bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for 30-day readmission following hypoglycemia-related emergency room and inpatient admissions
Authors: Emons M F , Bae J P , Hoogwerf B J , Kindermann S L , Taylor R J , Nathanson B H 
Published: April 2016

ObjectiveHypoglycemia is a serious complication of diabetes treatment. This retrospective observational study characterized hypoglycemia-related hospital emergency room (ER) and inpatient (in-pt) admissions and identified risk factors for 30-day all-cause and hypoglycemia-related readmission.Research design and methods4476 hypoglycemia-related ER and in-pt encounters with discharge dates from 1/1/2009 to 3/31/2014 were identified in a large, multicenter electronic health record database. Outcomes were 30-day all-cause ER/hospital readmission and hypoglycemia-related readmission. Multivariable logistic regression methods identified risk factors for both outcomes.Results1095 (24.5%) encounters had ER/hospital all-cause readmission within 30 days and 158 (14.4%) of these were hypoglycemia-related. Predictors of all-cause 30-day readmission included recent exposure to a hospital/nursing home (NH)/skilled nursing facility (SNF; OR 1.985, p<0.001); age 25–34 and 35–44 (OR 2.334 and 1.996, respectively, compared with age 65–74, both p<0.001); and African-American (AA) race versus all other race categories (OR 1.427, p=0.011). Other factors positively associated with readmission include chronic obstructive pulmonary disease, cerebrovascular disease, cardiac dysrhythmias, congestive heart disease, hypertension, and mood disorders. Predictors of readmissions attributable to hypoglycemia included recent exposure to a hospital/NH/SNF (OR 2.299, p<0.001), AA race (OR 1.722, p=0.002), age 35–44 (OR 3.484, compared with age 65–74, p<0.001), hypertension (OR 1.891, p=0.019), and delirium/dementia and other cognitive disorders (OR 1.794, p=0.038). Obesity was protective against 30-day hypoglycemia-related readmission (OR 0.505, p=0.017).ConclusionsFactors associated with 30-day all-cause and hypoglycemia-related readmission among patients with diabetic hypoglycemia include recent exposure to hospital/SNF/NH, adults <45 years, AAs, and several cardiovascular and respiratory-related comorbid conditions.
Realist evaluation of the antiretroviral treatment adherence club programme in selected primary healthcare facilities in the metropolitan area of Western Cape Province, South Africa: a study protocol
Authors: Mukumbang Ferdinand C , Van Belle Sara , Marchal Bruno , Van Wyk Brian 
Published: April 2016

IntroductionSuboptimal retention in care and poor treatment adherence are key challenges to antiretroviral therapy (ART) in sub-Saharan Africa. Community-based approaches to HIV service delivery are recommended to improve patient retention in care and ART adherence. The implementation of the adherence clubs in the Western Cape province of South Africa was with variable success in terms of implementation and outcomes. The need for operational guidelines for its implementation has been identified. Therefore, understanding the contexts and mechanisms for successful implementation of the adherence clubs is crucial to inform the roll-out to the rest of South Africa. The protocol outlines an evaluation of adherence club intervention in selected primary healthcare facilities in the metropolitan area of the Western Cape Province, using the realist approach.Methods and analysisIn the first phase, an exploratory study design will be used. Document review and key informant interviews will be used to elicit the programme theory. In phase two, a multiple case study design will be used to describe the adherence clubs in five contrastive sites. Semistructured interviews will be conducted with purposively selected programme implementers and members of the clubs to assess the context and mechanisms of the adherence clubs. For the programme's primary outcomes, a longitudinal retrospective cohort analysis will be conducted using routine patient data. Data analysis will involve classifying emerging themes using the context-mechanism-outcome (CMO) configuration, and refining the primary CMO configurations to conjectured CMO configurations. Finally, we will compare the conjectured CMO configurations from the cases with the initial programme theory. The final CMOs obtained will be translated into middle range theories.Ethics and disseminationThe study will be conducted according to the principles of the declaration of Helsinki (1964). Ethics clearance was obtained from the University of the Western Cape. Dissemination will be done through publications and curation.
How do women with chronic fatigue syndrome/myalgic encephalomyelitis rate quality and coordination of healthcare services? A cross-sectional study
Authors: Hansen Anne Helen , Lian Olaug S 
Published: April 2016

ObjectiveTo test the association between self-rated health and self-rated degree of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and CFS/ME patients' assessment of quality of primary care, specialist care and coordination of care.DesignCross-sectional study.SettingSelf-reported questionnaire data from women members of The Norwegian ME Association obtained in 2013.Participants431 women with CFS/ME aged 16–73 years.Main outcome measureThe participants' assessment of quality in primary care, specialist care and in coordination of care (good/very good or poor/very poor). Main explanatory variables: self-rated health and self-rated degree of CFS/ME.ResultsQuality of care was rated poor by 60.6% in primary care, by 47.7% in specialist care, and by 71.2% regarding coordination of care. Poorer self-rated health increased the probability of rating quality in primary care poor, particularly among women 40 years and over (OR 2.38, 95% CI 1.63 to 3.49), women with university education (OR 2.57, CI 1.68 to 3.94), and owing to less frequent general practitioner (GP) visits (OR 2.46, CI 1.60 to 3.78). Poorer self-rated health increased the probability of rating quality poor in specialist care (OR 1.38, CI 1.05 to 1.82), but not in coordination of care. A more severe CFS/ME was associated with a higher probability of rating quality in primary care poor (OR 0.61, CI 0.38 to 0.93). Frequent visitors and those with a long GP relationship were less likely to report primary care quality as poor.ConclusionsA large proportion of women with CFS/ME rated quality of care poor/very poor in primary care, specialist care and in coordination of care. The dissatisfaction was higher for primary care than for specialist care. Overall, poorer self-rated health and a more severe CFS/ME were associated with lower quality scores in primary and specialist care, but not in coordination of care. Healthcare services, as assessed by women with CFS/ME, do have a large potential for improvement.
Characterisation of an epigenetically altered CD4+CD28+Kir+T cell subset in autoimmune rheumatic diseases by multiparameter flow cytometry
Authors: Strickland Faith M , Patel Dipak , Khanna Dinesh , Somers Emily , Robida Aaron M , Pihalja Michael , Swartz Richard , Marder Wendy , Richardson Bruce 
Published: April 2016

ObjectivesAntigen-specific CD4+T cells epigenetically modified with DNA methylation inhibitors overexpress genes normally suppressed by this mechanism, including CD11a, CD70, CD40L and the KIR gene family. The altered cells become autoreactive, losing restriction for nominal antigen and responding to self-class II major histocompatibility complex (MHC) molecules without added antigen, and are sufficient to cause a lupus-like disease in syngeneic mice. T cells overexpressing the same genes are found in patients with active lupus. Whether these genes are co-overexpressed on the same or different cells is unknown. The goal of this study was to determine whether these genes are overexpressed on the same or different T cells and whether this subset of CD4+T cells is also present in patients with lupus and other rheumatic diseases.MethodsMulticolour flow cytometry was used to compare CD11a, CD70, CD40L and KIR expression on CD3+CD4+CD28+T cells to their expression on experimentally demethylated CD3+CD4+CD28+T cells and CD3+CD4+CD28+T cells from patients with active lupus and other autoimmune diseases.ResultsExperimentally demethylated CD4+T cells and T cells from patients with active lupus have a CD3+CD4+CD28+CD11ahiCD70+CD40LhiKIR+subset, and the subset size is proportional to lupus flare severity. A similar subset is found in patients with other rheumatic diseases including rheumatoid arthritis, systemic sclerosis and Sjögren's syndrome but not retroperitoneal fibrosis.ConclusionsPatients with active autoimmune rheumatic diseases have a previously undescribed CD3+CD4+CD28+CD11ahiCD70+CD40LhiKIR+T cell subset. This subset may play an important role in flares of lupus and related autoimmune rheumatic diseases, provide a biomarker for disease activity and serve as a novel therapeutic target for the treatment of lupus flares.
Prognostic Significance of VEGF after Twenty-Year Follow-up in a Randomized Trial of Fenretinide in Non–Muscle-Invasive Bladder Cancer
Authors: Puntoni Matteo , Petrera Marilena , Campora Sara , Garrone Elsa , Defferrari Carlotta , Torrisi Rosalba , Johansson Harriet , Bruno Silvia , Curotto Antonio , DeCensi Andrea 
Published: April 2016

Abstract
Non–muscle-invasive bladder cancer (NMIBC) may progress to muscle-invasive disease, but no effective preventive treatments are available. In addition, no reliable prognostic biomarkers have been identified. We assessed the long-term effect of the oral retinoid fenretinide and the prognostic value of circulating VEGF levels. We updated through the Tumor Registry the vital status of 99 patients with resected Ta/T1 bladder tumors who were recruited in a randomized trial of 2 years of fenretinide or no treatment in 1993–1994. Serum VEGF levels measured at baseline and 12 months were available in a subgroup of 62 patients. After a median of 20.5 years, 54 subjects died, 35 of any cancer and 14 of bladder cancer. Neither overall survival (OS), nor cancer survival (CS) or bladder cancer survival (BCS) was affected by fenretinide (log-rank P ≥ 0.2). DNA aneuploidy in bladder washing was associated with shorter OS (P = 0.02), CS (P = 0.05), and BCS (P = 0.09). Subjects with baseline VEGF levels in the top quintile (≥350 pg/mL) had a significantly shorter OS (P = 0.01), CS (P = 0.02), and BCS (P = 0.008). The trend across quintiles of VEGF was significant for BCS (P = 0.007). Multivariate analyses showed that, in addition to smoking status, VEGF level in the top quintile was an independent prognostic factor for OS (HR = 2.7; 95% CI, 1.1–6.5), CS (HR = 3.3; 95% CI, 1.1–9.4) and BCS (HR = 8.9; 95% CI,1.3–61). Fenretinide did not affect the long-term outcome of patients with NMIBC. High serum VEGF level was a significant predictor of overall and cancer death and may help to identify high-risk subjects who may benefit from a preventive therapy. Cancer Prev Res; 9(6); 437–44. ©2016 AACR.
In Pulmonary Arterial Hypertension, Reduced BMPR2 Promotes Endothelial-to-Mesenchymal Transition via HMGA1 and Its Target Slug
Authors: Hopper Rachel K. , Moonen Jan-Renier A.J. , Diebold Isabel , Cao Aiqin , Rhodes Christopher J. , Tojais Nancy F. , Hennigs Jan K. , Gu Mingxia , Wang Lingli , Rabinovitch Marlene 
Published: April 2016

Background—
We previously reported high-throughput RNA sequencing analyses that identified heightened expression of the chromatin architectural factor High Mobility Group AT-hook 1 (HMGA1) in pulmonary arterial endothelial cells (PAECs) from patients who had idiopathic pulmonary arterial hypertension (PAH) in comparison with controls. Because HMGA1 promotes epithelial-to-mesenchymal transition in cancer, we hypothesized that increased HMGA1 could induce transition of PAECs to a smooth muscle (SM)–like mesenchymal phenotype (endothelial-to-mesenchymal transition), explaining both dysregulation of PAEC function and possible cellular contribution to the occlusive remodeling that characterizes advanced idiopathic PAH.

Methods and Results—

We documented increased HMGA1 in PAECs cultured from idiopathic PAH versus donor control lungs. Confocal microscopy of lung explants localized the increase in HMGA1 consistently to pulmonary arterial endothelium, and identified many cells double-positive for HMGA1 and SM22α in occlusive and plexogenic lesions. Because decreased expression and function of bone morphogenetic protein receptor 2 (BMPR2) is observed in PAH, we reduced BMPR2 by small interfering RNA in control PAECs and documented an increase in HMGA1 protein. Consistent with transition of PAECs by HMGA1, we detected reduced platelet endothelial cell adhesion molecule 1 (CD31) and increased endothelial-to-mesenchymal transition markers, αSM actin, SM22α, calponin, phospho-vimentin, and Slug. The transition was associated with spindle SM-like morphology, and the increase in αSM actin was largely reversed by joint knockdown of BMPR2 and HMGA1 or Slug. Pulmonary endothelial cells from mice with endothelial cell–specific loss of
Bmpr2
showed similar gene and protein changes.

Conclusions—
Increased HMGA1 in PAECs resulting from dysfunctional BMPR2 signaling can transition endothelium to SM-like cells associated with PAH.
Morphological and molecular confirmation of the occurrence of Pyropia tanegashimensis (Bangiales, Rhodophyta) from Palaui Is., Sta. Ana, Cagayan, Philippines
Authors: DUMILAG RICHARD V. , AGUINALDO ZAE-ZAE A. , MINTU CYNTHIA B. , QUINTO MYRNA P. , AME EVELYN C. , ANDRES ROLANDO C. , MONOTILLA WILBERTO D. , YAP SANDRA L. 
Published: April 2016

The known morphological features in identifying common species of foliose Bangiales (e.g., members of Pyropia and Porphyra), which are very few and often overlapping, are recently resolved using comparative analysis of DNA sequences and statistics. Records of foliose Bangiales in the Philippines were historically identified based on morphology. Considering the recent radical changes in the taxonomy among these rhodophytes and problems posed by morphology-based identification, taxonomic re-appraisal of Philippine foliose Bangiales based on critical morphological and molecular studies is needed. This study used plastid rbcL and mitochondrial COI-5P gene sequences to investigate the identity of foliose Bangiales collected in Palaui Is., Sta. Ana, Cagayan, Philippines. Observation of key phenotypes revealed the identity of the collected materials as Py. tanegashimensis. Resulting phylogenetic trees showed placement of our collected specimens into a highly supported Py. tanegashimensis clade from Japan and Brazil. Our molecular analysis also suggested that the Philippine Py. tanegashimensis includes endemic populations distinct from the introduced strain originally reported from Brazil.
Mesoscale Model Evaluation Testbed (MMET): A Resource for Transitioning NWP Innovations from Research to Operations (R2O)
Authors: Wolff Jamie K. , Harrold Michelle , Hertneky Tracy , Aligo Eric , Carley Jacob R. , Ferrier Brad , DiMego Geoff , Nance Louisa , Kuo Ying-Hwa 
Published: April 2016

Abstract
A wide range of numerical weather prediction (NWP) innovations are under development in the research community that have the potential to positively impact operational models. The Developmental Testbed Center (DTC) helps facilitate the transition of these innovations from research to operations (R2O). With the large number of innovations available in the research community, it is critical to clearly define a testing protocol to streamline the R2O process. The DTC has defined such a process that relies on shared responsibilities of the researchers, the DTC, and operational centers to test promising new NWP advancements. As part of the first stage of this process, the DTC instituted the mesoscale model evaluation testbed (MMET), which established a common testing framework to assist the research community in demonstrating the merits of developments. The ability to compare performance across innovations for critical cases provides a mechanism for selecting the most promising capabilities for further testing. If the researcher demonstrates improved results using MMET, then the innovation may be considered for the second stage of comprehensive testing and evaluation (T&E) prior to entering the final stage of preimplementation T&E.
MMET provides initialization and observation datasets for several case studies and multiday periods. In addition, the DTC provides baseline results for select operational configurations that use the Advanced Research version of Weather Research and Forecasting Model (ARW) or the National Oceanic and Atmospheric Administration (NOAA) Environmental Modeling System Nonhydrostatic Multiscale Model on the B grid (NEMS-NMMB). These baselines can be used for testing sensitivities to different model versions or configurations in order to improve forecast performance.
Impact of Swell on Air–Sea Momentum Flux and Marine Boundary Layer under Low-Wind Conditions
Authors: Jiang Qingfang , Sullivan Peter , Wang Shouping , Doyle James , Vincent Linwood 
Published: April 2016

Abstract
The impact of fast-propagating swell on the air–sea momentum exchange and the marine boundary layer is examined based on multiple large-eddy simulations over a range of wind speed and swell parameters in the light-wind–fast-wave regime. A wave-driven supergeostrophic jet forms near the top of the wave boundary layer when the forwarding-pointing (i.e., negative) form drag associated with fast wind-following swell overpowers the positive surface shear stress. The magnitude of the form drag increases with the wavelength and slope and decreases with increasing wind speed, and the jet intensity in general increases with the magnitude of the surface form drag. The resulting negative vertical wind shear above the jet in turn enhances the turbulence aloft. The level of the wind maximum is found to be largely determined by the wavenumber and the ratio of the surface shear stress and form drag: the larger the magnitude of this ratio, the higher the altitude of the wind maximum.
Although the simulated wind profile often closely follows the log law in the wave boundary layer, the surface stress derived from the logarithmic wind profile is significantly larger than the actual total surface stress in the presence of swell. Therefore, the Monin–Obukhov similarity theory is generally invalid over swell-dominated ocean. This is attributed to the wave-induced contribution to momentum flux, which decays roughly exponentially in the vertical and is largely independent of local wind shear.
A Unified Theory for the Great Plains Nocturnal Low-Level Jet
Authors: Shapiro Alan , Fedorovich Evgeni , Rahimi Stefan 
Published: April 2016

Abstract
A theory is presented for the Great Plains low-level jet in which the jet emerges in the sloping atmospheric boundary layer as the nocturnal phase of an oscillation arising from diurnal variations in turbulent diffusivity (Blackadar mechanism) and surface buoyancy (Holton mechanism). The governing equations are the equations of motion, mass conservation, and thermal energy for a stably stratified fluid in the Boussinesq approximation. Attention is restricted to remote (far above slope) geostrophic winds that blow along the terrain isoheights (southerly for the Great Plains). Diurnally periodic solutions are obtained analytically with diffusivities that vary as piecewise constant functions of time and slope buoyancies that vary as piecewise linear functions of time. The solution is controlled by 11 parameters: slope angle, Coriolis parameter, free-atmosphere Brunt–Väisälä frequency, free-atmosphere geostrophic wind, radiative damping parameter, day and night diffusivities, maximum and minimum surface buoyancies, and times of maximum surface buoyancy and sunset. The Holton mechanism, by itself, results in relatively weak wind maxima but produces strong jets when paired with the Blackadar mechanism. Jets with both Blackadar and Holton mechanisms operating are shown to be broadly consistent with observations and climatological analyses. Jets strengthen with increasing geostrophic wind, maximum surface buoyancy, and day-to-night ratio of the diffusivities and weaken with increasing Brunt–Väisälä frequency and magnitude of minimum slope buoyancy (greater nighttime cooling). Peak winds are maximized for slope angles characteristic of the Great Plains.
The Roots of the Ecological Crisis and the Way Out: Creation Out of ‘no thing’ God Being ‘no thing’
Authors: Sahinidou Ioanna 
Published: April 2016

Plato defined the primal dualism of reality: its division into the invisible eternal realm of thought and the unshaped matrix of the visible temporal realm of corporeality. The hierarchy of mind over body is reflected in the hierarchy of male over female, of human over animals, and in the class hierarchy of rulers over workers. Plato adds the alienation from body and earth, as the lowest level of cosmic hierarchy. The interrelatedness and interdependence of all cosmic beings uncover the dualism: soul/body. The idea of creatio ex nihilo promotes the desecration of the created world, lying at the root of the eco-crisis. The patristic idea of creation ‘ἐξ οὐκ ὄντων’ [‘out of non-being’] refers to what in God is envisaged as the pre-ontological nihil from which all proceed, deconstructing the dualism of a spiritual and a materialistic cosmos.
Restraints in daily care for people with moderate intellectual disabilities
Authors: Van der Meulen Anne Pier S , Hermsen Maaike A , Embregts Petri JCM 
Published: April 2016

Background: Self-determination is an important factor in improving the quality of life of people with moderate intellectual disabilities. A focus on self-determination implies that restraints on the freedom of people with intellectual disabilities should be decreased. In addition, according to the Dutch Care and Coercion bill, regular restraints of freedom, such as restrictions on choice of food or whom to visit, should be discouraged. Such restraints are only allowed if there is the threat of serious harm for the clients or their surroundings. Research question: What do support staff consider as restraints on freedom and how do they justify these restraints? Research design: In this study, data were collected by semi-structured interviews. Participants and research context: Fifteen support staff working with clients with moderate intellectual disabilities were interviewed. All participants work within the same organisation for people with intellectual disabilities in the Eastern part of the Netherlands. Ethical considerations: The study was conducted according to good scientific inquiry guidelines and ethical approval was obtained from a university ethics committee. Findings: Most restraints of freedom were found to be centred around the basic elements in the life of the client, such as eating, drinking and sleeping. In justifying these restraints, support staff said that it was necessary to give clarity in what clients are supposed to do, to structure their life and to keep them from danger. Discussion: In the justification of restraints of freedom two ethical viewpoints, a principle-guided approach and an ethics of care approach, are opposing one other. Here, the self-determination theory can be helpful, while it combines the autonomy of the client, relatedness to others and the client’s competence. Conclusion: Despite the reasonable grounds support staff gave for restraining, it raises the question whether restraints of freedom are always in the interest of the client.