bluuebunny/crossref_metadata_2025_split huggingface dataset:
Geostrophic Adjustment and Wave–Vortex (Non)Interaction
Authors: Zeitlin Vladimir 
Published: April 2018

AbstractThe fundamental process of geostrophic adjustment is treated by the method of multi-scale asymptotic expansions in Rossby number and fast-time averaging (which is explained), first in the barotropic one-layer case, and then in the baroclinic two-layer case. Together with the standard quasi-geostrophic regime of parameters, the frontal (or semi-) geostrophic regime is considered. Dynamical separation of slow and fast motions is demonstrated in both regimes. The former obey quasi-geostrophic or frontal-geostrophic equations, thus providing formal justification of the heuristic derivation of Chapter 5. Fast motions are inertia-gravity waves in quasi-geostrophic case, and inertial oscillations in the frontal-geostrophic case. Geostrophic adjustment is also considered in the presence of coastal, topographic, and equatorial wave-guides, and, again, separation of fast and slow motions is demonstrated, the latter now including long Kelvin waves in the first case, long topographic waves in the second case, and long Kelvin and Rossby waves in the third case.
Instabilities in Cylindrical Geometry: Vortices and Laboratory Flows
Authors: Zeitlin Vladimir 
Published: April 2018

AbstractVortex solutions in cyclo-geostrophic equilibrium are described and their geostrophic and ageostrophic barotropic and baroclinic instabilities are studied along the lines of Chapter 10. Special attention is paid to centrifugal instability which, as the inertial instability of jets, is due to modes trapped in the anticyclonic shear in the vortex, and has asymmetric counterparts. Saturation of this instability is shown to exhibit some specific patterns. Instabilities of intense hurricane-like vortices are analysed and shown to be sensitive to fine details of the vortex profile. Nonlinear saturation of such instabilities exhibits typical secondary meso-vortex structures, and leads to intensification of the vortex. Special attention is paid to instabilities in laboratory flows in rotating cylindrical channels. Classification of these instabilities is given, and their nature, in terms of resonances between different wave modes, is established. Rigid-lid and free-surface configuration with topography are considered and compared with experiments.
Rotating Shallow-Water model with Horizontal Density and/or Temperature Gradients
Authors: Zeitlin Vladimir 
Published: April 2018

AbstractThe derivation of rotating shallow-water equations by vertical averaging and columnar motion hypothesis is repeated without supposing horizontal homogeneity of density/potential temperature. The so-called thermal rotating shallow-water model arises as the result. The model turns to be equivalent to gas dynamics with a specific equation of state. It is shown that it possesses Hamiltonian structure and can be derived from a variational principle. Its solution at low Rossby numbers should obey the thermo-geostrophic equilibrium, replacing the standard geostrophic equilibrium. The wave spectrum of the model is analysed, and the appearance of a whole new class of vortex instabilities of convective type, resembling asymmetric centrifugal instability and leading to a strong mixing at nonlinear stage, is demonstrated.
Trends in mental health outcomes and combat exposure among US marines returning from Iraq, Afghanistan or other deployments, 2004–13
Authors: Morgan Jessica Kelley , Levin-Rector Alison , Van Dorn Richard A , Trudeau James , Hourani Laurel L , Cartwright Joel K , Lattimore Pamela K 
Published: April 2018

Abstract

Background
As of 2015, more than 2.7 million US military Veterans have served in support of the Global War on Terror. The negative sequelae associated with deployment stressors and related traumas are well-documented. Although data on mental health issues are routinely collected from service members returning from deployment, these data have not been made publicly available, leaving researchers and clinicians to rely on convenience samples, outdated studies and small sample sizes.

Methods
Population-based data of US Marines returning from deployment between 2004 and 2013 were analyzed, using the Post-Deployment Health Assessment.

Results
Rates of Marines returning from Iraq who screened positive for depression ranged from 19.31 to 30.02%; suicidal ideation ranged from 0 to 1.44%. Marines screening positive for PTSD ranged from 3.00 to 12.41%; combat exposure ranged from 15.58 to 55.12%. Depression was indicated for between 12.54 and 30.04% of Marines returning from Afghanistan, while suicidal ideation ranged from 0 to 5.33%. PTSD percentages ranged from 6.64 to 18.18%; combat exposure ranged between 42.92 and 75%.

Conclusion
Our results support the heterogeneity of experiences and mental health sequelae of service members returning from deployments. Outcomes for Afghanistan and Iraq Veterans fluctuate with changes in OPTEMPO across theaters over time.
Assessment of Cartilage Growth After Biopsy of Osteochondral Loose Bodies in Adolescent Knees for Use in Autologous Chondrocyte Implantation
Authors: Robinson Sean , Kramer Jonathan , Shelton Trevor , Merriman Jarrad , Haus Brian 
Published: April 2018

Background:
The goal of this study is to determine whether harvested cartilage from an osteochondral loose body maintains the same viability for implantation as cartilage harvested from the traditional locations within the adolescent knee for autologous chondrocyte implantation (ACI).

Methods:
A retrospective study was performed on all ACI procedures performed from 2014 to 2017 at a single institution. Biopsies were derived from 2 groups: osteochondral loose body verses the intercondylar notch. The viability, yield, identity, potency, and density were obtained from each sample in addition to basic demographics and concomitant injuries. A total of 12 patients with osteochondral loose bodies 14.6 (SD=2.9) and 20 patients 13.6 (SD=3.3) with intercondylar notch biopsies were evaluated for the study.

Results:
In the microscopic and histologic comparison, there was no significant difference in viability: 94% in the loose bodies and 93% in the intercondylar notch groups, identity: 7.4 d5L versus 6.3 d5L, or yield. Minimum yield is presented as different units in Carticel (1.2×107 cells/vial) and matrix-induced ACI (>8500 relative fluorescent units) products; however, there was no difference between groups and all samples were above the acceptable limit. Minimum identity value is recorded as d5L> −2.00 and all samples were above this limit. In addition, no sample had signs of contamination or endotoxin in either group.

Conclusion:
These results demonstrate an alternative method for obtaining cartilage biopsies in ACI procedures that may limit short-term and long-term donor site morbidity.

Level of Evidence:
Level III.
The Arrival of Robotics in Spine Surgery
Authors: Ghasem Alexander , Sharma Akhil , Greif Dylan N. , Alam Milad , Maaieh Motasem Al 
Published: April 2018

Study Design.
Systematic review.

Objective.
The authors aim to review comparative outcome measures between robotic and free-hand spine surgical procedures including: accuracy of spinal instrumentation, radiation exposure, operative time, hospital stay, and complication rates.

Summary of Background Data.
Misplacement of pedicle screws in conventional open as well as minimally invasive surgical procedures has prompted the need for innovation and allowed the emergence of robotics in spine surgery. Before incorporation of robotic surgery in routine practice, demonstration of improved instrumentation accuracy, operative efficiency, and patient safety are required.

Methods.
A systematic search of the PubMed, OVID-MEDLINE, and Cochrane databases was performed for articles relevant to robotic assistance of pedicle screw placement. Inclusion criteria were constituted by English written randomized control trials, prospective and retrospective cohort studies involving robotic instrumentation in the spine. Following abstract, title, and full-text review, 32 articles were selected for study inclusion.

Results.
Intrapedicular accuracy in screw placement and subsequent complications were at least comparable if not superior in the robotic surgery cohort. There is evidence supporting that total operative time is prolonged in robot-assisted surgery compared to conventional free-hand. Radiation exposure appeared to be variable between studies; radiation time did decrease in the robot arm as the total number of robotic cases ascended, suggesting a learning curve effect. Multilevel procedures appeared to tend toward earlier discharge in patients undergoing robotic spine surgery.

Conclusion.
The implementation of robotic technology for pedicle screw placement yields an acceptable level of accuracy on a highly consistent basis. Surgeons should remain vigilant about confirmation of robotic-assisted screw trajectory, as drilling pathways have been shown to be altered by soft tissue pressures, forceful surgical application, and bony surface skiving. However, the effective consequence of robot-assistance on radiation exposure, length of stay, and operative time remains unclear and requires meticulous examination in future studies.

Level of Evidence: 4
Perioperative Use of Levosimendan Improves Clinical Outcomes in Patients After Cardiac Surgery: A Systematic Review and Meta-Analysis
Authors: Qiang Hua , Luo Xiu , Huo Jian-Hua , Wang Zhi-Quan 
Published: April 2018

Abstract:
Severe postoperative complications can affect cardiac surgery patients. Levosimendan is a novel calcium sensitizer commonly administered after cardiac surgery. However, the patient benefits are controversial. PubMed, Embase, and the Cochrane library were systematically searched for randomized controlled trials comparing levosimendan with control in adult cardiac surgery patients. Twenty-five studies (3247 patients) were included. Pooled data indicated that levosimendan reduced mortality after cardiac surgery [odds ratio (OR) 0.63, 95% confidence interval (CI): 0.47–0.84, P = 0.001]. However, this reduction was restricted to patients with low (<50%) left ventricular ejection fraction (OR 0.49, 95% CI: 0.35–0.70, P = 0.0001). It significantly reduced the incidence of postoperative acute kidney injury (OR 0.55, 95% CI: 0.41–0.74, P < 0.0001) and renal replacement therapy use (OR 0.56, 95% CI: 0.39–0.80, P = 0.002). Moreover, levosimendan significantly shortened the duration of the intensive care unit stay (weighted mean differences −0.49 day, 95% CI: −0.75 to −0.24, P = 0.0002) and mechanical ventilation use (weighted mean differences −2.30 hours, 95% CI: −3.76 to −0.84, P = 0.002). In conclusion, levosimendan reduced the mortality in patients with low left ventricular ejection fraction and decreased the incidence of acute renal injury and renal replacement therapy use. In addition, it shortened the duration of the intensive care unit stay and mechanical ventilation use.
Recovery of Corneal Clarity After DMEK Followed by Rebubbling Versus Uneventful DMEK
Authors: Lazaridis Apostolos , Fydanaki Ourania , Giallouros Eleftherios , Georgalas Ilias , Kymionis George , Sekundo Walter , Droutsas Konstantinos 
Published: April 2018

Purpose:
To evaluate the effect of a single rebubbling procedure after Descemet membrane endothelial keratoplasty (DMEK) on corneal backscatter and endothelial cell loss (ECL).

Methods:
Medical records of 130 consecutive DMEK cases (118 patients) were reviewed and 3 groups were formed: group 1 (n = 32), consisting of DMEK cases followed by 1 rebubbling; group 2a (n = 55), including uneventful DMEK cases with complete graft attachment; and group 2b (n = 25), including uneventful DMEK cases with minor peripheral detachment, not requiring rebubbling. Scheimpflug corneal densitometry (CD) of the central (0–2 mm), paracentral (2–6 mm), and mid-peripheral (6–10 mm) zones, endothelial cell density, central corneal thickness, and corneal volume were measured preoperatively and at 3, 6, 12, and 24 months.

Results:
Central CD in group 1 decreased from 32.3 ± 8.3 grayscale units preoperatively, to 21.2 ± 3.5 at 24 months. In group 2a, CD decreased from 37.0 ± 11.9 to 19.4 ± 3.0 and in group 2b from 32.5 ± 8.8 to 19.8 ± 3.1. No significant differences were observed among the 3 groups at any examination time point (P ≥ 0.12). At 3 months, paracentral CD of group 2a was significantly lower than that of group 1 (P = 0.047). Endothelial cell density at 3 months was higher in group 2a (1613 ± 503 cells/mm2) than in group 1 (1350 ± 557 cells/mm2; P = 0.033). ECL at 24 months was 56%, 43%, and 53% in groups 1, 2a, and 2b, respectively. Group 2a showed the lowest ECL, central corneal thickness, and corneal volume throughout the study period.

Conclusions:
A single rebubbling procedure does not increase the CD of the central cornea and but results in significantly higher ECL compared with uneventful DMEK with complete graft attachment.
Case of Primary Isolated Subconjunctival IgG4-Related Disease
Authors: Lee Hyo Seok , Choi Won , Kim Ga Eon , Yoon Kyung Chul 
Published: April 2018

Purpose:
To report a case of isolated subconjunctival ocular adnexal IgG4-related disease that met the diagnostic criteria according to the Japanese Ministry of Health, Labour and Welfare's 2011 guidelines.

Methods:
We report a case of a 56-year-old woman with a left subconjunctival mass for 3 months. Excisional biopsy was performed. Postoperatively, the patient underwent systemic and radiologic evaluations for IgG4-related disease.

Results:
The clinicopathologic study revealed storiform fibrosis and lymphoplasmacytic infiltration, with increased IgG4-positive plasma cells and an IgG4/IgG-positive plasma cell ratio of 40%. Serum IgG4 and IgG levels were slightly elevated. Systemic involvement was not detected.

Conclusions:
IgG4-related disease is well known in the orbit and ocular adnexa, particularly the lacrimal gland. However, subconjunctival involvement should be recognized as a possible presentation for this entity.
Clinical Experience in Minimally Invasive Cardiac Surgery with Virtually Wall-Less Venous Cannulas
Authors: Ferrari Enrico , von Segesser Ludwig K. , Berdajs Denis , Müller Ludwig , Halbe Maximilian , Maisano Francesco 
Published: April 2018

Objective Inadequate peripheral venous drainage during minimally invasive cardiac surgery (MICS) is a challenge and cannot always be solved with increased vacuum or increased centrifugal pump speed. The present study was designed to assess the benefit of virtually wall-less transfemoral venous cannulas during MICS. Methods Transfemoral venous cannulation with virtually wall-less cannulas (3/8″ 24F 530–630-mm ST) was performed in 10 consecutive patients (59 ± 10 years, 8 males, 2 females) undergoing MICS for mitral (6), aortic (3), and other (4) procedures (combinations possible). Before transfemoral insertion of wall-less cannulas, a guidewire was positioned in the superior vena cava under echocardiographic control. The wall-less cannula was then fed over the wire and connected to a minimal extracorporeal system. Vacuum assist was used to reach a target flow of 2.4 l/min per m2 with augmented venous drainage at less than −80 mm Hg. Results Wall-less venous cannulas measuring either 630 mm (n = 8) in length or 530 mm (n = 2) were successfully implanted in all patients. For a body size of 173 ± 11 cm and a body weight of 78 ± 26 kg, the calculated body surface area was 1.94 ± 0.32 m2. As a result, the estimated target flow was 4.66 ± 0.78 l/min, whereas the achieved flow accounted for 4.98 ± 0.69 l/min (107% of target) at a vacuum level of 21.3 ± 16.4 mm Hg. Excellent exposure and “dry” intracardiac surgical field resulted. Conclusions The performance of virtually wall-less venous cannulas designed for augmented peripheral venous drainage was tested in MICS and provided excellent flows at minimal vacuum levels, confirming an increased performance over traditional thin wall cannulas. Superior results can be expected for routine use.
Transconjunctival Triamcinolone Injection for Upper Lid Retraction in Thyroid Eye Disease—A New Injection Method
Authors: Young Stephanie Ming , Kim Yoon-Duck , Lang Stephanie S. , Woo Kyung In 
Published: April 2018

Purpose:
To evaluate the role of transconjunctival triamcinolone acetonide (TA) injection in the management of upper eyelid retraction in thyroid eye disease.

Methods:
Retrospective interventional review of all patients who underwent transconjunctival TA injection (40 mg/mL) for thyroid eye disease–related upper eyelid retraction from January 2010 to December 2016 in a single tertiary institution. The present study comprised 2 groups: Patients receiving only TA injection (group 1), and patients receiving both TA injection and other immunosuppressive therapy (group 2).

Results:
There were a total of 99 patients and 135 eyes. Group 1 comprised of 36 eyes (26.7%), while group 2 comprised 99 (73.3%). Normalization or improvement of margin reflex distance 1 was seen in 77.4% and 97.2% of group 1 patients at early and late review, respectively, and 77.6% and 87.8% of group 2, respectively. Absence or improvement in International Thyroid Eye Disease Society inflammatory index was seen in 83.9% and 86.1% of group 1 at early and late review, respectively, and 71.9% and 76.8% of group 2, respectively. Both active (73.7%) and inactive (79.3%) groups showed good early success for improvement in margin reflex distance 1, with increased late success and no significant difference between the groups. For International Thyroid Eye Disease Society inflammatory index, the active group had better early and late success than the inactive group, with the difference being significant (P = 0.002) for late success.

Conclusions:
Transconjunctival TA injection is an effective treatment option for thyroid eye disease–related upper eyelid retraction, as a primary and adjunctive treatment, in both active and inactive thyroid eye disease patients.
Perceptions of Missed Care Across Oncology Nursing Specialty Units
Authors: Villamin Colleen , Anderson Jacqueline , Fellman Bryan , Urbauer Diana , Brassil Kelly 
Published: April 2018

Background:
An opportunity was identified to compare perceptions of the occurrence and types of missed care at a comprehensive cancer center.

Purpose:
The purpose was to evaluate the difference in perceived occurrence and types of missed care between medical, surgical, and hematologic oncology units in the context of a newly implemented patient care delivery system, Primary Team Nursing (PTN).

Methods:
A descriptive, repeated-measures design was used. The MISSCARE survey was distributed electronically to 580 staff members across 6 inpatient units.

Results:
Frequently perceived elements of missed nursing care were ambulation, turning every 2 hours, and care conference attendance. At the time of study implementation, surgical units reported 0.24 higher scores than medical units (P = .017); hematology units reported 0.26 lower scores than surgical units (P = .005). PTN status did not affect MISSCARE scores (P = .525).

Conclusions:
Study findings suggest that perceived missed care in a comprehensive cancer center is similar to that in other hospital settings.
Frequency of and Reasons for False-Positive Consults Generated by the Malnutrition Screening Tool
Authors: Sturgill Alison , Stanczyk Kathy , Crouch Lori , Byrd Karen 
Published: April 2018

Background:
Nutrition screening on admission is one way to identify patients with malnutrition. The Malnutrition Screening Tool (MST) is a commonly used screening tool but has been found to generate false-positive consults.

Purpose:
The purpose of this research was two-fold: (1) to determine the percentage of nursing screens, using the MST, that generated a false-positive consult for a registered dietitian, and (2) to identify the reasons for these false-positive consults.

Methods:
During a 3-month period, registered dietitians documented the number of false-positive consults received from the MST and reasons they were received.

Results:
Of the registered dietitian consults generated, 5.5% were deemed false-positive. The most common reason for a false-positive consult was patient-reported weight loss that had resolved.

Conclusions:
As nurses are integral to completion of the MST, data generated can be used in ongoing education of nursing staff.
Pregnancy Complications Associated With Maternal Hypothyroidism: A Systematic Review
Authors: Shinohara Danielle Rosani , Santos Thais da Silva , de Carvalho Hayalla Corrêa , Lopes Laíza Cristina Bahls , Günther Luciene Setsuko Akimoto , Aristides Sandra Mara Alessi , Teixeira Jorge Juarez Vieira , Demarchi Izabel Galhardo 
Published: April 2018

Importance
Hypothyroidism is one of the most prevalent diseases in pregnancy, but there is no consensus about its management in pregnant women.

Objective
In this systematic review, we evaluated the association between pregnancy complications and treated or untreated maternal hypothyroidism.

Evidence Acquisition
PubMed and reference lists were searched for the Medical Subject Headings terms “pregnancy complications” and “hypothyroidism.” The eligibility criteria for inclusion in the study were an original study published between 2002 and 2013. Six reviewers independently selected the studies, and 3 extracted the data. Two reviewers assessed the risk of bias and quality of the studies.

Results
Eighteen studies were included in the systematic review. The most prevalent complications associated with maternal hypothyroidism were abortion, intrauterine fetal death, preterm delivery, and preeclampsia. The pregnancy outcome depended on the treatment that was received by the patient.

Conclusions
Strong evidence indicates that maternal hypothyroidism is associated with maternal-fetal complications, but no consensus was found among the studies reviewed herein. The dose of levothyroxine that is required to maintain euthyroidism is still questioned, but studies have suggested that levothyroxine should be adjusted according to the gestational period and laboratory profile.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, the learner should be better able to examine the association between hypothyroidism and pregnancy complications; compare the complications related to hypothyroidism before, during, and after pregnancy; analyze the relationship between complications encountered and the results of laboratory tests; and assess the ways in which the treatment is commonly performed.