bluuebunny/crossref_metadata_2025_split huggingface dataset:
Collateral Donor Artery Physiology and the Influence of a Chronic Total Occlusion on Fractional Flow Reserve
Authors: Ladwiniec Andrew , Cunnington Michael S. , Rossington Jennifer , Mather Adam N. , Alahmar Albert , Oliver Richard M. , Nijjer Sukhjinder S. , Davies Justin E. , Thackray Simon , Alamgir Farquad , Hoye Angela 
Published: March 2015

Background—
The presence of a concomitant chronic total coronary occlusion (CTO) and a large collateral contribution might alter the fractional flow reserve (FFR) of an interrogated vessel, rendering the FFR unreliable at predicting ischemia should the CTO vessel be revascularized and potentially affecting the decision on optimal revascularization strategy. We tested the hypothesis that donor vessel FFR would significantly change after percutaneous coronary intervention of a concomitant CTO.

Methods and Results—

In consecutive patients undergoing percutaneous coronary intervention of a CTO, coronary pressure and flow velocity were measured at baseline and hyperemia in proximal and distal segments of both nontarget vessels, before and after percutaneous coronary intervention. Hemodynamics including FFR, absolute coronary flow, and the coronary flow velocity–pressure gradient relation were calculated. After successful percutaneous coronary intervention in 34 of 46 patients, FFR in the predominant donor vessel increased from 0.782 to 0.810 (difference, 0.028 [0.012 to 0.044];
P
=0.001). Mean decrease in baseline donor vessel absolute flow adjusted for rate pressure product: 177.5 to 139.9 mL/min (difference −37.6 [−62.6 to −12.6];
P
=0.005), mean decrease in hyperemic flow: 306.5 to 272.9 mL/min (difference, −33.5 [−58.7 to −8.3];
P
=0.011). Change in predominant donor vessel FFR correlated with angiographic (%) diameter stenosis severity (
r
=0.44;
P
=0.009) and was strongly related to stenosis severity measured by the coronary flow velocity–pressure gradient relation (
r
=0.69;
P
<0.001).

Conclusions—
Recanalization of a CTO results in a modest increase in the FFR of the predominant collateral donor vessel associated with a reduction in coronary flow. A larger increase in FFR is associated with greater coronary stenosis severity.
Longitudinal Relationship Between Cerebral Small-Vessel Disease and Cerebral Blood Flow
Authors: van der Veen Pieternella H. , Muller Majon , Vincken Koen L. , Hendrikse Jeroen , Mali Willem P.T.M. , van der Graaf Yolanda , Geerlings Mirjam I. 
Published: March 2015

Background and Purpose—
Cerebral small-vessel disease and cerebral blood flow (CBF) are interrelated. However, the direction of the relationship is unknown, and longitudinal studies are scarce. We investigated the longitudinal relationship between CBF and white matter hyperintensities (WMHs) and lacunes, as representatives of cerebral small-vessel disease, in patients with manifest arterial disease.

Methods—
Within the Second Manifestations of Arterial Disease-Magnetic Resonance (SMART-MR) study, 1.5T brain magnetic resonance imaging, including an MR angiography, was obtained at baseline and after on ≈3.9 years of follow-up in 575 patients with manifest arterial disease (mean age, 57±10 years). Longitudinal associations of WMHs and lacunes with parenchymal CBF (pCBF; per 100-mL brain volume) were estimated using regression analyses, adjusted for age, sex, follow-up time, and baseline brain measures.

Results—
Baseline pCBF was not associated with progression of WMHs and lacunes over time. However, periventricular and deep WMHs at baseline were associated with decline in pCBF; mean (95% confidence interval) decline in pCBF per % intracranial volume increase in periventricular and deep WMH volume was −0.70 (−1.40 to −0.00) and −1.01 (−1.64 to −0.38) mL/min per 100-mL brain volume, respectively. These associations were partly explained by cardiovascular risk factors but remained significant for deep WMHs (mean decline [95% confidence interval] in pCBF per % intracranial volume increase in deep WMH volume was −0.92 [−1.56 to −0.28] mL/min per 100-mL brain volume). Lacunes were not associated with change in pCBF.

Conclusions—
In patients with manifest arterial disease, baseline periventricular and deep WMH volumes were associated with decline in pCBF over time, but baseline pCBF was not associated with progression of WMHs and lacunes over time.
Normobaric Hyperoxia Slows Blood–Brain Barrier Damage and Expands the Therapeutic Time Window for Tissue-Type Plasminogen Activator Treatment in Cerebral Ischemia
Authors: Liang Jia , Qi Zhifeng , Liu Wenlan , Wang Peng , Shi Wenjuan , Dong Wen , Ji Xunming , Luo Yumin , Liu Ke Jian 
Published: March 2015

Background and Purpose—

Prolonged ischemia causes blood–brain barrier (BBB) damage and increases the incidence of neurovasculature complications secondary to reperfusion. Therefore, targeting ischemic BBB damage pathogenesis is critical to reducing neurovasculature complications and expanding the therapeutic time window of tissue-type plasminogen activator (tPA) thrombolysis. This study investigates whether increasing cerebral tissue P
O
2
through normobaric hyperoxia (NBO) treatment will slow the progression of BBB damage and, thus, improve the outcome of delayed tPA treatment after cerebral ischemia.

Methods—

Rats were exposed to NBO (100% O
2
) or normoxia (21% O
2
) during 3-, 5-, or, 7-hour middle cerebral artery occlusion. Fifteen minutes before reperfusion, tPA was continuously infused to rats for 30 minutes. Neurological score, mortality rate, and BBB permeability were determined. Matrix metalloproteinase-9 was measured by gelatin zymography and tight junction proteins (occludin and cluadin-5) by Western blot in the isolated cerebral microvessels.

Results—
NBO slowed the progression of ischemic BBB damage pathogenesis, evidenced by reduced Evan blue leakage, smaller edema, and hemorrhagic volume in NBO-treated rats. NBO treatment reduced matrix metalloproteinase-9 induction and the loss of tight junction proteins in ischemic cerebral microvessels. NBO-afforded BBB protection was maintained during tPA reperfusion, resulting in improved neurological functions, significant reductions in brain edema, hemorrhagic volume, and mortality rate, even when tPA was given after prolonged ischemia (7 hours).

Conclusions—
Early NBO treatment slows ischemic BBB damage pathogenesis and significantly improves the outcome of delayed tPA treatment, providing new evidence supporting NBO as an effective adjunctive therapy to extend the time window of tPA thrombolysis for ischemic stroke.
Reconstructing Realities from Biblical Utopias
Authors: Uhlenbruch Frauke 
Published: March 2015

This article addresses two specific issues in reading the Hebrew Bible drawing on utopian theory: the possibility of reconstructing historical reality by reading a text as a utopia, and the variable of changing audiences throughout time and their impact on utopian readings. Suvin’s and Roemer’s definitions of utopia are used, but it is acknowledged that no one definition of utopia is necessarily more correct than another. ­Approaching the concept of utopia as a flexible ideal type, rather than with  a strict definition, is advocated. Utopia is seen as a specific response by the author(s) to a perceived reality; therefore it has been suggested that reading biblical texts as utopia can offer insight into social realities at the time of the text’s creation. This notion is examined critically, drawing on Holquist’s comparison of utopia to the abstraction of chess. While it is possible to make some statements about the social reality at the time of the production of the text by reading the text as a utopian representation, it must always be taken into account that each reconstruction of reality is only one possible interpretation offered by a member of a non-intended audience. A utopia’s relationship to realities is complex, and often aspects of its implied counter-piece, the dystopia, become visible when a transfer of a utopia into reality is attempted.
Baroclinic Eddies and the Extent of the Hadley Circulation: An Idealized GCM Study
Authors: Levine Xavier J. , Schneider Tapio 
Published: March 2015

The Hadley circulation has widened over the past 30 years. This widening has been qualitatively reproduced in general circulation model (GCM) simulations of a warming climate. Comprehensive GCM studies suggest this widening may be caused by a poleward shift in baroclinic eddy activity. Yet the limited amplitude of the climate change signals analyzed so far precludes a quantitative comparison with theories.This study uses two idealized GCMs, one with and one without an active hydrologic cycle, to investigate changes in the extent of the Hadley circulation over a wide range of climates. The climates span global-mean temperatures from 243 to 385 K and equator-to-pole temperature contrasts from 12 to 100 K. Baroclinic eddies control the extent of the Hadley circulation across most of these climates. A supercriticality criterion that quantifies the depth of baroclinic eddies relative to that of the troposphere turns out to be a good indicator of where baroclinic eddies become deep enough to terminate the Hadley circulation. The supercriticality depends on meridional temperature gradients and an effective stability that accounts for the effect of convective heating on baroclinic eddies.As the equator-to-pole temperature contrast weakens or the convective static stability increases, convective heating increasingly influences the thermal stratification of the troposphere and the supercriticality. Consistent with the supercriticality criterion, the Hadley circulation contracts as meridional temperature gradients increase, and it widens as the effective static stability increases. The former occurs during El Niño and may account for the observed Hadley circulation contraction then; the latter occurs during global warming.
The Sensitivity of Tropical Cyclone Activity to Off-Equatorial Thermal Forcing in Aquaplanet Simulations
Authors: Ballinger Andrew P. , Merlis Timothy M. , Held Isaac M. , Zhao Ming 
Published: March 2015

Abstract
The sensitivity of global tropical cyclone (TC) activity to changes in a zonally symmetric sea surface temperature (SST) distribution and the associated large-scale atmospheric circulation are investigated. High-resolution (~50-km horizontal grid spacing) atmospheric general circulation model simulations with maximum SST away from the equator are presented. Simulations with both fixed-SST and slab ocean lower boundary conditions are compared.
The simulated TCs that form on the poleward flank of the intertropical convergence zone (ITCZ) are tracked and changes in the frequency and intensity of those storms are analyzed between the different experiments. The total accumulated cyclone energy (ACE) increases as the location of the maximum SST shifts farther away from the equator. The location of the ITCZ also shifts in conjunction with changes to the SST profile, and this plays an important role in mediating the frequency and intensity of the TCs that form within this modeling framework.
The Seasonality of the Great Plains Low-Level Jet and ENSO Relationship
Authors: Krishnamurthy Lakshmi , Vecchi Gabriel A. , Msadek Rym , Wittenberg Andrew , Delworth Thomas L. , Zeng Fanrong 
Published: March 2015

Abstract
This study investigates the seasonality of the relationship between the Great Plains low-level jet (GPLLJ) and the Pacific Ocean from spring to summer, using observational analysis and coupled model experiments. The observed GPLLJ and El Niño–Southern Oscillation (ENSO) relation undergoes seasonal changes with a stronger GPLLJ associated with La Niña in boreal spring and El Niño in boreal summer. The ability of the GFDL Forecast-Oriented Low Ocean Resolution (FLOR) global coupled climate model, which has the high-resolution atmospheric and land components, to simulate the observed seasonality in the GPLLJ–ENSO relationship is assessed. The importance of simulating the magnitude and phase locking of ENSO accurately in order to better simulate its seasonal teleconnections with the Intra-Americas Sea (IAS) is demonstrated. This study explores the mechanisms for seasonal changes in the GPLLJ–ENSO relation in model and observations. It is hypothesized that ENSO affects the GPLLJ variability through the Caribbean low-level jet (CLLJ) during the summer and spring seasons. These results suggest that climate models with improved ENSO variability would advance our ability to simulate and predict seasonal variations of the GPLLJ and their associated impacts on the United States.
Synoptic Control of Cross-Barrier Precipitation Ratios for the Cascade Mountains
Authors: Mass Clifford , Johnson Neal , Warner Michael , Vargas Ricardito 
Published: March 2015

AbstractThis paper examines the synoptic control of precipitation contrasts across the Cascade Mountains of Washington State during the cool season. The average hourly precipitation for three stations on the western and eastern sides of the barrier is calculated, and composite synoptic conditions are determined for situations when precipitation is greater over the eastern slopes, similar precipitation falls on both sides, moderately greater precipitation falls on the western side, and substantially greater precipitation falls on the western side. Conditions prior to occluded/warm frontal passage are favorable for relatively equal precipitation amounts on both sides of the barrier, with extensive warm advection precipitation spreading over the region. Low-level winds are generally southerly during this period, resulting in less orographic modulation of precipitation on the north–south-oriented Cascades. In contrast, postfrontal conditions are associated with westerly flow, enhanced windward precipitation, and greater drying on the leeward (eastern) slopes. Postfrontal conditions also bring drying aloft and reduced stability at low levels, both of which contribute to the enhancement of precipitation on the western slopes. The variation of the cross-mountain precipitation ratio between El Niño and La Niña years can be explained by the associated synoptic configurations. El Niño years have weaker zonal winds and thus less orographic modulation. Furthermore, the lesser vertical stability of La Niña years enhances precipitation on the windward side of the barrier where shallow convection is released.
Anterior‐Commissure Laryngoscope Extraction of Esophageal Coins in Children Using an Apnea Technique
Authors: Tarrats Luis A. , Rivera‐Rodríguez Marinell , González Lorena , Vargas‐Pinto Susana , Garratón Miguel , Quintero Elisa , Riera‐March Antonio 
Published: March 2015

This is a case series with chart review of 59 consecutive pediatric patients with a diagnosis of cervical esophageal coin who underwent anterior‐commissure laryngoscope (ACLA) extraction during apnea. The purpose of this study was (1) to evaluate the efficacy and safety of coin extraction and (2) to analyze foreign body features and intraoperative physiological parameters (apnea time, O2 saturation and end‐tidal CO2 (ETCO2) of apnea, minimum O2 during procedure, and heart rate). The technique was completed in 94.9% of the sample. The mean of the length of apnea was 57.7 ± 25.2 seconds. The median minimum O2 saturation was 99.5% (minimum = 93, maximum = 100), and the median of the ETCO2 at the end of the procedure was 35.7 ± 4.8 mm Hg. Heart rates remained at baseline values during the procedure (P <. 001). This technique represents an efficient and secure modality for treatment. If successful, the patient can be safely discharged after clearance from anesthesia and a swallowing trial.
Diagnostic Accuracy of Various Imaging Modalities for Suspected Lower Extremity Stress Fractures
Authors: Wright Alexis A. , Hegedus Eric J. , Lenchik Leon , Kuhn Karin J. , Santiago Laura , Smoliga James M. 
Published: March 2015

Background: The literature is filled with conflicting findings regarding diagnostic accuracy and protocols for imaging suspected lower extremity stress fractures. The absence of systematic reviews on this topic has limited the development of evidence-based recommendations for appropriate imaging protocols in cases of suspected lower extremity stress fractures. Purpose: To determine the diagnostic accuracy statistics of imaging modalities used to diagnose lower extremity stress fractures and to synthesize evidence-based recommendations for clinical practice. Study Design: Systematic review. Methods: A generic search strategy for published studies was performed using multiple databases. A study was eligible for inclusion if it met all of the following criteria: (1) at least 1 diagnostic imaging modality was studied, (2) at least 1 radiological reference standard was used, (3) the study reported or allowed computation of diagnostic accuracy statistics (sensitivity, specificity, positive likelihood ratio, negative likelihood ratio), (4) a full-text version was available, (5) the article was written in English, and (6) the study included lower extremity stress fractures. Studies that examined asymptomatic individuals or patients with fractures due to disease or pharmacologic intervention were excluded. Results: Reported sensitivity and specificity (95% CI) were as follows: For conventional radiography, sensitivity ranged from 12% (0%-29%) to 56% (39%-72%) and specificity ranged from 88% (55%-100%) to 96% (87%-100%). For nuclear scintigraphy (NS), sensitivity ranged from 50% (23%-77%) to 97% (90%-100%) and specificity from 33% (12%-53%) to 98% (93%-100%). For magnetic resonance imaging (MRI), sensitivity ranged from 68% (45%-90%) to 99% (95%-100%) and specificity from 4% (0%-11%) to 97% (88%-100%). For computed tomography, sensitivity ranged from 32% (8%-57%) to 38% (16%-59%) and specificity from 88% (55%-100%) to 98% (91%-100%). For ultrasound, sensitivity ranged from 43% (26%-61%) to 99% (95%-100%) and specificity from 13% (0%-45%) to 79% (61%-96%). Conclusion: MRI was identified as the most sensitive and specific imaging test for diagnosing stress fractures of the lower extremity. When MRI is available, NS is not recommended because of its low specificity, high dosage of ionizing radiation, and other limitations. Conventional radiographs are likely to result in false negatives upon initial presentation, particularly in the early stages of stress fracture, and in some cases may not reveal an existing stress fracture at any time. A diagnostic imaging algorithm was developed with specific recommendations for cost-efficient imaging of low-risk and high-risk suspected stress fractures.
Gender and Batterer Intervention
Authors: Hamel John , Ferreira Regardt J. , Buttell Fred 
Published: March 2015

Objective: The purpose of the present study was to investigate the impact of gender and other variables commonly associated with intimate partner abuse perpetration on program completion and pretreatment abusiveness profiles among a sample of men and women ordered into a 52-week batterer intervention program (BIP). Method: The study employed a posttest only design with nonequivalent groups (comparing program completers to dropouts and men to women) in an analysis of 175 clients mandated into a BIP. Results: Analysis indicated that there were no significant differences between men and women in terms of program completion and that women were significantly more likely than men to report engaging in severe physical abuse perpetration, and a logistic regression analysis indicated that dropouts were 6 times more likely to have initiated physical abuse compared to completers. Conclusion: These findings reveal characteristics of BIP program participants as they relate to self-reported abusiveness and provide preliminary evidence suggesting that both BIP pretreatment profiles and treatment completion rates of men and women are similar, with implications for policy and treatment.
Osteonecrosis of the Knee After Anterior Cruciate Ligament Reconstruction
Authors: Lansdown Drew A. , Shaw Jeremy , Allen Christina R. , Ma C. Benjamin 
Published: March 2015

Background: Anterior cruciate ligament (ACL) reconstruction is performed commonly, with a low risk of complication. Osteonecrosis of the knee is a potentially devastating condition and has been observed both spontaneously and after meniscectomy, although osteonecrosis has not been described as a complication after ACL reconstruction. Purpose: To describe the development of osteonecrosis of the knee in 5 patients after arthroscopic ACL reconstruction. Study Design: Case series; Level of evidence, 4. Methods: This study involved 5 patients (mean age, 33.2 years) who developed osteonecrosis of the knee after ACL reconstruction. A retrospective chart review was performed to identify clinical characteristics and surgical factors present in each of the 5 cases. Results: In 4 cases, the pathologic changes were present in both the medial and lateral femoral condyles, with isolated lateral condyle changes in the other case. The mean time to diagnosis was 11.6 months. These patients underwent an average of 1.8 additional surgical procedures after the diagnosis of osteonecrosis. Conclusion: Osteonecrosis of the knee is a rare outcome after ACL reconstruction. We are unable to identify clear risk factors for the development of this complication, although we hope the presentation of these cases will help promote the identification of other cases in future studies.
Nebulized antibiotics for ventilator-associated pneumonia: a systematic review and meta-analysis
Authors: Zampieri Fernando G , Nassar Jr Antonio P , Gusmao-Flores Dimitri , Taniguchi Leandro U , Torres Antoni , Ranzani Otavio T 
Published: March 2015

Abstract
Introduction
Nebulized antibiotics are a promising new treatment option for ventilator-associated pneumonia. However, more evidence of the benefit of this therapy is required.

Methods
The Medline, Scopus, EMBASE, Biological Abstracts, CAB Abstracts, Food Science and Technology Abstracts, CENTRAL, Scielo and Lilacs databases were searched to identify randomized controlled trials or matched observational studies that compared nebulized antibiotics with or without intravenous antibiotics to intravenous antibiotics alone for ventilator-associated pneumonia treatment. Two reviewers independently collected data and assessed outcomes and risk of bias. The primary outcome was clinical cure. Secondary outcomes were microbiological cure, ICU and hospital mortality, duration of mechanical ventilation, ICU length of stay and adverse events. A mixed-effect model meta-analysis was performed. Trial sequential analysis was used for the main outcome of interest.

Results
Twelve studies were analyzed, including six randomized controlled trials. For the main outcome analysis, 812 patients were included. Nebulized antibiotics were associated with higher rates of clinical cure (risk ratio (RR) = 1.23; 95% confidence interval (CI), 1.05 to 1.43; I2 = 34%; D2 = 45%). Nebulized antibiotics were not associated with microbiological cure (RR = 1.24; 95% CI, 0.95 to 1.62; I2 = 62.5), mortality (RR = 0.90; CI 95%, 0.76 to 1.08; I2 = 0%), duration of mechanical ventilation (standardized mean difference = −0.10 days; 95% CI, −1.22 to 1.00; I2 = 96.5%), ICU length of stay (standardized mean difference = 0.14 days; 95% CI, −0.46 to 0.73; I2 = 89.2%) or renal toxicity (RR = 1.05; 95% CI, 0.70 to 1.57; I2 = 15.6%). Regarding the primary outcome, the number of patients included was below the information size required for a definitive conclusion by trial sequential analysis; therefore, our results regarding this parameter are inconclusive.

Conclusions
Nebulized antibiotics seem to be associated with higher rates of clinical cure in the treatment of ventilator-associated pneumonia. However, the apparent benefit in the clinical cure rate observed by traditional meta-analysis does not persist after trial sequential analysis. Additional high-quality studies on this subject are highly warranted.

Trial registration number
CRD42014009116. Registered 29 March 2014