bluuebunny/crossref_metadata_2025_split huggingface dataset:
Potential Cost-Effectiveness of Ambulatory Cardiac Rhythm Monitoring After Cryptogenic Stroke
Authors: Yong Jean Hai Ein , Thavorn Kednapa , Hoch Jeffrey S. , Mamdani Muhammad , Thorpe Kevin E. , Dorian Paul , Sharma Mike , Laupacis Andreas , Gladstone David J. 
Published: July 2016

Background and Purpose—
Prolonged ambulatory ECG monitoring after cryptogenic stroke improves detection of covert atrial fibrillation, but its long-term cost-effectiveness is uncertain.

Methods—
We estimated the cost-effectiveness of noninvasive ECG monitoring in patients aged ≥55 years after a recent cryptogenic stroke and negative 24-hour ECG. A Markov model used observed rates of atrial fibrillation detection and anticoagulation from a randomized controlled trial (EMBRACE) and the published literature to predict lifetime costs and effectiveness (ischemic strokes, hemorrhages, life-years, and quality-adjusted life-years [QALYs]) for 30-day ECG (primary analysis) and 7-day or 14-day ECG (secondary analysis), when compared with a repeat 24-hour ECG.

Results—
Prolonged ECG monitoring (7, 14, or 30 days) was predicted to prevent more ischemic strokes, decrease mortality, and improve QALYs. If anticoagulation reduced stroke risk by 50%, 30-day ECG (at a cost of USD $447) would be highly cost-effective ($2000 per QALY gained) for patients with a 4.5% annual ischemic stroke recurrence risk. Cost-effectiveness was sensitive to stroke recurrence risk and anticoagulant effectiveness, which remain uncertain, especially at higher costs of monitoring. Shorter duration (7 or 14 days) monitoring was cost saving and more effective than an additional 24-hour ECG; its cost-effectiveness was less sensitive to changes in ischemic stroke risk and treatment effect.

Conclusions—
After a cryptogenic stroke, 30-day ECG monitoring is likely cost-effective for preventing recurrent strokes; 14-day monitoring is an attractive value alternative, especially for lower risk patients. These results strengthen emerging recommendations for prolonged ECG monitoring in secondary stroke prevention. Cost-effectiveness in practice will depend on careful patient selection.
Taxonomic novelties in Erysimum for the Flora of Iran: E. polatschekii, a new alpine endemic, and E. scabrum, a new record
Authors: MOAZZENI HAMID , ASSADI MOSTAFA , ZARE GOLSHAN , MIRTADZADINI MANSOUR , Al-SHEHBAZ IHSAN A. 
Published: July 2016

During the work on herbarium material to prepare a taxonomic revision of Erysimum for the Flora of Iran, we found two interesting species not previously known for the country. Erysimum polatschekii is described as new from the alpine zone of Kerman Province (S Iran). It is closely related to the allopatric E. purpureum and E. pseudopurpureum, from which it differs by having bicolored flowers, clearly 2-lobed stigma, winged seeds, and different fruit indumentum. Erysimum scabrum, which grows in Lebanon, Syria, and Turkey, is recorded herein as new to the flora of Iran. Detailed descriptions, distribution maps, and illustrations for both species are provided.
The Art and Science of Climate Model Tuning
Authors: Hourdin Frédéric , Mauritsen Thorsten , Gettelman Andrew , Golaz Jean-Christophe , Balaji Venkatramani , Duan Qingyun , Folini Doris , Ji Duoying , Klocke Daniel , Qian Yun , Rauser Florian , Rio Catherine , Tomassini Lorenzo , Watanabe Masahiro , Williamson Daniel 
Published: July 2016

Abstract
The process of parameter estimation targeting a chosen set of observations is an essential aspect of numerical modeling. This process is usually named tuning in the climate modeling community. In climate models, the variety and complexity of physical processes involved, and their interplay through a wide range of spatial and temporal scales, must be summarized in a series of approximate submodels. Most submodels depend on uncertain parameters. Tuning consists of adjusting the values of these parameters to bring the solution as a whole into line with aspects of the observed climate. Tuning is an essential aspect of climate modeling with its own scientific issues, which is probably not advertised enough outside the community of model developers. Optimization of climate models raises important questions about whether tuning methods a priori constrain the model results in unintended ways that would affect our confidence in climate projections. Here, we present the definition and rationale behind model tuning, review specific methodological aspects, and survey the diversity of tuning approaches used in current climate models. We also discuss the challenges and opportunities in applying so-called objective methods in climate model tuning. We discuss how tuning methodologies may affect fundamental results of climate models, such as climate sensitivity. The article concludes with a series of recommendations to make the process of climate model tuning more transparent.
Vertical Mixing Derived from Surface Chlorophyll-a Concentrations of the North Atlantic Ocean
Authors: Hahn-Woernle Lisa , Dijkstra Henk A. , van der Woerd Hans J. 
Published: July 2016

AbstractVertical mixing is thought to play an essential role in phytoplankton blooms, yet measurements of mixing properties are very sparse. This paper presents a methodology to estimate profiles of the upper-ocean vertical mixing from satellite color observations, using a coupled turbulence–phytoplankton model and data assimilation–based calibration techniques. The method is tested at a location in the eastern North Atlantic for which an integrated set of observations (vertical mixing, phytoplankton, nutrients) is available. Results of identical twin experiments show that the method is very robust and achieves accurate turbulence model parameter calibrations even with noisy or sparsely sampled observations. The application of surface chlorophyll-a (Chl a) concentration to MODIS Aqua satellite observations leads two independent cases (data for the years 2009 and 2011) to a calibration of the model parameterization that produces weaker winter mixing compared to the standard configuration. As a consequence of the weaker mixing, the timing and intensity of increased surface Chl a satellite observations in spring and summer was reproduced by the model. Moreover, the weaker mixing resembles the in situ observations of vertical mixing better than the stronger mixing based on the standard configuration. This shows that the new calibration indeed improves the performance of the turbulence model.
Screening vs. non-screening detected colorectal cancer: Differences in pre-therapeutic work up and treatment
Authors: Saraste D , Martling A , Nilsson PJ , Blom J , Törnberg S , Janson M 
Published: July 2016

Objectives To compare preoperative staging, multidisciplinary team-assessment, and treatment in patients with screening detected and non-screening detected colorectal cancer. Methods Data on patient and tumour characteristics, staging, multidisciplinary team-assessment and treatment in patients with screening and non-screening detected colorectal cancer from 2008 to 2012 were collected from the Stockholm–Gotland screening register and the Swedish Colorectal Cancer Registry. Results The screening group had a higher proportion of stage I disease (41 vs. 15%; p < 0.001), a more complete staging of primary tumour and metastases and were more frequently multidisciplinary team-assessed than the non-screening group ( p < 0.001). In both groups, patients with endoscopically resected cancers were less completely staged and multidisciplinary team-assessed than patients with surgically resected cancers ( p < 0.001). No statistically significant differences were observed between the screening and non-screening groups in the use of neoadjuvant treatment in rectal cancer (68 vs.76%), surgical treatment with local excision techniques in stage I rectal cancer (6 vs. 9%) or adjuvant chemotherapy in stages II and III disease (46 vs. 52%). Emergency interventions for colorectal cancer occurred in 4% of screening participants vs. 11% of non-compliers. Conclusions Screening detected cancer patients were staged and multidisciplinary team assessed more extensively than patients with non-screening detected cancers. Staging and multidisciplinary team assessment prior to endoscopic resection was less complete compared with surgical resection. Extensive surgical and (neo)adjuvant treatment was given in stage I disease. Participation in screening reduced the risk of emergency surgery for colorectal cancer.
Ex-vivo release of Pipeline Embolization Device polytetrafluoroethylene (PTFE) sleeves for improved distal landing zone accuracy in-vivo: A technical note
Authors: Griessenauer Christoph J , Gupta Raghav , Moore Justin , Thomas Ajith J , Ogilvy Christopher S 
Published: July 2016

Background Distal landing zone accuracy is critical in some intracranial aneurysms treated with the Pipeline Embolization Device (PED), and delayed opening of the distal end of the device can complicate the procedure. Here, we report a technical nuance that facilitates accurate placement of the distal end of the PED by ex-vivo, pre-implantation release of the PED Flex polytetrafluoroethylene (PTFE) sleeves. Technical note The PED Flex is partially pushed out of the introducer sheath ex-vivo, pre-implantation until the distal PED opens entirely and the PTFE sleeves are located distal to the device. Without inverting the PTFE sleeves, the PED is carefully pulled back into the introducer sheath placing the PTFE sleeves inside the device. The PED is loaded into the microcatheter and advanced toward the site of implantation. When the PED is initially deployed and pushed out of the microcatheter, it opens immediately and provides an anchor for the remainder of the deployment process. We present a video (supplementary material) that illustrates the technique along with an illustrative case. Conclusion Ex-vivo, pre-implantation release of the PTFE sleeves is an option in aneurysm treatment where distal landing accuracy is critical. Even without the protection of the PTFE sleeves, our clinical observation shows that the PED can be advanced safely through the microcatheter in selected cases.
An updated systematic review and meta-analysis on the efficacy and tolerability of dipeptidyl peptidase-4 inhibitors in patients with type 2 diabetes with moderate to severe chronic kidney disease
Authors: Singh-Franco Devada , Harrington Catherine , Tellez-Corrales Eglis 
Published: July 2016

Objective: This updated meta-analysis determines the effect of dipeptidyl peptidase-4 inhibitors on glycemic and tolerability outcomes in patients with type 2 diabetes mellitus and chronic kidney disease with glomerular filtration rate of ⩽60 mL/min or on dialysis. Methods: In all, 14 citations were identified from multiple databases. Qualitative assessments and quantitative analyses were performed. Results: There were 2261 participants, 49–79 years of age, 49% men and 44% Caucasians. In seven placebo-comparator studies, reduction in hemoglobin A1c at weeks 12–24 was 0.55% (95% confidence interval: −0.68 to −0.43), P < 0.00001). In three sulfonylurea-comparator studies, dipeptidyl peptidase-4 inhibitors did not significantly reduce hemoglobin A1c at weeks 52–54 (−0.15% (95% confidence interval: −0.32 to 0.02)). In one sitagliptin versus albiglutide study, albiglutide significantly reduced hemoglobin A1c in patients with moderate renal impairment (−0.51%). A similar reduction in hemoglobin A1c was seen with sitagliptin versus vildagliptin (−0.56% vs −0.54%). Compared with placebo or sulfonylurea, dipeptidyl peptidase-4 inhibitors did not significantly reduce hemoglobin A1c after 12 and 54 weeks in patients on dialysis. Hypoglycemia was reported by ~30% of patients in both dipeptidyl peptidase-4 inhibitors and placebo groups over 24–52 weeks. While hypoglycemia was more common with a sulfonylurea at 52–54 weeks (risk ratio: 0.46 (95% confidence interval: 0.18 to 1.18)), there was significant heterogeneity ( I2  = 87%). Limitations included high drop-out rate from most studies and small number of active-comparator studies. Conclusions: Dipeptidyl peptidase-4 inhibitors in patients with chronic kidney disease caused a modest reduction in hemoglobin A1c versus placebo, but not when compared with sulfonylureas or albiglutide, or when used in patients on dialysis. Additional active-comparator studies are needed to further elucidate the role of dipeptidyl peptidase-4 inhibitors in patients with chronic kidney disease stages 3–5 or on dialysis.
Knowledge translation lessons from an audit of Aboriginal Australians with acute coronary syndrome presenting to a regional hospital
Authors: Haynes Emma , Hohnen Harry , Katzenellenbogen Judith M , Scalley Benjamin D , Thompson Sandra C 
Published: July 2016

Objective: Translation of evidence into practice by health systems can be slow and incomplete and may disproportionately impact disadvantaged populations. Coronary heart disease is the leading cause of death among Aboriginal Australians. Timely access to effective medical care for acute coronary syndrome substantially improves survival. A quality-of-care audit conducted at a regional Western Australian hospital in 2011–2012 compared the Emergency Department management of Aboriginal and non-Aboriginal acute coronary syndrome patients. This audit is used as a case study of translating knowledge processes in order to identify the factors that support equity-oriented knowledge translation. Methods: In-depth interviews were conducted with a purposive sample of the audit team and further key stakeholders with interest/experience in knowledge translation in the context of Aboriginal health. Interviews were analysed for alignment of the knowledge translation process with the thematic steps outlined in Tugwell’s cascade for equity-oriented knowledge translation framework. Results: In preparing the audit, groundwork helped shape management support to ensure receptivity to targeting Aboriginal cardiovascular outcomes. Reporting of audit findings and resulting advocacy were undertaken by the audit team with awareness of the institutional hierarchy, appropriate timing, personal relationships and recognising the importance of tailoring messages to specific audiences. These strategies were also acknowledged as important in the key stakeholder interviews. A follow-up audit documented a general improvement in treatment guideline adherence and a reduction in treatment inequalities for Aboriginal presentations. Conclusion: As well as identifying outcomes such as practice changes, a useful evaluation increases understanding of why and how an intervention worked. Case studies such as this enrich our understanding of the complex human factors, including individual attributes, experiences and relationships and systemic factors that shape equity-oriented knowledge translation. Given the potential that improving knowledge translation has to close the gap in Aboriginal health disparities, we must choose strategies that adequately take into account the unique contingencies of context across institutions and cultures.
Inhibiting TLR9 and other UNC93B1-dependent TLRs paradoxically increases accumulation of MYD88L265P plasmablasts in vivo
Authors: Wang James Q. , Beutler Bruce , Goodnow Christopher C. , Horikawa Keisuke 
Published: July 2016

Key Points
Inhibiting endosomal TLRs suppresses MYD88L265P B-cell proliferation in vitro. Inhibition of endosomal TLRs paradoxically enhances accumulation of MYD88L265P B cells as plasmablasts in vivo.
Prediction of bleeding events in patients with venous thromboembolism on stable anticoagulation treatment
Authors: Klok Frederikus A. , Hösel Volker , Clemens Andreas , Yollo Wilfrid D. , Tilke Clemens , Schulman Sam , Lankeit Mareike , Konstantinides Stavros V. 
Published: July 2016

Attempts at identifying patients with an elevated risk of bleeding while on anticoagulation following acute venous thromboembolism (VTE) have largely been unsuccessful thus far. We sought to develop a clinical prediction score for bleeding during stable anticoagulation treatment after acute VTE.We performed apost hocanalysis of the pooled RE-COVER studies, two double-blind randomised “sister” trials evaluating dabigatranversusstandard treatment in 5107 VTE patients.A score was derived from patients randomised to dabigatran using logistic regression analysis covering the complete follow-up period. The final model, named VTE-BLEED, included six variables and yielded a c-statistic of 0.72 (95% CI 0.67–0.76). Patients from the derivation cohort in the low-risk group (<2 points; 74% of the derivation population) had a bleeding incidence of 2.8% compared to 12.6% in the elevated-risk group (OR 5.0; 95% CI 3.5–7.1). The score proved accurate for our primary end-point,i.e.prediction of major bleeding after day 30 (“stable” anticoagulation), both in patients on dabigatran (c-statistic 0.75, 95% CI 0.61–0.89) and those on warfarin (0.78, 95% CI 0.68–0.86; p=0.77 for difference).The new VTE-BLEED score accurately predicted major bleeding events in VTE patients on stable anticoagulation with both dabigatran and warfarin.
RevEcoR: an R package for the reverse ecology analysis of microbiomes
Authors: Cao Yang , Wang Yuanyuan , Zheng Xiaofei , Li Fei , Bo Xiaochen 
Published: July 2016

AbstractBackgroundAll species live in complex ecosystems. The structure and complexity of a microbial community reflects not only diversity and function, but also the environment in which it occurs. However, traditional ecological methods can only be applied on a small scale and for relatively well-understood biological systems. Recently, a graph-theory-based algorithm called the reverse ecology approach has been developed that can analyze the metabolic networks of all the species in a microbial community, and predict the metabolic interface between species and their environment.ResultsHere, we present RevEcoR, an R package and a Shiny Web application that implements the reverse ecology algorithm for determining microbe–microbe interactions in microbial communities. This software allows users to obtain large-scale ecological insights into species’ ecology directly from high-throughput metagenomic data. The software has great potential for facilitating the study of microbiomes.ConclusionsRevEcoR is open source software for the study of microbial community ecology. The RevEcoR R package is freely available under the GNU General Public License v. 2.0 athttp://cran.r-project.org/web/packages/RevEcoR/with the vignette and typical usage examples, and the interactive Shiny web application is available athttp://yiluheihei.shinyapps.io/shiny-RevEcoR, or can be installed locally with the source code accessed fromhttps://github.com/yiluheihei/shiny-RevEcoR.
Frontline Science: Coincidental null mutation of Csf2rα in a colony of PI3Kγ−/− mice causes alveolar macrophage deficiency and fatal respiratory viral infection
Authors: Schneider Christoph , Nobs Samuel P , Heer Alex K , Hirsch Emilio , Penninger Josef , Siggs Owen M , Kopf Manfred 
Published: July 2016

Abstract
PI3Ks have been identified as key signaling proteins involved in many basic biologic processes in health and disease. Transgenic animals have been essential tools to study the underlying molecular mechanisms in this context and therefore, have been widely used to elucidate the role of these factors in many different settings. More specifically, PI3Kγ, a subunit highly expressed in the hematopoietic system, has been implicated to play an important role in many inflammatory diseases as well as cancer. Here, we report identification of multiple, additional, previously unknown mutations in the genome of a widely used PI3Kγ-deficient (PI3Kγ−/−) mouse colony. These include a STOP mutation in the GM-CSFRα chain, leading to a complete and specific deficiency in GM-CSF signaling. PI3Kγ−/− animals consequently lacked alveolar macrophages (AMs) and succumbed rapidly to influenza virus infection. Furthermore, PI3Kγ−/− mice carried an additional mutation that affects mucin 2 (Muc2) transcripts. This protein is strongly involved in the regulation of colorectal cancer, and indeed, conflicting reports have indicated that PI3Kγ−/− animals spontaneously develop colorectal tumors. Thus, we uncover previously unknown, confounding factors present in a strain of PI3Kγ−/− mice, leading to additional deficiencies in important signaling pathways with potentially wide-ranging implications for the interpretation of previous studies. By separating the mutations, we established a unique Csf2ra−/− mouse model that allows us to study the role of cell intrinsic GM-CSFR signaling in vivo without confounding variables introduced by defective IL-5R and IL-3R signaling in mice lacking the common β chain (Csf2rb).
La Falsification D'identité En France, Du Règne Personnel de Louis XIV à La Veille de La Révolution
Authors: Abad Reynald 
Published: July 2016

Précis
Jusqu'ici, la falsification d'identité sous l'Ancien Régime n'a guère été abordée qu'à travers la biographie des imposteurs célèbres ou l'étude des progrès de l'identification, ce qui revient à envisager la question à partir de cas particuliers ou du point de vue de l'autorité publique. Cet article se propose, au contraire, d'offrir un panorama aussi complet que possible de la falsification d'identité, en partant de la réalité du phénomène, c'est-à-dire des motivations et des méthodes des fraudeurs. Ce panorama, qui oblige à embrasser des aspects étonnamment variés de la vie sociale, s'accompagne de deux développements indispensables : l'un, préalable, pour définir rigoureusement la falsification d'identité ; l'autre, postérieur, pour analyser la législation pénale dans ce domaine. Il ressort de cette étude qu'il serait réducteur d'envisager exclusivement la falsification d'identité comme une catégorie de crime, plus ou moins nourrie par les progrès de l'identification : par la diversité de ses manifestations sociales, cette fraude dépasse à la fois la question de la criminalité et celle de la construction de l'Etat.
Drinking and Rebelling
Authors: Plack Noelle 
Published: July 2016

AbstractThis article presents a rereading of the largest and most notorious tax revolt of the French Revolution: the attacks on the customs wall in Paris, July 11–14, 1789. It also explores the subsequent trial of those arrested and the celebrations that took place on May 1, 1791, to mark the end of indirect taxation on consumer goods. It argues that the popular classes of Paris were politicized by their actions against consumption taxes during 1789–91. Wine was central to this campaign, as it became an object of protest and a symbol of liberty. Historians have shied away from examining these events, perhaps because of the influence of Hippolyte Taine's characterization of the inebriated, deranged crowd, but this movement against taxes on wine was essential to Parisian popular engagement with the Revolution in its early years.
Transsphenoidal Endoscopic Approach in the Treatment of Rathke's Cleft Cyst
Authors: Frank Giorgio , Sciarretta Vittorio , Mazzatenta Diego , Farneti Giovanni , Modugno Giovanni Carlo , Pasquini Ernesto 
Published: July 2016

Abstract

OBJECTIVE:
In this study, the usefulness of the transsphenoidal endoscopic approach in the treatment of a Rathke's cleft cyst is reported.

METHODS:
Between June 1998 and December 2002, 22 patients affected by sellar-suprasellar Rathke's cleft cysts were treated using a transsphenoidal endoscopic approach. Fourteen patients experienced pituitary dysfunction (64%), five experienced visual impairment (23%), and three reported headaches (14%).

RESULTS:
The patient follow-up ranged from 8 to 60 months (mean, 33 mo). Pituitary function was restored only in the four patients with hyperprolactinemia, whereas visual impairment and headache improved in all patients. However, when present before surgery, hypopituitarism was unaffected by surgery. Two patients experienced permanent diabetes insipidus (one of them before surgery). Only one recurrence was observed in a 13-year-old girl at 12 months after surgery, and it was treated using a new transsphenoidal endoscopic approach.

CONCLUSION:
The transsphenoidal endoscopic approach represents a straightforward and mini-invasive approach for the drainage and biopsy of a Rathke's cleft cyst.