bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Fluid Middle in South Korean Politics
Authors: Chae Haesook 
Published: December 2014

This article explores the role that political ideology played in shaping the outcome of the 2012 presidential election in South Korea. It conceptualizes political ideology as two-dimensional and utilizes cluster analysis to identify distinct ideological groups. By analyzing two sets of survey data collected in 2012, it discovers four ideological groups. A striking result uncovered by the cluster analysis is the change in party identification and voting in favor of the conservative party made by one group in particular—a change that proved to be the competitive edge the conservative party candidate needed to win the fiercely competitive two-way election. In other words, this group served as the fluid middle.
The Otologist’s Tuning Fork Examination—Are You Striking It Correctly?
Authors: Stevens Jayne R. , Pfannenstiel Travis J. 
Published: December 2014

ObjectiveTo determine if the manner in which a tuning fork is activated affects its vibrational response.Study DesignDiagnostic test assessment.SettingHearing Center of Excellence laboratory.Subjects and MethodsA Polytec OFV‐5000 scanning vibrometer was used to measure the vibrational response of 256‐Hz, 512‐Hz, and 1024‐Hz tuning forks after activation. The tuning forks were activated to varying intensities by striking 4 unique surfaces: the head, palm, a metal surface, and a wood table.ResultsThe fundamental frequency of the individual tuning fork was the dominant observed frequency in all testing scenarios. Additional nonharmonic frequencies were noted when the 256‐Hz and 512‐Hz tuning forks were struck off metal and wooden surfaces.ConclusionsAdditional nonfundamental sound frequencies produced secondary to striking a tuning fork off a metal object or a wooden table could affect clinical tuning fork examination and complicate decisions regarding surgical candidacy.
Delayed Nasoseptal Flaps for Endoscopic Skull Base Reconstruction
Authors: Choby Garret W. , Mattos Jose L. , Hughes Marion A. , Fernandez‐Miranda Juan C. , Gardner Paul A. , Snyderman Carl H. , Wang Eric W. 
Published: December 2014

ObjectivesTo assess delayed nasoseptal flaps as a viable reconstructive option for sellar defects, evaluate postoperative vascularity of delayed nasoseptal flaps, and compare cerebrospinal fluid leak and surgery‐specific complication rates of primary to delayed nasoseptal flaps.Study DesignCase series with chart review.SettingUniversity of Pittsburgh Medical Center.Subjects and MethodsAll patients undergoing transsellar approaches for skull base tumors from 2009 to 2013 were evaluated. In cases where the necessity of a vascularized reconstructive flap was made evident only after tumor resection, the nasoseptal flap was raised after tumor resection and/or cerebrospinal fluid leak development, thus constituting a delayed nasoseptal flap. Outcome measures include postoperative magnetic resonance imaging (MRI) findings, cerebrospinal leak rates, and complication rates.ResultsDuring this timeframe, 437 patients underwent transsellar approaches. Primary nasoseptal flaps were used to reconstruct 179 patients while 32 patients had delayed flaps. All available postoperative MRI scans of delayed nasoseptal flap patients maintained vascularity on examination of T1 postcontrast images. There was no significant difference in cerebrospinal fluid leak rate between primary (3.4%) and delayed flaps (3.1%) (P =. 95). There was no significant difference in surgery‐specific complication rates between primary flaps (10.6%) and delayed flaps (3.1%; P =. 14). Logistic regression analysis demonstrated no significant effect of flap type, age, or sex on cerebrospinal fluid leak rates.ConclusionDelayed nasoseptal flaps are a viable reconstructive option for sellar skull base defects. They maintain vascularity as evidenced on postoperative MRI and are comparable to primary nasoseptal flaps with regard to cerebrospinal fluid leak rates and complication rates.
Peripapillary retinal nerve fibre layer thickness in women with iron deficiency anaemia
Authors: Akdogan Elif , Turkyilmaz Kemal , Ayaz Teslime , Tufekci Damla 
Published: December 2014

Objective To evaluate peripapillary retinal nerve fibre layer (RNFL) thickness in adult women with iron deficiency anaemia and healthy control subjects. Methods Women with iron deficiency anaemia and age- and sex-matched healthy control subjects were sequentially recruited and underwent detailed ophthalmic examination, including spectral-domain optical coherence tomography (OCT). Serum haemoglobin (Hb), iron and ferritin concentrations, total iron-binding capacity (TIBC) and mean corpuscular volume were determined. Results Peripapillary RNFL thicknesses in the nasal and inferior quadrants were significantly smaller in patients ( n = 40) than in controls ( n = 40). In the patient group, there were significant correlations between inferior quadrant RNFL thickness and Hb, and between nasal quadrant RNFL thickness and serum iron and ferritin concentrations, and TIBC. Conclusion Iron deficiency anaemia reduces RNFL thickness in adult women.
The relationship between coronary artery disease and pericoronary epicardial adipose tissue thickness
Authors: Aydın Ayşe Murat , Kayalı Alperen , Poyraz Ahmet Kurşad , Aydın Kemal 
Published: December 2014

Objectives A retrospective study to investigate the relationship between epicardial adipose tissue thickness (EATT) and presence of coronary artery plaque, coronary artery disease (CAD) and CAD risk factors. Methods Multidetector computed tomography (MDCT) coronary angiography images were reviewed. Left anterior decending artery, right coronary artery and left circumflex artery pericoronary EATT were measured. Demographic, clinical and CAD risk factor data were obtained from medical records. Results Patients with CAD ( n = 49) had significantly larger mean EATT than those without CAD ( n = 101). Pericoronary EATT was significantly correlated with body mass index, total cholesterol level, coronary artery calcium score, hypertension and diabetes mellitus history. Conclusions There is an association between pericoronary EATT and CAD, as well as CAD risk factors. Pericoronary EATT measurement may become a widely used, easy-to-perform method for determining CAD risk.
Propensity Score Analysis
Authors: Lane Forrest C. , Gibbs SherRhonda 
Published: December 2014

The Problem Flexible work arrangements (FWAs) have long been heralded as antecedent to numerous positive organizational attitudes and outcomes. However, results on FWAs benefits are mixed which may be due to differences in employee characteristics. Not all individuals may desire such arrangements. This can confound group comparisons and may bias the results used in the development of human resource development (HRD) theory. The Solution Propensity score analysis is a statistical approach that utilizes covariates to match participants (e.g., FWAs vs. non-FWAs) on their likelihood of group assignment. Once matched, these differences are mitigated thus improving the ability to more precisely estimate program effects. The Stakeholders The intended audience for this article includes HRD scholars and scholar-practitioners interested in reducing non-equivalent group design bias in the context of flexible working arrangements and other HRD-related theory.
Fragmented care and whole-person illness: Decision-making for people with chronic end-stage kidney disease
Authors: Allen Dawn , Badro Valerie , Denyer-Willis Laurie , Ellen Macdonald Mary , Paré Anthony , Hutchinson Tom , Barré Paul , Beauchemin Roch , Bocti Helen , Broadbent Alison , Cohen S Robin 
Published: December 2014

Purpose The study reported herein sought to better understand how patients with multi-morbid, chronic illness—who receive care in institutions designed for treatment of acute illness—experience and engage in health-related decisions. Methods In an urban Canadian teaching hospital, we studied the interactions of six hemodialysis patients and 11 of the health professionals involved in their care. For 1 year (September 2009 to September 2010), we conducted ethnographic observation and interviews of six cases each comprising one hemodialysis patient and various health professionals including medical specialists, nurses, a social worker, and a dietician. Results We found that the ubiquity and complexity of health-related decision-making in the lives of these patients suggests the need for a more holistic interpretation of health-related decision-making. Discussion We propose an interpretation of decision-making as an ongoing process of integrating illness and life; as frequently open-ended, cumulative, and relational; and as fundamentally shaped by the fragmented delivery of care for patients with multiple morbidities. Conclusion Our understanding of decision-making suggests that people living with complex chronic illness need to receive care from institutions that recognize and address their multi-morbidity as a whole illness that is constantly being integrated into the life of a whole person.
A census of levels of critical care activity in acute hospitals in the Lancashire and South Cumbria Critical Care Network
Authors: Brookfield Sarah , Baldwin Andrea , Mousdale Stephen 
Published: December 2014

Objective: To examine the extent of critical care activity, on each weekday, in 9 hospitals accepting acute medical and surgical patients. Design: Census of 17339 patients in Lancashire and South Cumbria. Setting: All acute medical and surgical wards in these hospitals. Participants: Census conducted by the local service improvement leads for critical care. Method: A programme of dates was agreed on which to collect the data, in February and March 2004, for each day of the week including Saturday and Sunday. On each of these days the service improvement leads visited each ward in their acute hospitals and counted patients at different levels of need using the Intensive Care Society's Definitions of levels of critical care for Adult Patients (published in their standards and guidelines document). The locations of these patients were noted, in addition to the specific criteria which defined the individual level. Data was entered into a database for analysis and then returned to individual trusts' critical care delivery groups for discussion. Hospitals were also contacted to define their numbers of beds allocated for intensive care and high dependency care. Results: 19.49% (3380) of patients were defined as Level 1, 3.45% (598) of patients were level 2 and 0.99 % (171) were Level 3. Conclusions: Clinical activity at all levels was evenly distributed throughout the week and weekend. Demand for Level 2 support outstrips the supply of beds in higher care areas such as ITU and HDU. Many of these patients are managed on general wards, whereas beds defined as ITU beds outstrip Level 3 demand. Critical care services should focus on increasing flexibility of critical care bed use rather than predefining beds as for either ITU or HDU.
A Retrospective Study on the Initiation and Maintenance of Therapeutic Hypothermia after Cardiac Arrest. Are Simple Guidelines Easy to Follow?
Authors: Faber Peter , MacMillan Michael 
Published: December 2014

Background: Patients surviving a cardiac arrest often suffer debilitating neurological injury as a result of anoxic brain damage. Recent studies have demonstrated improved neurological outcome in cardiac arrest patients undergoing 12–24 hours of mild hypothermia. Reviewing the results from such studies the International Liaison Committee on Resuscitation has issued guidelines on hypothermia treatment in survivors of cardiac arrest. Aims: To determine the feasibility of a treatment protocol implementing the International Liaison Committee on Resuscitation guidelines on therapeutic hypothermia after cardiac arrest. Methods: A one-year retrospective analysis of cardiac arrest patients assigned to hypothermia treatment in an Intensive Care Unit. Results: Fifteen patients were assigned to hypothermia after cardiac arrest. No adverse side effects were observed as a result of the cooling procedure. The length of time to initiate and maintain cooling was the major deviation from the protocol. Conclusion: We recommend that hypothermia should be commenced as early as possible by using cold intravenous crystalloids. This is a safe procedure that can be done after the immediate resuscitation.
Intensive Insulin Therapy and Pentastarch Resuscitation in Severe Sepsis
Authors: O'Neil Pauline , Cuthbertson Brian , Cairns Chris 
Published: December 2014

Neither intensive insulin therapy nor the use of pentastarch as the resuscitation fluid reduces 28-day mortality or morbidity from severe sepsis. Intensive insulin therapy may cause harm because of increased hypoglycaemic episodes. Use of pentastarch increases the need for renal replacement therapy. Level of evidence: 1+ (RCT with a low risk of bias)
Do we know if our Patients are Delirious?
Authors: Kaye Callum 
Published: December 2014

Delirium in the intensive care unit (ICU) setting is a significant cause of morbidity, mortality and increases ICU, as well as hospital length of stay1,2. Furthermore, with so many of the risk factors being present in the critically ill patient in the ICU environment, it's not surprising that other studies have found that up to 80% of patients will be delirious at some point during admission3,4. We performed a small study in a Toronto Medical-Surgical ICU using the Confusion Assessment Method for the ICU (CAM-ICU)5 to determine the prevalence of delirium in this unit. We concurrently reviewed medical and nursing notes to identify documentation of symptoms and signs that could indicate possible delirium during routine clinical assessment of the patient.
Do Selective Digestive Decontamination (SDD) and Selective Oral Decontamination (SOD) Affect Mortality?
Authors: Price Richard 
Published: December 2014

In this cluster-randomised, multicentre study, topical plus systemic SDD and SOD reduced the incidence of death, with numbers needed to treat of 29 and 34, after statistical correction for baseline imbalance due to the cluster design of the study. Level of evidence: 1++ (RCT with very low risk of bias)
Using Low-Dose Methylprednisolone in Early ARDS Leads to a More Rapid Improvement in Lung Function
Authors: Appleton Richard 
Published: December 2014

Treating ventilated patients within 72 hours of the diagnosis of acute respiratory distress syndrome (ARDS) with prolonged low dose methylprednisolone leads to a more rapid improvement in lung function and may reduce the duration of mechanical ventilation and ICU stay. Level of evidence: 1− (RCT with a high risk of bias)
Intensive versus Conventional Glucose Control in Critically Ill Patients
Authors: Tanner Oona 
Published: December 2014

Intensive glucose control with a target blood glucose 4.5–6.0 mmol/L increases the risk of death at 90 days (number needed to harm (NNH)=38) and severe hypoglycaemia (NNH=16). Level of evidence: 1+ (RCT with a low risk of bias)
Procalcitonin to Guide Duration of Antibiotic Therapy in Intensive Care Patients: A Randomised Prospective Controlled Trial
Authors: Gopal Vijayakumar , Nallapareddy Sridhar 
Published: December 2014

In surgical intensive care patients, monitoring of procalcitonin (PCT) is a helpful tool for guiding antibiotic treatment when compared with a standard eight day regimen. This may contribute to an optimised antibiotic regimen with beneficial effects on microbial resistance and costs in intensive care medicine. Level of evidence: 1+ (RCT with a low risk of bias)
Nebulised Heparin is Associated with Fewer Days of Mechanical Ventilation in Critically Ill Patients
Authors: Gross Jamie 
Published: December 2014

This small randomised controlled trial (RCT) of ventilated patients failed to demonstrate an improvement in PaO2/FiO2 with the use of regular nebulised heparin. However, nebulised heparin was associated with an increase in ventilator-free days. Level of evidence: 1+ (RCT with a low risk of bias)
Use of Dexmedetomidine as a Sedative and Analgesic Agent in Critically Ill Adult Patients
Authors: Clark Sam , Ezra Martyn 
Published: December 2014

A meta-analysis of randomised controlled trials comparing dexmedetomidine to control sedation showed weak evidence that dexmedetomidine might reduce length of intensive care unit (ICU) stay in certain critically ill patients, but the risk of bradycardia was significantly higher when using both a loading dose and high maintenance doses (>0.7 μg/kg/h). There was, however, a significant heterogeneity between trials reported. Level of evidence: 1++ (Meta-analysis with a very low risk of bias)
A Randomised Trial on the Treatment of Refractory Status Epilepticus
Authors: Jenkinson Emma , Tulloch Laura , Tunnicliffe William 
Published: December 2014

This study failed to show a significant difference in outcome between those receiving propofol versus barbiturates in the treatment of refractory status epilepticus, except in duration of mechanical ventilation. However, due to a failure to recruit sufficient numbers of patients, the trial was significantly underpowered and we recommend caution when drawing any conclusions from the data. Level of evidence: 1− (RCT with a high risk of bias)
Corticosteroid after Etomidate in Critically Ill Patients
Authors: Dalay Satinder Kaur , Jagannathan Sathyanarayanan , Chadwick Sean 
Published: December 2014

In this prospective, single-centre, slightly underpowered, double-blind randomised controlled trial (RCT) with intention-to-treat analysis, use of moderate-dose hydrocortisone in etomidate-related adrenal insufficiency was not shown to reduce the proportion of patients with a cardiovascular Sequential Organ Failure Assessment (SOFA) score of 3 or 4. Level of evidence: 2B (CEBM, low quality RCT)
Daily Interruption of Sedation and Nursing-Implemented Sedation Protocol in Mechanically Ventilated Adult patients
Authors: Keough Jamie , Nee Patrick 
Published: December 2014

The combined use of daily interruption of sedation and a nursing-implemented sedation protocol targetting light sedation does not reduce duration of mechanical ventilation in adult ICU patients. Level of evidence: 1B (RCT with a low risk of bias)
Prone Positioning in Severe Acute Respiratory Distress Syndrome (ARDS)
Authors: Gill Raj , Wong Tracy , Johnston Andy 
Published: December 2014

Early use of the prone position for prolonged periods in severe ARDS is associated with a significant reduction in both 28-day and 90-day mortality (NNT 6). Level of evidence: 1B (CEBM, RCT of good quality)
The Optimum Location of Care for Traumatic Brain Injury Patients Admitted to Non-Specialist Hospitals
Authors: Fuller Gordon 
Published: December 2014

Early secondary transfer and specialist care may offer a survival benefit for head injury patients with non-surgical lesions initially admitted to non-specialist intensive care units. However, results must be interpreted with caution due to a high risk of bias. Level of evidence: 1B−, an individual cohort study with wide confidence intervals
Crystalloid or Hydroxyethyl Starch for Resuscitation in Intensive Care?
Authors: Banks Luke , Kirk-Bayley Justin 
Published: December 2014

There are concerns about the safety of hydroxyethyl starch (HES) solutions for intensive care patients regarding possible increased mortality and increased incidence of renal impairment with associated morbidity. This large trial showed no change in primary outcome related to mortality, but an increased relative risk of 21% for the use of renal replacement therapy. Level of evidence: 1B (individual RCT with narrow confidence intervals)
Volume-Outcome Relationships for Mechanically Ventilated Adult Patients
Authors: Farrands R , Duggleby Philip , Parekh Nilesh 
Published: December 2014

For mechanically ventilated patients there is a significant relationship between the annual volume (absolute number) of mechanically ventilated admissions to UK intensive care units and acute hospital mortality. Intensive care units admitting more than 321 ventilated patients per annum demonstrated a statistically significant survival benefit (p<0.02). This relationship was most pronounced among non-surgical admissions. Level of evidence: Level 2B: retrospective cohort study, but with concerns over validity.
Efficacy of 13.3 mg/24 h versus 4.6 mg/24 h rivastigmine patch on activities of daily living in severe Alzheimer’s disease
Authors: Micca Joseph L , Galvin James E , Velting Drew M , Meng Xiangyi 
Published: December 2014

Objective: Investigate efficacy of 13.3 mg/24 h rivastigmine patch in patients with severe Alzheimer’s disease on Alzheimer’s Disease Cooperative Study–Activities of Daily Living Scale–Severe Impairment Version items and domains. Methods: Retrospective analysis of the 24-week, randomized, double-blind ACTivities of daily living and cognitION (ACTION) study, using factor analysis to establish “best fit” for Alzheimer’s Disease Cooperative Study–Activities of Daily Living Scale–Severe Impairment Version items into domains. Treatment differences (13.3 vs 4.6 mg/24 h patch) on items and domains were assessed. Results: Overall, 632 patients provided Alzheimer’s Disease Cooperative Study–Activities of Daily Living Scale–Severe Impairment Version data. Factor analysis yielded four domains. The 13.3 versus 4.6 mg/24 h patch demonstrated significantly greater efficacy on “Daily function” ( p = 0.038), supported by greatest effect sizes on items within this domain, and trend toward greater efficacy on “Communication” ( p = 0.052). No significant between-group differences were observed on “Independence” ( p = 0.600) or “Environment” ( p = 0.261). Conclusion: The 13.3 mg/24 h patch was superior to 4.6 mg/24 h patch on “Daily function” in severe Alzheimer’s disease.
Vitamin D and depression: A case series
Authors: Nadkarni Pallavi S , Odejayi Gbolahan 
Published: December 2014

Introduction: Over two-thirds of Canadians are deficient in vitamin D. Clinical overlap can compound diagnosis of depression in vitamin D deficient individuals. Citing high costs, the Ministry of Health has restricted routine vitamin D screening and hence is not feasible. Objectives: The current case series is an attempt to recognise the clinical overlap between depression and vitamin D deficiency in order to avoid unnecessary antidepressant prescriptions and to demonstrate the role of collaborative care in such patients. Method: After appropriate ethics approval 62 patients from an outpatient clinic were screened for the diagnosis of treatment resistant depression. Those who had predominant somatic complaints were further screened for organic factors and those with inadequate vitamin D levels were referred to family physicians for supplementation with vitamin D. Results: More than 50% were detected deficient in vitamin D after our evaluation. They showed subjective improvement with vitamin D supplements. No modification of antidepressants was needed. Conclusion: Vitamin D deficiency should be suspected in depressed patients with prominent somatic symptoms and their treatment resistance should be reconsidered to avoid unnecessary exposure to mood stabilisers. Collaborating with primary care is advocated. Limitation: Co-prescription of an antidepressant is a confounder in our case series, and we propose more organised studies with objective rating scales.
Suppression of T-cell lymphomagenesis in mice requires PTEN phosphatase activity
Authors: Newton Ryan H. , Lu Yu , Papa Antonella , Whitcher Greg H. , Kang Youn-Jung , Yan Catherine , Pandolfi Pier Paolo , Turka Laurence A. 
Published: December 2014

Key Points
PTEN phosphatase activity, independent of other PTEN functions, is required to prevent T-cell lymphoma.