bluuebunny/crossref_metadata_2025_split huggingface dataset:
Doppler Circulation as a Fairly Range-Insensitive Far-Field Tornado Detection and Precursor Parameter
Authors: Davies-Jones Robert , Wood Vincent T. , Rasmussen Erik N. 
Published: May 2020

AbstractFormulas are obtained for observed circulation around and contraction rate of a Doppler radar grid cell within a surface of constant launch angle. The cell values near unresolved axisymmetric vortices vary greatly with beam-to-flow angle. To obtain reliable standard measures of vortex strength we bilinearly interpolate data to points on circles of specified radii concentric with circulation centers and compute the Doppler circulations around and the areal contraction rates of these circles from the field of mean Doppler velocities. These parameters are proposed for detection of strong tornadoes and mesocyclonic winds. The circulation and mean convergence around the Union City, Oklahoma, tornado of 24 May 1973 are computed. After doubling to compensate for the unobserved wind component, the circulation (1.1 × 105 m2 s−1) agrees with a previous photogrammetric measurement. The mature tornado was embedded in a region, 6 km in diameter, of nearly uniform strong convergence (~5.5 × 10−3 s−1) without a simultaneous mesocyclone. A model of a convergent vortex inputted to a Doppler radar emulator reproduces these results. Moving the model vortex shows that for a WSR-88D with superresolution, the circulation is relatively insensitive to range and azimuth. WSR-88D data of the 31 May 2013 El Reno storm are also analyzed. The tornado formed in a two-celled mesocyclone with strong inflow 5 km away. In the next 8 min the circulation near the axis doubled and the areal contraction rate at 5 km increased by 50%. This signified a large probability of strong tornadoes embedded in powerful storm-scale winds.
Neck Disability and Swallowing Function in Posttreatment Head and Neck Cancer Patients
Authors: Harris Alexandria , Lyu Lingyun , Wasserman‐Winko Tamara , George Susan , Johnson Jonas T. , Nilsen Marci Lee 
Published: May 2020

ObjectiveTo examine the relationship between symptoms of neck disability and swallowing dysfunction among head and neck cancer (HNC) survivors.Study DesignCross‐sectional analysis.SettingSingle‐center, university‐affiliated HNC survivorship clinic.Subjects and MethodsSurvivors’ patient‐reported symptoms of neck disability and swallowing dysfunction were prospectively collected from March 2017 to May 2018. Neck disability and swallowing dysfunction were measured using the Neck Disability Index and Eating Assessment Tool (EAT‐10), respectively. Linear regression was used to analyze the association between neck disability and swallowing dysfunction.ResultsA total of 179 survivors, predominantly male (n = 130, 72.6%) with an average age of 64.64 ± 9.91 years, were included in the analysis. Primary cancer sites were oropharynx (n = 85, 47.5%), oral cavity (n = 59, 33.0%), and larynx/hypopharynx (n = 35, 19.5%). Mean EAT‐10 score was 10.07 ± 10.89 (range = 0‐40; >2 indicative of swallowing dysfunction). Survivors treated for early stage cancer had lower EAT‐10 scores than those with advanced stage (early = 3.55 ± 7.46; advanced = 11.95 ± 11.02, P <. 001). After controlling for age, time since treatment, American Joint Committee on Cancer stage, and treatment modality, the EAT‐10 score for patients with mild neck disability was 6.88 (95% confidence interval [CI], 3.71‐10.06; P <. 001) points higher than those without neck disability, and the score for those with moderate‐complete neck disability was 13.65 (95% CI, 9.47‐17.83; P <. 001) points higher than those without neck disability.ConclusionsSwallowing dysfunction is a commonly recognized effect of HNC treatment. The prevalence and burden of neck disability are shown to be highly correlated with swallowing dysfunction. These results support the need for comprehensive, multidisciplinary rehabilitation interventions for patients with HNC.
Air in extracorporeal membrane oxygenation: can never be overemphasized
Authors: Yan Shujie , Lou Song , Zhao Yu , Liu Gang , Ji Bingyang 
Published: May 2020

Introduction: Air in extracorporeal membrane oxygenation circuit may lead to deleterious consequence. Case report: Three cases of air in extracorporeal membrane oxygenation were presented. Air was introduced from right jugular venous sheath during percutaneous septal repair, pulmonary artery catheter during intensive care unit, and sewing holes on atrial wall during surgery respectively. Accidents in Case 2 and Case 3 were successfully managed, while Case 1 was suspected of cerebral air embolism through transseptal right-to-left shunt. Discussion: With extracorporeal membrane oxygenation being widely applied in more clinical settings, especially in catheterization lab, risks of air in extracorporeal membrane oxygenation increase. More attention should be paid to patients with communication between right and left heart system, especially in situations when venous accesses’ exposure to air could not be avoided. Conclusion: Air in the extracorporeal membrane oxygenation circuit should never be overemphasized, especially during special procedures.
Characteristics and Outcomes of Patients Referred to an Emergency Department-Based End-of-Life Care Service in Hong Kong: A Retrospective Cohort Study
Authors: Chan Yat Chun , Yang Marc L. C. , Ho Hiu Fai 
Published: May 2020

Background: This study describes the characteristics and outcomes of patients referred to an emergency department (ED)-based end-of-life (EOL) service in a tertiary acute hospital in Hong Kong. We examine how emergency physicians (EPs) perform in recognizing and managing dying patients. Methods: From September 2010 to April 2018, patients referred to this EOL service in this hospital were included. A group of 5 EPs assessed whether the referred patient would die within a few days. Dying patients (EOL group) were admitted to ED-based EOL service whereas those not likely dying within few days (non-EOL group) would continue management in respective specialty wards. Baseline characteristics of these 2 groups were compared. The time-to-death and use of opioids and anticholinergics were compared. Results: In total, 783 of 830 patients assessed were recognized as being in dying phase, with 688 admitted under ED-based EOL care. Their demographics and characteristics were described. Mean time from assessment to death (time-to-death) was significantly less in EOL group (38.93 hours) than in non-EOL group (250.36 hours; P = .004). Mean time-to-death was not significantly different between those under EP-based EOL service or not. The ED-based EOL care had significantly more patients receiving symptomatic treatment. Interpretation: The characteristics of patients under an ED-based EOL service are described. Emergency physicians are capable of recognizing dying patients. Emergency department-based EOL service does not alter the dying process and offers adequate palliation of symptoms. Emergency physician should assume a more active role in providing adequate EOL care to suitable patients.
Follicular Cholecystitis: Reappraisal of Incidence, Definition, and Clinicopathologic Associations in an Analysis of 2550 Cholecystectomies
Authors: Saka Burcu , Memis Bahar , Seven Ipek Erbarut , Pehlivanoglu Burcin , Balci Serdar , Bagci Pelin , Reid Michelle , Dursun Nevra , Escalano Oscar Tapia , Roa Juan Carlos , Araya Juan Carlos , Kong So Yeon , Basturk Olca , Koshiol Jill , Adsay N. Volkan 
Published: May 2020

Context. Follicular cholecystitis (FC) is a poorly characterized entity. Objective. To determine its frequency/clinicopathologic associations. Design. A total of 2550 cholecystectomy specimens were examined. Two hundred three of these were consecutive routine cholecystectomies submitted entirely for microscopic examination to determine the relative frequency of incidental pathologies in gallbladders (GBs). The remainder had representative sampling. Underlying conditions were nonobstructive pathologies (1270 nonspecific cholecystitis), obstructive (62 distal biliary tract tumors, 35 primary sclerosing cholangitis, and 31 autoimmune pancreatitis), and neoplastic (n = 949). FC was defined as 3 distinct lymphoid follicles (LFs)/centimeter. Results. In the GBs totally submitted for microscopic examination, the true frequency of FC was found to be 2.5% (5/203), and in the representatively sampled group, it was 1.9%, with similar frequencies in nonobstructive, obstructive, and neoplastic cases (2.3%, 3.1%, and 1.3%, respectively, P = .77). When the 39 FC in nonneoplastic GBs contrasted with ordinary chronic cholecystitis, they were associated with older age (68 vs 49 years, P < .0001), similar gallstone frequency (68 vs 81%), female/male ratio (2.7 vs 2.6), and wall thickness (4 mm for both). None had lymphoma/parasites/ Salmonella infection. Of 17 cases who had undergone gastric biopsy, 5 had chronic gastritis (2 with Helicobacter pylori). Microscopically, the LFs were the main inflammatory process often with minimal intervening inflammation. IgG4-positive plasma cell density was low (<10/high-power field) in 21/24(87.5%) cases. Conclusions. Follicular cholecystitis is seen in 2% of cholecystectomies, typically in significantly older patients, suggesting a deranged immune response. A third of the patients reveal biopsy-proven gastritis. FC does not seem to be associated with autoimmunity, lymphoma, or obstructive pathologies.
Prognostic factors of ado-trastuzumab emtansine treatment in patients with metastatic HER-2 positive breast cancer
Authors: Tataroglu Ozyukseler Deniz , Basak Mustafa , Ay Seval , Koseoglu Aygül , Arıcı Serdar , Oyman Abdilkerim , Sürmeli Heves , Turan Merve , Turan Nedim , Odabaş Hatice , E Yıldırım Mahmut 
Published: May 2020

Background Ado-trastuzumab emtansine is an antibody-drug conjugate that combines the cytotoxic activity of emtansine with human epidermal growth factor receptor 2-targeted antitumor features of trastuzumab. Objective We conducted a study of metastatic breast cancer patients treated with trastuzumab emtansine. By evaluating progression-free survival, overall survival, and response rates, we aimed to find prognostic factors of trastuzumab emtansine treatment. Methods Our study is a single-center, retrospective, observational study. We have clinical data from 78 patients treated with trastuzumab emtansine for metastatic breast cancer, from May 2016 through May 2019, at Kartal Dr Lutfi Kirdar Education and Research Hospital, Medical Oncology Department. Our objective is to assess the survival and response rates in trastuzumab emtansine-treated individuals and the factors associated with survival. The factors we analyzed were cancer antigen 15-3 sensitivity, Eastern Cooperative Oncology Group-Performance Status, presence or absence of visceral metastases, presence or absence of cranial metastases, and treatment-associated thrombocytopenia. Results Among 78 patients, median progression-free survival was 7.8 months, and overall survival was 21.1 months. Twenty of the patients had an objective tumor response. The results showed that trastuzumab emtansine was tolerable with a manageable safety profile and consistent with the results of the previous literature. Mostly seen adverse events were anemia, thrombocytopenia, fatigue, and increased levels of alkaline phosphatase. Patients with Eastern Cooperative Oncology Group-Performance Status = 2 had worse progression-free survival and overall survival compared to ones with Eastern Cooperative Oncology Group-Performance Status < 2; progression-free survival and overall survival are worse in cancer antigen 15-3-sensitive breast cancer patients. According to our findings, treatment-associated thrombocytopenia was a significant prognostic factor for survival. Patients with thrombocytopenia had 12 months progression-free survival, whereas patients without thrombocytopenia had only 4.1 months progression-free survival. In like manner, overall survival was much better in the thrombocytopenia-experienced patients as 29.5 versus 11.8 months. Conclusions Trastuzumab emtansine prolongs progression-free survival and overall survival with a manageable safety profile. Thrombocytopenia, Eastern Cooperative Oncology Group-Performance Status, and cancer antigen 15-3 are correlated with progression-free survival and/or overall survival.
Endovascular versus surgical creation of arteriovenous fistula in hemodialysis patients: Cost-effectiveness and budget impact analyses
Authors: Rognoni Carla , Tozzi Matteo , Tarricone Rosanna 
Published: May 2020

Objectives: The aim of the present study was to perform cost-effectiveness and budget impact analyses comparing endovascular arteriovenous fistula creation to surgical arteriovenous fistula creation in hemodialysis patients from the National Healthcare Service (NHS) perspective in Italy. Methods: A systematic literature review has been conducted to retrieve complications’ rates after arteriovenous fistula creation procedures. One study comparing endovascular arteriovenous fistula creation, performed with WavelinQ device, to the surgical approach through propensity score matching was preferred to single-arm investigations to execute the economic evaluations. This study was chosen to populate a Markov model to project, on a time horizon of 1 year, quality adjusted life years and costs associated with endovascular arteriovenous fistula (WavelinQ) and surgical arteriovenous fistula options for both cohorts of incident and prevalent hemodialysis patients. Results: For both incident and prevalent hemodialysis patients, endovascular arteriovenous fistula creation, performed with WavelinQ, was the dominant strategy over surgical arteriovenous fistula approach, showing less cost and better patients’ quality of life. Compared to the current scenario, progressively increasing utilization rates of WavelinQ over surgical arteriovenous fistula creation in the next 5 years in incident hemodialysis patients are expected to save globally 30–36 million euros to the NHS. Conclusion: Endovascular arteriovenous fistula creation performed with WavelinQ could be a cost-saving strategy in comparison with the surgical approach for patients in hemodialysis. Future studies comparing different devices for endovascular arteriovenous fistula creation versus the surgical option would be needed to confirm or reject the validity of this preliminary evaluation. In the meantime, decision-makers can use these results to take decisions on the diffusion of endovascular procedures in Italy.
Discrepancy between two-dimensional and three-dimensional digital subtraction angiography for the planning of endovascular coiling of small cerebral aneurysms <5 mm
Authors: Wu Te-Chang , Tsui Yu-Kun , Chen Tai-Yuan , Ko Ching-Chung , Lin Chien-Jen , Chen Jeon-Hor , Lin Ching-Po 
Published: May 2020

Background To investigate the discrepancy between two-dimensional digital subtraction angiography and three-dimensional rotational angiography for small (<5 mm) cerebral aneurysms and the impact on decision making among neuro-interventional experts as evaluated by online questionnaire. Materials and methods Eight small (<5 mm) ruptured aneurysms were visually identified in 16 image sets in either two-dimensional or three-dimensional format for placement in a questionnaire for 11 invited neuro-interventionalists. For each set, two questions were posed: Question 1: “Which of the following is the preferred treatment choice: simple coiling, balloon remodeling or stent assisted coiling?”; Question 2: “Is it achievable to secure the aneurysm with pure simple coiling?” The discrepancies of angio-architecture parameters and treatment choices between two-dimensional-digital subtraction angiography and three-dimensional rotational angiography were evaluated. Results In all eight cases, the neck images via three-dimensional rotational angiography were larger than two-dimensional-digital subtraction angiography with a mean difference of 0.95 mm. All eight cases analyzed with three-dimensional rotational angiography, but only one case with two-dimensional-digital subtraction angiography were classified as wide-neck aneurysms with dome-to-neck ratio < 1.5. The treatment choices based on the two-dimensional or three-dimensional information were different in 56 of 88 (63.6%) paired answers. Simple coiling was the preferred choice in 66 (75%) and 26 (29.6%) answers based on two-dimensional and three-dimensional information, respectively. Three types of angio-architecture with a narrow gap between the aneurysm sidewall and parent artery were proposed as an explanation for neck overestimation with three-dimensional rotational angiography. Conclusions Aneurysm neck overestimation with three-dimensional rotational angiography predisposed neuro-interventionalists to more complex treatment techniques. Additional two-dimensional information is crucial for endovascular treatment planning for small cerebral aneurysms.
It’s Never Too Late: Neurological Outcome of Delayed Decompression in Tuberculosis of Spine
Authors: Rathod Tushar Narayan , Sathe Ashwin Hemant , Marathe Nandan Amrit 
Published: May 2020

Study Design: Retrospective observational study. Objective: To study the neurological recovery in patients with progressive neurological deficit undergoing delayed decompression and fixation in tuberculosis of spine. Methods: Retrospective analysis of 50 cases with thoracolumbar tuberculosis of spine, undergoing posterior decompression and instrumentation was done. Parameters like time interval between appearance of neurological deficit to decompression surgery, maximal spinal cord compression, neurology on admission, presence of drug resistance, and number of vertebrae involved were evaluated. The subjects were divided into 2 groups depending on neurological improvement measured with LEMS (Lower Extremity Motor Score) at the end of 1-year follow-up. Results: The mean LEMS score on admission was 27.72 (SD 12.88), which improved to 40.80 (SD 10.46) at the end of 1 year ( P < .001). A total of 26 (52%) subjects were categorized into “Satisfactory” outcome (LEMS >10) group and remaining 24 subjects formed the “nonsatisfactory” outcome group. The median time interval between the appearance of neurological deficit and decompression surgery was 23.50 days in the satisfactory group and 29.50 days ( P = .110) in the nonsatisfactory group. Maximal spinal cord compression was 0.370 in satisfactory group and 0.357 in nonsatisfactory group ( P = .754). The mean preoperative LEMS score was 34.62 in the satisfactory outcome group while that in the nonsatisfactory outcome group was 20.25 ( P < .001). Conclusion: There is significant scope for neurological improvement even after delayed decompression and fixation in cases of tuberculosis of spine with progressive neurological deficits. Preoperative neurological status was found to be the most significant determinant of postoperative neurological outcome.
The risk of multidrug- or rifampicin-resistance in malesversusfemales with tuberculosis
Authors: McQuaid C. Finn , Horton Katherine C. , Dean Anna S. , Knight Gwenan M. , White Richard G. 
Published: May 2020

Males are at an increased risk of tuberculosis (TB) disease compared to females. Additionally, several risk factors for multidrug-resistant (MDR) or rifampicin-resistant (RR) TB disease are more common in males, hence male TB patients may have a higher relative risk of MDR/RR-TB than female TB patients.We used sex-disaggregated data of TB patients reported to the World Health Organization for 106 countries to calculate male-to-female (M:F) risk ratios of having MDR/RR-TB.There was no evidence of either sex being more at risk of MDR/RR-TB in 81% (86 out of 106) of countries, with an overall random-effects weighted M:F risk ratio of 1.04 (95% CI 0.97–1.11). In 12% (13 out of 106) of countries there was evidence that males were more at risk, while in 7% (seven out of 106), females were more at risk. The risk of having TB that was MDR/RR increased for males compared to females as MDR/RR-TB incidence increased, and was higher for males than females in the former Soviet Union, where the risk ratio was 1.16 (1.06–1.28). Conversely, the risk increased for females compared to males as gross domestic product purchase power parity increased, and was higher for females than males in countries where the majority of TB burden was found in the foreign-born population, where the risk ratio was 0.84 (0.75–0.94).In general, the risk of MDR/RR-TB, among those with TB, is the same for males as for females. However, males in higher MDR/RR-TB burden countries, particularly the former Soviet Union, face an increased risk that their infection is MDR/RR-TB, highlighting the need for a sex-differentiated approach to TB case-finding and care.
Serology characteristics of SARS-CoV-2 infection after exposure and post-symptom onset
Authors: Lou Bin , Li Ting-Dong , Zheng Shu-Fa , Su Ying-Ying , Li Zhi-Yong , Liu Wei , Yu Fei , Ge Sheng-Xiang , Zou Qian-Da , Yuan Quan , Lin Sha , Hong Cong-Ming , Yao Xiang-Yang , Zhang Xue-Jie , Wu Ding-Hui , Zhou Guo-Liang , Hou Wang-Heng , Li Ting-Ting , Zhang Ya-Li , Zhang Shi-Yin , Fan Jian , Zhang Jun , Xia Ning-Shao , Chen Yu 
Published: May 2020

BackgroundTimely diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is a prerequisite for treatment and prevention. The serology characteristics and complement diagnosis value of the antibody test to RNA test need to be demonstrated.MethodSerial sera of 80 patients with PCR-confirmed coronavirus disease 2019 (COVID-19) were collected at the First Affiliated Hospital of Zhejiang University, Hangzhou, China. Total antibody (Ab), IgM and IgG antibodies against SARS-CoV-2 were detected, and the antibody dynamics during the infection were described.ResultsThe seroconversion rates for Ab, IgM and IgG were 98.8%, 93.8% and 93.8%, respectively. The first detectible serology marker was Ab, followed by IgM and IgG, with a median seroconversion time of 15, 18 and 20 days post exposure (d.p.e.) or 9, 10 and 12 days post onset (d.p.o.), respectively. The antibody levels increased rapidly beginning at 6 d.p.o. and were accompanied by a decline in viral load. For patients in the early stage of illness (0–7 d.p.o), Ab showed the highest sensitivity (64.1%) compared with IgM and IgG (33.3% for both; p<0.001). The sensitivities of Ab, IgM and IgG increased to 100%, 96.7% and 93.3%, respectively, 2 weeks later. When the same antibody type was detected, no significant difference was observed between enzyme-linked immunosorbent assays and other forms of immunoassays.ConclusionsA typical acute antibody response is induced during SARS-CoV-2 infection. Serology testing provides an important complement to RNA testing in the later stages of illness for pathogenic-specific diagnosis and helpful information to evaluate the adapted immunity status of patients.