bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prosodic Focus Interpretation in Spectrotemporally Degraded Speech by Non-Native Listeners
Authors: Everhardt Marita K. , Sarampalis Anastasios , Coler Matt , Başkent Deniz , Lowie Wander 
Published: August 2023

Purpose:
This study assesses how spectrotemporal degradations that can occur in the sound transmission of a cochlear implant (CI) may influence the ability of non-native listeners to recognize the intended meaning of utterances based on the position of the prosodically focused word. Previous research suggests that perceptual accuracy and listening effort are negatively affected by CI processing (or CI simulations) or when the speech is presented in a non-native language, in a number of tasks and circumstances. How these two factors interact to affect prosodic focus interpretation, however, remains unclear.

Method:
In an online experiment, normal-hearing (NH) adolescent and adult native Dutch learners of English and a small control group of NH native English adolescents listened to CI-simulated (eight-channel noise-band vocoded) and non–CI-simulated English sentences differing in prosodically marked focus. For assessing perceptual accuracy, listeners had to indicate which of four possible context questions the speaker answered. For assessing listening effort, a dual-task paradigm was used with a secondary free recall task.

Results:
The results indicated that prosodic focus interpretation was significantly less accurate in the CI-simulated condition compared with the non–CI-simulated condition but that listening effort was not increased. Moreover, there was no interaction between the influence of the degraded CI-simulated speech signal and listening groups in either their perceptual accuracy or listening effort.

Conclusion:
Non-native listeners are not more strongly affected by spectrotemporal degradations than native listeners, and less proficient non-native listeners are not more strongly affected by these degradations than more proficient non-native listeners.
Use of the Cell Saver as a Rapid Infusion Device
Authors: Johnson Howard D. , Morgan Marc S. , Utley Joe R. 
Published: August 2023

A Bio-Medicus pump with a model BP 80, flow probe, model DP 38, and Gott TDMAC Shunt tubing, primed with Plasma Lyte A, pH 7.4, was used during a repair of a descending aortic aneurysm. The Haemonetic Cell Saver Plus with 1/4" tubing, List #243, and Gish Cardiotomy ATR-2900F was used to process shed blood.
The patient was heparinized with 31,000 units of beef lung heparin (400 units/Kg) to maintain the activated clotting time above 480 seconds. The aneurysm was opened. Collateral bleeding caused the patient to bleed out excessively into the cell saver, rendering the Bio-Pump ineffective due to severe hypovolemia. As the bleeding was controlled, the cell saver was connected to the Gott TDMAC shunt tubing with a 1/4" X 3/8" connector to autotransfuse shed blood from the cardiotomy back to the patient, bypassing the cell saver centrifuge.
The aortic cross clamp time was 22 minutes. The patient suffered no complications and at the 12 month follow up, she continues to do well. In summary, we feel that the surgical team should be equipped to provide ancillary support as the situation requires.
Comparison Between Black Top CA510 and Flip Top FT CA510 Test Tubes in the Hemochron Blood Coagulation Timing System
Authors: Robles Francisco , DelRossi Anthony J. , Cilley Jonathan H. , Fuller Sidney J. , Dunmire Robert D. , Vertrees Roger A. 
Published: August 2023

The Hemochron System for in vivo determination of blood coagulation, commonly referred to as ACT, has routinely been used for patients undergoing extracorporeal bypass surgery. A modified version of the Black Top CA510 Hemochron test tube, the Flip Top FT CA510, has become increasingly utilized in the clinical setting. A comparative study determining reliability, reproducibility and relative accuracy between the two Hemochron tubes has been established.
Simultaneous ACT tests were performed on three hospitalized patients, totaling 22 blood samples taken altogether. Each tube was injected with 2ccs of blood per patient. ACT results were obtained and there appeared to be no significant difference between Group A (Black Top CA510) and Group B (Flip Top FT CA510). Additionally, the results in Group B indicated a higher degree of reliability with the newer tubes.
A Computer-Based Audio Challenge and Response Cardiopulmonary Bypass Checklist System
Authors: Berryessa Richard G. , Riley Jeffrey B. , Dunaway Michael W. , Crowley J.C. , Harshaw R.C. 
Published: August 2023

Comparisons continue to be made between perfusion and aviation. Although similarities exist there are important differences. One substantial dissimilarity is in the area of safety where commercial aviation has a dramatically lower accident rate than perfusion. Extensive safety systems, including the routine use of checklists, are a major factor in safe air travel.
Experience with the use of a checklist for cardiopulmonary bypass has proven useful for managing risk and assuring quality. Recent publications on cardiopulmonary bypass standards and safety mandate the use of checklists.
We borrowed from the aviation industry an audio checklist management system which employs digital speech technology. A small, mast-mounted, battery operated device with a lifelike voice challenges the perfusionist with a cardiopulmonary bypass checklist. After being challenged with a checklist item, the perfusionist responds verbally and advances to the next checklist item, by pressing a remote button. The device records the time that an item is checked and upon completion of the checklist prints a document for inclusion in the record.
The audio checklist includes pre-bypass set-up, pre and post-initiation, cardioplegia, pre-termination, and post-bypass checklists. Emergency procedure checklists, for common perfusion incidents, may be called-up by the perfusionist. The computer may be programmed to generate custom checklists to meet an individual perfusionist's need.
The audio checklist device assures consistency and frees the perfusionist from a more cumbersome paper checklist system. Use of the audio checklist device minimizes the diversion of the perfusionist's eyes and attention from cardiopulmonary bypass equipment and events.
Ancrod vs. Heparin: The Resulting Effect on Oxygenator Performance During Routine Cardiopulmonary Bypass
Authors: Benak AM , Zulys V , Calvieri B , Zombolas TL , Henderson MJ , Hurdle M , Glynn MFX 
Published: August 2023

Ancrod, a thrombin-like enzyme with anticoagulant properties, is extracted from the venom of the Malayan Pit Viper (Agkistron rhodostoma). Recently, Ancrod has been proposed as an alternate anticoagulant for cardiopulmonary bypass (CPB). In order to investigate the effect of Ancrod on the performance of the semi-porous hollow fiber membrane oxygenator now in use during CPB, in-line pressure measurements (pre- and post-oxygenator) and blood gas analysts were carried out in a clinical setting. A control group of 20 patients scheduled for coronary artery bypass grafts were coagulated with heparin and a study group of 20 patients underwent controlled defibrinogenation with Ancrod. There were no significant differences between groups with respect to blood gas values (pO2, PCO2) or pressure gradients across the membrane oxygenator and in all cases the intra-operative course was uneventful. Comparison of electron micrographs from various surfaces of the CPB circuit demonstrated less cellular and proteinaceous material were deposited on the study group's circuits than those of the patients anticoagulated with heparin.
This study confirms the efficacy of Ancrod as an alternate anticoagulant for CPB.
Report on the Clinical Trials of the Plexus Membrane Blood Oxygenator
Authors: Hodgson-Smith A. , Sutton R.G. , Riley J.B. , Stotland C.A. , Pienta M.E. , Dillon V. W. , Toomasian J.M. , Kratz J.M. , Crumbley A.J. , Crawford F.A. 
Published: August 2023

Twenty adult patients gave informed consent to clinical cardiopulmonary bypass (CPB) trials with a new adult hollow fiber membrane oxygenator. Clinical CPB trials averaged 88 ± 25 min (mean ± 1 SD) for these patients that weighed 78 ± 13 Kg and had BSA's = 1.9 ± 0.2 m2. Blood flow averaged 4.0 ± 0.8 L/min, and hypothermia was employed at 26.5 ± 2.4°C. FiO2's = 0.59 ± 0.15, and gas to blood flow ratios= 0.64 ± 0.18 were required to maintain the PaO2>100 mmHg and to accomplish alpha-stat. The oxygenator exhibited a pressure drop of 50-60 mmHg at 5.09 1/min and a heat exchanger performance factor over .55 during most of CPB.
Multiple regression analysis of the clinical database demonstrated that the FiO2 required to achieve a desired PaO2 was dependent on the blood flow, gas flow, and SvO2 (r2 = 0.83, standard error = 0.09). The gas flow required to accomplish alpha-stat was dependent on patient age, weight, blood flow, arterial blood temperature, and desired PaCO2 (r2 = 0.71, standard error= 0.6).
The Plexus blood oxygenator is safe for adult cardiopulmonary bypass and its clinical performance is statistically predictable.
In Vitro Comparison of ECC Blood Flow Measurement Techniques
Authors: Akers Thomas , Bolen Gregory , Gomez Julie , Hodgson-Smith Amy , Merrill Jonathan , Anderson Gary , Huddleson James , Moretz Timothy , Kirven Kimberly , Kirven Dennis , Sutton Robin G. , Riley Jeffrey B. 
Published: August 2023

Four extracorporeal blood flow measurement devices were compared for accuracy: the digital display (Stockert-Shiley roller pump), the Sarns doppler flow probe, the Transonic ultrasonic flow probe and the Biomedicus electromagnetic flow probe. The effects of changing temperature and hematocrit at various flows were compared.
Eighty-four blood flow measurements were recorded for hematocrits from 17.5% to 35.0%, temperatures from 25 to 37°C and flows from 3.0 to 5.5 LPM. A summary of the results follows:

ACTQ(r2)
HCT
TEMP
INTER
MEAN
STD. DEV

%DIFF
%DIFF

Biomedicus
.98
.0001
NS
.0053
1.0
2.3

Sams
.96
.0203
NS
NS
1.6
3.2

Shiley RPM
.99
NS
NS
NS
-2.3
1.5

Transonic
.99
.0001
NS
NS
4.3
1.4

ACTQ(r2) = correlation with actual flow, HCT = hematocrit effect on difference (p value), TEMP = temperature effect on difference (p value), INTER = 2way ANOVA interaction, MEAN/STD DEV %DIFF = average and one standard deviation of the percent difference between actual and reported flow, NS = non-significant.

All flow measurement systems correlated with actual flow(p<.001). The Biomedicus, Sarns and Transonic errors were affected by hematocrit, while none were affected by temperature. (p<.05)
Use of an Extracorporeal Circulation Workstation During the Routine Care of Cardiac Patients
Authors: Gaillard D. , Barraud C. , Bical O. , DeToni L. , Montejo L.S. , Vanetti A. 
Published: August 2023

In this presentation, we present a computerized system which acquires, stores and processes all parameters currently measured during heart surgery.
The aim of this computerized system is based on:

continuous acquisition and processing of patient and ECC data

user adaptability of the system to his or her requirements

user-friendliness

adaptability to all operating theater equipment.

The hardware includes an IBM PS/2, with a color screen and an HP laser printer.
This computer can receive seven different monitors. The incoming values are displayed either instantaneously or as averages. The results can be displayed either in color graphic form and updated automatically, or in tables.
All parameters commonly measured in the operating room at present can be recorded by the software; for example, all arterial and venous pressures, venous and arterial saturation, five different temperatures, cardiac output, ST segment level, pump flow rate, arterial and venous blood gases in continuous with CDI 300.
With any parameters, computed data, such as vascular resistances, O2 consumption are also obtained on a continuous basis.
It is a powerful instrument, not only for the whole surgical team because of its multiple personalization and interfacing capability, but also for use in research.
The Role of Antithrombin III in Heparin Resistance
Authors: Rivard Dennis C. , Thompson Steven J. , Cameron Duke 
Published: August 2023

Resistance to the anticoagulation action of sodium heparin during cardiopulmonary bypass is a serious concern and a poorly understood phenomenon. In the majority of cases, the desired prolongation of the activated clotting time (ACT) is achieved by administration of additional heparin. A patient's previous exposure to heparin has been suggested as the cause of this clinical dilemma. The administration of fresh frozen plasma to patients who demonstrated a heparin resistance have been shown to produce a normalization of their heparin/ACT dose response curve and a decrease in total heparin requirements during cardiopulmonary bypass. These results could be an indication of a deficiency of a component in patient's plasma.
This study was designed to compare antithrombin III (AT III) in two patient populations. Group A consisted of 15 patients receiving intravenous heparin therapy prior to cardiopulmonary bypass for greater than 24 hours. Population B included 15 patients who had not been exposed to heparin therapy preoperatively. All patients were candidates for coronary artery bypass grafting. The quantitative assay utilized the Loyal Rocket Immunoelectrophoresis Technique and the qualitative assay was determined by the AT III Anti-10A Activity Assay.
Two sample t-test analyses of variance revealed no statistical significance (p<0.05) between the two populations in either quantitative assay (p=0.054) or the qualitative assay (p=0.06). A comparison of the ration (qualitative/quantitative) showed a statistical difference (p=0.016).
It can be suggested from these results that the resistance to heparin demonstrated in heparin therapy patients is the result of a combination of factors associated with AT III. Administration of heparin decreases the available AT III and decreases its function. The combination of these two factors contributes to this resistance phenomenon.
Qualitative Assessment of Shed Mediastinal Blood
Authors: Volken U. , Walpothl B. , Nydegger U. , Althaus U. 
Published: August 2023

In a randomized prospective study of patients undergoing coronary bypass surgery, autologous blood from chest drainage was collected and retransfused into 10 patients (RTX) whereas 10 patients without retransfusion served as controls. There was no significant difference referring to age, weight, height, perfusion time, and number of distal anastomosis. Our main regard was directed to a qualitative analysis of the retransfused autologous blood. Results (mean values ± 1 SD/patient): one; there was no bacterial contamination in the shed mediastinal blood just prior to retransfusion, two; elevated levels of free plasma hemoglobin (otolidin-method) were encountered after one hour on cardiopulmonary bypass (CPB) and a six-fold increase in the shed mediastinal blood from the cardiotomy reservoir (211 ± 44 mg/dl), three; the potassium value in the cardiotomy reservoir was slightly increased (5.8 ± 2.9 mmol/l), four, in no case was hemoglobinuria or coagulation disfunction noted (the activated clotting time (ACT) after retransfusion did not change significantly ( 117 ± 15 sec) as compared to preoperative values (112 ± 16 sec)) five; no evidence for further complement activation (determined by C3a and C5b-9), induced by CPB, was seen, and six; red cell adenosine-triphosphate (ATP) in the shed mediastinal blood was lowered to 2.56 ± 0.78 umol/gHb whereas red cell 2,3diphosphoglycerate (2,3DPG) remained normal.
On the basis of these results we consider the retransfusion of shed mediastinal blood following cardiac surgery a simple and safe method of blood salvage.
Kraniale subarachnoidale Blutung nach ventraler zervikaler Osteosynthese – eine ungewöhnliche und schwerwiegende Komplikation durch Dislokation einer Zementplombe
Authors: Jarski Pawel , Rhode Veit , von Eckardstein Kajetan , von der Brelie Christian 
Published: August 2023

ZusammenfassungDie Behandlung von Densfrakturen gehört zum Standardrepertoire spinaler
Operationstechniken. Wir berichten von einem ungewöhnlichen Fall einer 73-jährigen Patientin,
die in einem externen Krankenhaus aufgrund einer Dens axis Fraktur Typ II nach Anderson und
dʼAlonzo mittels ventraler transartikulärer Osteosynthese sowie einer Dens-Zugschraube
behandelt wurde. Intraoperativ kam es zu einer Perforation der ventralen zervikalen Dura und
zu einem Liquorfluss über die kanülierte Zugschraube, sodass eine Palacosinjektion in die
Schraube hinein erfolgte. Danach folgte ein längeres unauffälliges Intervall, bevor es etwa 2
Jahre später durch ein Sturzgeschehen zu einem leichten Schädel-Hirn-Trauma (SHT) kam. Der auf
das Trauma folgende unmittelbare klinische Verlauf war zunächst unauffällig, eine Bildgebung
fand nicht statt. 5 Wochen später kam es jedoch dann plötzlich zu einer motorischen Unruhe und
einer spontanen Emesis. Die kraniale CT wies eine kraniale, v.a. perimedulläre
Subarachnoidalblutung (SAB) nach. In der weiterführenden Diagnostik konnte eine
Gefäßmissbildung als Ursache ausgeschlossen werden. Zudem sah man eine perimedullär
lokalisierte Palacosplombe. Wir vermuten, dass bereits initial eine intradurale Lage des
Palacosmaterials vorgelegen hat, welches aber zunächst noch fest mit der Zugschraube verbunden
war. Diese Verbindung wurde dann jedoch mutmaßlich durch das SHT gelöst, das Palacosmaterial
wurde von der Zugschraubenspitze abgeschert und hat dann letztlich zu einer Verletzung pialer
Gefäße und somit zur SAB geführt.Das ventrale Osteosynthesematerial wurde entfernt, eine Einspritzung von Fibrinkleber erfolgte zur Therapie des Liquorlecks. Im zweiten Schritt erfolgte die intradurale mikrochirurgische Entfernung des perimedullären Palacosmaterials sowie eine dorsale Osteosynthese nach Goel-Harms. Es folgte dann ein langer intensivmedizinischer Verlauf und letztlich die stationäre Anschlussheilbehandlung.
Minimalinvasive Chirurgie an der Halswirbelsäule: Evidenz, Tipps und Tricks
Authors: Kothe Ralph , Schmeiser Gregor , Papavero Luca 
Published: August 2023

ZusammenfassungAnalog zur Chirurgie an der Brust- und Lendenwirbelsäule, ist es auch an der
Halswirbelsäule das Bestreben der minimalinvasiven-Techniken (MIS), hinsichtlich der „target
surgery“ vergleichbare Ergebnisse zu den konventionellen Verfahren zu erzielen. Gleichzeitig
aber die Vorteile einer weniger traumatisierenden „access surgery“ zu bieten. Im Unterschied
zur BWS und LWS, kommen MIS-Techniken an der HWS überwiegend dorsal zum Einsatz. Dies
reduziert nicht ihre Bedeutung, da die zervikale Muskulatur sowohl biomechanisch – Halten des
Kopfgewichtes – als auch neurophysiologisch – Halten des Sehhorizonts – sehr anspruchsvolle
Funktionen erfüllt. Die Notwendigkeit die zugangsbedingte Muskeltraumatisierung operativ zu
minimieren ist selbsterklärend.Im Folgenden werden bekannte operative Verfahren in einer „aktualisierten“ Version vorgestellt: Bei der posterioren Foraminotomie führt der transmuskuläre Zugang zu einer Reduktion der Zugangsmorbidität. Die Laminoplastie ist im asiatischen Raum ein etabliertes Verfahren zur Dekompression der multisegmentalen zervikalen Stenose. Die hier vorgestellte unilaterale Variante ist weniger verbreitet, entbehrt aber nicht einer klinischen Begründung. Die Ergänzung mit einer unilateralen Instrumentation erweitert das Indikationsspektrum und wird auch von Kollegen in Fernost beginnend angewendet. Die C1/C2 Instrumentation gewinnt durch die Navigation an „Standardisierung“ und somit an Sicherheit. Die subaxiale Navigation begleitet den Wandel von dem offenen zum perkutanen Einbringen von Pedikelschrauben.Die erwähnten operativen Verfahren unterscheiden sich hinsichtlich Indikation, technischer
Durchführung und Akzeptanz. Eines ist ihnen gemeinsam: Die größtmögliche operative Sicherheit
mit dem Erhalt die Physiologie der Nackenmuskulatur zu vereinbaren.
Prevention of Fetal Anemia with Plasma Exchange and Intravenous Immunoglobulin in a Pregnancy with a Complex Anti-K and Anti-C Alloimmunization
Authors: Galoppi Paola , Rocca Ursula La , Giovannetti Gianluca , Perrone Giuseppina , Gozzer Maria , Bafti Mahnaz Shafii , Biondino Giovanna , Equitani Francesco , Neri Alessia , Savastano Giovanna , Pompeo Damiana , Lobozzo Benedetta , Santilio Isabella , Falco Federica , Paoli Adele Delli , Brunelli Roberto , Coluzzi Serelina 
Published: August 2023

AbstractHemolytic disease of the fetus and newborn (HDFN) remains the main cause of fetal anemia primarily due to RH-D maternal incompatibility but also to other rarer antigens. Anti-Kell mediated immunization is a rare disease involving about 0.1% of pregnant women causing a more severe HDFN compared to RH-D both for its anemia mechanism and because of lack of preventive immunoglobulin therapy. Although the standard treatment of fetal anemia is intrauterine transfusion (IUT), at early gestational age with high antibody titer and absence of ultrasound anemia signs, noninvasive strategies can be offered. We present a case of severe anti-Kell and anti-C Rh positive immunized pregnancy with high Kell titer at 14 weeks of gestation that successfully treated with plasma exchange and intravenous immunoglobulin to prevent the onset of fetal anemia and to avoid the need for IUT.
Pulsed Wave Doppler of Cardiac Valves
Authors: Senthilvel Karthik 
Published: August 2023

AbstractDespite newer techniques like tissue Doppler and speckle tracking, the need for a spectral Doppler still exists. It can give parameters that are not possible by newer techniques like peak systolic velocity and the ratio of time and velocity. In this article, we discuss the technique for doing pulsed wave Doppler for fetal cardiac valves.
Serum levels of interleukin-6 and tumor necrosis factor-alpha in diagnosis and prognosis of gallbladder cancer: a pilot study
Authors: Sharma Poonam , Sarath Krishnan M. P. , Gupta Amit , Gupta Sweety , Saxena Rahul , Mirza Anissa Atif , Goyal Bela 
Published: August 2023

Objectives:
Interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) are proin- flammatory cytokines that play a major role in tumorigenesis. These biomarkers are relatively unexplored in gallbladder cancer (GBC) for their diagnostic and prognostic utility.

Materials and Methods:
A total of 40 healthy controls and 40 GBC patients were recruited. Serum IL-6 and TNF-α levels were measured, and their diagnostic utility was analyzed using the receiver operating characteristics (ROC) curve. The relationship between clinicopathological variables and serum tumor markers (CEA, CA125, and CA19-9) in identifying GBC patients was also assessed.

Statistical Analysis:
Statistical analysis was performed using IBM SPSS version 25.0 (IBM Corporation, Armonk, New York, United States).

Results:
Serum IL-6 and TNF-α expression were significantly higher in the GBC group (for both IL-6 and TNF-α, p = 0.0001) than in healthy controls. ROC analysis revealed that the areas under the curve for serum IL-6 and TNF-α were 0.89 and 0.71, respectively. The sensitivity and specificity for serum IL-6 were 82.5 and 97.5%, respectively, at an optimal cutoff value of 10.34 pg/mL; for TNF-α, they were 40.0 and 100%, respectively, at a cutoff value of 0.24 pg/mL. There was also a significant difference in serum IL-6 levels between the resectable and nonresectable GBC groups. Serum IL-6 showed a positive correlation with CA125 (r = 0.34, p < 0.05), while no correlation was observed between serum TNF-α and serum tumor markers (CEA, CA125, and CA19-9).

Conclusion:
Serum IL-6 may serve as a diagnostic marker and a predictor of resect- ability, and it can be used in conjunction with other serum tumor markers in GBC.