bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and evaluation of a rigid esophagoscopy simulator for residency training
Authors: Allak Amir , Liu Yizhen E. , Oliynyk Marianna S. , Weng Kai H. , Jameson Mark J. , Shonka David C. 
Published: November 2015

Objectives/HypothesisRigid esophagoscopy is performed less frequently by resident trainees. Nonetheless, it remains important for certain indications, including foreign body extraction. This study describes the construction of a simulator and evaluates its utility in training residents.Study DesignSimulator development, fabrication, and procedural evaluation of postgraduate trainees.MethodsA simulator was developed and constructed in collaboration with a biomedical engineering team. Residents with varied experience in upper aerodigestive procedures performed rigid esophagoscopy on the model. Key steps and Accreditation Council for Graduate Medical Education's Objective Structured Assessment of Technical Skills (OSATS) criteria for rigid esophagoscopy were evaluated by a faculty surgeon. Pressure measurements were obtained from force sensors at the tip of the endoscope and incisors.ResultsFourteen trainees were evaluated. Operative rigid esophagoscopy and direct laryngoscopy case numbers were noted for each subject. OSATS scores and key steps of the procedure correlated with resident experience (R2 = 0.75, P < .0001 and R2 = 0.66, P < .001, respectively). Maximal pressure exerted on the simulator esophagus by the esophagoscope was inversely correlated with case number and was statistically significant (R2 = 0.51, P = .02), whereas length of procedure did not correlate (R2 = 0.04, P = .49). Maximal pressure on the incisors did not correlate (R2 = 0.25, P = .15).ConclusionsA simulator for training residents to perform rigid esophagoscopy was developed and utilized by a faculty proctor to objectively evaluate trainees. OSATS scores, performance of key procedural steps, and pressure exerted on the simulator tissue correlated with upper aerodigestive cases performed, demonstrating validity of the simulator.Level of EvidenceNA Laryngoscope, 126:616–619, 2016
Gaps in evidence: Management of pediatric obstructive sleep apnea without tonsillar hypertrophy
Authors: Tang Alice , Gropler Matthew , Duggins Angela L. , Amin Raouf S. , Shott Sally R. , Chini Barbara , Ishman Stacey L. 
Published: November 2015

Objectives/HypothesisPersistent obstructive sleep apnea (OSA) is demonstrated in 40% of children after adenotonsillectomy. We previously evaluated the basis of management decisions in children with OSA without tonsillar hypertrophy and found that 61% of decisions were non–evidence based. The aim of this study was to identify gaps in evidence for the management of children with OSA without tonsillar hypertrophy.Study DesignCase series.MethodsWe recorded all real‐time decisions made by pediatric subspecialists from eight disciplines that participated in an upper airway clinic and management conferences. Practitioners were immediately queried regarding the basis of their decisions, and non–evidence‐based decisions were categorized.ResultsDuring 10 case conferences and five clinics, 507 decisions were made for 63 children (43% with Down syndrome, 20% with Pierre Robin sequence). The 309 non–evidence‐based decisions most commonly pertained to follow‐up timing and appropriate subspecialty clinic location (116/309, 38%) as well as timing for repeat polysomnography (35/309, 11%), especially in children at high risk for persistent OSA after treatment. Additional gaps identified included the likelihood of OSA improvement from weight loss, and effectiveness of sleep surgical procedures (i.e., lingual tonsillectomy, posterior midline glossectomy, and craniofacial surgery) alone or in combination.ConclusionsIdentified gaps in evidence included timing and location of follow‐up, appropriate use of polysomnography for surveillance, effectiveness of specific surgical procedures performed alone and in combination, and the use of oral appliances and continuous positive airway pressure therapy in children with Down syndrome. We also found a need for studies to compare the effectiveness of these treatment options in diverse patient populations.Level of Evidence4 Laryngoscope, 126:758–762, 2016
“String Hallucinations”: Multimodal Tactile and Visual Hallucinations in Parkinson's Disease
Authors: Pérez‐Pérez Jesús , Pagonabarraga Javier , Fernández‐Bobadilla Ramón , Kulisevsky Jaime 
Published: November 2015

AbstractThe aim of this work was to report on 7 patients presenting a distinctive form of multimodal (tactile and visual) hallucinations for which the term “string hallucinations” is proposed. Having observed a patient interacting with imaginary strips of skin in his hands at our movement disorders unit, we prospectively studied PD patients and caregivers over a 6‐month period using a semistructured interview addressed to this particular phenomenon. Demographic characteristics as well as cognitive and motor function were assessed. A total of 7 of 164 PD patients (4.3%) observed during the study period had string hallucinations. One patient was cognitively intact and the other 6 had some degree of cognitive impairment. Common to the phenomenology of the hallucinations was the unpleasant feeling and vision of threads emerging from the subjects’ hands. Patients interacted with these “threads,” trying to remove them from their hands. Our study identifies a previously undescribed type of hallucinations in PD, characterized by a complex pattern of multimodal tactile and visual hallucinations.
Chronic insufficient sleep and diet quality: Contributors to childhood obesity
Authors: Cespedes Elizabeth M. , Hu Frank B. , Redline Susan , Rosner Bernard , Gillman Matthew W. , Rifas‐Shiman Sheryl L. , Taveras Elsie M. 
Published: November 2015

ObjectiveTo examine associations of chronic insufficient sleep with diet and whether diet explains the sleep‐adiposity relationship.MethodsIn Project Viva, 1,046 parents reported children's sleep duration at 6 m and annually until midchildhood (7 y). The main exposure was a sleep curtailment score (6 m‐7 y) ranging from 0 (maximal curtailment) to 13 (adequate sleep). In mid‐childhood, parents reported children's diet; researchers measured height/weight. Multivariable linear regression assessed associations of sleep with diet (Youth Healthy Eating Index [YHEI]); sleep with BMI z‐score adjusting for YHEI; and, secondarily, joint associations of sleep and YHEI with BMI.ResultsMean (SD) sleep and YHEI scores were 10.21 (2.71) and 58.76 (10.37). Longer sleep duration was associated with higher YHEI in mid‐childhood (0.59 points/unit sleep score; 95% CI: 0.32, 0.86). Although higher YHEI was associated with lower BMI z‐score (−0.07 units/10‐point increase; 95% CI: −0.13, −0.01), adjustment for YHEI did not attenuate sleep‐BMI associations. Children with sleep and YHEI scores below the median (<11 and <60) had BMI z‐scores 0.34 units higher (95% CI: 0.16, 0.51) than children with sleep and YHEI scores above the median.ConclusionsWhile parent‐reported diet did not explain inverse associations of sleep with adiposity, both sufficient sleep and high‐quality diets are important to obesity prevention.
Preventing excessive gestational weight gain among African American women: A randomized clinical trial
Authors: Herring Sharon J. , Cruice Jane F. , Bennett Gary G. , Rose Marisa Z. , Davey Adam , Foster Gary D. 
Published: November 2015

ObjectiveEvidence is lacking regarding effective weight control treatments in pregnancy for ethnic minority women with obesity. This study evaluated whether a technology‐based behavioral intervention could decrease the proportion of African American women with overweight or obesity who exceeded Institute of Medicine (IOM) guidelines for gestational weight gain.MethodsWe conducted a two‐arm pilot randomized clinical trial. Participants were 66 socioeconomically disadvantaged African American pregnant women (12.5 ± 3.7 weeks' gestation; 36% overweight, 64% obesity) recruited from two outpatient obstetric practices at Temple University between 2013 and 2014. We randomized participants to usual care (n = 33) or a behavioral intervention (n = 33) that promoted weight control in pregnancy. The intervention included: (1) empirically supported behavior change goals; (2) interactive self‐monitoring text messages; (3) biweekly health coach calls; and (4) skills training and support through Facebook.ResultsThe intervention reduced the proportion of women who exceeded IOM guidelines compared to usual care (37% vs. 66%, P = 0.033). Intervention participants gained less weight during pregnancy (8.7 vs. 12.3 kg, adjusted mean difference: −3.1 kg, 95% CI: −6.2 to −0.1). No group differences in neonatal or obstetric outcomes were found.ConclusionsThe intervention resulted in lower prevalence of excessive gestational weight gain.
Body fatness charts based on BMI and waist circumference
Authors: Lee Wang‐Sheng 
Published: November 2015

ObjectiveTo present percent body fat (PBF) charts based on body mass index (BMI) and waist circumference (WC) which can supplement current public health guidelines for obesity.MethodsBased on data from the National Health and Nutrition Examination Survey (NHANES) III for 18‐ to 65‐year‐olds, a semi‐parametric spline approach was utilized, in which no specific functional forms for BMI and WC are assumed, to depict graphically the relationship between BMI, WC, and PBF. Four distinct PBF charts were created, categorized by gender and ethnicity which are based on data from 2,170 white females, 1,902 African American females, 1,905 white males, and 1,635 African American males.ResultsPBF prediction based on the semi‐parametric spline model outperformed competing linear models. For men, BMI is largely inconsequential, and WC plays a primary role in determining PBF levels. For women, the interaction between BMI and WC is more complex. To have low body fat, women would need to watch both their BMI and WC measurements carefully.ConclusionsPBF charts, which incorporate information from three dimensions that are as simple to read as a BMI chart to help determine a person's level of fatness, were proposed.
Possible Rivaroxaban Failure during the Postpartum Period
Authors: Rudd Kelly M. , Winans Amanda R. McFee , Panneerselvam Narmadha 
Published: November 2015

Rivaroxaban, a factor Xa inhibitor, is a direct‐acting oral anticoagulant (DOAC) indicated for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and for reducing the risk of DVT and PE recurrence. To our knowledge, no data are presently available to guide DOAC dosing in the postpartum period when pharmacokinetic and pharmacodynamic changes induced by pregnancy have an impact on drug clearance and increase hypercoagulability for a period of 6–8 weeks after delivery. We describe the case of a 35‐year‐old postpartum woman who presented to the emergency department with a diagnosis of a new multiple segmental PE 5 days after starting rivaroxaban therapy for a diagnosis of DVT. No precipitating cause, including noncompliance, was identified as a source of thrombosis embolization or extension. The patient was admitted, a heparin infusion was started for the management of PE, and rivaroxaban was discontinued. She was transitioned to enoxaparin 1 mg/kg (90 mg) subcutaneously every 12 hours the next day, bridged to warfarin, and discharged home on the overlapping regimen with close follow‐up by the pharmacist‐managed outpatient Anticoagulation Management Service. To our knowledge, this is the first case report of potential failure associated with rivaroxaban therapy in the postpartum period, possibly due to pharmacokinetic alterations seen in the postpartum period contributing to decreased drug exposure, yielding reduced anticoagulant efficacy. Clinicians should carefully weigh the risks and benefits of DOAC therapy in postpartum patients or other special populations requiring anticoagulation therapy. This report also highlights the need for further research identifying the impact of pharmacokinetic changes induced by special populations and the need to develop monitoring assays for such clinical situations.
Efficient synthesis of ionic triblock copolyesters and facile access to charge‐reversal hybrid micelles
Authors: Wu Shaohua , Zheng Liuchun , Zhou Wen , Li Chuncheng , Xiao Yaonan , Zhu Wenxiang 
Published: November 2015

ABSTRACTNovel carboxyl‐ and amino‐functionalized copolyesters, based on poly(ε‐caprolactone)‐block‐poly(butylene fumarate)‐block‐poly(ε‐caprolactone), were efficiently synthesized via Michael‐type thiol‐ene click chemistry. The resulting amphiphilic copolyesters with controllable molecular weights and abundant positively or negatively charged groups could spontaneously form pH‐sensitive micelles in aqueous solutions, as confirmed by transmission electron microscopy, dynamic light scattering, fluorescence probing technique, and zeta potential analyses. Importantly, charge‐reversal hybrid micelles can be obtained by co‐assembly of carboxyl‐ and amino‐functionalized copolyesters. The surface charges of hybrid micelles reversed rapidly from negative to positive at isoelectric point via protonation of surface carboxyl and amino groups. Interestingly, the hybrid micelles showed apparent pH‐triggered Nile red‐release behavior in acidic condition resembling tumor intracellular environment, which is fairly desirable for drug delivery. Our work indicates that co‐assembly is a facile but efficient way to prepare charge‐reversal micelles, which have great potential to be used as intelligent drug delivery systems for cancer therapy. © 2015 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2016, 54, 1259–1267
Preparation and properties of thermoresponsive and conductive composite fibers with core‐sheath structure
Authors: Lin Mei‐Fei , Don Trong‐Ming , Chang Fang‐Tzu , Huang Shih‐Ru , Chiu Wen‐Yen 
Published: November 2015

ABSTRACTIn this research, thermoresponsive and conductive fibers with core‐sheath structure were fabricated by coaxial electrospinning. For preparing the spinning sheath solution, poly‐(N‐isopropylacrylamide‐co‐N‐methylolacrylamide) (PNN) copolymer having thermoresponsive and cross‐linkable properties was synthesized by free‐radical polymerization using redox initiators; it was then mixed with the conductive poly(3,4‐ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS) at different weight ratios in water. On the other hand, poly(butyl acrylate‐co‐styrene) (PBS) copolymer synthesized by emulsion polymerization was dissolved in chloroform and used as the spinning core solution. After electrospinning, the fibers were treated at 110 °C for 1 h to cross‐link the PNN portion in the sheath for strengthening the fibers. Well‐defined core‐sheath fibers were observed from SEM pictures; the outside and inside (core) diameters were 568 ± 24 and 290 ± 40 nm, respectively, as determined from TEM pictures. The fiber mats were further doped by DMSO to enhance their conductivity. For the fiber mat with the weight ratio of PEDOT:PSS/PNN at 0.20 in the sheath, its surface conductivity could reach 29.4 S/cm. In addition, the fiber mats exhibited thermoresponsive properties that both swelling ratio and electric resistance decreased with temperature. Furthermore, the fiber mats exhibited improved flexibility as evaluated via bending test. © 2015 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2016, 54, 1299–1307
Abbreviation modalities of nitrogen multiple‐breath washout tests in school children with obstructed lung disease
Authors: Green Kent , Ejlertsen Jacob S. , Madsen Astrid , Buchvald Frederik F. , Kongstad Thomas , Kobbernagel Helene , Gustafsson Per M. , Nielsen Kim G. 
Published: November 2015

SummaryRationale: Nitrogen multiple‐breath washout (N2 MBW) is a promising tool for assessing early lung damage in children with chronic obstructive pulmonary disease, but it can be a time‐consuming procedure. We compared alternative test‐shortening endpoints with the most commonly reported N2 MBW outcome, the lung clearance index, calculated as lung volume turnovers required to reach 2.5% of the starting N2 concentration (LCI2.5). Methods: Cross‐sectional study of triplicate N2 MBW measurements obtained in cystic fibrosis (CF) patients (N = 60), primary ciliary dyskinesia (PCD) patients (N = 28), and matched healthy controls (N = 48) aged 5–18 years. Bland–Altman analysis was used to compare LCI2.5 with earlier LCI endpoints (3%, 4%, 5%, 7%, and 9% of starting N2 concentration), Cn@TO6 (defined as % of N2 starting concentration when reaching six lung volume turnovers), and LCI derived from only two N2 MBW runs in each session. N2 MBW endpoints were analyzed as z‐scores calculated from healthy controls. Results: In PCD, Cn@TO6 and LCI2.5 exhibited similar values (mean [95%CI] difference: 0.33 [−0.24; 0.90] z‐scores), reducing the test duration by one‐third (5.4 min; 95%CI: 4.0; 6.8). All other tested alternative endpoints exhibited increasing disagreement with increasing LCI2.5. With an average reduction in test duration of 40%, LCI2.5 derived from two runs exhibited good agreement in all children. Conclusions: Cn@TO6 may be suggested as a potential test‐shortening endpoint in school children with PCD. In CF, early test termination may reduce measurement power with advancing pulmonary disease, suggesting differences in underlying pathophysiology. Two technically acceptable N2 MBW runs may be sufficient in school children irrespective of diagnosis with CF or PCD. Pediatr Pulmonol. 2016;51:624–632. © 2015 Wiley Periodicals, Inc.
Synchronisation of the equatorial QBO by the annual cycle in tropical upwelling in a warming climate
Authors: Rajendran Kylash , Moroz Irene M. , Read Peter L. , Osprey Scott M. 
Published: November 2015

The response of the period of the quasi‐biennial oscillation (QBO) to increases in tropical upwelling are considered using a one‐dimensional model. We find that the imposition of the annual cycle in tropical upwelling creates substantial variability in the period of the QBO. The annual cycle creates synchronisation regions in the wave forcing space, within which the QBO period locks onto an integer multiple of the annual forcing period. Outside of these regions, the QBO period undergoes discrete jumps as it attempts to find a stable relationship with the oscillator forcing. The resulting set of QBO periods can be either discrete or broad‐banded, depending on the intrinsic period of the QBO.We use the same model to study the evolution of the QBO period as the strength of tropical upwelling increases, as would be expected in a warmer climate. The QBO period lengthens and migrates closer towards 36‐ and 48‐month locking regions as upwelling increases. The QBO period does not vary continuously with increased upwelling, however, but instead transitions through a series of two‐ and three‐cycles before becoming locked to the annual cycle. Finally, some observational evidence for the cyclical behaviour of the QBO periods in the real atmosphere is presented.
Vitamin D status in cats with feline immunodeficiency virus
Authors: Titmarsh Helen F. , Lalor Stephanie M. , Tasker Severine , Barker Emily N. , Berry Jacqueline , Gunn‐More Danielle , Mellanby Richard J 
Published: November 2015

AbstractFeline immunodeficiency virus (FIV) is a lentivirus that can lead to a syndrome of acquired immune dysfunction. Infected cats often remain asymptomatic for several years before immune dysfunction leads to an increased risk for the development of systemic diseases, neoplasia and opportunistic infections. FIV is structurally related to human immunodeficiency virus (HIV) and the pathogenesis of FIV‐related disease is similar to that seen in HIV‐infected patients. Observational studies have documented an association between low plasma vitamin D and HIV infection. Vitamin D status has been shown to be associated with HIV‐related disease progression, morbidity and mortality. The objective of this study was to examine the hypothesis that vitamin D status, as assessed by serum 25‐hydroxyvitamin D [25(OH)D] concentrations, are lower in cats with FIV infection compared to healthy control cats. Serum 25(OH)D concentrations were measured in 20 healthy cats, 39 hospitalized ill cats and 59 cats infected with FIV. Cats which were FIV infected had significantly lower 25(OH)D concentrations compared to healthy control cats. Serum 25(OH)D concentrations were not significantly different between FIV‐infected cats and hospitalized ill cats. Further investigations are warranted to determine whether vitamin D status influences the prognosis of cats infected with FIV.
Global Attractors of Sixth Order PDEs Describing the Faceting of Growing Surfaces
Authors: Korzec M. D. , Nayar P. , Rybka P. 
Published: November 2015

Abstract
A spatially two-dimensional sixth order PDE describing the evolution of a growing crystalline surface h(x, y, t) that undergoes faceting is considered with periodic boundary conditions, as well as its reduced one-dimensional version. These equations are expressed in terms of the slopes

$$u_1=h_{x}$$

u
1

=

h
x

and

$$u_2=h_y$$

u
2

=

h
y

to establish the existence of global, connected attractors for both equations. Since unique solutions are guaranteed for initial conditions in

$$\dot{H}^2_{per}$$

H
˙

p
e
r

2

, we consider the solution operator

$$S(t): \dot{H}^2_{per} \rightarrow \dot{H}^2_{per}$$

S

(
t
)

:

H
˙

p
e
r

2

→

H
˙

p
e
r

2

, to gain our results. We prove the necessary continuity, dissipation and compactness properties.
Optimization for Early-Warning Monitoring Networks in Well Catchments Should Be Multi-objective, Risk-Prioritized and Robust Against Uncertainty
Authors: Bode Felix , Nowak Wolfgang , Loschko Matthias 
Published: November 2015

AbstractGroundwater abstraction wells are commonly protected by zones of restricted land use. Such well protection areas typically cannot cover the entire well catchment, and numerous risk sources remain. Each risk source could release contaminants at any time, affect the well earlier or later, and thus put the quality of supplied water at risk. In this context, it seems fortunate that most well catchments are equipped with monitoring networks. Such networks, however, often grew historically while following diverse purposes that changed with time. Thus, they are often inadequate (or at least suboptimal) as reliable risk control mechanism. We propose to optimize existing or new monitoring networks in a multi-objective setting. The different objectives are minimal costs, maximal reliability in detecting recent or future contaminant spills, and early detection. In a synthetic application scenario, we show that (1) these goals are in fact competing, and a multi-objective analysis is suitable, (2) the optimization should be made robust against predictive uncertainty through scenario-based or Monte Carlo uncertainty analysis, (3) classifying the risk sources (e.g., as severe, medium, almost tolerable) is useful to prioritize the monitoring needs and thus to obtain better compromise solutions under budgetary constraints, and (4) one can defend the well against risk sources at unknown locations through an adequate model for the residual risk. Overall, the concept brings insight into the costs of reliability, the costs of early warning, the costs of uncertainty, and into the trade-off between covering only severe risks versus the luxury situation of controlling almost tolerable risks as well.