bluuebunny/crossref_metadata_2025_split huggingface dataset:
A beam hardening and dispersion correction for x‐ray dark‐field radiography
Authors: Pelzer Georg , Anton Gisela , Horn Florian , Rieger Jens , Ritter André , Wandner Johannes , Weber Thomas , Michel Thilo 
Published: May 2016

Purpose:X‐ray dark‐field imaging promises information on the small angle scattering properties even of large samples. However, the dark‐field image is correlated with the object's attenuation and phase‐shift if a polychromatic x‐ray spectrum is used. A method to remove part of these correlations is proposed.Methods:The experimental setup for image acquisition was modeled in a wave‐field simulation to quantify the dark‐field signals originating solely from a material's attenuation and phase‐shift. A calibration matrix was simulated for ICRU46 breast tissue. Using the simulated data, a dark‐field image of a human mastectomy sample was corrected for the finger print of attenuation‐ and phase‐image.Results:Comparing the simulated, attenuation‐based dark‐field values to a phantom measurement, a good agreement was found. Applying the proposed method to mammographic dark‐field data, a reduction of the dark‐field background and anatomical noise was achieved. The contrast between microcalcifications and their surrounding background was increased.Conclusions:The authors show that the influence of and dispersion can be quantified by simulation and, thus, measured image data can be corrected. The simulation allows to determine the corresponding dark‐field artifacts for a wide range of setup parameters, like tube‐voltage and filtration. The application of the proposed method to mammographic dark‐field data shows an increase in contrast compared to the original image, which might simplify a further image‐based diagnosis.
Technical Note: A fast online adaptive replanning method for VMAT using flattening filter free beams
Authors: Ates Ozgur , Ahunbay Ergun E. , Moreau Michel , Li X. Allen 
Published: May 2016

Purpose:To develop a fast replanning algorithm based on segment aperture morphing (SAM) for online replanning of volumetric modulated arc therapy (VMAT) with flattening filter free (FFF) beams.Methods:A software tool was developed to interface with a VMAT research planning system, which enables the input and output of beam and machine parameters of VMAT plans. The SAM algorithm was used to modify multileaf collimator positions for each segment aperture based on the changes of the target from the planning (CT/MR) to daily image [CT/CBCT/magnetic resonance imaging (MRI)]. The leaf travel distance was controlled for large shifts to prevent the increase of VMAT delivery time. The SAM algorithm was tested for 11 patient cases including prostate, pancreatic, and lung cancers. For each daily image set, three types of VMAT plans, image‐guided radiation therapy (IGRT) repositioning, SAM adaptive, and full‐scope reoptimization plans, were generated and compared.Results:The SAM adaptive plans were found to have improved the plan quality in target and/or critical organs when compared to the IGRT repositioning plans and were comparable to the reoptimization plans based on the data of planning target volume (PTV)‐V100 (volume covered by 100% of prescription dose). For the cases studied, the average PTV‐V100 was 98.85% ± 1.13%, 97.61% ± 1.45%, and 92.84% ± 1.61% with FFF beams for the reoptimization, SAM adaptive, and repositioning plans, respectively. The execution of the SAM algorithm takes less than 10 s using 16‐CPU (2.6 GHz dual core) hardware.Conclusions:The SAM algorithm can generate adaptive VMAT plans using FFF beams with comparable plan qualities as those from the full‐scope reoptimization plans based on daily CT/CBCT/MRI and can be used for online replanning to address interfractional variations.
The use, appropriateness and outcomes of outpatient parenteral antimicrobial therapy
Authors: Hodgson Kate A , Huynh Julie , Ibrahim Laila F , Sacks Bronwyn , Golshevsky Daniel , Layley Michael , Spagnolo Mark , Raymundo Chin-Mae , Bryant Penelope A 
Published: May 2016

ObjectiveOutpatient parenteral antimicrobial therapy (OPAT) is increasingly used to treat children at home, but studies in children are scarce. We aimed to describe the use, appropriateness and outcomes of OPAT in children.DesignThis was a 12-month prospective observational study.SettingThe hospital-in-the-home programme of The Royal Children's Hospital Melbourne.PatientsAll patients receiving OPAT.InterventionsData were collected including demographics, diagnosis, type of venous access and antibiotic choice.Main outcome measuresLength of stay, adverse events, readmission rate and appropriateness of antibiotic use.Results228 patients received OPAT in 251 episodes. The median age was 7.4 years (range 1 week to 21 years), with 22 patients (10%) under 1 year. The most frequent diagnoses were exacerbation of cystic fibrosis (17%), urinary tract infection (12%) and cellulitis (9%). Most patients were transferred from the ward, but 18% were transferred directly from the emergency department, the majority with skin and soft-tissue infection (66%). Venous access was most commonly peripherally inserted central catheter (29%) and peripheral cannula (29%). 309 parenteral antibiotics were prescribed, most frequently ceftriaxone (28%) and gentamicin (19%). The majority of antibiotics (72%) were prescribed appropriately. However, 6% were deemed an inappropriate choice for the indication and 26% had inappropriate dose or duration. The incidence of central line-associated bloodstream infections was 0.9%. The unplanned readmission rate was 4%, with low rates of OPAT-related adverse events. Three children (1%) had an inadequate clinical response.ConclusionsOPAT is a safe and effective way of providing antibiotics to children. Despite high rates of appropriate antibiotic use, improvements can still be made.
Trends in suicidal behaviour in Dutch general practice 1983–2013: a retrospective observational study
Authors: de Beurs Derek P , Hooiveld Mariette , Kerkhof Ad J F M , Korevaar Joke C , Donker Gé A 
Published: May 2016

ObjectivesTo analyse trends in suicidal behaviour as reported by the Dutch sentinel general practices from 1983 to 2013. Second, to examine the relationship between suicidal behaviour and several patient characteristics. Finally, to compare the relationship between suicidal behaviour and patient characteristics before (1983–2007) and after (2008–2013) the start of the crisis.Setting40 general practices in the Netherlands during the period 1983–2013.ParticipantsPatients with an ICPC code of P77 (suicide attempt).Primary and secondary outcomesPrimary outcomes were age-adjusted and gender-specific trends in reported suicides (342) and suicide attempts (1614). Secondary outcomes were the relationship between suicidal behaviour and age, household composition, history of depression, recognition of suicide ideation, treatment before the suicidal behaviour and contact within the past month before suicidal behaviour for the period 1983–2013. Additionally, separate frequencies for the periods 1983–2007 and 2008–2013 were presented.ResultsJoin-point analyses revealed a significant rise in male suicides from 2008 (b=0.32, SE=0.1, p=0.008), and an increase in male suicide attempts since 2009 (b=0.19, SE=0.04, p<0.001). Female suicidal behaviour showed a steady decrease from 1989 to 2013(b=−0.03, SE=0.007, p<0.0001 for female suicide, b=−0.02, SE=0.002, p<0.001 for female attempts). Before 2007, a history of depression was reported in 65% (168/257) of the suicides. After the start of the recession, a depression was recognised in 44% (22/50) of the patients who died by suicide.ConclusionsSince 2008, there was a rise in the male suicide rate while female suicide behaviour has continued to decline. General practitioners less often reported a history of depression within patients who died due to suicide after 2007 than before. Training in the early recognition of suicide ideation in depressive patients might improve suicide prevention in primary care.
Effects of closure of an urban level I trauma centre on adjacent hospitals and local injury mortality: a retrospective, observational study
Authors: Crandall Marie , Sharp Douglas , Wei Xiong , Nathens Avery , Hsia Renee Y 
Published: May 2016

ObjectiveTo determine the association of the Martin Luther King Jr Hospital (MLK) closure on the distribution of admissions on adjacent trauma centres, and injury mortality rates in these centres and within the county.DesignObservational, retrospective study.SettingNon-public patient-level data from the state of California were obtained for all trauma patients from 1999 to 2009. Geospatial analysis was used to visualise the redistribution of trauma patients to other hospitals after MLK closed. Variance of observed to expected injury mortality using multivariate logistic regression was estimated for the study period.ParticipantsA total of 37 131 trauma patients were admitted to the five major south Los Angeles trauma centres from the MLK service area between 1999 and 2009.Main outcome measures(1) Number and type of trauma admissions to trauma centres in closest proximity to MLK; (2) inhospital injury mortality of trauma patients after the trauma centre closure.ResultsDuring and after the MLK closure, trauma admissions increased at three of the four nearby hospitals, particularly admissions for gunshot wounds (GSWs). This redistribution of patient load was accompanied by a dramatic change in the payer mix for surrounding hospitals; one hospital's share of uninsured more than tripled from 12.9% in 1999 to 44.6% by 2009. Overall trauma mortality did not significantly change, but GSW mortality steadily and significantly increased after the closure from 5.0% in 2007 to 7.5% in 2009.ConclusionsThough local hospitals experienced a dramatic increase in trauma patient volume, overall mortality for trauma patients did not significantly change after MLK closed.
Prognostic Value of Coronary Artery Calcium Scoring in Addition to Single-Photon Emission Computed Tomographic Myocardial Perfusion Imaging in Symptomatic Patients
Authors: Engbers Elsemiek M. , Timmer Jorik R. , Ottervanger Jan Paul , Mouden Mohamed , Knollema Siert , Jager Pieter L. 
Published: May 2016

Background—
The prognostic value of coronary artery calcium (CAC) scoring on top of myocardial perfusion imaging with single-photon emission computed tomography (SPECT) in patients suspected for coronary artery disease is not well established.

Methods and Results—

Four thousand eight hundred ninety-seven symptomatic patients without a history of coronary artery disease referred for SPECT and CAC scoring were included. Major adverse cardiac events (MACEs) were defined as late revascularization (>90 days after scanning), nonfatal myocardial infarction, and all-cause mortality. The frequency of abnormal SPECT increased with higher CAC scores, from 12% in patients with CAC scores of 0 to 19%, 32%, 37%, and 50% among those with CAC scores 1 to 99, 100 to 399, 400 to 999, and ≥1000, respectively (
P
<0.001). During a median follow-up of 940 days (25th to 75th percentile, 581–1377), a total of 278 MACEs were observed. Overall incidence of MACE was 2.3% per year. A stepwise increase of MACE was present with increasing CAC scores, both in patients with normal SPECT (annual event rate CAC score 0: 0.6%; CAC score ≥1000: 5.5%) and abnormal SPECT (annual event rate CAC score 0: 0.4%; CAC score ≥1000: 7.6%). After multivariate analysis, both SPECT and CAC score were independent predictors of MACE (CAC score ≥1000: hazard ratio, 7.7;
P
<0.001 and large perfusion defect on SPECT: hazard ratio, 3.7;
P
<0.001).

Conclusions—
CAC score and SPECT are independent predictors of MACE in patients suspected for coronary artery disease. Our findings strongly support performing a CAC score in addition to SPECT in symptomatic patients to better define the risk of events during follow-up.
Pharyngeal Electrical Stimulation for Treatment of Dysphagia in Subacute Stroke
Authors: Bath Philip M. , Scutt Polly , Love Jo , Clavé Pere , Cohen David , Dziewas Rainer , Iversen Helle K. , Ledl Christian , Ragab Suzanne , Soda Hassan , Warusevitane Anushka , Woisard Virginie , Hamdy Shaheen 
Published: May 2016

Background and Purpose—
Dysphagia is common after stroke, associated with increased death and dependency, and treatment options are limited. Pharyngeal electric stimulation (PES) is a novel treatment for poststroke dysphagia that has shown promise in 3 pilot randomized controlled trials.

Methods—
We randomly assigned 162 patients with a recent ischemic or hemorrhagic stroke and dysphagia, defined as a penetration aspiration score (PAS) of ≥3 on video fluoroscopy, to PES or sham treatment given on 3 consecutive days. The primary outcome was swallowing safety, assessed using the PAS, at 2 weeks. Secondary outcomes included dysphagia severity, function, quality of life, and serious adverse events at 6 and 12 weeks.

Results—

In randomized patients, the mean age was 74 years, male 58%, ischemic stroke 89%, and PAS 4.8. The mean treatment current was 14.8 (7.9) mA and duration 9.9 (1.2) minutes per session. On the basis of previous data, 45 patients (58.4%) randomized to PES seemed to receive suboptimal stimulation. The PAS at 2 weeks, adjusted for baseline, did not differ between the randomized groups: PES 3.7 (2.0) versus sham 3.6 (1.9),
P
=0.60. Similarly, the secondary outcomes did not differ, including clinical swallowing and functional outcome. No serious adverse device-related events occurred.

Conclusions—
In patients with subacute stroke and dysphagia, PES was safe but did not improve dysphagia. Undertreatment of patients receiving PES may have contributed to the neutral result.

Clinical Trial Registration—

URL:
http://www.controlled-trials.com
. Unique identifier: ISRCTN25681641.
Aspirin for Stroke Prevention in Elderly Patients With Vascular Risk Factors
Authors: Uchiyama Shinichiro , Ishizuka Naoki , Shimada Kazuyuki , Teramoto Tamio , Yamazaki Tsutomu , Oikawa Shinichi , Sugawara Masahiro , Ando Katsuyuki , Murata Mitsuru , Yokoyama Kenji , Minematsu Kazuo , Matsumoto Masayasu , Ikeda Yasuo 
Published: May 2016

Background and Purpose—
The effect of aspirin in primary prevention of stroke is controversial among clinical trials conducted in Western countries, and no data are available for Asian populations with a high risk of intracranial hemorrhage. The objective of this study was to evaluate the effect of aspirin on the risk of stroke and intracranial hemorrhage in the Japanese Primary Prevention Project (JPPP).

Methods—
A total of 14 464 patients (age, 60–85 years) with hypertension, dyslipidemia, and diabetes mellitus participated and were randomized into 2 treatment groups: 100 mg of aspirin or no aspirin. The median follow-up period was 5.02 years.

Results—

The cumulative rate of fatal or nonfatal stroke was similar for the aspirin (2.068%; 95% confidence interval [CI], 1.750–2.443) and no aspirin (2.299%; 95% CI, 1.963–2.692) groups at 5 years; the estimated hazard ratio was 0.927 (95% CI, 0.741–1.160;
P
=0.509). Aspirin nonsignificantly reduced the risk of ischemic stroke or transient ischemic attack (hazard ratio, 0.783; 95% CI, 0.606–1.012;
P
=0.061) and nonsignificantly increased the risk of intracranial hemorrhage (hazard ratio, 1.463; 95% CI; 0.956–2.237;
P
=0.078). A Cox regression adjusted by the risk factors for all stroke, which were age >70 years, smoking, and diabetes mellitus, supported the above result.

Conclusions—
Aspirin did not show any net benefit for the primary prevention of stroke in elderly Japanese patients with risk factors for stroke, whereas age >70 years, smoking, and diabetes mellitus were risk factors for stroke regardless of aspirin treatment.

Clinical Trial Registration—
URL: http://www.clinicaltrials.gov. Unique identifier: NCT00225849.
Systematic Review and Meta-Analysis of Bone Marrow–Derived Mononuclear Cells in Animal Models of Ischemic Stroke
Authors: Vahidy Farhaan S. , Rahbar Mohammad H. , Zhu Hongjian , Rowan Paul J. , Bambhroliya Arvind B. , Savitz Sean I. 
Published: May 2016

Background and Purpose—
Bone marrow–derived mononuclear cells (BMMNCs) offer the promise of augmenting poststroke recovery. There is mounting evidence of safety and efficacy of BMMNCs from preclinical studies of ischemic stroke; however, their pooled effects have not been described.

Methods—
Using Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, we conducted a systematic review of preclinical literature for intravenous use of BMMNCs followed by meta-analyses of histological and behavioral outcomes. Studies were selected based on predefined criteria. Data were abstracted by 2 independent investigators. After quality assessment, the pooled effects were generated using mixed-effect models. Impact of possible biases on estimated effect size was evaluated.

Results—
Standardized mean difference and 95% confidence interval for reduction in lesion volume was significantly beneficial for BMMNC treatment (standardized mean difference: −3.3; 95% confidence interval, −4.3 to −2.3). n=113 each for BMMNC and controls. BMMNC-treated animals (n=161) also had improved function measured by cylinder test (standardized mean difference: −2.4; 95% confidence interval, −3.1 to −1.6), as compared with controls (n=205). A trend for benefit was observed for adhesive removal test and neurological deficit score. Study quality score (median: 6; Q1–Q3: 5–7) was correlated with year of publication. There was funnel plot asymmetry; however, the pooled effects were robust to the correction of this bias and remained significant in favor of BMMNC treatment.

Conclusions—
BMMNCs demonstrate beneficial effects across histological and behavioral outcomes in animal ischemic stroke models. Although study quality has improved over time, considerable degree of heterogeneity calls for standardization in the conduct and reporting of experimentation.
Neural Correlates of Divided Attention in Natural Scenes
Authors: Fagioli Sabrina , Macaluso Emiliano 
Published: May 2016

Abstract
Individuals are able to split attention between separate locations, but divided spatial attention incurs the additional requirement of monitoring multiple streams of information. Here, we investigated divided attention using photos of natural scenes, where the rapid categorization of familiar objects and prior knowledge about the likely positions of objects in the real world might affect the interplay between these spatial and nonspatial factors. Sixteen participants underwent fMRI during an object detection task. They were presented with scenes containing either a person or a car, located on the left or right side of the photo. Participants monitored either one or both object categories, in one or both visual hemifields. First, we investigated the interplay between spatial and nonspatial attention by comparing conditions of divided attention between categories and/or locations. We then assessed the contribution of top–down processes versus stimulus-driven signals by separately testing the effects of divided attention in target and nontarget trials. The results revealed activation of a bilateral frontoparietal network when dividing attention between the two object categories versus attending to a single category but no main effect of dividing attention between spatial locations. Within this network, the left dorsal premotor cortex and the left intraparietal sulcus were found to combine task- and stimulus-related signals. These regions showed maximal activation when participants monitored two categories at spatially separate locations and the scene included a nontarget object. We conclude that the dorsal frontoparietal cortex integrates top–down and bottom–up signals in the presence of distractors during divided attention in real-world scenes.
Climatology and Interannual Variability of Quasi-Global Intense Precipitation Using Satellite Observations
Authors: Ricko Martina , Adler Robert F. , Huffman George J. 
Published: May 2016

Abstract
Climatology and variations of recent mean and intense precipitation over a near-global (50°S–50°N) domain on a monthly and annual time scale are analyzed. Data used to derive daily precipitation to examine the effects of spatial and temporal coverage of intense precipitation are from the current Tropical Rainfall Measuring Mission (TRMM) Multisatellite Precipitation Analysis (TMPA) 3B42 version 7 precipitation product, with high spatial and temporal resolution during 1998–2013. Intense precipitation is defined by several different parameters, such as a 95th percentile threshold of daily precipitation, a mean precipitation that exceeds that percentile, or a fixed threshold of daily precipitation value (e.g., 25 and 50 mm day−1). All parameters are used to identify the main characteristics of spatial and temporal variation of intense precipitation. High correlations between examined parameters are observed, especially between climatological monthly mean precipitation and intense precipitation, over both tropical land and ocean. Among the various parameters examined, the one best characterizing intense rainfall is a fraction of daily precipitation ≥ 25 mm day−1, defined as a ratio between the intense precipitation above the used threshold and mean precipitation. Regions that experience an increase in mean precipitation likely experience a similar increase in intense precipitation, especially during the El Niño–Southern Oscillation (ENSO) events. Improved knowledge of this intense precipitation regime and its strong connection to mean precipitation given by the fraction parameter can be used for monitoring of intense rainfall and its intensity on a global to regional scale.
On the Origin of a Chain of Eddies in the Gulf of Eilat/Aqaba
Authors: Biton Eli , Gildor Hezi 
Published: May 2016

AbstractThe Gulf of Eilat/Aqaba is a terminal, elongated basin that exchanges water with the northern Red Sea via the Straits of Tiran. This study used energy budgets of mean kinetic energy (MKE) and eddy kinetic energy (EKE; differentiated by a simple horizontal averaging filter), instability analysis, and numerical simulations to study the horizontal circulation of the gulf, which is characterized by the existence of a chain of eddies along its main axis. The kinetic energy is predominantly in the form of EKE. Energy conversion between MKE and EKE is negligible where the main sources for both energy reservoirs are the conversions from the available potential energy (APE). This term is balanced by the work done by pressure at the straits in case of MKE and by dissipation in the case of EKE. The MKE balance represents the coupling between the exchange flow at the straits and the wintertime dense water formation. The dense water exits through the straits while sinking adiabatically along the gulf. The strong variation in the shoreline/bathymetry triggers a baroclinic instability that enhances the eddy activity in the gulf. Thus, the baroclinic instability is an effective mechanism that transfers energy from the APE to the EKE. The EKE–APE conversion term involves vertical adiabatic motions that occur through the upwelling of relatively warm water in anticyclonic circulation regions and downwelling of colder water in adjacent regions with cyclonic circulation. Through these processes, the horizontal circulation is powered by the energy transferred from the APE. This explains the coupling between the temperature gradient and the eddy formation along the gulf.