bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hyponatremia Is an Independent Predictor of In-Hospital Mortality in Spontaneous Intracerebral Hemorrhage
Authors: Kuramatsu Joji B. , Bobinger Tobias , Volbers Bastian , Staykov Dimitre , Lücking Hannes , Kloska Stephan P. , Köhrmann Martin , Huttner Hagen B. 
Published: April 2014

Background and Purpose—
Hyponatremia is the most frequent electrolyte disturbance in critical care. Across various disciplines, hyponatremia is associated with increased mortality and longer hospital stay, yet in intracerebral hemorrhage (ICH) no data are available. This the first study that investigated the prevalence and clinical associations of hyponatremia in patients with ICH.

Methods—
This observational study included all consecutive spontaneous ICH patients (n=464) admitted during a 5-year period to the Department of Neurology. Patient characteristics, in-hospital measures, mortality, and functional outcome (90 days and 1 year) were analyzed to determine the effects of hyponatremia (Na <135 mEq/L). Multivariable regression analyses were calculated for factors associated with hyponatremia and predictors of in-hospital mortality.

Results—

The prevalence of hyponatremia on hospital admission was 15.6% (n=66). Normonatremia was achieved and maintained in almost all hyponatremia patients <48 hours. In-hospital mortality was roughly doubled in hyponatremia compared with nonhyponatremia patients (40.9%; n=27 versus 21.1%; n=75), translating into a 2.5-fold increased odds ratio (
P
<0.001). Multivariable analyses identified hyponatremia as an independent predictor of in-hospital mortality (odds ratio, 2.2; 95% confidence interval, 1.05–4.62;
P
=0.037). Within 90 days after ICH, hyponatremia patients surviving hospital stay were also at greater risk of death (odds ratio, 4.8; 95% confidence interval, 2.1–10.6;
P
<0.001); thereafter, mortality rates were similar.

Conclusions—
Hyponatremia was identified as an independent predictor of in-hospital mortality with a fairly high prevalence in spontaneous ICH patients. The presence of hyponatremia at hospital admission is related to an increased short-term mortality in patients surviving acute care, possibly reflecting a preexisting condition that is linked to worse outcome due to greater comorbidity. Correction of hyponatremia does not seem to compensate its influence on mortality, which strongly warrants future research.
Volume of Carotid Artery Ulceration as a Predictor of Cardiovascular Events
Authors: Kuk Mariya , Wannarong Thapat , Beletsky Vadim , Parraga Grace , Fenster Aaron , Spence J. David 
Published: April 2014

Background and Purpose—
Previous studies have shown the presence of ulceration in atherosclerotic plaque either by categorizing the plaque as complex (irregular morphology with ulcers) or smooth or by quantifying the number of ulcers observed in a specific region of interest. The aim of this study was to quantify carotid total ulcer volume by 3-dimensional ultrasound to investigate the relationship of total ulcer volume to vascular events (strokes, transient ischemic attack, myocardial infarction, revascularization, or death because of cardiovascular reasons).

Methods—

In total, 349 at-risk subjects provided written informed consent to carotid 3-dimensional ultrasound and were analyzed for ulcerations. Ulcer volume was defined as a distinct discontinuity in an atherosclerotic plaque, with a volume ≥1.00 mm
3
as measured using manual segmentation. The sum of the volumes of all ulcers seen in both carotids was the total ulcer volume. Participants were monitored for ≤5 years for outcomes, including cardiovascular events and death.

Results—

Kaplan–Meier survival analysis showed that subjects with total ulcer volume ≥5 mm
3
experienced a significantly higher risk of developing stroke, transient ischemic attack, or death (
P
=0.009) and of developing stroke/transient ischemic attack/death/myocardial infarction/revascularization (
P
=0.017). Lower ulcer volumes did not predict events nor did ulcer depth.

Conclusions—
Volume of carotid ulceration on 3-dimensional ultrasound predicts cardiovascular events. In addition to improving risk stratification, ulceration is a potential therapeutic target.
A Dynamical Model for the Leeuwin Undercurrent
Authors: Schloesser Fabian 
Published: April 2014

Abstract
Recently, Furue et al. explored analytic solutions to a dynamical model for the Leeuwin Current system (LCS) off the coast of Western Australia. Their linear, variable density, two-layer model reduces to a one-layer system near the coast. The circulation is determined by matching solutions in the coastal and offshore regions across the “grounding line” and displays many features observed in the LCS. However, it does not include a Leeuwin Undercurrent (LUC). Here, that model is extended considering an across-shore density gradient (front) caused by relatively light, tropical water being carried poleward by the Leeuwin Current (LC). As a result of including the front, the LCS circulation changes considerably; the LC deepens and strengthens significantly toward the pole, and the LCS now includes an equatorward LUC on the offshore edge of the LC. Differences in density and sea surface height across the front both contribute to the pressure gradient driving the LUC.
Assessment of CODAR SeaSonde and WERA HF Radars in Mapping Surface Currents on the West Florida Shelf*
Authors: Liu Yonggang , Weisberg Robert H. , Merz Clifford R. 
Published: April 2014

Abstract
Concurrently operated on the West Florida shelf for the purpose of observing surface currents are three long-range (4.9 MHz) Coastal Ocean Dynamics Applications Radar (CODAR) SeaSonde and two median-range (12.7 MHz) Wellen Radar (WERA) high-frequency (HF) radar systems. These HF radars overlook an array of moored acoustic Doppler current profilers (ADCPs), three of which are presently within the radar footprint. Analyzed herein are 3 months of simultaneous observations. Both the SeaSonde and WERA systems generally agree with the ADCPs to within root-mean-square differences (rmsd) for hourly radial velocity components of 5.1–9.2 and 3.8–6.5 cm s−1 for SeaSonde and WERA, respectively, and within rmsd for 36-h low-pass filtered radial velocity components of 2.8–6.0 and 2.2–4.3 cm s−1 for SeaSonde and WERA, respectively. The bearing offset and tidal and subtidal currents of total velocities are also assessed using the ADCP data. Despite differences in a variety of aspects between the direction-finding CODAR SeaSonde (long range, effective depth of 2.4 m, integration time of 4 h, and idealized antenna patterns) and the beam-forming WERA (median range, effective depth of 0.9 m, and integration time of 1 h), both HF radar systems demonstrated good surface current mapping capability. The differences between the velocities measured with the HF radar and the ADCP are sufficiently small in this low-energy shelf that much of these rmsd values may be accounted for by the expected measurement differences due to the horizontal, vertical, and temporal sampling differences of the ocean current observing systems used.
An Examination of the Feasibility of Linear Deterministic Sea Wave Prediction in Multidirectional Seas Using Wave Profiling Radar: Theory, Simulation, and Sea Trials
Authors: Belmont M. R. , Christmas J. , Dannenberg J. , Hilmer T. , Duncan J. , Duncan J. M. , Ferrier B. 
Published: April 2014

Abstract
For a number of maritime tasks there is a short time period, typically only a few tens of seconds, where a critical event occurs that defines a limiting wave height for the whole operation. Examples are the recovery of fixed and rotary winged aircraft, cargo transfers, final pipe mating in fluid transfer operations, and launch/recovery of small craft. The recovery of a 30-t rescue submersible onto a mother ship in the North Atlantic Treaty Organization (NATO) Submarine Rescue System is a prime example. In such applications short-term deterministic sea wave prediction (DSWP) can play a vital role in extending the sea states under which the system can be safely deployed. DSWP also has great potential in conducting experimental sea wave research at full scale. This report explores the feasibility of using data from an experimental wave profiling radar in achieving DSWP. The report includes theory, simulation, and field testing. Two forms of DSWP are employed: a fixed point system based upon a restricted set of wave directions from which some success is obtained and the other a fully two-dimensional technique that requires further development. The main finding is that using wave profiling radar for DSWP offers promise but requires improvements both to the spatial reliability and the resolution of the wave profiling radar and to the temporal resolution of its sweep before the technique can be considered to be viable as a usable tool.
Performance of Operational Model Precipitation Forecast Guidance during the 2013 Colorado Front-Range Floods*
Authors: Hamill Thomas M. 
Published: April 2014

Abstract
During the period 9–16 September 2013, more than 17 in. (~432 mm) of rainfall fell over parts of Boulder County, Colorado, with more than 8 in. (~203 mm) over a wide swath of Colorado’s northern Front Range. This caused significant flash and river flooding, loss of life, and extensive property damage. The event set a record for daily rainfall (9.08 in., or &gt;230 mm) in Boulder that was nearly double the previous daily rainfall record of 4.8 in. (122 mm) set on 31 July 1919. The operational performance of precipitation forecast guidance from global ensemble prediction systems and the National Weather Service’s global and regional forecast systems during this event is documented briefly in the article and more extensively in online supplemental appendixes. While the precipitation forecast guidance uniformly depicted a much wetter-than-average period over northeastern Colorado, none of the global nor most of the regional modeling systems predicted precipitation amounts as heavy as analyzed. Notable exceptions to this were the Short-Range Ensemble Forecast (SREF) members that used the Advanced Research Weather Research and Forecasting Model (ARW-WRF) dynamical core. These members consistently produced record rainfall in the Front Range. However, the SREF’s record rainfall was also predicted to occur the day before the heaviest actual precipitation as well as the day of the heaviest precipitation.
Chylothorax diagnosis: can the clinical chemistry laboratory do more?
Authors: Gibbons Stephen M , Ahmed Farhan 
Published: April 2014

Background Chylothorax is a rare anatomical disruption of the thoracic duct associated with a significant degree of morbidity and mortality. Diagnosis usually relies upon lipid analysis and visual inspection of the pleural fluid. However, this may be subject to incorrect interpretation. The aim of this study was to compare pleural fluid lipid analysis and visual inspection against lipoprotein electrophoresis. Methods Nine pleural effusion samples suspected of being chylothorax were analysed. A combination of fluid lipid analysis and visual inspection was compared with lipoprotein electrophoresis for the detection of chylothorax. Results There was 89% concordance between the two methods. Using lipoprotein electrophoresis as gold standard, calculated sensitivity, specificity, negative predictive value and positive predictive value for lipid analysis/visual inspection were 83%, 100%, 100% and 75%, respectively. Conclusion Examination of pleural effusion samples by lipoprotein electrophoresis may provide important additional information in the diagnosis of chylothorax.
Comparison of BD Vacutainer® Rapid Serum Tube and plasma for haemolysis markers in the emergency department
Authors: Ryan JB , Stuart LA , Southby SJ , Than MP , Mackay R , Florkowski CM , George PM 
Published: April 2014

Background In recent years, a rapid-clotting serum tube, BD Vacutainer® Rapid Serum Tube (RST™), was introduced to improve turn-around times for serum samples. Previous studies reported reduced concentrations of some markers of haemolysis in RST specimens compared to other serum or plasma samples. We aimed to compare RST to plasma tubes for haemolysis markers in an emergency department (ED) setting, where increased rates of haemolysis are commonly seen. Methods Patients presenting to ED over an eight-day period had an RST, BD Vacutainer® PST™ II (plasma) Tube and BD Vacutainer® Heparin (non-gel, plasma) Tube collected. Blood was drawn from an intravenous cannula, and samples were promptly analysed for haemolysis index, potassium, phosphate, aspartate aminotrasferase (AST), magnesium and lactate dehydrogenase (LD). Results A total of 347 patient samples were included, and 9.2% of the PST samples were haemolysed. The RST tubes had small increases in all of the haemolysis markers compared to both plasma tubes ( P ≤ 0.005), except LD which was lower in the RST group. There were no significant differences in the proportion of results above the upper reference limit between the tubes, except for LD which had a lower proportion in RST samples ( P ≤ 0.002). Conclusion Compared to plasma, RST specimens show small increases in several haemolysis markers, consistent with known differences between serum and plasma, but the proportion of elevated haemolysis markers is similar to plasma. In a setting with a high haemolysis rate such as ED, RST specimens provide a non-inferior sample type for markers of haemolysis.
An examination of the effectiveness of Handwriting Without Tears® instruction
Authors: Roberts Gwenyth I. , Derkach-Ferguson Alanna F. , Siever Jodi E. , Rose M. Sarah 
Published: April 2014

Background. Handwriting is an important childhood occupation, and implications of poor handwriting may have significant long-term effects. Purpose. The purpose of this study was to determine the effectiveness of Handwriting Without Tears® (HWT) on Grade 1 students’ handwriting and perception of skills. Methods. A cross-over design was used. Repeated measures, at three points, included the Minnesota Handwriting Assessment (MHA) and performance rating scales. Findings. Eighty-three boys and 66 girls with an average age of 6.2 years participated in the study. Students receiving HWT achieved significantly higher improvements compared to students with teacher-designed instruction in MHA Total Test Score and in MHA components of form, size, space, and alignment (all p < .05). Students had higher average performance ratings when receiving HWT in the first half of the school year. Implications. Instruction using HWT improves students’ perception and skill in handwriting performance.
Matrix-Applied Characterized Autologous Cultured Chondrocytes Versus Microfracture
Authors: Saris Daniel , Price Andrew , Widuchowski Wojciech , Bertrand-Marchand Marion , Caron Jacob , Drogset Jon Olav , Emans Pieter , Podskubka Ales , Tsuchida Anika , Kili Sven , Levine David , Brittberg Mats ,   on behalf of the SUMMIT study group, Paša Libor , Trc Tomas , Slynarski Konrad , Sanson Bernd-Jan , Bezuidenhoudt Mauritz 
Published: April 2014

Background: Randomized controlled trials studying the efficacy and safety of matrix-applied characterized autologous cultured chondrocytes (MACI) versus microfracture (MFX) for treating cartilage defects are limited. Purpose: To compare the clinical efficacy and safety of MACI versus MFX in the treatment of patients with symptomatic cartilage defects of the knee. Study Design: Randomized controlled clinical trial; Level of evidence, 1. Methods: Patients enrolled in the SUMMIT (Demonstrate the Superiority of MACI implant to Microfracture Treatment) trial had ≥1 symptomatic focal cartilage defect (Outerbridge grade III or IV; ≥3 cm2) of the femoral condyles or trochlea, with a baseline Knee Injury and Osteoarthritis Outcome Score (KOOS) pain value <55. The co–primary efficacy endpoint was the change in the KOOS pain and function subscores from baseline to 2 years. Histological evaluation and magnetic resonance imaging (MRI) assessments of structural repair tissue, treatment failure, the remaining 3 KOOS subscales, and safety were also assessed. Results: Of the 144 patients treated, 137 (95%) completed the 2-year assessment. Patients had a mean age of 33.8 years and a mean lesion size of 4.8 cm2. The mean KOOS pain and function subscores from baseline to 2 years were significantly more improved with MACI than with MFX (pain: MACI, 37.0 to 82.5 vs MFX, 35.5 to 70.9; function: MACI, 14.9 to 60.9 vs MFX, 12.6 to 48.7; P = .001). A significant improvement in scores was also observed on the KOOS subscales of activities of daily living (MACI, 43.5 to 87.2 vs MFX, 42.6 to 75.8; P < .001), knee-related quality of life (MACI, 18.8 to 56.2 vs MFX, 17.2 to 47.3; P = .029), and other symptoms (MACI, 48.3 to 83.7 vs MFX, 44.4 to 72.2; P < .001) for patients treated with MACI compared with MFX. Repair tissue quality was good as assessed by histology/MRI, but no difference was shown between treatments. A low number of treatment failures (nonresponders: MACI, 12.5% vs MFX, 31.9%; P = .016) and no unexpected safety findings were reported. Conclusion: The treatment of symptomatic cartilage knee defects ≥3 cm2 in size using MACI was clinically and statistically significantly better than with MFX, with similar structural repair tissue and safety, in this heterogeneous patient population. Moreover, MACI offers a more efficacious alternative than MFX with a similar safety profile for the treatment of symptomatic articular cartilage defects of the knee.
Rail grinding for the 21st century – taking a lead from the aerospace industry
Authors: Singleton Roger , Marshall Matthew B , Lewis Roger , Evans Gareth 
Published: April 2014

Rail grinding is a key maintenance activity for Network Rail. It is performed at night through possession of the track, so process speed is critical. Increasing the metal removal rate (MRR) of the rail grinding operations would be a way to improve the time taken for this operation. The aerospace industry has recently seen advances in grinding technologies that have increased MRR. This work was aimed at assessing their best practice and its application to rail grinding operations. Current Network Rail grinding operations include preventative and corrective re-profiling of the rail head. The majority of work performed in the UK is preventative re-profiling with current train speeds ranging from 1 to 10 mile/h. Opportunities exist to increase train speed and improve the productivity of this operation through the use of more advanced grinding technologies. The most relevant aerospace technology is high efficiency deep grinding (HEDG). This approach uses: a high surface speed of the grinding wheel, superabrasive tooling, and high workpiece feed rates to remove material quickly from the cut-zone. Productivity improvements were identified by applying theory on power requirements (by assessing the specific grinding energy) and chip thickness of the grinding process. Computer CAD/CAM modelling was also performed to assess the effect of changing grinding techniques on potential gouging of the track infrastructure and/or interference with example trackside obstructions. The work concluded that opportunities do exist to improve the current productivity of grinding operations. Utilizing HEDG technology theoretically provides a 100% train speed increase (utilizing the same power available with the current setup) for preventative re-profiling. This requires the application of high surface speeds of the grinding wheel and superabrasive technology. Further increases in train speed require increased spindle power. The chip thickness experienced by grinding grains is reduced for a peripheral grinding setup and high wheel surface speeds that is beneficial for wheel wear. The application of HEDG technology cutting on the periphery of the wheel provided optimum conditions during CAD/CAM simulation to avoid rail gouging, and any potential collision of the grinding stone with modelled trackside obstructions.
Contribution of ethics education to the ethical competence of nursing students
Authors: Cannaerts Nancy , Gastmans Chris , Casterlé Bernadette Dierckx de 
Published: April 2014

Aims: To review the literature on perceptions of nursing students and/or educators on the contribution of ethics education to ethical competence in nursing students. Background: Nurses do not always demonstrate the competencies necessary to engage in ethical practice. Educators continue to debate about the best ways to teach ethics to nurses so that they can develop ethical competencies. Data sources: MEDLINE, Embase, CINAHL, PsycINFO, and Web of Science. Review methods: A total of 15 articles with a quantitative, qualitative, or mixed-methods design published between January 1992 and March 2012 were analyzed. Results: According to students and educators, ethics education increases ethical perception of nursing students and the development of reflective and analytical skills. However, its contribution to the development of ethical behavior was barely mentioned. The accounts of students and educators revealed essential features of effective ethics education: active involvement of students in case study discussions and use of ethical frameworks. The use of activating educational strategies requires a safe learning environment where students can openly reflect on values at stake in their care practice. Conclusion: A better understanding of how students learn to develop ethical skills and of influencing factors can guide educators to develop ethics courses for nursing curriculum. Future research needs to focus on the methodological accuracy of sampling and measuring instruments.
Moral distress in the resuscitation of extremely premature infants
Authors: Molloy Jennifer , Evans Marilyn , Coughlin Kevin 
Published: April 2014

Objective: To increase our understanding of moral distress experienced by neonatal registered nurses when directly or indirectly involved in the decision-making process of resuscitating infants who are born extremely premature. Design: A secondary qualitative analysis was conducted on a portion of the data collected from an earlier study which explored the ethical decision-making process among health professionals and parents concerning resuscitation of extremely premature infants. Setting: A regional, tertiary academic referral hospital in Ontario offering a perinatal program. Participants: A total of 15 registered nurses were directly or indirectly involved in the resuscitation of extremely premature infants. Methods: Interview transcripts of nurses from the original study were purposefully selected from the original 42 transcripts of health professionals. Inductive content analysis was conducted to identify themes describing factors and situations contributing to moral distress experienced by nurses regarding resuscitation of extremely premature infants. Ethical considerations: Ethical approval was obtained from the research ethics review board for both the initial study and this secondary data analysis. Results: Five themes, uncertainty, questioning of informed consent, differing perspectives, perceptions of harm and suffering, and being with the family, contribute to the moral distress felt by nurses when exposed to neonatal resuscitation of extremely premature infants. An interesting finding was the nurses’ perceived lack of power and influence in the neonatal resuscitation decision-making process. Conclusion: Moral distress continues to be a significant issue for nursing practice, particularly among neonatal nurses. Strategies are needed to help mediate the moral distress experienced by nurses, such as debriefing sessions, effective communication, role clarification, and interprofessional education and collaboration.