bluuebunny/crossref_metadata_2025_split huggingface dataset:
Missed Ischemic Stroke Diagnosis in the Emergency Department by Emergency Medicine and Neurology Services
Authors: Arch Allison E. , Weisman David C. , Coca Steven , Nystrom Karin V. , Wira Charles R. , Schindler Joseph L. 
Published: February 2016

Background and Purpose—
The failure to recognize an ischemic stroke in the emergency department is a missed opportunity for acute interventions and for prompt treatment with secondary prevention therapy. Our study examined the diagnosis of acute ischemic stroke in the emergency department of an academic teaching hospital and a large community hospital.

Methods—
A retrospective chart review was performed from February 2013 to February 2014.

Results—

A total of 465 patients with ischemic stroke were included in the analysis; 280 patients from the academic hospital and 185 patients from the community hospital. One hundred three strokes were initially misdiagnosed that is 22% of the included strokes at the combined centers. Fifty-five of these were missed at the academic hospital (20%) and 48 were at the community hospital (26%,
P
=0.11). Thirty-three percent of missed cases presented within a 3-hour time window for recombinant tissue-type plasminogen activator eligibility. An additional 11% presented between 3 and 6 hours of symptom onset for endovascular consideration. Symptoms independently associated with greater odds of a missed stroke diagnosis were nausea/vomiting (odds ratio, 4.02; 95% confidence interval, 1.60–10.1), dizziness (odds ratio, 1.99; 95% confidence interval, 1.03–3.84), and a positive stroke history (odds ratio, 2.40; 95% confidence interval, 1.30–4.42). Thirty-seven percent of posterior strokes were initially misdiagnosed compared with 16% of anterior strokes (
P
<0.001).

Conclusions—
Atypical symptoms associated with posterior circulation strokes lead to misdiagnoses. This was true at both an academic center and a large community hospital. Future studies need to focus on the evaluation of identification systems and tools in the emergency department to improve the accuracy of stroke diagnosis.
Meteorological Regimes of the Most Intense Convective Systems along the Southern Himalayan Front
Authors: Wu Xueke , Qie Xiushu , Yuan Tie , Li Jinliang 
Published: February 2016

Abstract
Based on 16 years of Tropical Rainfall Measuring Mission (TRMM) data and NCEP Climate Forecast System Reanalysis data, the most intense convective systems (ICSs) along the southern Himalayan front (SHF) are studied using the multivariate techniques of principal component analysis in T mode and k-means cluster analysis. Three clusters, classified according to the near-surface fields of wind, specific humidity, convective available potential energy, and convective inhibition, correspond to the premonsoon (March–May), the establishment of the monsoon (late May–early June), and the Indian summer monsoon itself (June–September), respectively. The location of ICSs along the SHF is closely related to the establishment of the transport passage from the eastern SHF to the northwestern SHF along the Himalayas. During the premonsoon, the southwesterly wind is weak and moist air from the Bay of Bengal is transported to the eastern SHF, where ICSs are densely distributed. The oceanic southwesterly wind is enhanced and the transport passage extends to the central SHF during the monsoon establishment period, when ICSs distribute over the whole SHF homogeneously. The southwesterly wind is the strongest and the transport passage extends to the westernmost SHF after the monsoon is established, when ICSs mainly concentrate over the concave indentation region. Backward trajectory analysis confirms that, besides the local environment, the moisture transport from the Arabian Sea (17%) and the Bay of Bengal (9%) are two important long-range transport pathways for the summer monsoon ICSs at the western end of the SHF.
Estimating Uncertainties in High-Resolution Satellite Precipitation Products: Systematic or Random Error?
Authors: Maggioni Viviana , Sapiano Mathew R. P. , Adler Robert F. 
Published: February 2016

AbstractThis study proposes a method to quantify systematic and random components of the error associated with satellite precipitation products. Specifically, the Precipitation Uncertainties for Satellite Hydrology (PUSH) model is expanded to provide an estimate of those components of the root-mean-square error. The framework is tested on the TRMM Multisatellite Precipitation Analysis (TMPA) 3B42, real time (3B42RT), and 3B42, version 7 (3B42V7), products over the contiguous United States, using the NOAA Climate Prediction Center (CPC) Unified gauge product as reference. Results show that 3B42V7 exhibits much smaller errors than the real-time product and that the major component of the error associated with both TMPA 3B42 products is random, as the systematic error is almost completely removed by the bias adjustment applied to the two products. A strong dependence of both systematic and random error components on satellite rain rates—with larger error components at larger rain rates—is observed for both satellite products, which suggests that future satellite bias adjustment procedures should account for this dependence. The resulting error estimates and their random and systematic components allow inferences about the accuracy of these datasets and will enhance their deployment in numerous applications, from hydrological modeling and hazard mitigation to climate change studies and water management policy.
Increased aortic wall thickness on CT as a sign of prosthetic valve endocarditis
Authors: Fagman Erika , Bech-Hanssen Odd , Flinck Agneta , Lamm Carl , Svensson Gunnar 
Published: February 2016

Background Increased wall thickness in the aortic root has been suggested as an early sign of prosthetic valve endocarditis (PVE). However, there are no previous studies on the aortic wall thickness after aortic valve replacement (AVR) or in patients with PVE. Purpose To identify a clinically useful cutoff value for aortic wall thickness to detect PVE. Material and Methods Chest computed tomography (CT) studies (n = 303) on patients with a prosthetic aortic valve were retrospectively analyzed. CT studies on patients without PVE (n = 260) were compared with CT studies on patients with definite PVE (n = 43). A receiver operator characteristic (ROC) analysis was performed. Results In non-PVE patients, the wall thickness during the first 3 months postoperatively (n = 70, 4.5 ± 1.7 mm) was increased compared to beyond 3 months postoperatively (n = 190, 3.2 ± 1.0 mm, P < 0.001). Beyond 3 months postoperatively, the wall thickness 95th percentile was 5.0 mm without signs of further decrease with time. The wall thickness in PVE patients was 6.8 ± 3.0 mm (n = 43). Beyond 3 months postoperatively, ROC analysis yielded an area under the curve of 0.89 (95% CI, 0.81–0.96). With a cutoff value of 5 mm the sensitivity was 67%, specificity 95%, positive likelihood ratio 14.1, and negative likelihood ratio 0.35 of increased wall thickness in detecting PVE. Conclusion In the early postoperative period after AVR, the aortic wall thickness is increased compared to the late postoperative period. After 3 months, the wall thickness has decreased and stabilized. Increased wall thickness (>5 mm) beyond 3 months postoperatively significantly increases the likelihood of PVE.
Cryopyrin-associated periodic fever syndrome manifesting as Tolosa-Hunt syndrome
Authors: Höhne C , Schuh E , Kümpfel T , Straube A 
Published: February 2016

Background Tolosa-Hunt syndrome (THS) is characterized by unilateral orbital pain, ipsilateral oculomotor paresis and a prompt response to treatment with corticosteroids. Several reports have demonstrated that the clinical features of THS are not specific to one causal aetiology and can lead to misdiagnosis. Case report We report the case of a patient diagnosed with THS after an episode of unilateral orbital pain and diplopia with demonstration of granulomatous inflammation of both cavernous sinus on cerebral magnetic resonance imaging and an immediate response to treatment with corticosteroids. Progression of the disease over the following years, accompanied by increasing signs of inflammation on cerebral magnetic resonance imaging and cerebrospinal fluid pleocytosis, led to further diagnostic tests. Genetic analyses revealed a heterozygote low-penetrance mutation (Q703K) of the cryopyrin/ NLRP3 gene compatible with a cryopyrin-associated periodic fever syndrome. Discussion This case report demonstrates that THS can be a central nervous system manifestation of cryopyrin-associated periodic fever syndrome, which therefore represents a differential diagnosis of THS, even in elderly patients.
Graft Bending Angle at the Intra-articular Femoral Tunnel Aperture After Single-Bundle Posterior Cruciate Ligament Reconstruction
Authors: Jang Ki-Mo , Park Sung-Chul , Lee Dae-Hee 
Published: February 2016

Background: To date, no in vivo 3-dimensional computed tomography (3D-CT) studies have compared graft bending angles at the femoral tunnel aperture and femoral tunnel length in patients who underwent posterior cruciate ligament (PCL) reconstruction with outside-in (OI) and inside-out (IO) techniques. Purpose/Hypothesis: This study used in vivo 3D-CT analysis to compare graft bending angles at the femoral tunnel aperture and femoral tunnel lengths after OI and IO femoral drilling techniques in single-bundle PCL reconstruction. It was hypothesized that the graft bending angle at the femoral tunnel aperture would be less acute with the OI compared with the IO technique, with no difference in femoral tunnel lengths. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Immediate postoperative in vivo 3D-CT and curved planar reformation were used to assess the graft bending angles and femoral tunnel lengths in the sagittal, axial, and coronal planes in 67 patients who underwent single-bundle PCL reconstruction with the OI (n = 37) and IO (n = 30) techniques. Results: The mean graft bending angles on the sagittal and axial planes were 8.2° more acute (23.5° vs 15.3°, P = .011) and 5.3° more acute (49.0° vs 43.7°, P = .013), respectively, with the IO compared with the OI technique, but the difference in the coronal plane was not statistically significant (25.3° vs 24.8°, P = .623). Femoral tunnel length was similar in the 2 groups. Conclusion: The graft bending angles in single-bundle PCL reconstruction were more acute in the sagittal and axial planes with the IO compared with the OI technique, but there was no difference in the coronal plane. In addition, femoral tunnel lengths did not differ significantly in patients who underwent OI and IO single-bundle PCL reconstructions. Although further biomechanical studies are needed to evaluate the effect on graft failure of a <10° difference in graft bending angle, the small magnitude of this difference would likely have little adverse effect on graft survival.
The use of Rarefaction Analysis for Estimating Palynological Richness from Quaternary Pollen-Analytical Data
Authors: Birks H. J.B. , Line J. M. 
Published: February 2016

Reconstructing temporal changes in diversity from pollen assemblages is potentially important both palaeoecologically and ecologically because community diversity may, in part, result from historical processes. The use of diversity indices such as Shannon's information index or Simpson's index is not appropriate with pollen percentage data because such indices consider both the numbers of different taxa and their relative frequencies or representation. The latter aspect in pollen data is inevitably influenced by inherent differences in pollen production and dispersal. The total number of taxa present in a sample is a robust and useful measure of palynological richness if, and only if, all the pollen counts are standardized to a fixed number of grains. Rarefaction analysis implements such a standardization and provides minimum variance unbiased estimates of the expected number of taxa ( t) in a random sample of n individuals taken from a larger collection of N individuals containing T taxa. The underlying mathematical theory of rarefaction analysis and its important biological and palaeoecological assumptions are discussed. The use of rarefaction analysis is illustrated with three data-sets: Crose Mere, central England (0-c. 12 500 BP); Abernethy Forest, eastern Scotland (5500-12 100 BP); and three sites (Lochs Ashik, Cleat, Meodal) on the Isle of Skye, western Scotland, all covering the last 10 500 years. Palynological richness, as estimated by rarefaction analysis, is high in the protocratic phase (c. 9500-12 500 BP), low in the mesocratic phase (c. 5500-9500 BP), low in the oligocratic phase (0-c. 5500 BP), and high in the Homo sapiens phase (0-c. 5000 BP) of the Holocene. Although factors such as local site characteristics and pollen production, dispersal, and input may influence temporal changes in richness, changes in palynological richness are interpreted as reflecting predominantly the changing floristic richness of the vegetation types in the pollen-source area of a lake and the changing mosaic structure of the landscape through time. Intermediate levels of disturbance, either natural in the protocratic phase or anthropogenic in the Homo sapiens phase appear to be important in maximizing richness at the landscape scale by preventing (he dominance of any single component but insufficient to cause extinction of components at the landscape scale.
Increased concentration of plasma TNFR1 and TNFR2 in paediatric lupus nephritis
Authors: Patel M , Oni L , Midgley A , Smith E , Tullus K , Marks S D , Jones C A , Pilkington C , Beresford M W 
Published: February 2016

Background Juvenile-onset systemic lupus erythematous (JSLE) is a debilitating condition that frequently involves the kidneys (lupus nephritis; LN). Tumour necrosis factor alpha (TNF-α), an important pro-inflammatory cytokine, is expressed locally in the kidney and correlates with LN disease activity. The aim of this study was to ascertain whether soluble receptors for TNF-α (sTNFR1/sTNFR2) are significantly increased in children with LN. Methods Plasma samples were collected from JSLE patients at routine review. Concentrations of sTNFR1 and sTNFR2 were measured (median; interquartile range, IQR) using enzyme-linked immunosorbent assay (ELISA) in 25 JSLE patients (seven LN) and 20 healthy controls (HCs). Results sTNFR2 concentration was significantly increased in JSLE (5149 pg/dl, 3413–8561) compared to HCs (3858 pg/dl, 2254–5165; p = 0.049). sTNFR1 concentration was significantly increased in active LN ( n = 7, 1765 pg/dl, IQR 1133–4167) compared to inactive LN ( n = 18, 1104 pg/dl, 886–1272; p = 0.018). There was a non-significant increase in sTNFR2 concentration in active LN (9829 pg/dl, 3298–21271) compared to inactive LN (4595 pg/dl, 3345–6993; p = 0.146). sTNFR1 concentration correlated moderately with sTNFR2 ( r = 0.66, p < 0.001). sTNFR2 demonstrated strong positive correlations with ESR ( r = 0.941, p < 0.01) and anti-dsDNA antibodies ( r = 0.998, p = 0.041). Both receptors also positively correlated with creatinine (TNFR1 r = 0.81, p < 0.001; TNFR2 r = 0.50, p = 0.015) and urinary albumin creatinine ratio (TNFR1 r = 0.64, p < 0.01; TNFR2 r = 0.63, p < 0.01). Conclusions These data indicate that sTNFR1 and sTNFR2 concentrations are elevated in LN and may reflect renal activity. These results provide basis for further investigation into the pathological pathways underlying LN.
Pharmacists' roles in oncology pharmacy services: Results of a global survey
Authors: Holle Lisa M , Harris Christy S , Chan Alexandre , Fahrenbruch Rebecca J , Labdi Bonnie A , Mohs Jocelyn E , Norris Leann B , Perkins Janelle , Vela Cory M 
Published: February 2016

Background Oncology pharmacists are capable of providing medication therapy management (MTM) because of their level of training, practice experiences, and responsibilities. Very little data exist about their current practice, including changing roles in the multidisciplinary team, overall impact, and effects in the education of patients and healthcare professionals. Methods A 70-item survey about oncology pharmacists' activities in oral chemotherapy programs, MTM, and collaborative practice agreements (CPAs) was deployed using a web survey tool (Qualtrics, Provo, UT, USA), targeting pharmacist members of American College of Clinical Pharmacy (ACCP) Hematology/Oncology Practice and Research Network (PRN). The objective of this study was to determine oncology pharmacists' activities in areas of oral chemotherapy programs, MTM, and CPAs. A cross-sectional survey was distributed to the ACCP Hematology/Oncology PRN membership. Investigational Review Board approval was obtained. Results Of the 795 members who were sent the survey, 81 members (10%) responded; 33 respondents (47%) are involved with an oral chemotherapy program; with 42% measuring outcomes of programs. Only six pharmacists (19%) have published or presented their data. A total of 28 (35%) respondents provide MTM services, with almost half (43%) of these MTM services being dictated by CPAs. A small fraction of these pharmacists (21.4%) reported conducting quality assurance evaluations of their MTM services and three pharmacists (10.7%) reported publishing their results. Those pharmacists practicing under CPAs ( n = 28) were surveyed as to activities included in their CPA. The most common activities included adjusting medication, ordering, interpreting, and monitoring lab tests, developing therapeutic plans and educating patients. Reimbursement for providing these services was uncommon: MTM (4%), oral chemotherapy program (6%), and CPA services (11%). Reported obstacles to reimbursement included lack of understanding, administrative assistance, or time with setting up reimbursement models within the institution. Conclusion Many oncology pharmacists are participating in oral chemotherapy programs, MTM, and/or CPAs and perceived barriers were identified. Increased efforts should be directed toward prospectively reporting and assessing the impact these services have on patient care.
Examples of individual supported living for adults with intellectual disability
Authors: Cocks Errol , Thoresen Stian H , O’Brien Patricia , McVilly Keith , Thomson Allyson , Gadow Friederike , Crosbie Jenny , Prain Meredith 
Published: February 2016

Background: This article provides a qualitative account of four models of support for adults with intellectual disability in individual supported living (ISL) arrangements. Materials and Methods: Completion of the first 50 evaluations of 150 arrangements for the third phase of the ISL project provided the examples. Results: Four approaches are described: living alone, co-residency, relationship and host family. Within each type, wide variations occur particularly based on security of tenure, formal and informal support and management variations. Conclusion: Fifty evaluations so far illustrated a wide range of approaches to ISL, providing evidence of the critical importance of the formal and informal support environment and reinforcing the contention that ISL is appropriate for people with high support needs.
Using the modified Hand Injury Severity Score (mHISS) as an objective measure to evaluate a mechanism of triage in a hand therapy department
Authors: Alexander Anne 
Published: February 2016

Introduction Outpatient departments triage their patients to clinicians with the correct skills and experience to ensure an optimal outcome. Currently this is done through experience of senior clinicians, and varies from one hand therapy department to another. We wished to see if the modified Hand Injury Severity Score a (mHISSa) could be used as an objective tool to triage these patients. Methods The mHISS was adapted slightly, and became the mHISSa for this study. Two hundred patient referrals, of previously discharged patients, were reviewed. The grade of staff that had treated them was noted and the referral was scored against the mHISSa. This was used to determine if there was correlation between the score and the current triage pattern. Results We found a strong association ( p < 0.01) between the score and the current prioritisation practice. Two-thirds of patients with a minor score (<20) were treated by bands 5 and 6. Patients with a moderate score (21–50) were rarely seen by a band 5 or 6 and were more commonly treated by a band 7 (65% of the total with a moderate score). Those with score in the severe (51–100) and major (0 >101) categories were mostly treated by a band 7 therapists (79.4% of the total with that score) compared to 17.9% by band 6 and 2.6% by band 5. Discussion The mHISSa as used in this study can be used as an objective tool to assist with triaging patients, in this hand therapy department. Further work is needed nationally to see if the results can be generalised to other units.
Resistance related metabolic pathways for drug target identification in Mycobacterium tuberculosis
Authors: Cloete Ruben , Oppon Ekow , Murungi Edwin , Schubert Wolf-Dieter , Christoffels Alan 
Published: February 2016

Abstract
Background
Increasing resistance to anti-tuberculosis drugs has driven the need for developing new drugs. Resources such as the tropical disease research (TDR) target database and AssessDrugTarget can help to prioritize putative drug targets. Hower, these resources do not necessarily map to metabolic pathways and the targets are not involved in dormancy. In this study, we specifically identify drug resistance pathways to allow known drug resistant mutations in one target to be offset by inhibiting another enzyme of the same metabolic pathway. One of the putative targets, Rv1712, was analysed by modelling its three dimensional structure and docking potential inhibitors.

Results
We mapped 18 TB drug resistance gene products to 15 metabolic pathways critical for mycobacterial growth and latent TB by screening publicly available microarray data. Nine putative targets, Rv1712, Rv2984, Rv2194, Rv1311, Rv1305, Rv2195, Rv1622c, Rv1456c and Rv2421c, were found to be essential, to lack a close human homolog, and to share >67 % sequence identity and >87 % query coverage with mycobacterial orthologs. A structural model was generated for Rv1712, subjected to molecular dynamic simulation, and identified 10 compounds with affinities better than that for the ligand cytidine-5′-monophosphate (C5P). Each compound formed more interactions with the protein than C5P.

Conclusions
We focused on metabolic pathways associated with bacterial drug resistance and proteins unique to pathogenic bacteria to identify novel putative drug targets. The ten compounds identified in this study should be considered for experimental studies to validate their potential as inhibitors of Rv1712.
Judgments toward women wearing high heels: a forced-choice evaluation
Authors: Guéguen Nicolas , Stefan Jordy , Renault Quentin 
Published: February 2016

AbstractResearch reported that men interact with women wearing high heels more readily than with the same women wearing flat heels. However, the effect of heels on the judgment of women by both men and women has received little attention. Male and female participants viewed two photographs of the same woman’s body profile; the woman wore high heels in the one and flat heels in the other, although her shoes and feet were not visible. Participants were asked to select one photograph of the woman on several dimensions of body attractiveness. A significant greater number of male and female participants selected the target with high heels as the sexier, the prettier, and the more elegant, with the more attractive legs and buttocks. The same target was also perceived as the younger person and the photograph that would be preferred by others and the more appropriate for a photo album. The findings support the assumption that high heels could act as secondary sexual characteristics that increase the attractiveness of women to men.