bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cerebral Oximetry as a Real‐Time Monitoring Tool to Assess Quality of In‐Hospital Cardiopulmonary Resuscitation and Post Cardiac Arrest Care
Authors: Ibrahim Akram W. , Trammell Antoine R. , Austin Harland , Barbour Kenya , Onuorah Emeka , House Dorothy , Miller Heather L. , Tutt Chandila , Combs Deborah , Phillips Roger , Dickert Neal W. , Zafari A. Maziar 
Published: August 2015

Background

Regional cerebral oxygen saturation (
rSO
2
) as assessed by near infrared frontal cerebral spectroscopy decreases in circulatory arrest and increases with high‐quality cardiopulmonary resuscitation. We hypothesized that higher
rSO
2
during cardiopulmonary resuscitation and after return of spontaneous circulation (
ROSC
) would predict survival to discharge and neurological recovery.

Methods and Results

This prospective case series included patients experiencing in‐hospital cardiac arrest. Cerebral oximetry was recorded continuously from initiation of resuscitation until
ROSC
and up to 48 hours post‐arrest. Relationships between oximetry data during these time periods and outcomes of resuscitation survival and survival to discharge were analyzed. The cohort included 27 patients. Nineteen (70.3%) achieved
ROSC
, and 8 (29.6%) survived to discharge. Median arrest duration was 20.8 minutes (range=8 to 74). There was a significant difference in
rSO
2
between resuscitation survivors and resuscitation nonsurvivors at initiation of the resuscitative efforts (35% versus 17.5%,
P
=0.03) and during resuscitation (36% versus 15%,
P
=0.0008). No significant association was observed between
rSO
2
at
ROSC
or during the post‐arrest period and survival to discharge. Among patients who survived to discharge, there was no association between cerebral performance category and
rSO
2
at
ROSC
, during resuscitation, or post‐arrest.

Conclusions

Higher
rSO
2
levels at initiation of resuscitation and during resuscitation are associated with resuscitation survival and may reflect high‐quality cardiopulmonary resuscitation. However, in this small series,
rSO
2
was not predictive of good neurological outcome. Larger studies are needed to determine whether this monitoring modality can be used to improve clinical outcomes.
Infusion of Reconstituted High‐Density Lipoprotein, CSL112, in Patients With Atherosclerosis: Safety and Pharmacokinetic Results From a Phase 2a Randomized Clinical Trial
Authors: Tricoci Pierluigi , D'Andrea Denise M. , Gurbel Paul A. , Yao Zhenling , Cuchel Marina , Winston Brion , Schott Robert , Weiss Robert , Blazing Michael A. , Cannon Louis , Bailey Alison , Angiolillo Dominick J. , Gille Andreas , Shear Charles L. , Wright Samuel D. , Alexander John H. 
Published: August 2015

Background

CSL
112 is a new formulation of human apolipoprotein A‐I (apoA‐I) being developed to reduce cardiovascular events following acute coronary syndrome. This phase 2a, randomized, double‐blind, multicenter, dose‐ranging trial represents the first clinical investigation to assess the safety and pharmacokinetics/pharmacodynamics of a
CSL
112 infusion among patients with stable atherosclerotic disease.

Methods and Results

Patients were randomized to single ascending doses of
CSL
112 (1.7, 3.4, or 6.8 g) or placebo, administered over a 2‐hour period. Primary safety assessments consisted of alanine aminotransferase or aspartate aminotransferase elevations >3× upper limits of normal and study drug–related adverse events. Pharmacokinetic/pharmacodynamic assessments included apoA‐I plasma concentration and measures of the ability of serum to promote cholesterol efflux from cells ex vivo. Of 45 patients randomized, 7, 12, and 14 received 1.7‐, 3.4‐, and 6.8‐g
CSL
112, respectively, and 11 received placebo. There were no clinically significant elevations (>3× upper limit of normal) in alanine aminotransferase or aspartate aminotransferase. Adverse events were nonserious and mild and occurred in 5 (71%), 5 (41%), and 6 (43%) patients in the
CSL
112 1.7‐, 3.4‐, and 6.8‐g groups, respectively, compared with 3 (27%) placebo patients. The imbalance in adverse events was attributable to vessel puncture/infusion‐site bruising.
CSL
112 resulted in rapid (
T
max
≈2 hours) and dose‐dependent increases in apoA‐I (145% increase in the 6.8‐g group) and total cholesterol efflux (up to 3.1‐fold higher than placebo) (
P
<0.001).

Conclusions

CSL
112 infusion was well tolerated in patients with stable atherosclerotic disease.
CSL
112 immediately raised apoA‐I levels and caused a rapid and marked increase in the capacity of serum to efflux cholesterol. This potential novel approach for the treatment of atherosclerosis warrants further investigation.

Clinical Trial Registration

URL
:
http://www.ClinicalTrials.gov
. Unique identifier:
NCT
01499420.
The Signature of Aerosols and Meteorology in Long-Term Cloud Radar Observations of Trade Wind Cumuli
Authors: Lonitz Katrin , Stevens Bjorn , Nuijens Louise , Sant Vivek , Hirsch Lutz , Seifert Axel 
Published: August 2015

Abstract
The signature of aerosols and meteorology on the development of precipitation from shallow cumuli in the trades is investigated with ground-based lidar and radar remote sensing. The measurements are taken from a cloud observatory recently established on the windward shore of Barbados. Cloud microphysical development is explored through an analysis of the radar echo of shallow cumuli before the development of active precipitation. The increase of reflectivity with height (Z gradient) depends on the amount of cloud water, which varies with meteorology, and cloud droplet number concentration N, which varies with the aerosol. Clouds with a large Z gradient have a higher tendency to form precipitation than clouds with a small Z gradient. Under similar meteorological conditions, the Z gradient is expected to be large in an environment with few aerosols and small in an environment with many aerosols. The aerosol environment is defined using three methods, but only one (based on the Raman lidar linear-depolarization ratio) to measure dusty conditions correlates significantly with the Z gradient. On average, nondusty days are characterized by a larger Z gradient. However, the dust concentration varies seasonally and covaries with relative humidity. Large-eddy simulations show that small changes in the relative humidity can have as much influence on the development of precipitation within the cloud layer as large changes in N. When clouds are conditioned on their ambient relative humidity, the sensitivity of the Z gradient to dust vanishes.
Modeling Condensation in Shallow Nonprecipitating Convection
Authors: Grabowski Wojciech W. , Jarecka Dorota 
Published: August 2015

Abstract
Two schemes for modeling condensation in warm nonprecipitating clouds are compared. The first one is the efficient bulk condensation scheme where cloudy volumes are always at saturation and cloud water evaporates instantaneously to maintain saturation. The second one is the comprehensive bin condensation scheme that predicts the evolution of the cloud droplet spectrum and allows sub- and supersaturations in cloudy volumes. The emphasis is on the impact of the two schemes on cloud dynamics. Theoretical considerations show that the bulk condensation scheme provides more buoyancy than the bin scheme, but the effect is small, with the potential density temperature difference around 0.1 K for 1% supersaturation. The 1D advection–condensation tests document the high-vertical-resolution requirement for the bin scheme to resolve the cloud-base supersaturation maximum and CCN activation, which is difficult to employ in 3D cloud simulations. Simulations of shallow convection cloud fields are executed applying bulk and bin schemes, with the mean droplet concentrations in the bin scheme covering a wide range, from about 5 to over 4000 cm−3. Simulations employ the microphysical piggybacking methodology to extract impacts with high confidence. They show that the differences in cloud fields simulated with bulk and bin schemes come not from small differences in the condensation but from more significant differences in the evaporation of cloud water near cloud edges as a result of entrainment and mixing with the environment. The latter makes the impact of cloud microphysics on simulated macroscopic cloud field properties even more difficult to assess because of highly uncertain subgrid-scale parameterizations.
Comparing Trends in the Southern Annular Mode and Surface Westerly Jet
Authors: Swart Neil C. , Fyfe John C. , Gillett Nathan , Marshall Gareth J. 
Published: August 2015

Abstract
This paper examines trends in the southern annular mode (SAM) and the strength, position, and width of the Southern Hemisphere surface westerly wind jet in observations, reanalyses, and models from phase 5 of the Coupled Model Intercomparison Project (CMIP5). First the period over 1951–2011 is considered, and it is shown that there are differences in the SAM and jet trends between the CMIP5 models, the Hadley Centre gridded SLP (HadSLP2r) dataset, and the Twentieth Century Reanalysis. The relationships between these trends demonstrate that the SAM index cannot be used to directly infer changes in any one kinematic property of the jet. The spatial structure of the observed trends in SLP and zonal winds is shown to be largest, but also most uncertain, in the southeastern Pacific. To constrain this uncertainty six reanalyses are included and compared with station-based observations of SLP. The CMIP5 mean SLP trends generally agree well with the direct observations, despite some climatological biases, while some reanalyses exhibit spuriously large SLP trends. Similarly, over the more reliable satellite era the spatial pattern of CMIP5 SLP trends is in excellent agreement with HadSLP2r, whereas several reanalyses are not. Then surface winds are compared with a satellite-based product, and it is shown that the CMIP5 mean trend is similar to observations in the core region of the westerlies, but that several reanalyses overestimate recent trends. The authors caution that studies examining the impact of wind changes on the Southern Ocean could be biased by these spuriously large trends in reanalysis products.
A Cloud-to-Ground Lightning Climatology for Poland
Authors: Taszarek Mateusz , Czernecki Bartosz , Kozioł Aneta 
Published: August 2015

Abstract
This research focuses on the climatology of cloud-to-ground (CG) lightning flashes based on PERUN lightning detection network data from 2002 to 2013. To present various CG lightning flash characteristics, 10 km × 10 km grid cells are used, while for estimating thunderstorm days, circles with radii of 17.5 km in the 1 km × 1 km grid cells are used. A total of 4 328 892 CG lightning flashes are used to analyze counts, density, polarity, peak current, and thunderstorm days. An average of 151 days with thunderstorm (appearing anywhere in Poland) occurs each year. The annual number of days with thunderstorms increases southeasterly from the coast of the Baltic Sea (15–20 days) to the Carpathian Mountains (30–35 days). The mean CG lightning flash density varies from 0.2 to 3.1 flashes km−2 yr−1 with the highest values in the southwest–northeast belt from Kraków-Częstochowa Upland to the Masurian Lake District. The maximum daily CG lightning flash density in this region amounted to 9.1 km−2 day−1 (3 July 2012). The monthly variation shows a well-defined thunderstorm season extending from May to August with July as the peak month. The vast majority of CG lightning flashes were detected during the daytime (85%) with a peak at 1400 UTC and a minimum at 0700 UTC. Almost 97% of all CG lightning flashes in the present study had a negative current, reaching the highest average monthly values in February (55 kA) and the lowest in July (24 kA). The percentage of positive CG lightning flashes was the lowest during the summer (2%–3%) and the highest during the winter (10%–20%).
Evaluation of Customized Prosthesis for Irregularly Formed Tracheostoma After Laryngectomy
Authors: Doescher Johannes , Scheckenbach Kathrin , Angerstein Wolfgang , Veit Johannes A. , Laban Simon , Thierauf Julia , Theodoraki Marie-Nicole , Greve Jens , Schuler Patrick J. , Hoffmann Thomas K. 
Published: August 2015

Background: After laryngectomy, the tracheostoma forms the functional center for breathing and phonation. An occasionally occurring but typical problem can arise from an oversized and/or irregularly formed tracheostoma, hampering the temporary occlusion necessary for sufficient speech production. As an alternative to a surgical correction of the tracheostoma, an individually adjusted stoma silicone prosthesis may be used. Materials and Methods: Twenty-one patients suffering from irregularly formed tracheostoma after laryngectomy followed by insertion of a speech valve were provided with a silicone tracheostomal prosthesis. They underwent subjective assessment of voice quality and breathing function according to a standardized general questionnaire and to the Voice Handicap Index (VHI). Furthermore, a clinical evaluation was performed including detection of peristomal leakage and phonation time. Results and Discussion: Patients described a significant improvement of voice production with the tracheostomal prosthesis (averagely graded as 1.9 with and 3.2 without prosthesis, P = .0026). Breathing was also slightly improved by the prosthesis with an average grade of 1.7 compared to 2.3 with a conventional cannula ( P = .063). There was a strong correlation between self-evaluation and the total score of the VHI after insertion of the prosthesis ( P < .0001). Minor local skin reactions caused by the adhesive were described by 5 of the 21 patients. Conclusions: A tracheostomal prosthesis represents an efficient alternative to surgical revision of irregularly formed tracheostoma after laryngectomy, enhancing voice production and breathing function.
Positive Pressure Bronchoscopy Technique
Authors: Hall Michael B. , Johnston Douglas R. , Barth Patrick 
Published: August 2015

Objective: Foreign body aspiration into the tracheobronchial tree continues to be a challenging problem for otolaryngologists. This is especially true in patients with poor pulmonary reserve. Methods: We describe a novel technique in which an endotracheal sheathed bronchoscope is used as a means to provide positive pressure ventilation simultaneously during foreign body extraction. Results: This new technique afforded the bronchoscopist more time during retrieval of the foreign body where previous attempts were limited by rapid desaturations and the overall nature of the foreign body. Conclusion: The endotracheal sheathed bronchoscope is a safe and efficacious technique for challenging airway foreign bodies complicated by a patient’s limited pulmonary reserve.
The Diabetes Educator and the Diabetes Self-management Education Engagement
Authors: Sherr Dawn , Lipman Ruth D. 
Published: August 2015

Purpose The National Practice Study (NPS) is conducted biannually to assess current diabetes education practices in the United States with the goal of understanding current trends in the work in which diabetes educators engage. Methods The 2015 NPS contained 54 questions about the individuals providing diabetes education, people with diabetes participating in education, and programs providing the education. The survey was sent electronically to approximately 21 975 people who were members of the American Association of Diabetes Educators (AADE) or who were Certified Diabetes Educators with the National Certification Board for Diabetes Educators but were not currently AADE members. In addition, both the AADE and the National Certification Board for Diabetes Educators promoted participation in the NPS via social media. The combination of efforts resulted in completion of the survey by 4855 respondents. Testing was completed with a significance level of 0.05 or 95% confidence. Results Diabetes educators continue to represent a diverse group of health care professionals—nurses (50%), dietitians (35%), pharmacists (6%), and others (6%). By far, the most commonly held credential for the specialty continues to be the Certified Diabetes Educator (86%), with only 5% of survey respondents indicating that they held the Board Certified–Advanced Diabetes Management credential. Diabetes educators are working with individuals across the diabetes continuum, as well as with people who do not have diabetes but have other chronic conditions. The data demonstrate that much of the diabetes educator’s work with people with diabetes is beyond the first year of diagnosis. Diabetes educators are increasingly seen to be providing a broader array of the integrated AADE7 Self-Care Behaviors™. Conclusions The specialty of diabetes educator continues to be populated by a professionally diverse workforce, meeting the needs of people across a wide spectrum. Diabetes educators can be found providing services in primary prevention of diabetes, education and management for those diagnosed with diabetes, prevention of secondary complications, and more complex management of diabetes and its secondary complications. While diabetes educators were found to work with those newly diagnosed with diabetes, they continue to engage with people with diabetes at various times other than the year that they were diagnosed. There are still issues with participant readiness, as evidenced by program completion rates. Nonetheless, diabetes educators are increasingly seen to be providing the integrated engagement that is needed to better ensure that people with diabetes attain and maintain competency in self-management skills.
Shear Wave Elastography in the Diagnosis of Thyroid Nodules with Coexistent Chronic Autoimmune Hashimoto’s Thyroiditis
Authors: Liu Baoxian , Liang Jinyu , Zhou Luyao , Lu Ying , Zheng Yanling , Tian Wenshuo , Xie Xiaoyan 
Published: August 2015

ObjectiveTo evaluate the diagnostic performance of shear wave elastography (SWE) in the differentiation of malignant and benign thyroid nodules with coexistent Hashimoto’s thyroiditis (HT).Study DesignCase series with chart review.SettingTertiary general hospital.Subjects and MethodsFrom September 2012 to January 2014, conventional ultrasound and SWE were performed on 243 patients with 286 thyroid nodules with histologic results. The HT group consisted of 93 patients with 117 nodules. The non‐HT group consisted of 140 patients with 169 nodules.ResultsIn the benign and malignant nodules, there were no significant differences of the mean, minimum, or maximum SWE values between HT and non‐HT groups (P =. 158‐.945). However, SWE values of extranodular tissue were significantly higher in the HT group (P =. 000‐.011). In the HT group, the maximum SWE value showed the highest area under the receiver operating characteristic curve (0.817; 95% confidence interval,. 735‐.900), and there were no significant differences when compared with other SWE parameters (P =. 669‐.848). In the multivariate analysis, hypoechogenicity (odds ratio = 9.855, P =. 002), microcalcification (odds ratio = 3.977, P =. 046), and maximum SWE value (odds ratio = 40.712, P <. 001) were independent predictors of thyroid malignancy.ConclusionsSWE could be performed to obtain a differential diagnosis between malignant and benign thyroid nodules, including nodules with coexistent HT. Although all the SWE parameters within a 2‐mm region of interest that was placed on the stiffest region could be applied, we suggest that the maximum value of nodules harbored within a Hashimoto’s gland be used.
Quantitative Vestibular Labyrinthine Otopathology in Temporal Bones with Vestibular Schwannoma
Authors: Hızlı Ömer , Cureoglu Sebahattin , Kaya Serdar , Schachern Patricia A. , Paparella Michael M. , Adams Meredith E. 
Published: August 2015

ObjectiveDizziness associated with vestibular schwannoma is usually ascribed to retrolabyrinthine mechanisms. The goal of this study was to determine if quantitative peripheral vestibular (labyrinthine) otopathology was present in a series of patients with vestibular schwannoma.Study DesignComparative human temporal bone study.SettingOtopathology laboratory.Subjects and MethodsTemporal bones from 12 subjects with unilateral sporadic vestibular schwannoma were included. Based on differential interference contrast microscopy, type I and II vestibular hair cell counts were performed on each vestibular sense organ with minimal autolysis in which the neuroepithelium was oriented perpendicular to the plane of section. Hair cell densities (cells per 0.01‐mm2 surface area) and the presence of endolymphatic hydrops and precipitate within the endolymph or perilymph were compared between the tumor ears and the contralateral (control) ears.ResultsCompared with the contralateral ears, vestibular schwannoma ears had significantly more endolymphatic hydrops (P =. 049) and precipitate in the endolymph and perilymph (P =. 005), lower densities of type I and II vestibular hair cells in the lateral canal cristae (mean differences, respectively: 25.2 [P =. 001] and 10.8 [P <. 001]) and utricle (mean differences, respectively: 26.8 and 10.4 [P <. 001]), and lower densities of type I hair cells and the same density of type II hair cells in the saccule (mean differences, respectively: 26.5 [P <. 001] and 0.9 [P =. 46]).ConclusionPeripheral vestibular otopathology, manifested as reductions of vestibular hair cell densities, was identified in ears with vestibular schwannoma. Labyrinthine as well as retrolabyrinthine pathology may contribute to tumor‐related vestibular dysfunction.
A Meta‐analysis of Central Lymph Node Metastasis for Predicting Lateral Involvement in Papillary Thyroid Carcinoma
Authors: Lan Xiabin , Sun Wei , Zhang Hao , Dong Wenwu , Wang Zhihong , Zhang Ting 
Published: August 2015

ObjectiveWhether central lymph node metastasis is a reliable indicator of lateral lymph node metastasis in papillary thyroid carcinoma remains obscure. To investigate the value of central lymph node metastasis for predicting lateral compartment involvement, we performed a meta‐analysis of published studies.Data SourcesA systematic literature search of PubMed, EMBASE, and Chinese National Knowledge Infrastructure databases was completed, and the reference lists of the identified articles and prior relevant reviews were examined.Review MethodsTwo reviewers extracted data and assessed the quality of eligible studies independently. Odds ratios and 95% confidence intervals were pooled through a random effects meta‐analysis model.ResultsTwenty‐one studies were eligible and further analyzed in this meta‐analysis. The risk of lateral lymph node metastasis was significantly higher in the central lymph node–positive group than in the negative group (odds ratio = 7.64, 95% confidence interval: 5.59‐10.44), with moderate heterogeneity across studies (P =. 007, I2 = 48.6%). Subgroup analyses and sensitivity analysis suggested that the results were consistent and credible. However, Begg’s funnel plot and Egger linear regression test revealed a likelihood of publication bias (P =. 000).ConclusionThis meta‐analysis suggests that central lymph node metastasis is valuable for predicting lateral compartment involvement in patients with papillary thyroid carcinoma. For those patients with central lymph node metastasis, additional attention should be paid to the lateral neck, as the risk of lateral lymph node metastasis was significantly higher in the central lymph node–positive group than in the negative group. Further studies regarding appropriate management for patients with high risk of lateral involvement are needed.