes were identified: life versus death, internal versus external, benefits versus burdens, and controlling versus being controlled. The view of life and death influenced older people’s willingness to discuss their future. The characteristics, experiences, health status, family relationship, and available resources also affected their plans of advance care planning. Older people needed to balance the benefits and burdens of advance care planning, and then judge their own ability to make decisions about end-of-life care. Conclusion: Older people’s perspectives and experiences of advance care planning were varied and often conflicted; cultural differences amplified variances among older people. Truthful information, available resources, and family support are needed to enable older people to maintain dignity at the end of life. The views of life and death for older people from different cultures should be compared to assist health professionals to understand older people’s attitudes toward advance care planning, and thus to develop appropriate strategies to promote advance care planning in different cultures.
Cognitive stimulation therapy for people with dementia in practice: A service evaluation
Authors: Streater Amy , Aguirre Elisa , Spector Aimee , Orrell Martin 
Published: August 2016

Introduction Cognitive stimulation therapy is a well-recognised evidence-based cognitive psychosocial intervention for people with mild to moderate dementia. Despite increased use of the programme, little is known about its implementation in practice. Method A service evaluation of care home staff that received cognitive stimulation therapy training was conducted, and on-going support to deliver the programme in practice was provided. Outcome measures collected at baseline and 6 month follow up included sense of competence, learning transfer, dementia knowledge, and approaches to dementia. Attendance records were also collected. Results Ten out of 12 care homes attempted to deliver the cognitive stimulation therapy programme after receiving training and support. Overall, a high number of sessions were delivered. In addition, the staff members demonstrated significant improvements in positive approaches to dementia care and sense of competence. Conclusions This article reports encouraging findings of training and outreach support with demonstrated improvements in staff outcomes and successful implementation of the cognitive stimulation therapy programme. These results support the current evidence base supporting the use of cognitive stimulation therapy in routine care. This is relevant to occupational therapy as the profession plays a crucial part in the implementation of psychosocial interventions for dementia in practice.