bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tornadoes in Europe: Synthesis of the Observational Datasets
Authors: Antonescu Bogdan , Schultz David M. , Lomas Fiona , Kühne Thilo 
Published: January 2016

AbstractA synthesis of tornado observations across Europe between 1800 and 2014 is used to produce a pan-European climatology. Based on regional tornado-occurrence datasets and articles published in peer-reviewed journals, the evolution and the major contributions to tornado databases for 30 European countries were analyzed. Between 1800 and 2014, 9563 tornadoes were reported in Europe with an increase from 8 tornadoes per year between 1800 and 1850 to 242 tornadoes per year between 2000 and 2014. The majority of the reports came from northern, western, and southern Europe, and to a lesser extent from eastern Europe where tornado databases were developed after the 1990s. Tornadoes occur throughout the year with a maximum in June–August for most of Europe and in August–November for southern Europe. Tornadoes occur more frequently between 1300 and 1500 UTC over most of Europe and between 0900 and 1100 UTC over southern Europe. Where intensity was known, 74.7% of tornadoes were classified as F0 and F1, 24.5% as F2 and F3, and 0.8% as F4 and F5. Comparing this intensity distribution over Europe with the intensity distribution for tornadoes in the United States shows that tornadoes over western and eastern Europe are more likely to be supercellular tornadoes and those over northern and southern Europe are likely to also include nonsupercellular tornadoes.
Orbito-frontal cortex and thalamus volumes in the patients with obsessive-compulsive disorder before and after cognitive behavioral therapy
Authors: Atmaca Murad , Yildirim Hanefi , Yilmaz Seda , Caglar Neslihan , Mermi Osman , Korkmaz Sevda , Akaslan Unsal , Gurok M Gurkan , Kekilli Yasemin , Turkcapar Hakan 
Published: January 2016

Background The effect of a variety of treatment modalities including psychopharmacological and cognitive behavioral therapy on the brain volumes and neurochemicals have not been investigated enough in the patients with obsessive-compulsive disorder. Therefore, in the present study, we aimed to investigate the effect of cognitive behavioral therapy on the volumes of the orbito-frontal cortex and thalamus regions which seem to be abnormal in the patients with obsessive-compulsive disorder. We hypothesized that there would be change in the volumes of the orbito-frontal cortex and thalamus. Methods Twelve patients with obsessive-compulsive disorder and same number of healthy controls were included into the study. At the beginning of the study, the volumes of the orbito-frontal cortex and thalamus were compared by using magnetic resonance imaging. In addition, volumes of these regions were measured before and after the cognitive behavioral therapy treatment in the patient group. Results The patients with obsessive-compulsive disorder had greater left and right thalamus volumes and smaller left and right orbito-frontal cortex volumes compared to those of healthy control subjects at the beginning of the study. When we compared baseline volumes of the patients with posttreatment ones, we detected that thalamus volumes significantly decreased throughout the period for both sides and that the orbito-frontal cortex volumes significantly increased throughout the period for only left side. Conclusions In summary, we found that cognitive behavioral therapy might volumetrically affect the key brain regions involved in the neuroanatomy of obsessive-compulsive disorder. However, future studies with larger sample are required.
Poor response to platinum-based chemotherapy is associated with KRAS mutation and concomitant low expression of BRAC1 and TYMS in NSCLC
Authors: Zhou Hongxuan , Dai Yun , Zhu Liqun , Wang Chun , Fei Xiaodong , Pan Qin , Chen Juxiang , Shi Xianqing , Yang Yanfeng , Tao Xiaoxing , Shi Pinghuai 
Published: January 2016

Objective To evaluate treatment response, survival, and the associations between KRAS mutation status and tumour expression levels of BRCA1, TYMS and SRC retrospectively in a cohort of patients with non-small cell lung cancer (NSCLC), treated exclusively with conjunctive platinum-based doublet chemotherapy. Methods KRAS mutation status was determined via amplification refractory mutation and multiple quantitative polymerase chain reaction (PCR) analysis. Tumour expression levels of BRCA1, TYMS and SRC were determined via real time quantitative PCR. Results Patients with KRAS mutations ( n = 3) had significantly shorter survival duration than patients with wild type KRAS ( n = 42). Tumour expression levels of BRCA1 and TYMS, but not SRC, were significantly lower in patients with, than in those without, KRAS mutations. Tumour expression level of BRCA1 was positively correlated with survival duration. Conclusions KRAS mutation status and BRCA1 tumour expression are potential biomarkers for tailoring chemotherapy and predicting clinical outcome.
Validation of an Arabic Questionnaire for Symptom Assessment
Authors: Al-Shahri Mohammad Zafir , Al-Zahrani Ali Saeed , Alansari Ameenah , Abdullah Abdulrahman , Alshaqi Mohamed , Matar Areej , Hassan Azza , Shoukri Mohamed , Sroor Mahmoud Yassin 
Published: January 2016

Background: Impeccable assessment of symptoms is central to palliative care (PC) practice. Objectives: The study objectives are (1) to test the validity of the Arabic Questionnaire for Symptom Assessment (AQSA) as a self-administered (SA) tool for assessing the severity of the listed symptoms among PC patients and (2) to test the validity of AQSA when completed by a proxy. Methods: The AQSA is a tool for assessing the severity of 11 symptoms in addition to the overall suffering experience on a 0 to 10 numeric scale. Symptom scores on the SA AQSA were compared to scores obtained through interviews with patients. The same procedure was repeated with patients’ sitters to explore the validity of using the tool for symptom assessment by proxy. Results: The study involved 107 pairs (a patient and a sitter, each) with a mean age of 46.3 years (females 59.8%) for patients and 35.9 years (females 65.7%) for sitters. The correlation coefficient ( r) for agreement between SA and interview-based (IB) scores for patients ranged from .65 ( P < .0001) for drowsiness to .86 ( P < .0001) for pain. The SA AQSA showed positive correlation between sitters’ and patients’ scores, with r ranging from .28 ( P = .004) for depression to .62 ( P ≤ .0001) for vomiting. Conclusions: The strong positive correlation between SA and IB AQSA indicates that the former is a valid tool. When the SA AQSA is used by proxy, it showed moderate to strong positive correlation with patients’ actual scores for most of the symptoms.
Minimally Invasive Versus Open Distal Fibular Plating for AO/OTA 44-B Ankle Fractures
Authors: Chiang Chao-Ching , Tzeng Yun-Hsuan , Lin Chun-Cheng , Huang Ching-Kuei , Chang Ming-Chau 
Published: January 2016

Background: Open reduction and internal fixation (ORIF), the standard treatment for unstable ankle fractures, has well-known wound complications. Minimally invasive surgery (MIS) has been proposed to decrease these complications. The objectives of this study were to describe an algorithm of MIS for fibular plating and compare the radiographic restoration of fibular anatomy, functional outcomes, and complications between ORIF and MIS for ankle fractures. Methods: This retrospective study included 71 patients with AO/OTA 44-B ankle fractures treated by a single surgeon. ORIF group consisted of 34 patients (54.5-month follow-up) and MIS group was composed of 37 patients (55.9-month follow-up). Among 37 MIS patients, 13 patients were treated with minimally invasive percutaneous plate osteosynthesis and 24 patients with minimally invasive trans-fracture approach according to our MIS algorithm. Operative outcomes were evaluated and compared between the 2 groups by radiographic measurements, functional assessment, and complications. Results: The MIS group had less blood loss but longer operative time and greater exposure to fluoroscopy. Radiographic measurements revealed similar union time, fibular length, talocrural angle, medial clear space, and tibiofibular clear space in both groups. Lower visual analogue pain score was observed in the MIS group in the early postoperative period. At last follow-up, there were no significant differences regarding pain score, American Orthopaedic Foot & Ankle Society ankle-hindfoot score, and range of motion between the 2 groups. Total complication rate was significantly higher in the ORIF group. Conclusion: Patients with AO/OTA 44-B fractures treated with MIS fibular plating achieved similar radiographic and functional outcomes but had less pain in the early postoperative period and fewer wound complications compared with those treated with ORIF. Level of Evidence: Level III, retrospective comparative study.
Oesophageal biopsies are insufficient to predict final histology after endoscopic resection in early Barrett’s neoplasia
Authors: Werbrouck E , De Hertogh G , Sagaert X , Coremans G , Willekens H , Demedts I , Bisschops R 
Published: January 2016

BackgroundEndoscopic resection (ER) with or without ablation is the first choice treatment for early Barrett’s neoplasia. Adequate staging is important to assure a good oncological outcome.ObjectiveThe purpose of this study was to investigate the diagnostic accuracy of pre‐operative biopsies in patients who undergo ER for high‐grade dysplasia (HGD) or early adenocarcinoma (EAC) in Barrett’s oesophagus (BE) and the cardia.MethodsBetween November 2005–May 2012, 142 ERs performed in 137 patients were obtained. Worst pre‐ER and ER histology were compared. Upgrading/downgrading was defined as any more/less severe histological grading on the ER specimen.ResultsThe accuracy of pre‐ER biopsies in predicting final histology was 61%. ER changed the pre‐treatment diagnosis in 55 of the 142 procedures (39%) with downgrading in 23 cases (16%) and upgrading from HGD to T1a or T1b in 32 cases (23%). In the majority of upgraded cases, a visible lesion according to the Paris classification could be detected (26/32, 81%).ConclusionThe diagnostic accuracy of oesophageal biopsies alone in predicting final pathology in Barrett’s dysplasia is only 61%. The majority of upgraded lesions are detectable. When ablative therapy is considered in HGD Barrett's dysplasia a meticulous inspection for and removal of all small visible lesions is mandatory.
Staphylococcal enterotoxin A (SEA) stimulates STAT3 activation and IL-17 expression in cutaneous T-cell lymphoma
Authors: Willerslev-Olsen Andreas , Krejsgaard Thorbjørn , Lindahl Lise M. , Litvinov Ivan V. , Fredholm Simon , Petersen David L. , Nastasi Claudia , Gniadecki Robert , Mongan Nigel P. , Sasseville Denis , Wasik Mariusz A. , Bonefeld Charlotte M. , Geisler Carsten , Woetmann Anders , Iversen Lars , Kilian Mogens , Koralov Sergei B. , Odum Niels 
Published: January 2016

Key PointsStaphylococcal enterotoxins activate oncogenic pathways in CTCL. This discovery implies a novel role of microbes as drivers of disease progression.
Modelling subject-specific childhood growth using linear mixed-effect models with cubic regression splines
Authors: Grajeda Laura M. , Ivanescu Andrada , Saito Mayuko , Crainiceanu Ciprian , Jaganath Devan , Gilman Robert H. , Crabtree Jean E. , Kelleher Dermott , Cabrera Lilia , Cama Vitaliano , Checkley William 
Published: January 2016

Abstract
Background
Childhood growth is a cornerstone of pediatric research. Statistical models need to consider individual trajectories to adequately describe growth outcomes. Specifically, well-defined longitudinal models are essential to characterize both population and subject-specific growth. Linear mixed-effect models with cubic regression splines can account for the nonlinearity of growth curves and provide reasonable estimators of population and subject-specific growth, velocity and acceleration.

Methods
We provide a stepwise approach that builds from simple to complex models, and account for the intrinsic complexity of the data. We start with standard cubic splines regression models and build up to a model that includes subject-specific random intercepts and slopes and residual autocorrelation. We then compared cubic regression splines vis-à-vis linear piecewise splines, and with varying number of knots and positions. Statistical code is provided to ensure reproducibility and improve dissemination of methods. Models are applied to longitudinal height measurements in a cohort of 215 Peruvian children followed from birth until their fourth year of life.

Results
Unexplained variability, as measured by the variance of the regression model, was reduced from 7.34 when using ordinary least squares to 0.81 (p < 0.001) when using a linear mixed-effect models with random slopes and a first order continuous autoregressive error term. There was substantial heterogeneity in both the intercept (p < 0.001) and slopes (p < 0.001) of the individual growth trajectories. We also identified important serial correlation within the structure of the data (ρ = 0.66; 95 % CI 0.64 to 0.68; p < 0.001), which we modeled with a first order continuous autoregressive error term as evidenced by the variogram of the residuals and by a lack of association among residuals. The final model provides a parametric linear regression equation for both estimation and prediction of population- and individual-level growth in height. We show that cubic regression splines are superior to linear regression splines for the case of a small number of knots in both estimation and prediction with the full linear mixed effect model (AIC 19,352 vs. 19,598, respectively). While the regression parameters are more complex to interpret in the former, we argue that inference for any problem depends more on the estimated curve or differences in curves rather than the coefficients. Moreover, use of cubic regression splines provides biological meaningful growth velocity and acceleration curves despite increased complexity in coefficient interpretation.

Conclusions
Through this stepwise approach, we provide a set of tools to model longitudinal childhood data for non-statisticians using linear mixed-effect models.
Nutrition support practices in critically ill head-injured patients: a global perspective
Authors: Chapple Lee-anne S. , Chapman Marianne J. , Lange Kylie , Deane Adam M. , Heyland Daren K. 
Published: January 2016

Abstract
Background
Critical illness following head injury is associated with a hypermetabolic state but there are insufficient epidemiological data describing acute nutrition delivery to this group of patients. Furthermore, there is little information describing relationships between nutrition and clinical outcomes in this population.

Methods
We undertook an analysis of observational data, collected prospectively as part of International Nutrition Surveys 2007-2013, and extracted data obtained from critically ill patients with head trauma. Our objective was to describe global nutrition support practices in the first 12 days of hospital admission after head trauma, and to explore relationships between energy and protein intake and clinical outcomes. Data are presented as mean (SD), median (IQR), or percentages.

Results
Data for 1045 patients from 341 ICUs were analyzed. The age of patients was 44.5 (19.7) years, 78 % were male, and median ICU length of stay was 13.1 (IQR 7.9-21.6) days. Most patients (94 %) were enterally fed but received only 58 % of estimated energy and 53 % of estimated protein requirements. Patients from an ICU with a feeding protocol had greater energy and protein intakes (p <0.001, 0.002 respectively) and were more likely to survive (OR 0.65; 95 % CI 0.42-0.99; p = 0.043) than those without. Energy or protein intakes were not associated with mortality. However, a greater energy and protein deficit was associated with longer times until discharge alive from both ICU and hospital (all p <0.001).

Conclusion
Nutritional deficits are commonplace in critically ill head-injured patients and these deficits are associated with a delay to discharge alive.
Temporal variation in major trauma admissions
Authors: Kieffer WKM , Michalik DV , Gallagher K , McFadyen I , Bernard J , Rogers BA 
Published: January 2016

Introduction Trauma is a significant cause of morbidity and mortality in the UK. Since the inception of the trauma networks, little is known of the temporal pattern of trauma admissions. Methods Trauma Audit and Research Network data for 1 April 2011 to 31 March 2013 were collated from two large major trauma centres (MTCs) in the South East of England: Brighton and Sussex University Hospitals NHS Trust (BSUH) and St George's University Hospitals NHS Foundation Trust (SGU). The number of admissions and the injury severity score by time of admission, by weekdays versus weekend and by month/season were analysed. Results There were 1,223 admissions at BSUH and 1,241 at SGU. There was significant variation by time of admission; there were more admissions in the afternoons (BSUH p<0.001) and evenings (SGU p<0.001). There were proportionally more admissions at the weekends than on weekdays (BSUH p<0.001, SGU p=0.028). There was significant seasonal variation in admissions at BSUH (p<0.001) with more admissions in summer and autumn. No significant seasonal variation was observed at SGU (p=0.543). Conclusions The temporal patterns observed were different for each MTC with important implications for resource planning of trauma care. This study identified differing needs for different MTCs and resource planning should be individualised to the network.
Systematic review and meta-analysis of the association between frailty and outcome in surgical patients
Authors: Oakland K , Nadler R , Cresswell L , Jackson D , Coughlin PA 
Published: January 2016

Introduction Frailty is becoming increasingly prevalent in the elderly population although a lack of consensus regarding a clinical definition hampers comparison of clinical studies. More elderly patients are being assessed for surgical intervention but the effect of frailty on surgical related outcomes is still not clear. Methods A systematic literature search for studies prospectively reporting frailty and postoperative outcomes in patients undergoing surgical intervention was performed with data collated from a total of 12 studies. Random effects meta-analysis modelling was undertaken to estimate the association between frailty and mortality rates (in-hospital and one-year), length of hospital stay and the need for step-down care for further rehabilitation/nursing home placement. Results Frailty was associated with a higher in-hospital mortality rate (pooled odds ratio [OR]: 2.77, 95% confidence interval [CI]: 1.62–4.73), a higher one-year mortality rate (pooled OR: 1.99, 95% CI: 1.49–2.66), a longer hospital stay (pooled mean difference: 1.05 days, 95% CI: 0.02–2.07 days) and a higher discharge rate to further rehabilitation/step-down care (pooled OR: 5.71, 95% CI: 3.41–9.55). Conclusions The presence of frailty in patients undergoing surgical intervention is associated with poorer outcomes with regard to mortality and return to independence. Further in-depth studies are required to identify factors that can be optimised to reduce the burden of frailty in surgical patients.
The dendritic cell side of the immunological synapse
Authors: Verboogen Danielle R.J. , Dingjan Ilse , Revelo Natalia H. , Visser Linda J. , ter Beest Martin , van den Bogaart Geert 
Published: January 2016

AbstractImmune responses are initiated by the interactions between antigen-presenting cells (APCs), such as dendritic cells (DCs), with responder cells, such as T cells, via a tight cellular contact interface called the immunological synapse. The immunological synapse is a highly organized subcellular structure that provides a platform for the presentation of antigen in major histocompatibility class I and II complexes (MHC class I and II) on the surface of the APC to receptors on the surface of the responder cells. In T cells, these contacts lead to highly polarized membrane trafficking that results in the local release of lytic granules and in the delivery and recycling of T cell receptors at the immunological synapse. Localized trafficking also occurs at the APC side of the immunological synapse, especially in DCs where antigen loaded in MHC class I and II is presented and cytokines are released specifically at the synapse. Whereas the molecular mechanisms underlying polarized membrane trafficking at the T cell side of the immunological synapse are increasingly well understood, these are still very unclear at the APC side. In this review, we discuss the organization of the APC side of the immunological synapse. We focus on the directional trafficking and release of membrane vesicles carrying MHC molecules and cytokines at the immunological synapses of DCs. We hypothesize that the specific delivery of MHC and the release of cytokines at the immunological synapse mechanistically resemble that of lytic granule release from T cells.
Ingestion of a natural mineral-rich water in an animal model of metabolic syndrome: effects in insulin signalling and endoplasmic reticulum stress
Authors: Pereira Cidália D. , Passos Emanuel , Severo Milton , Vitó Isabel , Wen Xiaogang , Carneiro Fátima , Gomes Pedro , Monteiro Rosário , Martins Maria J. 
Published: January 2016

Abstract

Background: High-fructose and/or low-mineral diets are relevant in metabolic syndrome (MS) development. Insulin resistance (IR) represents a central mechanism in MS development. Glucocorticoid signalling dysfunction and endoplasmic reticulum (ER) and oxidative stresses strongly contribute to IR and associate with MS. We have described that natural mineral-rich water ingestion delays fructose-induced MS development, modulates fructose effects on the redox state and glucocorticoid signalling and increases sirtuin 1 expression. Here, we investigated mineral-rich water ingestion effects on insulin signalling and ER homeostasis of fructose-fed rats.

Materials and methods: Adult male Sprague-Dawley rats had free access to standard-chow diet and different drinking solutions (8 weeks): tap water (CONT), 10%-fructose/tap water (FRUCT) or 10%-fructose/mineral-rich water (FRUCTMIN). Hepatic and adipose (visceral, VAT) insulin signalling and hepatic ER homeostasis (Western blot or PCR) as well as hepatic lipid accumulation were evaluated.

Results: Hepatic p-IRS1Ser307/IRS1 (tendency), p-IRS1Ser307, total JNK and (activated IRE1α)/(activated JNK) decreased with fructose ingestion, while p-JNK tended to increase; mineral-rich water ingestion, totally or partially, reverted all these effects. Total PERK, p-eIF2α (tendency) and total IRS1 (tendency) decreased in both fructose-fed groups. p-ERK/ERK and total IRE1α increasing tendencies in FRUCT became significant in FRUCTMIN (similar pattern for lipid area). Additionally, unspliced-XBP1 increased with mineral-rich water. In VAT, total ERK fructose-induced increase was partially prevented in FRUCTMIN.

Conclusions: Mineral-rich water modulation of fructose-induced effects on insulin signalling and ER homeostasis matches the better metabolic profile previously reported. Increased p-ERK/ERK, adding to decreased IRE1α activation, and increased unspliced-XBP1 and lipid area may protect against oxidative stress and IR development in FRUCTMIN.