bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex Differences in Clinical Characteristics, Psychosocial Factors, and Outcomes Among Patients With Stable Coronary Heart Disease: Insights from the STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) Trial
Authors: Guimarães Patricia Oliveira , Granger Christopher B. , Stebbins Amanda , Chiswell Karen , Held Claes , Hochman Judith S. , Krug‐Gourley Susan , Lonn Eva , Lopes Renato D. , Stewart Ralph A. H. , Vinereanu Dragos , Wallentin Lars , White Harvey D. , Hagström Emil , Danchin Nicolas 
Published: September 2017

Background
Greater understanding of differences between men and women with coronary heart disease is needed.

Methods and Results

In this post hoc analysis of the STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) trial, we described psychosocial factors, treatments, and outcomes of men versus women with stable coronary heart disease and explored the association of sex with psychosocial characteristics and cardiovascular risk. Cox proportional hazards models were used to assess the relationship between sex and outcomes. Interactions among sex, psychosocial factors, and the composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke were tested. Of 15 828 patients, 2967 (19%) were women. Among women, 21.2% felt often or always stressed at home (versus 9.8% of men), and 19.2% felt often or always sad or depressed (versus 10.1% of men; all
P
<0.0001). The median duration of follow‐up was 3.7 years (25th–75th percentiles: 3.5–3.8 years). Use of evidence‐based medications for coronary heart disease at baseline and 24 months was similar between sexes, as were event rates for all outcomes analyzed. In the multivariable model including psychosocial measures, female sex was associated with lower cardiovascular risk. There was a statistically significant interaction (
P
=0.03) such that the lower risk in women varied by depressive symptom frequency, whereby women who were more depressed had a risk similar to men.

Conclusions
Female sex was independently associated with better long‐term clinical outcomes, although this was modified by frequency of depressive symptoms. This suggests that emotional state may be an important target for improving outcomes in patients with coronary heart disease, specifically in women.

Clinical Trial Registration
STABILITY ClinicalTrials.gov number (NCT00799903).
Evidence for a Nimbostratus Uncinus in a Convectively Generated Mixed-Phase Stratiform Cloud Shield
Authors: Schmidt Jerome M. , Flatau Piotr J. , Harasti Paul R. 
Published: September 2017

Abstract
The structure of a melting layer associated with a mesoconvective system is examined using a combination of in situ aircraft measurements and a unique Doppler radar operated by the U.S. Navy that has a range resolution as fine as 0.5 m. Interest in this case was motivated by ground-based all-sky camera images that captured the transient development of midlevel billow cloud structures within a precipitating trailing stratiform cloud shield associated with a passing deep convective system. A sequence of high-fidelity time–height radar measurements taken of this storm system reveal that the movement of the billow cloud structure over the radar site corresponded with abrupt transitions in the observed low-level precipitation structure. Of particular note is an observed transition from stratiform to more periodic and vertically slanted rain shaft structures that both radar and aircraft measurements indicate have the same temporal periodicity determined to arise visually between successive billow cloud bands. Doppler, balloon, and aircraft measurements reveal these transient bands are associated with a shallow circulation field that resides just above the melting level in a layer of moist neutral stability and strong negative vertical wind shear. The nature of these circulations and their impact on the evolving precipitation field are described in the context of known nimbostratus cloud types.
Impact of Tropical Deforestation and Forest Degradation on Precipitation over Borneo Island
Authors: Takahashi Atsuhiro , Kumagai Tomo’omi , Kanamori Hironari , Fujinami Hatsuki , Hiyama Tetsuya , Hara Masayuki 
Published: September 2017

AbstractSoutheast Asian tropical rain forests in the Maritime Continent are among the most important biomes in terms of global and regional water cycling. How land use and land cover change (LULCC) relating to deforestation and forest degradation alter the local hydroclimate over the island of Borneo is examined using the Weather Research and Forecasting (WRF) Model with an appropriate land surface model for describing the influence of changes in the vegetation status on the atmosphere. The model was validated against precipitation data from Tropical Rainfall Measuring Mission (TRMM) satellite 3B42 measurements. A main novelty in this analysis is that the diurnal cycle of precipitation over the island, which is a dominant climatic characteristic of the Maritime Continent, was successfully reproduced. To clarify the impact of the LULCC on the precipitation regimes over the island, numerical experiments were performed with the model that demonstrated the following. Deforestation that generates high albedo areas, such as bare lands, would induce a reduction in precipitation because of reductions in evapotranspiration, convection, and horizontal atmospheric moisture inflow. On the other hand, a decrease in evapotranspiration efficiency without changing the surface albedo could increase precipitation due to an increase in convection and horizontal atmospheric moisture inflow in compensation for the decrease in evapotranspiration. In detail, on the Maritime Continent, through changes in the land surface heating process and land–sea breeze circulation, the LULCC would impact the amplitude of the diurnal precipitation cycle in each region as defined according to the distance from the coast, resulting in changes in the precipitation regimes over the island.
Two-year results from a phase 2 extension study of oral amiselimod in relapsing multiple sclerosis
Authors: Kappos Ludwig , Arnold Douglas L , Bar-Or Amit , Camm A John , Derfuss Tobias , Sprenger Till , Davies Martin , Piotrowska Alexandra , Ni Pingping , Harada Tomohiko 
Published: September 2017

Background: Amiselimod, an oral selective sphingosine-1-phosphate 1 receptor modulator, suppressed disease activity dose-dependently without clinically relevant bradyarrhythmia in a 24-week phase 2, placebo-controlled study in relapsing-remitting multiple sclerosis. Objective: To assess safety and efficacy of amiselimod over 96 weeks. Methods: After completing the core study, patients on amiselimod continued at the same dose, whereas those on placebo were randomised 1:1:1 to amiselimod 0.1, 0.2 or 0.4 mg for another 72 weeks. Most patients receiving 0.1 mg were re-randomised to 0.2 or 0.4 mg upon availability of the core study results. Results: Of 415 patients randomised in the core study, 367 (88.4%) entered and 322 (77.6%) completed the extension. One or more adverse events were reported in 303 (82.6%) of 367 patients: ‘headache’, ‘lymphocyte count decreased’, ‘nasopharyngitis’ and ‘MS relapse’ were most common (14.7%–16.9%). No serious opportunistic infection, macular oedema or malignancy was reported and no bradyarrhythmia of clinical concern was observed by Holter or 12-lead electrocardiogram. The dose-dependent effect of amiselimod on clinical and magnetic resonance imaging-related outcomes from the core study was sustained in those continuing on amiselimod and similarly observed after switching to active drug. Conclusion: For up to 2 years of treatment, amiselimod was well tolerated and dose-dependently effective in controlling disease activity.
Anatomical features of the cervical spinal canal in Chiari I deformity with presyrinx: A case-control study
Authors: Gadde Judith A , Shah Vinil , Liebo Greta B , Ringstad Geir A , Pomeraniec I Jonathan , Bakke Soren J , Fric Radek , Ksendzovsky Alexander , Jane John A , Schwartz Erin S , Haughton Victor 
Published: September 2017

Purpose The relationship between syringomyelia and presyrinx, characterized by edema in the spinal cord, has not been firmly established. Patients with syringomyelia have abnormal spinal canal tapering that alters cerebrospinal fluid flow dynamics, but taper ratios in presyrinx have never been reported. We tested the hypothesis that presyrinx patients have abnormal spinal canal tapering. Materials and methods At six medical institutions, investigators searched the PACS system for patients with Chiari I and spinal cord edema unassociated with tumor, trauma, or other evident cause. In each case taper ratios were calculated for C1 to C4 and C4 to C7. In two age- and gender-matched control groups, Chiari I patients with no syringomyelia and patients with normal MR scans, the same measurements were made. Differences between groups were tested for statistical significance with t tests. Results The study enrolled 21 presyrinx patients and equal numbers of matched Chiari I and normal controls. C4 to C7 taper ratios were positive and steeper in presyrinx patients than in the normal controls ( p = 0.04). The upper cervical spine, C1 to C4, tapered negatively in cases and controls without significant differences between the groups. The difference in degree of tonsillar herniation was statistically significant between presyrinx patients and Chiari I controls ( p = 0.01). Conclusions Presyrinx patients have greater than normal positive tapering in the lower cervical spine and greater degree of tonsillar herniation than the controls.
Use of PROMIS for Patients Undergoing Primary Total Shoulder Arthroplasty
Authors: Dowdle S. Blake , Glass Natalie , Anthony Chris A. , Hettrich Carolyn M. 
Published: September 2017

Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) consists of question banks for health domains through computer adaptive testing (CAT). Hypothesis: For patients with glenohumeral arthritis, (1) there would be high correlation between traditional patient-reported outcome (PRO) measures and the PROMIS upper extremity item bank (PROMIS UE) and PROMIS physical function CAT (PROMIS PF CAT), and (2) PROMIS PF CAT would not demonstrate ceiling effects. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Sixty-one patients with glenohumeral osteoarthritis were included. Each patient completed the American Shoulder and Elbow Surgeons (ASES) assessment form, Marx Shoulder Activity Scale, Short Form–36 physical function scale (SF-36 PF), EuroQol 5 Dimensions (EQ-5D) questionnaire, Western Ontario Osteoarthritis Shoulder (WOOS) index, PROMIS PF CAT, and the PROMIS UE. Correlation was defined as high (>0.7), moderate (0.4-0.6), or weak (0.2-0.3). Significant floor and ceiling effects were present if more than 15% of individuals scored the lowest or highest possible total score on any PRO. Results: The PROMIS PF demonstrated excellent correlation with the SF-36 PF ( r = 0.81, P < .0001) and good correlation with the ASES ( r = 0.62, P < .0001), EQ-5D ( r = 0.64, P < .001), and WOOS index ( r = 0.51, P < .01). The PROMIS PF demonstrated low correlation with the Marx scale ( r = 0.29, P = .02). The PROMIS UE demonstrated good correlation with the ASES ( r = 0.55, P < .0001), SF-36 ( r = 0.53, P < .01), EQ-5D ( r = 0.48, P < .01), and WOOS ( r = 0.34, P <.01), and poor correlation with the Marx scale ( r = 0.06, P = .62). There were no ceiling or floor effects observed. The mean number of items administered by the PROMIS PRO was 4. Conclusion: These data suggest that for a patient population with operative shoulder osteoarthritis, PROMIS UE and PROMIS PF CAT may be valid alternative PROs. Additionally, PROMIS PF CAT offers a decreased question burden with no ceiling effects.
Recombinant ADAMTS-13: first-in-human pharmacokinetics and safety in congenital thrombotic thrombocytopenic purpura
Authors: Scully Marie , Knöbl Paul , Kentouche Karim , Rice Lawrence , Windyga Jerzy , Schneppenheim Reinhard , Hovinga Johanna A. Kremer , Kajiwara Michiko , Fujimura Yoshihiro , Maggiore Caterina , Doralt Jennifer , Hibbard Christopher , Martell Leah , Ewenstein Bruce 
Published: September 2017

Key PointsFirst-in-human, phase 1 study, recombinant ADAMTS-13 was safe, nonimmunogenic, and tolerated in congenital thrombotic thrombocytopenic purpura. Recombinant ADAMTS-13 pharmacokinetic profile was comparable to plasma infusion studies, with evidence of pharmacodynamic activity.
TLR5 signaling in murine bone marrow induces hematopoietic progenitor cell proliferation and aids survival from radiation
Authors: Zhang Benyue , Oyewole-Said Damilola , Zou Jun , Willliams Ifor R. , Gewirtz Andrew T. 
Published: September 2017

Key PointsFlagellin activates TLR5 signaling in mouse bone marrow and induces hematopoietic progenitor cell proliferation. Flagellin-induced MPP3 cells aid the survival of mice exposed to lethal irradiation.
Disease severity and slower psychomotor speed in adults with sickle cell disease
Authors: Jorgensen Dana R. , Metti Andrea , Butters Meryl A. , Mettenburg Joseph M. , Rosano Caterina , Novelli Enrico M. 
Published: September 2017

Key PointsFirst study of cognitive functioning in adult patients with SCD genotypes other than homozygous for hemoglobin S. Patients with “severe” genotypes had significantly poorer speed of processing when compared with those with “moderate” genotypes.
Incidence and Risk Factors of Coagulation Profile Derangement After Liver Surgery: Implications for the Use of Epidural Analgesia—A Retrospective Cohort Study
Authors: Jacquenod Pierre , Wallon Grégoire , Gazon Mathieu , Darnis Benjamin , Pradat Pierre , Virlogeux Victor , Farges Olivier , Aubrun Frédéric 
Published: September 2017

BACKGROUND:
Hepatic surgery is a major abdominal surgery. Epidural analgesia may decrease the incidence of postoperative morbidities. Hemostatic disorders frequently occur after hepatic resection. Insertion or withdrawal (whether accidental or not) of an epidural catheter during coagulopathic state may cause an epidural hematoma. The aim of the study is to determine the incidence of coagulopathy after hepatectomy, interfering with epidural catheter removal, and to identify the risk factors related to coagulopathy.

METHODS:
We performed a retrospective review of a prospective, multicenter, observational database including patients over 18 years old with a history of liver resection. Main collected data were the following: age, preexisting cirrhosis, Child-Pugh class, preoperative and postoperative coagulation profiles, extent of liver resection, blood loss, blood products transfused during surgery. International normalized ratio (INR) ≥1.5 and/or platelet count <80,000/mm3 defined coagulopathy according to the neuraxial anesthesia guidelines. A logistic regression analysis was performed to assess the association between selected factors and a coagulopathic state after hepatic resection.

RESULTS:
One thousand three hundred seventy-one patients were assessed. Seven hundred fifty-nine patients had data available about postoperative coagulopathy, which was observed in 53.5% [95% confidence interval, 50.0–57.1]. Maximum derangement in INR occurred on the first postoperative day, and platelet count reached a trough peak on postoperative days 2 and 3. In the multivariable analysis, preexisting hepatic cirrhosis (odds ratio [OR] = 2.49 [1.38–4.51]; P = .003), preoperative INR ≥1.3 (OR = 2.39 [1.10–5.17]; P = .027), preoperative platelet count <150 G/L (OR = 3.03 [1.77–5.20]; P = .004), major hepatectomy (OR = 2.96 [2.07–4.23]; P < .001), and estimated intraoperative blood loss ≥1000 mL (OR = 1.85 [1.08–3.18]; P = .025) were associated with postoperative coagulopathy.

CONCLUSIONS:
Coagulopathy is frequent (53.5% [95% confidence interval, 50.0–57.1]) after liver resection. Epidural analgesia seems safe in patients undergoing minor hepatic resection without preexisting hepatic cirrhosis, showing a normal preoperative INR and platelet count.
Anesthesia Capacity in Ghana: A Teaching Hospital’s Resources, and the National Workforce and Education
Authors: Brouillette Mark A. , Aidoo Alfred J. , Hondras Maria A. , Boateng Nana A. , Antwi-Kusi Akwasi , Addison William , Hermanson Alec R. 
Published: September 2017

BACKGROUND:
Quality anesthetic care is lacking in low- and middle-income countries (LMICs). Global health leaders call for perioperative capacity reports in limited-resource settings to guide improved health care initiatives. We describe a teaching hospital’s resources and the national workforce and education in this LMIC capacity report.

METHODS:
A prospective observational study was conducted at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, during 4 weeks in August 2016. Teaching hospital data were generated from observations of hospital facilities and patient care, review of archival records, and interviews with KATH personnel. National data were obtained from interviews with KATH personnel, correspondence with Ghana’s anesthesia society, and review of public records.

RESULTS:
The practice of anesthesia at KATH incorporated preanesthesia clinics, intraoperative management, and critical care. However, there were not enough physicians to consistently supervise care, especially in postanesthesia care units (PACUs) and the critical care unit (CCU). Clean water and electricity were usually reliable in all 16 operating rooms (ORs) and throughout the hospital. Equipment and drugs were inventoried in detail. While much basic infrastructure, equipment, and medications were present in ORs, patient safety was hindered by hospital-wide oxygen supply failures and shortage of vital signs monitors and working ventilators in PACUs and the CCU. In 2015, there were 10,319 anesthetics administered, with obstetric and gynecologic, general, and orthopedic procedures comprising 62% of surgeries. From 2011 to 2015, all-cause perioperative mortality rate in ORs and PACUs was 0.65% or 1 death per 154 anesthetics, with 99% of deaths occurring in PACUs. Workforce and education data at KATH revealed 10 anesthesia attending physicians, 61 nurse anesthetists (NAs), and 7 anesthesia resident physicians in training. At the national level, 70 anesthesia attending physicians and 565 NAs cared for Ghana’s population of 27 million. Providers were heavily concentrated in urban areas, and NAs frequently practiced independently. Two teaching hospitals provided accredited postgraduate training modeled after European curricula to 22 anesthesia resident physicians.

CONCLUSIONS:
While important limitations to capacity exist in Ghana, the overall situation is good compared to other LMICs. Many of the challenges encountered resulted from insufficient PACU and CCU provisions and few providers. Inadequate outcomes reporting made analysis and resolution of problem areas difficult. While many shortcomings stemmed from limited funding, strengthening physician commitment to overseeing care, ensuring oxygen supplies are uninterrupted, keeping ventilators in working order, and making vital signs monitors ubiquitously available are feasible ways to increase patient safety with the tools currently in place.
Citation of a taxon name identifier issued by the ICN‐recognized registration repositories instead of taxon name author citation
Authors: Rambold Gerhard , Bensch Konstanze , Kirk Paul M. , Yao Yi-Jian , Robert Vincent , Sanz Veronica , Triebel Dagmar 
Published: September 2017

AbstractProblems with taxon name author citation in the running text of scientific articles are outlined. Particularly, the length of author names strings has significantly increased in the last decades, which could be demonstrated by analysis of names in the LIAS database. In addition, ambiguity of author name citation has increased because of variations in author name abbreviation and incomplete or incorrect citation of authors’ names. It is therefore suggested that in non‐taxonomic scientific publications, author names should be replaced by taxon name identifiers as issued by registration repositories. The advantage of such approach especially in context with linked open data and semantic network challenges is described. An additional recommendation in Article 46 of the ICN with an example is suggested.
DEVELOPMENT OF A HYDROGEN MANAGEMENT CONCEPT FOR THE CANADIAN SUPERCRITICAL WATER-COOLED REACTOR
Authors: Gardner Lee Brian , Ryland Don K , Suppiah Sam 
Published: September 2017

Accidental hydrogen production in nuclear reactors has been a significant focus of nuclear reactor safety for decades. However, since the accident at Fukushima Daiichi nuclear generating station, hydrogen safety in nuclear reactors is a more relevant topic. As new reactor concepts, such as the supercritical water-cooled reactor (SCWR), are designed and developed the risk of unintentional hydrogen generation is not eliminated; however, it can be mitigated in the design.A systematic assessment of the hydrogen risk from both normal and accident conditions in the Canadian SCWR design was performed, in which various techniques to mitigate the hydrogen combustion potential were considered. While the rate of hydrogen generation under normal operating conditions was found to be low when held at supercritical water conditions, conservative estimates suggest that a significant quantity of hydrogen may be produced and released to the containment building in a severe accident. As a result, a hydrogen–oxygen management concept has been proposed to mitigate the hydrogen produced in a severe accident that includes a nitrogen-inerted containment building to reduce the combustion potential of hydrogen and the installation of passive autocatalytic recombiners for oxygen management. This hydrogen–oxygen management concept results in significant design changes and likely significant economic and operational impacts on the Canadian SCWR design.
The variability in Oxford hip and knee scores in the preoperative period: is there an ideal time to score?
Authors: Quah C , Holmes D , Khan T , Cockshott S , Lewis J , Stephen A 
Published: September 2017

Background All NHS-funded providers are required to collect and report patient-reported outcome measures for hip and knee arthroplasty. Although there are established guidelines for timing such measures following arthroplasty, there are no specific time-points for collection in the preoperative period. The primary aim of this study was to identify whether there was a significant amount of variability in the Oxford hip and knee scores prior to surgical intervention when completed in the outpatient clinic at the time of listing for arthroplasty or when completed at the preoperative assessment clinic. Methods A prospective cohort study of patients listed for primary hip or knee arthroplasty was conducted. Patients were asked to fill in a preoperative Oxford score in the outpatient clinic at the time of listing. They were then invited to fill in the official outcome measures questionnaire at the preoperative assessment clinic. The postoperative Oxford score was then completed when the patient was seen again at their postoperative follow up in clinic. Results Of the total of 109 patients included in this study period, there were 18 (17%) who had a worse score of 4 or more points difference and 43 (39.4%) who had an improvement of 4 or more points difference when the scores were compared between time of listing at the outpatient and at the preoperative assessment clinic. There was a statistically significant difference (P = 0.0054) in the mean Oxford scores. Conclusions The results of our study suggest that there should be standardisation of timing for completing the preoperative patient-reported outcome measures.