bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns of Anticoagulation Use and Cardioembolic Risk After Catheter Ablation for Atrial Fibrillation
Authors: Noseworthy Peter A. , Yao Xiaoxi , Deshmukh Abhishek J. , Van Houten Holly , Sangaralingham Lindsey R. , Siontis Konstantinos C. , Piccini Jonathan P. , Asirvatham Samuel J. , Friedman Paul A. , Packer Douglas L. , Gersh Bernard J. , Shah Nilay D. 
Published: November 2015

Background

There is significant practice variation in oral anticoagulation (
OAC
) use following catheter ablation for atrial fibrillation. It is not clear whether the risk of cardioembolism increases after discontinuation of
OAC
following catheter ablation.

Methods and Results

We identified 6886 patients within a large national administrative claims database who underwent catheter ablation for atrial fibrillation between January 1, 2005, and September 30, 2014. We assessed the effect of time off of
OAC
by
CHA
2
DS
2
‐
VAS
c score (after adjusting for other comorbidities) on risk of cardioembolism, using Cox proportional hazards models. There was an increase in the use of non–vitamin K
OAC
after ablation from 0% in 2005 to 69.8% in 2014.
OAC
discontinuation was high, with only 60.5% and 31.3% of patients remaining on
OAC
at 3 and 12 months, respectively. The rate of discontinuation was higher in low‐risk patients (82% versus 62.5% at 12 months for
CHA
2
DS
2
‐
VAS
c 0–1 versus ≥2, respectively;
P
<0.001). Stroke occurred in 1.4% of patients with
CHA
2
DS
2
‐
VAS
c ≥2 and 0.3% of those with
CHA
2
DS
2
‐
VAS
c 0 or 1 over the study follow‐up. The risk of cardioembolism in the first 3 months after ablation was increased among those with any time off
OAC
(hazard ratio 8.06 [95%
CI
1.53–42.3],
P
<0.05). The risk of cardioembolism beyond 3 months was increased with
OAC
discontinuation among high‐risk patients (hazard ratio 2.48 [95%
CI
1.11–5.52],
P
<0.05) but not low‐risk patients.

Conclusion

The overall risk of stroke in postablation patients is low; however,
OAC
discontinuation after ablation is common and is associated with increased risk of cardioembolism for all patients within the first 3 months and for high‐risk patients in the long term. Continuing
OAC
for at least 3 months in all patients and indefinitely in high‐risk patients appears to be the safest strategy.
Discovery of New Risk Markers for Ischemic Stroke Using a Novel Targeted Proteomics Chip
Authors: Lind Lars , Siegbahn Agneta , Lindahl Bertil , Stenemo Markus , Sundström Johan , Ärnlöv Johan 
Published: November 2015

Background and Purpose—
Emerging technologies have made it possible to simultaneously evaluate a large number of circulating proteins as potential new stroke risk markers.

Methods—
We explored associations between 85 cardiovascular proteins, assessed by a proteomics chip, and incident ischemic stroke in 2 independent cohorts of elderly (Prospective Investigation of the Vasculature in Uppsala Seniors [PIVUS]: n=977; 50% women, mean age=70.1 years, 71 fatal/nonfatal ischemic stroke events during 10.0 years; and Uppsala Longitudinal Study in Adult Men [ULSAM]: n=720, mean age=77.5 years, 75 ischemic stroke events during 9.5 years). The proteomics chip uses 2 antibodies for each protein and a polymerase chain reaction step to achieve a high-specific binding and the possibility to measure multiple proteins in parallel, but gives no absolute concentrations.

Results—

In PIVUS, 16 proteins were related to incident ischemic stroke using a false discovery rate of 5%. Of these, N-terminal pro-B-type natriuretic peptide (
P
=0.0032), adrenomedullin (
P
=0.018), and eosinophil cationic protein (
P
=0.0071) were replicated in ULSAM after adjustment for established stroke risk factors. In predefined secondary meta-analyses of individual data, interleukin-27 subunit α, growth/differentiation factor 15, urokinase plasminogen activator surface receptor, tumor necrosis factor receptor superfamily member 6, macrophage colony-stimulating factor 1, and matrix metalloproteinase-7 were also potential risk markers for ischemic stroke after adjustment for multiple comparisons (
P
<0.0006). The addition of N-terminal pro-B-type natriuretic peptide, adrenomedullin, and eosinophil cationic protein to a model with established risk factors increased the C-statistic from 0.629 to 0.689 (
P
=0.001).

Conclusions—
Our data suggest that large-scale proteomics analysis is a promising way of discovering novel biomarkers that could substantially improve the prediction of ischemic stroke.
A new deep-sea species of the genus Systellaspis (Decapoda, Caridea, Oplophoridae) in the western Pacific
Authors: Sha Zhongli , Wang Yanrong 
Published: November 2015

A new species ofSystellaspisSpence Bate, 1888,Systellaspis liuisp. nov., was discovered in the deep waters of the western Pacific. It is closely allied toS. debilis(A. Milne-Edwards, 1881), but it differs morphologically in the blade of the scaphocerite being equipped with a medial dorsal groove, the spines on pereiopods 1 to 5, the dorsal margin of the third abdominal somite with a carina, the posterior margin of the fifth abdominal somite, and the dorsal margin of the telson armed with at least two rows of spines on each side. A key to the species ofSystellaspisis provided.
The Effects of Weather and Environmental Factors on West Nile Virus Mosquito Abundance in Greater Toronto Area
Authors: Yoo E.-H. , Chen D. , Diao Chunyuan , Russell Curtis 
Published: November 2015

Abstract
We investigated how weather conditions and environmental factors affect the spatiotemporal variability in Culex pipiens population using the data collected from a surveillance program in Ontario, Canada, from 2005 to 2008. This study assessed the relative influences of temperature and precipitation on the temporal patterns of mosquito abundance using harmonic analysis and examined the associations with major landscape predictors, including land-use type, population density, and elevation, on the spatial patterns of mosquito abundance. The intensity of trapping efforts on the mosquito abundance at each trap site was examined by comparing the spatial distribution of mosquito abundance in relation to the spatial intensity of trapping efforts. The authors used a mixed effects modeling approach to account for potential dependent structure in mosquito surveillance data due to repeated observations at single trap sites and/or similar mosquito abundance at nearby trap sites each week. The model fit was improved by taking into account the nested structure of mosquito surveillance data and incorporating the temporal correlation in random effects.
A New Understanding of El Niño’s Impact over East Asia: Dominance of the ENSO Combination Mode
Authors: Zhang Wenjun , Li Haiyan , Stuecker Malte F. , Jin Fei-Fei , Turner Andrew G. 
Published: November 2015

Abstract
Previous studies have shown that the Indo-Pacific atmospheric response to ENSO comprises two dominant modes of variability: a meridionally quasi-symmetric response (independent of the annual cycle) and an antisymmetric response (arising from the nonlinear atmospheric interaction between ENSO variability and the annual cycle), referred to as the combination mode (C-mode). This study demonstrates that the direct El Niño signal over the tropics is confined to the equatorial region and has no significant impact on the atmospheric response over East Asia. The El Niño–associated equatorial anomalies can be expanded toward off-equatorial regions by the C-mode through ENSO’s interaction with the annual cycle. The C-mode is the prime driver for the development of an anomalous low-level anticyclone over the western North Pacific (WNP) during the El Niño decay phase, which usually transports more moisture to East Asia and thereby causes more precipitation over southern China. An atmospheric general circulation model is used that reproduces well the WNP anticyclonic anomalies when both El Niño sea surface temperature (SST) anomalies as well as the SST annual cycle are prescribed as boundary conditions. However, no significant WNP anticyclonic circulation anomaly appears during the El Niño decay phase when excluding the SST annual cycle. The analyses herein of observational data and model experiments suggest that the annual cycle plays a key role in the East Asian climate anomalies associated with El Niño through their nonlinear atmospheric interaction. Hence, a realistic simulation of the annual cycle is crucial in order to correctly capture the ENSO-associated climate anomalies over East Asia.
Impact of East Asian Summer Monsoon Heating on the Interannual Variation of the South Asian High
Authors: Zhang Pengfei , Liu Yimin , He Bian 
Published: November 2015

Abstract
Occupying the upper troposphere over subtropical Eurasia during boreal summer, the South Asian high (SAH) is thought to be a regulator of the East Asian summer monsoon (EASM), which is particularly important for regional climate over Asia. However, there is feedback of the condensational heating associated with EASM precipitation to SAH variability. In this study, interannual variation of SAH intensity and the mechanisms are investigated. For strong SAH cases, the high pressure system intensifies and expands. Significant positive anomalies of the geopotential height and upper-tropospheric temperature were found over the Middle East and to the east of the Tibetan Plateau (TP), namely, the western and the eastern flanks of the SAH. The dynamical diagnosis and the numerical experiments consistently show that the interannual variation of SAH intensity is strongly affected by EASM precipitation over the eastern TP–Yangtze River valley. The feedback of the condensational heating anomaly to the SAH is summarized as follows: Excessive EASM heating excites a local anticyclone in the upper troposphere and warms the upper troposphere, leading to the eastward extension of the SAH’s eastern edge and reinforcing geopotential height anomalies over East Asia. Furthermore, the monsoonal heating excites a westward-propagating Rossby wave that increases the upper-tropospheric geopotential height and warms the upper troposphere over the Middle East. In conclusion, this study suggests a mechanistic paradigm in which the EASM may also be a modulator of SAH variation rather than just a passive result of the latter as traditionally thought. The results suggest that the EASM and the SAH are a tightly interactive system.
Constraining Future Summer Austral Jet Stream Positions in the CMIP5 Ensemble by Process-Oriented Multiple Diagnostic Regression*
Authors: Wenzel Sabrina , Eyring Veronika , Gerber Edwin P. , Karpechko Alexey Yu. 
Published: November 2015

Abstract
Stratospheric ozone recovery and increasing greenhouse gases are anticipated to have a large impact on the Southern Hemisphere extratropical circulation, shifting the jet stream and associated storm tracks. Models participating in phase 5 of the Coupled Model Intercomparison Project poorly simulate the austral jet, with a mean equatorward bias and 10° latitude spread in their historical climatologies, and project a wide range of future trends in response to anthropogenic forcing in the representative concentration pathway (RCP) scenarios. Here, the question is addressed whether the unweighted multimodel mean (uMMM) austral jet projection of the RCP4.5 scenario can be improved by applying a process-oriented multiple diagnostic ensemble regression (MDER). MDER links future projections of the jet position to processes relevant to its simulation under present-day conditions. MDER is first targeted to constrain near-term (2015–34) projections of the austral jet position and selects the historical jet position as the most important of 20 diagnostics. The method essentially recognizes the equatorward bias in the past jet position and provides a bias correction of about 1.5° latitude southward to future projections. When the target horizon is extended to midcentury (2040–59), the method also recognizes that lower-stratospheric temperature trends over Antarctica, a proxy for the intensity of ozone depletion, provide additional information that can be used to reduce uncertainty in the ensemble mean projection. MDER does not substantially alter the uMMM long-term position in jet position but reduces the uncertainty in the ensemble mean projection. This result suggests that accurate observational constraints on upper-tropospheric and lower-stratospheric temperature trends are needed to constrain projections of the austral jet position.
Effects of Land Surface Schemes on WRF-Simulated Geopotential Heights over China in Summer 2003*
Authors: Zeng Xin-Min , Wang B. , Zhang Y. , Zheng Y. , Wang N. , Wang M. , Yi X. , Chen C. , Zhou Z. , Liu H. 
Published: November 2015

Abstract
To quantify and explain effects of different land surface schemes (LSSs) on simulated geopotential height (GPH) fields, we performed simulations over China for the summer of 2003 using 12-member ensembles with the Weather Research and Forecasting (WRF) Model, version 3. The results show that while the model can generally simulate the seasonal and monthly mean GPH patterns, the effects of the LSS choice on simulated GPH fields are substantial, with the LSS-induced differences exceeding 10 gpm over a large area (especially the northwest) of China, which is very large compared with climate anomalies and forecast errors. In terms of the assessment measures for the four LSS ensembles [namely, the five-layer thermal diffusion scheme (SLAB), the Noah LSS (NOAH), the Rapid Update Cycle LSS (RUC), and the Pleim–Xiu LSS (PLEX)] in the WRF, the PLEX ensemble is the best, followed by the NOAH, RUC, and SLAB ensembles. The sensitivity of the simulated 850-hPa GPH is more significant than that of the 500-hPa GPH, with the 500-hPa GPH difference fields generally characterized by two large areas with opposite signs due to the smoothly varying nature of GPHs. LSS-induced GPH sensitivity is found to be higher than the GPH sensitivity induced by atmospheric boundary layer schemes. Moreover, theoretical analyses show that the LSS-induced GPH sensitivity is mainly caused by changes in surface fluxes (in particular, sensible heat flux), which further modify atmospheric temperature and pressure fields. The temperature and pressure fields generally have opposite contributions to changes in the GPH. This study emphasizes the importance of choosing and improving LSSs for simulating seasonal and monthly GPHs using regional climate models.
Incorporating Diagnosed Intercept Parameters and the Graupel Category within the ARPS Cloud Analysis System for the Initialization of Double-Moment Microphysics: Testing with a Squall Line over South China
Authors: Pan Yujie , Xue Ming , Ge Guoqing 
Published: November 2015

Abstract
In this study, a new set of reflectivity equations are introduced into the Advanced Regional Prediction System (ARPS) cloud analysis system. This set of equations incorporates double-moment microphysics information in the analysis by adopting a set of diagnostic relationships between the intercept parameters and the corresponding mass mixing ratios. A reflectivity- and temperature-based graupel classification scheme is also implemented according to a hydrometeor identification (HID) diagram. A squall line that occurred on 23 April 2007 over southern China containing a pronounced trailing stratiform precipitation region is used as a test case to evaluate the impacts of the enhanced cloud analysis scheme.
The results show that using the enhanced cloud analysis scheme is able to better capture the characteristics of the squall line in the forecast. The predicted squall line exhibits a wider stratiform region and a more clearly defined transition zone between the leading convection and the trailing stratiform precipitation region agreeing better with observations in general, when using the enhanced cloud analysis together with the two-moment microphysics scheme. The quantitative precipitation forecast skill score is also improved.
Elongated Uvula Causing Chronic Cough
Authors: Loftus Patricia A. , Stegnjajic Arsen , Tibbetts Kathleen M. , Badhey Arvind K. , Glicksman Jeffrey 
Published: November 2015

Objective: A subset of patients previously diagnosed with idiopathic chronic cough were found to have an elongated uvula contacting the laryngeal surface of the epiglottis and inducing a cough reflex. These patients were successfully treated with an in-office modified uvulopalatoplasty procedure (mUPP) at our institution. We aim to further categorize this subset of patients and describe the mUPP that can potentially offer this group of patients cure for their chronic cough. Study Design: Institutional Review Board–approved retrospective chart review. Methods: Patient demographics, medical history, associated symptoms, prior treatment remedies, and response to mUPP were recorded and analyzed for 30 patients who underwent an in-office mUPP. Results: The majority of patients were middle-aged, nonsmoking females with symptoms of globus sensation and a gag reflex when lying supine. 96.7% of patients reported complete resolution or noticeable improvement of their cough following mUPP. There were no complications from this in-office procedure in our study. Conclusions: The authors’ main goals are to make other physicians aware of this under-recognized subset of patients with chronic cough who have an identifiable and treatable cause for their symptoms and to provide the steps of a simple and effective surgical solution to chronic cough in this group of patients.
Prediction of lung tumor palpability using high-resolution computed tomography
Authors: Isaka Tetsuya , Ito Hiroyuki , Yokose Tomoyuki , Kondo Tetsuro , Nagata Masashi , Nishii Teppei , Yamada Kouzo , Nakayama Haruhiko , Masuda Munetaka 
Published: November 2015

Background Palpation is the most important means of locating lung tumors and resecting them with sufficient margins. This study aimed to predict the palpability of pulmonary lesions using high-resolution computed tomography. Methods Eighty-six pulmonary lesions were palpated in fresh resected lung specimens from July 2013 to March 2014. The following parameters were compared between 10 impalpable and 76 palpable lesions: maximum tumor size in pulmonary and bone window level settings, consolidation tumor size in pulmonary window level setting, and pleural-tumor distance. In 54 adenocarcinomas, the lepidic component and fibrosis foci rates were compared between the two groups. Results Tumor size in bone window level setting and the consolidation tumor size were significantly smaller in the impalpable group (both p < 0.001), and an operational cutoff of 5 mm was identified by receiver-operating characteristic analysis (sensitivity/specificity was 90.0%/94.7% and 90.0%/86.9%, respectively). Pulmonary lesions were impalpable with 87.5% probability when the tumor size in bone window level setting was ≤5 mm and the pleural-tumor distance was ≥ 5 mm, and with 85.7% probability when the consolidation tumor size was ≤5 mm and the pleural-tumor distance was ≥ 5 mm. Lepidic component and fibrosis foci rates of impalpable/palpable lesions were 96.0%/52.8% and 4.0%/24.7%, respectively (both p < 0.001). Conclusions Tumor size in bone window level setting or a consolidation tumor size ≤5 mm and pleural-tumor distance ≥ 5 mm are simple criteria that are potentially useful indicators for preoperative marking to locate small-sized lepidic-predominant adenocarcinomas with few fibrotic foci.
Radiologic evaluation of lumps in the male breast
Authors: Tangerud Åse , Potapenko Ivan , Skjerven Helle Kristine , Stensrud Mats Julius 
Published: November 2015

Background Gynecomastia has a typical appearance on mammography, and occurs frequently in men. However, imaging is often performed on men with breast lumps to exclude breast cancer, which only comprises 1% of male breast masses. Purpose To assess whether ultrasound and fine needle aspiration cytology (FNAC) are necessary investigations when mammograms show classical gynecomastia. Material and Methods We have retrospectively collected data on male patients referred for mammography during the period 2011–2013 (a total of 539 patients). All radiological images were re-read, and descriptions of ultrasound images were reviewed. Clinical information supplied with the original referrals was assessed, along with pathology and cytology reports. Results Among the 539 male patients who underwent mammography, 483 were also examined with ultrasound, and 335 were further evaluated with FNAC. Mammograms showed gynecomastia in 350 patients, and among these subjects ultrasound was performed in 340 (97%), FNAC in 261 (75%), and core biopsies in four (1%) patients. The diagnosis gynecomastia was unchanged in all patients who underwent FNAC or biopsy. Malignant tumors were found in eight patients, six of which were invasive ductal carcinomas. Conclusion In patients with a classical appearance of gynecomastia on mammography, supplemental ultrasound, FNAC, or biopsy is superfluous and contributes to unnecessary costs.
A body-sized phantom for evaluation of diffusion-weighted MRI data using conventional, readout-segmented, and zoomed echo-planar sequences
Authors: Ihalainen Toni , Kuusela Linda , Soikkeli Maiju , Lantto Eila , Ovissi Ali , Sipilä Outi 
Published: November 2015

Background Abdominal diffusion-weighted imaging (DWI) has been rapidly increasing during the last few years. For the evaluation of new DWI techniques, the development of suitable phantoms and quality assurance methods is important. Purpose To construct a body-diameter phantom for abdominal DWI and study the impact of different acquisition options on image quality. Material and Methods A phantom with a diameter of 31 cm and a volume of 26 L was constructed, containing four samples representing a clinically relevant range of apparent diffusion coefficient (ADC) values. Measurements were carried out on 1.5T and 3.0T MRI systems using conventional echo-planar imaging (EPI), readout-segmented EPI, and zoomed EPI (3.0T) sequences. The effects of parallel imaging, coil intensity normalization, and patient-specific B1 shim (3.0T) were also examined. ADC values and signal-to-noise ratios of the samples were measured, and the level of artifacts was visually evaluated. Results The agreement of ADC values between different acquisition options was generally good, but higher values (by 0.07 × 10–3 mm2/s on the average) with readout-segmented EPI as well as ADC variations of approximately 0.1 × 10–3 mm2/s in slice direction were observed. The image artifacts were reduced by using patient-specific B1 shim, readout-segmented EPI, or zoomed EPI. Conclusion The body-sized phantom demonstrated well the expected image artifacts in DWI with large field of view. The use of patient-specific B1 shim, readout-segmented EPI, or zoomed EPI improved image quality of DWI in this study.