bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Variations in Upper-Level Shear on Simulated Supercells
Authors: Warren Robert A. , Richter Harald , Ramsay Hamish A. , Siems Steven T. , Manton Michael J. 
Published: March 2017

It has previously been suggested, based on limited observations, that vertical wind shear in the upper troposphere is a key control on supercell morphology, with the low-precipitation, high-precipitation, and classic archetypes favored under strong, weak, and moderate shear, respectively. The idea is that, with increasing upper-level shear (ULS), hydrometeors are transported farther from the updraft by stronger storm-relative anvil-level winds, limiting their growth and thereby reducing precipitation intensity. The present study represents the first attempt to test this hypothesis, using idealized simulations of supercells performed across a range of 6–12-km shear profiles. Contrary to expectations, there is a significant increase in surface precipitation and an associated strengthening of outflow winds as ULS magnitude is increased from 0 to 20 m s−1. These changes result from an increase in storm motion, which drives stronger low-level inflow, a wider updraft, and enhanced condensation. A further increase in ULS magnitude to 30 m s−1 promotes a slight reduction in storm intensity associated with surging rear-flank outflow. However, this transition in behavior is found to be sensitive to other factors that influence cold-pool strength, such as mixed-layer depth and model microphysics. Variations in the vertical distribution and direction of ULS are also considered, but are found to have a much smaller impact on storm intensity than variations in ULS magnitude. Suggestions for the disparity between the current results and the aforementioned observations are offered and the need for further research on supercell morphology—in particular, simulations in drier environments—is emphasized.
Transition Phase Nutrition Recommendations: A Missing Link in the Nutrition Management of Preterm Infants
Authors: Brennan Ann‐Marie , Fenton Sarah , Murphy Brendan P. , Kiely Mairead E. 
Published: March 2017

AbstractBackground: Despite the availability of international nutrition recommendations, preterm infants remain vulnerable to suboptimal nutrition. The standard approach of assessing nutrient intakes chronologically may make it difficult to identify the origin of nutrient deficits and/or excesses. Objective: To develop a “nutrition phase” approach to evaluating nutrition support, enabling analysis of nutrient intakes during the period of weaning from parenteral nutrition (PN) to enteral nutrition (EN), called the transition (TN) phase, and compare the data with those analyzed using the standard “chronological age” approach to assess whether the identification of nutrient deficits and/or excesses can be improved. Methods: Analysis of a comprehensive nutrition database developed using actual nutrient intake data collected on an hourly basis in 59 preterm infants (birth weight ≤1500 g, gestation <34 weeks) over the period of PN delivery (range, 2–21 days). Results: The nutrition phase analysis approach revealed substantial macronutrient and energy deficits during the TN phase. In particular, deficits were identified as maximal during the EN‐dominant TN phase (enteral feeds ≥80 mL/kg/d) of the infant’s nutrition course. In contrast, the chronological age analysis approach did not reveal a corresponding pattern of deficit occurrence but rather intakes that approximated or exceeded recommendations. Conclusion: Actual intakes of nutrients, analyzed using a nutrition phase approach to evaluating nutrition support, enabled a more infant‐driven rather than age‐driven application of nutrition recommendations. This approach unmasked nutrient deficits occurring during the transition phase. Overcoming nutrient deficits in this nutrition phase should be prioritized to improve the nutrition management of preterm infants.
Anatomy‐Specific Virtual Reality Simulation in Temporal Bone Dissection: Perceived Utility and Impact on Surgeon Confidence
Authors: Locketz Garrett D. , Lui Justin T. , Chan Sonny , Salisbury Kenneth , Dort Joseph C. , Youngblood Patricia , Blevins Nikolas H. 
Published: March 2017

ObjectiveTo evaluate the effect of anatomy‐specific virtual reality (VR) surgical rehearsal on surgeon confidence and temporal bone dissection performance.Study DesignProspective pre‐ and poststudy of a novel virtual surgical rehearsal platform.SettingAcademic otolaryngology–head and neck surgery residency training programs.Subjects and MethodsSixteen otolaryngology–head and neck surgery residents from 2 North American training institutions were recruited. Surveys were administered to assess subjects' baseline confidence in performing 12 subtasks of cortical mastoidectomy with facial recess. A cadaver temporal bone was randomly assigned to each subject. Cadaver specimens were scanned with a clinical computed tomography protocol, allowing the creation of anatomy‐specific models for use in a VR surgical rehearsal platform. Subjects then rehearsed a virtual mastoidectomy on data sets derived from their specimens. Surgical confidence surveys were administered again. Subjects then dissected assigned cadaver specimens, which were blindly graded with a modified Welling scale. A final survey assessed the perceived utility of rehearsal on dissection performance.ResultsOf 16 subjects, 14 (87.5%) reported a significant increase in overall confidence after conducting an anatomy‐specific VR rehearsal. A significant correlation existed between perceived utility of rehearsal and confidence improvement. The effect of rehearsal on confidence was dependent on trainee experience and the inherent difficulty of the surgical subtask. Postrehearsal confidence correlated strongly with graded dissection performance. Subjects rated anatomy‐specific rehearsal as having a moderate to high contribution to their dissection performance.ConclusionAnatomy‐specific virtual rehearsal improves surgeon confidence in performing mastoid dissection, dependent on surgeon experience and task difficulty. The subjective confidence gained through rehearsal correlates positively with subsequent objective dissection performance.
A Survey of Wisconsin Pediatricians’ Knowledge and Practices Regarding the Human Papillomavirus Vaccine
Authors: Rohrbach Marc R. , Wieland Aaron M. 
Published: March 2017

ObjectiveThe human papillomavirus (HPV) is common and carries a significant burden of disease. This is increasingly apparent in males with the rising incidence of HPV‐related oropharyngeal cancer. Unfortunately, vaccination rates remain poor and are lowest in males. It is unclear if pediatricians are aware of the alarming rise of HPV‐mediated head and neck cancers and the disproportionate effect on males.Study DesignThis investigation used a cross‐sectional descriptive survey research design.SettingThe survey was developed by investigators in the University of Wisconsin Division of Otolaryngology.Subjects and MethodsThe survey was distributed to 831 members of the Wisconsin Chapter of the American Academy of Pediatrics.ResultsA total response rate of 49.6% was achieved. Most supported routine vaccination in both sexes. Females are regarded as being at higher risk of an HPV‐related cancer and are more often recommended vaccination. Most providers are unaware of the magnitude of HPV‐related oropharyngeal cancer and the greater affliction in males.ConclusionsMale vaccination is overwhelmingly supported by Wisconsin pediatricians, yet there is a preponderance toward vaccinating females, who are perceived as having greater risk for HPV‐associated disease. This is likely because providers are unaware of the magnitude of HPV‐driven oropharyngeal cancer and its predilection for males. A lack of provider awareness, in combination with out‐of‐date education material for parents, likely contributes to poor vaccination rates in males.
Epidemiology of Nasopharyngeal Lymphoma in the United States: A Population‐Based Analysis of 1119 Cases
Authors: Han Albert Y. , Kuan Edward C. , Alonso Jose E. , Badran Karam W. , St. John Maie A. 
Published: March 2017

ObjectivesTo describe the incidence and determinants of survival of patients with nasopharyngeal lymphoma (NPL) between 1973 and 2012 using the Surveillance, Epidemiology, and End Results (SEER) database.Study DesignRetrospective cohort study using a national database.MethodsThe SEER registry was used to calculate survival trends for patients with NPL between 1973 and 2012. Patient data were then analyzed with respect to histopathology, age, sex, race, histologic subtype, Ann Arbor stage, and whether radiation therapy was given. Overall survival (OS) and disease‐specific survival (DSS) were calculated.ResultsA total of 1119 cases of NPL were identified. The cohort was composed of 58.8% males. The mean age at diagnosis was 59.3 years. The median OS was 8.2 years. B‐cell non‐Hodgkin’s lymphomas (NHLs) accounted for most cases (77.5%), with natural killer (NK)/T‐cell lymphomas comprising 6.0% of cases. A total of 41.5% patients received radiation therapy. OS at 2, 5, and 10 years was 70%, 57%, and 45%, respectively. On multivariate analysis, advanced age and NK/T‐cell NHL histologic subtype were associated with worse OS and DSS, while radiation therapy was associated with improved OS and DSS (all P <. 05).ConclusionWith the exception of NK/T‐cell NHL subtypes, NPL is associated with a fair prognosis, with younger age, low Ann Arbor stage, and radiation therapy being independent positive prognosticators for survival.
Dexmedetomidine Effect on Emergence Agitation and Delirium in Children Undergoing Laparoscopic Hernia Repair: a Preliminary Study
Authors: Sun Yingying , Li Yuanhai , Sun Yajuan , Wang Xing , Ye Hongwu , Yuan Xianren 
Published: March 2017

Objective To evaluate the safety and efficacy of dexmedetomidine (Dex) to prevent emergence agitation (EA) and delirium (ED) in children undergoing laparoscopic hernia repair under general anesthesia. Methods 100 children (1–5 years, 10–25 kg) were randomized into four groups: controls (saline) and intravenous Dex at 0.25, 0.5, and 1.0 µg/kg (D1, D2, D3, respectively). Dex/saline infusion was started following anesthesia. EA and ED were evaluated on a 5-point scale. Results For the C, D1, D2, and D3 groups, respectively, EA frequencies were 45.8%, 30.4%, 12%, 4%; ED frequencies 29.1%, 13%, 4%, 4%; CHIPPS scores 8, 6, 3, 3; sevoflurane doses from 13.2 ± 3.4 (controls) to 9.4 ± 3.5 ml (D3). Intervals until mask removal/spontaneous eye opening were significantly longer for D2 and D3 than controls. PACU stay was longer for D3. Conclusions There was significantly less postoperative EA and pain, with less sevoflurane required, using Dex.
Early Renal Replacement Therapy Versus Standard Care in the ICU: A Systematic Review, Meta-Analysis, and Cost Analysis
Authors: Chaudhuri Dipayan , Herritt Brent , Heyland Daren , Gagnon Louis-Philippe , Thavorn Kednapa , Kobewka Daniel , Kyeremanteng Kwadwo 
Published: March 2017

Objective: Renal replacement therapy (RRT) is the treatment of choice for severe acute kidney injury, but there are no firm guidelines as to the time of initiation of RRT in the critically ill. The primary objective of this study is to determine 1-month mortality rates of early versus late dialysis in critical care. As secondary end points, we provide a cost analysis of early versus late RRT initiation, intensive care unit (ICU) length of stay (LOS), hospital LOS, and number of patients on dialysis at day 60 postrandomization. Data Sources: We identified all randomized controlled trials (RCTs) through EMLINE and MEDBASE that examined adult patients admitted to critical care who were randomized to receiving early dialysis versus standard of care. Study Selection: Inclusion criteria: (1) RCTs conducted after the year 2000, (2) the population evaluated had to be adults admitted to ICU, (3) the intervention had to be early RRT versus standard care, and (4) outcomes had to measure patient mortality. Data Extraction: Two independent investigators reviewed search results and identified appropriate studies. Information was extracted using standardized case report forms. Data Synthesis: Overall, 7 RCTs were included with a total of 1400 patients. Early RRT showed no survival benefit when compared to standard treatment (odds ratio [OR], 0.90 95% confidence interval [95% CI] 0.70-1.15, P = .39). There was no significant difference in length of hospital stay in patients with early RRT (−1.55 days [95% CI −4.75 to 1.65, P = .34]), in length of ICU stay (−0.79 days [95% CI −2.09 to 0.52], P = .24), or proportion of patients on dialysis at day 60 (OR 0.93 [95% CI 0.62 to 1.43], P = .79). Per patient, there is likely a small increase in costs (<US$1000) owing to increased total dialysis. Conclusion: Across all measured domains, there is no clear benefit to early RRT. Moreover, this intervention may result in increased costs and exposes patients to an invasive therapy with potential harm.
Cost-effectiveness of pharmacist care for managing hypertension in Canada
Authors: Marra Carlo , Johnston Karissa , Santschi Valerie , Tsuyuki Ross T. 
Published: March 2017

Background:More than half of all heart disease and stroke are attributable to hypertension, which is associated with approximately 10% of direct medical costs globally. Clinical trial evidence has demonstrated that the benefits of pharmacist intervention, including education, consultation and/or prescribing, can help to reduce blood pressure; a recent Canadian trial found an 18.3 mmHg reduction in systolic blood pressure associated with pharmacist care and prescribing. The objective of this study was to evaluate the economic impact of such an intervention in a Canadian setting.Methods:A Markov cost-effectiveness model was developed to extrapolate potential differences in long-term cardiovascular and renal disease outcomes, using Framingham risk equations and other published risk equations. A range of values for systolic blood pressure reduction was considered (7.6-18.3 mmHg) to reflect the range of potential interventions and available evidence. The model incorporated health outcomes, costs and quality of life to estimate an overall incremental cost-effectiveness ratio. Costs considered included direct medical costs as well as the costs associated with implementing the pharmacist intervention strategy.Results:For a systolic blood pressure reduction of 18.3 mmHg, the estimated impact is 0.21 fewer cardiovascular events per person and, discounted at 5% per year, 0.3 additional life-years, 0.4 additional quality-adjusted life-years and $6,364 cost savings over a lifetime. Thus, the intervention is economically dominant, being both more effective and cost-saving relative to usual care.Discussion:Across a range of one-way and probabilistic sensitivity analyses of key parameters and assumptions, pharmacist intervention remained both effective and cost-saving.Conclusion:Comprehensive pharmacist care of hypertension, including patient education and prescribing, has the potential to offer both health benefits and cost savings to Canadians and, as such, has important public health implications.
Discrepancies Between Blood Glucose and Interstitial Glucose—Technological Artifacts or Physiology: Implications for Selection of the Appropriate Therapeutic Target
Authors: Siegmund Thorsten , Heinemann Lutz , Kolassa Ralf , Thomas Andreas 
Published: March 2017

Background: For decades, the major source of information used to make therapeutic decisions by patients with diabetes has been glucose measurements using capillary blood samples. Knowledge gained from clinical studies, for example, on the impact of metabolic control on diabetes-related complications, is based on such measurements. Different to traditional blood glucose measurement systems, systems for continuous glucose monitoring (CGM) measure glucose in interstitial fluid (ISF). The assumption is that glucose levels in blood and ISF are practically the same and that the information provided can be used interchangeably. Thus, therapeutic decisions, that is, the selection of insulin doses, are based on CGM system results interpreted as though they were blood glucose values. Methods: We performed a more detailed analysis and interpretation of glucose profiles obtained with CGM in situations with high glucose dynamics to evaluate this potentially misleading assumption. Results: Considering physical activity, hypoglycemic episodes, and meal-related differences between glucose levels in blood and ISF uncover clinically relevant differences that can make it risky from a therapeutic point of view to use blood glucose for therapeutic decisions. Conclusions: Further systematic and structured evaluation as to whether the use of ISF glucose is more safe and efficient when it comes to acute therapeutic decisions is necessary. These data might also have a higher prognostic relevance when it comes to long-term metabolic consequences of diabetes. In the long run, it may be reasonable to abandon blood glucose measurements as the basis for diabetes management and switch to using ISF glucose as the appropriate therapeutic target.
German Heterosexual Women’s Pornography Consumption and Sexual Behavior
Authors: Sun Chyng Feng , Wright Paul , Steffen Nicola 
Published: March 2017

This study found that German heterosexual women’s personal and partnered consumption of pornography were positively correlated with their desire to engage in or having previously engaged in submissive (but not dominant) sexual behaviors such as having their hair pulled, having their face ejaculated on, being spanked, choked, called names, slapped, and gagged. The association between women’s partnered pornography consumption and submissive sexual behavior was strongest for women whose first exposure to pornography was at a young age. The findings also indicated that women’s personal and partnered pornography consumption were uniquely related to their engagement in submissive sexual behavior. Public Health Significance Statement: This study suggests that greater exposure to pornography among heterosexual German women is associated with their desire to engage in or having previously engaged in submissive sexual behaviors but not dominant behaviors. This pattern of correlations aligns with sexual script theory and content analyses of dominance and submission and gender in pornography. It does not align with the perspective that measures of pornography consumption are simply proxies for factors such as a high sex drive or an adventurous approach to sex.
Effects of Vitellaria paradoxa (C.F. Gaertn.) aqueous leaf extract administration on Salmonella typhimurium-infected rats
Authors: Fodouop Siméon Pierre Chegaing , Tala Sedric Donald , Keilah Lunga Paul , Kodjio Norbert , Yemele Mefokou Didiane , Nwabo Kamdje Armel Herve , Nji-kah Bridget , Tchoumboue Joseph , Gatsing Donatien 
Published: March 2017

Abstract
Background
The present study investigates the effects of Vitellaria paradoxa crude extract administration on Salmonella typhimurium infected Wistar rats.

Methods
Rats were infected by single dose oral administration of Salmonella typhimurium (1.5×108 CFU). Negative control groups were infected and treated orally with distilled water (vehicle), neutral control group were not infected, while the four test groups were treated up to 18 days with 55 mg/kg, 110 mg/kg, 220 mg/kg and 440 mg/kg body weight of aqueous extract of V. paradoxa respectively. The effects of this extract administration on serum markers (total protein, creatinine, transaminases, bilirubin and lipid profile) as well as acute toxicity test and phytochemical screening were also investigated.

Results
Following in vivo studies, aqueous extract of V. paradoxa allowed to clear salmonellosis in previously infected rats within twelve days of treatment. Infection has resulted in a significant increase of transaminases activity. Besides, significant decrease was observed in liver and kidney relative weight and their protein content. Nevertheless, administration of this plant extract at higher doses has resulted in the correction of some of these injuries. Results obtained from acute toxicity study showed that mice administered with the aqueous leaf extract exhibited a mild reaction to noise and pinch; excreted watery discharges and the LD50 value was 12.0 g/kg. In addition, the extract showed no toxic effect after 14 days. However, it may have a sedative effect or depressant effect on the central nervous system, may induce a decrease in plasma levels of algogenic substances, and may cause diarrhea at high doses. Phytochemical screening of the extract revealed the presence of flavonoids, alkaloids, tannins, phenols and polyphenols, saponins, anthocyanins, steroids and anthraquinones.

Conclusions
These results support the ethnomedicinal use of V. paradoxa, and suggest that its leave can be used in the management antibacterial phytomedicine.
Time-average velocity estimation through surface-wave analysis: Part 1 — S-wave velocity
Authors: Socco Laura Valentina , Comina Cesare , Khosro Anjom Farbod 
Published: March 2017

In some areas, the estimation of static corrections for land seismic data is a critical step of the processing workflow. It often requires the execution of additional surveys and data analyses. Surface waves (SWs) in seismic records can be processed to extract local dispersion curves (DCs) that can be used to estimate near-surface S-wave velocity models. Here we focus on the direct estimation of time-average S-wave velocity models from SW DCs without the need to invert the data. Time-average velocity directly provides the value of one-way time, given a datum plan depth. The method requires the knowledge of one 1D S-wave velocity model along the seismic line, together with the relevant DC, to estimate a relationship between SW wavelength and investigation depth on the time-average velocity model. This wavelength/depth relationship is then used to estimate all the other time-average S-wave velocity models along the line directly from the DCs by means of a data transformation. This approach removes the need for extensive data inversion and provides a simple method suitable for industrial workflows. We tested the method on synthetic and field data and found that it is possible to retrieve the time-average velocity models with uncertainties less than 10% in sites with laterally varying velocities. The error on one-way times at various depths of the datum plan retrieved by the time-average velocity models is mostly less than 5 ms for synthetic and field data.