bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of sustained drug-free diabetes remission over 48 weeks following short-term intensive insulin therapy in early type 2 diabetes
Authors: Kramer Caroline K , Zinman Bernard , Choi Haysook , Retnakaran Ravi 
Published: August 2016

ObjectiveIn early type 2 diabetes (T2DM), short-term intensive insulin therapy (IIT) for 2–4 weeks can decrease insulin resistance, reduce glucagonemia, improve β-cell function, and even induce a remission of diabetes that can last up to 1 year in some patients. However, little is known about the predictors of such a sustained remission.MethodsWe evaluated data from the placebo arm of a double-blind randomized controlled trial in which patients with early T2DM (≤7 years duration) underwent 4 weeks of IIT (basal detemir, bolus aspart), followed by placebo therapy for 48 weeks (n=25). Participants underwent an oral glucose tolerance test every 12 weeks, enabling serial assessment of insulin sensitivity, α-cell response, and β-cell function. Diabetes remission was defined as A1c<6.5% on no medication for T2DM.ResultsAt 48 weeks post-IIT, 56% of the participants remained in remission. Comparison of remitters to non-remitters revealed no differences in waist, body mass index, insulin sensitivity (Matsuda index), or glucagon profile, either at baseline or over 48 weeks. Compared to non-remitters, the remission group had lower baseline A1c (p=0.006) and better baseline β-cell function (Insulin Secretion-Sensitivity Index-2) (p=0.01) that was then sustained across 48 weeks post-IIT (p=0.006). On logistic regression analyses, however, shorter duration of diabetes supplanted baseline A1c (p=0.24) and β-cell function (p=0.19) as an independent predictor of remission (p=0.04). In particular, diabetes duration <2 years predicted persistence of remission (p=0.006).ConclusionsThe key determinant of the likelihood of inducing sustained drug-free diabetes remission with short-term IIT is early intervention, particularly within the first 2 years after diagnosis.Trial registration numberClinicalTrials.GovNCT01270789; Post-results.
Provision of care for chronic kidney disease by non-nephrologists in a developing nation: a national survey
Authors: Al Shamsi S , Al Dhanhani A , Sheek-Hussein M M , Bakoush O 
Published: August 2016

ObjectivesThe prevalence of chronic kidney disease (CKD) in developing countries has increased dramatically. This study aimed to explore the practice patterns of non-dialysis-dependent CKD care in an affluent developing country.SettingsPrimary and specialised healthcare facilities of public and private sectors in the United Arab Emirates.Participants159 non-nephrologist physicians practising in the United Arab Emirates.InterventionsA 28-item online self-administered questionnaire based on CKD clinical practice guidelines.Primary and secondary outcome measuresThe physicians' approach to identifying and managing patients with CKD.ResultsThe survey was completed by 159 non-nephrologists, of whom 135 reported having treated patients with CKD. Almost all the respondents screen patients with hypertension and diabetes for CKD, but one-third of them do not screen patients with cardiovascular disease and elderly patients for CKD. The use of accurate CKD screening tests (estimated glomerular filtration rate and albumin/creatinine ratio) was suboptimal (77% and 59% of physicians used the procedures, respectively). One-third of the physicians do not offer treatment with inhibitors of the renin–angiotensin system to patients with CKD, and only 66% offer antilipid treatment. In general, the primary healthcare physicians are more familiar than secondary healthcare physicians with the diagnosis and management of patients with CKD.ConclusionsWe identified substantial physician-declared deficiencies in the practice of identifying and managing early CKD. Integration of quality CKD care within the healthcare system is required to face the increasing burden of CKD in the United Arab Emirates and possibly in other developing nations.
Early PREdiction of Severe Sepsis (ExPRES-Sepsis) study: protocol for an observational derivation study to discover potential leucocyte cell surface biomarkers
Authors: Datta Deepankar , Conway Morris Andrew , Antonelli Jean , Warner Noel , Brown Kenneth Alun , Wright John , Simpson A John , Rennie Jillian , Hulme Gillian , Lewis Sion Marc , Mare Tracey Anne , Cookson Sharon , Weir Christopher John , Dimmick Ian , Keenan Jim , Rossi Adriano Giorgio , Shankar-Hari Manu , Walsh Timothy S 
Published: August 2016

IntroductionSepsis is an acute illness resulting from infection and the host immune response. Early identification of individuals at risk of developing life-threatening severe sepsis could enable early triage and treatment, and improve outcomes. Currently available biomarkers have poor predictive value for predicting subsequent clinical course in patients with suspected infection. Circulating leucocytes provide readily accessible tissues that reflect many aspects of the complex immune responses described in sepsis. We hypothesise that measuring cellular markers of immune responses by flow cytometry will enable early identification of infected patients at risk of adverse outcomes. We aim to characterise leucocyte surface markers (biomarkers) and their abnormalities in a population of patients presenting to the hospital emergency department with suspected sepsis, and explore their ability to predict subsequent clinical course.Methods and analysisWe will conduct a prospective, multicentre, clinical, exploratory, cohort observational study. To answer our study question, 3 patient populations will be studied. First, patients with suspected sepsis from the emergency department (n=300). To assess performance characteristics of potential tests, critically ill patients with established sepsis, and age and gender matched patients without suspicion of infection requiring hospital admission (both n=100) will be recruited as comparator populations. In all 3 groups, we plan to assess circulating biomarker profiles using flow cytometry. We will select candidate biomarkers by cross-cohort comparison, and then explore their predictive value for clinical outcomes within the cohort with suspected sepsis.Ethics and disseminationThe study will be carried out based on the principles in the Declaration of Helsinki and the International Conference on Harmonisation Good Clinical Practice. Ethics approval has been granted from the Scotland A Research Ethics Committee (REC) and Oxford C REC. On conclusion of this study, the results will be disseminated via peer-reviewed journals.Trial registration numberNCT02188992; Pre-results.
Using best practice to create a pathway to improve management of irritable bowel syndrome: aiming for timely diagnosis, effective treatment and equitable care
Authors: Williams Marianne , Barclay Yvonne , Benneyworth Rosie , Gore Steve , Hamilton Zoe , Matull Rudi , Phillips Iain , Seamark Leah , Staveley Kate , Thole Steve , Greig Emma 
Published: August 2016

BackgroundIrritable bowel syndrome (IBS) costs the National Health Service almost £12 million per annum. Despite national guidelines advising primary care management, these have failed to stem secondary care referrals of patients with likely IBS for unnecessary and costly assessment and investigation without necessarily achieving resolution of their symptoms.MethodsIn 2011, an integrated team from primary and secondary care developed a business case using baseline data to create a Somerset-wide IBS pathway using Clinical Commissioning Group funding. This provided face-to-face general practitioners (GP) education, developed a diagnostic pathway and funded faecal calprotectin (FC) testing to exclude inflammatory pathology for patients aged 16–45 years with likely IBS and no alarm symptoms. For those with FC≤50 μg/g, we provided a management algorithm and community-based dietetic treatment. Audit results measured usage and outcomes from FC testing, changes in patterns and costs of new patients reviewed in gastroenterology outpatients and dietetic IBS treatment outcomes.ResultsThe proportion of new patient slots used reduced from 14.3% to 8.7% over 10 months while overall costs reduced by 25% for patients with no alarm symptoms and likely IBS aged 16–45 years. FC results confirmed research findings with no inflammatory pathology, if FC≤50 μg/g over 2 years. 63% of patients had satisfactory control of their IBS after specialist dietetic input with 74% reporting improved quality of life.ConclusionsThe combination of GP education, providing diagnosis and management pathways, using FC to exclude inflammatory pathology and providing an effective treatment for patients with likely IBS appeared successful in our pilot. This proved cost-effective, reduced secondary care involvement and improved patient care.
Tunable multi-wavelength thulium-doped fiber laser incorporating two-stage cascaded Sagnac loop comb filter
Authors: Zhu Lianqing , He Wei , Dong Mingli , Lou Xiaoping , Luo Fei 
Published: August 2016

A tunable multi-wavelength narrow-linewidth thulium-doped fiber laser employing two-stage cascaded Sagnac loop mirrors is proposed and experimentally demonstrated. The designed fiber laser is composed of a pump source, wavelength division multiplex, circulator, thulium-doped fiber, polarization controllers (PCs), couplers and polarization-maintaining fibers (PMFs). Two cascaded Sagnac loops are used as the cavity reflector and filter, and the proposed filter is fabricated using two sections of PMFs with 2-m and 1-m lengths, respectively. In the experiment, the laser threshold is 110 mW, and laser can emit single, double, triple, quadruple and quintuple wavelengths in the spectral range of 1873–1901 nm through the simultaneous adjustment of the two PCs. The power fluctuations and 3-dB linewidth are less than 2.1 dB and 0.2 nm, respectively, over 10 min at room temperature, and the side-mode suppression ratio is greater than 20 dB. The proposed laser will be useful in various fields, such as spectral analysis, fiber sensing and optical communication.
Adipocytes and Neutrophils Give a Helping Hand to Pancreatic Cancers
Authors: Bronte Vincenzo , Tortora Giampaolo 
Published: August 2016

Abstract
Summary: Obesity-induced inflammation can build up a confined microenvironment in pancreatic adenocarcinoma that is associated with increased desmoplasia, neutrophil recruitment, reduced delivery of chemotherapeutic drugs, and immune evasion. Targeting molecular pathways empowering this circuit might represent a necessary measure to reach clinical efficacy for combination therapies in patients with excess body weight. Cancer Discov; 6(8); 821–3. ©2016 AACR.
See related article by Incio et al., p. 852.
An Idealized Numerical Simulation Investigation of the Effects of Surface Drag on the Development of Near-Surface Vertical Vorticity in Supercell Thunderstorms
Authors: Markowski Paul M. 
Published: August 2016

AbstractIdealized simulations are used to investigate the contributions of frictionally generated horizontal vorticity to the development of near-surface vertical vorticity in supercell storms. Of interest is the relative importance of barotropic vorticity (vorticity present in the prestorm environment), baroclinic vorticity (vorticity that is principally generated by horizontal buoyancy gradients), and viscous vorticity (vorticity that originates from the subgrid-scale turbulence parameterization, wherein the effects of surface drag reside), all of which can be advected, tilted, and stretched. Equations for the three partial vorticities are integrated in parallel with the model. The partial vorticity calculations are complemented by analyses of circulation following material circuits, which are often able to be carried out further in time because they are less susceptible to explosive error growth.Near-surface mesocyclones that develop prior to cold-pool formation (this only happens when the environmental vorticity is crosswise near the surface) are dominated by only barotropic vertical vorticity when the lower boundary is free slip, but both barotropic and viscous vertical vorticity when surface drag is included. Baroclinic vertical vorticity grows large once a cold pool is established, regardless of the lower boundary condition and, in fact, dominates at the time the vortices are most intense in all but one simulation (a simulation dominated early by a barotropic mode of vortex genesis that may not be relevant to real convective storms).
Climatology and Structures of Southwest Vortices in the NCEP Climate Forecast System Reanalysis
Authors: Feng Xinyuan , Liu Changhai , Fan Guangzhou , Liu Xiaodong , Feng Caiyun 
Published: August 2016

Abstract
The southwest vortex (SWV) is a meso-α-scale cyclonic low pressure system originating in southwest China. It is a high-impact precipitation-generating weather system in this region and a large downstream area. A climatology of the SWV over 1979–2010 is presented here. Results indicate that the SWV is a common regional weather system with about 73 annual occurrences. Two primary genesis regions are identified, one in the Sichuan basin and another one in the southeast flank of the Tibetan Plateau. SWV genesis displays seasonality with a spring–summer preference and diurnal variations. The average life cycle, horizontal dimension, and translation speed are 15.1 h, 435 km, and 8.6 m s−1, respectively. SWVs are classified into four types that show regional and seasonal contrasts in structure. In type I, the winter–spring elevated dry vortex in the basin is vertically confined to a shallow layer between 850 and 600 hPa and tilts northeastward. The low-level vortex has a cold center, and the middle to upper levels feature baroclinicity. In type II, the nighttime warm-season precipitating vortex system in the basin has a deep structure with the cyclonic vorticity extending from the surface into the upper troposphere. The nonsevere precipitating vortex (type IIa) is weakly baroclinic and tilts northward with height, whereas the severe precipitating vortex (type IIb) is vertically aligned. For type III, in the southern mountains, the shallow surface-based vortex develops in a well-mixed boundary layer and vertically tilts in the upslope direction and has a warm and low-humidity core. For type IV, the heavy precipitating vortex in the mountainous region is large, deep, and nearly upright with a fairly barotropic environment.
Estimates of Global Surface Hydrology and Heat Fluxes from the Community Land Model (CLM4.5) with Four Atmospheric Forcing Datasets
Authors: Wang Aihui , Zeng Xubin , Guo Donglin 
Published: August 2016

Abstract
Global land surface hydrology and heat fluxes can be estimated by running a land surface model (LSM) driven by the atmospheric forcing dataset. Previous multimodel studies focused on the impact of different LSMs on model results. Here the sensitivity of the Community Land Model, version 4.5 (CLM4.5), results to the atmospheric forcing dataset is documented. Together with the model default global forcing dataset (CRU–NCEP, hereafter CRUNCEP), three newly developed, reanalysis-based, near-surface meteorological datasets (i.e., MERRA, CFSR, and ERA-Interim) with the precipitation adjusted by the Global Precipitation Climatology Project monthly product were used to drive CLM4.5. All four simulations were run at 0.5° × 0.5° grids from 1979 to 2009 with the identical initialization. The simulated monthly surface hydrology variables, fluxes, and the forcing datasets were then evaluated against various observation-based datasets (soil moisture, runoff, snow depth and water equivalent, and flux tower measurements). To partially avoid the mismatch between model gridbox values and point measurements, three approaches were taken. The model simulations based on three newly constructed forcing datasets are overall better than the simulation from CRUNCEP, in particular for soil moisture and snow quantities. The ensemble mean from the CLM4.5 simulations using the four forcing datasets is generally superior to individual simulations, and the ensemble mean latent and sensible heat fluxes over global land (60°S–90°N) are 42.8 and 40.3 W m−2, respectively. The differences in both precipitation and other atmospheric forcing variables (e.g., air temperature and downward solar radiation) contribute to the differences in simulated results. The datasets are available from the authors for further evaluation and for various applications.
Portable Electronics and Trends in Goods Stolen from the Person
Authors: Thompson Rebecca 
Published: August 2016

Objectives: To better understand theft of portable electronic goods, this study examined the type of goods stolen during theft and robbery in England and Wales over almost two decades. Methods: Using all sweeps of the Crime Survey for England and Wales between 1994 and 2011, the proportion of incidents where a particular item was stolen was calculated and then compared over time. Results: A small range of items accounted for the bulk of what was taken, namely, cash, purses/wallets, credit/debit cards, and mobile phones. Conclusions: Considerable changes to the stolen goods landscape were found, with a shift from more traditional items such as cash and purses/wallets to portable electronic items such as mobile phones. Recommendations are made for preventing the loss of the items most frequently stolen during offenses of theft and robbery.
Effectiveness of Allograft Reconstruction vs Tenodesis for Irreparable Peroneus Brevis Tears
Authors: Pellegrini Manuel J. , Glisson Richard R. , Matsumoto Takumi , Schiff Adam , Laver Lior , Easley Mark E. , Nunley James A. 
Published: August 2016

Background: Irreparable peroneus brevis tendon tears are uncommon, and there is scant evidence on which to base operative treatment. Options include tendon transfer, segmental resection with tenodesis to the peroneus longus tendon, and allograft reconstruction. However, the relative effectiveness of the latter 2 procedures in restoring peroneus brevis function has not been established. Methods: Custom-made strain gage–based tension transducers were implanted into the peroneus longus and brevis tendons near their distal insertions in 10 fresh-frozen cadaver feet. Axial load was applied to the foot, and the peroneal tendons and antagonistic tibialis anterior and posterior tendons were tensioned to 50% and 100% of physiologic load. Distal tendon tension was recorded in this normal condition and after sequential peroneus brevis-to-longus tenodesis and peroneus brevis allograft reconstruction. Measurements were made in 5 foot inversion/eversion and plantarflexion/dorsiflexion positions. Results: Distal peroneus brevis tendon tension after allograft reconstruction significantly exceeded that measured after tenodesis in all tested loading conditions ( P ≤ 0.022). With 50% of physiologic load applied, peroneus brevis tension was 1% to 28% of normal (depending on foot position) after tenodesis and 73% to 101% of normal after allograft reconstruction. Under the 100% loading condition, peroneus brevis tension was 6% to 43% of normal after tenodesis and 88% to 99% of normal after reconstruction with allograft. Distal peroneus longus tension remained within 20% of normal under all operative and loading conditions. Conclusion: Allograft reconstruction of a peroneus brevis tendon tear in this model substantially restored distal tension when the peroneal tendons and their antagonists were loaded to 50% and 100% of physiologic load. Tenodesis to the peroneus longus tendon did not effectively restore peroneus brevis tension under the tested conditions. Clinical Relevance: Because tenodesis was demonstrated to be ineffective for restoration of peroneus brevis function, this procedure may result in an imbalanced foot clinically.
Association of asymptomatic spinal cord lesions and atrophy with disability 5 years after a clinically isolated syndrome
Authors: Brownlee WJ , Altmann DR , Alves Da Mota P , Swanton JK , Miszkiel KA , Wheeler-Kingshott CAM Gandini , Ciccarelli O , Miller DH 
Published: August 2016

Background: Spinal cord pathology is an important substrate for long-term disability in multiple sclerosis (MS). Objective: To investigate longitudinal changes in spinal cord lesions and atrophy in patients with a non-spinal clinically isolated syndrome (CIS), and how they relate to the development of disability. Methods: In all, 131 patients with a non-spinal CIS had brain and spinal cord imaging at the time of CIS and approximately 5 years later (median: 5.2 years, range: 3.0–7.9 years). Brain magnetic resonance imaging (MRI) measures consisted of T2-hyperintense and T1-hypointense lesion loads plus brain atrophy. Spinal cord MRI measures consisted of lesion number and the upper cervical cord cross-sectional area (UCCA). Disability was measured using the Expanded Disability Status Scale (EDSS). Multiple linear regression was used to identify independent predictors of disability after 5 years. Results: During follow-up, 93 (71%) patients were diagnosed with MS. Baseline spinal cord lesion number, change in cord lesion number and change in UCCA were independently associated with EDSS ( R2 = 0.53) at follow-up. Including brain T2 lesion load and brain atrophy only modestly increased the predictive power of the model ( R2 = 0.64). Conclusion: Asymptomatic spinal cord lesions and spinal cord atrophy contribute to the development of MS-related disability over the first 5 years after a non-spinal CIS.
Magnetic Resonance–Guided High-Intensity-Focused Ultrasound for Palliation of Painful Skeletal Metastases: A Pilot Study
Authors: Chan Michael , Dennis Kristopher , Huang Yuexi , Mougenot Charles , Chow Edward , DeAngelis Carlo , Coccagna Jennifer , Sahgal Arjun , Hynynen Kullervo , Czarnota Gregory , Chu William 
Published: August 2016

Background: Bone is one of the most common sites of metastases, with bone metastases-related pain representing a significant source of morbidity among patients with cancer. Magnetic resonance–guided focused ultrasound is a noninvasive, outpatient modality with the potential for treating painful bone metastases. The aim of this study is to report our initial experience with magnetic resonance–guided focused ultrasound in the treatment of bone metastases and our preliminary analysis of urinary cytokine levels after therapy. Methods: This was a single-center pilot study of 10 patients with metastatic cancer to investigate the feasibility of magnetic resonance–guided focused ultrasound for primary pain control in device-accessible skeletal metastases. Treatments were performed on a clinical magnetic resonance–guided focused ultrasound system using a volumetric ablation technique. Primary efficacy was assessed using Brief Pain Inventory scores and morphine equivalent daily dose intake at 3 time points: before, day 14, and day 30 after the magnetic resonance–guided focused ultrasound treatment. Urine cytokines were measured 3 days before treatment and 2 days after the treatment. Results: Of the 10 patients, 8 were followed up 14 days and 6 were followed up 30 days after the treatment. At day 14, 3 patients (37.5%) exhibited partial pain response and 4 patients (50%) exhibited an indeterminate response, and at day 30 after the treatment, 5 patients (83%) exhibited partial pain response. No treatment-related adverse events were recorded. Of the urine cytokines measured, only Transforming growth factor alpha (TGFα) demonstrated an overall decrease, with a trend toward statistical significance ( P = .078). Conclusion: Our study corroborates magnetic resonance–guided focused ultrasound as a feasible and safe modality as a primary, palliative treatment for painful bone metastases and contributes to the limited body of literature using magnetic resonance–guided focused ultrasound for this clinical indication.