bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cross Validation of Rainfall Characteristics Estimated from the TRMM PR, a Combined PR–TMI Algorithm, and a C-POL Ground Radar during the Passage of Tropical Cyclone and Nontropical Cyclone Events over Darwin, Australia
Authors: Deo Anil , Munchak S. Joseph , Walsh Kevin J. E. 
Published: October 2018

AbstractThis study cross validates the radar reflectivity Z; the rainfall drop size distribution parameter (median volume diameter Do); and the rainfall rate R estimated from the Tropical Rainfall Measuring Mission (TRMM) satellite Precipitation Radar (PR), a combined PR and TRMM Microwave Imager (TMI) algorithm (COM), and a C-band dual-polarized ground radar (GR) for TRMM overpasses during the passage of tropical cyclone (TC) and non-TC events over Darwin, Australia. Two overpass events during the passage of TC Carlos and 11 non-TC overpass events are used in this study, and the GR is taken as the reference. It is shown that the correspondence is dependent on the precipitation type whereby events with more (less) stratiform rainfall usually have a positive (negative) bias in the reflectivity and the rainfall rate, whereas in the Do the bias is generally positive but small (large). The COM reflectivity estimates are similar to the PR, but it has a smaller bias in the Do for most of the greater stratiform events. This suggests that combining the TMI with the PR adjusts the Do toward the “correct” direction if the GR is taken as the reference. Moreover, the association between the TRMM estimates and the GR for the two TC events, which are highly stratiform in nature, is similar to that observed for the highly stratiform non-TC events (there is no significant difference), but it differs considerably from that observed for the majority of the highly convective non-TC events.
The Action Is Everywhere, But Greater at More Localized Spatial Scales: Comparing Concentrations of Crime across Addresses, Streets, and Neighborhoods
Authors: O’Brien Daniel T. 
Published: October 2018

Objectives: Recent work has debated which geographic scale is most relevant to understanding the clustering of crime and disorder across a city. This study introduces nested Gini coefficients that help answer this question by disentangling concentrations of crime at multiple scales in a single city while also controlling for artifacts of arithmetic and urban form. Methods: The study examines six indices of crime and disorder drawn from requests for government services received by the City of Boston in 2011 for addresses ( N = 98,355) nested in street segments ( N = 13,048) nested in census tracts ( N = 178). Nested Gini coefficients assessed the average concentration at each level independent of the higher geographic unit (e.g., the streets of a single tract). Results: Concentrations were greatest at addresses, then at streets, and then at tracts. Compared to whole-city calculations, they showed equal or greater levels of concentration of crime and disorder for addresses, but lower concentrations for streets. Controlling for the number of locations on a street or in a tract also markedly diminished concentrations. Conclusions: The findings indicate a continued need to explain concentrations of crime, especially at localized geographic scales.
Guess the weight: the accuracy of estimated weight for surgical admissions – a comparison study
Authors: Thomas Rachel AB , Empey Julie-Ann , Seth Subodh , Crozier Joseph 
Published: October 2018

Background and aims An accurate body weight is vital for safe dosing of many drugs. Weight is often unavailable for emergency admissions and an estimation is used. Emergency Department staff are poor at estimating patient weight, but no data existed for surgical admissions. This study assesses the reliability of weight estimation by patients and healthcare workers. Methods and results All emergency surgical patients admitted during one week were approached. If consented, four healthcare workers (consultant, foundation doctor, nurse, support worker) independently estimated their weight. The patients then gave their estimate. Actual weight was measured and data analysed. Seventy-two consecutive surgical admissions were included, aged 16–95 and 52% male. Healthcare workers correctly (within ±10% margin) estimated the weight for only 57% of patients. Further statistical analysis confirmed that staff are inaccurate estimators and patients are better at estimating their own weight (p < 0.006). Conclusions Staff are poor at estimating weight and the study was unable to show statistical superiority of any professional group when guessing weights. There was also a tendency for staff to increasingly under-estimate as weight increases. Patients are the most accurate estimators, but self-reporting is still too unreliable for drug dosing and should stop.
Assessment of three methods for removing massive air in a cardiopulmonary bypass circuit: simulation-based multi-discipline training in West China Hospital
Authors: Liu Ting , Qin Zhen , Luo Ming , Tan Zhao-Xia , Xiong Ji-Yue , Gu Gang-Jian , Yu Xiang , Li Qi , Zhou Rong-Hua 
Published: October 2018

Background and Objective: A multi-discipline cardiac and cardiopulmonary bypass (CPB) team simulation scenario was established to compare three different de-airing approaches dealing with massive air embolism in CPB, so as to formulate a standardized procedure to handle this adverse acute event more proficiently and ensure clinical safety. Method: A simulation-based clinical CPB massive air embolism scenario was developed by a cardiac and CPB team. Study Objects: Five licensed perfusionists and five CPB trainees were matched randomly into five pairs. Each pair would simulate the three different de-airing approaches separately as followed: (1) Conventional Method: arterial line filter (ALF) de-airing purge line and oxygenator self-recirculation bypass were used to de-air; (2) Arterial-Venous Loop (A-V Loop) Method: surgeons reconnected the arterial and venous lines to de-air by restoring the original priming A-V loop configuration; (3) Isolation of the ALF Method: this ensures de-bubbling of the CPB circuit, but bypasses the ALF function. Assessment Criteria: (1) Times to recovery (duration of the circulation suspension); (2) Subjective evaluation of skill and non-skill performances. Results: As to times to recovery, the Conventional Method group took 290.6 s ± 36.2, the A-V Loop Method group took 196.8 s ± 52.0 and the Isolation of ALF group took 99.4 s ± 15.1. The statistical difference is significant among the three groups (p<0.01). The subjective evaluation of training performance indicates that this simulation-based training is effective in assessing both skill and non-skill abilities. Conclusion: CPB simulation-based training was effective in comparing de-airing strategies and can instruct perfusion practices how to optimize techniques. For well-trained, multi-discipline cardiac teams, the A-V Loop Method is highly efficient and reliable in managing CPB massive air embolism. For cardiac teams that do not have this sophisticated training, the Isolation of ALF Method should be their alternative option.
Performance changes of venous valves following tissue treatment with novel in vitro system
Authors: Easson Garrett , Laughlin Megan , Jensen Hanna , Haney Kevin , Girardot Marc , Jensen Morten 
Published: October 2018

Objectives The purpose of this study is to test venous valve performance and identify differences between native tissue and replacement devices developed with traditional tissue treatment methods using a new in vitro model with synchronized hemodynamic parameters and high-speed valve image acquisition. Methods An in vitro model mimicking the venous circulation to test valve performance was developed using hydrostatic pressure driven flow. Fresh and glutaraldehyde-treated vein segments were placed in the setup and opening/closing of the valves was captured by a high-speed camera. Hemodynamic data were obtained using synchronized hardware and virtual instrumentation. Results Geometric orifice area and opening/closing time of the valves was evaluated at the same hemodynamic conditions. A reduction in geometric orifice area of 27.2  ± 14.8% (p < 0.05) was observed following glutaraldehyde fixation. No significant difference in opening/closing time following chemical fixation was observed. Conclusions The developed in vitro model was shown to be an effective method for measuring the performance of venous valves. The observed decrease in geometric orifice area following glutaraldehyde treatment indicates a decrease in flow through the valve, demonstrating the consequences of traditional tissue treatment methods.
Percutaneous sclerotherapy of para-orbital and orbital venous malformation: A single center, case series
Authors: Ahmad Saima , Akhtar Fahd Kamal 
Published: October 2018

Purpose To present a case series of percutaneous sclerotherapy of para-orbital and orbital venous malformations. Method Seven patients with venous malformations in the orbital and para-orbital region were reviewed. Puncture venogram was performed on all patients and image guided bleomycin injections using biplane digital subtraction in angiography suite. Results Average age of patients at the time of the procedure was 22 years old with the youngest being five years of age and the oldest being 50 years. Follow-ups ranged from 3 months to 18 months and the average follow-up duration was 13 months. The patients had no intraprocedural complications and reported symptomatic relief of pain as per the last follow-up. Patients have shown no symptoms or signs of recurrence of lesions with uneventful recovery so far. Conclusions Percutaneous sclerotherapy of orbital Venous Malformations with bleomycin is a safe and well-controlled procedure done in real time; it has no major systemic adverse side effects and higher efficacy than other sclerosing agents.
Publication of UK NICE Clinical Guidelines 168 has not significantly changed the management of leg ulcers in primary care: An analysis of The Health Improvement Network database
Authors: Davies Huw OB , Popplewell Matthew , Bate Gareth , Ryan Ronan P , Marshall Tom P , Bradbury Andrew W 
Published: October 2018

Background NICE Clinical Guidelines (CG) 168, published in July 2013, recommend specialist vascular referral for all leg ulcers, defined as a break in the skin below the knee that has not healed within two weeks. Aim To examine the impact of CG168 on the primary care management of leg ulcers using The Health Improvement Network database. Methods An eligible population of approximately two million adult patients was analysed over two 18-month periods before and after publication of CG168. Those with a new diagnosis of leg ulcers in each time period were analysed in terms of demographics, specialist referral and superficial venous ablation. Results We identified 7532 and 7462 new diagnoses of leg ulcers in the pre- and post-CG168 cohorts, respectively. Patients with a new diagnosis of leg ulcers were elderly (median age: 77 years both cohorts) and less likely to be male (47% both cohorts). There were 2259 (30.0%) and 2329 (31.2%) vascular service referrals in the pre- and post-CG168 cohorts, respectively (hazard ratio, 1.05, 95% CI: 0.99, 1.11, p = 0.096). The median interval between general practitioner diagnosis and referral was 1.5 days in both cohorts. Patients from both cohorts who were referred for a new diagnosis of leg ulcers were equally likely to receive superficial venous ablation. Conclusions Disappointingly, we have been unable to demonstrate that publication of NICE CG168 has been associated with a meaningful change in leg ulcer management in primary care in line with guideline recommendations.
The effectiveness and safety of biological therapeutics in juvenile-onset systemic lupus erythematosus (JSLE): a systematic review
Authors: Peterknecht E , Keasey M P , Beresford M W 
Published: October 2018

Objective To systematically review and summarize the available literature regarding the effectiveness and safety of biologics in the treatment of juvenile-onset systemic lupus erythematosus. Methods PubMed was systematically searched for relevant literature (2012–2017 inclusive) using the following criteria: (1) patients diagnosed with juvenile-onset systemic lupus erythematosus (≤18 years at diagnosis); (2) treatment with any biological agent; and (3) outcome measures assessing effectiveness and safety. Systematic literature reviews, meta-analyses, randomized controlled trials, cohort studies, case control studies, cross sectional surveys and case-series with ≥3 patients were included. Independent extraction of articles by two authors using predefined criteria was performed. The quality of each study was assessed using CASP tools and Oxford CEBM Levels of Evidence. Results Nine articles met inclusion criteria: six cohort studies, two case series and one pilot study, totalling 230 patients. All but one article reported the effects of rituximab, the other those of belimumab. Overall, patients had active disease refractory to standard of care regimens using corticosteroids and immunosuppressants. Available evidence for rituximab demonstrated improvements in disease activity, complement levels and anti-dsDNA titres accompanying a steroid-sparing effect. Conclusion Rituximab can be considered an effective treatment in juvenile-onset systemic lupus erythematosus patients with severe disease manifestations and/or refractory disease. Based on current evidence, use of belimumab in juvenile-onset systemic lupus erythematosus patients cannot be recommended. The long-term safety of these biological agents remains uncertain. Further prospective studies, ideally robust randomized controlled trials, are urgently needed to obtain more accurate data on the effectiveness and long-term safety of rituximab, belimumab and other biologics in juvenile-onset systemic lupus erythematosus.
Increased CD4+CD25-Foxp3+ T cells in Chinese systemic lupus erythematosus: correlate with disease activity and organ involvement
Authors: Yin Z-J , Ju B-M , Zhu L , Hu N , Luo J , He M , Feng X-Y , Lv X-H , Pu D , He L 
Published: October 2018

Objective The increment of CD4+CD25−Foxp3+T cells has been reported in systemic lupus erythematosus (SLE) patients. However, the exact identity of this T cell subset is still unclear. Thus, we analyzed CD4+CD25−Foxp3+T cells and Treg cells (CD4+CD25+Foxp3+ T cells) in a large sample of Chinese SLE patients in different disease states. Methods A total of 280 SLE patients and 38 healthy volunteers were enrolled, which included 21 patients with untreated new-onset lupus (UNOL), 13 patients with drug withdrawal more than 6 months and 246 patients with treatments. Phenotypic and functional analysis of peripheral blood CD4+CD25−Foxp3+ T cells and Treg cells were performed by flow cytometry. The correlation of CD4+CD25−Foxp3+T cells and Treg cells with disease activity, clinical indicators and organ involvement were analyzed. Results CD4+CD25−Foxp3+ T cells and Treg cells were significantly increased in SLE patients and showed significantly positive correlations with disease activity. CD4+CD25−Foxp3+ T cells were significantly increased in patients with skin and hematologic involvement as well as arthritis. Diverse changes between CD4+CD25−Foxp3+ T cells and Treg cells when faced with different medications, especially HCQ and MMF. CD4+CD25−Foxp3+ T cells expressed more IFN-γ and less CTLA-4 than CD4+CD25+Foxp3+ T cells, which were similar to CD4+CD25+Foxp3− T cells, and expressed similar IL-17, ICOS and Helios to CD4+CD25+Foxp3+ T cells. The synthesis capacity of IL-10 of CD4+CD25−Foxp3+ T cells and the expression of GITR on CD4+CD25−Foxp3+ T cells were between CD4+CD25+Foxp3+ and CD4+CD25+Foxp3− T cells. Conclusions Our results indicate that increased CD4+CD25−Foxp3+ T cells in lupus patients, which combined the features of suppression and pro-inflammatory, may serve as a biomarker for disease activity and organ involvement in SLE.
The relationship amongst ethical position, religiosity and self-identified culture in student nurses
Authors: White Jane H , Peirce Anne Griswold , Jacobowitz William 
Published: October 2018

Background/purpose: Research from other disciplines demonstrates that ethical position, idealism, or relativism predicts ethical decision-making. Individuals from diverse cultures ascribe to various religious beliefs and studies have found that religiosity and culture affect ethical decision-making. Moreover, little literature exists regarding undergraduate nursing students’ ethical position; no studies have been conducted in the United States on students’ ethical position, their self-identified culture, and intrinsic religiosity despite an increase in the diversity of nursing students across the United States. Participants and Research Context Objectives: The study’s two aims were to determine the relationship of self-identified culture, religiosity, and ethics position of undergraduate nursing student and whether students’ level of education and past ethics courses taken related to idealism. Two hundred and twelve volunteer undergraduate students participated. Research design: A descriptive cross-sectional study was designed for participants who completed the Ethical Position Questionnaire, The intrinsic subscale of the Religious Orientation Scale, and a Demographic, Cultural, Ethnicity Form. To test the five hypotheses, analyses included t-tests, correlations, and ANOVA. Ethical Considerations: The study was approved by the Institutional Review Board at Adelphi University. Results: Idealism and intrinsic religiosity were significantly related. Differences were observed for intrinsic religiosity and idealism for cultural identity and cultural dimensions such as parents’ place of birth, and if participants were US born. Students’ level of education or participation in past courses on ethics did not influence idealism. Conclusions: The study’s findings were similar to most of the research from other disciplines on culture, ethics position, and religiosity. Generic courses on ethics taken prior to clinical work may not assist nursing students in integrating principles into complex ethical dilemmas. Self-identified culture, religion, and intrinsic religiosity related to ethics position; completing ethics courses and level of education, juniors compared with seniors, did not influence idealism. Faculty should consider integrating students’ culture, religious orientation, and ethics position into teaching ethics for all levels of nursing education.
Evaluating ethical sensitivity in surgical intensive care nurses
Authors: Basar Zehra , Cilingir Dilek 
Published: October 2018

Background and aim: Surgical intensive care nurses should have ethical sensitivity allowing them to identify ethical issues in order that they can recognize them and make the right decisions. This descriptive study was conducted with the aim of evaluating the ethical sensitivity of surgical intensive care nurses. Materials and methods: The research was carried out with the participation of 160 nurses in six Turkish hospitals, four state, one university, and one private. The data were collected using the “Nurse Description Form” developed by the researcher and the “Ethical Sensitivity Questionnaire.” The percent, mean, standard deviation, median, minimum and maximum values, significance test for the difference between two means, variance analysis, Mann–Whitney U test, and Kruskal–Wallis Variance Analysis test were used to evaluate the data. Ethical considerations: Ethical commission permission and the corporate permission of the hospitals were received before conducting the research. Results: It was determined that the ethical sensitivities of surgical intensive care nurses were moderate based on the Ethical Sensitivity Questionnaire total score and subdimension score averages. A statistical difference was determined between the Ethical Sensitivity Questionnaire total score of surgical intensive care nurses and the institution where they worked, the period of working in the occupation, and the period of working in the intensive care unit (p < 0.05). Conclusion: Based on the results of the research, the organization of training and studies devoted to the elimination of ethical sensitivity differences between institutions and workers is suggested.
The relationship amongst student nurses’ values, emotional intelligence and individualised care perceptions
Authors: Culha Yeliz , Acaroglu Rengin 
Published: October 2018

Background: Students’ gaining and adopting basic professional values, improving their emotional intelligence skills during the process of nursing education plays a significant role on meeting the needs of healthy/patient individual and his or her family, and individualized care practices. Objectives: This (descriptive, correlational) research was carried out to evaluate the nursing values, emotional intelligence levels, and individualized care perceptions of senior nursing students and to determine the relationship between them. Research question: (1) What is the status of students to adopt nursing values? (2) What is the level of students’ emotional intelligence? (3) What is the students’ individualized care perception? (4) Is there a relationship between students’ nursing values, levels of emotional intelligence, and individualized perceptions of care? Participants and research context: The research was carried out with 218 senior nursing students at the Faculty of Nursing, affiliated to a state university in Istanbul, who agreed to participate in the study, completing basic nursing education in May 2017. Ethical considerations: Ethical approval for this study was obtained from the Ethics Committee of Clinical Investigations of the Istanbul University Dentistry Faculty. Written permission was also obtained from the institution that research would be conducted. Before the data were collected, verbal permission was obtained by the investigator. Findings: It was observed that nursing values perceptions of students, emotional intelligence levels and individualized care perceptions were at a good level and there was a supportive relationship between them in the positive direction. It was determined that emotional intelligence skills of students, adoption of nursing values and individualized care perceptions increased in parallel with each other. Conclusion: In nursing education, nursing values peculiar to affective field, caring behaviors, and emotional intelligence skills that are guiding to maintain and direct these behaviors should be gained to students by supporting with correct learning methods and role models.