bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical–Statistical Model for Summer Extreme Temperature Events over South Korea
Authors: Lim Won-Il , Seo Kyong-Hwan 
Published: January 2019

AbstractExtreme temperature events have a significant impact on human life and property. Since the Korean Peninsula is affected by the high variability of the East Asian summer monsoon system, it is difficult to predict extreme temperature events skillfully. Here, we construct an empirical model to investigate the interannual variation of the frequency of summer extreme temperature events over South Korea by identifying predictors (explanatory variables) from ocean boundary conditions. The selected explanatory variables are sea surface temperature anomalies (SSTAs) over the North Atlantic, the western North Pacific, and the eastern North Pacific. The cross-validated correlation skill of the statistical model constructed using a 23-yr dataset is estimated to be 0.77. A common feature that all three explanatory variables contain is the development of an anticyclonic circulation anomaly over the Korean Peninsula. The North Atlantic SSTA predictor acts as a forcing mechanism for the generation of Rossby wave trains downstream, developing an anticyclonic circulation anomaly in the lower and upper troposphere over the Korean Peninsula. The western North Pacific (WNP) warm SSTA predictor induces a cyclonic circulation anomaly over the WNP and an anticyclonic circulation anomaly over the Korean Peninsula, resembling the Pacific–Japan teleconnection mechanism that represents the northward Rossby wave propagation over the western Pacific. Through air–sea interaction, the tripolar SSTA pattern in the eastern North Pacific representing the North Pacific gyre oscillation induces two opposite precipitation anomalies in the equatorial Maritime Continent and the Philippine Sea. These diabatic anomalies excite northward-propagating Rossby waves that form a cyclonic circulation anomaly in the WNP area and an anticyclonic anomaly over the Korean Peninsula.
The Commonwealth Grants Power
Authors: Campbell Enid 
Published: January 2019

The Commonwealth grants power refers to the legislative power conferred by section 96 of the federal Constitution. Section 96 provides that:
During a period of ten years after the establishment of the Commonwealth and thereafter until the Parliament otherwise provides, the Parliament may grant financial assistance to any State on such terms and conditions as the Parliament thinks fit.There is no exact counterpart of this section in the United States Constitution, though Congress has authority to make grants to States under the so-called General Welfare clause—section 8 of Article I—which declares that:
The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States.
Children with Cleft Palate: Predictors of Otologic Issues in the First 10 Years
Authors: Funamura Jamie L. , Lee Janet W. , McKinney Samantha , Bayoumi Ahmed G. , Senders Craig W. , Tollefson Travis T. 
Published: January 2019

ObjectiveTo evaluate the characteristics of children with cleft palate associated with persistent otologic issues in the first 10 years of life.Study DesignCase series with chart review.SettingSingle academic center.Subjects and MethodsChildren born with cleft palate from 2003 to 2007 and treated by the UC Davis Cleft and Craniofacial Team between January 2003 and December 2017 were included in the study. Data from 143 patients were analyzed via Wilcoxon rank sum and Fisher exact tests for univariate analysis and logistic regression to determine adjusted odds ratios.ResultsThe median length of follow‐up was 9.9 years, and the age at last ear examination was 10.7 years. At the last evaluation, unresolved otologic issues were common, with at least 1 ear having a tympanic membrane (TM) perforation (16.1%), a tympanostomy tube (36.2%), or conductive hearing loss (23.1%). After adjusting for demographic and clinical characteristics, history of palate revision or speech surgery was associated with having a TM perforation (P =. 02). The only clinical variables associated with conductive hearing loss was the presence of a TM perforation (P <. 01) or a genetic abnormality (P =. 02). Severity of palatal clefting was not associated with specific otologic or audiologic outcomes after adjusting for other characteristics.ConclusionA large proportion of children with cleft palate have persistent otologic issues at age 10 years and would benefit from continued close monitoring well after the age when most children have normalized eustachian tube function. Prolonged otologic issues were not found to be associated with cleft type.
Effect of Adenotonsillectomy on Ambulatory Blood Pressure in Pediatric Obstructive Sleep Apnea: 6‐Month Follow‐up Study
Authors: Kang Kun‐Tai , Chiu Shuenn‐Nan , Lin Che‐Yi , Weng Wen‐Chin , Lee Pei‐Lin , Hsu Wei‐Chung 
Published: January 2019

ObjectiveTo investigate 24‐hour ambulatory blood pressure changes 6 months after surgery among children with obstructive sleep apnea.Study DesignProspective interventional study.SettingTertiary medical hospital.Subjects and MethodsChildren aged 4 to 16 years with symptoms of obstructive sleep apnea (apnea‐hypopnea index >1) were recruited. All children underwent adenotonsillectomy and postoperative polysomnography overnight. The 24‐hour ambulatory blood pressure was measured before and 6 months after surgery.ResultsThe study cohort enrolled 124 children: mean (SD) age, 7.3 (3.1) years; 73% boys. After surgery, the apnea‐hypopnea index significantly decreased from 13.3 (18.1) to 3.3 (7.2) events per hour (P <. 001). Overall systolic blood pressure and diastolic blood pressure were not significantly different following surgery, while daytime systolic blood pressure was slightly increased (114.3 to 117.3 mm Hg, P <. 01) postoperatively. The hypertensive group (n = 43) exhibited significantly decreased levels of overall diastolic, nighttime systolic, and nighttime diastolic blood pressure (P <. 05), and 54% of hypertensive children became nonhypertensive after surgery. The nonhypertensive group (n = 81) showed slightly increased levels of nocturnal overall systolic, daytime systolic, and nighttime systolic blood pressure. A generalized linear mixed model revealed that children with hypertension had a greater decrease in systolic and diastolic ambulatory blood pressure during the daytime and nighttime (all P <. 05) than those without hypertension.ConclusionsAmbulatory blood pressure changes after adenotonsillectomy among children with obstructive sleep apnea are minimal. The decrease in ambulatory blood pressure after surgery is more prominent for hypertensive children than nonhypertensive children.
Pre-emptive Analgesia with Epidural Morphine or Morphine and Bupivacaine
Authors: Subramaniam B. , Pawar D. K. , Kashyap L. 
Published: January 2019

Studies of pre-emptive analgesia in humans have shown conflicting results. The study design, patient population and the duration of assessment of postoperative pain are important in the evaluation of pre-emptive analgesia. We carried out a prospective, randomized, double-blind controlled study in 80 patients of physical status ASA 1–3 undergoing upper abdominal and thoracic surgery. Patients received two epidural injections, one 20 minutes before induction and the other at the end of surgery. Study solution was either morphine (50 μg/kg), with or without 0.1% bupivacaine in 10 ml of normal saline, or normal saline alone. The study groups (Pre M, Pre MB) were given either morphine or morphine-bupivacaine before induction and saline at the end of surgery. The control groups (Post M, Post MB) were given saline before induction and morphine or morphine-bupivacaine at the end of surgery. Postoperative pain was assessed with a Visual Analogue Scale (VAS) during coughing and deep breathing at six-hourly intervals for five days. Epidural morphine was given if the VAS exceeded 4. Pre MB compared to Post MB had a significantly increased interval between the analgesic top-ups (P<0.01) and decreased total postoperative morphine requirements (P<0.0001) and number of top-ups (P<0.001). Pre M and Post M were comparable. Pre MB compared to Pre M had significantly decreased total postoperative morphine requirements (P<0.0001) and number of top-ups (P<0.0001). Epidural morphine plus bupivacaine is effective as a pre-emptive analgesic. Morphine plus bupivacaine has better efficacy than morphine given alone before the induction of anaesthesia.
Clinical Evaluation of the Non-Invasive Cardiac Output (NICO) Monitor in the Intensive Care Unit
Authors: Van Heerden P. V. , Baker S. , Lim S. I. , Weidman C. , Bulsara M. 
Published: January 2019

The Non-invasive Cardiac Output (NICO) monitor (Novametrix Medical Systems Inc., Wallingford, CT, U.S.A.) utilizes a minimally-invasive partial rebreathing method to determine cardiac output by means of a differential form of the Fick equation. We evaluated the NICO monitor by comparing its output to paired measurements obtained by the standard thermodilution (TD) technique in patients who had recently undergone cardiac surgery. Forty-two paired measurements were carried out in 12 patients. The correlation between the two methods was moderate with a correlation coefficient of 0.691. Repeated measures ANOVA showed that TD measures of cardiac output were significantly higher than those obtained by the NICO monitor (P=0.0003). Comparison of the two techniques using the method described by Bland and Altman showed decreased correlation at higher values of cardiac output. We conclude that the NICO monitor may well have a place in intensive care monitoring, provided patients are not breathing spontaneously and are able to tolerate a 4 mmHg rise in P a co 2. It is less suitable for use in patients with a high cardiac output state.
A Randomized Comparison of Low-Dose Ketamine and Lignocaine Infiltration with Ketamine-Diazepam Anaesthesia for Post Partum Tubal Ligation in Vanuatu
Authors: Grace R. F. , Lesteour T. , Sala T. , Stewart J. 
Published: January 2019

Ketamine remains one of the most commonly used anaesthetic agents around the world. Despite it being the anaesthetic agent of choice in many developing nations, there is a paucity of literature describing ketamine in the developing world. In what we believe is the first randomized controlled trial to be performed in Vanuatu (formerly the New Hebrides) we compared the use of ketamine 0.9 mg/kg and diazepam 0.07 mg/kg with ketamine 0.3 mg/kg and 2% lignocaine infiltration in 50 Melanesian women undergoing post partum tubal ligation. All women received 0.5 mg/kg intramuscular pethidine. Visual analog pain scores and verbal numeric satisfaction scores were similar between the groups. However the time to obeyed command was significantly faster in the 0.3 mg/kg ketamine group (7.0±4.9 vs 13.0±9.2 min). The incidence of dreaming was similar and the content rated as pleasant by both groups. In institutions where post-anaesthesia care resources are limited, 0.3 mg/kg ketamine with local anaesthesia provides for earlier self-care of patients after tubal ligation, without compromise of analgesia, emergence or satisfaction. The implications of these findings extend to other procedures that require short general anaesthesia, which can be adequately performed with low-dose ketamine and local anaesthesia. The latter technique allows more rapid awakening.
Latex Hypersensitivity in Spinal Cord Injured Adult Patients
Authors: Mertes P. M. , Mouton C. , Frémont S. , Brugerolle B. , Moneret-Vautrin D. A. , Lavaud F. , Laxenaire M. C. 
Published: January 2019

Latex hypersensitivity is a major cause of anaphylaxis during anaesthesia. Patients with spina bifida, health care or rubber industry workers have been considered at risk for latex sensitization. By analogy, the existence of other at-risk subsets of patients with latex exposure due to frequent surgical procedures has been suggested. The aim of this study was to evaluate the prevalence of latex sensitization in a cohort of adult patients with spinal cord injury and repeated latex exposure. Forty-two adult patients with spinal cord injury were studied and retrospectively compared to a group of 30 children with spina bifida evaluated using a similar protocol. Patients were administered a questionnaire concerning history of latex hypersensitivity, atopy, and surgical procedures. Latex sensitivity was investigated by skin prick-tests and latex-specific IgE assay. The search for atopy was based on in vivo and in vitro tests against a panel of environmental allergens. No chronic spinal cord injured patient had a history of latex allergy. When compared with spina bifida, the number of surgical procedures was not statistically different. Although not significantly different, the prevalence of atopy was higher in spina bifida patients. The high level of latex sensitization in spina bifida patients contrasted sharply with the absence of sensitization observed on both skin and in vitro tests in patients with spinal cord injury (P<0.0001). This study confirms that adult patients with chronic neurologic defects resulting from spinal cord injury exhibit a low risk of latex sensitization. These results suggest that considering adult patients with repeated surgical procedures as a group at risk for latex sensitization because of a high degree of latex exposure should be re-examined.
Concealed Post-Tonsillectomy Haemorrhage Associated with the Use of the Antiemetic Tropisetron
Authors: Herreen P. G. , Wiese M. C. R. 
Published: January 2019

A two-year-old child experienced concealed haemorrhage after adenotonsillectomy. In our patient, the absence of vomited or significant gastric blood and the presence of melaena stools may partly be attributed to prophylactic antiemetic treatment with tropisetron. This group of patients has a high incidence of postoperative nausea and vomiting, and antiemetic treatment is important and valuable. Rather than advocating the withholding of prophylactic antiemetic treatment, we suggest that whatever medication and techniques are used, good clinical care is dependent on careful postoperative observation and assessment for an appropriate period of time.
Reduced Red Cell 2,3-Diphosphoglycerate Concentrations in Critical Illness without Decreased in Vivo P50
Authors: Morgan T. J. , Koch D. , Morris D. , Clague A. , Purdie D. M. 
Published: January 2019

We investigated whether red cell 2,3-diphosphoglycerate (2,3-DPG) concentrations are reduced in critical illness, whether acidaemia, hypophosphataemia or anaemia influence 2,3-DPG, and whether there is any net effect on in vivo P50. Twenty healthy, non-smoking, male volunteers were compared with 20 male intensive care patients with APACHE 2 scores >20 on the preceding day. Those transfused in this time were excluded. Venous red cell 2,3-DPG concentrations were measured in both groups. In the patient group, routine multichannel biochemical profile and arterial blood gas analysis were also performed and in vivo P50 calculated. The mean 2,3-DPG concentration was significantly lower in the patient group than in the controls (4.2±1.3 mmol/l vs 4.9±0.5 mmol/l, P=0.016). The patients were well oxygenated (lowest arterial PO2=75 mm Hg) and showed a tendency to acidaemia (median pH 7.37, range 7.06 to 7.48) and anaemia (median haemoglobin concentration 113 g/l, range 89 to 154 g/l). By linear regression of patient data, pH had a significant effect on 2,3-DPG concentrations (r=0.6, P=0.011). Haemoglobin and phosphate concentrations did not, but there were few abnormal phosphate values. There was no correlation between 2,3-DPG concentrations and in vivo P50 (r2 ≤0.08). We conclude that 2,3-DPG concentrations were reduced in a broad group of critically ill patients. Although this would normally reduce the P50, the reduction was primarily linked with acidaemia, which increases the P50. Overall, there was no net effect on the P50 and thus no affinity-related decrease in tissue oxygenation.
Haemodilution-Induced Enhancement of Coagulation is Attenuated in Vitro by Restoring Antithrombin III to Pre-Dilution Concentrations
Authors: Ruttmann T. G. , James M. F. M. , Lombard E. H. 
Published: January 2019

Moderate haemodilution enhances coagulability in vitro and in vivo as measured by thrombelastography (TEG). The mechanism has never been established. We have conducted an in vitro study to determine whether the effect can be moderated or prevented when the reduction in antithrombin III caused by dilution is prevented by supplementation. Blood from 20 volunteers was divided into four samples. One sample was not diluted and served as control (C). Another was diluted (by 20%) with saline (S). The third was diluted by 20% with saline plus two units of antithrombin (AT III) (SA). The fourth remained undiluted, with two units of added AT III (CA). Coagulation was measured in all four samples using the TEG. In a separate laboratory study, the levels of AT III were measured in control samples and compared with levels after 20% dilution, and 20% dilution with two units of AT III added to the diluent. Enhanced coagulation was demonstrated in saline-diluted samples (S) by shortening of r- and k-times, and increased alpha angle. In the SA samples, r-time shortening was prevented; k-time shortening and alpha-angle increase persisted, but to a reduced degree (difference from saline-only dilution P<0.051). There were no differences between samples C and CA. A predictable drop of AT III (24.2%) occurred with saline dilution, while AT III levels in the AT III/Saline group were similar to the undiluted control. Haemodilution-induced coagulation enhancement is attenuated, but not prevented, if AT III levels are maintained in the normal range. This is in keeping with the established concept of an antithrombin threshold preventing positive coagulation feedback into the intrinsic pathway.
An Evaluation of Non-Invasive Blood Pressure (NIBP) Monitoring on the Wrist: Comparison with Upper Arm NIBP Measurement
Authors: Emerick D. R. 
Published: January 2019

The arm is the traditional site for application of an oscillometric non-invasive blood pressure (NIBP) cuff. This study, which compares upper arm NIBP to wrist NIBP, involved 510 same arm sequential paired blood pressure (BP) measurements in 85 volunteers. Wrist NIBP consistently overestimated mean arterial, systolic and diastolic pressure by approximately 10 mmHg. Ninety per cent of the mean arterial pressure differences at the wrist were within a range of ±9 mmHg around a mean difference of 10.6 mmHg. The systolic pressure difference was 11.2 mmHg with 90% of differences between ±12 mmHg. The diastolic pressure difference was 10.2 mmHg with 90% of differences between ±9 mmHg. With the device used and within the normal blood pressure range, compensation can be performed by subtracting 10 mmHg from the measured values or simply by elevating the wist about 15 cm and taking the BP at face value. Wrist NIBP may be a viable clinical alternative in situations where difficulty occurs with upper arm NIBP measurement.
Diclofenac or Paracetamol for Analgesia in Paediatric Myringotomy Outpatients
Authors: Tay C. L. M. , Tan S. 
Published: January 2019

This prospective, randomized, double-blind study compared the analgesic efficacy of oral diclofenac resinate 0.5 mg.kg -1 with paracetamol 15 mg.kg -1 for control of postoperative pain in paediatric patients for outpatient bilateral myringotomy and tube insertion. Paracetamol, the most commonly used oral analgesic for paediatric patients, was compared with a new palatable syrup formulation of diclofenac. Sixty-three ASA 1 or ASA 2 children aged one year and above were randomly assigned to receive diclofenac (Group A) or paracetamol (Group B). The study drug was given 30 to 60 minutes before induction of anaesthesia. Anaesthesia was induced with either inhalational sevoflurane or intravenous thiopentone. All subjects received intravenous fentanyl 1 μg.kg -1 intraoperatively. Postoperative pain was assessed by a blinded observer using the CHEOPS score on eye-opening, and then at 10, 30 and 60 minutes. Children with a CHEOPS score >7 received further fentanyl 1 μg.kg -1. The number of cases requiring this “rescue” analgesia was recorded. Both groups were comparable in demographics, induction technique, duration of anaesthesia and time between premedication and induction of anaesthesia. Overall, CHEOPS scores were low for both groups at all times and did not differ between the groups at any time. Twenty per cent of the diclofenac group and 27% of the paracetamol group required rescue analgesia (not statistically significant). The efficacy of diclofenac 0.5 mg.kg –1 and paracetamol 15 mg.kg –1 as oral analgesic premedication for BMT was comparable in children receiving an anaesthetic which included intraoperative administration of fentanyl 1 μg.kg –1.
Inhibition of Bacterial Growth by Lignocaine in Propofol Emulsion
Authors: Ozer Z. , Ozturk C. , Altunkan A. A. , Cinel I. , Oral U. 
Published: January 2019

Contamination of propofol, in an emulsion formulation, has been associated with infective complications. Local anaesthetics, some of which are known to have antibacterial properties, are frequently added to the solution to reduce pain on injection. We examined the growth rates of E. coli, S. aureus, S. epidermidis and P. aeruginosa in propofol with and without lignocaine 0.1%–2% after incubation for 2, 5 and 24 hours at 37°C. Growth of microorganisms in each solution was compared by counting the number of colony forming units (CFU). Propofol supported the growth of all microorganisms. An increase in the number of CFUs was observed in all drug combinations 2, 5 and 24 hours after inoculation except for S.aureus (P<0.05). No difference was found in CFU numbers between 2 and 5 hours for this microorganism. With E.coli, a significant decline in colony counts was observed in mixtures of 1% and 2% lignocaine (P<0.05). With the other microorganisms only 2% lignocaine showed a significant reduction in the number of CFUs (P<0.05). We conclude that lignocaine in recommended clinical doses (0.05%–0.1%) did not exhibit adequate antibacterial activity to prevent infective complications.