bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Possible Three-Dimensional Mechanism for Oscillating Wobbles in Tropical Cyclone–Like Vortices with Concentric Eyewalls
Authors: Menelaou Konstantinos , Yau M. K. , Lai Tsz-Kin 
Published: March 2018

Abstract
It is known that concentric eyewalls can influence tropical cyclone (TC) intensity. However, they can also influence TC track. Observations indicate that TCs with concentric eyewalls are often accompanied by wobbling of the inner eyewall, a motion that gives rise to cycloidal tracks. Currently, there is no general consensus of what might constitute the dominant triggering mechanism of these wobbles. In this paper we revisit the fundamentals. The control case constitutes a TC with symmetric concentric eyewalls embedded in a quiescent environment. Two sets of experiments are conducted: one using a two-dimensional nondivergent nonlinear model and the other using a three-dimensional nonlinear model. It is found that when the system is two-dimensional, no wobbling of the inner eyewall is triggered. On the other hand, when the third dimension is introduced, an amplifying wobble is evident. This result contradicts the previous suggestion that wobbles occur only in asymmetric concentric eyewalls. It also contradicts the suggestion that environmental wind shear can be the main trigger. Examination of the dynamics along with complementary linear eigenmode analysis revealed the triggering mechanism to be the excitation of a three-dimensional exponentially growing azimuthal wavenumber-1 instability. This instability is induced by the coupling of two baroclinic vortex Rossby waves across the moat region. Additional sensitivity analyses involving reasonable modifications to vortex shape parameters, perturbation vertical length scale, and Rossby number reveal that this instability can be systematically the most excited. The growth rates are shown to peak for perturbations characterized by realistic vertical length scales, suggesting that this mechanism can be potentially relevant to actual TCs.
Comparison of posterior occlusion between patients with anterior open bite and scissor deep bite
Authors: Qi Kun , Xu Yifei , Hou Yuxia , Wang Mei-Qing 
Published: March 2018

Objective A minor alteration in the posterior occlusal height elicits a large transformation in the anterior vertical dimension. Thus, the present study was performed to determine whether a posterior cusp-to-cusp relation that increases the posterior vertical dimension contributes to an anterior open bite. Methods Study casts were examined from orthodontic patients aged 10 to 27 years, 21 with an open bite and 28 with a scissor deep bite. A logistic regression model was used to analyze the contribution of various factors to these two anterior occlusal patterns. The dental arch width and number of worn cusps were compared between the two groups. Results Patients with an open bite had a significantly higher incidence of a posterior buccal–lingual cusp-to-cusp relation, wider mandibular arch in the molar region, and larger numbers of worn maxillary buccal cusps and mandibular lingual cusps than patients with a scissor deep bite. Conclusions A posterior buccal–lingual cusp-to-cusp relation is associated with a larger anterior vertical dimension, such as that in patients with an open bite.
Immunosuppressive and antiviral treatment of hepatitis C virus–associated glomerular disease: A long-term follow-up
Authors: Fabrizi Fabrizio , Aghemo Alessio , Lampertico Pietro , Fraquelli Mirella , Cresseri Donata , Moroni Gabriella , Passerini Patrizia , Donato Francesca M , Messa Piergiorgio 
Published: March 2018

Background: The evidence in the medical literature on the treatment of hepatitis C virus–associated glomerular disease is extremely limited. The advent of nonconventional immunosuppressive agents and direct-acting antivirals promises high efficacy and safety. Aims: We conducted an open-label, single-arm clinical study to examine the efficacy and safety of a combined approach for hepatitis C virus–associated glomerular disease. Methods: In the first phase of the study, patients with hepatitis C virus–associated glomerular disease received interferon-based antiviral therapy and immunosuppressive agents; since 2013, interferon-free antiviral therapy was adopted and novel immunosuppressants (including B-cell depleting agents and mycophenolate mofetil) or immunomodulators (ribavirin) were choiced. Virological and clinical responses were evaluated over a long observation period (median follow-up of 60 weeks and 46.5 months after the end of treatment with interferon and direct-acting antiviral agents, respectively). Results: We enrolled 25 consecutive patients with hepatitis C virus–associated glomerular disease, 8 being liver transplant recipients for hepatitis C. A total of 13 patients received therapy with direct-acting antivirals and experienced sustained viral response (serum hepatitis C virus RNA <12 IU/mL, 12 weeks after treatment ended, sustained viral response12). The mean (±standard deviation) proteinuria decreased from 2.61 ± 1.01 at baseline to 1.71 ± 1.43 (g/day) at sustained viral response 48, p = 0.031; microscopic hematuria and serum cryoglobulins disappeared in six (50%) and seven (64%) patients, respectively, after sustained viral response by direct-acting antivirals. Adverse events occurred in 69% (9/13) of patients and were mild, with four cases of ribavirin-related anemia requiring blood transfusions (no drop-outs). After sustained viral response by direct-acting antivirals, immunosuppressive and immunomodulatory agents were initiated in clinical relapsers ( n = 2) and nonresponders ( n = 3) with some benefit. Among patients on interferon-based regimens ( n = 12), viral response (sustained viral response 24) and dropout rates were 58% (7/12) and 33% (4/12), respectively. After sustained viral response by interferon-based therapy, clinical relapsers ( n = 3) were successfully managed with immunosuppressive agents in two patients. Conclusion: Treatment with direct-acting antivirals provides excellent rates of viral response and safety in patients with hepatitis C virus–related glomerular disease; viral response was frequently accompanied by clinical improvement. The absence of hepatitis C virus RNA from serum allowed immunosuppressive and immunomodulatory therapies with benefits for glomerular abnormalities and no concern on hepatitis C virus replication.
iStent inject as a reasonable alternative procedure following failed trabeculectomy?
Authors: Davids Anja-Maria , Pahlitzsch Milena , Boeker Alexander , Torun Necip , Bertelmann Eckart , Maier-Wenzel Anna-Karina , Hager Annette , Gonnermann Johannes , Klamann Matthias 
Published: March 2018

Purpose: The aim of this study is to assess the intraocular pressure lowering effect and the performance of the glaucoma therapy of the iStent inject in glaucoma patients with uncontrolled intraocular pressure after failed trabeculectomy. Methods: In this retrospective study, iStent inject implantation (Glaukos Corporation, Laguna Hills, CA, USA) was performed in 22 eyes of 21 subjects suffering from glaucoma (n = 18 primary open angle glaucoma, n = 3 pseudoexfoliation glaucoma, and n = 1 for secondary glaucoma) with an intraocular pressure above target pressure after failed trabeculectomy (mean = 9.6 ± 8.1 years; range: 1–35 years). The intraocular pressure and the number of antiglaucomatous medication were assessed preoperatively, 1 day, 6 weeks, 3 months, 6 months, and 1 year after surgery and compared to preoperative findings (SPSS v23.0; Shapiro–Wilk test, Wilcoxon test, Friedman test). Results: The results showed a significant intraocular pressure decrease from 22.5 ± 4.6 to 15.5 ± 3.4 mmHg after 1 year follow-up (p = 0.012). The glaucoma therapy was 2.6 ± 1.2 preoperatively and reduced to 2.25 ± 1.5 number of medications after 1 year (p > 0.05). There was no significant difference in the number of medication during the whole follow-up period (1 year, p = 0.012). No significant intra- or postoperative complications were reported. Conclusion: Minimal invasive glaucoma surgery (iStent inject) can offer an effective intraocular pressure reduction in advanced adult primary and secondary open angle glaucoma after failed trabeculectomy in a follow-up period of 1 year. Glaucoma therapy, however, needs to be maintained to achieve an individual target pressure and to prevent glaucoma progression. In addition, a failure rate of 27.3% makes it necessary to select carefully patients for this treatment option.
Effect of changing from preserved prostaglandins to preservative-free tafluprost in patients with glaucoma on tear film thickness
Authors: Hommer Anton , Schmidl Doreen , Kromus Martina , Bata Ahmed M , Fondi Klemens , Werkmeister René M , Baar Carina , Schmetterer Leopold , Garhöfer Gerhard 
Published: March 2018

Purpose: Long-term glaucoma therapy with preservative-containing eye drops may impact ocular surface health. This study was performed to investigate whether a switch from preserved topical prostaglandin therapy to preservative-free tafluprost therapy improves precorneal tear film thickness in patients with glaucoma or ocular hypertension. Methods: A total of 30 patients who were under topical preservative-containing prostaglandin monotherapy for at least 6 months were included. Patients were then switched from preserved prostaglandin therapy to unpreserved tafluprost drops once daily. Tear film thickness was measured at baseline and 4 and 12 weeks after therapy change with an ultrahigh-resolution optical coherence tomography system. Furthermore, clinical measures of ocular surface disease were determined and symptoms were assessed using the Dry Eye–Related Quality-of-Life Score. Results: After switching to unpreserved tafluprost, tear film thickness significantly increased from 4.7 ± 0.5 to 5.0 ± 0.6 µm 4 weeks after therapy change and still tended to be increased after 12 weeks (4.8 ± 0.7 µm). Breakup time significantly increased from 5.1 ± 2.3 to 7.2 ± 3.4 s and to 10.1 ± 3.6 s after therapy change. In addition, a significant decrease in corneal staining score from 1.8 ± 0.7 to 1.4 ± 0.8 after 4 weeks and to 0.7 ± 0.7 after 12 weeks treatment was observed. Switching to preservative-free drops reduced Dry Eye–Related Quality-of-Life Score from 11.4 ± 11.0 to 5.7 ± 6.4 and to 4.7 ± 7.5. Conclusion: Our data show that switching to preservative-free tafluprost leads to an increase in tear film thickness, breakup time, and an improvement of Dry Eye–Related Quality-of-Life Score. Our results therefore indicate that a switch to unpreserved tafluprost is beneficial for ocular surface health in patients under long-term preserved prostaglandin eye drops.
Linguistic attitudes and contact effects in Toronto’s heritage languages: A variationist sociolinguistic investigation
Authors: Nagy Naomi 
Published: March 2018

Aims and objectives: I review several methods of constructing bridges between structural linguistic variation in language contact situations and linguistic attitudes and prestige. Methodology design: Data are examined for heritage varieties of Cantonese, Faetar, Italian, Korean, Polish, Russian and Ukrainian spoken in Toronto, Canada, and in the corresponding homeland varieties, in an effort to consider how the notions of ‘prestige’ and ‘attitude’ are best operationalized in heritage language studies and to seek associations between structural variation and prestige. Linguistic variation is explored via multivariate analysis of (linguistic and) social factors, in order to determine which factors best account for the selection of competing variants of selected sociolinguistic variables (primarily null subject variation and voice onset time) in spontaneous speech. The attitudinal or prestige aspect is explored in several ways: comparison of ethnolinguistic vitality, language status (in popular and academic media) and ethnic orientation. It is hypothesized that: • communities with a higher ethnolinguistic vitality will be more resistant to contact-induced variation; • varieties exhibiting more contact-induced variation will more likely have acquired a label distinct from the homeland variety; • within a generation, speakers with greater affinity for or more frequent use of English will show stronger contact effects; and • successive generations of speakers, with increasing contact with English, will show greater contact effects. Conclusions/originality/significance: These hypotheses are not supported by our data.
The continuity of social care when moving across regional boundaries
Authors: Marsland Dave , White Caroline , Manthorpe Jill 
Published: March 2018

Summary This paper reports the experiences of adults in receipt of social care when relocating to new local authorities, and of family carers. While many matters need to be considered when moving, the study focused specifically on the ‘portability’ of social care. The study draws on data from semi-structured interviews conducted between July and November 2013 with 12 adults who had relocated between English local authorities. Data were collected prior to the implementation of the Care Act 2014; the potential impact of the Act in respect of relocation is considered. Findings Although some positive experiences were identified, participants primarily reported challenges when moving with social care support. Five themes were identified, these related to the amount of organisation, planning and activity required; the need for a timely approach and the risk of delays and interruptions to care delivery; differences between the practices of local authorities; a lack of control and involvement; a negative impact on emotional and physical well-being. As a result of such difficulties, some experienced delays or interruptions to their care and support; lost all or some of their care package; experienced stress, anxiety and worry. Applications The paper documents the experiences of people relocating with social care support, which have been little explored to date within the UK or internationally, and contributes to the evidence base in respect of relocation and portability of care. It highlights the importance of smooth transitions for those relocating between local authorities, and the potential for social workers to assist by addressing potential problems.
Synergistic activation of ERK1/2 between A-fiber neurons and glial cells in the DRG contributes to pain hypersensitivity after tissue injury
Authors: Yamakita Shunsuke , Horii Yasuhiko , Takemura Hitomi , Matsuoka Yutaka , Yamashita Ayahiro , Yamaguchi Yosuke , Matsuda Megumi , Sawa Teiji , Amaya Fumimasa 
Published: March 2018

Background Intense nociceptive signaling arising from ongoing injury activates primary afferent nociceptive systems to generate peripheral sensitization. ERK1/2 phosphorylation in dorsal root ganglion can be used to visualize intracellular signal activity immediately after noxious stimulation. The aim of this study was to investigate spatiotemporal characteristics of ERK1/2 phosphorylation against tissue injury in the primary afferent neurons. Methods Plantar incisions were made in the hind paws of Sprague-Dawley rats (n =150). Levobupivacaine was injected into the plantar aspect of the paws and ankles, Mitogen-activated protein kinase kinase (MEK) inhibitor was injected into the paw, and carbenoxolone, dual inhibitor of the gap junction and pannexin channel, was intraperitoneally injected. Pain hypersensitivity was investigated by a behavioral study, while phosphorylated ERK1/2 was detected in dorsal root ganglion and hind paw using immunohistochemistry and Western blot. Results Phosphorylated ERK1/2 was induced in dorsal root ganglion (26.8 ± 2.9% at baseline, 65.6 ± 3.6% at 2 min, and 26.3 ± 3.4% at 2 h) after the incision. NF-200 positive A-fiber neurons and satellite glial cells were positive for phosphorylated ERK1/2. Injury-induced pain hypersensitivity was abolished by MEK inhibitor. Levobupivacaine treatment inhibited phosphorylated ERK1/2 induction, carbenoxolone treatment inhibited glial phosphorylated ERK1/2 at 2 min after the injury, and carbenoxolone inhibited pain hypersensitivity and neuronal phosphorylated ERK1/2 at 1 h after the injury. Conclusion ERK1/2 phosphorylation in A-fiber neurons and satellite glial cells immediately after injury contributes to the generation of pain hypersensitivity. Signal communication between neurons and satellite glial cells expands the duration of neuronal ERK1/2 phosphorylation and pain hypersensitivity at 1 h after tissue injury.
Sepsis in Obstetrics Score (SOS) utility and validation for triaging patients with obstetric sepsis in the emergency department: Evidence from a low income health care setting
Authors: Agarwal Rachna , Yadav Rajesh Kumar , Mohta Medha , Sikka Meera , Radhakrishnan Gita 
Published: March 2018

Background Illness severity scores commonly used in critical care settings are not considered appropriate in obstetric practice as they do not account for pregnancy physiology. A new illness severity score called the ‘Sepsis in Obstetrics Score’ (SOS) was introduced by Albright et al. for triaging patients with sepsis in pregnancy in an emergency department setting. Objectives We aimed to determine whether this score could predict the need for critical care support using the presence of organ failure as the identification criteria. Severity and culture positivity in pregnancy-associated sepsis was also assessed. Materials and methods All pregnant, postabortal and postpartum women with suspected sepsis were enrolled (as per systemic inflammatory response syndrome criteria) were enrolled. Severe pregnancy-associated sepsis was defined as dysfunction of one or more organs due to sepsis. The severity of pregnancy-associated sepsis was graded according to the number of organ failures. A SOS cut off of 6 was taken for statistical analysis. Results Out of 100 women with pregnancy-associated sepsis, ‘severe sepsis’ was present in 58%. When the SOS test performance was compared with the severity of pregnancy-associated sepsis, it had sensitivity of 68.9% and specificity of 80.9%, positive predictive value of 83% and negative predictive value 65% to predict severe sepsis. The area under curve for the SOS detecting severe pregnancy-associated sepsis was 0.810. SOS predicted organ failure in pregnancy-associated sepsis and this was statistically significant for all organs involved. Culture positivity did not correlate with the SOS in our study. Conclusions Sepsis in Obstetrics Score correlated well with organ failure in pregnancy-associated sepsis. It had a high positive predictive value (83%) for severe sepsis.
Utility of serum phosphate as a marker for predicting the severity of post‐endoscopic retrograde cholangiopancreatography pancreatitis
Authors: Choi Young Hoon , Jang Dong Kee , Lee Sang Hyub , Jang Sunguk , Choi Jin Ho , Kang Jinwoo , Paik Woo Hyun , Lee Jun Kyu , Ryu Ji Kon , Kim Yong-Tae 
Published: March 2018

BackgroundTo date, no reliable marker for predicting the severity of post‐endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis exists. A previous animal study reported a correlation between serum phosphate level and the severity of acute pancreatitis.ObjectiveThe purpose of this study was to evaluate the feasibility of serum phosphate as a marker for predicting the severity of post‐ERCP pancreatitis in humans.MethodsA cohort of patients that were diagnosed with post‐ERCP pancreatitis between January 2005 and December 2016 was queried. In addition to serum phosphate levels measured between 12 and 24 hours after ERCP, several candidates deemed suitable for accurately predicting the severity of post‐ERCP pancreatitis were also explored.ResultsA total of 191 patients with severe (n = 42, 22.0%) and mild‐to‐moderate (n = 149, 78.0%) post‐ERCP pancreatitis were included. Several factors for predicting severe post‐ERCP pancreatitis were identified in the multivariate analysis: malignancy as the primary indication for ERCP (odds ratio (OR) 2.65, P = 0.038), systemic inflammatory response syndrome (OR 4.49, P = 0.016) and serum phosphate level (OR 1.97, P = 0.040). In the receiver operating characteristic analysis, the area under the curve of serum phosphate level for severe post‐ERCP pancreatitis was 0.65 (95% confidence interval, 0.56–0.75). The optimal cut‐off value of serum phosphate level for prediction of severe post‐ERCP pancreatitis was 3.35 mg/dL (sensitivity, 0.62; specificity, 0.73).ConclusionsSerum phosphate level after ERCP can be used as a reliable prognostic marker in predicting the severity of post‐ERCP pancreatitis. Future prospective studies would be the cogent next step in validating its value.
The Effectiveness of Osteoporosis Screening and Treatment in the Midwest
Authors: Patel Dharmik , Worley John R. , Volgas David A. , Crist Brett D. 
Published: March 2018

Introduction: With osteoporosis on the rise across the United States, the goal of this prospective study is to determine the effectiveness of our Midwest level-1 trauma center in diagnosing, treating, and educating osteoporosis patients after fracture with the use of questionnaires. Secondarily, we aimed to identify barriers that prevent our patients from complying with bone health recommendations. Methods: One hundred participants (≥55 years) were given 2 questionnaires (Fracture Risk Assessment Tool and a study-specific questionnaire) that were administered during the patient’s visit to the orthopedic trauma clinic. A group of patients diagnosed with osteoporosis was compared to a group of patients not diagnosed with osteoporosis. Statistical analyses were performed using SPSS 24 (IBM Corp, Chicago, Illinois). Results: Patients who had been diagnosed with osteoporosis were significantly older (72.7 vs 66.5, P = .009) and more were women (86.2% vs 66.2%, P = .043). Significantly, fewer patients without the diagnosis of osteoporosis had a history of fragility fracture (56.3%) compared to 92.9% of those diagnosed with osteoporosis ( P < .001). Of those with dual-energy X-ray absorptiometry (DXA) recommended by a healthcare provider, 20 (55.6%) of those without the diagnosis of osteoporosis and 13 (52%) of those with the diagnosis of osteoporosis had DXA screening before their fragility fracture ( P = .499). More patients diagnosed with osteoporosis (93.1%) were taking calcium and vitamin D supplementation compared to 66.2% of those without the diagnosis of osteoporosis ( P = .005). Only 37.9% of patients with the diagnosis of osteoporosis were receiving US Food and Drug Administration–approved medications for the management of their disease. Discussion: In patients without previous osteoporosis diagnosis, 59 (83.1%) of the 71 claimed that they did not receive any preventative education about osteoporosis, while 21 (72.4%) of the 29 patients with the diagnosis of osteoporosis claimed that they did not receive a preventative education ( P = .165). Both groups lacked optimum diagnosis, treatment, and education of osteoporosis. Conclusion: Our study highlights the need for a deliberate effort of a multidisciplinary team to focus efforts in all stages of osteoporosis management.
Median-based Rules for Decision-making under Complete Ignorance
Authors: Bhattacharyya Aditi 
Published: March 2018

This article characterizes a class of rules for decision-making when an agent knows the possible states of the world and the outcome of each of his/her actions for each state, but does not have any information about the probabilities of the states. The existing literature in this framework has mainly considered ‘max’-based or ‘min’-based rules and their variants. Such rules reflect rather extreme forms of optimism or pessimism on the part of an agent. In contrast, this paper focuses on the median outcome(s) and characterizes a class of decision-making rules which reflects a more ‘balanced’ attitude towards uncertainty. We also discuss a possible interpretation of our result in terms of the ranking of alternative social states that an individual may have when he/she is under the Rawlsian ‘veil of ignorance’. JEL Classifications: D81