bluuebunny/crossref_metadata_2025_split huggingface dataset:
From siphonophores to deep scattering layers: uncertainty ranges for the estimation of global mesopelagic fish biomass
Authors: Proud Roland , Handegard Nils Olav , Kloser Rudy J , Cox Martin J , Brierley Andrew S 
Published: March 2018

AbstractThe mesopelagic community is important for downward oceanic carbon transportation and is a potential food source for humans. Estimates of global mesopelagic fish biomass vary substantially (between 1 and 20 Gt). Here, we develop a global mesopelagic fish biomass model using daytime 38 kHz acoustic backscatter from deep scattering layers. Model backscatter arises predominantly from fish and siphonophores but the relative proportions of siphonophores and fish, and several of the parameters in the model, are uncertain. We use simulations to estimate biomass and the variance of biomass determined across three different scenarios; S1, where all fish have gas-filled swimbladders, and S2 and S3, where a proportion of fish do not. Our estimates of biomass ranged from 1.8 to 16 Gt (25–75% quartile ranges), and median values of S1 to S3 were 3.8, 4.6, and 8.3 Gt, respectively. A sensitivity analysis shows that for any given quantity of fish backscatter, the fish swimbladder volume, its size distribution and its aspect ratio are the parameters that cause most variation (i.e. lead to greatest uncertainty) in the biomass estimate. Determination of these parameters should be prioritized in future studies, as should determining the proportion of backscatter due to siphonophores.
Operation Pacific Haven: Humanitarian Medical Support for Kurdish Evacuees
Authors: Rumbaugh Jack R. 
Published: March 2018

Abstract
This article reviews the medical aspects of the humanitarian assistance mission Joint Task Force Operation Pacific Haven from September 1996 to April 1997. It reviews the effectiveness of the deployable medical units used to support the medical screening, treatment, and processing of more than 6,600 Kurdish evacuees applying for political asylum in the United States. The distinct cultural mores and language barriers of the Kurdish population made the provision of even basic medical care a challenge. Designed for combat service support, these deployable medical units were successful in the performance of the comprehensive public health and humanitarian assistance medical support mission because of the support of two on-island military treatment facilities. In short, for military medicine to successfully conduct humanitarian assistance and/or disaster relief missions, deployable medical units need to be designed, equipped, staffed, and trained to perform these operations.
The Health and Physical Readiness of Army Reservists: A Current Review of the Literature and Significant Research Questions
Authors: Wynd Christine A. , Ryan-Wenger Nancy A. 
Published: March 2018

Abstract
Individual soldier combat readiness through enhanced physical fitness is a major emphasis in the United States military today. Unfortunately, the prevalence of cigarette smoking, alcohol abuse, and other poor health practices continues to be reported at higher rates for active duty military personnel than for civilian populations. There is a dearth of research about health and fitness in the Army Reserve. Changing trends point toward more rapid mobilization of reservists for peacekeeping and combat missions throughout the world; however, it is important to remember that the Army Reserve is unique in its blending of both military and civilian occupational environments. The purpose of this paper is to review the current literature regarding Army Reserve health behaviors and physical readiness. Examples of significant future research questions are provided. More studies are needed to assess both individual motivational activities and organizational values that enhance health-promoting efforts. Interventions can then be designed to eliminate impediments to health and endorse specific organizational values and interpersonal skills that increase healthy behaviors.
Physiological Effects of Thermal Stress on Aviators Flying a UH-60 Helicopter Simulator
Authors: Reardon Matthew , Fraser Beth , Omer Julia 
Published: March 2018

Abstract
An evaluation of the physiological effects on aviators of heat stress (90°F wet bulb globe temperature [WBGT]) versus a cooler condition (70°F WBGT) when wearing either a MOPPO (Mission-Oriented Protective Posture 0) uniform or a MOPP4 ensemble encumbered with a ballistic chest plate and overwater survival gear was performed at the United States Army Aeromedical Research Laboratory. The study used a repeated-measures design with 14 aviators flying 4-hour missions in a UH-60 helicopter simulator. Average crew endurance in the MOPP4-hot condition was reduced to one-third of the fully completed mission time of 309 minutes. For the hot condition, core temperature in the simulator rose 1.4°F/hour when aviators wore the encumbered MOPP4 ensemble versus 0.27°F/hour when they wore the MOPPO uniform. Sweating rate in the MOPP4-hot condition was 1,523 ml/hour, resulting in 2.5% dehydration, in contrast to 183 ml/hour and 0.9% dehydration in the MOPP4-cool condition. In this study, pilots flying realistic UH-60 simulator sorties rapidly incurred significant physiological heat strain when wearing an encumbered MOPP4 flight ensemble in hot cockpit conditions.
A New Wellness Center Concept: Integration of the Physical Therapy and the Morale, Welfare, and Recreation Departments
Authors: Woodhead Alfred B. 
Published: March 2018

Abstract
This case study describes the implementation of a wellness center based on the integration of a Navy outpatient physical therapy department and a morale, welfare, and recreation cardiovascular center. The logistics and services provided are discussed. The productivity of the physical therapy department based on the monthly number of patient treatments is assessed. A statistically significant increase in patient visits of 38% above the previous year was noted. The newly established cardiovascular center averaged 1,500 client visits monthly. This unique collaboration appears to hold promise as an effective wellness center concept.
High-Velocity Gunshot Wounds to the Head and Neck: A Review of Wound Ballistics
Authors: Yetiser Sertac , Kahramanyol Mustafa 
Published: March 2018

Abstract
Patients who sustain gunshot injuries to the head and neck face heavy tissue damage and eventually life-threatening conditions. A very significant factor that determines the degree of injury is the course and extent of the missile track. The missile track is well correlated with bullet structure, size, and velocity, which have distinct features in civilian and military firearm injuries. The missile entrance or exit wound may be out of sight in some injuries, and often it is difficult to predict the severity of the injury in the chaotic circumstances of the battlefield. We studied the wound ballistics in five soldiers who suffered penetrating cranial and cervical firearm injuries.
Dark matter dynamics in Abell 3827: new data consistent with standard cold dark matter
Authors: Massey Richard , Harvey David , Liesenborgs Jori , Richard Johan , Stach Stuart , Swinbank Mark , Taylor Peter , Williams Liliya , Clowe Douglas , Courbin Frédéric , Edge Alastair , Israel Holger , Jauzac Mathilde , Joseph Rémy , Jullo Eric , Kitching Thomas D , Leonard Adrienne , Merten Julian , Nagai Daisuke , Nightingale James , Robertson Andrew , Romualdez Luis Javier , Saha Prasenjit , Smit Renske , Tam Sut-Ieng , Tittley Eric 
Published: March 2018

AbstractWe present integral field spectroscopy of galaxy cluster Abell 3827, using Atacama Large Millimetre Array (ALMA) and Very Large Telescope/Multi-Unit Spectroscopic Explorer. It reveals an unusual configuration of strong gravitational lensing in the cluster core, with at least seven lensed images of a single background spiral galaxy. Lens modelling based on Hubble Space Telescope imaging had suggested that the dark matter associated with one of the cluster's central galaxies may be offset. The new spectroscopic data enable better subtraction of foreground light, and better identification of multiple background images. The inferred distribution of dark matter is consistent with being centred on the galaxies, as expected by Λ cold dark matter. Each galaxy's dark matter also appears to be symmetric. Whilst, we do not find an offset between mass and light (suggestive of self-interacting dark matter) as previously reported, the numerical simulations that have been performed to calibrate Abell 3827 indicate that offsets and asymmetry are still worth looking for in collisions with particular geometries. Meanwhile, ALMA proves exceptionally useful for strong lens image identifications.
Perspectives on symptom experiences and symptom reporting among individuals on hemodialysis
Authors: Flythe Jennifer E , Dorough Adeline , Narendra Julia H , Forfang Derek , Hartwell Lori , Abdel-Rahman Emaad 
Published: March 2018

ABSTRACT

Background
Individuals on hemodialysis bear substantial symptom burdens, but providers often underappreciate patient symptoms. In general, standardized, patient-reported symptom data are not captured during routine dialysis care. We undertook this study to better understand patient experiences with symptoms and symptom reporting. In exploratory interviews, we sought to describe hemodialysis nurse and patient care technician perspectives on symptoms and symptom reporting.

Methods
We conducted semi-structured interviews with 42 US hemodialysis patients and 13 hemodialysis clinic personnel. Interviews were conducted between February and October 2017 and were analyzed using thematic analysis.

Results
Seven themes were identified in patient interviews: (i) symptoms engendering symptoms, (ii) resignation that life is dependent on a machine, (iii) experiencing the life intrusiveness of dialysis, (iv) developing adaptive coping strategies, (v) creating a personal symptom narrative, (vi) negotiating loss of control and (vii) encountering the limits of the dialysis delivery system. Overall, patient symptom experiences and perceptions appeared to influence symptom-reporting tendencies, leading some patients to communicate proactively about symptoms, but others to endure silently all but the most severe symptoms. Three themes were identified in exploratory clinic personnel interviews: (i) searching for symptom explanations, (ii) facing the limits of their roles and (iii) encountering the limits of the dialysis delivery system. In contrast to patients, clinic personnel generally believed that most patients were inclined to spontaneously report their symptoms to providers.

Conclusions
Interviews with patients and dialysis clinic personnel suggest that symptom reporting is highly variable and likely influenced by many personal, treatment and environmental factors.
Delays in diagnosis for children with newly diagnosed central nervous system tumors
Authors: Coven Scott L , Stanek Joseph R , Hollingsworth Ethan , Finlay Jonathan L 
Published: March 2018

Abstract

Background
United States studies documenting time interval from symptom onset to definitive diagnosis for childhood central nervous system (CNS) tumors are more than a quarter-century old. The purpose of this study is to establish an accurate and contemporary Ohio baseline of the diagnostic interval for children with newly diagnosed CNS tumors.

Methods
Medical records were retrospectively reviewed for 301 children with newly diagnosed CNS tumors from January 2004 to August 2015 at Nationwide Children’s Hospital. We obtained comprehensive data on 171 patients (56.8%). Records were reviewed for age, gender, tumor type, presenting symptoms, number of health care visits prior to diagnosis, time interval (in months) from onset of symptoms to definitive diagnosis, and any associated genetic syndromes.

Results
Of the 171 patients with newly diagnosed CNS tumors, 25 children (14.6%) had a known cancer predisposition syndrome (all with neurofibromatosis type 1). Among the remaining 146 children, the median and mean time intervals from symptom onset to definitive diagnosis were 42 days and 138 days (range < 1 to 2190 days), respectively.

Conclusions
We have documented and quantified the contemporary delays in diagnosis of childhood brain tumors in central Ohio to serve as a benchmark for our future planned interventions to reduce the time interval from symptom onset to diagnosis through adaptation of the United Kingdom HeadSmart program throughout the state of Ohio and ultimately throughout the United States.
Symptomatic Acute Toxoplasmosis in Returning Travelers
Authors: Henao-Martínez Andrés F , Franco-Paredes Carlos , Palestine Alan G , Montoya Jose G 
Published: March 2018

Abstract
We report a family who acquired acute toxoplasmosis after a trip to Central America. One member developed severe clinical manifestations including bilateral chorioretinitis, hepatitis, and myocarditis requiring therapy. Symptomatic acute toxoplasmosis is unusual and possesses a diagnostic challenge. We discuss the clinical and epidemiological implications, laboratory diagnosis, and treatment plan.
Is there an association between psychological factors and developing complex regional pain syndrome after an ankle fracture?
Authors: Alluri Ram K. , Bouz Gabriel , Foster Brock , Wang Christopher , Marecek Geoffrey , Tan Eric W. 
Published: March 2018

Background:
The purpose of this study was to evaluate the association between psychological dysfunction and developing complex regional pain syndrome (CRPS) after an ankle fracture.

Methods:
The PearlDiver database was used to identify patients who sustained an ankle fracture and developed CRPS based on the presence or absence of psychological disorders.

Results:
Results of the database identified 163,529 patients who sustained an ankle fracture, and CRPS was identified in 10,127 (6.2%) of these patients. The risk of developing CRPS after an ankle fracture was significantly elevated, with an odds ratio (OR) of 5.44 (P<0.0001) in patients with a psychological disorder. There was no additional risk (OR 0.98, P=0.31) for developing CRPS in patients with a psychological disorder who underwent operative management.

Conclusions:
In patients with known psychological comorbidities who sustain an ankle fracture and have atypical posttraumatic pain, there should be elevated suspicion for CRPS.
One Brace: One Visit: Treatment of Pediatric Distal Radius Buckle Fractures With a Removable Wrist Brace and No Follow-up Visit
Authors: Kuba Megan H.M. , Izuka Byron H. 
Published: March 2018

Background:
Previous studies have showed the efficacy of removable brace treatment for distal radius buckle fractures in children, whereas others have independently suggested that these injuries do not require additional radiographic imaging. However, no study has sought to collectively determine whether treating pediatric distal radius buckle fractures with a removable brace and no follow-up visit or imaging after the initial visit is a safe and satisfactory protocol.

Methods:
In total, 42 consecutive patients with a distal forearm buckle fracture seen by a single fellowship trained pediatric orthopaedic surgeon were eligible to participate. Two patients refused participation, yielding 40 patients treated with a standard protocol of immobilization with a removable wrist brace for a prescribed period of time with no additional imaging or clinical follow-up. Two staggered telephone surveys were then conducted. The first survey was conducted within 1 week of the designated brace-removal date to determine the exact date the brace was discontinued. The second survey was conducted 5 to10 months postinjury to determine patient outcomes and parent satisfaction.

Results:
In total, 100% of patients were reached for the initial survey and 90% (36/40) of patients were reached for the secondary survey. There were no complications, including refracture or residual pain, following treatment. In total, 100% of parents felt their child had returned to full and normal function and all said they would choose to have the same treatment again. In total, 67% of parents would have had to take time off from work and 77% of children would have missed school if they had hypothetically been required to attend a follow-up appointment.

Conclusion:
Treatment of pediatric distal forearm buckle fractures with a removable wrist brace and no follow-up visit or radiographs results in both excellent patient outcomes and parental satisfaction.

Level of Evidence:
Level IV—case series.
Integrative Music Therapy
Authors: Barnes Thomas Bryan 
Published: March 2018

ABSTRACT:
Music plays a significant role in the lives of individuals across the lifespan. Some healthcare providers may not appreciate music therapy and the positive benefits it can have on the environment, patients, caregivers, and healthcare staff. Integrative Music Therapy (IMT) has proven to be effective in multiple settings, offering therapy for behavioral, emotional, physiological, psychological, and psychosocial needs. IMT, performed by a trained, certified professional (MT-BC), does not seek to replace medication or other procedures, but works synergistically with provided healthcare.
Student Perceptions of Spirituality and Spiritual Care
Authors: Kroning Maureen 
Published: March 2018

ABSTRACT
Nurse educators must equip students with beginning skills of assessment, communication, and awareness of spiritual care. Barriers to spiritual care—lack of time or of space, inadequate training—reduce nurses' provision of spiritual care. Nursing students observe patient needs for spiritual care, but often are not skilled or comfortable offering spiritual care. This article relays observations of 28 senior nursing students about spirituality and spiritual care with implications for teaching.
Preradiotherapy Tumor Volume in Local Control of Squamous Cell Carcinoma of the Supraglottic Larynx
Authors: Nurkic Sommer , Nurkic Tarik , Morris Christopher G. , Amdur Robert J. , Mendenhall William M. 
Published: March 2018

Objectives:
Examine the utility of pretreatment computed tomography in predicting local control (LC) in squamous cell carcinoma of the supraglottic larynx treated with primary radiotherapy (RT).

Methods:
In total, 167 patients treated between 1983 and 2013 were reviewed. Patients had received pretreatment diagnostic computed tomographic imaging of the larynx and neck from which primary tumor volume (PrTV) was delineated. LC, larynx function at last follow-up, and RT complications were recorded. PrTV was evaluated with respect to outcome.

Results:
In this study, median age was 61 years, and mean follow-up was 96 months. In total, 43% had T1-T2, 46% had T3, and 11% had T4 disease; 49% had N0 disease. Median tumor volume, 5.1 cm3 (0.4 to 188 cm3). Mean dose, 74 Gy; 20% received concurrent chemotherapy. Overall, 10-year LC was 78.9%. Ten-year LC stratified by tumor volume was: 0 to 4.9 cm3, 90.8%; 5 to 8.9 cm3, 67.3%; and >9 cm3, 69.4%. Ten-year LC with preserved larynx function was: 0 to 4.9 cm3, 76.7%; 5 to 8.9 cm3, 61.5%; and >9 cm3, 53.4%. LC and LC with preserved larynx function was significantly different between PrTV groups (P<0.001). On multivariate analysis, PrTV was a significant predictor of LC and LC with preserved larynx function (P<0.005). Six patients developed soft tissue necrosis; 2 suffered fatal carotid blowouts. Patients with grade 5 complications received concomitant chemotherapy. Four patients required total laryngectomy; 14 required permanent tracheostomy or gastrostomy tube.

Conclusion:
Pretreatment PrTV helps identify patients most likely to experience LC with primary RT alone or combined chemoradiation. LC for supraglottic larynx squamous cell carcinoma is optimal if the PrTV is <5.0 cm3.
Emphasis on Systemic Therapy in Women With Pelvic Bone Metastasis at Time of Diagnosis of Cervical Cancer
Authors: Manders Dustin B. , Sims Travis T. , Albuquerque Kevin V. , Carlson Matthew J. , Richardson Debra L. , Kehoe Siobhan M. , Miller David S. , Lea Jayanthi S. 
Published: March 2018

Objective:
Cervical cancer presenting with metastases to the bony pelvis is rare. No available literature addresses the treatment and prognosis of these patients. Our objective was to review our experience treating women with this rare presentation.

Methods:
We performed a review of all patients treated for cervical cancer at a single institution between January 1, 2007 and November 30, 2014. All patients had pretreatment imaging with computed tomography or positron emission tomography/computed tomography. Included patients had evidence of pelvic bone metastases by imaging before initiation of treatment.

Results:
A total of 349 women were treated for cervical cancer during the study interval. Of these, 13 (3.7%) were identified as having pelvic bone metastases at initial presentation. Four of 13 patients had pelvic-confined disease and were treated with curative-intent radiation. The remainder had disseminated disease and were treated with palliative radiation. Only one complete response was seen. Seven patients received salvage chemotherapy. The median overall survival was 8.5 months. Survival was statistically similar in those who received palliative rather than curative radiotherapy (8.7 vs. 8.1 mo, P=0.76) and in those who received any postradiation chemotherapy (8.9 vs. 6.1 mo, P=0.066). Chemotherapy with bevacizumab resulted in the only 2 long-term survivors (both alive at 32.4 and 37.5 mo). All others have died of disease.

Conclusions:
Cervical cancer metastatic to the bony pelvis at initial presentation portends a dismal prognosis. Patients should be informed about this poor prognosis, and allowed to make an informed decision when considering curative-intent versus palliative treatment. Incorporation of bevacizumab appears to improve survival.
Parental Perception of Flourishing in School-Aged Children: 2011–2012 National Survey of Children's Health
Authors: Kandasamy Veni , Hirai Ashley H. , Ghandour Reem M. , Kogan Michael D. 
Published: March 2018

ABSTRACT:

Objective:
Flourishing reflects positive mental health and thriving and is important for children's development and well-being. Few national studies of flourishing among school-aged children exist. Exposure to socioeconomic disadvantage is negatively associated with social and health outcomes, including flourishing. This analysis describes independent associations of the child, family, school, and neighborhood factors with flourishing, which we hypothesized may contribute to sociodemographic disparities.

Methods:
Data from the 2011–2012 National Survey of Children's Health were used to examine parental perception of flourishing among school-aged children (6–17 years of age; n = 59,362). Flourishing was defined as curiosity about learning, resilience, and self-regulation. Unadjusted and adjusted associations between sociodemographic, child, family, school and neighborhood factors and flourishing were explored using χ2 tests and sequential logistic regression models.

Results:
Overall, 48.4% of school-aged children were perceived by parents to be flourishing. There were significant sociodemographic disparities with non-Hispanic black children (37.4%) and those below the federal poverty level (37.9%) among the least likely to flourish. After adjustment, sex, race/ethnicity, parent education, child's age, physical activity, special health care needs status, adequate sleep, adverse childhood experiences, family meals, hours of television watched, extracurricular activities, school safety, neighborhood safety, neighborhood support, and presence of amenities were significantly associated with flourishing (p < 0.05). Disparities by poverty level and household structure were no longer significant.

Conclusion:
Addressing factors associated with parent-perceived flourishing including child, family, school and neighborhood factors such as physical activity, adequate sleep, and school/neighborhood safety may promote flourishing and reduce disparities.