bluuebunny/crossref_metadata_2025_split huggingface dataset:
Temporal Trends in Predictors of Early and Late Mortality After Emergency Coronary Artery Bypass Grafting for Cardiogenic Shock Complicating Acute Myocardial Infarction
Authors: Davierwala Piroze M. , Leontyev Sergey , Verevkin Alexander , Rastan Ardawan J. , Mohr Matthias , Bakhtiary Farhad , Misfeld Martin , Mohr Friedrich W. 
Published: October 2016

Background:
Cardiogenic shock after acute myocardial infarction is an indication for emergent coronary artery bypass grafting in patients not amenable to percutaneous coronary intervention. Our study aimed to evaluate and identify risk factors for early and long-term outcomes in such patients.

Methods:
A total of 508 patients who underwent coronary artery bypass grafting for cardiogenic shock complicating acute myocardial infarction between January 2000 and June 2014 were divided into 3 time cohorts: 2000 to 2004 (n=204), 2005 to 2009 (n=166), and 2010 to 2014 (n=138). Predictors of in-hospital mortality for each time cohort and long-term mortality for all patients were identified by logistic and Cox regression analyses, respectively.

Results:

Mean age was 68.3±9.8 years. Of the 508 patients, 78.5% had 3-vessel and 47.1% had left main disease. Left ventricular function <30% was observed in 44.1% of patients, with 30.4%, 37.9%, 52.9%, and 3.1% requiring preoperative resuscitation, ventilation, intra-aortic balloon pump, and extracorporeal membrane oxygenation support, respectively. Overall in-hospital mortality was 33.7%; declined from 42.2% to 30.7% to 24.6%, respectively, for the 3 time cohorts (
P
=0.02); and was independently predicted by serum lactate >4 mmol/L (odds ratio [OR], 4.78; 95% confidence interval, 2.88–7.95;
P
<0.0001), ST-segment–elevation myocardial infarction (OR, 2.10; 95% confidence interval, 1.36–3.26;
P
=0.001), age >75 years (OR, 2.01; 95% confidence interval, 1.06–3.85;
P
=0.03), and left ventricular ejection fraction <30% (OR, 1.83; 95% confidence interval, 1.15–2.91;
P
=0.01). Cumulative survival was 42.6±2.0% and 33.4±2.0% at 5 and 10 years, respectively, and correspondingly improved to 64.3±3.0% and 49.8±3.0% in hospital survivors. Serum lactate >4 mmol/L (OR, 2.2;
P
<0.0001), incremental age (OR, 1.05;
P
<0.0001), New York Heart Association class IV (OR, 1.33;
P
=0.02), diabetes mellitus (OR, 1.39;
P
=0.005), and preoperative inotropic (OR, 2.61;
P
=0.001) and extracorporeal membrane oxygenation (OR, 1.68;
P
=0.05) support predicted late mortality.

Conclusions:
Emergency coronary artery bypass grafting in patients with acute myocardial infarction complicated by cardiogenic shock is associated with a high in-hospital mortality, which showed a significant decline with time. Hospital survivors have good long-term outcomes, which demonstrate the beneficial effect of surgical revascularization. Preoperative serum lactate >4 mmol/L is a strong predictor of both early and late mortality.
Single-Ventricle Outcomes After Neonatal Palliation of Severe Ebstein Anomaly With Modified Starnes Procedure
Authors: Kumar S. Ram , Kung Grace , Noh Nathan , Castillo Novel , Fagan Brian , Wells Winfield J. , Starnes Vaughn A. 
Published: October 2016

Background:
We have previously shown that neonates in profound cardiogenic shock caused by a severe Ebstein anomaly can be successfully salvaged with fenestrated right ventricular exclusion and systemic to pulmonary shunt (modified Starnes procedure). The long-term outcome of single-ventricle management in these patients is not known.

Methods:
We retrospectively reviewed the records of patients who underwent neonatal Starnes procedure between 1989 and 2015. Patient demographics, clinical variables, and outcome data were collected.

Results:

Twenty-seven patients (13, 48% boys) underwent the Starnes procedure at 7 (5–9) days of life. All were intubated and on prostaglandin, 24 (89%) were inotrope dependent, and 22 (81%) had no antegrade flow from the right ventricle. Three patients underwent nonfenestrated right ventricular exclusion, 2 (67%) of whom died. Of the remaining 24, 3 (13%) died during the same hospitalization. The 22 neonatal survivors have been followed for 7 (6–8) years: 1 patient is awaiting a Glenn procedure; 1 died after undergoing a Glenn procedure; and the remaining 20 patients have successfully undergone Fontan completion. Their indexed pulmonary vascular resistance was 1.8 (1.2–2.3) W/m
2
, and mean pulmonary pressure was 12 (9–18) mm Hg. At last follow-up, 1 patient had died, and the remaining patients had normal left ventricular function, and all but 1 have New York Heart Association class I symptoms. Two patients have required pacemaker implantation, whereas the rest are in sinus rhythm. Survival for the entire cohort at 1, 5, and 10 years is 81±4%, 81±5%, and 76±3%, respectively, whereas for those with fenestrated right ventricular exclusion, survival at 1, 5, and 10 years is 87±2%, 87±2%, and 81±4%, respectively.

Conclusions:
Long-term single-ventricle outcomes among neonatal survivors of the modified Starnes procedure are excellent. There is reliable remodeling of the excluded right ventricle and good function of the left ventricle.
Spatiotemporal Temperature Variability over the Tibetan Plateau: Altitudinal Dependence Associated with the Global Warming Hiatus
Authors: Cai Danlu , You Qinglong , Fraedrich Klaus , Guan Yanning 
Published: October 2016

Abstract
The recent slowdown in global warming has initiated a reanalysis of temperature data in some mountainous regions for understanding the consequences and impact that a hiatus has on the climate system. Spatiotemporal temperature variability is analyzed over the Tibetan Plateau because of its sensitivity to climate change with a station network updated to 2014, and its linkages to remote sensing–based variability of MODIS daytime and nighttime temperature are investigated. Results indicate the following: 1) Almost all stations have experienced a notable warming in the time interval 1961–2014, with most obvious warming in winter, which depends on the selected time intervals. 2) There is no clear shift from a predominant warming to a near stagnation during the most recent period (2001–present). 3) Uniform altitudinal dependence of temperature change trends could not be confirmed for all regions, time intervals, and seasons, but sometimes an altitude threshold around 3 km is apparent. 4) Most of the meteorological stations are associated with MODIS temperature warming pixels, and thus regional cooling is missing when considering only the locations of meteorological stations. In summarizing, previous studies based on station observations do not provide a complete picture for the temperature change over the Tibetan Plateau. Remote sensing–based analyses have the potential to find early signals of regional climate changes and assess the impact of global climate changes in complex regional, seasonal, and altitudinal environments.
CMIP5 Projections of Two Types of El Niño and Their Related Tropical Precipitation in the Twenty-First Century
Authors: Xu Kang , Tam Chi-Yung , Zhu Congwen , Liu Boqi , Wang Weiqiang 
Published: October 2016

Abstract
Future projections of the eastern-Pacific (EP) and central-Pacific (CP) types of El Niño in the twenty-first century, as well as their associated tropical circulation and precipitation variability, are investigated using historical runs and representative concentration pathway 8.5 (RCP8.5) simulations from 31 coupled models in phase 5 of the Coupled Model Intercomparison Project (CMIP5). As inferred from CMIP5 models that best capture both El Niño flavors, EP El Niño sea surface temperature (SST) variability will become weaker in the future climate, while no robust change of CP El Niño SST is found. Models also reach no consensus on the future change of relative frequency from CP to EP El Niño. However, there are robust changes in the tropical overturning circulation and precipitation associated with both types of El Niño. Under a warmer climate, magnitudes of precipitation anomalies during EP El Niño are projected to increase, presenting significant enhancement of the dry (wet) signal over the western (central–eastern) Pacific. This is consistent with an accelerated hydrological cycle in the deep tropics; hence, a “wet get wetter” picture appears under global warming, accompanied by a weakened anomalous Walker circulation. For CP El Niño, drier-than-normal conditions will be intensified over the tropical central–eastern Pacific in the future climate, with stronger anomalous sinking related to the strengthened North Pacific local Hadley cell. These results suggest that, besides the enhanced basic-state hydrological cycle over the tropics, other elements, such as the anomalous overturning circulation, might also play a role in determining the ENSO precipitation response to a warmer background climate.
Tropical Cyclones in the 7-km NASA Global Nature Run for Use in Observing System Simulation Experiments
Authors: Reale Oreste , Achuthavarier Deepthi , Fuentes Marangelly , Putman William M. , Partyka Gary 
Published: October 2016

AbstractThe National Aeronautics and Space Administration (NASA) nature run (NR), released for use in observing system simulation experiments (OSSEs), is a 2-yr-long global nonhydrostatic free-running simulation at a horizontal resolution of 7 km, forced by observed sea surface temperatures (SSTs) and sea ice, and inclusive of interactive aerosols and trace gases. This article evaluates the NR with respect to tropical cyclone (TC) activity. It is emphasized that to serve as an NR, a long-term simulation must be able to produce realistic TCs, which arise out of realistic large-scale forcings. The presence in the NR of the relevant dynamical features over the African monsoon region and the tropical Atlantic is confirmed, along with realistic African easterly wave activity. The NR Atlantic TC seasons, produced with 2005 and 2006 SSTs, show interannual variability consistent with observations, with much stronger activity in 2005. An investigation of TC activity over all the other basins (eastern and western North Pacific Ocean, north and south Indian Ocean, and Australian region), together with important elements of the atmospheric circulation, such as the Somali jet and westerly bursts, reveals that the model captures the fundamental aspects of TC seasons in every basin, producing a realistic number of TCs with realistic tracks, life spans, and structures. This confirms that the NASA NR is a very suitable tool for OSSEs targeting TCs and represents an improvement with respect to previous long simulations that have served the global atmospheric OSSE community.
A Multiscale Reexamination of the Pacific–South American Pattern
Authors: O’Kane Terence J. , Monselesan Didier P. , Risbey James S. 
Published: October 2016

Abstract
The authors undertake a multiscale spectral reexamination of the variability of the Pacific–South American (PSA) pattern and the mechanisms by which this variability occurs. Time scales from synoptic to interannual are investigated, focusing on the means by which tropical variability is communicated to the midlatitudes and on in situ forcing within the midlatitude waveguides. Particular interest is paid to what fraction of the total variability associated with the PSA, occurring on interannual time scales, is attributable to tropical forcing relative to that occurring on synoptic and intraseasonal time scales via internal waveguide dynamics. In general, it is found that the eastward-propagating wave train pattern typically associated with the PSA manifests across time scales from synoptic to interannual, with the majority of the variability occurring on synoptic-to-intraseasonal time scales largely independent of tropical convection. It is found that the small fraction of the total variance with a tropical signal occurs via the zonal component of the thermal wind modulating both the subtropical and polar jets. The respective roles of the Hadley circulation and stationary Rossby wave sources are also examined. Further, a PSA-like mode is identified in terms of the slow components of higher-order modes of tropospheric geopotential height. This study reestablishes the multiscale nonlinear nature of the PSA modes arising largely as a manifestation of internal midlatitude waveguide dynamics and local disturbances.
Is there a difference in physical activity levels in patients before and up to one year after unilateral total hip replacement? A systematic review and meta-analysis
Authors: Withers Thomas M , Lister Sarah , Sackley Catherine , Clark Allan , Smith Toby O 
Published: October 2016

Objective:To determine the difference in physical activity levels before and up to one year after unilateral primary total hip replacement.Data sources:A search was performed on 13 July 2016. Studies were eligible for inclusion if they presented preoperative and up to one year postoperative measures of physical activity for patients who had undergone unilateral primary total hip replacement.Review methods:Any article that used a measure of physical activity pre and up to one year post-unilateral primary total hip replacement. Data was synthesised using a meta-analysis with 95% confidence intervals (CI), if appropriate. The Critical Appraisal Skills Programme cohort study checklist was used to assess the quality of evidence.Results:From 6024 citations, 17 studies were selected: Nine studies were analysed in a meta-analysis and eight studies were analysed qualitatively. The quality of the evidence was ‘low’ to ‘moderate’. There was no statistically significant difference in physical activity pre- to post-total hip replacement when assessed using: movement-related activity (mean difference (MD): −0.08; 95% CI: 1.60, 1.44; I2= 0%; n = 77), percentage of 24-hours spent walking (MD: −0.21; 95% CI: −1.36, 0.93; I2= 12%; n = 65), 6-minute walk test (MD: −60.85; 95% CI: −122.41, 0.72; I2= 84%; n = 113) or the cardiopulmonary exercise test (MD: −0.24; 95% CI: −1.36, 0.87; I2= 0%; n = 76).Conclusion:There is no statistically significant difference in physical activity levels before and up to one year after unilateral primary total hip replacement. However, the low to moderate methodological quality of the included articles should be taken into consideration when drawing conclusions.
Clusterflock: a flocking algorithm for isolating congruent phylogenomic datasets
Authors: Narechania Apurva , Baker Richard , DeSalle Rob , Mathema Barun , Kolokotronis Sergios-Orestis , Kreiswirth Barry , Planet Paul J 
Published: October 2016

Abstract

Background
Collective animal behavior, such as the flocking of birds or the shoaling of fish, has inspired a class of algorithms designed to optimize distance-based clusters in various applications, including document analysis and DNA microarrays. In a flocking model, individual agents respond only to their immediate environment and move according to a few simple rules. After several iterations the agents self-organize, and clusters emerge without the need for partitional seeds. In addition to its unsupervised nature, flocking offers several computational advantages, including the potential to reduce the number of required comparisons.

Findings
In the tool presented here, Clusterflock, we have implemented a flocking algorithm designed to locate groups (flocks) of orthologous gene families (OGFs) that share an evolutionary history. Pairwise distances that measure phylogenetic incongruence between OGFs guide flock formation. We tested this approach on several simulated datasets by varying the number of underlying topologies, the proportion of missing data, and evolutionary rates, and show that in datasets containing high levels of missing data and rate heterogeneity, Clusterflock outperforms other well-established clustering techniques. We also verified its utility on a known, large-scale recombination event in Staphylococcus aureus. By isolating sets of OGFs with divergent phylogenetic signals, we were able to pinpoint the recombined region without forcing a pre-determined number of groupings or defining a pre-determined incongruence threshold.

Conclusions
Clusterflock is an open-source tool that can be used to discover horizontally transferred genes, recombined areas of chromosomes, and the phylogenetic ‘core' of a genome. Although we used it here in an evolutionary context, it is generalizable to any clustering problem. Users can write extensions to calculate any distance metric on the unit interval, and can use these distances to ‘flock' any type of data.
Draft genome sequence of Streptomyces sp. TP-A0867, an alchivemycin producer
Authors: Komaki Hisayuki , Ichikawa Natsuko , Oguchi Akio , Hamada Moriyuki , Harunari Enjuro , Kodani Shinya , Fujita Nobuyuki , Igarashi Yasuhiro 
Published: October 2016

AbstractStreptomyces sp. TP-A0867 (=NBRC 109436) produces structurally complex polyketides designated alchivemycins A and B. Here, we report the draft genome sequence of this strain together with features of the organism and assembly, annotation, and analysis of the genome sequence. The 9.9 Mb genome of Streptomyces sp. TP-A0867 encodes 8,385 putative ORFs, of which 7,232 were assigned with COG categories. We successfully identified a hybrid polyketide synthase (PKS)/ nonribosomal peptide synthetase (NRPS) gene cluster that could be responsible for alchivemycin biosynthesis, and propose the biosynthetic pathway. The alchivemycin biosynthetic gene cluster is also present in Streptomyces rapamycinicus NRRL 5491T, Streptomyces hygroscopicus subsp. hygroscopicus NBRC 16556, and Streptomyces ascomycinicus NBRC 13981T, which are taxonomically highly close to strain TP-A0867. This study shows a representative example that distribution of secondary metabolite genes is correlated with evolution within the genus Streptomyces.
Experimental measurements for improved understanding and simulation of snowmelt events in the Western Tatra Mountains
Authors: Krajčí Pavel , Danko Michal , Hlavčo Jozef , Kostka Zdeněk , Holko Ladislav 
Published: October 2016

Abstract
Snow accumulation and melt are highly variable. Therefore, correct modeling of spatial variability of the snowmelt, timing and magnitude of catchment runoff still represents a challenge in mountain catchments for flood forecasting. The article presents the setup and results of detailed field measurements of snow related characteristics in a mountain microcatchment (area 59 000 m2, mean altitude 1509 m a. s. l.) in the Western Tatra Mountains, Slovakia obtained in winter 2015. Snow water equivalent (SWE) measurements at 27 points documented a very large spatial variability through the entire winter. For instance, range of the SWE values exceeded 500 mm at the end of the accumulation period (March 2015). Simple snow lysimeters indicated that variability of snowmelt and discharge measured at the catchment outlet corresponded well with the rise of air temperature above 0°C. Temperature measurements at soil surface were used to identify the snow cover duration at particular points. Snow melt duration was related to spatial distribution of snow cover and spatial patterns of snow radiation. Obtained data together with standard climatic data (precipitation and air temperature) were used to calibrate and validate the spatially distributed hydrological model MIKE-SHE. The spatial redistribution of input precipitation seems to be important for modeling even on such a small scale. Acceptable simulation of snow water equivalents and snow duration does not guarantee correct simulation of peakflow at short-time (hourly) scale required for example in flood forecasting. Temporal variability of the stream discharge during the snowmelt period was simulated correctly, but the simulated discharge was overestimated.
Identification of long-term high-flow regime changes in selected stations along the Danube River
Authors: Pekárová Pavla , Pramuk Branislav , Halmová Dana , Miklánek Pavol , Prohaska Stevan , Pekár Ján 
Published: October 2016

Abstract
The aim of the paper is to study spatial and temporal changes in the magnitude, duration and frequency of high flows in the Danube basin. A hydrological series of the mean daily discharges from 20 gauging stations (operated minimally since 1930) were used for the analysis of changes in the daily discharges. The high flow events were classified into three classes: high flow pulses, small floods, and large floods. For each year and for each class, the means of the peak discharges, the number and duration of events, and the rate of changes of the rising and falling limbs of the waves were determined.
The long-term trends of the annual time series obtained were analyzed and statistically evaluated. The long-term high flow changes were found to be different in three individual high flow classes. The duration of the category of high flow pulses is decreasing at 19 stations on the Danube and is statistically significant at the Linz, Vienna, Bratislava and Orsova stations. The frequency of the high flow pulses is increasing in all 20 stations. Also, the rising and falling rates of the high flow pulse category are increasing at the majority of the stations. The long-term trends of the selected characteristics of the small floods are very similar to the trends of the high flow pulses, i.e., the duration of small floods is decreasing, and their mean number per year is increasing. In the category of large floods the changes were not proved.
Vandetanib induces a marked anti-tumor effect and amelioration of ectopic Cushing’s syndrome in a medullary thyroid carcinoma patient
Authors: Bseiso Hashem , Lev-Cohain Naama , Gross David J , Grozinsky-Glasberg Simona 
Published: October 2016

Summary
A 55-year-old woman diagnosed with sporadic MTC underwent total thyroidectomy 20 years ago. After the first surgery, elevated calcitonin levels in parallel with local disease persistence were noted and therefore she underwent repeated neck dissections. During follow-up, multiple foci of metastatic disease were noted in the neck and mediastinal lymph nodes, lungs and bones; however, the disease had an indolent course for a number of years, in parallel with a calcitonin doubling time of more than two years and without significant symptoms. During a routine follow-up visit 2 years ago, findings suggestive of Cushing’s syndrome were observed on physical examination. The biochemical evaluation demonstrated markedly elevated serum calcitonin level, in parallel with lack of cortisol suppression after an overnight 1 mg dexamethasone suppression test, lack of cortisol and ACTH suppression after high-dose IV dexamethasone 8 mg, elevated plasma ACTH up to 79 pg/mL (normal <46 pg/mL) and elevated 24-h urinary free cortisol up to 501 µg/24 h (normal 9–90 µg/24 h). After a negative pituitary MRI, she underwent IPSS, which was compatible with EAS. Whole-body CT demonstrated progressive disease at most of the tumor sites. Treatment with vandetanib at a dosage of 200 mg/day was commenced. The patient showed a significant, rapid and consistent clinical improvement already after two months of treatment, in parallel with biochemical improvement, whereas a decrease in tumor size was demonstrated on follow-up CT.

Learning points:

Ectopic Cushing’s syndrome due to ectopic ACTH secretion (EAS) by MTC is an uncommon and a poor prognostic event, being associated with significant morbidity and mortality.
We demonstrate that vandetanib is effective in controlling the signs and symptoms related to the EAS in patients with advanced progressive MTC.
We demonstrate that vandetanib is effective in decreasing tumor size and in inducing tumor control.