bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Empirical Statistical Downscaling Models’ Skill in Predicting Tanzanian Rainfall and Their Application in Providing Future Downscaled Scenarios
Authors: Mtongori Habiba I. , Stordal Frode , Benestad Rasmus E. 
Published: October 2015

Abstract
Projections of three important seasonal rainfall parameters—total precipitation (), wet-day mean () and wet-day frequency ()—considered to be relevant to crop agriculture were performed. Links between large-scale climate variables and local precipitation in Tanzania were investigated during the March–May (MAM), October–December (OND), and December–April (DJFMA) rainfall seasons. Variables found to have strong links were used to downscale the local precipitation for three future periods; near term, midcentury, and end of century. Downscaling models for , and were calibrated using observed large-scale seasonal rainfall and projected downscaled parameters were obtained based on rainfall simulations from ensembles of GCMs. The models’ skill scores were found to be sensitive to the domain size and number of leading EOFs used. The common EOF method employed in the downscaling modulated the skills depending on the GCMs used. The spread in the rainfall projections was found to be larger in OND and moderate in MAM and DJFMA. The multimodel mean projections in response to two RCPs (RCP4.5 and RCP8.5) suggest a shift toward wetter (drier) conditions () for OND (DJFMA) for all three periods. There is no uniform projection for MAM; some stations are projected to feature wetter and some drier conditions. In the midcentury and end of century, there is an increase of precipitation to about 40% for some areas getting OND rainfall and a decrease of precipitation up to about 10% for some areas getting MAM or DJFMA rainfall. Generally, the magnitude of change strongly differs across the areas.
Estimating age-specific trends in circulating testosterone and sex hormone-binding globulin in males and females across the lifespan
Authors: Handelsman David J , Sikaris Ken , Ly Lam P 
Published: October 2015

Background Age-specific trends of serum testosterone and sex hormone-binding globulin across the full lifespan have not been reported. Methods We deduced age-specific trends in serum testosterone and sex hormone-binding globulin in males and females between ages 10 and 90 from a large sample of consecutive results from a single large pathology laboratory. Coded results of 110,712 consecutive blood samples requesting serum testosterone over seven years (2007–2013) comprising blood testosterone, sex hormone-binding globulin and calculated free testosterone together with gender and age were analysed create smoothed age-specific centiles (2.5%, 5%, 25%, 50%, 75%, 95%, 97.5%) for males and females. Results These identified the pubertal increases in serum testosterone in males peaking at 20 years of age and remaining stable thereafter until the eighth decade. In females, circulating testosterone peaked in late adolescence and declined gradually over the next two decades but remained stable across menopause and beyond. After early childhood, serum sex hormone-binding globulin declines to a nadir in males at the age of 20 years and remains stable till the sixth decade with a gradual, progressive rise thereafter. In females, the sex hormone-binding globulin nadir is reached earlier with levels rising gradually and progressively with age thereafter and accelerating after the age of 70 years. Females also exhibit a second sex hormone-binding globulin peak during reproductive ages reflected only in upper centiles due to effects of pregnancy and oral contraceptive use in a significant minority of females. Conclusions This large sample of clinical data provides a comprehensive profile of androgen status across the lifespan from early adolescence to late old age.
How do management and non-management employees perceive workplace wellness programmes? A qualitative examination
Authors: Caperchione Cristina M , Reid R Colin , Sharp Paul G , Stehmeier Joshua 
Published: October 2015

Objectives: The value of workplace wellness programmes (WWPs) has been established in the literature. Such programmes, however, have an increased likelihood for success when both management and non-management employees’ perspectives and needs are incorporated into development and implementation. This study aimed to identify the perspectives of each of these two employee groups as a means of informing the future development and implementation of WWPs. Methods: Nine focus groups ( N = 56) were held in western Canada with participants employed at four diverse organisations consisting of >100 employees. Each participating organisation provided two separate groups, consisting of one management group and one non-management group. Participants were asked to share their perceptions, attitudes and beliefs concerning WWPs. Thematic inductive analysis was conducted to elicit emergent areas of focus. Results: Three areas of focus were identified: (1) role of the company in WWPs, (2) elements of successful WWPs and (3) mandatory participation in WWPs. Providing a clear indication of the roles and responsibilities of both employee groups, making these initiatives part of the organisational strategic plan, demonstrating a long term commitment to such programmes, and having employees play participatory roles in the design, implementation and decision making process, are components that need consideration. Conclusion: Both employee groups agreed that their organisation played a role in employee health. Similarities and discrepancies of the beliefs between groups are highlighted and key considerations are presented. Findings have implications for the future development and implementation of WWPs.
Short-term and longer-term survival after veno-arterial extracorporeal membrane oxygenation in an adult patient population: does older age matter?
Authors: Narotsky David L , Mosca Matthew S , Mochari-Greenberger Heidi , Beck James , Liao Ming , Mongero Linda , Bacchetta Matthew 
Published: October 2015

Background: Veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO) is increasingly being used for patients with refractory cardiopulmonary failure. This study evaluates the short-term (to discharge) and longer-term (1 year) survival among older (⩾65 years) versus younger (<65 years) adults, adjusted for comorbidities, in a diverse cohort of V-A ECMO patients. Methods: This was a retrospective cohort analysis of 131 adult patients (28% ⩾65 years old) who received V-A ECMO at an academic medical center from 2004-2013. Demographics, comorbidities and surgical characteristics were abstracted from the medical records and verified. Mortality status at discharge and at one year post-ECMO were determined by the hospital clinical information system, updated monthly with Social Security Death Index data. Cox proportional hazard analyses were conducted to evaluate associations between age strata and mortality at discharge and at one year post ECMO initiation, adjusted for covariates. Results: The survival rate following V-A ECMO was 48% (n=68/131) to discharge and 44% (n=58/131) to one year. Age ⩾65 versus <65 was significantly associated with increased mortality during hospitalization (HR:2.03; 95%CI=1.23-3.33) and at one year (HR:1.81; 95% CI=1.12-2.93); these associations were attenuated and did not retain statistical significance after adjustment for comorbidities (HR:1.61; 95%CI=0.90-2.88 and HR:1.42; 95% CI=0.81-2.50, respectively). Statistically significant predictors of mortality at discharge and one year included history of coronary artery bypass graft, peripheral vascular disease and renal failure/dialysis (p<0.05). Conclusions: Older age was not independently associated with short-term or longer-term survival among V-A ECMO patients, but may reflect greater comorbidity, suggesting that age alone may not disqualify patients from V-A ECMO therapy.
Meta-analysis comparing doublet and single cytotoxic agent therapy as first-line treatment in elderly patients with advanced nonsmall-cell lung cancer
Authors: Wang ShengFei , Wang Qin , Tian Jianhui , Zhou Zhiyi , Jiao Lijing , Fu Yanli , Chen Sufeng , Zhang Jie , Xu Ling 
Published: October 2015

Objective To perform a systematic review and meta-analysis comparing doublet versus single agent therapy in elderly patients with advanced nonsmall-cell lung cancer (NSCLC). Methods PubMed® and Cochrane databases, and American Society of Clinical Oncology, World Congress of Lung Cancer, and European Society of Medical Oncology abstracts were searched. Endpoints were overall survival (OS), 1-year survival rate (1-year SR), overall response rate (ORR), and grade 3/4 adverse events. Subgroup analyses were based on chemotherapy regimens and race. Results Out of 11 studies (13 randomized trials; n = 2782), doublet therapy was associated with significantly increased OS (hazard ratio [HR] 0.89, 95% confidence interval [CI] 0.83, 0.95), 1-year SR (risk ratio [RR] 1.15, 95% CI 1.04, 1.28), and ORR (RR 1.39, 95% CI 1.39, 1.86) versus single-agents. Chemotherapy regimen-based subgroup analyses favoured platinum-based doublet therapy for OS (RR 0.71, 95% CI 0.60, 0.84), 1-year SR (RR 1.28, 95% CI 1.11, 1.47), and ORR (RR 1.88, 95% CI 1.49, 2.38). Race-based subgroup analyses revealed increased benefit from doublet therapy in Asian populations for ORR (RR 1.70, 95% CI 1.29, 2.23) but not increased survival benefit. Higher incidences of grade 3/4 anaemia (RR 2.23, 95% CI 1.61, 3.09), thrombocytopenia (RR 2.47, 95% CI 1.17, 5.20), and fatigue (RR 1.36, 95% CI 1.06, 1.74) were observed with doublet versus single-agent therapy. Conclusions Doublet therapy was associated with significantly increased OS, 1-year SR and ORR compared with single agent therapy. Race may be considered when choosing doublet versus single-agent therapy as first-line treatment of NSCLC in elderly patients.
Correlation of deglutition in subacute ischemic stroke patients with peripheral blood adaptive immunity: Essential amino acid improvement
Authors: Aquilani Roberto , Emilio Benevolo , Dossena Maurizia , Baiardi Paola , Testa Amidio , Boschi Federica , Viglio Simona , Iadarola Paolo , Pasini Evasio , Verri Manuela 
Published: October 2015

We aimed to document in stroke patients peripheral blood immune cell profiles, their relations with neuro-functional tests, and any possible influence of supplemented essential amino acids (EAAs) may have on both the immune system and the relationship of the latter with neuro-function. Forty-two dysphagic stroke patients (27 men; 71±9 years) underwent bio-humoral measurements, neuro-functional tests, including Functional Independence Measure (FIM) and Dysphagia Outcome and Severity Scale (DOSS), and were randomized to receive EAAs 8 g/d (EAA group) or isocaloric maltodextrin (placebo group). At discharge all measurements were repeated 38±1 days after randomization. At admission, total white cell (TWC), neutrophil (N), and lymphocyte (Lymph) counts were normal and the N/Lymph ratio was higher than normal values (<3.0). At discharge, both TWC and N decreased while Lymph increased significantly. As a result, the N/Lymph ratio significantly decreased ( P <0.001) returning to normal levels. Absolute Lymph counts and Lymph % TWC correlated positively with DOSS (r = +0.235, P = 0.04 and r = +0.224, P = 0.05, respectively), negatively with C-reactive protein natural logarithm (ln CRP) ( P = 0.02 and P = 0.0001, respectively), which is an inflammation marker. N correlated positively with ln CRP ( P = 0.001) and had a slight negative association with FIM ( P = 0.07). The N/Lymph ratio was inversely related to FIM (r = −0.262, P = 0.02) and DOSS (r = −0.279, P = 0.01). Finally, FIM correlated with DOSS (r = +0.35, P = 0.05). For the regression analysis, the overtime changes of Lymph % TWC correlated significantly with DOSS ( P = 0.01). There was a positive correlation between Lymph % TWC and DOSS for the entire stroke population ( P = 0.015). While this correlation was not important for the placebo group ( P = 0.27), it was significant in the EAA subgroup ( P = 0.018). In the sub-acute stroke stage, there may be slight alterations of peripheral blood immune cells. Lymph cells are associated with improved neuro-function tests with evidence that this association is enhanced by supplementing EAAs.
Acute Respiratory Distress Syndrome: Mortality in a Single Center According to Different Definitions
Authors: Santa Cruz Roberto , Alvarez Lic. Veronica , Heredia Roberto , Villarejo Fernando 
Published: October 2015

Background: Mortality in acute lung injury (ALI) remains high, with outcome data arising mostly from multicenter studies. We undertook this investigation to determine hospital mortality in patients with ALI in a single center. Methods: We studied patients admitted between 2005 and 2012 with ALI and acute respiratory distress syndrome (ARDS) according to the American European Consensus Conference (AECC) criteria and recorded clinical variables. Thereafter, patients were classified as subgroups according to the AECC and Berlin definition in order to compare the clinical characteristics and outcomes. Results: In the 93 patients comprising the study, hospital mortality was 38%. Mortality at 28 days was 36%. Multivariate analysis associated hospital mortality with age and Pao2/Fio2 on day 1 ( P < .001). Differences resulted between the subgroups of AECC (ALI vs ARDS) and Berlin (mild vs moderate vs severe ARDS) in the lung injury score, Pao2/Fio2, Pao2/PAo2, PaCo2 on day 1, and hospital mortality. Conclusion: The overall hospital mortality (38%) was similar to that of other studies and according to the presence of ARDS (Pao2/Fio2 ≤ 200), we found significant differences between ALI and ARDS (AECC) and between mild and moderate or severe ARDS (Berlin) in baseline respiratory variables and mortality.
An examination of supportive management practices promoting health workforce stability in remote northern Australia
Authors: Onnis Leigh-ann Lesley 
Published: October 2015

Objective: The aim of this study is to examine management practices that support the wellbeing of health professionals working in remote regions, which may improve workforce retention. Method: An online questionnaire was distributed to health professionals working in remote regions of the Kimberley and North Queensland. A response rate of 20% was achieved. Results: The findings suggest that, for health professionals working in remote regions of northern Australia, accessing adequate support is one of the most challenging aspects of working in remote regions. Hence, in remote regions where turnover is high, retention of competent health professionals may benefit from management practices that provide improved personal and professional support. Conclusions: Health professionals working in remote Australia face unique pressures due to their geographical and professional isolation. Therefore, providing support improves their professional competence and personal wellbeing, and promotes workforce stability, which benefits the remote community through better access to health services.
Endovascular treatment of occluded and stenotic visceral vessels in patients with chronic mesenteric ischemia
Authors: Christofi Georgia , Donas Konstantinos P , Pitoulias Georgios A , Torsello Giovanni , Schwindt Arne G , Stavroulakis Konstantinos 
Published: October 2015

Objective Current evidence in the literature about endovascular treatment (ET) of visceral vessels in patients with chronic mesenterial ischemia (CMI) based on morphological characteristics is limited. The aim of this study was the evaluation of ET in occluded and stenotic visceral vessels. Methods Patients undergoing ET for CMI between November 2000 and November 2012 were included in this retrospective study. Primary measure outcome was the symptom-free survival (SFS). Secondary outcomes were primary (PPR), secondary patency (SPR) rates and technical success rate (TSR). A Cox-regression analysis identified risk factors for the primary and secondary measure outcomes. Results Forty patients were included in the present study (men: 21, mean age: 68). The overall number of vessels with intention-to-treat was 62. Fifty-two visceral arteries (18 occlusions and 34 stenoses) were successfully treated by endovascular means. The overall TSR was 84%. Visceral vessel occlusions and atherosclerotic disease of the superior mesenteric artery (SMA) were identified as independent risk factors for poorer TSR ( p < 0.05). The 12-month SFS was 60%. The overall 12-month PPR and SPR were 71% and 94%, respectively. No significant differences were observed between occluded and stenotic vessels ( p > 0.05) concerning the PPR. On the other hand, the subgroup analysis revealed higher SPR among occluded visceral vessels ( p < 0.001) and coeliac axis lesions ( p < 0.001). Conclusions ET was associated with high incidence of symptoms recurrence despite the satisfying patency rates in both occluded and stenotic vessels. Additionally, visceral vessel occlusion and presence of atherosclerotic lesions in the SMA were associated with poorer TSR.
Evaluating Joint Morbidity after Chondral Harvest for Autologous Chondrocyte Implantation (ACI)
Authors: McCarthy Helen S. , Richardson James B. , Parker Jane C. E. , Roberts Sally 
Published: October 2015

Objective To establish if harvesting cartilage to source chondrocytes for autologous chondrocyte implantation (ACI) results in donor site morbidity. Design Twenty-three patients underwent ACI for chondral defects of either the ankle or the hip. This involved cartilage harvest from the knee (stage I), chondrocyte expansion in the laboratory and implantation surgery (stage II) into the affected joint. Prior to chondral harvest, no patient had sought treatment for their knee. Lysholm knee scores were completed prior to chondral harvest and annually post-ACI. Histological analyses of the donor site were performed at 12.3 ± 1.5 months for 3 additional patients who had previously had ACI of the knee. Results The median preoperative Lysholm score was 100, with no significant differences observed at either 13.7±1.7 months or 4.8±1.8 years postharvest (median Lysholm scores 91.7 and 87.5, respectively). Patients whose cartilage was harvested from the central or medial trochlea had a significantly higher median Lysholm score at latest follow-up (97.9 and 93.4, respectively), compared with those taken from the intercondylar notch (median Lysholm score 66.7). The mean International Cartilage Repair Society (ICRS) II histological score for the biopsies taken from the donor site of 3 additional knee ACI patients was 117 ± 10 (maximum score 140). Conclusions This study suggests that the chondral harvest site in ACI is not associated with significant joint morbidity, at least up to 5 years postharvest. However, one should carefully consider the location for chondral harvest as this has been shown to affect knee function in the longer term.
Teaching of intermittent self-catheterisation through dedicated nurse-led TOV clinic for patients with uncomplicated acute urinary retention: How useful is it in practice?
Authors: Bekarma H , Rooney H , Khan R , Miller G , Dunn I 
Published: October 2015

Objectives: Acute urinary retention (AUR) is a common urological emergency. Our institution has established an outpatient pathway for managing patients with uncomplicated AUR on discharge from A&E: with catheter education and alpha-blocker therapy. They are followed up in a nurse-led clinic where intermittent self-catheterisation (ISC) can be taught if required. The aim of this study is to investigate the outcomes of our nurse-led trial of void (TOV) clinic and specifically the merit of teaching ISC. Methods: Data was prospectively collected and analysed for all patients with AUR who were followed up in the nurse-led TOV clinic between October 2012 and December 2014. Results: Over 26 months, 120 men with AUR attended the TOV clinic with an average age of 71 years (range 28–94 years). Forty-nine of 120 (41%) patients had an identifiable cause for AUR (UTI=13, constipation=13, alcohol=11, anti-cholinergics=7, post-operative=4 and post-brachytherapy=1). Sixty-four men passed and 50 failed TOV. Six were excluded from this analysis as they did not proceed to TOV in clinic (three requested LTC and three were not appropriate for outpatient clinic). All 50 patients who failed TOV were offered ISC. Thirty-two of 50 patients (64%) learnt ISC. Ten declined and eight were unable to perform ISC. Only seven of 50 patients (14%) went on to have a TURP, four of whom had declined to learn ISC. Of the remaining 43 patients, 24 (56%) had return of spontaneous voiding. Conclusion: In our experience, a pathway for reviewing AUR patients in a nurse-led TOV clinic where expertise for ISC tuition is available is extremely useful. In our series, only 14% of patients who failed TOV required TURP. Bladder function often returns to normal over time but ISC offers patients an autonomous management option if satisfactory to themselves whilst avoiding the complications of LTC.
Race, Rehabilitation, and 30-Day Readmission After Elective Total Knee Arthroplasty
Authors: Jorgenson Erik S. , Richardson Diane M. , Thomasson Arwin M. , Nelson Charles L. , Ibrahim Said A. 
Published: October 2015

Introduction: To examine racial variations in access to postacute care (PAC) and rehabilitation (Rehab) services following elective total knee arthroplasty and whether where patients go after surgery for PAC/Rehab is associated with 30-day readmission to acute care facility. Materials and Methods: Sample consisted of 129 522 patients discharged from 169 hospitals in the State of Pennsylvania between fiscal years 2008 and 2012. We used multinomial regression models to assess the relationship between patient race and discharge destination after surgery, for patients aged 18 to 64 years and for those aged 65 and older. We used multivariable (MV) regression and propensity score (PS) approaches to examine the relationship between patient discharge destination after surgery for PAC/Rehab and 30-day readmission, controlling for key individual- and facility-level factors. Results: Lower proportions of younger patients compared to those older than 65 were discharged to inpatient rehabilitation facilities (IRFs; 5.8% vs 12.6%, respectively) and skilled nursing facilities (SNFs; 15.2% vs 32.7%, respectively) compared to home-based Rehab (self-care; 23.3% vs 14.2%, respectively). Compared to whites, African American patients had significantly higher odds of discharge to IRF (age < 65, odds ratio = 2.04; age ≥ 65, odds ratio = 1.64) and to SNF (age < 65, odds ratio = 2.86; age ≥ 65, odds ratio = 2.19) and discharge to home care in patients younger than 65 years (odds ratio = 1.31). The odds of 30-day readmission among patients discharged to an IRF (MV odds ratio = 7.76; PS odds ratio = 8.34) and SNF (MV odds ratio = 2.01; PS odds ratio = 1.83) were significantly higher in comparison to patients discharged home with self-care. Conclusion: African American patients with knee replacement are more likely to be discharged to inpatient Rehab settings following surgery. Inpatient Rehab is significantly associated with 30-day readmission to acute care facility.
NADPH oxidase controls neutrophilic response to sterile inflammation in mice by regulating the IL-1α/G-CSF axis
Authors: Bagaitkar Juhi , Pech Nancy K. , Ivanov Stoyan , Austin Anthony , Zeng Melody Yue , Pallat Sabine , Huang Guangming , Randolph Gwendalyn J. , Dinauer Mary C. 
Published: October 2015

Key Points
Dysregulated IL-1α in NADPH oxidase null (Cybb KO) mice initiated increased G-CSF–induced neutrophilia, exacerbating sterile inflammation. Reduction of early neutrophilic response promoted resolution in Cybb KO mice.