bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recognized Obstructive Sleep Apnea is Associated With Improved In‐Hospital Outcomes After ST Elevation Myocardial Infarction
Authors: Mohananey Divyanshu , Villablanca Pedro A. , Gupta Tanush , Agrawal Sahil , Faulx Michael , Menon Venugopal , Kapadia Samir R. , Griffin Brian P. , Ellis Stephen G. , Desai Milind Y. 
Published: July 2017

Background

Obstructive sleep apnea (
OSA
) is an independent risk factor for many cardiovascular conditions such as coronary artery disease, myocardial infarction, systemic hypertension, pulmonary hypertension, and stroke. However, the association of
OSA
with outcomes in patients hospitalized for
ST
‐elevation myocardial infarction remains controversial.

Methods and Results

We used the nation‐wide inpatient sample between 2003 and 2011 to identify patients with a primary discharge diagnosis of
ST
‐elevation myocardial infarction and then used the International Classification of Diseases, Clinical Modification code 327.23 to identify a group of patients with
OSA
. The primary outcome of interest was in‐hospital mortality, and secondary outcomes were in‐hospital cardiac arrest, length of stay and hospital charges. Our cohort included 1 850 625 patients with
ST
‐elevation myocardial infarction, of which 1.3% (24 623) had documented
OSA
.
OSA
patients were younger and more likely to be male, smokers, and have chronic pulmonary disease, depression, hypertension, known history of coronary artery disease, dyslipidemia, obesity, and renal failure (
P
<0.001 for all). Patients with
OSA
had significantly decreased in‐hospital mortality (adjusted odds ratio, 0.78 [95%
CI
, 0.73–0.84]), longer hospital stay (5.00±4.68 versus 4.85±5.96 days), and incurred greater hospital charges ($79 460.12±70 621.91 versus $62 889.91±69 124.15). There was no difference in incidence of in‐hospital cardiac arrest (adjusted odds ratio, 0.93 [95%
CI
, 0.84–1.03]) between these 2 groups.

Conclusion

ST
‐elevation myocardial infarction patients with recognized
OSA
had significantly decreased mortality compared with patients without
OSA
. Although patients with
OSA
had longer hospital stays and incurred greater hospital charges, there was no difference in incidence of in‐hospital cardiac arrest.
Evaluating Climate Models with an African Lens
Authors: James Rachel , Washington Richard , Abiodun Babatunde , Kay Gillian , Mutemi Joseph , Pokam Wilfried , Hart Neil , Artan Guleid , Senior Cath 
Published: July 2017

AbstractClimate models are becoming evermore complex and increasingly relied upon to inform climate change adaptation. Yet progress in model development is lagging behind in many of the regions that need the information most, including in Africa. Targeted model development for Africa is crucial and so too is targeted model evaluation. Assessment of model performance in specific regions often follows a “validation” approach, focusing on mean biases, but if models are to be improved, it is important to understand how they simulate regional climate dynamics: to move from validation to process-based evaluation. This evaluation may be different for every region and requires local weather and climate expertise: a “one size fits all” approach could overlook important, region-specific phenomena. So which are the important processes in African regions? And how might they be evaluated? This paper addresses these questions, drawing on the expertise of a team of scientists from Central, East, southern, and West Africa. For each region, the current understanding of climate models is reviewed, and an example of targeted evaluation is provided, including analysis of moist circulations, teleconnections, and modes of variability. A pan-African perspective is also considered, to examine processes operating between regions. The analysis is based on the Met Office Unified Model, but it uses diagnostics that might be applied to other models. These examples are intended to prompt further discussion among climate modelers and African scientists about how to best evaluate models with an African lens, and promote the development of a model evaluation hub for Africa, to fast track understanding of model behavior for this important continent.
The Possible Role of Density Current Dynamics in the Generation of Low-Level Vertical Vorticity in Supercells
Authors: Houston Adam L. 
Published: July 2017

Abstract
A physical mechanism based on density current dynamics is proposed to explain the generation of low-level vertical vorticity in supercells. This mechanism may serve as one explanation for the associative relationship between environmental low-level vertical shear and the occurrence of significant tornadoes. The mechanism proposed herein represents an indirect connection to the generation of strong surface-based rotation: the barotropic horizontal vorticity associated with the vertical shear acts to amplify existing rotation but does not directly contribute to surface rotation. The proposed mechanism couples the likelihood of a tornado to the vertical shear through the pattern of vertical motion induced through interaction of a deformed gust front and the environmental vertical shear.
Results from the experiments conducted to test the veracity of the proposed mechanism illustrate that inferred patterns of tilting and vortex line orientation are consistent with the generation of positive vertical vorticity near the axis of the existing mesocyclone and negative vertical vorticity along the rear-flank gust front. Moreover, inferred tilting is found to scale with the magnitude of the environmental vertical shear, consistent with the climatologies that motivate this work. Experiments also reveal that the proposed mechanism is capable of relating boundary deformation, mesocyclone strength, and hodograph shape to the ultimate likelihood of tornadogenesis.
Evaluating Seasonal Orographic Precipitation in the Interior Western United States Using Gauge Data, Gridded Precipitation Estimates, and a Regional Climate Simulation
Authors: Jing Xiaoqin , Geerts Bart , Wang Yonggang , Liu Changhai 
Published: July 2017

Abstract
There are several high-resolution (1–12 km) gridded precipitation datasets covering the interior western United States. This study cross validates seasonal orographic precipitation estimates from the Snowpack Telemetry (SNOTEL) network; the national hourly multisensor precipitation analysis Stage IV dataset (NCEP IV); four gauge-driven gridded datasets; and a 10-yr, 4-km, convection-permitting Weather Research and Forecasting (WRF) Model simulation. The NCEP IV dataset, which uses the NEXRAD network and precipitation gauges, is challenged in this region because of blockage and lack of low-level radar coverage in complex terrain. The gauge-driven gridded datasets, which statistically interpolate gauge measurements over complex terrain to better estimate orographic precipitation, are challenged by the highly heterogeneous, weather-dependent nature of precipitation in complex terrain at scales finer than can be resolved by the gauge network, such as the SNOTEL network. Gauge-driven gridded precipitation estimates disagree in areas where SNOTEL gauges are sparse, especially at higher elevations. The WRF simulation captures wintertime orographic precipitation distribution and amount well, and biases over specific mountain ranges are identical to those in an independent WRF simulation, suggesting that these biases are at least partly due to errors in the snowfall measurements or the gridding of these measurements. The substantial disagreement between WRF and the gridded datasets over some mountains may motivate reevaluation of some gauge records and installation of new SNOTEL gauges in regions marked by large discrepancies between modeled and gauge-driven precipitation estimates.
The Dominant Modes of Recycled Monsoon Rainfall over India
Authors: Sujith K. , Saha Subodh Kumar , Pokhrel Samir , Hazra Anupam , Chaudhari Hemantkumar S. 
Published: July 2017

Abstract
This study estimates the seasonal mean (June–September) recycled rainfall and investigates its dominant modes of variability over the continental regions of the Indian summer monsoon. A diagnostic method based on the basic atmospheric water vapor budget equation is employed in order to partition the observed rainfall into recycled and advected components. The global teleconnections with the recycled (advected) rainfall are found to be weak (strong), which is consistent with the basic assumptions of the sources of atmospheric water vapor. It is shown that the mean recycled rainfall over the Indo-Gangetic Plain, central India, and western Himalayas ranges between 10% and 40% of the total rainfall. While EOF1 (38.5%) of the recycled rainfall reveals covariability between the regional and external influences, EOF2 (14%) shows a mode independent to the external influences (i.e., advected rainfall), prevailing over the Indo-Gangetic Plain. Furthermore, a strong decreasing trend in PC2 over the last 36 years suggests a change in the local feedback (land, atmosphere), which in turn may have also contributed to the decreasing trend in the observed monsoon rainfall over central and northern India.
Occupational therapists’ awareness of guidelines for assessment and diagnosis of developmental coordination disorder
Authors: Karkling Morgan , Paul Alissa , Zwicker Jill G. 
Published: July 2017

Background. Developmental coordination disorder (DCD) is a motor skills disorder that can have negative lifelong psychosocial impacts if not diagnosed. Occupational therapists have a role in facilitating a diagnosis for children with DCD through assessment. Purpose. The purpose of this study was to determine the level of understanding of current DCD guidelines for assessment and diagnosis among occupational therapists working in paediatric settings in British Columbia, Canada. Method. An online survey was e-mailed to occupational therapists who consented to be contacted for research purposes; 169 paediatric therapists responded. Data were reported using percentage, mean, and standard deviation of responses for each answer. Findings. Although many occupational therapists are aware of DCD and the diagnostic criteria, most are unaware of current guidelines for assessment and diagnosis. Many are using cutoff scores inconsistent with current recommendations and thus may not be facilitating a diagnosis when one may be appropriate. Implications. Occupational therapists may benefit from targeted education regarding DCD assessment and diagnosis.
Falls prevention interventions for older adults with low vision: A scoping review
Authors: Blaylock Sarah E. , Vogtle Laura K. 
Published: July 2017

Background. Older adults with low vision are especially vulnerable to falls. There are no comprehensive reviews of fall prevention interventions for older adults with vision loss who live in the community. Purpose. The aim of this study was to review the evidence regarding community-based falls prevention interventions that appear inclusive of and/or accessible to individuals with low vision. Method. A scoping review was completed using the framework developed by Arksey and O’Malley, and the charted data were analyzed using sums and percentages and qualitative content analysis. Findings. Seventeen publications were selected for this review. The analysis allowed for a thorough description of the types of falls prevention interventions (multiple components, home safety/modification, tai chi, the Alexander Technique, improvement of vision through vision assessment and referral, vision/agility training, and yoga), how each intervention addresses vision impairment, and the relation of results to falls risk. Implications. Falls prevention research targeting individuals with visual impairment is limited, and the intervention approaches available may not be effective for older adults with permanent vision loss.
Production, characterization and application of nanotechnology-based vegetable multi-component theospheres in nonwovens: A women's intimate hygiene approach
Authors: Pohlmann Mariana , Paese Karina , Frank Luíza Abrahão , Guterres Silvia Stanisçuaski 
Published: July 2017

The main objective of this work was to develop a nanotechnology-based component containing substances of vegetable origin, such as butters and essential oils, whose properties may help balance the vulvovaginal microbiota and be applied in nonwovens for feminine hygiene products. The high-pressure homogenization technique was used to obtain the aqueous dispersion of these nanoparticles containing tea tree oil, alpha-bisabolol, resveratrol, grape seed oil and citric acid, namely VM-Theospheres (theospheres are nanoparticles formed by Theobroma grandiflorum butter). The average particle size range was 274 ± 5 nm. The stability tests indicated that formulation status remained stable at room temperature for 28 days. In vitro analysis of skin penetration and irritation showed that the VM-Theospheres can be considered safe for use in feminine hygiene products. The production of an absorbent layer was performed by impregnation of VM-Theospheres in nonwovens. The results revealed that spraying was the most effective method, without the need to treat the samples first.
A potential therapeutic pitfall in the treatment of venous reflux due to variant planar anatomy of varicose segments
Authors: Deniz Sinan , Tureli Derya , Akpinar Burcu , Oguzkurt Levent 
Published: July 2017

Purpose To elaborate on a planar anatomic variant of great saphenous vein as a potential therapeutic pitfall in the treatment of venous reflux. Materials and methods Lower extremity veins in 568 limbs with great saphenous vein insufficiency were sonographically mapped. A rather overlooked variation, the saphenous bow, was studied with emphasis on anatomic clarification and its involvement in venous insufficiency. Results This variation, observed in 5.1% (n = 29) of limbs, comprised two segments; one uninterrupted great saphenous vein proper coursing throughout saphenous compartment and one extra-compartmental segment originating distally from and proximally fusing with it. Venous arch remains within compartment only briefly during take-off and re-entry. Extra-compartmental venous arch had reflux either alone (10.3%) or together with intra-compartmental segment (75.9%). Conclusion This variation, part of saphenous segmental aplasia/hypoplasia complex, is associated with venous insufficiency. Meticulous mapping of great saphenous vein territory and identification of such variants during planning stage is indispensable for optimal clinical outcomes of treatment.
Quasi-experimental evaluation of a multifaceted intervention to improve quality of end-of-life care and quality of dying for patients with advanced dementia in long-term care institutions
Authors: Verreault René , Arcand Marcel , Misson Lucie , Durand Pierre J , Kroger Edeltraut , Aubin Michèle , Savoie Maryse , Hadjistavropoulos Thomas , Kaasalainen Sharon , Bédard Annick , Grégoire Annie , Carmichael Pierre-Hughes 
Published: July 2017

Background: Improvement in the quality of end-of-life care for advanced dementia is increasingly recognized as a priority in palliative care. Aim: To evaluate the impact of a multidimensional intervention to improve quality of care and quality of dying in advanced dementia in long-term care facilities. Design: Quasi-experimental study with the intervention taking place in two long-term care facilities versus usual care in two others over a 1-year period. The intervention had five components: (1) training program to physicians and nursing staff, (2) clinical monitoring of pain using an observational pain scale, (3) implementation of a regular mouth care routine, (4) early and systematic communication with families about end-of-life care issues with provision of an information booklet, and (5) involvement of a nurse facilitator to implement and monitor the intervention. Quality of care was assessed with the Family Perception of Care Scale. The Symptom Management for End-of-Life Care in Dementia and the Comfort Assessment in Dying scales were used to assess the quality of dying. Participants: A total of 193 residents with advanced dementia and their close family members were included (97 in the intervention group and 96 in the usual care group). Results: The Family Perception of Care score was significantly higher in the intervention group than in the usual care group (157.3 vs 149.1; p = 0.04). The Comfort Assessment and Symptom Management scores were also significantly higher in the intervention group. Conclusions: Our multidimensional intervention in long-term care facilities for patients with terminal dementia resulted in improved quality of care and quality of dying when compared to usual care.
External validation and clinical utility of a prediction model for 6-month mortality in patients undergoing hemodialysis for end-stage kidney disease
Authors: Forzley Brian , Er Lee , Chiu Helen HL , Djurdjev Ognjenka , Martinusen Dan , Carson Rachel C , Hargrove Gaylene , Levin Adeera , Karim Mohamud 
Published: July 2017

Background: End-stage kidney disease is associated with poor prognosis. Health care professionals must be prepared to address end-of-life issues and identify those at high risk for dying. A 6-month mortality prediction model for patients on dialysis derived in the United States is used but has not been externally validated. Aim: We aimed to assess the external validity and clinical utility in an independent cohort in Canada. Design: We examined the performance of the published 6-month mortality prediction model, using discrimination, calibration, and decision curve analyses. Setting/participants: Data were derived from a cohort of 374 prevalent dialysis patients in two regions of British Columbia, Canada, which included serum albumin, age, peripheral vascular disease, dementia, and answers to the “the surprise question” (“Would I be surprised if this patient died within the next year?”). Results: The observed mortality in the validation cohort was 11.5% at 6 months. The prediction model had reasonable discrimination (c-stat = 0.70) but poor calibration (calibration-in-the-large = −0.53 (95% confidence interval: −0.88, −0.18); calibration slope = 0.57 (95% confidence interval: 0.31, 0.83)) in our data. Decision curve analysis showed the model only has added value in guiding clinical decision in a small range of threshold probabilities: 8%–20%. Conclusion: Despite reasonable discrimination, the prediction model has poor calibration in this external study cohort; thus, it may have limited clinical utility in settings outside of where it was derived. Decision curve analysis clarifies limitations in clinical utility not apparent by receiver operating characteristic curve analysis. This study highlights the importance of external validation of prediction models prior to routine use in clinical practice.
Radiographic temporal subtraction analysis can detect finger joint space narrowing progression in rheumatoid arthritis with clinical low disease activity
Authors: Okino Taichi , Kamishima Tamotsu , Lee Sutherland Kenneth , Fukae Jun , Narita Akihiro , Ichikawa Shota , Tanimura Kazuhide 
Published: July 2017

Background Recent papers suggest that finger joints with positive synovial vascularity (SV) assessed by ultrasonography under clinical low disease activity (CLDA) in rheumatoid arthritis (RA) patients may cause joint space narrowing (JSN) progression. Purpose To investigate the performance of a computer-based method by directly comparing with the conventional scoring method in terms of the detectability of JSN progression in hand radiography of RA patients with CLDA. Material and Methods Fifteen RA patients (13 women, 2 men) with long-term sustained CLDA of >2 years were included. Radiological progression of finger joints was measured or scored using the computer-based method which can detect JSN progression between two radiographic images as the joint space difference index (JSDI), as well as the Genant-modified Sharp score (GSS). We also quantitatively assessed SV of these joints using ultrasonography. Results Out of 270 joints, we targeted 259 finger joints after excluding nine damaged joints (four ankylosis, three complete luxation, and two subluxation) and two improved joints according to the GSS results. The JSDI of finger joints with JSN progression was significantly higher than those without JSN progression ( P = 0.018). The JSDI of finger joints with ultrasonographic SV was significantly higher than those without ultrasonographic SV ( P = 0.004). Progression in JSDI showed stronger associations with ultrasonographic SV than progression in GSS (odds ratio [95% confidence interval]: 7.19 [3.37–15.36] versus 5.84 [2.76–12.33]). Conclusion The computer-based method was comparable to the conventional scoring method regarding the detectability of JSN progression in RA patients with CLDA.
The rs10229583 polymorphism near paired box gene 4 is associated with gestational diabetes mellitus in Chinese women
Authors: Xu Tianyi , Shi Yiru , Liu Jiangbo , Liu Yun , Zhu Ailin , Xie Cui , Zhang Yan , Chen Yan , Ren Lirong 
Published: July 2017

Objective The rs10229583 polymorphism near paired box gene 4 ( PAX4) is associated with insulin resistance and type 2 diabetes. Mutations in the PAX4 gene may be associated with impaired differentiation/development of pancreatic islet beta cells during fetal development and, consequently, a compromised insulin response to high blood glucose. To ascertain whether this polymorphism plays a role in gestational diabetes mellitus (GDM), we investigated the genotypic and allele frequency differences between GDM and normal pregnancies. Methods A total of 310 GDM and 440 normal pregnancies were evaluated. Allele and genotype frequencies of rs10229583 were determined for all participants with Sanger sequencing and SNaPshot. Association of the allele and genotypes of the single nucleotide polymorphism with the disease was analyzed using Pearson’s χ2 test and OR (odds ratio). Results The G allele was more frequent in patients with GDM compared with controls (OR = 1.47, 95% confidence interval (CI): 1.12–1.939). The GG genotype frequency of rs10229583 was significantly different between subjects with GDM and normal controls (OR = 1.411, 95% CI: 1.032–1.928). The OR of the GA +  GG genotype was 3.182 (95% CI: 1.294–7.826) for patients with GDM compared with controls. Conclusion The present study suggests that rs10229583 is associated with GDM.
Influence of infectious disease seasonality on the performance of the outbreak detection algorithm in the China Infectious Disease Automated-alert and Response System
Authors: Wang Ruiping , Jiang Yonggen , Guo Xiaoqin , Wu Yiling , Zhao Genming 
Published: July 2017

Objective The Chinese Center for Disease Control and Prevention developed the China Infectious Disease Automated-alert and Response System (CIDARS) in 2008. The CIDARS can detect outbreak signals in a timely manner but generates many false-positive signals, especially for diseases with seasonality. We assessed the influence of seasonality on infectious disease outbreak detection performance. Methods Chickenpox surveillance data in Songjiang District, Shanghai were used. The optimized early alert thresholds for chickenpox were selected according to three algorithm evaluation indexes: sensitivity (Se), false alarm rate (FAR), and time to detection (TTD). Performance of selected proper thresholds was assessed by data external to the study period. Results The optimized early alert threshold for chickenpox during the epidemic season was the percentile P65, which demonstrated an Se of 93.33%, FAR of 0%, and TTD of 0 days. The optimized early alert threshold in the nonepidemic season was P50, demonstrating an Se of 100%, FAR of 18.94%, and TTD was 2.5 days. The performance evaluation demonstrated that the use of an optimized threshold adjusted for seasonality could reduce the FAR and shorten the TTD. Conclusions Selection of optimized early alert thresholds based on local infectious disease seasonality could improve the performance of the CIDARS.