bluuebunny/crossref_metadata_2025 huggingface dataset:
МОЖЛИВОСТІ ВИКОРИСТАННЯ СТИМУЛЯЦІЙНОГО НАВЧАННЯ ДЛЯ ПІДВИЩЕННЯ ЯКОСТІ ПРАКТИЧНОЇ ПІДГОТОВКИ СТУДЕНТІВ ПРИ ВИВЧЕННІ АКУШЕРСТВА ТА ГІНЕКОЛОГІЇ
Authors: Petrenko N. V. , Marushchak M. I. , Krynytska I. Ya.
Published: March 2018

Мета: дослідити можливості та переваги можливих форм роботи в симуляційному центрі для підвищення ефективності практичної підготовки студентів при вивченні акушерства та гінекології.Матеріали і методи. Застосовано методи системного підходу та системного аналізу для оцінки існуючих та розробки нових методик інтерактивних методів навчання.Результати. Основними формами роботи студентів у симуляційному центрі є базова медична практика, яка дозволяє відпрацювання методики виконання базових лікарських навичок на моделі з високим рівнем реалістичності під контролем викладача та динамічна робота, яка передбачає виконання певного алгоритму дій у змодельованій клінічній ситуації. При виконанні клінічного сценарію відпрацьовують командну взаємодію, де важливим є розподіл та делегування обов’язків, спілкування між членами команди, виконання призначень, прийняття рішень.Висновки. Підготовка висококваліфікованого фахівця, формування професійних компетентностей передбачає, що ґрунтовні теоретичні знання повинні бути підтверджені практичними навичками, що можливо завдяки симуляційному навчанню, яке передує та доповнює клінічне навчання.
ЛЕЙОМІОМА МАТКИ І БЕЗПЛІДДЯ (ОГЛЯД ЛІТЕРАТУРИ)
Authors: Khmil S. V. , Korda I. V. , Drozdovska Yu. B. , Khmil M. S. , Chudiyovych N. Ya.
Published: March 2018

Мета: провести аналіз сучасної вітчизняної та зарубіжної літератури стосовно причин виникнення, етіопатогенезу лейоміоми матки, сучасних методів лікування та впливу даної патології на фертильність жінки.Матеріали і методи: У дослідженні використано бібліосемантичний та аналітичний методи.Результати. Під час виконання дослідження було проведено огляд та проаналізовано 34 джерела сучасної вітчизняної та зарубіжної літератури щодо питання лейоміоми матки та її впливу на стан репродуктивного здоров’я жінки.Висновки. На сьогодні питання вибору оптимальної тактики лікування лейоміоми залишається дуже дискусійним. Комбінована терапія з використанням сучасних технік (органозберігаючих операцій, емболізація маткових артерій, сфокусований ультразвук під контролем МРТ) та досягнень фармакотерапії (уліпристал, міфепристон, аГнРГ) є пріоритетним напрямком у сучасній гінекології. За допомогою даних методів лікування вдається зберегти та реалізувати репродуктивний потенціал жінок репродуктивного віку з лейоміомою матки.
Effects of sandblasting of prosthetic abutment surfaces on the tensile strength of cement-retained crowns, using a cementing technique: an in vitro study
Authors: Igai Fernando , Mori Matsuyoshi , Contin Ivo , Steagall Junior Washington , Tortamano Neto Pedro
Published: March 2018

Objective: The tensile strength effects on the sandblasting of the abutment associated with a cementing technique are not well documented. The objective of this study is to analyze the tensile strength of prosthetic crowns cemented on standard and sandblasted abutments, using a cementing technique. Methods: Experimental groups were formed according to ce­menting technique (control and practice abutment technique) and prosthetic abutment roughness (standard and sandblas­ted), totaling forty specimens. The crowns were cemented with Zinc Phosphate cement. Statistical analysis was conducted with an α at 0.05. Results: Considering the cementation techniques analysis, there were no statistically significant differen­ces between the groups, with mean tensile strength values of 157.83±22.16 N for the control technique, and 159.95±46.40 N for the practice abutment technique on the standard surface. Result analysis of the control technique (626.23±34.80 N) and practice abutment technique (642.62±94.00 N) indicated no significant differences on the sandblasted surface. Consi­dering the surface roughness analysis, significant differences were observed, with values of 157.83±22.16 N for the control technique/standard surface group and 626.23±34.80 N for the control technique/sandblasted surface group. Significant differences were observed in the practice abutment technique/standard surface group with 159.95±46.40 N values, compa­red to the 642.62±94.00 N value for the practice abutment technique/sandblasted group. Conclusions: The practice abut­ment cementing technique showed no significant differences with the control technique, regarding to the tensile strength, in the two surfaces (standard and sandblasted) used in the study. The sandblasting of prosthetic abutments led to a signifi­cant increase on the tensile strength considering the two studied cementation techniques.
Dominant Role for Regulatory T Cells in Protecting Females Against Pulmonary Hypertension
Authors: Tamosiuniene Rasa , Manouvakhova Olga , Mesange Paul , Saito Toshie , Qian Jin , Sanyal Mrinmoy , Lin Yu-Chun , Nguyen Linh P. , Luria Amir , Tu Allen B. , Sante Joshua M. , Rabinovitch Marlene , Fitzgerald Desmond J. , Graham Brian B. , Habtezion Aida , Voelkel Norbert F. , Aurelian Laure , Nicolls Mark R.
Published: March 2018

Rationale:

Pulmonary arterial hypertension (PH) is a life-threatening condition associated with immune dysregulation and abnormal regulatory T cell (Treg) activity, but it is currently unknown whether and how abnormal Treg function differentially affects males and females.

Objective:

To evaluate whether and how Treg deficiency differentially affects male and female rats in experimental PH.

Methods and Results:

Male and female athymic
rnu/rnu
rats, lacking Tregs, were treated with the VEGFR2 (vascular endothelial growth factor receptor 2) inhibitor SU5416 or chronic hypoxia and evaluated for PH; some animals underwent Treg immune reconstitution before SU5416 administration. Plasma PGI
2
(prostacyclin) levels were measured. Lung and right ventricles were assessed for the expression of the vasoprotective proteins COX-2 (cyclooxygenase 2), PTGIS (prostacyclin synthase), PDL-1 (programmed death ligand 1), and HO-1 (heme oxygenase 1). Inhibitors of these pathways were administered to athymic rats undergoing Treg immune reconstitution. Finally, human cardiac microvascular endothelial cells cocultured with Tregs were evaluated for COX-2, PDL-1, HO-1, and ER (estrogen receptor) expression, and culture supernatants were assayed for PGI
2
and IL (interleukin)-10. SU5416-treatment and chronic hypoxia produced more severe PH in female than male athymic rats. Females were distinguished by greater pulmonary inflammation, augmented right ventricular fibrosis, lower plasma PGI
2
levels, decreased lung COX-2, PTGIS, HO-1, and PDL-1 expression and reduced right ventricular PDL-1 levels. In both sexes, Treg immune reconstitution protected against PH development and raised levels of plasma PGI
2
and cardiopulmonary COX-2, PTGIS, PDL-1, and HO-1. Inhibiting COX-2, HO-1, and PD-1 (programmed death 1)/PDL-1 pathways abrogated Treg protection. In vitro, human Tregs directly upregulated endothelial COX-2, PDL-1, HO-1, ERs and increased supernatant levels of PGI
2
and IL-10.

Conclusions:

In 2 animal models of PH based on Treg deficiency, females developed more severe PH than males. The data suggest that females are especially reliant on the normal Treg function to counteract the effects of pulmonary vascular injury leading to PH.
Association of Obesity With Severity of Heart Failure Exacerbation: A Population‐Based Study
Authors: Hirayama Atsushi , Goto Tadahiro , Shimada Yuichi J. , Faridi Mohammad Kamal , Camargo Carlos A. , Hasegawa Kohei
Published: March 2018

Background

Obesity and heart failure (
HF
) are important public health problems in the United States. Although studies have reported the association between obesity and higher chronic morbidity of
HF
, little is known about the relations of obesity with severity of
HF
exacerbation and in‐hospital mortality; therefore, we aimed to investigate the associations of obesity with severity of
HF
exacerbation and in‐hospital mortality.

Methods and Results

This retrospective cohort study of adults hospitalized for
HF
exacerbation used population‐based data sets (the State Inpatient Databases) of 7
US
states from 2012 to 2013. The outcomes were acute severity measures—use of positive pressure ventilation and hospital length of stay—and in‐hospital mortality. We determined the associations between obesity and these outcomes, including adjustment for sociodemographic factors and comorbidities. We identified 219 465 patients hospitalized for
HF
exacerbation. Of those, 37 539 (17.1%) were obese. Obese patients had a significantly higher risk of positive pressure ventilation use compared with nonobese patients (13.6% versus 8.8%), with a corresponding adjusted odds ratio of 1.61 (95% confidence interval, 1.55–1.68;
P
<0.001). Likewise, obese patients were more likely to have hospital length of stay of ≥4 days compared with nonobese patients (62.5% versus 56.7%), with an adjusted odds ratio of 1.40 (95% confidence interval, 1.37–1.44;
P
<0.001). In contrast, obese patients had significantly lower in‐hospital mortality compared with nonobese patients (1.7% versus 3.3%), with an adjusted odds ratio of 0.87 (95% confidence interval, 0.80–0.95;
P
=0.002).

Conclusions

Based on large population‐based data sets of patients with
HF
exacerbation, obesity was associated with higher acute severity measures but lower in‐hospital mortality.
Role of Blood Lipids in the Development of Ischemic Stroke and its Subtypes
Authors: Hindy George , Engström Gunnar , Larsson Susanna C. , Traylor Matthew , Markus Hugh S. , Melander Olle , Orho-Melander Marju
Published: March 2018

Background and Purpose—

Statin therapy is associated with a lower risk of ischemic stroke supporting a causal role of low-density lipoprotein (LDL) cholesterol. However, more evidence is needed to answer the question whether LDL cholesterol plays a causal role in ischemic stroke subtypes. In addition, it is unknown whether high-density lipoprotein cholesterol and triglycerides have a causal relationship to ischemic stroke and its subtypes. Our aim was to investigate the causal role of LDL cholesterol, high-density lipoprotein cholesterol, and triglycerides in ischemic stroke and its subtypes through Mendelian randomization (MR).

Methods—

Summary data on 185 genome-wide lipids-associated single nucleotide polymorphisms were obtained from the Global Lipids Genetics Consortium and the Stroke Genetics Network for their association with ischemic stroke (n=16 851 cases and 32 473 controls) and its subtypes, including large artery atherosclerosis (n=2410), small artery occlusion (n=3186), and cardioembolic (n=3427) stroke. Inverse-variance–weighted MR was used to obtain the causal estimates. Inverse-variance–weighted multivariable MR, MR-Egger, and sensitivity exclusion of pleiotropic single nucleotide polymorphisms after Steiger filtering and MR-Pleiotropy Residual Sum and Outlier test were used to adjust for pleiotropic bias.

Results—

A 1-SD genetically elevated LDL cholesterol was associated with an increased risk of ischemic stroke (odds ratio: 1.12; 95% confidence interval: 1.04–1.20) and large artery atherosclerosis stroke (odds ratio: 1.28; 95% confidence interval: 1.10–1.49) but not with small artery occlusion or cardioembolic stroke in multivariable MR. A 1-SD genetically elevated high-density lipoprotein cholesterol was associated with a decreased risk of small artery occlusion stroke (odds ratio: 0.79; 95% confidence interval: 0.67–0.90) in multivariable MR. MR-Egger indicated no pleiotropic bias, and results did not markedly change after sensitivity exclusion of pleiotropic single nucleotide polymorphisms. Genetically elevated triglycerides did not associate with ischemic stroke or its subtypes.

Conclusions—

LDL cholesterol lowering is likely to prevent large artery atherosclerosis but may not prevent small artery occlusion nor cardioembolic strokes. High-density lipoprotein cholesterol elevation may lead to benefits in small artery disease prevention. Finally, triglyceride lowering may not yield benefits in ischemic stroke and its subtypes.
Atrial Cardiopathy and the Risk of Ischemic Stroke in the CHS (Cardiovascular Health Study)
Authors: Kamel Hooman , Bartz Traci M. , Elkind Mitchell S.V. , Okin Peter M. , Thacker Evan L. , Patton Kristen K. , Stein Phyllis K. , deFilippi Christopher R. , Gottesman Rebecca F. , Heckbert Susan R. , Kronmal Richard A. , Soliman Elsayed Z. , Longstreth W.T.
Published: March 2018

Background and Purpose—

Emerging evidence suggests that an underlying atrial cardiopathy may result in thromboembolism before atrial fibrillation (AF) develops. We examined the association between various markers of atrial cardiopathy and the risk of ischemic stroke.

Methods—

The CHS (Cardiovascular Health Study) prospectively enrolled community-dwelling adults ≥65 years of age. For this study, we excluded participants diagnosed with stroke or AF before baseline. Exposures were several markers of atrial cardiopathy: baseline P-wave terminal force in ECG lead V
1
, left atrial dimension on echocardiogram, and N terminal pro B type natriuretic peptide (NT-proBNP), as well as incident AF. Incident AF was ascertained from 12-lead electrocardiograms at annual study visits for the first decade after study enrollment and from inpatient and outpatient Medicare data throughout follow-up. The primary outcome was incident ischemic stroke. We used Cox proportional hazards models that included all 4 atrial cardiopathy markers along with adjustment for demographic characteristics and established vascular risk factors.

Results—

Among 3723 participants who were free of stroke and AF at baseline and who had data on all atrial cardiopathy markers, 585 participants (15.7%) experienced an incident ischemic stroke during a median 12.9 years of follow-up. When all atrial cardiopathy markers were combined in 1 Cox model, we found significant associations with stroke for P-wave terminal force in ECG lead V
1
(hazard ratio per 1000 μV*ms 1.04; 95% confidence interval, 1.001–1.08), log-transformed NT-proBNP (hazard ratio per doubling of NT-proBNP, 1.09; 95% confidence interval, 1.03–1.16), and incident AF (hazard ratio, 2.04; 95% confidence interval, 1.67–2.48) but not left atrial dimension (hazard ratio per cm, 0.96; 95% confidence interval, 0.84–1.10).

Conclusions—

In addition to clinically apparent AF, other evidence of abnormal atrial substrate is associated with subsequent ischemic stroke. This finding is consistent with the hypothesis that thromboembolism from the left atrium may occur in the setting of several different manifestations of atrial disease.
Computer and Information Technology, Firm Growth, and Industrial Restructuring: Evidence from Manufacturing in the People's Republic of China
Authors: Shen Guangjun
Published: March 2018

Computer and information technology is considered one of the most powerful engines of modern growth, but more empirical evidence is needed to quantify its impacts. This paper studies the role of computer and information technology in industrial restructuring by observing structural change in the manufacturing sector in the People's Republic of China using a large firm-level data set. Computer and information technology is found to boost changes in industrial structure substantially. This paper also identifies faster and higher-quality growth of firms as the underlying channel through which computer use can improve industrial structure. Firms using computers grow faster, spend more on research and development, and enjoy greater productivity.
Cooperating yet distinct brain networks engaged during naturalistic paradigms: A meta-analysis of functional MRI results
Authors: Bottenhorn Katherine L. , Flannery Jessica S. , Boeving Emily R. , Riedel Michael C. , Eickhoff Simon B. , Sutherland Matthew T. , Laird Angela R.
Published: March 2018

Cognitive processes do not occur by pure insertion and instead depend on the full complement of co-occurring mental processes, including perceptual and motor functions. As such, there is limited ecological validity to human neuroimaging experiments that use highly controlled tasks to isolate mental processes of interest. However, a growing literature shows how dynamic, interactive tasks have allowed researchers to study cognition as it more naturally occurs. Collective analysis across such neuroimaging experiments may answer broader questions regarding how naturalistic cognition is biologically distributed throughout the brain. We applied an unbiased, data-driven, meta-analytic approach that uses k-means clustering to identify core brain networks engaged across the naturalistic functional neuroimaging literature. Functional decoding allowed us to, then, delineate how information is distributed between these networks throughout the execution of dynamical cognition in realistic settings. This analysis revealed six recurrent patterns of brain activation, representing sensory, domain-specific, and attentional neural networks that support the cognitive demands of naturalistic paradigms. Although gaps in the literature remain, these results suggest that naturalistic fMRI paradigms recruit a common set of networks that allow both separate processing of different streams of information and integration of relevant information to enable flexible cognition and complex behavior.
Patterns of Industrialisation and the State of Industrial Labour in Post-WTO-Accession Vietnam
Authors: Masina Pietro P. , Cerimele Michela
Published: March 2018

Since the mid-2000s Vietnam has become an important manufacturing hub in garment and, increasingly, in electronics. However, the expansion of an FDI-dominated, export-oriented manufacturing did not contribute to a genuine national industrialisation process and the weight of manufacturing on GDP has actually declined. Low industrial wages (associated with poor working conditions) have emerged as a structural (rather than transitory) competitive factor for the country’s participation in global production networks.
God Who Curses is Cursed
Authors: Bitrus Ibrahim S.
Published: March 2018

Using historical critical methods of interpretation, many Western and African scholars have dismissed the use of imprecation in Africa as an incantatory, uncritical, and above all, unwholesome Christian practice. But using an Afrocentric method of interpretation, I argue that African Christians’ use of imprecation is a legitimate Christian prayer that is consistent with God’s character of retributive justice, regardless of its unwholesomeness. For many African Christians, to imprecate is to participate in the ongoing and eschatological reality of God’s holy indignation, and judgment against systemic forces of oppression, injustice, and impunity perpetrated by the powers of the enemy.
Dancing at Both Weddings
Authors: Feldman Jan
Published: March 2018

A new feminist movement is on the rise in Israel. It is led by haredi (ultra-Orthodox) women, usually known for their silent acquiescence to the rabbinate. They are not looking to create a revolution, but their activism may have implications not only for women, but for Israel in general. Based on interviews with haredi activists, Knesset (Parliament) members, secular and religious women heads of ngos, and academics, we contend that political activism, especially for haredi women with little education, experience, and resources, is not ironic, but rather, an appropriate vehicle for advancing their agenda. Other avenues of activity are closed for haredi women. Politics, which is assimilated into the category of “secular” activities, is likely to generate less opposition from their community. Haredi women and the state of Israel are trying to dance at two different weddings: at one, the tune being played is that of women’s rights and democracy; at the other, it is Jewish law, with its religious patriarchy.
Prodromus of a fern flora for Bolivia. XXI. Dicksoniaceae
Authors: LEHNERT MARCUS , KESSLER MICHAEL
Published: March 2018

We provide a synopsis to the fern family Dicksoniaceae in Bolivia, comprising the genera Dicksonia and Lophosoria, each with one variable species in the country: Dicksonia karsteniana and Lophosoria quadripinnata.
Checklist of the dragonflies (Odonata) of Iran with new records and notes on distribution and taxonomy
Authors: SCHNEIDER THOMAS , IKEMEYER DIETMAR , MÜLLER OLE , DUMONT HENRI J.
Published: March 2018

Iran has a complex dragonfly fauna influenced by contacts and overlaps of different geographical zones. Its fauna is dominated by Eurosiberian taxa. However, the SE Province Sistãn-va-Baluchestãn is rich in oriental species, many of which having their western distribution limit in Iran. In NE-Iran, Irano-Turanian elements live and in the S- and SW-Iran African species are found. The Iranian Odonata fauna seems well studied, however, a closer look reveals many uncertainties and confusion, some records coming clearly from misidentification whereas other, which were missing proofs of correct identification remains to be confirmed. Even today, every new collecting trip reveals species new for Iran whereas species new for science are still detected, although rarely. In this checklist we include seven taxa new for Iran: Stylurus ubadschii (although a male of uncertain origin is recorded in Schmidt (1954), Ischnura senegalensis (although two uncertain records were published by Martin (1912) and Schmidt (1954), Coenagrion ponticum, C. lunulatum, C. pulchellum, Lestes macrostigma, and Calopteryx splendens tschaldirica. We critically checked all available data, including all published records. Fourteen taxa have been rejected, or placed in the category for need of confirmation. Till the end of 2017, 100 autochthonous taxa of dragonflies and two migratory species could be confirmed to be or have been present in Iran. We provide distribution maps, created after evaluation of published data and containing our own data from 12 trips to Iran, travelling over 35000 km in the country. Over 200 new localities are integrated. Taxonomic confusion is reduced by rejecting the following taxa for Iran: Calopteryx splendens mingrelica, C. hyalina, Erythromma najas, Aeshna cyanea, Gomphus davidi, and Sympetrum sinaiticum. We regard the taxa Gomphus amseli and G. schneiderii transcaspicus as synonyms of G. schneiderii, and Onychogomphus forcipatus lucidostriatus as a synonym of O. f. albotibialis.
More cautionary tales: family, generic and species synonymies of recently published taxa of ghost and mud shrimps (Decapoda: Axiidea and Gebiidea)
Authors: DWORSCHAK PETER C. , POORE GARY C. B.
Published: March 2018

Re-examination of the holotype of Neoaxius nicoyaensis Sakai, 2017 showed that it is conspecific with the axiid Guyanacaris caespitosa Squires, 1979 and thus Neoaxius Sakai, 2017 and Neoaxiidae Sakai, 2017 are respectively subjective junior synonyms of Guyanacaris Sakai, 2011 and Axiidae Huxley, 1879. The types and numerous specimens of the callianassid Trypaea vilavelebita Sakai & Türkay, 2012 are juveniles of the common northeastern Atlantic-Mediterranean species, Callianassa subterranea (Montagu, 1808); the name is therefore a subjective junior synonym. The monotypic callianopsid genera Pleurocalliax Sakai, 2011, Neocallianopsis Sakai, 2011 and Phaetoncalliax Sakai, Türkay, Beuck & Freiwald, 2015 are found not to differ from Callianopsis de Saint Laurent, 1973, the only alleged differences found to be untrue or trivial. Phaetoncalliax mauritana Sakai, Türkay, Beuck & Freiwald, 2015 and Neocallianopsis africana Sakai, Türkay, Beuck & Freiwald, 2015 are thereby transferred to Callianopsis, the latter a subjective junior synonym of the former. Contrary to the assertion of its author, the gourretiid Pseudogourretia portsudanensis Sakai, 2005, the only species in its genus, has no pleurobranchs. The genus Pseudogourretia Sakai, 2005 is therefore synonymised with Gourretia de Saint Laurent, 1973. The respective holotypes of Paracalliax stenophthalmus Sakai, Türkay, Beuck & Freiwald, 2015 and Paracalliax bollorei de Saint Laurent, 1979 were re-examined. Both are from the Banc d’Arguin, off Mauritania, and are identical at the species level. The upogebiid Kuwaitupogebia nithyanandan Sakai, Türkay & Al Aidaroos, 2015 from Kuwait is identical to Upogebia balmaorum Ngoc-Ho, 1990 from the Seychelles, Madagascar and tropical Western Australia. Kuwaitupogebia Sakai, Türkay & Al Aidaroos, 2015 is therefore synonymised with Upogebia Leach, 1814 and Kuwaitupogebiidae Sakai, Türkay & Al Aidaroos, 2015 with Upogebiidae Borradaile, 1903.
Two new species of the genus Daptonema Cobb, 1920 (Nematoda: Xyalidae) found in an intertidal seagrass bed on the coast of the Andaman Sea, Thailand, with reference to the taxonomic status of the genus Trichotheristus Wieser, 1956
Authors: ARYUTHAKA CHITTIMA , KITO KENJI
Published: March 2018

Daptonema chonispiculum sp. n. and D. phuketense sp. n. are described from the Ban Pa Khlok seagrass bed, Phuket Province, Thailand. Daptonema chonispiculum sp. n. is characterized by spicules with funnel-shaped proximal ends, and D. phuketense sp. n. is unique in having the third caudal gland filled with fibrous contents. Each new species also differs from most related species in body length, de Man’s indices, length of the cephalic setae and somatic/cervical setae, distance of the amphids from the anterior of the body, and length of the spicules. The new species most closely resemble D. hirsutum, D. platonovae, and D. robustum, with similar body lengths, long cervical setae located in the anterior pharyngeal region, small amphids, L-shaped spicules and a gubernaculum with a long dorso-caudal apophysis. Regarding the taxonomic status of Daptonema and Trichotheristus, we agree with the synonymization of Trichotheristus with Daptonema by Tchesunov (1990), based on taxonomic review of Trichotheristus and a comparison of the diagnostic features separating the genera. We propose a new combination, Daptonema galeatum comb. n., and a new name, Daptonema nearticulatum sp. n. for Trichotheristus articulatus Huang & Zhang, 2006.
Defining Single Extreme Weather Events in a Climate Perspective
Authors: Cattiaux Julien , Ribes Aurélien
Published: March 2018

Weather extremes are the showcase of climate variability. Given their societal and environmental impacts, they are of great public interest. The prevention of natural hazards, the monitoring of single events, and, more recently, their attribution to anthropogenic climate change constitute key challenges for both weather services and scientific communities. Before a single event can be scrutinized, it must be properly defined; in particular, its spatiotemporal characteristics must be chosen. So far, this definition is made with some degree of arbitrariness, yet it might affect conclusions when explaining an extreme weather event from a climate perspective. Here, we propose a generic road map for defining single events as objectively as possible. In particular, as extreme events are inherently characterized by a small probability of occurrence, we suggest selecting the space–time characteristics that minimize this probability. In this way, we are able to automatically identify the spatiotemporal scale at which the event has been the most extreme. According to our methodology, the European heat wave of summer 2003 would be defined as a 2-week event over France and Spain and the Boulder, Colorado, intense rainfall of September 2013 a 5-day local event. Importantly, we show that in both cases, maximizing the rarity of the event does not maximize (or minimize) its fraction of attributable risk to anthropogenic climate change.
On the Need to Modify the Sea Surface Roughness Formulation over Shallow Waters
Authors: Jiménez Pedro A. , Dudhia Jimy
Published: March 2018

The wind stress formulation in an atmospheric model over shallow waters is investigated using year-long observations of the wind profile within the first 100 m of the atmosphere and mesoscale simulations. The model experiments use a range of planetary boundary layer parameterizations to quantify the uncertainty related to the turbulent closure assumptions and thus to isolate the dominant influence of the surface roughness formulation. Results indicate that a positive wind speed bias exists when common open-ocean formulations for roughness are adopted for a region with a water depth of 30 m. Imposition of a wind stress formulation that is consistent with previous shallow-water estimates is necessary to reconcile model wind speeds with observations, providing modeling evidence that supports the increase of surface drag over shallow waters. The possibility of including water depth in the parameterization of roughness length is examined.
Orographic Precipitation Response to Microphysical Parameter Perturbations for Idealized Moist Nearly Neutral Flow
Authors: Morales Annareli , Morrison Hugh , Posselt Derek J.
Published: March 2018

This study explores the sensitivity of clouds and precipitation to microphysical parameter perturbations using idealized simulations of moist, nearly neutral flow over a bell-shaped mountain. Numerous parameters are perturbed within the Morrison microphysics scheme. The parameters that most affect cloud and precipitation characteristics are the snow fall speed coefficient As, snow particle density ρs, rain accretion (WRA), and ice–cloud water collection efficiency (ECI). Surface precipitation rates are affected by As and ρs through changes to the precipitation efficiency caused by direct and indirect impacts on snow fall speed, respectively. WRA and ECI both affect the amount of cloud water removed, but the precipitation sensitivity differs. Large WRA results in increased precipitation efficiency and cloud water removal below the freezing level, indirectly decreasing cloud condensation rates; the net result is little precipitation sensitivity. Large ECI removes cloud water above the freezing level but with little influence on overall condensation rates. Two environmental experiments are performed to test the robustness of the results: 1) reduction of the wind speed profile by 30% (LowU) and 2) decreasing the surface potential temperature to induce a freezing level below the mountain top (LowFL). Parameter perturbations within LowU result in similar mechanisms acting on precipitation, but a much weaker sensitivity compared to the control. The LowFL case shows ρs is no longer a dominant parameter and As now induces changes to cloud condensation, since more of the cloud depth is present above the freezing level. In general, perturbations to microphysical parameters affect the location of peak precipitation, while the total amount of precipitation is more sensitive to environmental parameter perturbations.
Ocean and Ice Shelf Tides from CryoSat-2 Altimetry
Authors: Zaron Edward D.
Published: March 2018

A new empirical model of ocean tides has been developed for the Weddell Sea, south of 66°S, between 90°W and 0°, using six years of radar altimeter data from the CryoSat-2 satellite mission. Because of its long ground-track repeat period (368 days) and its diverse measurement modes, low-rate mode (LRM) over the ocean and synthetic aperture radar interferometric mode (SARin) over ice surfaces and parts of the ocean, the CryoSat-2 data pose a number of challenges for tidal analysis. The space and time sampling properties of the exact repeat, near-repeat, and crossover ground tracks have been analyzed to discover which tides may be estimated using a combination of conventional harmonic analysis and local spatial regression. Using this information, the M2, S2, K2, N2, K1, O1, P1, and Q1 tides have been mapped for both the ocean and floating ice shelves in this domain. Validation against independent in situ data, along with comparison with existing tide models, finds that the CryoSat-2-derived tides are consistent with previous estimates and that they are more accurate than other models at the M2 and S2 frequencies. The high inclination of the CryoSat-2 orbit causes the orbit plane to precess relatively slowly, which leads to significantly less accurate estimates of the K2 tide. This purely empirical model ought to provide improved tidal corrections for studies of low-frequency variability and secular trends in ice shelf thickness, and it suggests that further increases in quantitative accuracy could be achieved by assimilation of CryoSat-2 data into dynamical tide models.
Improving Winter Storm Forecasts with Observing System Simulation Experiments (OSSEs). Part I: An Idealized Case Study of Three U.S. Storms
Authors: Peevey Tanya R. , English Jason M. , Cucurull Lidia , Wang Hongli , Kren Andrew C.
Published: March 2018

Severe weather events can have a significant impact on local communities because of the loss of life and property. Forecast busts associated with high-impact weather events have been attributed to initial condition errors over data-sparse regions, such as the Pacific Ocean. Numerous flight campaigns have found that targeted observations over these areas can improve forecasts. To better understand the impacts of measurement type and sampling domains on forecast performance, observing system simulation experiments are performed using the National Centers for Environmental Prediction Global Forecast System (GFS) with hybrid 3DEnVar data assimilation and the ECMWF T511 nature run. First, three types of simulated perfect dropsonde observations (temperature, specific humidity, and wind) are assimilated into the GFS over a large idealized sampling domain covering the Pacific Ocean. For the three winter storms studied, forecast error was found to be significantly reduced with all three types of measurements providing the most benefit (%–15% reduction in error). Instances when forecasts are not improved are investigated and concluded to be due to challenging meteorological structures, such as cutoff lows and interactions with atmospheric structures outside the sampling domain. Second, simulated dropsondes are assimilated over sensitive areas and flight tracks established using the ensemble transform sensitivity (ETS) technique. For all three winter storms, forecast error is reduced up to 5%, which is less than that found using an idealized domain. These results suggest that targeted observations over the Pacific Ocean may provide a small improvement to winter storm forecasts over the United States.
Five-Year Survival of Short Single-Tooth Implants (6 mm): A Randomized Controlled Clinical Trial
Authors: Naenni N. , Sahrmann P. , Schmidlin P.R. , Attin T. , Wiedemeier D.B. , Sapata V. , Hämmerle C.H.F. , Jung R.E.
Published: March 2018

The aim of the present study was to evaluate whether 6-mm dental implants in the posterior segments of either jaw perform equally well in terms of clinical and radiographic outcomes when compared with 10-mm implants after 5 y of loading. Patients with single-tooth gaps in the posterior area who were scheduled for implant therapy were randomly assigned to a group receiving either a 6- or 10-mm implant. After a healing period of 10 wk, implants were loaded with a screw-retained single crown and followed up at yearly intervals. Of 96 patients, 86 could be recalled after 5 y. The implant survival rates amounted to 91% (95% confidence interval: 0.836 to 0.998) for the 6-mm group and 100% for the 10-mm group ( P = 0.036). Median crown-to-implant (C/I) ratios were 1.75 (interquartile range [IQR], 1.50 to 1.90) for the 6-mm group and 1.04 (IQR, 0.95 to 1.15) for the 10-mm group, whereas the median marginal bone levels measured −0.29 mm (IQR, −0.92 to 0.23) for the 6-mm group and −0.15 mm (IQR: −0.93 – 0.41) for the 10-mm group after 5 y. The C/I ratio turned out to be statistically significant ( P < 0.001), whereas marginal bone levels showed no significant difference between the groups. The 6-mm implants exhibited significantly lower survival rates than the 10-mm implants over 5 y, whereas there was no difference between upper and lower jaws in terms of survival ( P = 0.58). Lost implants did not show any sign of marginal bone loss or peri-implant infection previous to loss of osseointegration. High C/I ratio and implant length had no significant effect on marginal bone level changes or technical and biological complications (German Clinical Trials Registry: DRKS00006290).
Utility of Eating Assessment Tool–10 in Predicting Aspiration in Patients with Unilateral Vocal Fold Paralysis
Authors: Zuniga Steven A. , Ebersole Barbara , Jamal Nausheen
Published: March 2018

Objective

Examine the incidence of penetration/aspiration in patients with unilateral vocal fold immobility and investigate the relationship with self‐reported perception of dysphagia.

Study Design

Case series with chart review.

Setting

Academic cancer center.

Subjects and Methods

Adult patients with unilateral vocal fold immobility diagnosed between 2014 and 2016 were reviewed. Patients were stratified into an aspiration group and a nonaspiration group using objective findings on flexible endoscopic evaluation of swallowing, as scored using Rosenbek's Penetration Aspiration Scale. Objective findings were compared to patient perception of dysphagia. Bivariate linear correlation analysis was performed to evaluate correlation between Eating Assessment Tool–10 scores and presence of aspiration. Tests of diagnostic accuracy were calculated to investigate the predictive value of Eating Assessment Tool–10 scores >9 on aspiration risk.

Results

Of the 35 patients with new‐onset unilateral vocal fold immobility were evaluated, 25.7% (9/35) demonstrated tracheal aspiration. Mean ± SD Eating Assessment Tool–10 scores were 19.2 ± 13.7 for aspirators and 7.0 ± 7.8 for nonaspirators (P =. 016). A statistically significant correlation was demonstrated between increasing Eating Assessment Tool–10 scores and Penetration Aspiration Scale scores (r = 0.511, P =. 002). Diagnostic accuracy analysis for aspiration risk in patients with an Eating Assessment Tool–10 score >9 revealed a sensitivity of 77.8% and a specificity of 73.1%.

Conclusion

Patient perception of swallowing difficulty may have utility in predicting aspiration risk. An EAT–10 of >9 in patients with unilateral vocal fold immobility may portend up to a 5 times greater risk of aspiration. Routine swallow testing to assess for penetration/aspiration may be indicated in patients with unilateral vocal fold immobility.
Evidence‐Based Medicine in Otolaryngology, Part 8: Shared Decision Making—Impact, Incentives, and Instruments
Authors: Ikeda Allison K. , Hong Paul , Ishman Stacey L. , Joe Stephanie A. , Randolph Gregory W. , Shin Jennifer J.
Published: March 2018

In our previous installment, we introduced shared decision making (SDM) as a collaborative process in which patients, families, and clinicians develop a mutually optimized treatment plan when more than 1 reasonable treatment option exists. In this subsequent installment of our Evidence‐Based Medicine in Otolaryngology Series, we expand on the topic of SDM, including the related current state of clinical decision making, the impact of SDM on health care utilization and patient satisfaction, the potential role of system and society changes, the experience with SDM as it relates to race and ethnicity, existing financial incentives, and the validated instruments that assess the extent to which SDM occurs.
Adverse Events and Time to Diagnosis of In‐Office Laryngeal Biopsy Procedures
Authors: Cohen Jacob T. , Bishara Taiser , Trushin Vladimir , Benyamini Limor
Published: March 2018

Objective

To examine the adverse events and time to diagnosis of in‐office laryngeal biopsy (IOB) procedures.

Study Design

Retrospective cohort study.

Setting

Outpatient clinic–tertiary referral medical center.

Subjects and Methods

A total of 390 IOBs were included in this study. Data on demographic characteristics, outcomes, and complications were collected. Complications were classified as severe—necessitating further intervention or admission—or mild and self‐limited. Delay in diagnosis, assessed as a complication of IOB, was calculated as the time from initial examination to final diagnosis.

Results

Of 390 IOBs, 4 (1%) had complications: epistaxis (n = 2), vocal fold hematoma (n = 1), and aspiration event (n = 1). There were no reports of complications at follow‐up. The sensitivity of IOB versus direct laryngoscopy biopsies was 77.8%, and the specificity was 95.1%. When the IOB showed malignancy as a final diagnosis, time to diagnosis was 10.7 days (95% CI, 8.6‐12.8). When IOB pathology results changed from benign or carcinoma in situ to malignant (squamous cell carcinoma) by direct laryngoscopy, time to diagnosis was longer: 49.1 days (95% CI, 38.1‐60.1) and 36.1 days (95% CI, 15.1‐57.1; P <. 05), respectively.

Conclusions

In this cohort, IOBs appear to be free of significant adverse events. IOBs for suspicious laryngeal lesions shorten the time to diagnosis and treatment for the majority of patients; the minority showed a small and insignificant delay.
Conditioning and Testing Protocol Combinations to Detect Asphalt Mixture Damage
Authors: Bazuhair Rabeea W. , Pittman Carl V. , Howard Isaac L. , Jordan Walter S. , Hemsley James Michael , Baumgardner Gaylon L.
Published: March 2018

Asphalt mixes often have many ingredients that can interact with each other. When put into service, where there are multiple environmental effects, there are many interactions that need mixture testing. This paper’s objective was to evaluate laboratory conditioning protocols coupled with subsequent property measurements for their ability to detect damage of asphalt mixtures in the southeastern U.S. climate (or similar climates). The investigation’s focus is the property measurements themselves, and in particular how a given test can simultaneously assess multiple types of damage (i.e. oxidation, moisture damage, and freeze-thaw damage). While in service, mixtures can be damaged in multiple manners so laboratory conditioning protocols that expose specimens to multiple types of damage are needed as are test(s) that can detect these damages in a manner that can help assess performance during service. Four plant produced mixtures with all virgin ingredients were evaluated at intermediate temperatures with mixture and binder tests. The mixtures were well suited for such a comparison because they consisted of all virgin binder. Indirect tensile (IDT) strength did not relate to Cantabro Mass Loss (CML) or binder test results, which was concerning. Even more concerning was IDT’s inability to respond to laboratory conditioning protocols that considered multiple environmental effects (i.e., oxidation, moisture, and freeze-thaw). CML results related to binder properties and were able to reasonably detect multiple types of environmental effects. As such, Cantabro testing is recommended over tensile strength for intermediate temperature mixture property assessments related to non-load associated environmental effects.
Conditions Required for a Hybrid Artificial Liver Support System using a PUF/Hepatocyte-Spheroid Packed-Bed Module and it's use in Dogs with Liver Failure
Authors: Ijima H. , Nakazawa K. , Koyama S. , Kaneko M. , Matsushita T. , Gion T. , Shirabe K. , Shimada M. , Takenaka K. , Sugimachi K. , Funatsu K.
Published: March 2018

We studied the effects of a hybrid artificial liver support system we developed on dogs with hepatic failure. The system consisted of a multi-channel polyurethane foam packed-bed culture module, including primary dog hepatocyte spheroids.

Blood ammonia was well metabolized by 20 g hepatocytes, but the other functions such as glucose concentration, total bile acid concentration, and survival time required 30 g hepatocytes to improve conditions. We found that we should use a culture substratum that easily forms spheroids, and that an artificial liver module should be used as soon as possible after spheroid formation by hepatocytes in the module.
Laser Technology in Orthopedics: Preliminary Study on Low Power Laser Therapy to Improve the Bone-Biomaterial Interface
Authors: Guzzardella G.A. , Torricelli P. , Aldini N Nicoli , Giardino R.
Published: March 2018

Low Power Laser (LPL) seems to enhance the healing of bone defects and fractures. The effect of LPL In other orthopedic areas such as osteointegration of implanted prosthetic bone devices is still unclear. In the present study, 12 rabbits were used to evaluate whether Ga-AI-As (780 nm) LPL stimulation has positive effects on osteointegration. Hydroxyapatite (HA) cylindrical nails were drilled into both distal femurs of rabbits. From postoperative day 1 and for 5 consecutive days, the left femura of all rabbits were given LPL treatment (Laser Group-LG) with the following parameters: 300 Joule/cm2 1 Watt, 300 Hertz, pulsating emission, 10 minutes. The right femura were sham-treated (Control Group-CG). At 4 and 8 weeks after implantation, histologic and histomorphometric investigations evaluated bone-biomaterial-contact. Histomorphometry showed a higher degree of osteointegration at the HA-bone interface in the LG Group at 4 (p<0.0005) and 8 weeks (p<0.001). These preliminary positive results seem to support the hypothesis that LPL treatment can be considered a good tool to enhance the bone-implant interface in orthopedic surgery.
Investigation of Bilirubin Removal by NK-110 Resin Hemoperfusion in Jaundiced Dogs
Authors: Ji-Chang S. , Shao-Cheng Q. , Chen-Yang Z. , Fu-Hua N. , Shao-Ming H. , Tao L. , Run-Hai C. , Chang-Zhi C. , Ming-Rong T. , Hui-Ming W. , Yao-Ting Y.
Published: March 2018

A jaundiced dog model was made by common bile duct-inferior vena cava shunt with a silicon rubber tube. Blood bilirubin levels increased from 0.25 ± 0.16 (SD) mg% to 15 ± 1.4 (SD) mg%. These dog models were treated with a column containing 200 gm of macroreticular resin NK-110 which was linked between the femoral artery and vein. The rate of blood flow through the column was 200 ml/min.

It was shown that total bilirubin reduced from 15 ± 1.4 (SD) to 7.4 ± 0.61 (SD), conjugated bilirubin decreased from 6.97 ± 0.63 to 3.5 ± 0.33 (SD) and unconjugated bilirubin from 7.8 ± 2.1 to 4.2 ± 0.4 (SD). There were no significant changes in protein, electrolyte, blood gases and acid base balance. Results show that NK-110 resin has good blood-compatible and adsorption properties.
Influence of Dialysis Membranes on the Convective Transport of Middle Molecules
Authors: de Francisco A.L. M. , Gordillo J. , Cotorruelo J.G. , Ruiz L. , Gonzalez M. , Morales P. , Arias M.
Published: March 2018

Ultrafiltrates from 10 patients in chronic maintenance hemodialysis (7 males and 3 females) were obtained simultaneously using three different membranes: cuprophan, polyacrilonitrile and polysulfone. Middle molecules (MM) chromatographic profiles and total MM amount were determined by gel chromatography and high performance liquid chromatography.

The convective transport of MM was similar and not membrane related. Hemofiltration, a predominantly convective solute transfer procedure using high flux membranes such as polyacrilonitrile and polysulfone, in which large amounts of fluids have to be ultrafiltered, is an effective form of MM removal.
Calcification of Chemically Treated Bovine Pericardium
Authors: Gatti A.M. , Galloni M. , Monari E. , Noera G. , Pasquino E. , Vallana F.
Published: March 2018

One of the most important problems arising in cardiac bioprostheses made with bovine pericardium and, more generally, with biologically-derived tissues is tissue calcification. The present study assessed four chemical treatments on patches of bovine pericardium, intended to avoid or minimize calcification.

Pericardium specimens were treated with: A) 0.5% glutaraldehyde; B) 0.5% glutaraldehyde + 4% formaldehyde; C) same as A, but with a further neutralization treatment; D) acylation of fresh bovine pericardium.

Circular samples of 1 cm diameter were subcutaneously implanted in the abdominal region of three groups of six rats. The explants were retrieved after 2, 4 and 8 weeks. The calcium content and the histological results showed better behaviour for C and D samples than with the commonly used fixation methods (A and B). The lowest calcification was observed with treatment D, even though its morphological structures were somewhat modified with homogenation of collagen bundles. Among the glutaraldehyde-based treatments, treatment C appears to be the most promising because the pericardium shows slower calcium accumulation with a diffusive pattern.