bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genetic Loci Associated With Atrial Fibrillation: Relation to Left Atrial Structure in the Framingham Heart Study
Authors: Magnani Jared W. , Yin Xiaoyan , McManus David D. , Chuang Michael L. , Cheng Susan , Lubitz Steven A. , Arora Garima , Manning Warren J. , Ellinor Patrick T. , Benjamin Emelia J. 
Published: April 2014

Background

Atrial fibrillation (
AF
) results in significant morbidity and mortality. Genome‐wide association studies (
GWAS
) have identified genetic variants associated with
AF
. Whether genetic variants associated with
AF
are also associated with atrial structure, an intermediate phenotype for
AF
, has had limited investigation. We sought to investigate associations between single nucleotide polymorphisms (
SNP
s) and atrial structure obtained by cardiovascular imaging in the Framingham Heart Study.

Methods and Results

We selected 11
SNP
s that have been associated with
AF
in
GWAS
. We examined the
SNP
s' relations to cross‐sectional left atrial (
LA
) dimensions (determined by transthoracic echocardiography) and
LA
volume (determined by cardiovascular magnetic resonance [
CMR
]) employing linear regression. The total sample included 1555 participants with
CMR LA
volume (age 60±9 years, 53% women) and 6861 participants with echocardiographic
LA
diameter (age 48±13 years, 52% women) measured. We employed a significance threshold of
P<
0.0023 to account for multiple testing of the 11
SNP
s and 2
LA
measures. In a primary analysis, no
SNP
s were significantly related to the
LA
measures. Likewise, in secondary analyses excluding individuals with prevalent
AF
(n=77,
CMR
sample; n=105, echocardiography sample) no
SNP
s were related to
LA
volume or diameter.

Conclusion

In a community‐based cohort, we did not identify a statistically significant association between selected
SNP
s associated with
AF
and measures of
LA
anatomy. Further investigations with larger longitudinally assessed samples and a broader array of
SNP
s may be necessary to determine the relation between genetic loci associated with
AF
and atrial structure.
The East African Long Rains in Observations and Models
Authors: Yang Wenchang , Seager Richard , Cane Mark A. , Lyon Bradfield 
Published: April 2014

Abstract
Decadal variability of the East African precipitation during the season of March–May (long rains) is examined and the performance of a series of models in simulating the observed features is assessed. Observational results show that the drying trend of the long rains is associated with decadal natural variability associated with sea surface temperature (SST) variations over the Pacific Ocean. Empirical orthogonal function (EOF), linear regression, and composite analyses all show the spatial pattern of the associated SST field to be La Niña like. The SST-forced International Research Institute for Climate and Society (IRI) forecast models are able to capture the East African precipitation climatology, the decadal variability of the long rains, and the associated SST anomaly pattern but are not consistent with observations from the 1970s. The multimodel mean of the SST-forced models from the Coupled Model Intercomparison Project phase 5 (CMIP5) Atmospheric Model Intercomparison Project (AMIP) experiment captures the climatology and the drying trend in recent decades. The fully coupled models from the CMIP5 historical experiment, however, have systematic errors in simulating the East African precipitation climatology by underestimating the long rains while overestimating the short rains. The multimodel mean of the historical simulations of the long rains anomalies, which is the best estimate of the radiatively forced change, shows a weak wetting trend associated with anthropogenic forcing. The SST anomaly pattern associated with the long rains has large discrepancies with the observations. The results herein suggest caution in projections of East African precipitation from CMIP5 or the relationship between the East African precipitation and the SST spatial pattern found in paleoclimate studies with coupled climate models.
Resolved Snowball Earth Clouds
Authors: Abbot Dorian S. 
Published: April 2014

AbstractRecent general circulation model (GCM) simulations have challenged the idea that a snowball Earth would be nearly entirely cloudless. This is important because clouds would provide a strong warming to a high-albedo snowball Earth. GCM results suggest that clouds could lower the threshold CO2 needed to deglaciate a snowball by a factor of 10–100, enough to allow consistency with geochemical data. Here a cloud-resolving model is used to investigate cloud and convection behavior in a snowball Earth climate. The model produces convection that extends vertically to a similar temperature as modern tropical convection. This convection produces clouds that resemble stratocumulus clouds under an inversion on modern Earth, which slowly dissipate by sedimentation of cloud ice. There is enough cloud ice for the clouds to be optically thick in the longwave, and the resulting cloud radiative forcing is similar to that produced in GCMs run in snowball conditions. This result is robust to large changes in the cloud microphysics scheme because the cloud longwave forcing, which dominates the total forcing, is relatively insensitive to cloud amount and particle size. The cloud-resolving model results are therefore consistent with the idea that clouds would provide a large warming to a snowball Earth, helping to allow snowball deglaciation.
Ranking of Tornado Outbreaks across the United States and Their Climatological Characteristics
Authors: Fuhrmann Christopher M. , Konrad Charles E. , Kovach Margaret M. , McLeod Jordan T. , Schmitz William G. , Dixon P. Grady 
Published: April 2014

Abstract
The calendar year 2011 was an extraordinary year for tornadoes across the United States, as it marked the second highest annual number of tornadoes since 1950 and was the deadliest tornado year since 1936. Most of the fatalities in 2011 occurred in a series of outbreaks, highlighted by a particularly strong outbreak across the southeastern United States in late April and a series of outbreaks over the Great Plains and Midwest regions in late May, which included a tornado rated as a category 5 event on the enhanced Fujita scale (EF5) that devastated the town of Joplin, Missouri. While most tornado-related fatalities often occur in outbreaks, very few studies have examined the climatological characteristics of outbreaks, particularly those of varying strength. In this study a straightforward metric to assess the strength, or physical magnitude, of tornado outbreaks east of the Rocky Mountains from 1973 to 2010 is developed. This measure of outbreak strength, which integrates the intensity of tornadoes [Fujita (F)/EF-scale rating] over their distance traveled (pathlength), is more highly correlated with injuries and fatalities than other commonly used variables, such as the number of significant tornadoes, and is therefore more reflective of the potential threat of outbreaks to human life. All outbreaks are then ranked according to this metric and their climatological characteristics are examined, with comparisons made to all other tornadoes not associated with outbreaks. The results of the ranking scheme are also compared to those of previous studies, while the strongest outbreaks from 2011 are ranked among other outbreaks in the modern record, including the April 1974 Super Outbreak.
Development of a high-resolution melting genotyping assay for the angiotensin I converting enzyme insertion/deletion polymorphism and establishment of genotype-specific reference intervals in a Danish population
Authors: Nissen Peter H , Campbell Nina Buntzen , Højskov Carsten S , Fløe Andreas , Hoffmann Hans Jürgen , Hilberg Ole , Ladefoged Søren A , Møller Holger J 
Published: April 2014

Background: The serum-angiotensin I converting enzyme (s-ACE) activity is influenced by a genetic insertion/deletion (I/D) polymorphism in the ACE gene, and the resulting large interindividual variation in s-ACE limits the use of normal reference intervals in the evaluation of sarcoidosis. In this study, we developed a new method for genotyping the I/D polymorphism in ACE and established genotype-specific reference intervals in order to improve the diagnostic accuracy and the value for treatment of sarcoidosis. Methods: The new genotyping assay is based on high-resolution melting (HRM) using LCGreen + and was used to genotype 400 healthy Danish individuals. The assay was compared to a real-time polymerase chain reaction (RT-PCR) assay in a validation set of 86 samples. Enzyme activity in serum was measured using the Infinity™ ACE Liquid Stable Reagent from Thermo adapted for the ABX Pentra analyzer. Results: There was full concordance between genotyping assays. The three genotypes II, ID and DD were present with a frequency of 0.23, 0.51 and 0.26. The distribution of s-ACE values in the total population was non-Gaussian (non-parametric 95% reference interval 12.0–60.0 U/L). The median activities of the genotypes differed significantly ( P<0.0001). Ninety-five per cent non-parametric reference intervals for the subpopulations were determined to 6.3–38.5, 14.0–56.0 and 23.3–71.2 U/L for II, ID and DD, respectively. Conclusion: We have developed a simple and robust method for ACE genotyping and determined genotype-specific reference intervals for s-ACE concentrations in the Danish population. The new reference intervals may increase the value of s-ACE measurements.
Preanalytical study of fetuin-A: effect of sample type, processing speed and freeze–thaw cycles
Authors: McArthur Lisa , Johnston Lisa , Sattar Naveed , Logue Jennifer , Welsh Paul 
Published: April 2014

Background It has been suggested that fetuin-A may be a potential biomarker of cardiometabolic disease. However, few studies have investigated preanalytical factors that might impact the measurement of fetuin-A in the circulation. This pilot study aimed to investigate the preanalytical variables of sample type, timing of sample centrifugation and the impact of freeze–thaw cycles on the concentration of fetuin-A in serum or EDTA-plasma. Methods Blood samples were taken from 19 male or female healthy volunteers, aged 18–70 years, and left at ambient room temperature for 2 h or 48 h. The tubes were then centrifuged, serum and EDTA-plasma separated, and fetuin-A concentrations measured using a commercially available enzyme-linked immunosorbent assay (ELISA). Results There was no significant difference between the concentrations of fetuin-A in EDTA-plasma and serum following separation from whole blood at 2 h postcollection ( P = 0.78). The median (interquartile range) concentrations of fetuin-A in EDTA-plasma separated at 2 h and 48 h postcollection were 589  µg/mL (484–703  µg/mL) and 767  µg/mL (687–942  µg/mL), respectively ( P < 0.0005). For serum, equivalent concentrations were 606  µg/mL (501–669  µg/mL) at 2 h and 607  µg/mL (564–757  µg/mL) at 48 h postcollection ( P = 0.06). Fetuin-A concentrations measured in EDTA-plasma and serum showed no significant change following three freeze–thaw cycles in samples separated at 2 h postcollection (EDTA-plasma P = 0.16; serum P = 0.89). Conclusion This small pilot study has shown that serum is preferable to EDTA-plasma for the measurement of fetuin-A. It has also shown that fetuin-A appears to be as stable after three freeze–thaw cycles as it is after one.
Safety and efficacy of forefoot surgery under ankle block anaesthesia
Authors: Russell DF , Pillai A , Kumar CS 
Published: April 2014

Background Ankle block as the sole anaesthetic for forefoot surgery is not used uniformly throughout the UK despite obvious advantages and widespread use internationally. Aim Evaluation of safety and effectiveness of performing elective forefoot surgery under ankle block anaesthesia alone in a pilot cohort of patients in a Scottish unit. Methods Data were collected from 81 consecutive forefoot procedures (71 patients) using a standardised questionnaire including incremental pain assessment (0–10; 0 no pain, 10 severe pain). Results Seven patients reported pain during surgery; average score 0.17. Average pain scores 6, 12, 24 and 48 h following surgery were 1.5, 3.09, 2.3 and 1.9, respectively. All patients were discharged home and walking on the same day. Conclusion Forefoot surgery under ankle block alone may be safe and effective. Anaesthesia obtained permitted routine forefoot procedures and provided lasting post-operative analgesia. Combined with intra-operative sedation, use of ankle tourniquet and same day discharge, it had very high patient acceptance and satisfaction.
On uncertainties in simulations in engineering design: A statistical tolerance analysis application
Authors: Walter Michael , Storch Markus , Wartzack Sandro 
Published: April 2014

Simulations not only facilitate new and unprecedented insights in highly sophisticated science areas, but also support product design in engineering in terms of improved functionality, cost and time issues. However, as a matter of fact, simulations examine limited excerpts of real systems with accompanying simplifications, abstractions and idealizations. Hence, there is a distinct need to be aware of upcoming risks in simulation outcomes caused by uncertainties. These influence every step of forward-thinking simulation design which is not only restrained by modeling practice but begins with reality perception itself. The intention of the paper is to embed an awareness of uncertainty in the context of simulation by linking major classes of uncertainty with uncertainties within simulations in engineering design. Besides the decisive inclusion of reality as the starting point, mathematic approaches are also used to understand how those uncertainty classes evolve through exponential knowledge creation of systems. The transfer to statistical tolerance analysis shall finally put emphasis on the practical classification of uncertainty, starting from data preparation via concept design and mathematical implementation to result depiction. In the end, the reader’s conception of possible uncertainties in special simulation cases shall be sharpened which, vice versa, shall lead to even better and well-thought-out simulation outcomes.
Needs and Concerns of Family Caregivers of Persons With Type 2 Diabetes
Authors: Scarton Lisa J. , Bakas Tamilyn , Miller Wendy R. , Poe G. Doug , Huber Lesa L. 
Published: April 2014

Purpose The purposes of this review were to identify the needs and concerns of family caregivers of persons with type 2 diabetes and to develop recommendations for future research on family caregivers of American Indians with type 2 diabetes. Searching the Cumulative Index to Nursing and Allied Health, Ovid, and PubMed, an extensive literature review was conducted using 10 search terms for articles published from 1990 to 2013. References of retrieved studies were also searched. Conclusions On the basis of the search criteria, 6 studies exploring the needs and concerns of family caregivers of persons with type 2 diabetes were identified. Findings were placed in 5 predetermined categories derived from Bakas et al’s needs and concerns framework: (1) finding information and resources related to type 2 diabetes, (2) dealing with the emotions and behaviors of the care recipient, (3) providing physical care, (4) providing instrumental care, and (5) dealing with one’s own personal responses to caregiving. The cross-cultural literature helped identify common ground and specific literature about the experiences of American Indian caregivers. Further research is needed on the needs of caregivers of persons with type 2 diabetes, particularly those in the Native American and other minority populations. Findings can be used to develop interventions to improve outcomes for these caregivers.
Factors associated with atrial fibrillation in rheumatic mitral stenosis
Authors: Pourafkari Leili , Ghaffari Samad , Bancroft George R , Tajlil Arezou , Nader Nader D 
Published: April 2014

Background Atrial fibrillation is a complication of mitral valve stenosis that causes several adverse neurologic outcomes. Our objective was to establish a mathematical model to predict the risk of atrial fibrillation in patients with mitral stenosis. Methods Of 819 patients with mitral stenosis who were screened, 603 were enrolled in the study and grouped according to whether they were in sinus rhythm or atrial fibrillation. Demographic, echocardiographic, and hemodynamic data were recorded. Logistic regression models were constructed to identify the relative risks for each contributing factor and calculate the probability of developing atrial fibrillation. Receiver operating characteristic curves were plotted. Results Two hundred (33%) patients had atrial fibrillation; this group was older, in a higher functional class, more likely to have suffered previous thromboembolic events, and had significantly larger left atrial diameters, lower ejection fractions, and lower left atrial appendage emptying flow velocity. The factors independently associated with atrial fibrillation were left atrial strain (odds ratio = 7.53 [4.47–12.69], p < 0.001), right atrial pressure (odds ratio = 1.09 [1.02–1.17], p = 0.01), age (odds ratio = 1.14 [1.05–1.25], p = 0.002), and ejection fraction (odds ratio = 0.92 [0.87–0.97], p = 0.003). The area under the curve for the combined receiver operating characteristic for this model was 0.90 ± 0.12. Conclusion Age, right atrial pressure, ejection fraction, and left atrial strain can be used to construct a mathematical model to predict the development of atrial fibrillation in rheumatic mitral stenosis.
General practitioners’ perspectives on the avoidability of hospitalizations at the end of life: A mixed-method study
Authors: De Korte-Verhoef Maria C , Pasman H Roeline W , Schweitzer Bart PM , Francke Anneke L , Onwuteaka-Philipsen Bregje D , Deliens Luc 
Published: April 2014

Background: Many patients are hospitalized in the last months of life. Little is known about the avoidability of these hospitalizations. Aim: To explore whether and how hospitalizations could have been avoided in the last 3 months of life and barriers to avoid this, according to general practitioners in the Netherlands. Design: Sequential mixed-method design, starting with a cross-sectional nationwide questionnaire study among general practitioners, followed by in-depth interviews. Setting/participants: General practitioners were asked about their most recent patient who died non-suddenly and who was hospitalized in the last 3 months of life. Additionally, 18 of these general practitioners were interviewed in depth about the situation surrounding hospitalization. Results: According to 24% of 319 general practitioners, the last hospitalization in the final 3 months of their patient’s life could have been avoided. Of all avoidable hospitalizations, 46% could have been avoided by proactive communication with the patient, 36% by more communication between professionals around hospitalization, 28% by additional care and treatment at home, and 10% by patient and family support. In the in-depth interviews, general practitioners confirmed the aforementioned strategies, but also mentioned various barriers in daily practice, such as the timing of proactive communication with the patient, incompleteness of information transfer in acute situations, and the lack of awareness among patients and family that death was near. Conclusion: A proactive approach could avoid some of the hospitalizations at the end of life, in the opinion of general practitioners. More insight is needed into communication and psychological barriers for timely discussions about end-of-life issues.
MRI characteristics of intraductal papilloma
Authors: Wang Wei , Ding Jianhui , Yang Wentao , Li Yuan , Zhou Liangping , Zhang Shengjian , Zhu Hui , Mao Jian , Tang Jie , Gu Yajia , Peng Weijun 
Published: April 2014

Background Intraductal papilloma (IDP) is the most common pathological finding in women with pathological nipple discharge. Magnetic resonance imaging (MRI) has shown potential for characterizing breast tumors; however, MRI findings of IDPs are inconclusive, and certain diagnostic standards are lacking. Purpose: To characterize the MRI features of IDP from a relatively large cohort. Material and Methods We retrospectively reviewed from 358 women with IDPs that were confirmed by histopathology. The clinical and imaging findings in 70 patients who underwent preoperative MRI were analyzed. MRI analyses included morphology and dynamic contrast-enhanced MRI. Results In 70 patients, 77 IDPs were detected on MRI, which revealed the following three patterns: small luminal mass papillomas; tumor-like papillomas; and MRI-occult papillomas. Fourteen IDPs involved small, oval, smooth, and contrast-enhanced masses at the posterior end of the enlarged duct corresponding to small luminal mass papillomas. Seven IDPs had large diameters along the direction of the breast duct, indicating the typical MRI findings for IDP. Of 47 tumor-like papillomas, 16 cases showed large diameters along the direction of the breast duct and close to the nipple (within 4 cm), seven cases resembled invasive breast cancer on MRI, and the remaining 24 were (24/47) undistinguishable from other benign breast diseases. Sixteen IDPs were MRI-occult papillomas that could not be distinguished from the surrounding benign disease by either contrast-enhanced MRI or fat-suppressed T2-weighted MRI. Conclusion Small luminal mass papillomas or tumor-like papillomas with the largest diameters along the direction of the breast duct and close to the nipple (within 4 cm) might be the typical MRI findings for IDPs.
‘Out of the frying pan’: the challenges of prescribing for insomnia in psychiatric patients
Authors: Huthwaite Mark , Cleghorn Mark , MacDonald Joanna 
Published: April 2014

Objectives: Managing insomnia is a common challenge for psychiatrists and their patients. We have observed an increasing use of quetiapine as a hypnosedative. Methods: We conducted an audit with the aim of establishing the prescribing patterns of local general psychiatrists in New Zealand, comparing them with established guidelines and determining the extent of the prescribing of quetiapine as a hypnosedative. Participant psychiatrists were recruited from peer review groups. Each participant provided anonymised prescribing information from 10 patients and noted their intention when prescribing. Results: Twenty-five clinicians (58% response rate) responded with prescriptions for 100 in-patients and 177 community mental health patients. 60% of in-patients and 62% of community patients were prescribed medications to aid with sleep. The most commonly prescribed medications were zopiclone, quetiapine and benzodiazepines. Prescribing adhered with the recommended guidelines for 20% of benzodiazepine and 35% of zopiclone prescriptions. Two thirds (60%) of the community prescriptions for quetiapine were primarily for hypnosedation. Conclusions: There is little concordance between guidelines for hypnosedative prescribing and the practices of general psychiatrists. Less zopiclone and fewer benzodiazepines were prescribed than in other studies, while more quetiapine was prescribed. The ‘off-label’ use of quetiapine and the duration of zopiclone and benzodiazepine use are discussed.
Modified Oblique Keller Capsular Interposition Arthroplasty (MOKCIA) for Treatment of Late-Stage Hallux Rigidus
Authors: Johnson Jeffrey E. , McCormick Jeremy J. 
Published: April 2014

Hallux rigidus is a term used to describe painful, limited motion and localized arthritis at the hallux metatarsophalangeal (MTP) joint. With early hallux rigidus, a dorsal cheilectomy can decrease pain and improve motion. With later stage disease, a hallux MTP arthrodesis is commonly chosen to decrease pain, sacrificing motion by fusing the hallux MTP joint. We present an alternative technique to arthrodesis for late stage hallux rigidus—the modified oblique Keller capsular interposition arthroplasty (MOKCIA). With this operation, the dorsal capsule of the hallux MTP joint is interposed into the joint, offering pain relief without sacrificing range of motion. Level of Evidence: Level V, expert opinion.