bluuebunny/crossref_metadata_2025_split huggingface dataset:
Synoptic Analysis and Hindcast of an Intense Bow Echo in Western Europe: The 9 June 2014 Storm
Authors: Mathias Luca , Ermert Volker , Kelemen Fanni D. , Ludwig Patrick , Pinto Joaquim G. 
Published: April 2017

Abstract
On Pentecost Monday, 9 June 2014, a severe linearly organized mesoscale convective system (MCS) hit Belgium and western Germany. This storm was one of the most severe thunderstorms in Germany in decades. The synoptic-scale and mesoscale characteristics of this storm are analyzed based on remote sensing data and in situ measurements. Moreover, the forecast potential of the storm is evaluated using sensitivity experiments with a regional climate model. The key ingredients for the development of the Pentecost storm were the concurrent presence of low-level moisture, atmospheric conditional instability, and wind shear. The synoptic and mesoscale analysis shows that the outflow of a decaying MCS above northern France triggered the storm, which exhibited the typical features of a bow echo like a bookend vortex and a rear-inflow jet. This resulted in hurricane-force wind gusts (reaching 40 m s−1) along a narrow swath in the Rhine–Ruhr region leading to substantial damage. Operational numerical weather prediction models mostly failed to forecast the storm, but high-resolution regional model hindcasts enable a realistic simulation of the storm. The model experiments reveal that the development of the bow echo is particularly sensitive to the initial wind field and the lower-tropospheric moisture content. Adequate initial and boundary conditions are therefore essential for realistic numerical forecasts of such a bow echo event. It is concluded that the Pentecost storm exhibited a comparable structure and a similar intensity to observed bow echo systems in the United States.
Clinical Profile, Management, and Outcome in Patients With Out-of-Hospital Cardiac Arrest and ST Segment Elevation Myocardial Infarction: Insights From a 20-Year Registry
Authors: Arabi Abdul Rahman , Patel Ashfaq , Al Suwaidi Jassim , Gehani A. A. , Singh Rajvir , Albinali Hajar A. 
Published: April 2017

Aim of the Study: We studied the clinical profile, management, and outcomes of patients with out-of-hospital cardiac arrest (OHCA) with and without ST-elevation myocardial infarction (STEMI). Methods: Retrospective analysis of the 20-year registry data (January 1991- June 2010) was conducted on patients with cardiac disease hospitalized at Hamad General Hospital and Qatar Heart Hospital, Doha, Qatar. Results: A total of 987 patients with OHCA were admitted to the cardiology department during the study period; among them, 296 (30%) patients had STEMI. Compared to the patients with OHCA without STEMI, the patients who had OHCA with STEMI were younger (53 ± 13 vs 58 ± 16 years; P = .001), more likely to be male (78% vs 34%; P = .001), smokers (35% vs 14%) but less likely to have hypertension (30% vs 48%; P = .001), diabetes (32% vs 47%, P = .001), and chronic renal failure (3.4% vs 9%; P = .002). The use of thrombolytic treatment in patients with STEMI increased from 21.6% (period 1991-1095) to 44.4% (period 2006-2010); P = .04. Conclusion: Percutaneous coronary intervention had increased significantly during the last quarter of the study. There was a decline in the in-hospital mortality among patients with STEMI during the last quarter of the study.
Heritage and the Social Construction of Citizen Power in Historic Neighborhoods of Santiago
Authors: Rojas Alcayaga Mauricio 
Published: April 2017

One of the great changes in the field of heritage studies is the abandonment of the idea of heritage as linked to the inert and monumental past and as a category established only by the state with the support of private patronage in its protection. Citizen empowerment with regard to its establishment, protection, and reinterpretation, with a strong territorial and grassroots component, has transformed it into a field of sociocultural dispute over space and memory in the present. Heritage is a social construction in the dialectic of power. Heritage movements organized in two historic neighborhoods in Santiago are resisting and transforming a capitalist model of urban planning that affects their culture, tradition, and collective memory—their ways of living and identity. Their contributions to an emerging political dispute over heritage add new meanings to a field in need of them. Uno de los grandes cambios en el campo de los estudios del patrimonio es el abandono de la noción de patrimonio como algo vinculado al pasado inerte y monumental y como una categoría establecida sólo por el estado con el apoyo del mecenazgo privado para su protección. El fortalecimiento de la participación ciudadana con relación a su establecimiento, protección y reinterpretación, con un fuerte componente territorial y de base, lo ha transformado en un campo de conflicto sociocultural sobre el espacio y la memoria en el presente. El patrimonio es una construcción social en la dialéctica del poder. Los movimientos organizados que luchan por el patrimonio en dos barrios históricos de Santiago están resistiendo y transformando un modelo capitalista de planificación urbana que afecta su cultura, su tradición y su memoria colectiva– en otras palabras, sus formas de convivir y su identidad. Su participación en este emergente conflicto político sobre el patrimonio le añade nuevos significados a un campo que los necesita.
Intracochlear Pressure Changes due to 2 Electrode Types: An Artificial Model Experiment
Authors: Mittmann Philipp , Mittmann Marlene , Ernst Arneborg , Todt Ingo 
Published: April 2017

ObjectiveTo preserve residual hearing in cochlear implant surgery, the electrode design has been refined, and an atraumatic insertion has become one aspect of cochlear implant research. Previous studies have described the effect of insertion speed and opening of the round window membrane on intracochlear pressure changes. The aim of our current study was to observe intracochlear pressure changes due to different cochlear implant electrodes in an artificial cochlear model with stable surrounding factors.Study DesignProspective controlled study.SettingTertiary referral center.Subjects and MethodsThe experiments were performed in an artificial cochlear model with a pressure sensor in the apical area. With straight and perimodiolar electrode arrays, 5 insertions with the same insertion speed and 5 insertions over the same time were performed.ResultsWith the perimodiolar high‐volume electrode, significantly greater intracochlear fluid pressure changes were observed than with the straight electrode. Compared with the straight electrode, the perimodiolar electrode induces significantly higher pressure peaks (1.12 ± 0.15 vs 0.86 ± 0.05 mm Hg, P =. 006) and significantly higher amplitudes (0.38 ± 0.07 vs 0.09 ± 0.07 mm Hg, P <. 001).ConclusionThe reliable preservation of residual hearing is an important multifactorial challenge in modern cochlear implant surgery. Insertion speed, handling, and electrode design are known to influence the preservation of residual hearing. In our artificial model experiments, we could prove objectively that the volume of the electrodes has a significant influence on the intracochlear pressure changes during cochlear implantation.
Initial perceptions of palliative care: An exploratory qualitative study of patients with advanced cancer and their family caregivers
Authors: Collins Anna , McLachlan Sue-Anne , Philip Jennifer 
Published: April 2017

Background: Despite evidence for early integration of palliative care for people with advanced cancer and their families, patterns of late engagement continue. Prior research has focused on health professionals’ attitudes to palliative care with few studies exploring the views of patients and their carers. Aim: To explore initial perceptions of palliative care when this is first raised with patients with advanced cancer and their families in Australian settings. Design: Cross-sectional, prospective, exploratory qualitative design, involving narrative-style interviews and underpinned by an interpretative phenomenological framework. Setting/participants: Purposively sampled, English-speaking, adult patients with advanced cancer ( n = 30) and their nominated family caregivers ( n = 25) recruited from cancer services at a tertiary metropolitan hospital in Melbourne, Victoria, Australia. Results: Three major themes evolved which represent the common initial perceptions of palliative care held by patients with advanced cancer and their carers when this concept is first raised: (1) diminished care, (2) diminished possibility and (3) diminished choice. Palliative care was negatively associated with a system of diminished care which is seen as a ‘lesser’ treatment alternative, diminished possibilities for hope and achievement of ambitions previously centred upon cure and diminished choices for the circumstances of one’s care given all other options have expired. Conclusion: While there is an increasing move towards early integration of palliative care, this study suggests that patient and caregiver understandings have not equally progressed. A targeted public health campaign is warranted to disentangle understandings of palliative care as the ‘institutional death’ and to reframe community rhetoric surrounding palliative care from that of disempowered dying to messages of choice, accomplishment and possibility.
Urine TREM-1 as a marker of urinary tract infection in children
Authors: Sierra-Diaz Erick , Bravo Cuéllar Alejandro , Ortiz Lazareno Pablo Cesar , García Gutiérrez Mariana , Georgina Hernandez Flores , Anaya Prado Roberto 
Published: April 2017

Objective Triggering receptor expressed on myeloid cells (TREM)-1 is a receptor that is thought to improve recognition of patients with true infection. In this study, we investigated whether Triggering receptor expressed on myeloid cells (TREM-1) is present in urine samples from children with urinary tract infection (UTI) and in samples from healthy children. Methods A total of 128 samples met the inclusion criteria for the study. Urine samples were processed for culture and urinalysis as a regular protocol for patients with UTI. Samples were classified according to culture and urinalysis results. TREM-1 protein expression was detected with flow cytometry and sTREM-1 was assessed by ELISA. Results Flow cytometry showed detectable expression of TREM-1 in 100% of samples, UTI and non-UTI groups ( p < 0.001). Mean fluorescence intensity of TREM-1 was different between the groups ( p < 0.001). Levels of sTREM-1 were detected in patients with UTI, but not in non-UTI patients. Conclusions All of our patients (healthy and diseased) showed TREM-1 expression. However, TREM-1 levels in patients with UTI tend to be higher and are associated with increased neutrophils and cytokine activity induced by bacteria.
Use of the chop hook to stabilize the capsular bag in patients with crystalline lens dislocations and cataracts
Authors: Zeng Yanfeng , Fan Licheng , Lu Peirong 
Published: April 2017

Objective To observe the treatment effects of chop hook-assisted phacoemulsification surgery in patients with crystalline lens dislocation. Methods Thirty-seven eyes with cataracts and crystalline lens dislocations underwent cataract surgery. An L-shaped chop hook was introduced into the anterior chamber, and the tip was pushed or pulled to the centre of the anterior capsular edge of the zonular dialysis during the cataract operation. Postoperative follow-up was conducted for ≥ 1 month. Results All patients’ postoperative visual abilities improved except one patient with glaucoma. One patient who underwent −5D intraocular lens implantation exhibited vision of 1/50. Visual acuity was less than 6/20 in 6 eyes, 6/20 to 10/20 in 7 eyes, and greater than 10/20 in 22 eyes. Conclusions L-shaped chop hooks can be used to push or pull the anterior capsular edge of the zonular dialysis for protection and avoidance of further zonular damage. This strategy provides satisfactory effects and reduces use of additional instruments.
Comparing costs of illness of multiple sclerosis in three different years: A population-based study
Authors: Gyllensten Hanna , Wiberg Michael , Alexanderson Kristina , Friberg Emilie , Hillert Jan , Tinghög Petter 
Published: April 2017

Background: Little is known about changes in the costs of illness (COI) among multiple sclerosis (MS) patients during recent years. Objectives: To compare the COI among MS patients and matched controls in 2006, 2009, and 2012, respectively, indicating the costs attributable to the MS disease. Methods: Three cross-sectional datasets were analyzed, including all MS patients in Sweden aged 20–60 years and five matched controls for each of them. The analyses were based on 10,531 MS patients and 52,655 matched controls for 2006, 11,722 and 58,610 individuals for 2009, and 12,789 and 63,945 for 2012. Nationwide registers, including prescription drug use, specialized healthcare, sick leave, and disability pension, were linked to estimate the prevalence-based COI. Results: Adjusted for inflation, the average difference in COI between MS patients and matched controls were Swedish Krona (SEK) 243,751 (95% confidence interval: SEK 239,171–248,331) in 2006, SEK 238,971 (SEK 234,516–243,426) in 2009, and SEK 225,923 (SEK 221,630–230,218) in 2012. The difference in indirect costs were SEK 170,502 (SEK 166,478–174,525) in 2006, SEK 158,839 (SEK 154,953–162,726) in 2009, and SEK 141,280 (SEK 137,601–144,960) in 2012. Conclusion: The inflation-adjusted COI of MS patients was lower in 2012 than in 2006, in particular regarding indirect costs.
High EDSS can predict risk for upper urinary tract damage in patients with multiple sclerosis
Authors: Ineichen Benjamin V , Schneider Marc P , Hlavica Martin , Hagenbuch Niels , Linnebank Michael , Kessler Thomas M 
Published: April 2017

Background: Neurogenic lower urinary tract dysfunction (NLUTD) is very common in patients with multiple sclerosis (MS), and it might jeopardize renal function and thereby increase mortality. Although there are well-known urodynamic risk factors for upper urinary tract damage, no clinical prediction parameters are available. Objective: We aimed to assess clinical parameters potentially predicting urodynamic risk factors for upper urinary tract damage. Methods: A consecutive series of 141 patients with MS referred from neurologists for primary neuro-urological work-up including urodynamics were prospectively evaluated. Clinical parameters taken into account were age, sex, duration, and clinical course of MS and Expanded Disability Status Scale (EDSS). Results: Multivariate modeling revealed EDSS as a clinical parameter significantly associated with urodynamic risk factors for upper urinary tract damage (odds ratio = 1.34, 95% confidence interval (CI) = 1.06–1.71, p = 0.02). Using receiver operator characteristic (ROC) curves, an EDSS of 5.0 as cutoff showed a sensitivity of 86%–87% and a specificity of 52% for at least one urodynamic risk factor for upper urinary tract damage. Conclusion: High EDSS is significantly associated with urodynamic risk factors for upper urinary tract damage and allows a risk-dependent stratification in daily neurological clinical practice to identify MS patients requiring further neuro-urological assessment and treatment.
Commercially available glutenases: a potential hazard in coeliac disease
Authors: Krishnareddy Suneeta , Stier Kenneth , Recanati Maya , Lebwohl Benjamin , Green Peter HR 
Published: April 2017

Background: The only treatment for celiac disease (CD) is a gluten-free diet (GFD). However, there is interest among patients in a medical therapy to replace or help with a GFD. Therapies include gluten-degrading enzymes (glutenases). There are glutenases available marketed as dietary supplements that have not been demonstrated to digest the toxic epitopes of gluten. Methods: We investigated the contents, claims, and disclaimers of glutenase products and assessed patient interest using Google AdWords to obtain Google search frequencies. Results: Among 14 glutenase product, all contained proteases, eight contained X-prolyl exopeptidase dipeptidyl peptidase IV, two did not state the protease contents, and eight failed to specify the name or origin of all proteases. Eleven contained carbohydrases and lipases and three probiotics. One declared wheat and milk as allergens, two contained herbal products (type not stated) and one Carica papaya. Thirteen claimed to degrade immunogenic gluten fragments, four claimed to help alleviate gastrointestinal symptoms associated with eating gluten. Disclaimers included not being evaluated by the US Food and Drug Administration and products not intended to diagnose, treat, cure, or prevent any disease. On Google AdWords, the search frequency for the product names and the search terms was 3173 searches per month. Conclusions: The names of these products make implicit claims that appear to be supported by the claims on the labels and websites for which there is no scientific basis. Google search data suggest great interest and therefore possible use by patients with CD. There needs to be greater oversight of these ‘drugs’.
Closing the Loop in Adults, Children and Adolescents With Suboptimally Controlled Type 1 Diabetes Under Free Living Conditions: A Psychosocial Substudy
Authors: Barnard Katharine D. , Wysocki Timothy , Ully Vanessa , Mader Julia K. , Pieber Thomas R. , Thabit Hood , Tauschmann Martin , Leelarathna Lalantha , Hartnell Sara , Acerini Carlo L. , Wilinska Malgorzata E. , Dellweg Sibylle , Benesch Carsten , Arnolds Sabine , Holzer Manuel , Kojzar Harald , Campbell Fiona , Yong James , Pichierri Jennifer , Hindmarsh Peter , Heinemann Lutz , Evans Mark L. , Hovorka Roman 
Published: April 2017

Objective: The objective was to explore psychosocial experiences of closed loop technology for adults, children, and adolescents with type 1 diabetes and their parents taking part in two multicenter, free-living, randomized crossover home studies. Methods: Participants using insulin pump therapy were randomized to either 12 weeks of automated closed-loop glucose control, then 12 weeks of sensor augmented insulin pump therapy (open loop), or vice versa. Closed loop was used for 24 hours by adults and overnight only by children and adolescents. Participants completed the Diabetes Technology Questionnaire (DTQ) periodically and shared their views in semistructured interviews. This analysis characterizes the impact of the technology, positive and negative aspects of living with the device, alongside participants’ expectations, hopes, and anxieties. Results: Participants were 32 adults, age 38.6 ± 9.6 years, 55% male, and 26 children, mean age 12 years (range 6-18 years), 54% male. DTQ results indicated moderately favorable impact of, and satisfaction with, both open and closed loop interventions, but little evidence of a comparative advantage of either. Key positive themes included perceived improved blood glucose control, improved general well-being, particularly on waking, improved sleep, reduced burden of diabetes, and visibility of data. Key negative themes included having to carry around the equipment and dislike of the pump and second cannula (ie, sensor) inserted. Conclusions: Overall, participants reported a positive experience of the closed loop technology. Results are consistent with previous research with size of equipment continuing to be a problem. Progress is being made in the usability of the closed-loop system.
Burkholderia cepacia complex and limited cutaneous vasculitis in patients with cystic fibrosis: a case series
Authors: Kayria Muttardi , Chris Orchard , Dhasmana Devesh J , Nilesh Morar , Hodson Margaret E , Khin Gyi , Diana Bilton , Simmonds Nicholas J 
Published: April 2017

Lesson There is a high association of reactive skin presentations, mainly limited cutaneous vasculitis in patients with cystic fibrosis and Burkholderia cepcia complex chronic infection. This may be due to raised levels of circulating inflammatory mediators.
Distribution of Salivary Testosterone in Men and Women in a British General Population-Based Sample: The Third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)
Authors: Keevil Brian G. , Clifton Soazig , Tanton Clare , Macdowall Wendy , Copas Andrew J. , Lee David , Field Nigel , Mitchell Kirstin R. , Sonnenberg Pam , Bancroft John , Mercer Cath H. , Johnson Anne M. , Wellings Kaye , Wu Frederick C. W. 
Published: April 2017

Abstract

Introduction:
Measurement of salivary testosterone (Sal-T) to assess androgen status offers important potential advantages in epidemiological research. The utility of the method depends on the interpretation of the results against robustly determined population distributions, which are currently lacking.

Aim:
To determine age-specific Sal-T population distributions for men and women.

Methods:
Morning saliva samples were obtained from participants in the third National Survey of Sexual Attitudes and Lifestyles, a probability sample survey of the British general population. Sal-T was measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Linear and quantile regression analyses were used to determine the age-specific 2.5th and 97.5th percentiles for the general population (1675 men and 2453 women) and the population with health exclusions (1145 men and 1276 women).

Results:
In the general population, the mean Sal-T level in men decreased from 322.6 pmol/L at 18 years of age to 153.9 pmol/L at 69 years of age. In women, the decrease in the geometric mean Sal-T level was from 39.8 pmol/L at 18 years of age to 19.5 pmol/L at 74 years of age. The annual decrease varied with age, with an average of 1.0% to 1.4% in men and 1.3% to 1.5% in women. For women, the 2.5th percentile fell below the detection limit (&lt;6.5 pmol/L) from age 52 years onward. The mean Sal-T level was approximately 6 times greater in men than in women, and this remained constant over the age range. The Sal-T level was lowest for men and highest for women in the summer. The results were similar for the general population with exclusions.

Conclusions:
To our knowledge, this is the first study to describe the sex- and age-specific distributions for Sal-T in a large representative population using a specific and sensitive LC-MS/MS technique. The present data can inform future population research by facilitating the interpretation of Sal-T results as a marker of androgen status.
Patterns of ocular inflammation in patients with miliary tuberculosis
Authors: Mehta Salil 
Published: April 2017

Background: Ocular morbidity associated with systemic tuberculosis is common. The clinical picture varies from anterior uveitis, intermediate uveitis and posterior uveitis to even panuveitis. There is little data on the correlation between specific systemic presentations and the ocular inflammation. We conducted a retrospective review of the ocular findings in the case records of patients admitted with a diagnosis of miliary tuberculosis. These patients were then referred for a more detailed ophthalmic evaluation. Methods: We analysed the case records of patients with a clinical diagnosis of miliary tuberculosis over a 10-year period at Lilavati Hospital and Research Center, Mumbai. Results: In total, 11 immunocompetent patients were identified. All 22 eyes showed normal findings on slit lamp examination. Dilated fundus examination showed single or multiple tubercles. In our cohort, the ocular findings were exclusively in the form of choroidal tuberculosis, either unilaterally or bilaterally. Slit lamp examination revealed no anterior segment inflammation Conclusions: We suggest that this pattern of choroidal/retinal tuberculosis in the absence of anterior and intermediate segment inflammation is specific for miliary tuberculosis and may be related to a specific immune response.