bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pre-Hospital Medications in Total Hip Arthroplasty: Risk Factors for Poor Outcomes
Authors: Dietrich Michael , Zingg Patrick O. , Egbring Marco , Kamath Atul F. , Dora Claudio 
Published: April 2015

Introduction The influence of co-morbidities on complication rates and length of hospitalisation after surgery is well recognised. Clinical instruments predicting this influence, are of increasing interest. We sought to determine whether a count of a patient's preoperative pharmaceuticals would be associated to postoperative outcomes. Material and Methods In this retrospective, consecutive case series, 668 patients undergoing elective primary total hip arthroplasty (THA) were analysed. Age, gender, BMI, ASA-classification, nicotine or alcohol abuse, and the number and type of medications were documented. Results Mean age was 63 years (18-94), 53% were females. A total of 60 (8.9%) local and 19 (2.8%) systemic complications occurred during hospital stay. A total of 11 (1.6%) patients died, while 49 (7.3%) local complications occurred during the first postoperative year. Length of hospital stay, blood transfusions, and morbidity were found to be significantly related to the quantity of medications (p<0.001). While the risk of an extended hospital stay (>7 days) increased by a factor of 1.15 (CI: 1.08-1.22) with each medication, the risk of experiencing a complication within the first postoperative year was 1.19 times (CI: 1.07-1.29) for each additional medication. Type of medication also influenced morbidity: the odds ratio was 1.89 (CI: 1.05-3.41) for platelet inhibiting agents and 4.07 (CI: 1.96-8.42) for oral anticoagulants in early morbidity, which increased to 6.05 (CI:2.92-12.53) in 1-year follow-up. Conclusions The investigation illustrated the significant influence of the number and/or type of medication on complications, morbidity and prolonged hospital stay. This predictive tool may be useful, for physicians and non-health professionals, in estimating particular outcomes after elective THA.
The Population Attributable Risk of Nutrition and Lifestyle on Hip Fractures
Authors: Pripp Are Hugo , Dahl Ola E. 
Published: April 2015

Introduction Norway is among the countries with the highest incidence of hip fractures, and how to reduce this incidence is a major public health concern. Materials and Methods The population attributable risk (PAR), which measures the portion of hip fracture incidences in the population that can be attributed to an exposure if there is a causal relationship, was assessed for the exposure to excessive alcohol consumption, being underweight, low calcium from dairy products, low physical activity and current tobacco smoking. The risk ratio (RR) of the exposures summarized from systematic reviews and meta-analyses, as well as their prevalence from national statistics or Norwegian population-based studies, were used to estimate PARs. Results Low physical activity and current tobacco smoking had the highest RR for hip fractures, with 1.65 (95% CI 1.50-1.81) and 1.52 (95% CI 1.41-1.63). Low physical activity had the highest prevalence in the population (27.4%) and the highest PAR (0.151), followed by tobacco smoking (PAR = 0.081) and excessive alcohol consumption (PAR = 0.01). By comparison, being underweight and low calcium from dairy products had negligible PAR estimates. Conclusions From a public health perspective, increased daily physical activity is the most promising intervention to reduce the incidence of hip fractures. Reduced smoking and alcohol consumption are of relevance, but other health risks related to these exposures are of greater public health concern. Low body weight and nutritional calcium from dairy products seem to be of less importance.
Review of Transposed Basilic Vein Access for Hemodialysis
Authors: Akoh Jacob A. , Paraskeva Panoraia P. 
Published: April 2015

Background There is ongoing debate about the use of transposed basilic vein (TBV) fistula and the choice between it and prosthetic arteriovenous graft (AVG). This paper reviews the available literature relating to TBV fistula in terms of surgical technique, patency rates, complications, access survival and compares it with prosthetic AVG for hemodialysis (HD). Methods Review of English language publications on TBV during the last two decades. Findings The rate of fistula maturation was higher in the two-stage group, although the mean diameter of the basilic vein was smaller. Dialysis via central venous catheters at time of surgery was most prevalent in patients undergoing staged procedures—14% in one-stage TBV and 43% in two-stage TBV. Several authors report 1-year cumulative patency rate of 47% to 96% and 59% to 90% for TBV and AVG, respectively. TBV provides a more cost-effective option and should be considered the next choice when primary autogenous fistulae are not possible, whereas AVGs are easier to create, can be punctured earlier and have a greater reintervention rate if the access fails. Conclusions This analysis shows that TBV has several advantages over AVG and provides a valuable access for HD but raises the need for a comparative trial between TBV and the newer generation AVGs. There is no clear superiority of the one-stage over the two-stage procedure.
PIK3CA Mutations in Small Bowel Adenocarcinoma
Authors: Shenoy Santosh 
Published: April 2015

Aims and Background PIK3CA mutations involving exons 9 and 20 are among the most common aberrations seen in human malignancies. The identification of PIK3CA mutations in small bowel adenocarcinoma (SBA) is sparse. There is some evidence that tumors with this mutation may be a good target for inhibitors of the PI3K pathway. Case report We report an exon 9 (G1624A: E542K) hot spot mutation in a 69-year-old man with sporadic jejunal cancer (T3, NI). A systemic search was made for other reports using Medline/Embase along with Sangers Institute Cancer Genome Project database. We analyzed and describe this mutation in these patients, including one of ours. Results and Conclusion A total of 8 tumor samples with confirmed somatic mutations out of a total of 86 samples were noted: rate 9.3% (95% confidence interval 4.5% to 17.5%). Overall, PIK3CA mutations were more common in duodenum (62.5%) and located most commonly on exon 9. The significance of PIK3CA mutation in SBA is unclear. Further studies on mutation analysis in larger cohorts with SBA are in order to identify and confirm relationships between these mutations and various clinical and pathologic variables such as age, lymph node status, distant metastasis, stage, and progression-free survival and association with other gene mutations.
Silva Rerum I, Silva Rerum II, and Silva Rerum III—Between Fact and Fiction Recreating the Early Modern Culture of the Polish Lithuanian Commonwealth in Contemporary Literature
Authors: Sabaliauskaitė Kristina 
Published: April 2015

Abstract
The author of a planned tetralogy of historical novels, set in seventeenth to eighteenth- century Poland- Lithuania and originally published in Lithuanian, discusses her project, of which the first three installments were published between 2008 and 2014. She begins with an overview of Lithuanian historical fiction and its conventions, from which her own departs in significant ways. The Silva Rerum series depicts the era of decline of the Polish- Lithuanian Commonwealth, told through the multigenerational story of a Lithuanian noble family of Samogitia and Vilnius. Care has been taken to reflect historical and linguistic accuracy. The forthcoming final volume will conclude with the end of the old Commonwealth.
Age‐Related Differences in the Quantitative Echo Texture of the Median Nerve
Authors: Li Xiang , Li Jia W. , Ho Anthony M.-H. , Karmakar Manoj K. 
Published: April 2015

ObjectivesCurrently, there are no quantitative data on the echo texture of a peripheral nerve. This study was designed to objectively compare the differences in the echo texture of the median nerve in the young and the elderly.MethodsThe median nerves of 10 healthy young volunteers (<30 years old; group Y) and 10 elderly patients undergoing lower limb surgery (>60 years old; group E) were scanned at the mid forearm by a standardized protocol. The echo texture of a normalized median nerve image was analyzed for the echo intensity and spatial distribution of pixels. Noise in the image was reduced by using a median filter, and thresholding was performed thereafter. In the resultant binary image, the cross‐sectional area, echo intensity, white area index, and black area index of the median nerve were determined by computerized texture analysis.ResultsThe mean cross‐sectional area of the median nerve in group E was significantly smaller than that in group Y (P = .002). The mean echo intensity and white area index in group E were significantly higher than those in group Y (P= .002 and .012). The mean black area index in group E was correspondingly significantly lower than that in group Y (P = .012). In group Y, the mean white area index was significantly lower than the black area index (P = .006) but not in group E (P = .213).ConclusionsThere are significant differences in the echo texture of the median nerve between the young and the elderly. These differences may be due to age‐related changes in the relative proportion of neural fascicles and connective tissue within the nerve.
Differences in Liver Fibrosis Between Patients With Chronic Hepatitis B and C
Authors: Tai Dar-In , Tsay Pei-Kwei , Jeng Wen-Juei , Weng Chia-Chan , Huang Shiu-Feng , Huang Chien-Hao , Lin Shi-Ming , Chiu Cheng-Tang , Chen Wei-Ting , Wan Yung-Liang 
Published: April 2015

ObjectivesThe purpose of this study was to evaluate liver fibrosis by acoustic radiation force impulse (ARFI) measurements at 2 locations in patients with chronic hepatitis B and C.MethodsA total of 204 consecutive patients (146 male and 58 female) with chronic hepatitis B (n = 121) and C (n = 83) who underwent liver biopsy were enrolled. All patients received ARFI measurements at 2 locations in the right intercostal space on the same day as biopsy.ResultsThere was no difference in median ARFI values between detection locations. However, a significant difference was found for low and high values between locations (median ± SD, 1.38 ± 0.43 versus 1.56 ± 0.55 m/s; P < .001). By receiver operating characteristic (ROC) curve analysis for a METAVIR fibrosis score of F4 (cirrhosis), the lower value of 2 measurements had the highest area under the ROC curve (0.750), followed by the mean value (0.744) and the higher value (0.730). Patients with hepatitis C had a higher area under the ROC curve than patients with hepatitis B (0.824 versus 0.707) for predicting liver cirrhosis. By logistic regression analysis, ARFI was the best modality for predicting liver cirrhosis in hepatitis C, and conventional sonography was the best modality in hepatitis B (P < .001). The ARFI value in patients with hepatitis B was significantly influenced by liver inflammation (P = .019).ConclusionsAcoustic radiation force impulse imaging is the modality of choice for predicting liver cirrhosis in chronic hepatitis C, whereas conventional sonography is still the modality of choice in chronic hepatitis B.
Importance of an Adequately Performed Valsalva Maneuver for Detecting a Right‐to‐Left Shunt Indicating Foramen Ovale Reopening
Authors: Wei Dongmei , Ju Yi 
Published: April 2015

ObjectivesThe purpose of this study was to investigate the importance of an adequately performed Valsalva maneuver for detecting a right‐to‐left shunt indicating reopening of the functional closure of the foramen ovale.MethodsWe prospectively analyzed 260 patients (102 women and 158 men; mean age ± SD, 41 ± 19 years; range, 13–83 years) who underwent transesophageal echocardiography and agitated saline injection. Two‐dimensional echocardiography, color Doppler imaging, and microbubbles were used to detect right‐to‐left shunts, and the Valsalva maneuver was performed to determine whether the functional closure of the foramen ovale had reopened.ResultsTransesophageal echocardiography with color Doppler imaging identified a patent foramen ovale in 20 patients: 18 patients with a patent foramen ovale had left‐to‐right shunts, and 2 patients with atrial septal defects had bidirectional shunts. Both patients with atrial septal defects showed right‐to‐left shunt microbubbles without and with the Valsalva maneuver, whereas all 18 patients with a patent foramen ovale showed right‐to‐left shunt microbubbles only after the Valsalva maneuver. Foramen ovale reopening was identified by transesophageal echocardiography in an additional 40 patients with no shunt during rest on agitated saline injection and in whom the right‐to‐left shunt appeared only after the Valsalva maneuver. The Valsalva maneuver could cause an atrial septal swing, and its sensitivity and specificity were 100%.ConclusionsAn adequately performed Valsalva maneuver is important for detecting a right‐to‐left shunt indicating reopening of the functional closure of the foramen ovale.
Multicentury changes in ocean and land contributions to the climate‐carbon feedback
Authors: Randerson J. T. , Lindsay K. , Munoz E. , Fu W. , Moore J. K. , Hoffman F. M. , Mahowald N. M. , Doney S. C. 
Published: April 2015

AbstractImproved constraints on carbon cycle responses to climate change are needed to inform mitigation policy, yet our understanding of how these responses may evolve after 2100 remains highly uncertain. Using the Community Earth System Model (v1.0), we quantified climate‐carbon feedbacks from 1850 to 2300 for the Representative Concentration Pathway 8.5 and its extension. In three simulations, land and ocean biogeochemical processes experienced the same trajectory of increasing atmospheric CO2. Each simulation had a different degree of radiative coupling for CO2 and other greenhouse gases and aerosols, enabling diagnosis of feedbacks. In a fully coupled simulation, global mean surface air temperature increased by 9.3 K from 1850 to 2300, with 4.4 K of this warming occurring after 2100. Excluding CO2, warming from other greenhouse gases and aerosols was 1.6 K by 2300, near a 2 K target needed to avoid dangerous anthropogenic interference with the climate system. Ocean contributions to the climate‐carbon feedback increased considerably over time and exceeded contributions from land after 2100. The sensitivity of ocean carbon to climate change was found to be proportional to changes in ocean heat content, as a consequence of this heat modifying transport pathways for anthropogenic CO2 inflow and solubility of dissolved inorganic carbon. By 2300, climate change reduced cumulative ocean uptake by 330 Pg C, from 1410 Pg C to 1080 Pg C. Land fluxes similarly diverged over time, with climate change reducing stocks by 232 Pg C. Regional influence of climate change on carbon stocks was largest in the North Atlantic Ocean and tropical forests of South America. Our analysis suggests that after 2100, oceans may become as important as terrestrial ecosystems in regulating the magnitude of the climate‐carbon feedback.
Frequency dependence of delayed and instantaneous triggering on laboratory and simulated faults governed by rate‐state friction
Authors: van der Elst Nicholas J. , Savage Heather M. 
Published: April 2015

AbstractEarthquake triggering by transient stresses is commonly observed; however, some aspects remain unexplained. The first is the often‐observed delay between the triggered earthquakes and the triggering waves, and the second is the unexpected effectiveness of transient stressing in the seismic frequency band. Previous theoretical and laboratory studies have suggested that seismic transients should have little impact on faults if the duration of the transient is smaller than the timescale for nucleation of slip. We reexamine the dynamics of stress triggering during stick‐slip sliding on a laboratory fault and make three important observations that pertain to earthquake triggering. (1) Delayed triggering (clock advance) occurs for both bare granite surfaces and granular gouge prior to the onset of instantaneous triggering. (2) Triggering occurs much earlier in the stick‐slip cycle than expected for a simple Coulomb stress threshold. (3) Shorter‐period (higher stressing rate) pulses are more effective at triggering than longer‐period pulses of the same stress amplitude. We use numerical simulations to show that rate‐state friction can explain each of the observed features but not all three simultaneously. Only the Ruina slip law for state evolution, in which faults must slip to heal, can reproduce early‐onset and stressing rate‐dependent triggering. The laboratory and numerical experiments show that faults can remain relatively weak over much of the seismic cycle and that the triggered response depends on a competition between healing and weakening during triggered slip. Transient stressing at seismic frequencies may be more effective at triggering earthquakes than previously recognized.
Lidar observations of gravity wave activity in the middle atmosphere over Davis (69°S, 78°E), Antarctica
Authors: Kaifler B. , Lübken F.‐J. , Höffner J. , Morris R. J. , Viehl T. P. 
Published: April 2015

AbstractA 16 month series of lidar measurements in the stratosphere and mesosphere‐lower thermosphere (MLT) region over Davis Station (69°S, 78°E) in Antarctica is used to study gravity waves. The unprecedentedly large number of observations totaling 2310 h allows us to investigate seasonal variations in gravity wave activity in great detail. In the stratosphere the gravity wave potential energy density (GWPED) is shown to have a large seasonal variation with a double peak in winter and minimum in summer. We find conservative wave propagation to occur between 29 and 41 km altitude in winter as well as in summer, whereas smaller energy growth rates were observed in spring and autumn. These results are consistent with selective critical‐level filtering of gravity waves in the lower stratosphere. In the MLT region the GWPED is found to have a semiannual oscillation with maxima in winter and summer. The structure of the winter peak is identical to that in the stratosphere, suggesting that the gravity wave flux reaching the MLT region is controlled by the wind field near the tropopause level.
Spatiotemporal variability of modern precipitation δ18O in the central Andes and implications for paleoclimate and paleoaltimetry estimates
Authors: Fiorella Richard P. , Poulsen Christopher J. , Pillco Zolá Ramiro S. , Barnes Jason B. , Tabor Clay R. , Ehlers Todd A. 
Published: April 2015

AbstractUnderstanding the patterns of rainfall isotopic composition in the central Andes is hindered by sparse observations. Despite limited observational data, stable isotope tracers have been commonly used to constrain modern‐to‐ancient Andean atmospheric processes, as well as to reconstruct paleoclimate and paleoaltimetry histories. Here, we present isotopic compositions of precipitation (δ18Op and δDp) from 11 micrometeorological stations located throughout the Bolivian Altiplano and along its eastern flank at ~21.5°S. We collected and isotopically analyzed 293 monthly bulk precipitation samples (August 2008 to April 2013). δ18Op values ranged from −28.0‰ to 9.6‰, with prominent seasonal cycles expressed at all stations. We observed a strong relationship between the δ18Op and elevation, though it varies widely in time and space. Constraints on air sourcing estimated from atmospheric back trajectory calculations indicate that continental‐scale climate dynamics control the interannual variability in δ18Op, with upwind precipitation anomalies having the largest effect. The impact of precipitation anomalies in distant air source regions to the central Andes is in turn modulated by the Bolivian High. The importance of the Bolivian High is most clearly observed on the southern Bolivian Altiplano. However, monthly variability among Altiplano stations can exceed 10‰ in δ18Op on the plateau and cannot be explained by elevation or source variability, indicating a nontrivial role for local scale effects on short timescales. The strong influence of atmospheric circulation on central Andean δ18Op requires that paleoclimate and paleoaltimetry studies consider the role of South American atmospheric paleocirculation in their interpretation of stable isotopic values as proxies.
Orographic effects of the subtropical and extratropical Andes on upwind precipitating clouds
Authors: Viale Maximiliano , Garreaud René 
Published: April 2015

AbstractThe orographic effect of the Andes (30°S–55°S) on upwind precipitating clouds from midlatitude frontal systems is investigated using surface and satellite data. Rain gauges between 33°S and 44°S indicate that annual precipitation increases from the Pacific coast to the windward slopes by a factor of 1.8 ± 0.3. Hourly gauges and instantaneous satellite estimates reveal that the cross‐barrier increase in annual precipitation responds to an increase in both the intensity and frequency of precipitation. CloudSat satellite data indicate that orographic effects of the Andes on precipitating ice clouds increase gradually from midlatitudes to subtropics, likely as a result of a reduction of synoptic forcing and an increase of the height of the Andes equatorward. To the south of 40°S, the thickness of clouds slightly decreases from offshore to the Andes. The total ice content increases substantially from the open ocean to the coastal zone (except to the south of 50°S, where there is no much variation over the ocean), and then experience little changes in the cross‐mountain direction over the upstream and upslope sectors. Nevertheless, the maximum ice content over the upslope sector is larger and occurs at a lower level than their upwind counterparts. In the subtropics, the offshore clouds contain almost no ice, but the total and maximum ice content significantly increases toward the Andes, with values being much larger than their counterparts over the extratropical Andes. Further, the largest amounts of cloud ice are observed upstream of the tallest Andes, suggesting that upstream blocking dominates there.
Manufacturing and mechanical characterization of perforated hybrid composites based on flexible polyurethane foam
Authors: Lou Ching‐Wen , Huang Shih‐Yu , Yan Ruosi , Lin Jia‐Horng 
Published: April 2015

ABSTRACTThis study focused on the fabrication and mechanical evaluation of nonwoven reinforced flexible polyurethane foam composites. Effects of perforation ratio, aperture size, and perforation depth on bursting and low‐velocity impact responses of perforated composite panels were investigated. The nonwoven fabric used for cover sheet was composed of flame retardant polyester, low‐melting point polyester, and recycled Kevlar staple fibers. Blending ratio of Kevlar fiber was confirmed to have relation to mechanical mechanism of cushioning layer. The highest mechanical strength value was obtained at 5 wt % of Kevlar ratio because of the highest cohesive force among recycled Kevlar, flame retardant polyester, and low‐melting point polyester fibers was provided at the blending ratio. The perforated high‐density flexible polyurethane foam composites panel was adhered with intra‐ply hybrid laminates with various areal densities on each face to form sandwich structural composites. The results revealed that perforation ratio and aperture significantly influenced the bursting and low‐velocity impact resistance behaviors of the perforated composites panel. Perforated composites with 10% perforation ratio and 4 mm aperture lead to maximum bursting strength of 437 N. Additional hybrid laminates significantly promoted the maximum bursting strength of the semiperforated hybrid composites by 212%. © 2015 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2015, 132, 42288.