bluuebunny/crossref_metadata_2025_split huggingface dataset:
End-of-Life Care Intensity and Hospice Use
Authors: Wang Shi-Yi , Aldridge Melissa D. , Gross Cary P. , Canavan Maureen , Cherlin Emily , Johnson-Hurzeler Rosemary , Bradley Elizabeth 
Published: April 2016

Objectives:
Despite increased hospice use over the last decade, end-of-life care intensity continues to increase. To understand this puzzle, we sought to examine regional variation in intensive end-of-life care and determine its associations with hospice use patterns.

Methods:
Using Medicare claims for decedents aged 66 years and above in 2011, we assessed end-of-life care intensity in the last 6 months of life across hospital referral regions (HRRs) as measured by proportion of decedents per HRR experiencing hospitalization, emergency department use, intensive care unit (ICU) admission, and number of days spent in hospital (hospital-days) and ICU (ICU-days). Using hierarchical generalized linear models and adjusting for patient characteristics, we examined whether these measures were associated with overall hospice use, very short (≤7 d), medium (8–179 d), or very long (≥180 d) hospice enrollment, focusing on very short stay.

Results:
End-of-life care intensity and hospice use patterns varied substantially across HRRs. Regional-level end-of-life care intensity was positively correlated with very short hospice enrollment. Comparing HRRs in the highest versus the lowest quintiles of intensity in end-of-life care, regions with more intensive care had higher rates of very short hospice enrollment, with adjusted odds ratios (AOR) 1.14 [99% confidence interval (CI), 1.04–1.25] for hospitalization; AOR, 1.23 (CI, 1.12–1.36) for emergency department use; AOR, 1.25 (CI, 1.14–1.38) for ICU admission; AOR, 1.10 (CI, 1.00–1.21) for hospital-days; and AOR, 1.20 (CI, 1.08–1.32) for ICU-days.

Conclusions:
At the regional level, increased end-of-life care intensity was consistently associated with very short hospice use.
In Situ Visualization of the Dynamics in Xylem Embolism Formation and Removal in the Absence of Root Pressure: A Study on Excised Grapevine Stems
Authors: Knipfer Thorsten , Cuneo Italo F. , Brodersen Craig R. , McElrone Andrew J. 
Published: April 2016

AbstractGas embolisms formed during drought can disrupt long-distance water transport through plant xylem vessels, but some species have the ability to remove these blockages. Despite evidence suggesting that embolism removal is linked to the presence of vessel-associated parenchyma, the underlying mechanism remains controversial and is thought to involve positive pressure generated by roots. Here, we used in situ x-ray microtomography on excised grapevine stems to determine if embolism removal is possible without root pressure, and if the embolism formation/removal affects vessel functional status after sample excision. Our data show that embolism removal in excised stems was driven by water droplet growth and was qualitatively identical to refilling in intact plants. When stem segments were rehydrated with H2O after excision, vessel refilling occurred rapidly (&lt;1 h). The refilling process was substantially slower when polyethylene glycol was added to the H2O source, thereby providing new support for an osmotically driven refilling mechanism. In contrast, segments not supplied with H2O showed no refilling and increased embolism formation. Dynamic changes in liquid/wall contact angles indicated that the processes of embolism removal (i.e. vessel refilling) by water influx and embolism formation by water efflux were directly linked to the activity of vessel-associated living tissue. Overall, our results emphasize that root pressure is not required as a driving force for vessel refilling, and care should be taken when performing hydraulics measurements on excised plant organs containing living vessel-associated tissue, because the vessel behavior may not be static.
Anthropometric discriminators of type 2 diabetes among White and Black American adults
Authors: Hardy Dale S. , Stallings Devita T. , Garvin Jane T. , Gachupin Francine C. , Xu Hongyan , Racette Susan B. 
Published: April 2016

AbstractBackgroundThe aim of the present study was to determine the best anthropometric discriminators of type 2 diabetes mellitus (T2DM) among White and Black males and females in a large US sample.MethodsWe used Atherosclerosis Risk in Communities study baseline data (1987–89) from 15 242 participants (1827 with T2DM) aged 45–65 years. Anthropometric measures included a body shape index (ABSI), body adiposity index (BAI), body mass index, waist circumference (WC), waist:  height ratio (WHtR), and waist:  hip ratio (WHR). All anthropometric measures were standardized to Z‐scores. Using logistic regression, odds ratios for T2DM were adjusted for age, physical activity, and family history of T2DM. The Akaike information criterion and receiver operating characteristic C‐statistic were used to select the best‐fit models.ResultsBody mass index, WC, WHtR, and WHR were comparable discriminators of T2DM among White and Black males, and were superior to ABSI and BAI in predicting T2DM (P < 0.0001). Waist circumference, WHtR, and WHR were the best discriminators among White females, whereas WHR was the best discriminator among Black females. The ABSI was the poorest discriminator of T2DM for all race–gender groups except Black females. Anthropometric values distinguishing T2DM cases from non‐cases were lower for Black than White adults.ConclusionsAnthropometric measures that included WC, either alone or relative to height (WHtR) or hip circumference (WHR), were the strongest discriminators of T2DM across race–gender groups. Body mass index was a comparable discriminator to WC, WHtR, and WHR among males, but not females.
Palaeovalleys in foreland ramp settings: what happens as accommodation decreases down dip?
Authors: Jerrett Rhodri M. , Flint Stephen S. , Brunt Rufus L. 
Published: April 2016

AbstractRecent advances in our understanding of palaeovalleys are largely guided by examples from passive margins, in which accommodation increases down depositional dip. This study tests these models against a dataset from the Pennsylvanian Breathitt Group of the central Appalachian foreland basin, USA. This fluvio‐deltaic succession contains extensive erosionally based fluvio‐estuarine sand bodies that can be tracked over 80 km down depositional dip from a proximal zone of high accommodation close to the orogenic margin to a distal, lower accommodation zone close to the cratonic margin of the basin. The sand bodies are up to 25 m thick, multi‐storey and characterized in their lower parts by strongly amalgamated storeys containing sandy fluvial to estuarine bar accretion elements, and in their middle to upper parts by more fully preserved storeys up to 10 m thick and laterally extensive over 100s of metres. The upper storeys include abandonment channel‐fills of heterolithic marine or marginal marine deposits or muddy to sandy point‐bar elements. Three major regional‐scale architectures include: (i) Tabular sand bodies that everywhere incise open marine prodelta and mouth bar facies and are interpreted as palaeovalleys formed during falling stage and lowstand systems tracts, when eustatic sea‐level fall outpaced tectonic subsidence across the entire study area. (ii) Sand bodies that incise genetically related floodplain lake and/or bay‐fill minor mouth bar deposits up depositional dip and open marine prodelta and mouth bar facies down dip. These stacked distributary channel deposits map down dip into palaeovalleys and formed when up dip subsidence rate resulted in positive, but reduced rate of accommodation creation, while lower tectonic subsidence rate down‐dip resulted in incision. (iii) Sand bodies that incise genetically related floodplain, lake and/or bay‐fill minor mouth bars up dip and pass down‐dip into genetically related unconfined floodplain, prodelta and mouth bar deposits. These sand bodies represent stacked distributary channel fills and channel amalgamation was the product of high rates of lateral migration, typical of the behaviour of channels above their backwater reach. Case (2) sand bodies demonstrate that in rapidly subsiding foreland basins, cross‐shelf palaeovalleys may form down depositional dip from aggradational, distributive fluival strata. Additionally, the genetic relationship between stacked distributary channels and palaeovalleys supports recent models for palaeovalley formation that emphasize diachronous, cut‐and‐fill during falling stage and lowstands of relative sea level.
Coronary Artery Disease Is a Predictor of Progression to Dialysis in Patients With Chronic Kidney Disease, Type 2 Diabetes Mellitus, and Anemia: An Analysis of the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT)
Authors: Sabe Marwa A. , Claggett Brian , Burdmann Emmanuel A. , Desai Akshay S. , Ivanovich Peter , Kewalramani Reshma , Lewis Eldrin F. , McMurray John J. V. , Olson Kurt A. , Parfrey Patrick , Solomon Scott D. , Pfeffer Marc A. 
Published: April 2016

Background

Although clear evidence shows that chronic kidney disease is a predictor of cardiovascular events, death, and accelerated coronary artery disease (
CAD
) progression, it remains unknown whether
CAD
is a predictor of progression of chronic kidney disease to end‐stage renal disease. We sought to assess whether
CAD
adds prognostic information to established predictors of progression to dialysis in patients with chronic kidney disease, diabetes, and anemia.

Methods and Results

Using the previously described Trial to Reduce Cardiovascular Events With Aranesp Therapy (
TREAT
) population, we compared baseline characteristics of patients with and without
CAD
. Cox proportional hazards models were used to assess the association between
CAD
and the outcomes of end‐stage renal disease and the composite of death or end‐stage renal disease. Of the 4038 patients, 1791 had a history of known
CAD
. These patients were older (mean age 70 versus 65 years,
P
<0.001) and more likely to have other cardiovascular disease.
CAD
patients were less likely to have marked proteinuria (29% versus 39%,
P
<0.001), but there was no significant difference in estimated glomerular filtration rate between the 2 groups. After adjusting for age, sex, race, estimated glomerular filtration rate, proteinuria, treatment group, and 14 other renal risk factors, patients with
CAD
were significantly more likely to progress to end‐stage renal disease (adjusted hazard ratio 1.20 [95%
CI
1.01–1.42],
P
=0.04) and to have the composite of death or end‐stage renal disease (adjusted hazard ratio 1.15 [95%
CI
1.01–1.30],
P
=0.03).

Conclusions

In patients with chronic kidney disease, diabetes, and anemia, a history of
CAD
is an independent predictor of progression to dialysis. In patients with diabetic nephropathy, a history of
CAD
contributes important prognostic information to traditional risk factors for worsening renal disease.
Lipoprotein(a) Interactions With Low‐Density Lipoprotein Cholesterol and Other Cardiovascular Risk Factors in Premature Acute Coronary Syndrome (ACS)
Authors: Afshar Mehdi , Pilote Louise , Dufresne Line , Engert James C. , Thanassoulis George 
Published: April 2016

Background

Current recommendations for lipoprotein(a) (Lp[a]) focus on the control of other risk factors, including lowering low‐density lipoprotein cholesterol (
LDL
‐C), with little evidence to support this approach. Identifying interactions between Lp(a) and other risk factors could identify individuals at increased risk for Lp(a)‐mediated disease.

Methods and Results

We used a case‐only study design and included 939 participants (median age=49 years, interquartile range 46–53, women=33.1%) from the
GENdE
r and Sex determInantS of cardiovascular disease: from bench to beyond‐Premature Acute Coronary Syndrome (
GENESIS
‐
PRAXY
) study, a multicenter prospective cohort study of premature acute coronary syndrome. There was a higher prevalence of elevated Lp(a) levels (>50 mg/dL; 80th percentile) in
PRAXY
participants as compared to the general population (31% versus 20%;
P
<0.001). Lp(a) was strongly associated with
LDL
‐C (adjusted β 0.17;
P
<0.001). Individuals with high Lp(a) were more likely to have
LDL
‐C >2.5 mmol/L, indicating a synergistic interaction (adjusted odds ratio 1.51; 95%
CI
1.08–2.09;
P
=0.015). The interaction with high Lp(a) was stronger at increasing
LDL
‐C levels (
LDL
‐C >3.5, adjusted odds ratio 1.87;
LDL
‐C >4.5, adjusted odds ratio 2.72). In a polytomous logistic model comparing mutually exclusive
LDL
‐C categories, the interaction with high Lp(a) became attenuated at
LDL
‐C ≤3.5 mmol/L (odds ratio 1.16; 95%
CI
0.80–1.68,
P
=0.447). Other risk factors were not associated with high Lp(a).

Conclusions

In young acute coronary syndrome patients, high Lp(a) is more prevalent than in the general population and is strongly associated with high
LDL
‐C, suggesting that Lp(a) confers greater risk for acute coronary syndrome when
LDL
‐C is elevated. Individuals with high Lp(a) and
LDL
‐C >3.5 mmol/L may warrant aggressive
LDL
‐C lowering.
Association of Thoracic Aorta Calcium Score With Exercise Blood Pressure Response and Clinical Outcomes in Elderly Individuals: Differential Impact of Aorta Calcification Compared With Coronary Artery Calcification
Authors: Cho In‐Jeong , Chang Hyuk‐Jae , Cho Iksung , Heo Ran , Lee Sang‐Eun , Shim Chi Young , Hong Geu‐Ru , Chung Namsik 
Published: April 2016

Background

The structure of the aorta is considered to influence exercise systolic blood pressure (
SBP
) response, which, in turn, might impact upon adverse outcomes. The current study sought to investigate the relationship of aortic calcification and exercise
SBP
with adverse outcomes among elderly individuals.

Methods and Results

We retrospectively reviewed 702 elderly individuals (>65 years of age) without obstructive coronary artery disease (
CAD
; luminal stenosis <50%) who underwent coronary computed tomography (
CT
) and exercise treadmill testing. Δ
SBP
stage2
and Δ
SBP
peak
were defined as the difference in systolic blood pressure (
SBP
) between rest and stage 2 or peak exercise, respectively. Thoracic aortic calcium score (
TACS
) and coronary artery calcium score (
CACS
) were measured using
CT
scanning procedures. The primary endpoints were defined as all‐cause death, admission for heart failure, obstructive
CAD
requiring coronary intervention, and stroke. In multivariable models, Δ
SBP
stage2
and Δ
SBP
peak
were positively related with
log
(
TACS
+1), even after adjusting for various clinical variables, baseline
SBP
, and
CACS
(
P
<0.001). During a median follow‐up period of 65 months, there were 59 events (8.4%). In a multivariate Cox regression model, independent predictors for all events were age (hazard ratio [
HR
], 1.12; 95%
CI
, 1.05–1.19;
P
<0.001), dyslipidemia (
HR
, 1.96; 95%
CI
, 1.14–3.37;
P
=0.015), and the 4th quartile of
TACS
(
HR
, 1.24; 95%
CI
, 1.03–1.49;
P
=0.024). Among individual events, the 4th quartile of
TACS
was the only independent predictor for stroke (
HR
, 2.15; 95%
CI
, 1.09–5.13;
P
=0.044), whereas
CACS
≥400 mm
3
was an independent predictor for obstructive
CAD
requiring intervention (
HR
, 7.04; 95%
CI
, 1.58–31.36;
P
=0.010).

Conclusions

Aortic calcification was related to
SBP
response during exercise and was an independent predictor for outcomes, especially stroke, regardless of resting
SBP
or
CACS
.
Smoker's Paradox in Patients With ST‐Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
Authors: Gupta Tanush , Kolte Dhaval , Khera Sahil , Harikrishnan Prakash , Mujib Marjan , Aronow Wilbert S. , Jain Diwakar , Ahmed Ali , Cooper Howard A. , Frishman William H. , Bhatt Deepak L. , Fonarow Gregg C. , Panza Julio A. 
Published: April 2016

Background

Prior studies have found that smokers undergoing thrombolytic therapy for
ST
‐segment elevation myocardial infarction have lower in‐hospital mortality than nonsmokers, a phenomenon called the “smoker's paradox.” Evidence, however, has been conflicting regarding whether this paradoxical association persists in the era of primary percutaneous coronary intervention.

Methods and Results

We used the 2003–2012 National Inpatient Sample databases to identify all patients aged ≥18 years who underwent primary percutaneous coronary intervention for
ST
‐segment elevation myocardial infarction. Multivariable logistic regression was used to compare in‐hospital mortality between smokers (current and former) and nonsmokers. Of the 985 174 patients with
ST
‐segment elevation myocardial infarction undergoing primary percutaneous coronary intervention, 438 954 (44.6%) were smokers. Smokers were younger, were more often men, and were less likely to have traditional vascular risk factors than nonsmokers. Smokers had lower observed in‐hospital mortality compared with nonsmokers (2.0% versus 5.9%; unadjusted odds ratio 0.32, 95%
CI
0.31–0.33,
P
<0.001). Although the association between smoking and lower in‐hospital mortality was partly attenuated after baseline risk adjustment, a significant residual association remained (adjusted odds ratio 0.60, 95%
CI
0.58–0.62,
P
<0.001). This association largely persisted in age‐stratified analyses. Smoking status was also associated with shorter average length of stay (3.5 versus 4.5 days,
P
<0.001) and lower incidence of postprocedure hemorrhage (4.2% versus 6.1%; adjusted odds ratio 0.81, 95% CI 0.80–0.83,
P
<0.001) and in‐hospital cardiac arrest (1.3% versus 2.1%; adjusted
OR
0.78, 95%
CI
0.76–0.81,
P
<0.001).

Conclusions

In this nationwide cohort of patients undergoing primary percutaneous coronary intervention for
ST
‐segment elevation myocardial infarction, we observed significantly lower risk‐adjusted in‐hospital mortality in smokers, suggesting that the smoker's paradox also applies to
ST
‐segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention.
Prophylactic efficacy of BeneFIX vs Alprolix in hemophilia B mice
Authors: Cooley Brian , Funkhouser William , Monroe Dougald , Ezzell Ashley , Mann David M. , Lin Feng-Chang , Monahan Paul E. , Stafford Darrel W. 
Published: April 2016

Key PointsBecause extravascular FIX is physiologically important, FIXs circulating levels do not independently predict hemostatic potential. A saphenous vein hemophilia B mouse model shows that 7 days postinfusion FIX-Fc and FIX provide equal hemostatic protection.
Short Communication: Rhizoctonia-like fungi isolated from roots of Dendrobium lancifolium var. papuanum and Calanthe triplicata in Papua, Indonesia
Authors: AGUSTINI VERENA , SUFAATI SUPENI , SUHARNO SUHARNO , SUWANNASAI NUTTIKA 
Published: April 2016

Agustini V, Sufaati S, Suharno, Suwannasai N. 2016. Rhizoctonia-like fungi isolated from roots of Dendrobium lancifoliumÂ var. papuanum and Calanthe triplicata in Papua, Indonesia. Biodiversitas 17: 377-383. The aim of this study was to isolate and identifyRhizoctonia-like fungi associated with the roots of the terrestrial orchids Dendrobium lancifolium A. Rich var. papuanum and CalantheÂ triplicata (Willem) Ames in Papua. The fungi were isolated from the transversal section of the orchid roots. Two isolates have been morphologically identified as genus Rhizoctonia. Further identification was carried out based on the analysis of nucleotide sequences generated from ITS and 28S rDNA. The results revealed that both isolates closed to Ceratobasidium sp. and the phylogenetic analysis confirmed that they were determined as Rhizoctonia-like fungi.
The cultural significance of the Turkish 9 rhythm: Timing, tradition, and identity
Authors: Aydın Emir Cenk 
Published: April 2016

Folk music throughout Anatolia and Thrace contains significant information about a performers social experience and background. In Turkey social information is commonly communicated through rhythm. Types of traditional music, particularly types with specific rhythmic structures and patterns, are often indicative of an ethnic or regional Turkish identity, an origin or affiliation. The 9 beat rhythmic structures are very common in the Folk Music of Anatolia. They are seen nearly everywhere in different arrangements and tempo values.In this article I will discuss the 9 beat time signature and specific 9/8 timed music belonging to and performed by groups that are often considered somewhat marginal in the contemporary Turkish Republic. For example, distinct types of rhythms and music (and corresponding social dances) are performed among defined Turkish identity groups such as Alevi (9/8), Zeybek (9/4 or 9/2), Yörük (9/16), and Rom (9/8). I will pay special attention to nine rhythms and discuss in more detail how each unique rhythmic pattern communicates a great deal of social and regional knowledge in Turkey.
Educational design of short, audio-only podcasts: The teacher and student experience
Authors: Taylor Lucy , Clark Steve 
Published: April 2016

<blockquote>This paper reports the findings of an exploratory study on the use of podcasting in higher education. The study was conducted during 2007 and 2008 and involved students from 20 units of study. Research data was gathered by distributing an in-class survey to 4584 enrolled students, with 39% (1780) of students completing the survey. Qualitative data was gathered by conducting student focus groups, with a total of 158 students participating, and interviewing teaching staff on their podcasting experiences. The results identified three broad approaches to podcasting employed: <em>re-framed</em> podcasts, or content reproduced in multiple media (e.g., textbook chapters summarised as podcast episodes); <em>complementary</em> podcasts that added extra information to enhance the student learning experience; and<em>supplementary</em> podcasts that re-design and broadcast content previously presented in class.</blockquote><p> </p>
Learning strategies and motivational factors predicting information literacy self-efficacy of e-learners
Authors: Kiliç-Çakmak Ebru 
Published: April 2016

<blockquote>Rapid increase in information sources in different formats, developments in technology and need for lifelong learning have drawn increased attention to needs for information literacy. Although information literacy is significant for students of all educational levels, it has become even more significant for e-learners. Therefore, this study explores learning strategies and motivational factors predicting information literacy self-efficacy of e-learning students. This study was carried out with 119 e-learners using the <em>Information Literacy Self-efficacy Scale</em> and the <em>Motivated Strategies for Learning Questionnaire.</em> Results indicate that metacognitive, effort management, elaboration and critical thinking strategies, as well as control belief, predict different dimensions of information literacy self-efficacy.</blockquote><p> </p>