bluuebunny/crossref_metadata_2025_split huggingface dataset:
Night-time communication at Stanford University Hospital: perceptions, reality and solutions
Authors: Sun Andrew Jordan , Wang Libo , Go Minjoung , Eggers Zac , Deng Raymond , Maggio Paul , Shieh Lisa 
Published: October 2017

BackgroundResident work hour restrictions have led to the creation of the ‘night float’ to care for the patients of multiple primary teams after hours. These residents are often inundated with acute issues in the numerous patients they cover and are less able to address non-urgent issues that arise at night. Further, non-urgent pages may contribute to physician alarm fatigue and negatively impact patient outcomes.ObjectiveTo delineate the burden of non-urgent paging at night and propose solutions.MethodsWe performed a resident review and categorisation of 1820 pages to night floats between September 2014 and December 2014. Both attending and nursing review of 10% of pages was done and compared.ResultsOf reviewed pages, 62.1% were urgent and 27.7% were non-urgent. Attending review of random page samples correlated well with resident review. Common reasons for non-urgent pages were non-urgent patient status updates, low-priority order requests and non-critical lab values.ConclusionsA significant number of non-urgent pages are sent at night. These pages likely distract from acute issues that arise at night and place an unnecessary burden on night floats. Both behavioural and systemic adjustments are needed to address this issue. Possible interventions include integrating low-priority messaging into the electronic health record system and use of charge nurses to help determine urgency of issues and batch non-urgent pages.
Comparison of elevated phosphorylated neurofilament heavy chains in serum and cerebrospinal fluid of patients with amyotrophic lateral sclerosis
Authors: De Schaepdryver Maxim , Jeromin Andreas , Gille Benjamin , Claeys Kristl G , Herbst Victor , Brix Britta , Van Damme Philip , Poesen Koen 
Published: October 2017

ObjectivePhosphorylated neurofilament heavy chain (pNfH) levels are elevated in cerebrospinal fluid (CSF) of patients with amyotrophic lateral sclerosis (ALS). Instead of CSF, we explored blood as an alternative source to measure pNfH in patients with ALS.MethodsIn this single centre retrospective study, 85 patients with ALS, 215 disease controls (DC) and 31 ALS mimics were included. Individual serum pNfH concentrations were correlated with concentrations in CSF and with several clinical parameters. The performance characteristics of pNfH in CSF and serum of patients with ALS and controls were calculated and compared using receiver operating characteristic (ROC) curves.ResultsCSF and serum pNfH concentrations in patients with ALS correlated well (r=0.652, p<0.0001) and were significantly increased compared with DC (p<0.0001) and ALS mimics (p<0.0001). CSF pNfH outperformed serum pNfH in discriminating patients with ALS from DC and ALS mimics (difference between area under the ROC curves: p=0.0001 and p=0.0005; respectively). Serum pNfH correlated inversely with symptom duration (r=−0.315, p=0.0033). CSF and serum pNfH were lower when the disease progression rate was slower (r=0.279, p<0.01 and r=0.289, p<0.01; respectively). Unlike CSF, serum pNfH did not correlate with the burden of clinical and electromyographic motor neuron dysfunction.ConclusionsCSF and serum pNfH concentrations are elevated in patients with ALS and correlate with the disease progression rate. Moreover, CSF pNfH correlates with the burden of motor neuron dysfunction. Our findings encourage further pursuit of CSF and serum pNfH concentrations in the diagnostic pathway of patients suspected to have ALS.
Predictors of risk for sudden death in childhood hypertrophic cardiomyopathy: the importance of the ECG risk score
Authors: Östman-Smith Ingegerd , Sjöberg Gunnar , Rydberg Annika , Larsson Per , Fernlund Eva 
Published: October 2017

ObjectiveTo establish which risk factors are predictive for sudden death in hypertrophic cardiomyopathy (HCM) diagnosed in childhood.MethodsA Swedish national cohort of patients with HCM diagnosed <19 years of age was collected between 1972 and 2014, consisting of 155 patients with available ECGs, with average follow-up of 10.9±(SD 9.0) years, out of whom 32 had suffered sudden death or cardiac arrest (SD/CA group). Previously proposed risk factors and clinical features, ECG and ultrasound measures were compared between SD/CA group and patients surviving >2 years (n=100), and features significantly more common in SD/CA group were further analysed with univariate and multivariate Cox hazard regression in the total cohort.ResultsRanked according to relative risk (RR) the ECG risk score >5 points had an RR of 46.5 (95% CI 6.6 to 331), sensitivity of 97% (83% to 100%) and specificity of 80% (71% to 88%) (p<0.0001), and was the best ECG predictor, predicting a 5-year risk of SD/CA of 30.6%. The following are other features with importantly raised RR: Detroit wall thickness Z-score >4.5: 9.9 (3.1 to 31.2); septal thickness ≥190% of upper limit of normal for age (septum in % of 95th centile for age (SEPPER) ≥190%): 7.9 (3.2 to 19.4); ventricular tachycardia: 9.1 (3.6 to 22.8); ventricular ectopics on exercise testing: 7.4 (2.7 to 20.2); and left ventricular outflow gradient (left ventricular outflow tract obstruction (LVOTO)) >50 mm Hg: 6.6 (4.0 to 11.0). Family history was non-significant. Multivariate Cox hazard analysis gives the following as early predictors: limb-lead QRS amplitude sum (p=0.020), SEPPER ≥190% (p<0.001) and LVOTO at rest (p=0.054); and for late predictors: last ECG risk score (p=0.002) and last Detroit Z-score (p=0.001). Both early (p=0.028) and late (p=0.037) beta-blocker doses reduced risk in the models.ConclusionsECG phenotype as assessed by ECG risk score is important for risk of sudden death and should be considered for inclusion in risk stratification of paediatric patients with HCM.
Assessing the extent of non-aggressive cancer in clinically detected stage I non-small cell lung cancer
Authors: Kale Minal S , Sigel Keith , Mhango Grace , Wisnivesky Juan P 
Published: October 2017

BackgroundOverdiagnosis among clinically detected lung cancers likely consists of cases that are non-aggressive and slowly progressive and will never disseminate, cause symptoms or be a threat to a subject’s survival, even if untreated. In this study, we estimate the prevalence of non-aggressive lung cancers from a large, population-based cancer registry.MethodsWe identified individuals ≥65 years with histologically confirmed, untreated stage I non-small cell lung cancers (NSCLCs) from the Surveillance, Epidemiology, and End Results-Medicare registry. We estimated the rate of non-aggressive lung cancers by determining the point at which the cumulative lung cancer-specific survival curve no longer changed (ie, the slope approaches zero). At this point, there are no additional deaths due to progressive lung cancer observed among untreated patients after adjusting for deaths from competing risks (these long-term survivors can be considered ‘non-aggressive cases).ResultsThe overall rate of non-aggressive cancers among 2197 clinically detected cases of untreated stage I NSCLC was 2.4%, 95% CI: 1.0% to 3.8%. The rate of non-aggressive cancer was 1.9% (95% CI: 0.0% to 4.9%) for women and 2.4% (95% CI: 0.7% to 4.1%) for men (p=0.84). When stratifying by tumour size, non-aggressive cancer rates were 10.2% (95% CI: 0.0% to 29.3%), 2.1% (95% CI: 0.0% to 9.2%), 4.9% (95% CI: 0.0% to 10.3%), 1.8% (95% CI: 0.0% to 5.2%) and 0.0% (95% CI: 0.0% to 1.0%) for tumour sizes <15 mm, 15–24 mm, 25–34 mm, 35–44 mm and ≥45 mm, respectively. In comparison with the smallest tumour sizes (<15 mm), the rates of non-aggressive cancers were not statistically significantly different for tumour sizes 15–24 mm (p=0.36), 25–34 mm (p=0.57), 35–44 mm (p=0.38) and tumour sizes >45 mm (p=0.30).DiscussionWe found relatively low rates of non-aggressive cancers among clinically detected, stage I NSCLC regardless of sex or size. Our findings suggest that most clinically diagnosed early stage cancers should be treated with curative intent.
Interaction of Antitumor Agent Mitoxantrone with Double Helical Synthetic Polyribonucleotides Poly(G)⋅Poly(C) and Poly(I)⋅Poly(C)
Authors: Babayan Yuri S. , Hakobyan Sergey N. , Ghazaryan Rusanna S. , Shahinyan Mariam A. 
Published: October 2017

The interaction of antitumor drug mitoxantrone (MTX) with double-stranded synthetic RNA homopolymers has been studied by means of spectroscopic (UV-Visible absorption, circular dichroism) techniques. The results show a base specificity in this interaction: the association constant with poly(G)[Formula: see text]poly(C) is higher than with poly(I)[Formula: see text]poly(C).Values of changes of the system enthalpy and entropy due to complex-formation were determined through the temperature dependence of the binding constant. Calculations show that due to the intercalation interaction of MTX, the values of changes of the system entropy and enthalpy differ from those obtained at ehtidium bromide interaction with synthetic polyribonucleotides, which shows that the intercalation interaction of MTX with double-stranded RNA significantly differs from that of ethidium bromide with RNA.
Natural Killer T-cell Immunotherapy in Combination with Chemotherapy-Induced Immunogenic Cell Death Targets Metastatic Breast Cancer
Authors: Gebremeskel Simon , Lobert Lynnea , Tanner Kaitlyn , Walker Brynn , Oliphant Tora , Clarke Livia E. , Dellaire Graham , Johnston Brent 
Published: October 2017

Abstract
Natural killer T (NKT) cells are glycolipid-reactive lymphocytes that promote cancer control. In previous studies, NKT-cell activation improved survival and antitumor immunity in a postsurgical mouse model of metastatic breast cancer. Herein, we investigated whether NKT-cell activation could be combined with chemotherapeutic agents to augment therapeutic outcomes. Gemcitabine and cyclophosphamide analogues enhanced the potential immunogenicity of 4T1 mammary carcinoma cells by increasing the expression of antigen-presenting molecules (MHC-I, MHC-II, and CD1d) and promoting exposure or release of immunogenic cell death markers (calreticulin, HMGB1, and ATP). In 4T1 primary tumor and postsurgical metastasis models, BALB/c mice were treated with cyclophosphamide or gemcitabine. NKT cells were then activated by transfer of dendritic cells loaded with the glycolipid antigen α-galactosylceramide (α-GalCer). Chemotherapeutic treatments did not impact NKT-cell activation but enhanced recruitment into primary tumors. Cyclophosphamide, gemcitabine, or α-GalCer–loaded dendritic cell monotherapies decreased tumor growth in the primary tumor model and reduced metastatic burden and prolonged survival in the metastasis model. Combining chemotherapeutics with NKT-cell activation therapy significantly enhanced survival, with surviving mice exhibiting attenuated tumor growth following a second tumor challenge. The frequency of myeloid-derived suppressor cells was reduced by gemcitabine, cyclophosphamide, or α-GalCer–loaded dendritic cell treatments; cyclophosphamide also reduced the frequency of regulatory T cells. Individual treatments increased immune cell activation, cytokine polarization, and cytotoxic responses, although these readouts were not enhanced further by combining therapies. These findings demonstrate that NKT-cell activation therapy can be combined with gemcitabine or cyclophosphamide to target tumor burden and enhance protection against tumor recurrence. Cancer Immunol Res; 5(12); 1086–97. ©2017 AACR.
Does Moderate Drinking Increase the Risk of Atrial Fibrillation? The Norwegian HUNT (Nord‐Trøndelag Health) Study
Authors: Gémes Katalin , Malmo Vegard , Laugsand Lars Erik , Loennechen Jan Pål , Ellekjaer Hanne , László Krisztina D. , Ahnve Staffan , Vatten Lars J. , Mukamal Kenneth J. , Janszky Imre 
Published: October 2017

Background

Compelling evidence suggests that excessive alcohol consumption increases the risk of atrial fibrillation (
AF
), but the effect of light‐moderate alcohol consumption is less certain. We investigated the association between alcohol consumption within recommended limits and
AF
risk in a light‐drinking population.

Methods and Results

Among 47 002 participants with information on alcohol consumption in a population‐based cohort study in Norway, conducted from October 2006 to June 2008, 1697 validated
AF
diagnoses were registered during the 8 years of follow‐up. We used Cox proportional hazard models with fractional polynomials to analyze the association between alcohol intake and
AF
. Population attributable risk for drinking within the recommended limit (ie, at most 1 drink per day for women and 2 drinks per day for men without risky drinking) compared with nondrinking was also calculated. The average alcohol intake was 3.8±4.8 g/d. The adjusted hazard ratio for
AF
was 1.38 (95% confidence interval, 1.06–1.80) when we compared participants consuming >7 drinks per week with abstainers. When we modeled the quantity of alcohol intake as a continuous variable, the risk increased in a curvilinear manner. It was higher with heavier alcohol intake, but there was virtually no association at <1 drink per day for women and <2 drinks per day for men in the absence of risky drinking. The population attributable risk among nonrisky drinkers was 0.07% (95% confidence interval, −0.01% to 0.13%).

Conclusions

Although alcohol consumption was associated with a curvilinearly increasing risk of
AF
in general, the attributable risk of alcohol consumption within recommended limits among participants without binge or problem drinking was negligible in this population.
Development and Decay Processes of Dual Inversion Layers in Winter over the Northwest Coast of the South China Sea
Authors: Nodzu Masato I. , Ogino Shin-Ya , Matsumoto Jun 
Published: October 2017

Abstract
Inversion layers in the lower troposphere appear centered at two heights, 1.5 and 4 km, over the northwestern coast of the South China Sea in late boreal winter. The mechanisms of these dual inversion layers are investigated with thermal budget and composite analyses of the JRA-55 dataset. The thermal budget analysis classifies inversion layers between the levels of 700 and 600 hPa into two types. One type is related to high pressure moving southward along the eastern edge of the Tibetan Plateau; the arrival of the high coincides with subsidence that warms the 600-hPa level more strongly, and the stability increases between the 700- and 600-hPa levels. The other type is related to a synoptic-scale eastward-propagating wave in the upper troposphere. The upper-level high pressure in the wave is accompanied by a midtropospheric warm area whose intrusion at the 600-hPa level generates the inversion layers. Inversions between the levels of 925 and 850 hPa are related to heating and cooling by horizontal advection of potential temperature in the upper and lower levels, respectively. The vertical contrast of horizontal advection corresponds to a frontlike structure at the southern edge of a pressure surge. The pressure surge has a similar structure with the high pressure moving along the plateau edge as mentioned for the former type of inversion layers between the 700- and 600-hPa levels.
Statistical Analysis of the Quantified Relationship between Evaporation Duct and Oceanic Evaporation for Unstable Conditions
Authors: Zhang Qi , Yang Kunde , Yang Qiulong 
Published: October 2017

AbstractAn analysis is conducted for the first time to statistically quantify the relationship between the evaporation duct and oceanic evaporation. Through sensitivity analysis, under unstable conditions (air–sea temperature difference less than zero), evaporation duct and evaporation are found to maintain a similar trend with variations in air–sea variables, indicating a possible inherent connection. Furthermore, scatterplots of relevant historical data reveal that the evaporation duct generally increases in a power-law manner with evaporation. Therefore, logarithmic transformation is performed on the data, and then linear regression is adopted to derive the analytical expression of the linear trend. Additionally, based on this analytical expression, a three-parameter empirical model is proposed to estimate the temporal clustering, and the estimated result shows good agreement with the real distribution. The spatial variations of the parameters modeled over different focus areas reflect the influence of geophysical parameters.
Stability of Procainamide Injection in Clear Glass Vials and Polyvinyl Chloride Bags
Authors: Donnelly Ronald F. 
Published: October 2017

Objectives: The objective of this study was to evaluate the chemical stability of procainamide hydrochloride, 100 mg/mL, when repackaged in clear glass vials or diluted to 3 mg/mL with normal saline and packaged in polyvinyl chloride (PVC) bags when stored at either 23°C and exposed to light (ETL) or 5°C and protected from light (PFL). Methods: Solutions were assayed using a stability-indicating high-performance liquid chromatography method. Samples (5 mL) were collected from triplicate containers on days 0, 7, 14, 21, 28, 56, 91, and 193. Color/clarity and pH changes were also monitored at each time interval. Results: During the study, all samples remained clear and there was only a slight pH change. The color of the solutions stored at 23°C intensified but did not correlate with a significant decrease in concentration, while solutions stored at 5°C remained unchanged. Solutions repackaged in glass vials were stable for 193 days when stored at 23ºC and ETL or 5ºC and PFL. When further diluted to 3 mg/mL with normal saline and packaged in PVC bags, procainamide was also stable for 193 days at either 23ºC and ETL or 5°C and PFL. Conclusions: The stability of procainamide, 100 mg/mL, repackaged in clear glass vials was 193 days when stored at either 23ºC and ETL or 5ºC or PFL. If diluted further to 3 mg/mL with normal saline and packaged in PVC bags, the drug was also stable for 193 days at either 23ºC and ETL or 5°C and PFL.
Development of a Seating Comfort Questionnaire for Motorcycles
Authors: Velagapudi Sai Praveen , Ray Gaur Gopal 
Published: October 2017

Objective The aim of this study is to develop a reliable and valid Motorcycle Seating Comfort Questionnaire (MSCQ). Background Motorcycle seat development is an iterative process based on subjective evaluations; however, there are no established subjective tools for evaluation of seating comfort. Research also suggests that seating comfort in motorcycles is poor and needs improvement. The development of a MSCQ therefore is an important step that can enable further research and aid in improving the design of motorcycle seats. Method The MSCQ is developed following guidelines available in literature and referring to established questionnaires for seating comfort in passenger cars. The MSCQ is further refined based on pilot studies and interviews with experts. The final version of the MSCQ is then statistically evaluated for reliability and validity. The reliability is evaluated using a test-retest protocol with 31 volunteers. The validity is evaluated by comparing the ratings of the MSCQ with that of the Category Partitioning Scale (CP50 scale). The validity test is carried out with 15 volunteers evaluating five motorcycles using both scales. Results The results show that the MSCQ is reliable with a significant test-retest reliability coefficient ( r = 0.72, p < .01, n = 31) and internal consistency (Cronbach’s α = 0.81, n = 31). The results also show that ratings of the MSCQ have a significant correlation ( r = −0.765, p < .05, n = 15) with that of CP50, establishing its validity. Conclusions A Motorcycle Seating Comfort Questionnaire is developed in this study with statistically established reliability and validity. Applications The MSCQ can be used as a tool for evaluation of seating comfort in motorcycles. The MSCQ can also form a basis for further research on motorcycle seating to develop prediction models and guidelines for the design of motorcycle seats.
Liquid chromatography tandem-mass spectrometry (LC-MS/MS) and dried blood spot sampling applied to pharmacokinetics studies in animals: Correlation of classic and block design
Authors: Baldo Matías N , Angeli Emmanuel , Gareis Natalia C , Hunzicker Gabriel A , Murguía Marcelo C , Ortega Hugo H , Hein Gustavo J 
Published: October 2017

A relative bioavailability study (RBA) of two phenytoin (PHT) formulations was conducted in rabbits, in order to compare the results obtained from different matrices (plasma and blood from dried blood spot (DBS) sampling) and different experimental designs (classic and block). The method was developed by liquid chromatography tandem-mass spectrometry (LC-MS/MS) in plasma and blood samples. The different sample preparation techniques, plasma protein precipitation and DBS, were validated according to international requirements. The analytical method was validated with ranges 0.20–50.80 and 0.12–20.32 µg ml−1, r > 0.999 for plasma and blood, respectively. Accuracy and precision were within acceptance criteria for bioanalytical assay validation (< 15 for bias and CV% and < 20 for limit of quantification (LOQ)). PHT showed long-term stability, both for plasma and blood, and under refrigerated and room temperature conditions. Haematocrit values were measured during the validation process and RBA study. Finally, the pharmacokinetic parameters (Cmax, Tmax and AUC0–t) obtained from the RBA study were tested. Results were highly comparable for matrices and experimental designs. A matrix correlation higher than 0.975 and a ratio of (PHT blood) = 1.158 (PHT plasma) were obtained. The results obtained herein show that the use of classic experimental design and DBS sampling for animal pharmacokinetic studies should be encouraged as they could help to prevent the use of a large number of animals and also animal euthanasia. Finally, the combination of DBS sampling with LC-MS/MS technology showed to be an excellent tool not only for therapeutic drug monitoring but also for RBA studies.