bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evolution of Pre- and Postconvective Environmental Profiles from Mesoscale Convective Systems during PECAN
Authors: Hitchcock Stacey M. , Schumacher Russ S. , Herman Gregory R. , Coniglio Michael C. , Parker Matthew D. , Ziegler Conrad L. 
Published: April 2019

Abstract
During the Plains Elevated Convection at Night (PECAN) field campaign, 15 mesoscale convective system (MCS) environments were sampled by an array of instruments including radiosondes launched by three mobile sounding teams. Additional soundings were collected by fixed and mobile PECAN integrated sounding array (PISA) groups for a number of cases. Cluster analysis of observed vertical profiles established three primary preconvective categories: 1) those with an elevated maximum in equivalent potential temperature below a layer of potential instability; 2) those that maintain a daytime-like planetary boundary layer (PBL) and nearly potentially neutral low levels, sometimes even well after sunset despite the existence of a southerly low-level wind maximum; and 3) those that are potentially neutral at low levels, but have very weak or no southerly low-level winds. Profiles of equivalent potential temperature in elevated instability cases tend to evolve rapidly in time, while cases in the potentially neutral categories do not. Analysis of composite Rapid Refresh (RAP) environments indicate greater moisture content and moisture advection in an elevated layer in the elevated instability cases than in their potentially neutral counterparts. Postconvective soundings demonstrate significantly more variability, but cold pools were observed in nearly every PECAN MCS case. Following convection, perturbations range between −1.9 and −9.1 K over depths between 150 m and 4.35 km, but stronger, deeper stable layers lead to structures where the largest cold pool temperature perturbation is observed above the surface.
Early Otorrhea Rates: A Randomized Trial of Ciprofloxacin versus Saline Drops after Tympanostomy Tubes
Authors: Gabarain Gabriel , Baird Rachel , Morisada Megan , Anne Samantha , Hopkins Brandon 
Published: April 2019

Objective: The objectives of this study are to evaluate incidence, duration, and quality of life (QOL) impact of early tympanostomy tube otorrhea and tube patency when comparing topical ciprofloxacin versus normal saline use in the perioperative period. Methods: Overall, 200 patients undergoing tube placement between November 19, 2015, and September 12, 2016, were randomized to intraoperative plus 5 days of either topical ciprofloxacin or normal saline. Parents or caregivers reported the incidence, duration, and QOL impact of early otorrhea via 4 weekly surveys. In addition, the patient’s otorrhea history and tube patency were evaluated at a 4- to 6-week postoperative visit. Results: Survey and in-office follow-ups were completed on 128 patients. The overall otorrhea incidence was 23.9% for normal saline and 16.7% for ciprofloxacin ( P = .32). The week-by-week otorrhea incidence was not statistically different. The percentage of days otorrhea was present, likewise, was not statistically different (normal saline 4.5%, ciprofloxacin 2.8%; P = .74). The QOL impact was not statistically different (normal saline 1.2, ciprofloxacin 1.5; P = .71). Tube patency was not statistically different, with only 1 of 280 ears occluded at follow-up. Conclusion: We find no difference in the incidence, duration, and QOL impact of early tympanostomy tube otorrhea or tube patency between ciprofloxacin and normal saline. This supports the option to substitute normal saline for ciprofloxacin in ears without an active ear infection at the time of tube placement, which would reduce both cost and unnecessary antibiotic use. Level of Evidence: 1b
Double-Layer Tympanic Membrane Graft in Type I Tympanoplasty
Authors: Bedri Es-hak , Korra Bilen , Redleaf Miriam , Worku Alemayehu 
Published: April 2019

Background: Some discussion remains among otologists regarding the best grafts for tympanic membrane closure. It is unclear whether double-layer grafts are superior to single-layer and whether single-layer cartilage is superior to fascia or perichondrium alone. The objective of the current study was to examine the relative efficacy of single-layer versus double-layer tympanic membrane grafting techniques. Materials and Methods: A retrospective review of the medical records was used to address the objective of the study. Patients operated on in an over/under technique by the same surgeon underwent single-layer perichondrium or single-layer perichondrium with a cartilage island, or a double-layer of perichondrium combined with periochondrium with a cartilage island. The outcomes assessed were tympanic membrane reperforation and hearing improvement. Results: A total of 135/177 (76%) perichondrium grafts had no reperforation, and 43/55 (78%) perichondrium with cartilage island grafts had no reperforation; 352/390 (90%) of the double-layer closures had no reperforation. There was no statistically significant difference in reperforation rates between the 2 single-layer techniques ( P = .926). The difference in reperforation rates after the double-layer closure versus the perichondrium single-layer closure was statistically significant ( P = .001), as was the difference in reperforation rates after the double-layer closure versus the cartilage island single-layer closure ( P = .02). All 3 groups showed statistically significant hearing improvement postoperatively ( P < .0001). Preoperative hearing levels ( P = .179), postoperative hearing ( P = .857), and decibels of hearing improvement ( P = .356) were the same for all 3 groups. Conclusion: Double-layer closure gives lower tympanic membrane reperforation rates than does single-layer closure, as well as similar hearing outcomes.
Modified expansive laminoplasty and fusion compared with anterior cervical surgeries in treating four-level cervical spondylotic myelopathy
Authors: Zhou Chuanli , Liu Chenguang , Panchal Ripul R. , Ma Xuexiao , Chen Xiaoliang 
Published: April 2019

Objective To compare modified expansive laminoplasty and fusion (MELF) with anterior cervical corpectomy and fusion (ACCF), and anterior cervical discectomy and fusion (ACDF), in treating four-level cervical spondylotic myelopathy (CSM). Methods This retrospective study included patients with four-level CSM who had undergone surgery at the Affiliated Hospital of Qingdao University between January 2013 and May 2015. D-values, Cobb’s angle, Japanese Orthopaedic Association (JOA) score and quality of life (SF-36 scores) were compared between patients treated with ACCF/ACDF versus MELF. Results Twenty-six patients who underwent ACCF/ACDF and 26 who underwent MELF were included, and all showed bone fusion following treatment. The most common complications were dysphasia (12/26) in the ACCF/ACDF group and axial neck pain (7/26) in the MELF group. C5 nerve root palsy was not observed in either group. D value and Cobb’s angle changes showed that ACDF/ACCF was more effective in curve correction than MELF. Postoperative improvements in JOA and SF-36 scores were noted in both groups, with no statistically significant between-group differences. Conclusion Anterior and posterior approaches may produce similar clinical outcomes in the surgical management of four-level CSM. MELF may avoid known complications of the posterior approach.
Outcomes of CPC-CBT in Sweden Concerning Psychosocial Well-Being and Parenting Practice: Children’s Perspectives
Authors: Thulin Johanna , Nilsson Doris , Svedin Carl Göran , Kjellgren Cecilia 
Published: April 2019

Purpose: This study explores the outcome of the intervention combined parent child–cognitive behavioral therapy (CPC-CBT) for physically abused children. Method: This study includes a clinical sample of children ( n = 62) referred to Child Welfare Service due to reports of child physical abuse who completed CPC-CBT. A pretest/posttest design was applied to assess changes on the Trauma Symptom Checklist for Children (TSCC) after treatment and was compared with normative values. In addition, the occurrence of corporal punishment from pre to posttest was explored. Results: Children reported a significant decrease in parental use of corporal punishment after treatment and a significant reduction in symptoms associated with trauma (decreased to normal values for TSCC). The positive changes remained at the 6-month follow-up. Conclusions: The CPC-CBT intervention seemed to decrease parental use of corporal punishment and increase the well-being of children. Clinical implications are discussed.
Efficacy and toxicity of mustargen, vincristine, procarbazine and prednisone (MOPP) for the treatment of relapsed or resistant lymphoma in cats
Authors: MaloneyHuss Martha A , Mauldin Glenna E , Brown Dorothy C , Veluvolu Sridhar M , Krick Erika L 
Published: April 2019

Objectives The aims of this study were to evaluate the safety of mustargen, vincristine, procarbazine and prednisone (MOPP) chemotherapy in the treatment of relapsed or refractory feline lymphoma, and to determine the overall response rate and median remission time with this protocol. Methods The medical records of 38 cats with relapsed or refractory lymphoma treated with MOPP chemotherapy at three institutions (University of Pennsylvania, the Animal Medical Center, and VCA Western Veterinary Specialist and Emergency Centre) were examined. Information evaluated included patient signalment, feline immunodeficiency virus/feline leukemia virus status, anatomic location(s) of lymphoma, prior protocols (type and number), MOPP doses, MOPP response, remission duration, hematologic and biochemical parameters, and owner-reported adverse effects. Results Overall, 70.3% of cats responded to MOPP chemotherapy. Among the responders, the median remission duration was 166 days. The most common adverse effects were neutropenia and gastrointestinal upset, which were reported in 18.4% of cats. In 55.3% of cats, no adverse effects were reported. In total, 30.8% of responders continued to respond 6 months following the initiation of MOPP, and 15.4% maintained a response 1 year after starting MOPP. Conclusions and relevance MOPP is a safe protocol for the treatment of relapsed or refractory feline lymphoma, with a promising overall response rate and median remission time.
Main Clinical Use of Additive Manufacturing (Three-Dimensional Printing) in Finland Restricted to the Head and Neck Area in 2016–2017
Authors: Pettersson A.B.V. , Salmi M. , Vallittu P. , Serlo W. , Tuomi J. , Mäkitie A. A. 
Published: April 2019

Background and Aims: Additive manufacturing or three-dimensional printing is a novel production methodology for producing patient-specific models, medical aids, tools, and implants. However, the clinical impact of this technology is unknown. In this study, we sought to characterize the clinical adoption of medical additive manufacturing in Finland in 2016–2017. We focused on non-dental usage at university hospitals. Materials and Methods: A questionnaire containing five questions was sent by email to all operative, radiologic, and oncologic departments of all university hospitals in Finland. Respondents who reported extensive use of medical additive manufacturing were contacted with additional, personalized questions. Results: Of the 115 questionnaires sent, 58 received answers. Of the responders, 41% identified as non-users, including all general/gastrointestinal (GI) and vascular surgeons, urologists, and gynecologists; 23% identified as experimenters or previous users; and 36% identified as heavy users. Usage was concentrated around the head area by various specialties (neurosurgical, craniomaxillofacial, ear, nose and throat diseases (ENT), plastic surgery). Applications included repair of cranial vault defects and malformations, surgical oncology, trauma, and cleft palate reconstruction. Some routine usage was also reported in orthopedics. In addition to these patient-specific uses, we identified several off-the-shelf medical components that were produced by additive manufacturing, while some important patient-specific components were produced by traditional methodologies such as milling. Conclusion: During 2016–2017, medical additive manufacturing in Finland was routinely used at university hospitals for several applications in the head area. Outside of this area, usage was much less common. Future research should include all patient-specific products created by a computer-aided design/manufacture workflow from imaging data, instead of concentrating on the production methodology.
Safety of EndoAnchors in real-world use: A report from the Manufacturer and User Facility Device Experience database
Authors: Masoomi Reza , Lancaster Emily , Robinson Alexander , Hacker Ethan , Krajcer Zvonimir , Gupta Kamal 
Published: April 2019

Objectives A hostile proximal neck anatomy is the most common cause of abdominal aorta endovascular aneurysm repair failure leading to a higher risk of device migration, proximal type I endoleak, and subsequent open surgical repair. Endostapling is a technique to attain better fixation of the endograft to the aortic wall, and the only available device in the USA is Aptus Heli-FX EndoAnchor system (Medtronic Vascular, Santa Rosa, CA, USA). Preliminary data have shown efficacy and safety of its use, and the aim of this study is to assess device-related adverse events in real-world clinical use. Methods We quarried data from the publicly available Manufacturer and User Facility Device Experience database to identify Aptus Heli-FX EndoAnchor system-related adverse reports in endovascular aneurysm repair since FDA approval till August 31, 2017. An estimate of total devices implanted in the United States was quoted around 7,000 (Medtronic marketing internal data). Results Our query identified 229 separate reports, of which there were 85 adverse events (1.2% of the estimated EndoAnchor systems used). The most common adverse events were device dislodgement/fracture (65) and applicator malfunction (20). Conclusion In early post-FDA approval use in a real-world setting, the EndoAnchor system is associated with a low rate of adverse events. Device dislodgement and embolization remain the most common adverse events. With increasing use of these devices in more difficult anatomy, careful patient selection and careful attention to technique may help to reduce these events even further.
The impact of an obstetrician-led, labor ward critical care unit: A prospective comparison of outcomes before and after establishment
Authors: Langenegger Eduard J , Hall DR , Mattheyse F , Harvey J 
Published: April 2019

Objective To investigate the outcomes of critically ill obstetric patients managed in a obstetric critical care unit in South Africa. Methods Patients with severe maternal morbidity managed in the labor ward of Tygerberg Hospital were studied over three months before the establishment of the obstetrician-led obstetric critical care unit. One year later, patients managed in the obstetric critical care unit were studied using the same methods. The primary outcome measures were maternal morbidity and mortality. Results In the before-obstetric critical care unit prospective audit 63 patients met criteria for obstetric critical care. During the second period 60 patients were admitted to the obstetric critical care unit. There were no significant differences between the groups in baseline characteristics, admission indications or Acute Physiology and Chronic Health Evaluation scores. Continuous positive airway pressure ( p < 0.01) was utilized more in the second group. Seven deaths occurred in the first, but none in the second group ( p = 0.01). Conclusion The establishment of an obstetrician-led obstetric critical care unit facilitated a decrease in maternal mortality. Trial registration: Not applicable.
Nox2 NADPH oxidase is dispensable for platelet activation or arterial thrombosis in mice
Authors: Sonkar Vijay K. , Kumar Rahul , Jensen Melissa , Wagner Brett A. , Sharathkumar Anjali A. , Miller Francis J. , Fasano MaryBeth , Lentz Steven R. , Buettner Garry R. , Dayal Sanjana 
Published: April 2019

Abstract
Deficiency of the Nox2 (gp91phox) catalytic subunit of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase is a genetic cause of X-linked chronic granulomatous disease, a condition in which patients are prone to infection resulting from the loss of oxidant production by neutrophils. Some studies have suggested a role for superoxide derived from Nox2 NADPH oxidase in platelet activation and thrombosis, but data are conflicting. Using a rigorous and comprehensive approach, we tested the hypothesis that genetic deficiency of Nox2 attenuates platelet activation and arterial thrombosis. Our study was designed to test the genotype differences within male and female mice. Using chloromethyl-dichlorodihydrofluorescein diacetate, a fluorescent dye, as well as high-performance liquid chromatography analysis with dihydroethidium as a probe to detect intracellular reactive oxygen species (ROS), we observed no genotype differences in ROS levels in platelets. Similarly, there were no genotype-dependent differences in levels of mitochondrial ROS. In addition, we did not observe any genotype-associated differences in platelet activation, adhesion, secretion, or aggregation in male or female mice. Platelets from chronic granulomatous disease patients exhibited similar adhesion and aggregation responses as platelets from healthy subjects. Susceptibility to carotid artery thrombosis in a photochemical injury model was similar in wild-type and Nox2-deficient male or female mice. Our findings indicate that Nox2 NADPH oxidase is not an essential source of platelet ROS or a mediator of platelet activation or arterial thrombosis in large vessels, such as the carotid artery.
Over- and under-diagnosis in asthma
Authors: Kavanagh Joanne , Jackson David J. , Kent Brian D. 
Published: April 2019

Asthma is extremely common with a prevalence of approximately 10% in Europe. It presents with symptoms which have a broad differential diagnosis and examination can be entirely normal. There is no agreed gold standard to diagnose asthma, and the objective tests that can aid diagnosis are often poorly available to primary care physicians. There is evidence that asthma is widely misdiagnosed. Overdiagnosis leads to unnecessary treatment and a delay in making an alternative diagnosis. Underdiagnosis risks daily symptoms, (potentially serious) exacerbations and long-term airway remodelling. An agreed standardised approach to diagnosis, with inclusion of objective measurements prior to treatment, is required to reduce misdiagnosis of asthma.Key pointsAsthma presents with common respiratory symptoms and physical examination is often normal; in addition, the most widely available tests (peak flow and spirometry) can be normal unless the patient is exacerbating.Treating asthma prior to carrying out objective tests decreases their sensitivity and can make confirmation of the diagnosis difficult.There is no single gold standard test to diagnose asthma, and there are significant differences between the suggested algorithms in commonly used guidelines.Both under- and over-diagnosis are widespread and lead to significant risks to patients.
Development of a heart rate variability and complexity model in predicting the need for life-saving interventions amongst trauma patients
Authors: Kumar Aravin , Liu Nan , Koh Zhi Xiong , Chiang Jayne Jie Yi , Soh Yuda , Wong Ting Hway , Ho Andrew Fu Wah , Tagami Takashi , Fook-Chong Stephanie , Ong Marcus Eng Hock 
Published: April 2019

Abstract

Background
Triage trauma scores are utilised to determine patient disposition, interventions and prognostication in the care of trauma patients. Heart rate variability (HRV) and heart rate complexity (HRC) reflect the autonomic nervous system and are derived from electrocardiogram (ECG) analysis. In this study, we aimed to develop a model incorporating HRV and HRC, to predict the need for life-saving interventions (LSI) in trauma patients, within 24 h of emergency department presentation.

Methods
We included adult trauma patients (≥ 18 years of age) presenting at the emergency department of Singapore General Hospital between October 2014 and October 2015. We excluded patients who had non-sinus rhythms and larger proportions of artefacts and/or ectopics in ECG analysis. We obtained patient demographics, laboratory results, vital signs and outcomes from electronic health records. We conducted univariate and multivariate analyses for predictive model building.

Results
Two hundred and twenty-five patients met inclusion criteria, in which 49 patients required LSIs. The LSI group had a higher proportion of deaths (10, 20.41% vs 1, 0.57%, p &lt; 0.001). In the LSI group, the mean of detrended fluctuation analysis (DFA)-α1 (1.24 vs 1.12, p = 0.045) and the median of DFA-α2 (1.09 vs 1.00, p = 0.027) were significantly higher. Multivariate stepwise logistic regression analysis determined that a lower Glasgow Coma Scale, a higher DFA-α1 and higher DFA-α2 were independent predictors of requiring LSIs. The area under the curve (AUC) for our model (0.75, 95% confidence interval, 0.66–0.83) was higher than other scoring systems and selected vital signs.

Conclusions
An HRV/HRC model outperforms other triage trauma scores and selected vital signs in predicting the need for LSIs but needs to be validated in larger patient populations.
Characteristics and origin of the pore structure of the lacustrine tight oil reservoir in the northwestern Jiuquan Basin, China
Authors: Fan Chunyan , Tang Xianglu , Zhang Yuanyin , Song Yan , Jiang Zhenxue , Luo Qun , Li Baiying 
Published: April 2019

The pore structure controls the formation processes of tight oil reservoirs. It is meaningful to study the characteristics and origin of the pore structure of the tight oil reservoir. We have analyzed the pore structure of the tight oil reservoir by thin sections, scanning electron microscopy, and mercury intrusion porosimetry. We analyze the origin of the pore structure based on sedimentological, diagenetic, and tectonism processes. The porosity of the tight oil reservoirs is mainly approximately 2%–10%, and the permeability is mainly from 0.01 to 0.3 mD. The pores of the lacustrine tight oil reservoir can be classified into the primary pore and the secondary pore. The main pores are matrix micropores and clay intercrystalline pores, as well as a few dissolved pores. However, the primary residual intergranular pore has almost disappeared, leading to a poor connectivity with a general size between 20 and 50 μm. The pore throat is divided into three categories (type I, type II, and type III) according to the porosity, permeability, and throat size and distribution. We determine that the pore structure of the lacustrine tight oil reservoir is related to sedimentary, diagenetic processes, and later tectonic events. The compaction and cementation are the main factors, whereas the dissolution and tectonic events have minor effects.