bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictability of Two Types of El Niño Assessed Using an Extended Seasonal Prediction System by MIROC
Authors: Imada Yukiko , Tatebe Hiroaki , Ishii Masayoshi , Chikamoto Yoshimitsu , Mori Masato , Arai Miki , Watanabe Masahiro , Kimoto Masahide 
Published: July 2015

Abstract
Predictability of El Niño–Southern Oscillation (ENSO) is examined using ensemble hindcasts made with a seasonal prediction system based on the atmosphere and ocean general circulation model, the Model for Interdisciplinary Research on Climate, version 5 (MIROC5). Particular attention is paid to differences in predictive skill in terms of the prediction error for two prominent types of El Niño: the conventional eastern Pacific (EP) El Niño and the central Pacific (CP) El Niño, the latter having a maximum warming around the date line. Although the system adopts ocean anomaly assimilation for the initialization process, it maintains a significant ability to predict ENSO with a lead time of more than half a year. This is partly due to the fact that the system is little affected by the “spring prediction barrier,” because increases in the error have little dependence on the thermocline variability. Composite analyses of each type of El Niño reveal that, compared to EP El Niños, the ability to predict CP El Niños is limited and has a shorter lead time. This is because CP El Niños have relatively small amplitudes, and thus they are more affected by atmospheric noise; this prevents development of oceanic signals that can be used for prediction.
Analysis of the safety and efficacy of diabetic ketoacidosis management in a Community General Hospital, 2001–2010: a descriptive study
Authors: Peeters E , van IJperen WJ , Robertson L , Royle P , van IJperen WJ 
Published: July 2015

Background The recommended place for treatment of diabetic ketoacidosis in children is a paediatric High Dependency Unit. This facility is not available in all areas where children with type 1 diabetes mellitus are cared for. Aims This study investigates the safety and efficacy of diabetic ketoacidosis management in a community general hospital without a paediatric high dependency unit. Methods Data from children with diabetic ketoacidosis were collected from all diabetes related admissions in Dr Gray’s Hospital, Elgin from 2001 to 2010. Observations were compared with safety indicators (pH, bicarbonate, glucose, electrolytes and cerebral oedema) and were reviewed for the recovery to normal values (pH, bicarbonate), without abnormal fluctuation (electrolytes, glucose) and without neurological complications (cerebral oedema). Results The 114 patients generated 251 diabetes-related admissions, 118 for diabetic ketoacidosis treatment of whom 99 patients were treated with intravenous fluids and insulin. The mean time to recover to a pH of at least 7.30 was 655 minutes (120–1410 min). There were 79 (4.37% of 1808) glucose readings dropping more than 5.0 mmol/l per hour. There were six hypoglycaemic events (2.3–2.9 mmol/l) and in one case potassium dropped to 2.2 mmol/l. There was no case which developed into cerebral oedema. Conclusion Treatment of diabetic ketoacidosis in a community general hospital managed with a protocol for fluids, insulin and strict monitoring has shown to be effective in achieving recovery and to safely avoid complications.
The Aging Voice
Authors: Vaca Miguel , Mora Elena , Cobeta Ignacio 
Published: July 2015

ObjectivesTo evaluate the impact on voice quality of 2 pathogenic factors involved in age‐related dysphonia: glottal gap and decline in respiratory function.Study DesignCross‐sectional prospective.SettingsTertiary referral center.Subjects and MethodsA total of 105 healthy patients ≥65 years old were included, with a maximum phonation time ≤15 seconds for men and ≤12 seconds for women. Laryngostroboscopy and spirometry were conducted to assess the glottal gap and respiratory function, and 4 profiles were defined according to their combination: glottal deficit, respiratory deficit, combined deficit, and no deficit. Differences across profiles in phonation times, acoustic parameters, and GRBAS scale and Voice Handicap Index–10 scores were analyzed according to Kruskal‐Wallis and Mann‐Whitney nonparametric tests. Multiple regression was performed to estimate the influence of each pathogenic factor.ResultsRespiratory deficit was the most frequent profile (37%). When compared to the other groups, patients with combined deficit had shorter phonation times for men (8.5 seconds; Kruskal‐Wallis, P =. 009) and women (7.8 seconds; P =. 003), worse jitter (8.3%; P =. 001), GRBAS scale (5.8; P <. 001), and Voice Handicap Index–10 (7.7; P =. 002).ConclusionAge‐related respiratory and laryngeal changes have a negative impact on vocal quality, especially when both deficits are present.
Migraine aura symptoms: Duration, succession and temporal relationship to headache
Authors: Viana Michele , Linde Mattias , Sances Grazia , Ghiotto Natascia , Guaschino Elena , Allena Marta , Terrazzino Salvatore , Nappi Giuseppe , Goadsby Peter J , Tassorelli Cristina 
Published: July 2015

Background As there are no biological markers, a detailed description of symptoms, particularly temporal characteristics, is crucial when diagnosing migraine aura. Hitherto these temporal aspects have not been studied in detail. Methods We conducted a prospective diary-aided study of the duration and the succession of aura symptoms and their temporal relationship with headache. Results Fifty-four patients completed the study recording in a diary the characteristics of three consecutive auras ( n = 162 auras). The median duration of visual, sensory and dysphasic symptoms were 30, 20 and 20 minutes, respectively. Visual symptoms lasted for more than one hour in 14% of auras ( n = 158), sensory symptoms in 21% of auras ( n = 52), and dysphasic symptoms in 17% of auras ( n = 18). Twenty-six percent of patients had at least one aura out of three with one symptom lasting for more than one hour. In aura with multiple symptoms the subsequent symptom, second versus first one or third versus second, might either start simultaneously (34 and 18%), during (37 and 55%), with the end (5 and 9%), or after (24 and 18%) the previous aura symptom. The headache phase started before the aura (9%), simultaneously with the onset of aura (14%), during the aura (26%), simultaneously with the end of aura (15%) or after the end of aura (36%). Conclusion We provide data to suggest that symptoms may last longer than one hour in a relevant proportion of auras or migraine with aura patients, and that there is a high variability of scenarios in terms of time relationship among aura symptoms and between aura and headache.
Away from Grass-roots? The Irony of the Chinese Rural Legal Service
Authors: Fu Hualing 
Published: July 2015

AbstractThe paper examines three factors that are driving and constraining the development of rural legal services delivery in China: geographic limitation, professional interest and political intervention. Firstly, regarding geographic limitation: geography matters, and rurality creates natural barriers for rural residents in limiting the access to legal services. There is an inherent spatial inequality for rural population when it comes to the distribution of legal services, and geographic isolation and remoteness nurture a particular type of legal culture among rural residents. Secondly, regarding professional interest: professionalism matters. There are strong ideological and economic forces which pull the rural legal service providers away from their grass-roots. The calling of an emerging legal professionalism (and the related financial incentives) demands a certain degree of legal knowledge and qualification, rules of procedures, code of conduct and regularity in legal practice. In order to survive in an increasingly competitive legal market, rural legal service providers have to run legal practices as a business, considering the ‘bottom line’ and following the logic of a legal market. Finally, regarding political intervention: politics matters. To overcome geographic barriers and correct market failure, the government would need to step in to provide or supplement legal services in rural areas by introducing a public dimension of legal services. Politics may ameliorate where the legal service market fails.
Skin prick test results to artesunate in children sensitized to Artemisia vulgaris L
Authors: Mori F , Pantano S , Rossi ME , Montagnani C , Chiappini E , Novembre E , Galli L , de Martino M 
Published: July 2015

Artemisia vulgaris L and Artemisia annua L (Chinese: qinghao) are similar plants of the Asterbaceae family. Artesunate, a semi-synthetic derivate of artemisin which is the active principle extract of the plant qinghao, has antimalarial properties. Some cases of severe allergic reactions to artesunate have been described. The purpose of this study was to evaluate the association between positive skin tests to Artemisia vulgaris L allergen and a preparation of injectable artesunate. A total of 531 children were skin prick tested with inhalants (including Artemisia vulgaris L), foods, and artesunate. Among the 59 patients positive to Artemisia vulgaris L only one child was also positive to artesunate. No child was positive to artesunate in those negative to Artemisia vulgaris L. We conclude that Artemisia vulgaris L sensitization is not associated with sensitization to artesunate; consequently, skin test to artesunate should not be carried out before using the drug considering the rare allergic reactions.
Loading, release and stability of epirubicin-loaded drug-eluting beads
Authors: Spindeldreier Kirsten C , Thiesen Judith , Krämer Irene 
Published: July 2015

Purpose The aim of this study was to determine the loading efficiency, physico-chemical stability and release of epirubicin-loaded DC Bead™ (Biocompatibles UK Ltd, a BTG International group company) (bead size 70–150 µm (=DC Bead M1™) and 100–300 µm) after loading with epirubicin solution (2 mg/ml) or reconstituted powder formulation (25 mg/ml) and controlled storage. Methods DC Bead™ were loaded with 76 mg epirubicin solution (Epimedac™, Medac GmbH) or 75 mg epirubicin powder formulation (Farmorubicin™, Pharmacia Pfizer GmbH) per 2 ml of beads. Drug loading efficiency and stability were determined by measuring the epirubicin concentration in the excess solution after predetermined intervals (maximum 24 h) and different agitation conditions. Syringes with loaded beads were stored protected from light at room temperature. At predetermined intervals the beads were transferred into 200 ml phosphate buffered solution (pH 7.2) as elution medium and stirred automatically for 2 h not followed or followed by addition of 200 ml of 20% sodium chloride (=NaCl) solution and stirred for another 2 h to analyse the drug release and integrity of the epirubicin-loaded beads. Elution experiments were performed and samples taken periodically over a four-week period (day 0, 7, 14 and 28). A reversed-phase high-performance liquid chromatography assay with ultraviolet detection was utilized to analyse the concentration and purity of epirubicin. Results The loading procedure for DC Bead™ with epirubicin drug solutions resulted in a loading percentage of 95–99% within 6 h dependent on the bead size, epirubicin concentration in the loading solution and loading conditions. Loading levels remained stable and no epirubicin degradation products were observed over the period of 28 days, while the loaded beads were stored light protected at room temperature. Release of epirubicin into 200 ml phosphate buffered solution elution medium and additionally followed by release into the admixture with 200 ml 20% NaCl solution amounted to 5% and about 20% of the loaded epirubicin, respectively. Integrity of loaded epirubicin was proven over 28 days. Conclusions Epirubicin can be loaded into DC Bead™ of different sizes using the epirubicin powder formulation (25 mg/ml) or epirubicin injection concentrate (2 mg/ml). Physico-chemical stability is maintained over a period of at least 28 days when stored light protected at room temperature. Elution of epirubicin is dependent on the volume and cation exchange capacity of the elution medium.
What happens when GPs engage in commissioning? Two decades of experience in the English NHS
Authors: Miller Rosalind , Peckham Stephen , Coleman Anna , McDermott Imelda , Harrison Stephen , Checkland Kath 
Published: July 2015

Objective To review the evidence on commissioning schemes involving clinicians in the United Kingdom National Health Service, between 1991 and 2010; report on the extent and impact of clinical engagement; and distil lessons for the development of such schemes both in the UK and elsewhere. Methods A review of published evidence. Five hundred and fourteen abstracts were obtained from structured searches and screened. Full-text papers were retrieved for UK empirical studies exploring the relationship between commissioners and providers with clinician involvement. Two hundred and eighteen published materials were reviewed. Results The extent of clinical engagement varied between the various schemes. Schemes allowing clinicians to act autonomously were more likely to generate significant engagement, with ‘virtuous cycles’ (experience of being able to make changes feeding back to encourage greater engagement) and ‘vicious cycles’ (failure to influence services generating disengagement) observed. Engagement of the wider general practitioner (GP) membership was an important determinant of success. Most impact was seen in GP prescribing and the establishment of services in general practices. There was little evidence of GPs engaging more widely with public health issues. Conclusion Evidence for a significant impact of clinical engagement on commissioning outcomes is limited. Initial changes are likely to be small scale and to focus on services in primary care. Engagement of GP members of primary care commissioning organizations is an important determinant of progress, but generates significant transaction costs.
Validity of the School-age Assessment of Attachment for moderate-risk, rural early adolescents
Authors: Kidwell Shari L , Sizemore Kayla M , Qu Jin , Fugate Katelyn M , Deaton Michelle S , Blevins Morgan D 
Published: July 2015

Introduction: This study provides evidence of validity of the School-age Assessment of Attachment (SAA) through longitudinal comparison with the Preschool Assessment of Attachment (PAA) and with concurrent attachment assessments and measures of risk and parenting. Determining which assessment had the greatest validity with this moderate-risk sample would be of benefit to those working with troubled young people and their families. Hypotheses: Children’s SAA classifications were expected to correspond to their PAA, a behavioral attachment assessment, parenting, and risk. An attachment questionnaire was predicted to not accurately indicate children’s risk status. Design: The design was an 8-year longitudinal follow-up of rural Appalachian American preschoolers. Method: The participants were 21 children and their caregivers. The PAA was completed at age 4. The SAA, a self-report questionnaire, and a parent–child conflict resolution task were completed at age 12. Parents completed assessments of depression, trauma, stress, and perceptions of helplessness. Results: The PAA was related to the SAA and the dyadic behavioral task. The SAA was consistently associated with measures of parenting and family risk. The attachment questionnaire performed poorly for children with higher risk status, suggesting more (not less) sensitive and responsive parenting.
Exercise augments the nocturnal prolactin rise in exercise-trained men
Authors: Hackney Anthony C. , Davis Hope C. , Lane Amy R. 
Published: July 2015

Objective: The objective of this study was to profile over a 24 h period the prolactin responses of exercise-trained men on a day involving rest with no exercise in comparison to a day involving exercise training sessions. Methods: This is a quasi-experimental design study using repeated measures determination of 24 h prolactin responses in exercise-trained men ( n = 16; age = 27.3± 3.3 years (mean ± standard deviation)). Blood samples were taken hourly over a 24 h period on a day involving two intensive exercise training sessions (ED), and on a separate control day (CD) with no exercise activity. The order of the ED and CD was randomized. Physical activity and diet were controlled and replicated for the ED and CD. Blood specimens were handled, prepared and analyzed utilizing appropriate standard clinical practices. The data were analyzed with the Friedman analysis of variance and Nemenyi post hoc statistical procedure for repeated measures. Results: On the CD, prolactin displayed a typical circadian rhythm with daytime values of the hormone being less than the nocturnal rise once sleep had begun ( p < 0.05; 16:00–20:00 h > all other times). On the ED, prolactin responses were noticeably different from those of the CD. The morning and afternoon exercise sessions included significant increases in prolactin immediately at the end of the exercise sessions, being greater than corresponding CD time points ( p < 0.01; 01:00 h and 10:00 h); also for the second hour (2 h) following the morning exercise session. On the ED there was a displayed circadian nocturnal response in the hormone with 16:00–24:00 h being elevated above the all nonexercise effected values for that specific day ( p < 0.01). Finally, the ED nocturnal elevation for prolactin for 16:00–24:00 h was significantly greater than the same respective hours on the CD ( p < 0.05). Conclusion: Findings clearly demonstrated that nocturnal prolactin responses are augmented in exercise-trained men on days when they perform exercise. The mechanisms inducing this adaptive response are unclear but warrant further investigation.
Implications of miscoding urological procedures in an era of financial austerity – ‘Every Penny Counts’
Authors: Cheema Zubair A , Khwaja Sikandar A 
Published: July 2015

Objectives The study aimed to find out any inaccuracy in coding of elective urology procedures and associated financial implications. Design Retrospective audit and re-audit. Settings Introduction of payment by results was introduced in the NHS in England in 2002. This meant that hospitals are paid on individual patient basis according to their human resource group (HRG) rather than a block contract. Current coding system uses office of population census and surveys classification. These along with other variables determine the final human resource group code defining final payment. Participants None. Main outcome measure Retrospective analysis of coding for all inpatient urological procedures was performed over a period of two months. All documented Office of Population Census and Surveys codes were recorded and reviewed by urology trainee along with the head of professional coders. As a result of first analysis the deficiencies were identified and revised Office of Population Census and Surveys codes were used to generate the final human resource group codes. After six months a re-audit was done. Results In the initial study, 121 cases were reviewed. Twenty per cent of these cases were miscoded. The revised Office of Population Census and Surveys codes led to change of final human resource group code and hence recovery of a payment of £10,716. Analysis after six months showed a considerable improvement with incorrect coding reduced to 11%. Conclusion Our findings highlight potential discrepancies in coding which can lead to significant financial loss. It is important that surgeons involve and train the coding department so that coding errors can be avoided. This will put us in better position to deal with Nicolson Challenge.
Incidence of acute disseminated encephalomyelitis in the Jiangsu province of China, 2008–2011
Authors: Chen Yong , Ma Fubao , Xu Yuanling , Chu Xuhua , Zhang Jinlin 
Published: July 2015

Background It is important to have an estimate of the incidence of acute disseminated encephalomyelitis (ADEM) because the incidence of ADEM is unknown and the outcomes undefined in China. Objectives This study attempts to describe ADEM incidence in large Chinese populations located in four geographically different and moderately distant areas of the same province. Methods A retrospective investigation was conducted with ADEM patients in Nanjing, Nantong, Yancheng and Xuzhou. The survey was carried out in regions that might have received patients meeting the case definition of ADEM provided by the International Pediatric MS Study Group from 2008 to 2011. A total of 125 hospitals were included and 412 patients were identified through the hospital information systems (HIS). Results The incidence of ADEM was 0.32/100,000/year. There are two peaks on the age-specific ADEM rates curve. One is 0.77/100,000/year among 0- to 9-year-olds, the other is 0.45/100,000/year in those aged 50–59 years. The incidence rate found for ADEM in males was 0.34/100,000/year, and in females was 0.29/100,000/year. The highest incidence rate was in Nanjing (0.40/100,000/year). Conclusions The average annual incidence of ADEM was 0.32/100,000/year. The peak age of onset was 50–59 years old and 0–9 years old. The incidence among males was insignificantly higher than that among females. There was no significant difference in incidence by seasonal variation.
Impact of ATG-containing reduced-intensity conditioning after single- or double-unit allogeneic cord blood transplantation
Authors: Pascal Laurent , Tucunduva Luciana , Ruggeri Annalisa , Blaise Didier , Ceballos Patrice , Chevallier Patrice , Cornelissen Jan , Maillard Natacha , Tabrizi Reza , Petersen Eefke , Linkesch Werner , Sengeloev Henrik , Kenzey Chantal , Pagliuca Antonio , Holler Ernst , Einsele Hermann , Gluckman Eliane , Rocha Vanderson , Yakoub-Agha Ibrahim 
Published: July 2015

Key Points
When possible, ATG should be avoided in adults undergoing UCBT following Cy/Flu/TBI200 regimen.
Black-white racial disparities in sepsis: a prospective analysis of the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort
Authors: Moore Justin Xavier , Donnelly John P. , Griffin Russell , Safford Monika M. , Howard George , Baddley John , Wang Henry E. 
Published: July 2015

Abstract
Introduction
Sepsis is a major public health problem. Prior studies using hospital-based data describe higher rates of sepsis among black than whites participants. We sought to characterize racial differences in incident sepsis in a large cohort of adult community-dwelling adults.

Methods
We analyzed data on 29,690 participants from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We determined the associations between race and first-infection and first-sepsis events, adjusted for participant sociodemographics, health behaviors, chronic medical conditions and biomarkers. We also determined the association between race and first-sepsis events limited to first-infection events. We contrasted participant characteristics and hospital course between black and white sepsis hospitalizations.

Results
Among eligible REGARDS participants there were 12,216 (41.1 %) black and 17,474 (58.9 %) white participants. There were 2,600 first-infection events; the incidence of first-infection events was lower for black participants than for white participants (12.10 vs. 15.76 per 1,000 person-years; adjusted HR 0.65; 95 % CI, 0.59-0.71). There were 1,526 first-sepsis events; the incidence of first-sepsis events was lower for black participants than for white participants (6.93 vs. 9.10 per 1,000 person-years, adjusted HR 0.64; 95 % CI, 0.57-0.72). When limited to first-infection events, the odds of sepsis were similar between black and white participants (adjusted OR 1.01; 95 % CI, 0.84-1.21). Among first-sepsis events, black participants were more likely to be diagnosed with severe sepsis (76.9 % vs. 71.5 %).

Conclusion
In the REGARDS cohort, black participants were less likely than white participants to experience infection and sepsis events. Further efforts should focus on elucidating the underlying reasons for these observations, which are in contrast to existing literature.