bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vascular Neurologists as Directors of Stroke Centers in the United States
Authors: Ramirez Lucas , Krug Aaron , Nhoung Heng , Kazaryan Suzie , Gasparian Gregory , Perese Joshua , Razmara Ali , Liebeskind David S. , Majersik Jennifer J. , Sanossian Nerses 
Published: July 2015

Background and Purpose—
Hospital certification as primary and comprehensive stroke center is associated with improvement in care. We aimed to characterize the leadership at stroke centers nationwide to determine the proportion led by vascular neurologists, a board-recognized subspecialty focusing on stroke care.

Methods—
We identified hospitals in the United States holding primary and comprehensive stroke center designation as of September 2013. We contacted each hospital to identify the medical director and used data from relevant medical boards to determine specialization. Sex and date of medical school graduation were obtained from an online physician database.

Results—

Of the 1167 primary and 50 comprehensive stroke center hospitals certified by the Joint Commission (n=1114), Det Norske Veritas (n=68), and Healthcare Facilities Accreditation Program (n=35), we identified the director in 940 (77%). Leadership was most often by a neurologist (n=745; 79%) followed by physicians in emergency medicine (n=58; 6%) and internal medicine (n=17; 2%). Vascular neurologists (n=319) led about one-third of stroke centers. Directors were mostly men (n=764; 81%), with a median number of years after medical school graduation of 25 (interquartile range, 18–34). Comprehensive stroke centers were more likely than primary stroke centers to have leadership by vascular neurologist (77%, n=37 versus 32%, n=282;
P
<0.001).

Conclusions—
Vascular neurologist led about one-third of stroke centers. There is opportunity for vascular neurologists to increase their role in stroke center directorship.
A Review of Drought in the Middle East and Southwest Asia
Authors: Barlow Mathew , Zaitchik Benjamin , Paz Shlomit , Black Emily , Evans Jason , Hoell Andrew 
Published: July 2015

AbstractThe Middle East and southwest Asia are a region that is water stressed, societally vulnerable, and prone to severe droughts. Large-scale climate variability, particularly La Niña, appears to play an important role in regionwide droughts, including the two most severe of the last 50 years—1999–2001 and 2007/08—with implications for drought forecasting. Important dynamical factors include orography, thermodynamic influence on vertical motion, storm-track changes, and moisture transport. Vegetation in the region is strongly impacted by drought and may provide an important feedback mechanism. In future projections, drying of the eastern Mediterranean region is a robust feature, as are temperature increases throughout the region, which will affect evaporation and the timing and intensity of snowmelt. Vegetation feedbacks may become more important in a warming climate. There are a wide range of outstanding issues for understanding, monitoring, and predicting drought in the region, including dynamics of the regional storm track, the relative importance of the range of dynamical mechanisms related to drought, the regional coherence of drought, the relationship between synoptic-scale mechanisms and drought, the predictability of vegetation and crop yields, the stability of remote influences, data uncertainty, and the role of temperature. Development of a regional framework for cooperative work and dissemination of information and existing forecasts would speed understanding and make better use of available information.
Fog Forecasting for Melbourne Airport Using a Bayesian Decision Network
Authors: Boneh Tal , Weymouth Gary T. , Newham Peter , Potts Rodney , Bally John , Nicholson Ann E. , Korb Kevin B. 
Published: July 2015

Abstract
Fog events occur at Melbourne Airport, Melbourne, Victoria, Australia, approximately 12 times each year. Unforecast events are costly to the aviation industry, cause disruption, and are a safety risk. Thus, there is a need to improve operational fog forecasting. However, fog events are difficult to forecast because of the complexity of the physical processes and the impact of local geography and weather elements. Bayesian networks (BNs) are a probabilistic reasoning tool widely used for prediction, diagnosis, and risk assessment in a range of application domains. Several BNs for probabilistic weather prediction have been previously reported, but to date none have included an explicit forecast decision component and none have been used for operational weather forecasting. A Bayesian decision network [Bayesian Objective Fog Forecast Information Network (BOFFIN)] has been developed for fog forecasting at Melbourne Airport based on 34 years’ worth of data (1972–2005). Parameters were calibrated to ensure that the network had equivalent or better performance to prior operational forecast methods, which led to its adoption as an operational decision support tool. The current study was undertaken to evaluate the operational use of the network by forecasters over an 8-yr period (2006–13). This evaluation shows significantly improved forecasting accuracy by the forecasters using the network, as compared with previous years. BOFFIN-Melbourne has been accepted by forecasters because of its skill, visualization, and explanation facilities, and because it offers forecasters control over inputs where a predictor is considered unreliable.
Bilateral subclavian vein sheaths for superior vena cava drainage during thoracoscopic repair of atrial septal defects: cosmetic outcomes, safety and effectiveness
Authors: Lei Qian , Zeng Qing-Shi , Zhang Xiao-Shen , Xie Bin , Huang Huan-Lei , Wang Sheng , Guo Hui-Ming , Chen Ji-Mei , Zhuang Jian 
Published: July 2015

Objective: To investigate the cosmetic outcomes, safety and effectiveness of using bilateral subclavian vein sheaths for superior vena cava drainage during thoracoscopic repair of atrial septal defects. Methods: Sixty-one consecutive adults scheduled for thoracoscopic repair of atrial septal defects between July 2012 and June 2013 were randomized into two groups: one group underwent placement of a 16 Fr percutaneous superior vena cava cannula (n = 30) and the other group underwent placement of bilateral 8 Fr subclavian vein sheaths (n = 31) for superior vena cava drainage during peripheral cardiopulmonary bypass. The perioperative data, central venous pressure during cardiopulmonary bypass, complications and the patient satisfaction scale scores for the incisions were compared between the two groups. Results: The theoretical cardiopulmonary bypass flow rate was reached without complications in all patients. The average central venous pressure during cardiopulmonary bypass was not significantly different between the two groups [(6.9 ± 3.1) mmHg vs. (7.0 ± 3.5) mmHg, p=0.92]. The patient satisfaction scale scores for the incisions were significantly higher in the patients who underwent placement of bilateral subclavian vein sheaths than in the patients who underwent placement of a percutaneous superior vena cava cannula [(2.81 ± 0.75) vs. (2.07 ± 0.74), p<0.001]. Conclusions: Placement of bilateral subclavian vein sheaths is a safe and effective alternative to placement of a percutaneous superior vena cava cannula for superior vena cava drainage during thoracoscopic repair of atrial septal defects and results in greater patient satisfaction with the cosmetic outcome.
Comparing the effects of whole-body vibration to standard exercise in ambulatory people with Multiple Sclerosis: a randomised controlled feasibility study
Authors: Uszynski Marcin Kacper , Purtill Helen , Donnelly Alan , Coote Susan 
Published: July 2015

Objectives: This study aimed firstly to investigate the feasibility of the study protocol and outcome measures, secondly to obtain data in order to inform the power calculations for a larger randomised controlled trial, and finally to investigate if whole-body vibration (WBV) is more effective than the same duration and intensity of standard exercises (EXE) in people with Multiple Sclerosis (PwMS). Design: Randomised controlled feasibility study. Setting: Outpatient MS centre. Subjects: Twenty seven PwMS (age mean (SD) 48.1 (11.2)) with minimal gait impairments. Interventions: Twelve weeks of WBV or standard EXE, three times weekly. Main measures: Participants were measured with isokinetic muscle strength, vibration threshold, Timed Up and Go test (TUG), Mini-BESTest (MBT), 6 Minute Walk test (6MWT), Multiple Sclerosis Impact Scale 29 (MSIS 29), Modified Fatigue Impact Scale (MFIS) and Verbal Analogue scale for sensation (VAS) pre and post 12 week intervention. Results: WBV intervention was found feasible with low drop-out rate (11.1%) and high compliance (90%). Data suggest that a sample of 52 in each group would be sufficient to detect a moderate effect size, with 80% power and 5% significance for 6 minute walk test. Large effect sizes in favour of standard exercise were found for vibration threshold at 5th metatarsophalangeal joint and heel ( P=0.014, r= 0.5 and P=0.005, r=0.56 respectively). No between group differences were found for muscle strength, balance or gait ( P>0.05). Conclusions: Data suggest that the protocol is feasible, there were no adverse effects. A trial including 120 people would be needed to detect an effect on walking endurance.
Low dose CT of the lumbar spine compared with radiography: a study on image quality with implications for clinical practice
Authors: Alshamari Muhammed , Geijer Mats , Norrman Eva , Lidén Mats , Krauss Wolfgang , Wilamowski Franciszek , Geijer Håkan 
Published: July 2015

Background Lumbar spine radiography is often performed instead of CT for radiation dose concerns. Purpose To compare image quality and diagnostic information from low dose lumbar spine CT at an effective dose of about 1 mSv with lumbar spine radiography. Material and Methods Fifty-one patients were examined by both methods. Five reviewers scored all examinations on eight image quality criteria using a five-graded scale and also assessed three common pathologic changes. Results Low dose CT scored better than radiography on the following: sharp reproduction of disc profile and vertebral end-plates (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.3–2.5), intervertebral foramina and pedicles (OR, 4.3; 95% CI, 3.1–5.9), intervertebral joints (OR, 139; 95% CI, 59–326), spinous and transverse processes (OR, 7.0; 95% CI, 4.3–11.2), sacro-iliac joints (OR, 4.2; 95% CI, 3.2–5.7), reproduction of the adjacent soft tissues (OR, 2.9; 95% CI, 2.1–4.0), and absence of any obscuring superimposed gastrointestinal gas and contents (OR, 188; 95% CI, 66–539). Radiography scored better on sharp reproduction of cortical and trabecular bone (OR, 0.3; 95% CI, 0.2–0.4). The reviewers visualized disk degeneration, spondylosis/diffuse idiopathic skeletal hyperostosis (DISH) and intervertebral joint osteoarthritis more clearly and were more certain with low dose CT. Mean time to review low dose CT was 204 s (95% CI, 194–214 s.), radiography 152 s (95% CI, 146–158 s.). The effective dose for low dose CT was 1.0–1.1 mSv, for radiography 0.7 mSv. Conclusion Low dose lumbar spine CT at about 1 mSv has superior image quality to lumbar spine radiography with more anatomical and diagnostic information.
Autoinflammation Around AES Total Ankle Replacement Implants
Authors: Koivu Helka , Takakubo Yuya , Mackiewicz Zygmunt , Al-Samadi Ahmed , Soininen Antti , Peled Nitai , Kukis Modestas , Trokovic Nina , Konttinen Yrjö T. 
Published: July 2015

Background Failure of total ankle replacement (TAR) can be characterized by early peri-implant osteolysis even in the presence of very modest numbers of wear particles. The hypothesis of the study was that this reaction is in part mediated by autoinflammatory responses mediated via damage-associated molecular patterns (DAMPs, danger signals) and pattern-recognizing danger signal receptors (PRRs). Methods: Peri-implant tissue and control samples from 10 patients with AES implants were immunostained for hypoxia inducible factor-1α (HIF-1α), activated caspase-3, high-mobility group box 1 (HMGB1), receptor for advanced glycation end product (RAGE), and toll-like receptors TLR2 and TLR4. Results were evaluated on a 0 to 4 scale (from 0% to >50% stained area). Results: Peri-implant tissue around failed TAR implants had a relatively high mean HIF-1α score of 3 on a scale, which however was similar in control samples. HMGB1 (a DAMP) was seen to be mobilized from nuclei to cellular cytoplasm, and the active caspase-3+ cells were increased. All PRRs were increased in revision samples. Conclusions: Increased expression of HMGB1 and other danger signals together with increased PRR-dependent responsiveness could contribute to autoinflammatory peri-implantitis, multilocular cyst formation, and osteolysis in failed TAR implants. Level of Evidence: Level IV, case series.
Comparative study on the effectiveness of corticosteroid injections between trigger fingers with and without proximal interphalangeal joint flexion contracture
Authors: Shinomiya R. , Sunagawa T. , Nakashima Y. , Kawanishi Y. , Masuda T. , Ochi M. 
Published: July 2015

Trigger fingers with proximal interphalangeal joint flexion contracture are suggested to have a poorer response to corticosteroid injection than those without contracture, though this has not been proven scientifically. We compared the clinical response to corticosteroid injection between trigger fingers with and without proximal interphalangeal joint contracture, and investigated the influence of the injection on the A1 pulley and flexor digitorum tendons using ultrasonography. One month after injection, pain was significantly reduced in the no contracture group, and 56% of trigger fingers with proximal interphalangeal joint contracture resolved. Before injection, relative thickening of the A1 pulley and flexor digitorum tendons, and a partial hypoechoic lesion of the flexor digitorum superficialis tendon were observed in the contracture group. One month after injection, the thickening of the tendons and the A1 pulley was reduced, but the partial hypoechoic lesion was still observed in significant numbers. We have demonstrated that the presence of a proximal interphalangeal joint contracture was associated with a reduced clinical response to corticosteroid injection, and we suggest that the pathologic change in the flexor digitorum superficialis tendon, represented by the partial hypoechoic lesion, contributed to corticosteroid injection resistance. Level of evidence: IV
When can I drive? Return to driving following a wrist fracture: A critical review
Authors: Stinton Susan B , Edgar Dale W , Moloney Niamh A , Refshauge Kathryn , Pappas Evangelos 
Published: July 2015

Introduction The primary aim of this review was to identify literature that examined factors which influence driving performance following a wrist fracture. Given the known scarcity of research in this area, secondary aims were to detail current practices including the driving habits of patients following a wrist fracture and health professionals’ opinions on safe return to driving. Methods We performed a search in April 2015 using three electronic databases to obtain relevant literature in the English language. Relevant studies including clinical trials, surveys and case reports were reviewed. Results The search identified 12 relevant studies. Five of these were clinical studies with a crossover design that investigated the driving ability of uninjured individuals with the wrist immobilised in a cast. The remaining were survey-based studies. The clinical trials showed that the presence of a wrist cast reduced driving performance in uninjured individuals. No studies investigated driving performance in individuals with a wrist fracture. The surveys showed that this patient group returns to driving despite perceived safety risks. Inconsistency in expert opinions on whether individuals with a wrist fracture are safe to drive was highlighted. Conclusions There is evidence to suggest that driving performance is reduced in uninjured individuals when wearing a cast immobilising the wrist; however, the influence of wrist fracture is unknown. This, along with safety implications resulting from current driving behaviours and inconsistent information provided to patients regarding return to driving, highlights the need for further studies to ascertain which factors influence driving performance following wrist fracture.
Effects of Dexamethasone Concentration and Timing of Exposure on Chondrogenesis of Equine Bone Marrow–Derived Mesenchymal Stem Cells
Authors: Tangtrongsup Suwimol , Kisiday John D. 
Published: July 2015

Objective Dexamethasone is known to support mesenchymal stem cell (MSC) chondrogenesis, although the effects of dose and timing of exposure are not well understood. The objective of this study was to investigate these variables using a laboratory model of MSC chondrogenesis. Design Equine MSCs were encapsulated in agarose and cultured in chondrogenic medium with 1 or 100 nM dexamethasone, or without dexamethasone, for 15 days. Samples were analyzed for extracellular matrix (ECM) accumulation, prostaglandin E2 and alkaline phosphatase secretion, and gene expression of selected collagens and catabolic enzymes. Timing of exposure was evaluated by ECM accumulation after dexamethasone was withdrawn over the first 6 days, or withheld for up to 3 or 6 days of culture. Results ECM accumulation was not significantly different between 1 and 100 nM dexamethasone, but was suppressed ~40% in dexamethasone-free cultures. Prostaglandin E2 secretion, and expression of catabolic enzymes, including matrix metalloproteinase 13, and type X collagen was generally lowest in 100 nM dexamethasone and not significantly different between 1 nM and dexamethasone-free cultures. Dexamethasone could be withheld for at least 2 days without affecting ECM accumulation, while withdrawal studies suggested that dexamethasone supports ECM accumulation beyond day 6. Conclusion One nanomolar dexamethasone supported robust cartilage-like ECM accumulation despite not having an effect on markers of inflammation, although higher concentrations of dexamethasone may be necessary to suppress undesirable hypertrophic differentiation. While early exposure to dexamethasone was not critical, sustained exposure of at least a week appears to be necessary to maximize ECM accumulation.
Effect of the economic crisis on the production of immunology patents managed through the Patent Cooperation Treaty agreement from 2004–2011
Authors: Campos Elena , Campos Adolfo 
Published: July 2015

Objectives To determine the evolution of patents in immunology, as a result of research and innovation in the years 2004–2011. Design The search for patents published internationally in immunology was made by using the SCOPUSTM database. SCOPUS gives information about over 23 million patents. The extracted data from patents were: inventors and applicants; their nationalities; sections, classes and subclasses of the International Patent Classification. Participants 89 countries Setting Data have been obtained from the database SCOPUS. It has been used for the international patent classification. Main outcome measures Patents by country, Productive sectors, Productive areas Results A total of 17,281 patents were applied for immunology during 2004–2011 of which 16,811 were from 30 Organisation for Economic Cooperation and Development countries, and 5326 from 28 countries in the European Union. These patents were granted in 89 countries and 13,699 of them were submitted by researchers from only one country. Private entities applied for 62.45% of all patents, universities 17.48%, hospitals 3.40% and public research organisations and private applicants applied for the rest. The university that made more applications was the University of California with 315 and the company was Genentech Inc. (US) with 302. The reduction in the number of applications of international patents in all disciplines of science also affected the area of immunology. Conclusions Collaboration in immunology between universities, companies and hospitals is hard because their interests are different. It is shown in patent applications that the majority of patents in immunology are applied for by only one entity. Patents in immunology are developed, mainly, in aspects such as medical preparations, peptides, mutation or genetic engineering, therapeutic activity of chemical compounds and analysing materials by determining their chemical or physical properties.
Digital flexor tendon contracture treated by tenectomy: different clinical presentations in three cats
Authors: Cabon Quentin , Plante Jérôme , Gatineau Matthieu 
Published: July 2015

Case series summary Three cats, Siamese or Siamese cross, were presented with a chronic thoracic limb weightbearing lameness. Previous anti-inflammatory administrations were unable to improve lameness consistently in the three cats. Two of the three cats had undergone onychectomy several years before presentation. A permanent flexion of the proximal interphalangeal joint of one or more digits, associated with a difficult and painful extension of the proximal interphalangeal joint, was noticed during orthopedic examination. A digital flexor tendon contracture was suspected and confirmed with radiographic examination. Surgical exploration was then performed. For all cats, treatment consisted of a tenectomy or tenotomy of the superficial and deep digital flexor tendons in order to release the contracture. The three cats responded well to the surgical treatment and became sound around 2–4 weeks after surgery. Relevance and novel information Digital flexor tendon contracture is rarely reported as a cause of lameness in cats. It should be considered in a differential diagnosis of feline lameness whenever onychectomy has been performed in the past. The precise etiology that explains this tendon contracture is unknown, but trauma or breed predisposition could represent potential causes.
Cryptococcal nasopharyngeal polypoid mass in a cat
Authors: Livet Véronique , Javard Romain , Alexander Kate , Girard Christiane , Dunn Marilyn 
Published: July 2015

Case summary An indoor 9-year-old castrated male domestic cat was referred with a 4 month history of increased upper airway noise. Computed tomography revealed a nasopharyngeal polypoid mass, which was removed endoscopically with basket forceps. Histopathology was compatible with a polypoid granulomatous pharyngitis with Cryptococcus-like organisms. This was supported by a positive serum latex cryptococcal antigen agglutination test (LCAT). Minimal inflammation of the nasal tissue was noted on histopathology, with no evidence of fungus. Following endoscopic removal of the mass, the patient was treated with systemic antifungal medication (itraconazole). One year after diagnosis, the LCAT titer was negative and the cat remained free of clinical signs. Relevance and novel information This case report emphasizes the importance of considering Cryptococcus species as a potential etiology in cats presented with signs of nasopharyngeal obstruction with an isolated nasopharyngeal polypoid mass, even if kept indoors.