bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arctic Air Masses in a Warming World
Authors: Gervais Melissa , Atallah Eyad , Gyakum John R. , Tremblay L. Bruno 
Published: January 2016

Abstract
An important aspect of understanding the impacts of climate change on society is determining how the distribution of weather regimes will change. Arctic amplification results in greater warming over the Arctic compared to the midlatitudes, and this study examines how patterns of Arctic air masses will be affected. The authors employ the Community Earth System Model Large Ensemble (CESM-LE) RCP 8.5, consisting of 30 ensemble members run through the twenty-first century. Self-organizing maps are used to define archetypes of 850-hPa equivalent potential temperature anomalies with respect to a changing climate and assess changes in their frequency of occurrence. In the model, a pattern with negative anomalies over the central Arctic becomes less frequent in the future. There is also an increase in the frequency of patterns associated with an amplified ridge (trough) with positive (negative) anomalies over western (eastern) North America. It is hypothesized that the increase in frequency of such patterns is the result of enhanced forcing of baroclinic waves owing to reduced sea ice over the western Arctic. There is also a decline in patterns that have anomalously high over the North Atlantic, a pattern that is associated with intense ridging in the 500-hPa flow over the North Atlantic and colder over Europe. The authors relate the decrease of these patterns to an enhancement of the North Atlantic jet induced by a warming deficit in the North Atlantic Ocean.
Cytokine profiles in overweight and obese subjects and normal weight individuals matched for age and gender
Authors: Azizian Maryam , Mahdipour Elahe , Mirhafez Seyed Reza , Shoeibi Sara , Nematy Mohsen , Esmaily Habibollah , Ferns Gordon AA , Ghayour-Mobarhan Majid 
Published: January 2016

Background Obesity is associated with a state of systemic inflammation, mediated by adipose tissue-derived cytokines that may also have metabolic effects, including an effect on insulin resistance. The aim of this study was to compare the serum profile of pro- and anti-inflammatory cytokines in obese and non-obese subjects. Methods A total of 242 subjects who were either overweight or obese (body mass index [BMI] ≥ 25 kg/m2) and non-obese subjects (body mass index <25 kg/m2), were recruited in Mashhad in northeastern Iran. The concentrations of serum interleukin-1α, -1β, -2, -4, -6, -8 and -10 (IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8 and IL-10), were measured in all subjects, together with serum vascular endothelial growth factor, interferon-γ, epidermal growth factor, monocyte chemoattractant protein-1 and tumour necrosis factor-α. Results The groups differed significantly with respect to measures of adiposity and fasted lipid profile. Serum pro-inflammatory cytokines interferon-γ and interleukin-1α, and anti-inflammatory cytokines, interleukin-10, and epidermal growth factor were significantly different between obese and non-obese individuals, as was serum high-sensitivity C-reactive protein. Multivariate regression showed that waist circumference was significantly and independently related to serum monocyte chemoattractant protein-1concentrations ( P = 0.001). Conclusion Despite significant differences in several cytokines between the groups, only monocyte chemoattractant protein-1appeared to be independently related to a measure of adiposity in this population sample from Iran.
State, State Institutions, and Political Power in Brazil
Authors: Boito Armando , Saad-Filho Alfredo 
Published: January 2016

The political conflicts during the Workers’ Party administrations led by Luís Inácio Lula da Silva and Dilma Rousseff have been driven by disputes between two fractions of the country’s bourgeoisie: the internal and the internationalized bourgeoisie. Their ideologies, policies, institutions, and forms of political representation have determined government policies and outcomes. These processes have unfolded within an authoritarian democracy whose structures have not been challenged by the party. The party’s limited power and continuing timidity have produced an aggressive reaction by the internationalized bourgeoisie and the upper middle class, leading to a severe crisis in the administration of President Dilma Rousseff. Durante os dois governos do Partido dos Trabalhadores (PT), chefiados por Luís Inácio Lula da Silva e por Dilma Rousseff, os conflitos políticos têm sido conflagrados por disputas entre duas facções burguesas do país: a burguesia interna e a burguesia internacionalizada. Suas respectivas formas de representações políticas, ideologias, programas, bem como instituições têm determinado políticas governamentais e seus resultados. Esses processos evoluíram em uma democracia autoritária, cujas estruturas não foram contestadas pelo PT. A timidez contínua e o poder limitado do partido têm produzido uma reação agressiva por parte da burguesia internacionalizada e da classe média alta, levando a uma crise severa na administração da Presidente Dilma Rousseff.
Does Type of Pharyngeal Packing during Sinonasal Surgery Have an Effect on PONV and Throat Pain?
Authors: Meco Basak Ceyda , Ozcelik Menekse , Yildirim Guclu Cigdem , Beton Suha , Islamoglu Yuce , Turgay Aysegul , Meco Cem , Batislam Yesim 
Published: January 2016

ObjectivePostoperative nausea and vomiting (PONV) is a common problem that affects up to 30% of all surgical patients after general anaesthesia, which increases in sinonasal surgery due the very potent emetic effect of ingested blood that is swallowed during the procedures. Therefore, a hypo/oropharyngeal packing is commonly placed in an effort to prevent blood ingestion. The primary aim of this study was to compare the efficacy of 3 packing types in preventing PONV and to compare the results with patients who received no packing. The secondary aim was to compare the postoperative throat pain in all 4 groups.Study DesignA prospective double‐blind randomized controlled study.SettingA university hospital.Subjects and MethodsAfter Institutional Review Board approval and informed consent, 201 adult patients scheduled for sinonasal surgery were randomized to 4 groups to have dry packing (n = 52), packing soaked with water (n = 48), packing soaked with chlorhexidine gluconate and benzydamine hydrochloride (n = 51), or no packing (n = 50). Postoperative PONV and throat pain were assessed.ResultsDemographic data, procedural characteristics, and PONV risk scores were similar among groups. The PONV incidences, throat pain scores, and analgesic use were comparable in all 4 groups.ConclusionDespite commonly used practices, usage of different types of pharyngeal packing did not affect incidence of PONV and throat pain, nor did usage of no packing.
Endoscopic Salivary Stone Fragmentation with Pneumatic Lithotripsy in a Simulation Model
Authors: Hoffman Henry T. , Walvekar Rohan R. , Tracy Chad R. , Kolenda Jack , Pagedar Nitin 
Published: January 2016

ObjectiveTo evaluate the endoscopic fragmentation and removal of human salivary stones by employing intracorporeal pneumatic lithotripsy in a clinical simulation model of the submandibular gland.Study DesignSimulation model evaluating endoscopic management of human salivary stones.SettingLaboratory.Subjects and MethodsA flexible nitinol contact probe adapted to a CO2‐driven handheld salivary pneumatic lithotripter was deployed through a sialendoscope to disrupt parotid (n = 1) and submandibular (n = 8) stones embedded in separate 3‐dimensionally printed plastic models of the mouth and submandibular glands. Simulation included endoscopic removal of small stone fragments by standard basket retrieval supplement by irrigation and suction through a salivary duct introducer system. Correlations were made between stone volume and density with the duration of the procedures and number of pneumatic pulses required to disrupt and remove stone fragments.ResultsAmong the 8 stones fragmented sufficiently to permit either full endoscopic removal (n = 7) or removal of the central portion leaving an adherent rind to the duct (n = 1), the average procedure time (32 minutes) and the average number of pneumatic pulses (98) correlated with stone density (range, 0.4‐1.5 g/mL) and stone volume (range, 0.05‐0.4 mL). One stone was sufficiently resistant to fragmentation as to prevent successful removal.ConclusionsModification to the evolving technology of intracorporeal pneumatic management of nephrolithiasis was successfully applied in an ex vivo model to simulate management of sialolithiasis.
Educational Value of a Medical Student–Led Head and Neck Cancer Screening Event
Authors: Freiser Monika E. , Desai Dipan D. , Azcarate Patrick M. , Szczupak Mikhaylo , Cohen Erin R. , Raffa Francesca N. , George Joshua S. , Lo Kaming , Nayak Chetan S. , Weed Donald T. , Sargi Zoukaa B. 
Published: January 2016

ObjectiveTo evaluate improvement of medical student knowledge of head and neck cancer (HNC) through participation in HNC screening fairs run by medical students.Study DesignProspective cohort study of surveys assessing medical students’ knowledge of HNC before and after volunteering at screening fairs.SettingFour screening fairs held at the University of Miami Miller School of Medicine during Oral, Head and Neck Cancer Awareness Week.SubjectsMedical student screening fair volunteers.MethodsFour HNC screening fairs were organized by medical student volunteers. All students completed a preevent survey assessing baseline knowledge and participated in an otolaryngologist‐led training session about HNC and the screening examination. During the screening events, students educated guests about HNC and performed physician‐guided history and physical examinations. Finally, students completed identical surveys 1 week and 3 months after the event.ResultsThirty‐four (n = 34) students completed the preevent surveys. At baseline, 59%, 44%, and 24% named tobacco, alcohol, and human papilloma virus as risk factors, compared with 84%, 81%, and 69% on 3 month follow‐up, respectively. Out of 6 analyzed questions, the median total number of correctly answered questions improved from 2 on pretest to 5 at 3 months (P <. 0001).ConclusionVolunteer participation in a HNC screening program improves medical students’ knowledge of HNC risk factors and symptoms. This innovative approach to students’ education via participation and organization of screening events is a useful method of improving their HNC knowledge.
Is the devil in the detail? The quality and clinical impact of information provided on requests for non-trauma emergency abdominal CT scans
Authors: Ihuhua Puleinge , Pitcher Richard D 
Published: January 2016

Background The role of the radiology information system in streamlining imaging workflow and enhancing efficiency in digital radiology departments is now well established. Although there is increasing use of systems with the capacity for computerized physician order entry, there has been limited work on the quality of clinical data provided on electronic diagnostic imaging requests. Purpose To assess the quality of clinical details provided on electronic diagnostic imaging requests (DIR) for emergency non-trauma abdominal computed tomography (CT) scans, and the impact of such data on radiological outcomes. Material and Methods We conducted a retrospective analysis of 100 consecutive electronic DIRs for emergency non-trauma abdominal CT scans for patients with an acute abdomen in a tertiary-level public-sector hospital. The quality of clinical data was assessed using the Royal College of Physicians’ referral guidelines and correlated with radiological outcomes, defined as a definitive CT diagnosis. Results Eighty-eight percent of requests presented a clear clinical question, 48% recorded clinical examination details, 29% had adequate clinical histories, and 17% included laboratory investigations, while only 2% of requests were complete in all respects. Although 88% of scans yielded a definitive radiological diagnosis, there was no association between the adequacy of DIR details and a definitive radiological outcome. Conclusion Our findings underscore the non-specific clinical presentation of non-trauma-related abdominal emergencies and the pivotal role of CT in providing a definitive diagnosis in this setting. We suggest that the appropriate triage of patients presenting with an acute, non-trauma abdomen is the overriding clinical imperative.
Distribution of dystrophin gene deletions in a Chinese population
Authors: Li Yuanyuan , Liu Zhuo , OuYang Shengrong , Zhu Yanli , Wang Liwen , Wu Jianxin 
Published: January 2016

Objective To describe the deletion patterns and distribution characteristics of the dystrophin gene in a Chinese population of patients with Duchenne muscular dystrophy (DMD) or Becker muscular dystrophy (BMD). Methods Patients with DMD/BMD were recruited. Deletions in 19 exons of the dystrophin gene were evaluated using accurate multiplex polymerase chain reaction (PCR). Result Multiplex PCR identified deletions in 238/401 (59.4%) patients with DMD/BMD. Of these, 196 (82.4%) were in the distal hotspot, 32 (13.4%) were in the proximal hotspot, five (2.1%) were in both regions and five (2.1%) were in neither hotspot. Deletions were classified into 54 patterns. Exon 49 was the most frequently deleted. The reading frame rule was upheld for 91.9% of cases. Conclusion Accurate multiplex PCR for 19 exons is an effective diagnostic tool.
Concussion Increases Odds of Sustaining a Lower Extremity Musculoskeletal Injury After Return to Play Among Collegiate Athletes
Authors: Brooks M. Alison , Peterson Kaitlin , Biese Kevin , Sanfilippo Jennifer , Heiderscheit Bryan C. , Bell David R. 
Published: January 2016

Background: Previous studies have identified abnormalities in brain and motor functioning after concussion that persist well beyond observed clinical recovery. Recent work suggests subtle deficits in neurocognition may impair neuromuscular control and thus potentially increase risk of lower extremity musculoskeletal injury after concussion. Purpose: To determine the odds of sustaining an acute lower extremity musculoskeletal injury during the 90-day period after return to play from concussion in a cohort of National Collegiate Athletic Association (NCAA) Division I collegiate athletes. Study Design: Cohort study; Level of evidence, 3. Methods: Included in this study were 87 cases of concussion among 75 athletes (58 men; 17 women) participating in NCAA Division I football, soccer, hockey, softball, basketball, wrestling, or volleyball at a single institution from 2011 to 2014. The 90-day period after return to play for each case of concussion was reviewed for acute noncontact lower extremity musculoskeletal injury. Each 90-day period after return to play was matched to the same 90-day period in up to 3 controls. Control athletes without a history of concussion in the previous year were matched to concussed athletes by sport team/sex, games played, and position. A total of 182 control (136 men; 46 women) 90-day periods were reviewed for acute injury. Conditional logistic regression was used to assess the association between concussion and subsequent risk of acute lower extremity musculoskeletal injury. Results: The incidence of acute lower extremity musculoskeletal injury was higher among recently concussed athletes (15/87; 17%) compared with matched controls (17/182; 9%). The odds of sustaining an acute lower extremity musculoskeletal injury during the 90-day period after return to play were 2.48 times higher in concussed athletes than controls during the same 90-day period (odds ratio, 2.48; 95% CI, 1.04-5.91; P = .04). Conclusion: Concussed athletes have increased odds of sustaining an acute lower extremity musculoskeletal injury after return to play than their nonconcussed teammates. The study results suggest further investigation of neurocognitive and motor control deficits may be warranted beyond the acute injury phase to decrease risk for subsequent injury.
Lessons from Civil Resistance for the Battle against Financial Corruption
Authors: Ackerman Peter , Beyerle Shaazka 
Published: January 2016

AbstractThe first part of this article presents an overview of civil resistance theory and practice, including key concepts and the historical record of nonviolent movements ending authoritarian and occupying regimes. It will also present a practical checklist for assessing why people power movements succeed or fail. The second part of this article will demonstrate how civil resistance applies to the global scourge of financial corruption. It will first illustrate two recent successful people power campaigns against financial corruption, then examine their dynamics in terms of new research and analysis of organized, collective nonviolent action targeting graft and abuse. Finally, it will adapt the general civil resistance checklist to the anti-corruption arena, concluding with the specific elements that are most critical to curbing financial corruption.
Telephone communication between practice nurses and older patients with long term conditions – a systematic review
Authors: Raphael Deborah , Waterworth Susan , Gott Merryn 
Published: January 2016

Background and aims Long term conditions are a significant health problem faced by older people worldwide. Telephone communication is often used to deliver health care to patients and is an important tool in improving access to care. Previous research has shown that primary health care nurses communicate with patients by telephone, but little is known about the way in which telephone communication can be used to benefit older patients with long term conditions. The aims of this review were to identify the range and scope of telephone use between practice nurses working in primary health care and older people with long term conditions, explore which elements of this communication has been successful, and determine whether older people see telephone communication as useful for their needs. Methods A systematic search of the literature was conducted through CINAHL, Medline, Web of Science and EMBASE between July and August 2015. Included were English language articles containing older adults, primary care nurses and both qualitative and quantitative designs. Results Five studies met the inclusion criteria. All were intervention studies, and none looked at routine telephone communication between nurse and patient. Most studies showed that telephone based interventions were successful in improving pre-determined disease-specific health indicators. Conclusions All telephone communication interventions in this review focused on a specific long term condition, which they aimed to help patients self-manage. While all studies' samples included older patients, they did not consider them separately in relation to the effectiveness of the intervention. What was also lacking was the patient perspective regarding effectiveness in all but one study.
T cells from patients with Candida sepsis display a suppressive immunophenotype
Authors: Spec Andrej , Shindo Yuichiro , Burnham Carey-Ann D. , Wilson Strother , Ablordeppey Enyo A. , Beiter Evan R. , Chang Katherine , Drewry Anne M. , Hotchkiss Richard S. 
Published: January 2016

Abstract
Background
Despite appropriate therapy, Candida bloodstream infections are associated with a mortality rate of approximately 40 %. In animal models, impaired immunity due to T cell exhaustion has been implicated in fungal sepsis mortality. The purpose of this study was to determine potential mechanisms of fungal-induced immunosuppression via immunophenotyping of circulating T lymphocytes from patients with microbiologically documented Candida bloodstream infections.

Methods
Patients with blood cultures positive for any Candida species were studied. Non-septic critically ill patients with no evidence of bacterial or fungal infection were controls. T cells were analyzed via flow cytometry for cellular activation and for expression of positive and negative co-stimulatory molecules. Both the percentages of cells expressing particular immunophenotypic markers as well as the geometric mean fluorescence intensity (GMFI), a measure of expression of the number of receptors or ligands per cell, were quantitated.

Results
Twenty-seven patients with Candida bloodstream infections and 16 control patients were studied. Compared to control patients, CD8 T cells from patients with Candidemia had evidence of cellular activation as indicated by increased CD69 expression while CD4 T cells had decreased expression of the major positive co-stimulatory molecule CD28. CD4 and CD8 T cells from patients with Candidemia expressed markers typical of T cell exhaustion as indicated by either increased percentages of or increased MFI for programmed cell death 1 (PD-1) or its ligand (PD-L1).

Conclusions
Circulating immune effector cells from patients with Candidemia display an immunophenotype consistent with immunosuppression as evidenced by T cell exhaustion and concomitant downregulation of positive co-stimulatory molecules. These findings may help explain why patients with fungal sepsis have a high mortality despite appropriate antifungal therapy. Development of immunoadjuvants that reverse T cell exhaustion and boost host immunity may offer one way to improve outcome in this highly lethal disorder.
Reported burden on informal caregivers of ICU survivors: a literature review
Authors: van Beusekom Ilse , Bakhshi-Raiez Ferishta , de Keizer Nicolette F. , Dongelmans Dave A. , van der Schaaf Marike 
Published: January 2016

Abstract
Background
Critical illness and the problems faced after ICU discharge do not only affect the patient, it also negatively impacts patients’ informal caregivers. There is no review which summarizes all types of burden reported in informal caregivers of ICU survivors. It is important that the burdens these informal caregivers suffer are systematically assessed so the caregivers can receive the professional care they need. We aimed to provide a complete overview of the types of burdens reported in informal caregivers of adult ICU survivors, to make recommendations on which burdens should be assessed in this population, and which tools should be used to assess them.

Method
We performed a systematic search in PubMed and CINAHL from database inception until June 2014. All articles reporting on burdens in informal caregivers of adult ICU survivors were included. Two independent reviewers used a standardized form to extract characteristics of informal caregivers, types of burdens and instruments used to assess these burdens. The quality of the included studies was assessed using the Newcastle-Ottawa and the PEDro scales.

Results
The search yielded 2704 articles, of which we included 28 in our review. The most commonly reported outcomes were psychosocial burden. Six months after ICU discharge, the prevalence of anxiety was between 15 % and 24 %, depression between 4.7 % and 36.4 % and post-traumatic stress disorder (PTSD) between 35 % and 57.1 %. Loss of employment, financial burden, lifestyle interference and low health-related quality of life (HRQoL) were also frequently reported. The most commonly used tools were the Hospital Anxiety and Depression Scale (HADS), Centre for Epidemiological Studies-Depression questionnaire, and Impact of Event Scale (IES). The quality of observational studies was low and of randomized studies moderate to fair.

Conclusions
Informal caregivers of ICU survivors suffer a substantial variety of burdens. Although the quality of the included studies was poor, there is evidence that burden in the psychosocial field is most prevalent. We suggest screening informal caregivers of ICU survivors for anxiety, depression, PTSD, and HRQoL using respectively the HADS, IES and Short Form 36 and recommend a follow-up period of at least 6 months.