bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dynamic laryngeal collapse associated with poll flexion as a complication of laryngeal tie‐forward surgery in three harness racehorses
Authors: Vermedal Hanna , Strand Eric 
Published: November 2019

AbstractObjectiveTo report dynamic laryngeal collapse (DLC) associated with poll flexion as a potential complication of the laryngeal tie‐forward procedure (LTFP) in harness racehorses.Study designShort case series.AnimalsThree harness racehorses.MethodsPreoperative and postoperative medical records of all harness racehorses that underwent the LTFP were reviewed, as were high‐speed treadmill videoendoscopy recordings of 35 horses that returned for upper airway evaluation postoperatively.ResultsOne standardbred and two Norwegian coldblooded trotters in which dorsal displacement of the soft palate had been initially diagnosed were found to have bilateral arytenoid cartilage and vocal fold collapse associated with poll flexion after the LTFP. These three horses were otherwise clinically normal when exercised in free head carriage.ConclusionDynamic laryngeal collapse associated with poll flexion can occur as a complication after the LTFP in harness racehorses and should be considered as a differential in horses with persistence of airway problems after surgery.Clinical significancePostoperative DLC may be underdiagnosed in harness racehorses because this complication is obvious only when horses are driven with bit and reins during high speed treadmill or overground videoendoscopy.
Impact of Different Volume Sizes on Dynamic Stability of a Gas Turbine-Fuel Cell Hybrid System
Authors: Abrassi Alessio , Traverso Alberto , Tucker David , Liese Eric 
Published: November 2019

Abstract
A dynamic model is developed for a microgas turbine (MGT), characterized by an intrinsic free-spool configuration, coupled to large volumes. This is inspired by an experimental facility at the National Energy Technology Laboratory (NETL) called hybrid performance (Hyper), which emulates a hybrid MGT and Fuel Cell system. The experiment and model can simulate stable and unstable operating conditions. The model is used to investigate the effects of different volumes on surge events, and to test possible strategies to safely avoid or recover from unstable compressor working conditions. The modeling approach is started from the Greitzer lumped parameter approach, and it has been improved with integration of empirical methods and simulated components to better match the real Hyper plant layout and performance. Pressure, flowrate, and frequency plots are shown for the surge behavior comparing two different volume sizes, for cases where gas turbine shaft speed is uncontrolled (open loop) and controlled (closed-loop). The ability to recover from a surge event is also demonstrated.
Performance of r-Adaptation Using Truncation Error-Based Equidistribution
Authors: Jackson Charles W. , Roy Christopher J. 
Published: November 2019

Abstract
This paper investigates the computational cost of performing r-adaptation by equidistributing the truncation error. This adaptation approach is applied to several two-dimensional (2D) problems using the Euler and laminar Navier–Stokes equations. The costs of performing the adaptation are compared to uniform refinement, and it is shown that adaptation can be far cheaper than uniform refinement. This paper also presents a new method of refining the equidistributed meshes. This new approach allows the adaptation to be performed on much coarser meshes and provides a method of refining these coarse, adapted meshes to meet a discretization-error target for the problem. We show that this approach can be at least 16–24 times cheaper than uniform refinement for the problems investigated here. This approach also is at least ten times faster than performing r-adaptation on a fine enough mesh to obtain the target discretization-error level.
Enteric-Coated Sodium Bicarbonate Attenuates Gastrointestinal Side-Effects
Authors: Hilton Nathan Philip , Leach Nicholas Keith , Craig Melissa May , Sparks S. Andy , McNaughton Lars Robert 
Published: November 2019

Enteric-formulated capsules can mitigate gastrointestinal (GI) side effects following sodium bicarbonate (NaHCO3) ingestion; however, it remains unclear how encapsulation alters postingestion symptoms and acid–base balance. The current study aimed to identify the optimal ingestion form to mitigate GI distress following NaHCO3 ingestion. Trained males (n = 14) ingested 300 mg/kg body mass of NaHCO3 in gelatin (GEL), delayed-release (DEL), and enteric-coated (ENT) capsules or a placebo in a randomized cross-over design. Blood bicarbonate anion concentration, potential hydrogen, and GI symptoms were measured pre- and postingestion for 3 hr. Fewer GI symptoms were reported with ENT NaHCO3 than with GEL (p = .012), but not with DEL (p = .106) in the postingestion phase. Symptom severity decreased with DEL (4.6 ± 2.8 arbitrary units) compared with GEL (7.0 ± 2.6 arbitrary units; p = .001) and was lower with ENT (2.8 ± 1.9 arbitrary units) compared with both GEL (p < .0005) and DEL (p = .044) NaHCO3. Blood bicarbonate anion concentration increased in all NaHCO3 conditions compared with the placebo (p < .0005), although this was lower with ENT than with GEL (p = .001) and DEL (p < .0005) NaHCO3. Changes in blood potential hydrogen were reduced with ENT compared with GEL (p = .047) and DEL (p = .047) NaHCO3, with no other differences between the conditions. Ingestion of ENT NaHCO3 attenuates GI disturbances for up to 3 hr postingestion. Therefore, ENT ingestion forms may be favorable for those who report GI disturbances with NaHCO3 supplementation or for those who have previously been deterred from its use altogether.
Mixed Flavonoid Supplementation Attenuates Postexercise Plasma Levels of 4-Hydroxynonenal and Protein Carbonyls in Endurance Athletes
Authors: Nieman David C. , Valacchi Giuseppe , Wentz Laurel M. , Ferrara Francesca , Pecorelli Alessandra , Woodby Brittany , Sakaguchi Camila A. , Simonson Andrew 
Published: November 2019

This double-blinded, placebo controlled, randomized crossover trial investigated the influence of 2-week mixed flavonoid versus placebo supplementation on oxinflammation markers after a 75-km cycling time trial in 22 cyclists (42.3 ± 1.7 years). Blood samples were collected before and after the 2-week supplementation, and then 0 hr, 1.5 hr, and 21 hr post 75-km cycling (176 ± 5.4 min, 73.4 ±2.0% maximal oxygen consumption). The supplement provided 678-mg flavonoids with quercetin (200 mg), green tea catechins (368 mg, 180-mg epigallocatechin gallate), and anthocyanins (128 mg) from bilberry extract, with caffeine, vitamin C, and omega-3 fatty acids added as adjuvants. Blood samples were analyzed for blood leukocyte counts, oxinflammation biomarkers, including 4-hydroxynonenal, protein carbonyls, and peripheral blood mononuclear mRNA expression for cyclooxygenease-2 and glutathione peroxidase. Each of the blood biomarkers was elevated postexercise (time effects, all ps < .01), with lower plasma levels for 4-hydroxynonenal (at 21-hr postexercise) in flavonoid versus placebo (interaction effect, p = .008). Although elevated postexercise, no trial differences for the neutrophil/lymphocyte ratio (p = .539) or peripheral blood mononuclear mRNA expression for cyclooxygenease-2 (p = .322) or glutathione peroxidase (p = .839) were shown. Flavonoid supplementation prior to intensive exercise decreased plasma peroxidation and oxidative damage, as determined by 4-hydroxynonenal. Postexercise increases were similar between the flavonoid and placebo trials for peripheral blood mononuclear mRNA expression for cyclooxygenease-2 and the nuclear factor erythroid 2-related factor 2 related gene glutathione peroxidase (NFE2L2). The data support the strategy of flavonoid supplementation to mitigate postexercise oxidative stress in endurance athletes.
Living at the edge of an active volcano: Risk from lava flows on Mt. Etna
Authors: Del Negro Ciro , Cappello Annalisa , Bilotta Giuseppe , Ganci Gaetana , Hérault Alexis , Zago Vito 
Published: November 2019

AbstractLava flows represent the greatest threat by far to exposed population and infrastructure on Mt. Etna, Italy. The increasing exposure of a larger population, which has almost tripled in the area around Mt. Etna during the past 150 years, has resulted from poor assessment of the volcanic hazard and inappropriate land use in vulnerable areas. Here we quantify the lava flow risk on the flanks of Mt. Etna volcano using a Geographic Information System (GIS)-based approach that integrates the hazard with the exposure of elements at stake. The hazard, which shows the long-term probability related to lava flow inundation, is obtained by combining three different kinds of information: the spatiotemporal probability of new flank eruptive vents opening in the future, the event probability associated with classes of expected eruptions, and the overlapping of lava flow paths simulated by the MAGFLOW model. Data including all exposed elements were gathered from institutional web portals and high-resolution satellite imagery and organized in four thematic layers: population, buildings, service networks, and land use. The total exposure is given by a weighted linear combination of the four thematic layers, where weights are calculated using the Analytic Hierarchy Process (AHP). The resulting risk map shows the likely damage caused by a lava flow eruption and allows rapid visualization of the areas subject to the greatest losses if a flank eruption were to occur on Mt. Etna. The highest risk is found in the southeastern flank due to the combination of high hazard and population density.
Holocene earthquake history and slip rate of the southern Teton fault, Wyoming, USA
Authors: DuRoss Christopher B. , Gold Ryan D. , Briggs Richard W. , Delano Jaime E. , Ostenaa Dean A. , Zellman Mark S. , Cholewinski Nicole , Wittke Seth J. , Mahan Shannon A. 
Published: November 2019

AbstractThe 72-km-long Teton normal fault bounds the eastern base of the Teton Range in northwestern Wyoming, USA. Although geomorphic surfaces along the fault record latest Pleistocene to Holocene fault movement, the postglacial earthquake history of the fault has remained enigmatic. We excavated a paleoseismic trench at the Buffalo Bowl site along the southernmost part of the fault to determine its Holocene rupture history and slip rate. At the site, ∼6.3 m of displacement postdates an early Holocene (ca. 10.5 ka) alluvial-fan surface. We document evidence of three surface-faulting earthquakes based on packages of scarp-derived colluvium that postdate the alluvial-fan units. Bayesian modeling of radiocarbon and luminescence ages yields earthquake times of ca. 9.9 ka, ca. 7.1 ka, and ca. 4.6 ka, forming the longest, most complete paleoseismic record of the Teton fault. We integrate these data with a displaced deglacial surface 4 km NE at Granite Canyon to calculate a postglacial to mid-Holocene (14.4–4.6 ka) slip rate of ∼1.1 mm/yr. Our analysis also suggests that the postglacial to early Holocene (14.4–9.9 ka) slip rate exceeds the Holocene (9.9–4.6 ka) rate by a factor of ∼2 (maximum of 3); however, a uniform rate for the fault is possible considering the 95% slip-rate errors. The ∼5 k.y. elapsed time since the last rupture of the southernmost Teton fault implies a current slip deficit of ∼4–5 m, which is possibly explained by spatially/temporally incomplete paleoseismic data, irregular earthquake recurrence, and/or variable per-event displacement. Our study emphasizes the importance of minimizing slip-rate uncertainties by integrating paleoseismic and geomorphic data sets and capturing multiple earthquake cycles.
Assessing safety in hormonal male contraception: a critical appraisal of adverse events reported in a male contraceptive trial
Authors: Abbe Carmen , Roxby Alison C 
Published: November 2019

IntroductionThere is unmet need for male contraceptive options, but a recent injectable combination male contraceptive trial was terminated early due to adverse events (AEs).MethodsWe examined the frequency of reported AEs by male research participants compared with AEs reported in prescribing information of approved female hormonal contraceptive methods. Published data from trials of the top five most-used female hormonal contraceptives, supplemented by contemporary contraceptive research, were compared with the frequency of AEs reported in a male injectable hormonal contraceptive trial.ResultsWe observed similar frequencies of AEs reported by users of male contraceptives compared with those reported by female users. Among quantitatively comparable AEs, compared with men, women reported experiencing higher frequencies of headaches, pelvic pain, and weight gain and similar frequencies of decreased libido. Compared with women, men reported experiencing higher frequencies of acne and mood changes. Men discontinued participation due to AEs at a lower frequency than women.ConclusionsFemale hormonal methods generally have similar frequencies of AEs to those reported in a recent male hormonal contraceptive trial, and male users had lower rates of discontinuation due to AEs. There were fewer serious AEs of the male contraceptive than reported in contemporary female trials which resulted in FDA licensure. This suggests there may be implicit bias in the scientific community regarding the level of acceptable risk for users of male contraceptive methods.
Impact of household composition and satisfaction with family life on self-reported sexual health outcomes of high-school students in Hong Kong
Authors: Wong William Chi Wai , Choi Edmond P H , Holroyd Eleanor , Ip Patrick , Fan Susan , Yip Paul S F 
Published: November 2019

BackgroundThe study aimed to examine the impact of household composition and satisfaction with family life on sexual behaviours among high school male and female students (aged 11–22 years) in Hong Kong.MethodHigh schools were randomly selected, and the final sample comprised 25 schools. Students were divided into two groups ('living with both biological parents' vs 'not living with both biological parents'). Students were asked to rate their satisfaction with family life on a five-point Likert scale in a self-administered questionnaire. Dependent variables were sexual experience, sexual harassment, sexting and nude chats. Multiple logistic regression was used to analyse the results.Results3907 students were included in the analysis. 202 students (5.2%) were sexually active. 505 students had ever (13.0%) sexually harassed others and 303 students (7.8%) had ever been sexually harassed by others. 58 students (1.5%) had ever had nude chats. 1005 students (25.8%) had sexted in the last 12 months. Students who lived with both biological parents were less like to be sexually active, to sext and to have nude chats than those who did not. Students who had higher family life satisfaction were less likely to be sexually active, to sexually harass others, to be sexually harassed by others, to sext and to have nude chats than students who had lower satisfaction with their family life.ConclusionsSexual health programmes and interventions should consider family functioning. Students who have low family satisfaction and those who do not live with both their biological parents should be targeted for sexual health interventions.
Osler Centenary Papers: Would Sir William Osler be a role model for medical trainees and physicians today?
Authors: Murthy Vivek K , Wright Scott M 
Published: November 2019

AbstractIf Sir William Osler were alive and practising as one of our contemporary colleagues, would he be viewed as a role model by medical trainees and other physicians? Recently published literature has sought to define clinical excellence; this characterisation of physician performance establishes a context in which role models in medicine can be appraised. Building on this framework, we present rich anecdotes and quotes from Sir William Osler himself, his colleagues, and his students to consider whether Osler would have been regarded as a role model for clinical excellence today. This paper illustrates convincingly that William Osler indeed personified clinical excellence and would have been appreciated as a consummate role model if he were alive and on a medical school’s faculty today. However, a century has passed since his death, and he is not sufficiently visible today to serve as a role model to modern medical trainees and physicians. Moreover, we speculate that Osler himself would not have wanted to be a role model for today’s trainees, as he emphasised that medicine is best learned from teachers at the bedside—a place where he cannot be. Reanimating Osler through rich stories and inspiring quotes, and translating his example of clinical excellence into modern clinical practice, can remind us all to carry Oslerian virtues with us in our professional work.
10 Osler as a role model for today
Authors: Wright Scott 
Published: November 2019

Abstract
If Sir William Osler were alive and practicing as one of our contemporary colleagues, would he be viewed as a role model by medical trainees and other physicians? Recently published literature has sought to define clinical excellence; this characterization of physician performance establishes a context upon which role models in medicine can be appraised. Building on this framework, we present rich anecdotes and quotes from Sir William Osler himself, his colleagues, and his students to consider whether Osler would have been regarded as a role model for clinical excellence today.
This manuscript illustrates convincingly that William Osler indeed personified clinical excellence and would have been appreciated as a consummate role model if he were alive and on a medical school’s faculty today. However, a century has passed since his death, and he is not sufficiently visible today to serve as a role model to modern medical trainees and physicians. Moreover, we speculate that Osler himself would not want to be a role model for today’s trainees, as he emphasized that medicine is best learned from teachers at the bedside – a place where he cannot be. Reanimating Osler through rich stories and inspiring quotes, and translating his example of clinical excellence into modern clinical practice, can remind us all to carry Oslerian virtues with us in our professional work.
2 Advances in oral and insulin treatments for diabetes
Authors: Chowdhury Tahseen A 
Published: November 2019

Abstract
Prevalence of type 2 diabetes is rising worldwide, and adding significant burdens of morbidity, mortality and financial costs to healthcare systems worldwide. Whilst cardiovascular risk reduction is central to diabetes management, improved glycaemic control remains an important aim of management, in order to reduce the risk of microvascular complications.
In this presentation, I hope to remind the audience why diabetes is such an important condition, to review the evidence behind tight glucose control, and to assess the options and evidence behind newer oral and injectable therapies in the management of glucose in type 2 diabetes. I will also discuss recent studies concerning the prevention and remission of type 2 diabetes.
Finally, I hope to highlight the huge potential value of new technology in the management of Type 1 diabetes, which is set to change the treatment of this condition completely in the next few years.
8 General surgical foundation doctor optimisation of daily practice
Authors: Feldano Emmanuel , Ramasubbu Ben 
Published: November 2019

Abstract

Introduction
Traditionally the role of a surgical foundation year 1 (FY1s) doctors consisted of long working hours, multiple on call shifts and little to rest however, the introduction of European working time directive now means that FY1s are constricted to 48 hours per week on average and various other regulations that junior doctors should abide by yet the same quantity of daily tasks remains the same. In this study we looked at the difficulties FY1s now face in their daily working day and if some of these issues could be resolved by implementing some structural changes.

Methods
The study was conducted in three cycles, each lasting five days (Monday to Friday). Cycle 1 included shadowing of Surgical FY1s on wards for five consecutive days observing daily routine (arrival, lunch and departure time), task completion, communication and handovers. Following this multiple interventions were made to the structure of their daily practice to improve productivity and performance. These improvements were measured in cycle 2 (as the new model was scaffolded into place) and cycle 3 (strictly observed).

Results
In cycle 1 we observed that 100% of F1s arrived to work on time, there was no set times for lunch and all of the FY1s lunches were interrupted. There was no structure for handovers and 100% of F1s stayed at work beyond there contracted hours. In second cycle, 100% of F1s had lunch between the hours of 12pm-1PM on 3/5 days and 75% on the remaining two days. 75% of F1s had uninterrupted lunches on all 5 days. Morning and afternoon handovers were completed every day. In cycle 3 the results remained as high. There was no significant difference in number of tasks between week 1, 2 and 3.

Conclusion
Through the implementation of daily structure and other interventions involving the multidisciplinary team we improved the quality of F1s working day and increased the efficiency of service delivered on the surgical ward.
Effect of lidocaine cream analgesia for chest drain tube removal after video-assisted thoracoscopic surgery for lung cancer: a randomized clinical trial
Authors: Watanabe Shin-nosuke , Imai Kazuhiro , Kimura Tetsu , Saito Yoshitaro , Takashima Shinogu , Matsuzaki Ikuo , Kurihara Nobuyasu , Atari Maiko , Matsuo Tsubasa , Iwai Hidenobu , Sato Yusuke , Motoyama Satoru , Nomura Kyoko , Nishikawa Toshiaki , Minamiya Yoshihiro 
Published: November 2019

Background and objectivesPain management makes an important contribution to good respiratory care and early recovery after thoracic surgery. Although the development of video-assisted thoracoscopic surgery (VATS) has led to improved patient outcomes, chest tube removal could be distressful experience for many patients. The aim of this trial was to test whether the addition of lidocaine cream would have a signiﬁcant impact on the pain treatment during chest tube removal from patients who had undergone VATS for lung cancer.MethodsThis clinical trial was a double-blind randomized study. Forty patients with histologically confirmed lung cancer amenable to lobectomy/segmentectomy were enrolled. All patients had standard perioperative care. Patients were randomly assigned to receive either epidural anesthesia plus placebo cream (placebo, Group P) or epidural anesthesia plus 7% lidocaine cream cutaneously around the chest tube insertion site and on the skin over the tube’s course 20 min (Group L) before chest drain removal.ResultsVisual analog scale (VAS) scores were higher in Group P (median 5, IQR, 3.25-8) than in Group L (median 2, IQR, 1-3). Pain intensities measured using a PainVision system were also higher in Group P (median 296.7, IQR, 216.9–563.5) than Group L (median 41.2, IQR, 11.8–97.0). VAS scores and the pain intensity associated with chest drain removal were significantly lower in Group L than Group P (p=0.0002 vs p<0.0001).ConclusionAnalgesia using lidocaine cream is a very simple way to reduce the pain of chest tube removal after VATS.Trial registration numberUMIN000013824.
On stochastic effects and primordial black-hole formation
Authors: Kühnel Florian , Freese Katherine 
Published: November 2019

AbstractThe effect of large quantum fluctuations on primordial black-hole formation for inflationary models with a quasi-inflection point is investigated. By using techniques of stochastic inflation in combination with replica field theory and the Feynman–Jensen variational method, it is non-perturbatively demonstrated that the abundance of primordial black holes is amplified by several orders of magnitude as compared to the classical computation.