bluuebunny/crossref_metadata_2025 huggingface dataset:
A simple Bayesian approach to tree‐ring dating
Authors: Hassan M. M. , Jones E. , Buck C. E.
Published: March 2019

Tree‐ring dating involves matching sequences of ring widths from undated timbers to dated sequences known as ‘master’ chronologies. Conventionally, the undated timbers (from a building or woodland) are sequentially matched against one another, using t‐tests to identify the relative offsets with the ‘best’ match, thus producing a ’site’ chronology. A date estimate is obtained when this is matched to a local master chronology of known calendar age. Many tree‐ring sequences in the UK produce rather low t‐values and are thus declared not to have a ‘best’ match to a master chronology. Motivated by this and the routine use of Bayesian statistical methods to provide a probabilistic approach to radiocarbon dating, this paper investigates the practicality of Bayesian dendrochronology. We explore a previously published model for the relationship between ring widths and the underlying climatic signal, implementing it within the Bayesian framework via a simulation‐based approach. Probabilities for a match at each offset are produced, removing the need to identify a single ‘best’ match. The Bayesian model proves successful at matching in both simulated and real examples.
Progression and individual differences in children's series completion after dynamic testing
Authors: Touw Kirsten W. J. , Vogelaar Bart , Thissen Floor , Rovers Sanne , Resing Wilma C. M.
Published: March 2019

Background

The need to focus more on children's abilities to change requires new assessment technologies in education. Process‐oriented assessment can be useful in this regard. Dynamic testing has the potential to provide in‐depth information about children's learning processes and cognitive abilities.

Aim

This study implemented a process‐oriented dynamic testing procedure to obtain information regarding children's changes in series‐completion skills in a computerised test setting. We studied whether children who received a graduated prompts training would show more progression in series‐completion than children who received no training, and whether trained children would use more advanced explanations of their solutions than their untrained peers.

Sample

Participants were 164 second‐grade children with a mean age of 7;11 years. Children were split into an unguided practice or a dynamic testing condition.

Methods

The study employed a pre‐test‐training‐post‐test design. Half of the children were trained in series‐completion, and the other half did not receive any feedback on their problem solving. Using item response theory analysis, we inspected the progression paths of the children in the two conditions.

Results and conclusions

Children who received training showed more progression in their series‐completion skills than the children who received no training. In addition, the trained children explained their solutions in a more advanced manner, when compared with the non‐trained control group. This information is valuable for educational practice as it provides a better understanding of how learning occurs and which factors contribute to cognitive changes.
School‐age outcomes of late‐talking toddlers: Long‐term effects of an early lexical deficit
Authors: Grossheinrich Nicola , Schulte‐Körne Gerd , Marschik Peter B , Kademann Stefanie , von Suchodoletz Waldemar , Sachse Steffi
Published: March 2019

Background

Early intervention for children identified as late talkers (LTs) at the age of 24 months is still a controversial issue in research and clinical routine. Previous studies have shown inconsistent results regarding predictors of early lexical deficits on school‐age outcomes of late‐talking toddlers.

Methods

In a five‐wave follow‐up study, we investigated various aspects of language and literacy abilities in 39 German‐speaking third‐graders who had been identified as LTs at the age of 24 months, compared to 39 typically developing children (TDC) also attending the third grade. The duration of auditory sensory memory was examined at the age of 4 years using mismatch negativity (MMN) of tones – an event‐related potential not confounded by any language skill. In addition, the predictive value of memory performance was examined in a longitudinal perspective.

Results

Overall, LTs scored within normal range in language and literacy assessments. However, LTs differed from TDC in vocabulary size, verbalization of semantic relations, non‐word repetition, and spelling. The findings can be explained by phonological working memory. The duration of auditory sensory memory and spatial working memory did not account for any variance.

Conclusions

LTs sustain persistent phonological processing limitations even though their native language and literacy performance lay within the normal range at school age. Further research on second language acquisition, academic achievements, and the efficacy of early intervention in late‐talking toddlers is recommended.
Efficacy and safety of insulin degludec/insulin aspart versus biphasic insulin aspart 30 in Chinese adults with type 2 diabetes: A phase III, open‐label, 2:1 randomized, treat‐to‐target trial
Authors: Yang Wenying , Ma Jianhua , Hong Tianpei , Liu Ming , Miao Heng , Peng Yongde , Wang Changjiang , Xu Xiangjin , Yang Tao , Nielsen Anne M. , Pan Lili , Liu Weihong , Zhao Weigang
Published: March 2019

Aims

To assess the efficacy and safety of twice‐daily insulin degludec/insulin aspart (IDegAsp) versus biphasic insulin aspart 30 (BIAsp 30) twice daily, both ± metformin, in Chinese adults (N = 543) with type 2 diabetes (T2D) inadequately controlled on premixed/self‐mixed or basal insulin ± metformin.

Materials and methods

We conducted a 26‐week, phase III, open‐label, treat‐to‐target, 2:1 randomized trial. Hierarchical testing was used with non‐inferiority of glycated haemoglobin (HbA1c) change from baseline to week 26 as the primary endpoint and superiority for the confirmatory secondary endpoints which were as follows: change from baseline in fasting plasma glucose (FPG); nocturnal confirmed hypoglycaemic episodes (12:01–5:59 am, inclusive); total confirmed hypoglycaemic episodes (severe or plasma glucose <3.1 mmol/L with/without symptoms); body weight; and percentage of responders (HbA1c <53 mmol/mol [<7.0%]) without confirmed hypoglycaemic episodes.

Results

Non‐inferiority for change from baseline to week 26 in HbA1c and superiority of IDegAsp twice daily versus BIAsp 30 twice daily for change in FPG, nocturnal confirmed and total confirmed hypoglycaemic episodes, was demonstrated. Estimated rates of nocturnal confirmed and total confirmed hypoglycaemic episodes were 47% and 43% lower, respectively, with IDegAsp twice daily versus BIAsp 30 twice daily. Superiority for change in body weight was not confirmed. Participants were more likely to reach the HbA1c goal of <53 mmol/mol (<7.0%) without confirmed hypoglycaemia with IDegAsp twice daily versus BIAsp 30 twice daily by trial end. No new safety signals were identified.

Conclusions

The efficacy and safety of IDegAsp in Chinese patients with T2D was demonstrated, confirming results from international trials.
Can orthognathic surgery be expected to improve patients’ psychological well‐being? The challenge of hedonic adaptation
Authors: Ashton‐James Claire E. , Chemke‐Dreyfus Axel
Published: March 2019

In addition to improved oral health and function, many people are motivated to undergo orthognathic surgery to improve their facial aesthetics and overall psychological well‐being (daily affect and satisfaction with life). This article explains the phenomenon of hedonic adaptation, which challenges the notion that patients treated with orthognathic surgery can expect to experience improvements in psychological well‐being following surgery. We review evidence for hedonic adaptation across a variety of life circumstances and explain the psychological processes which account for the relative stability of people's well‐being over their life course despite significant positive (and negative) changes in their circumstances. We examine the conditions that assist and inhibit hedonic adaptation to positive life events, and argue that if patients are made aware of these processes, they are more likely to achieve sustained improvements in psychological well‐being following orthognathic surgery. Based on our narrative review of evidence for hedonic adaptation, we conclude that orthognathic surgery should not be expected to improve patients’ psychological well‐being in the long term and suggest that patients be advised to take intentional steps to preserve any improvements in their day‐to‐day affect and satisfaction with life that arise as a result of their surgery.
Growth and nutrition of cowpea (Vigna unguiculata) under water deficit as influenced by microbial inoculation via seed coating
Authors: Rocha Inês , Ma Ying , Vosátka Miroslav , Freitas Helena , Oliveira Rui S.
Published: March 2019

Drought can drastically reduce cowpea [Vigna unguiculata (L.) Walp.] biomass and grain yield. The application of plant growth‐promoting rhizobacteria and arbuscular mycorrhizal fungi can confer resistance to plants and reduce the effects of environmental stresses, including drought. Seed coating is a technique which allows the application of minor amounts of microbial inocula. Main effects of the factors inoculation and water regime showed that: severe or moderate water deficit had a general negative impact on cowpea plants; total biomass production, seed weight and seed yield were enhanced in plants inoculated with P. putida; inoculation of R. irregularis significantly increased nitrogen (N) and phosphorus (P) shoot concentrations; and R. irregularis enhanced both chlorophyll b and carotenoids contents, particularly under severe water deficit. Plants inoculated with P. putida + R. irregularis had an increase in shoot P concentration of 85% and 57%, under moderate and severe water deficit, respectively. Singly inoculated P. putida improved potassium shoot concentration by 25% under moderate water deficit. Overall, in terms of agricultural productivity the inoculation of P. putida under water deficit might be promising. Seed coating has the potential to be used as a large‐scale delivery system of beneficial microbial inoculants.
Electrocardiographic parameters ofSapajus libidinosus(SPIX, 1823) after chemical immobilization with tiletamine‐zolazepam
Authors: de La Salles Ana Yasha F. , Andrade Jéssica K. , Lemos Khelven K. A. , Carreiro Artur da N. , de Souza Joyce G. , Costa Tiago S. F. , Reinaldo Maria Patrícia O. S. , de Souza Almir P. , de Menezes Danilo José A.
Published: March 2019

Background

Tiletamine‐zolazepam is a widely used as an alternative chemical immobilization method in non‐human primates, with a safe application pathway and necessary relaxation. In order to determine the electrocardiographic parameters ofSapajus libidinosusafter intramuscular tiletamine‐zolazepam administration at the dose of 5 mg/kg, nine animals were submitted to anesthesia.

Methods

The interpretation of the electrocardiogram determined: heart rate in bpm and heart rhythm, P wave, P‐R interval, R wave, QRS complex, T wave, Q‐T interval, corrected QT interval and electrical axis. The mean HR was 206 ± 32 bpm.

Results

The majority of the monkeys showed normal sinus rhythm, but one animal showed sinus tachycardia. The most commonly observed electrical axis was between +30° and +90°. Two animals presented bigger alterations in the tracing such as low amplitude QRS and T wave bigger than 1/4 of the R wave.

Conclusions

The administration of tiletamine‐zolazepam was safe and efficacious, with minimal cardiovascular effects.
Tibial tuberosity advancement technique in small breed dogs: study of 30 consecutive dogs (35 stifles)
Authors: Ferreira A. J. A. , Bom R. M. , Tavares S. O.
Published: March 2019

Objectives

To assess the outcome and peri‐operative complications of the tibial tuberosity advancement technique in small dogs with cranial cruciate ligament rupture.

Materials and Methods

Cranial cruciate ligament rupture was diagnosed by positive drawer sign or tibial thrust test and confirmed at surgery in 30 dogs (35 stifles) weighing less than 15 kg. Clinical and radiographic follow‐up was obtained at 4 and 12 weeks or later. Thigh diameter and affected and non‐affected stifle joint flexion and extension angles were also measured.

Results

At 4‐week follow‐up 26 of 35 (74%), eight of 35 (23%) and one of 35 (3%) showed no, mild and moderate lameness, respectively. Similarly, at 12 weeks or later the respective outcomes were 32 of 35 (91%), two of 35 (6%) and one of 35 (3%). The mean thigh diameter of affected limbs at 12 or more weeks was 96% of the mean of normal limbs and stifle range of motion reached 98% of normal extension and 97% of normal flexion. There were complications in two of 35 stifles: one screw partially inserted into the joint and postoperative wound dehiscence, both of which required surgical correction.

Clinical Significance

The tibial tuberosity advancement technique leads to acceptable outcomes in small dogs with cranial cruciate ligament rupture.
Multiple curve Lévy forward price model allowing for negative interest rates
Authors: Eberlein Ernst , Gerhart Christoph , Grbac Zorana
Published: March 2019

In this paper, we develop a framework for discretely compounding interest rates that is based on the forward price process approach. This approach has a number of advantages, in particular in the current market environment. Compared to the classical as well as the Lévy Libor market model, it allows in a natural way for negative interest rates and has superb calibration properties even in the presence of extremely low rates. Moreover, the measure changes along the tenor structure are significantly simplified. These properties make it an excellent base for a postcrisis multiple curve setup. Two variants for multiple curve constructions based on the multiplicative spreads are discussed. Time‐inhomogeneous Lévy processes are used as driving processes. An explicit formula for the valuation of caps is derived using Fourier transform techniques. Relying on the valuation formula, we calibrate the two model variants to market data.
When East Meets West: International Change and Its Effects on Domestic Cultural Institutions
Authors: Maags Christina , Trifu Ioan
Published: March 2019

Domestic governments increasingly face the pressure to follow policy developments occurring at the international or supranational level. Yet international laws and policies need to be “translated” to suit domestic political institutions and newly adopted policies may challenge or contradict preexisting domestic policies, institutions, and interests. To explore the domestic impact of international institutional developments, we studied the United Nations Educational, Scientific, and Cultural Organization (UNESCO) Convention for the Safeguarding of Intangible Cultural Heritage and its adoption in four countries (Japan, China, France, and Germany). Using historical institutionalism, this comparative case study sheds light on the effects of the Convention on cultural governance systems in two supposedly different “camps” within the UNESCO: the East and the West. The study argues that it is the interaction and entangled relationship of exogenous and endogenous factors over time, particularly the timing and sequence in which they constrain and facilitate change, which shape actors’ preferences and institutional development at both levels.

Related Articles

Blanton, Robert G. 2000. “A Multidimensional Assessment of Interdependence.”Politics & Policy28 (4): 759‐774.https://doi.org/10.1111/j.1747-1346.2000.tb00799.x

Hankivsky, Olena. 2013. “Gender Mainstreaming: A Five‐Country Examination.”Politics & Policy41 (5): 621‐655.https://doi.org/10.1111/polp.12037

Peralta, J. Salvador. 2013. “Do Culture and Institutions Matter? Explaining the Sources of Cross‐National Regime Support?”Politics & Policy41 (4): 479‐508.https://doi.org/10.1111/polp.12024

Related Media

UNESCO. 2003. “Text of the Convention for the Safeguarding of the Intangible Cultural Heritage.”http://www.unesco.org/culture/ich/en/convention

United Nations. 2014. “Global Governance and Global Rules for Development in the Post‐2015 Era.”http://www.un.org/en/development/desa/policy/cdp/cdp_publications/2014cdppolicynote.pdf
Detection of an HLA‐B*15 variant, HLA‐B*15:141, in a Taiwanese individual
Authors: Yang Kuo‐Liang , Lin Py‐Yu
Published: March 2019

Nucleotide replacements at codons 131 and 135 of HLA‐B*15:35 results in a new allele, HLA‐B*15:141.
Use of cyanoacrylate adhesive in the surgical management of feline corneal sequestrum: 16 cases (2011‐2018)
Authors: Pumphrey Stephanie A. , Desai Sujata J. , Pizzirani Stefano
Published: March 2019

Objective

To evaluate the use of cyanoacrylate adhesive as an adjunct to lamellar keratectomy in cats with corneal sequestrum.

Methods

Medical records were reviewed to identify cats with naturally occurring midstromal corneal sequestra treated with lamellar keratectomy and cyanoacrylate adhesive. All cats also had a bandage contact lens placed for postoperative comfort. Data collected included breed, age, sex, and reproductive status of the cat, eye involved, presence or absence of neovascularization at the time of surgery, history of prior sequestra, additional ocular procedures performed, use of neuromuscular blocking agents, procedure time, time to cessation of topical medications, time to recurrence or last follow‐up, and complications aside from recurrence.

Results

Sixteen cats met study criteria, with a median follow‐up time of 17.5 months in those without recurrence. Median time to cessation of topical medications was 4 weeks. Fourteen cats (87%) have not experienced recurrence. Other than recurrence in two cats, no significant complications were noted. Aside from purebred status, no commonalities were found between the two cats with recurrence. Neuromuscular blocking agents were not used during surgery in most cases. Median procedure time was 10 minutes.

Conclusions

Cyanoacrylate adhesive is an effective and safe alternative to grafting procedures in cats undergoing lamellar keratectomy for treatment of corneal sequestrum. Recurrence rates are comparable to those seen with grafting techniques. Benefits of this approach include decreased anesthesia time, lower procedure costs, and short duration of postoperative treatment.
Comparison of generic and disease‐specific measures in their ability to detect differences in pressure ulcer clinical groups
Authors: Rutherford Claudia , Campbell Rachel , Brown Julia M. , Smith Isabelle , Costa Daniel S. J. , McGinnis Elizabeth , Wilson Lyn , Gilberts Rachael , Brown Sarah , Coleman Susanne , Collier Howard , Nixon Jane E.
Published: March 2019

Patient‐reported outcomes can be included as end points in pressure ulcer (PU) intervention trials to provide information to inform decision‐making and improve the lives of patients. However, the challenge for researchers and clinicians is identifying and choosing an appropriate instrument for each particular application that suits their research questions and clinical context. To provide researchers and clinicians with the information needed to inform choice of patient‐reported outcome measures, we compared a generic and disease‐specific measures’ ability to discriminate between clinical groups known to differ, and determined their responsiveness to change. We performed analyses on a subset of patients recruited to the PRESSURE 2 trial that completed the pressure ulcer quality of life instrument—prevention version (PU‐QOL‐P) and Short Form 12 Questionnaire (SF12) measures at baseline and 30‐day posttreatment. Known‐group validity and responsiveness‐to‐change analyses were conducted. The analysis sample consisted of 617 patients that completed both measures at baseline. Known‐group validity revealed that some PU‐QOL‐P symptoms and function scales differentiated between people with category 2 PUs and those without PUs. A less meaningful pattern of results was observed for the SF12 scales, suggesting that the PU‐QOL‐P is more sensitive to differences between PU and non‐PU populations. Responsiveness analysis revealed that the PU‐QOL‐P was more responsive in detecting disease severity than the SF12. The PU‐QOL‐P provides a standardized method for assessing PU‐specific symptoms and functioning outcomes and is suitable for quantifying the benefits of PU interventions from the patient's perspective. Generic measures are useful for group comparisons of global quality of life domains. Choice of measure for each particular application should be determined by the purpose of the measurement and the information required.
Investigation of Agrresion Levels of the University Ice Hockey Players According to Different Variables
Authors: Gülbahçe Öner , Gülbahçe Arzu
Published: March 2019

This study was conducted in order to investigate aggression levels of the university ice hockey players in the academic year of 2017-2018 according to different variables. The universe of the research consisted of university students and the sample of the research consisted of 91 students, 49 of whom were male and 42 were female, who participated to UNİLİG Ice Hockey Championship organized in Erzurum, Turkey on 22 February to 2 March 2018. The Buss-Perry aggression scale, which was adapted to Turkish by Madran (2013), was used to determine aggression levels of the students’. In the analysis of the data, frequency distribution was used to determine the demographic characteristics, the Independent Samples T test was used to examine the differentiation status between two independent variables and aggression, and the One Way Anova analysis tests were conducted to examine the differentiation status between more than two variables and aggression. All these tests were analyzed in SPSS 21 package program and the significance was evaluated at p<0,05 level. It was found that there was a significant difference between the students’ sub-dimensions of aggression and gender, age, weekly training time, and purpose of playing ice hockey.In sub-dimensions of anger, physical and verbal aggression, it was found that the total score of the male students were higher than the female students. In the sub-dimension of verbal aggression, the total scores of the students younger than 20 years old were lower than the students in 21-24 years old and the students more than 25 years old. In the sub-dimension of verbal aggression, the total scores of students doing 3-5 hours weekly training were lower than the students doing training more than 6 hours a week. In the sub-dimension of physical aggression, the total scores of the students doing sports with purpose of financial benefit were higher than the students doing sports with purpose of social activity and being healthy.In ice hockey, which is a sport where the aggression employs a lot of role and has a direct impact on success, players are advised to take various trainings such as anger control to prevent their aggressive behaviors.
Primary School Teachers’ Opinions on Professional Development (Professional Development Model Proposal)
Authors: Ekinci Eyüp , Acar Filiz Evran
Published: March 2019

The purpose of this study is to provide a model for effective professional development by taking the opinions of the primary school teachers on professional development. Grounded theories and techniques which are qualitative research methods have used in the research. Twenty primary school teachers from a district, Küçükçekmece, Istanbul participated in the study, and the data were collected through interview. To reach the model, firstly, the opinions of the participants about the concept of professional development, the processes of providing professional development and the characteristics of effective professional development were taken. The opinions about the idea of professional development are in three sub-categories: change, experience, and burnout; views on the processes of ensuring professional development are in four sub-categories: physical conditions, technology, academic resource, and training process and opinions on the characteristics of effective professional development are being convenience to the needs, right of choice, appropriate content selection, development strategy, active learning environment, and cooperation. In the light of these results, effective professional development model categories are feeling a need, goal setting, planning, development process, and evaluation respectively and these categories constitute a cycle in itself. It was concluded that there should be support and monitoring activities to ensure coordination between the main categories and teacher(s).
Prevention and management of primary postpartum hemorrhage among puerperae in a teaching hospital in São Paulo, Brazil: a best practice implementation project
Authors: Ogawa Luciana , Shimoda Gilcéria Tochika , Wei Chang Yi , Püschel Vilanice Alves de Araújo
Published: March 2019

Objectives:

The aim of this project was to develop and implement strategies to promote standardization and formal documentation of increased bleeding within the first 24 h after birth, in compliance with best practice.

Introduction:

Official data from Brazil shows a maternal mortality rate of around 52 to 75 deaths per 100,000 live births, 8% of which are caused by hemorrhage. Early diagnosis is promoted through standardization and formal documentation of the first signs of hemorrhage.

Methods:

The current implementation project used the Joanna Briggs Institute Practical Application of Clinical Evidence System, a baseline audit was conducted on a sample size of 108 patients and 67 nursing staff. Based on the results of the baseline audit, strategies to address non-compliance were developed and implemented. A follow-up audit was conducted on a sample size of 110 patients and 68 nursing staff, using the same audit criteria.

Results:

The baseline audit showed poor compliance with evidence-based best practice in every criterion. The implemented protocol for postpartum hemorrhage was well received by the nursing staff, promoting early diagnosis of increased bleeding within 24 h after birth and providing support for further medical treatment. There were significant improvements in every best practice criterion in the follow-up audit.

Conclusion:

The current implementation project managed to improve the nursing staff professional practice, reducing the absence of records while promoting greater awareness of the first signs of primary postpartum hemorrhage.
A Data-Driven, Statistical Feature-Based, Neural Network Method for Rotary Seal Prognostics
Authors: Ramachandran Madhumitha , Siddique Zahed
Published: March 2019

Failure of the rotary seal is one of the foremost causes of breakdown in rotary machinery, and such a failure can be catastrophic, resulting in costly downtime and large expenses. Assessing the performance degradation of the rotary seal is very important for maintenance decision-making. Although significant progress has been made over the last 5 years to understand the degradation of seals using experimental verification and numerical simulation, there is a research gap on the data-driven-based tools and methods to assess the health condition of rotary seals. In this paper, we propose a data-driven-based performance degradation assessment approach to classify the running/health condition of rotary seals, which was not considered in the previous studies. Statistical time domain features are extracted from friction torque-based degradation signals collected from a rotary setup. Wrapper-based feature selection approach is used to select relevant features, with multilayer perceptron neural network utilized as a classification technique. To validate the proposed methodology, an accelerated aging and testing procedure is developed to capture the performance of rotary seals. The study findings indicate that multilayer perceptron (MLP) classifier built using features related to the amplitude of torque signal has a better classification accuracy for unseen data when compared with logistic regression and random forest classifiers.
Contrast-enhanced carotid ultrasonography and MRI plaque imaging to identify patients developing in-stent intimal hyperplasia after carotid artery stenting
Authors: Hagiwara Yuta , Takao Naoki , Takada Tatsuro , Shimizu Takahiro , Yoshie Tomohide , Fukano Takayuki , Tokuyama Yoshiaki , Usuki Noriko , Ueda Toshihiro , Hasegawa Yasuhiro
Published: March 2019

Aim: In-stent intimal hyperplasia (ISH) observed after carotid artery stenting (CAS) may lead to in-stent restenosis. We aimed to investigate whether contrast-enhanced carotid ultrasonography (CEUS) and magnetic resonance imaging (MRI) plaque imaging prior to CAS are predictive for ISH at 6 months after CAS.Material and method: A total of 14 patients (13 men, 1 woman; mean age, 74.2 years) were prospectively enrolled. CEUS and MRI plaque imaging were performed before CAS. ISH was diagnosed by carotid angiography at 6 months after CAS. Patients were divided into two groups based on the thicknessof ISH and age, risk factors, enhancement in CEUS, MRI plaque imaging and number of replaced stents were compared between groups.Results: Carotid angiography at 6 months after CAS revealed ISH in 10 patients. Plaque enhancement on CEUS was observed in 6 patients, all of whom showed ISH. A significant association was seen between plaque enhancement on CEUS and development of ISH (χ2 test, CEUS enhancement (+) 100% vs. CEUS enhancement (-) 50% p=0.040). Carotid plaques in 12 patients were diagnosed as unstable by MRI plaque imaging. Presence of ISH was significantly associated with unstable plaque diagnosed by MRI plaque imaging (χ2 test, unstable 83% vs. stable 0%; p=0.016).Conclusion: Carotid plaque MRI and CEUS may be useful to predict ISH after CAS.
Data sharing for pediatric cancers
Authors: Vaske Olena Morozova , Haussler David
Published: March 2019

Last month, in a conference call held by the U.S. Department of Health and Human Services and National Institutes of Health (NIH), it was revealed that a large focus of President Trump's pledge to fund childhood cancer research will be genomic data sharing. Although the United States has only 5% of the world's pediatric cancer cases, it has disproportionately more resources and access to genomic information compared to low-income countries. We hope that the spotlight on genomic data sharing in the United States will galvanize the world's pediatric cancer community to elevate genomic data sharing to a level where its full potential can finally be realized.
Primary central nervous system plasmablastic lymphoma in an HIV-positive patient
Authors: Rhoades Ruben , Gong Jerald , Palmisiano Neil , Alpdogan Onder
Published: March 2019

Plasmablastic lymphoma (PBL) is a rare subtype of diffuse large B-cell lymphoma, highly associated with HIV and Epstein-Barr virus (EBV) infections. It commonly presents in extranodal sites, often an oral mass, but reports of primary central nervous system PBL (PCNSPBL) are exceedingly rare. Here, we report on a 33-year-old man with newly diagnosed HIV infection who presented with acute-onset unilateral visual disturbance and was found to have biopsy-proven PCNSPBL. The neoplastic cells displayed a plasmacytoid appearance, with the expression of CD38 and CD138, and were positive for EBV by in situ hybridisation for EBV-encoded RNA. Systemic workup revealed the presence of Kaposi sarcoma, but no evidence of lymphoma. He is currently being treated with high-dose methotrexate, as well as antiretroviral therapy for his HIV infection, and has achieved a complete response.
Anti-Amphiphysin-associated limbic encephalitis in a 72-year-old patient with aortic angiosarcoma
Authors: Wagner-Altendorf Tobias A , Wandinger Klaus-Peter , Frydrychowicz Alex , Merseburger Axel S , Münte Thomas F
Published: March 2019

Paraneoplastic autoimmune encephalopathic syndromes have been described most often in association with small cell lung cancer or breast cancer, tumours of the ovaries, testes, lymphoma and thymoma. Antibodies associated with paraneoplastic encephalopathies are, among others, anti-Hu, anti-Ma2 and, in part, anti-N-methyl-D-aspartate(NMDA)-receptor antibodies. Here, we present the case of a 72-year-old patient hospitalised due to progressive cognitive decline and disorientation. Diagnostic workup revealed paraneoplastic anti-amphiphysin associated limbic encephalitis on the basis of an aortic angiosarcoma with metastases to kidney, muscle and bones. Highly aggressive chemotherapy as well as immunosuppressive therapy and cytoreductive laparoscopic nephrectomy were initiated. However, follow-up revealed further tumour progress and a worsening of neurological symptoms.
Plasmapheresis and corticosteroids in infective endocarditis-related crescentic glomerulonephritis
Authors: Malhotra Kunal , Yerram Preethi
Published: March 2019

Infective endocarditis (IE)-related glomerulonephritis (GN) typically resolves with the treatment of IE. A 59-year-old woman with a baseline creatinine of 0.7 mg/dL presented with rash on her legs, night sweats and weight loss for 3 weeks. Further evaluation revealed IE. Her blood cultures grew gamma-haemolytic streptococcus, which subsequently cleared on appropriate antibiotic therapy. Her creatinine, however, progressively worsened requiring haemodialysis. Kidney biopsy showed immune complex-mediated necrotising and crescentic GN. She was started on plasmapheresis (PE) and high-dose steroids with rapid taper, with subsequent improvement in her creatinine to 0.8 mg/dL. She subsequently had aortic valve replacement and ventricular septal defect closure. She did not improve as expected with antibiotic therapy but turned around dramatically with steroids and PE. Our case supports the possible beneficial role of PE and steroids in IE-related crescentic GN that worsens despite appropriate antibiotic therapy, although the risks of immunosuppression and aggravating endocarditis need to be considered.
Acute myeloid leukaemia: an unusual cause of biliary strictures
Authors: Beck Adele , Hunter Hannah , Jackson Simon , Sheridan David
Published: March 2019

A 17-year-old man with no significant past medical history presented with a 2-week history of worsening jaundice, lethargy, anorexia and progressive right upper quadrant abdominal pain. There were no stigmata of chronic liver disease. Initial investigations were suggestive of cholangitis with large intrahepatic and extrahepatic bile duct strictures but otherwise normal hepatic and splenic appearances. A percutaneous transhepatic cholangiogram with the positioning of drains was performed to alleviate the obstructive jaundice. Within 2 weeks of the first presentation, full blood count revealed a significantly raised white blood count and a subsequent peripheral blood smear and bone marrow were consistent with a diagnosis of acute myeloid leukaemia. Chemotherapy was started after partial improvement of his obstructive jaundice. Complete morphological and cytogenetic remission was obtained 4 weeks after the first cycle of chemotherapy (half dose of daunorubicin and full dose of cytarabine, treated off trial) on control bone marrow. The patient remains in remission.
Compartment syndrome as a late presentation of brachial artery pseudoaneurysm following shaft of humerus fracture
Authors: Das Sudhanshu Sekhar , Behera Sudarsan , Das Gurudip , Patro Bishnu Prasad
Published: March 2019

Peripheral artery pseudoaneurysm is rare in upper extremities compared with lower extremities. Early diagnosis and prompt management are two cornerstones of successful outcomes in these cases. Delay can lead to limb and life-threatening complications. We present a case of compartment syndrome of upper limb as a sequel to pseudoaneurysm of brachial artery for which we had to do shoulder disarticulation. The patient recovered uneventfully.
Asymptomatic bacteriuria in pregnancy: systematic reviews of screening and treatment effectiveness and patient preferences
Authors: Wingert Aireen , Pillay Jennifer , Sebastianski Meghan , Gates Michelle , Featherstone Robin , Shave Kassi , Vandermeer Ben , Hartling Lisa
Published: March 2019

Objective

To systematically review screening and treatment effectiveness, and patient preferences, to inform recommendations by the Canadian Task Force on Preventive Health Care on screening for asymptomatic bacteriuria in pregnancy.

Design

We searched multiple databases (inception to September 2017) and grey literature sources for studies on screening effectiveness and patient preferences. For treatment with antibiotics, we searched three databases for systematic reviews and obtained search results of the Cochrane Pregnancy and Childbirth Group’s Trials Register to update a Cochrane review. Study selection, risk of bias assessment and evaluation of the quality for each outcome using Grading of Recommendations Assessment, Development and Evaluation was completed independently by two reviewers with consensus. Meta-analysis was conducted when appropriate as were analyses based on planned subgroup variables.

Outcomes

For screening and treatment effectiveness: maternal and perinatal mortality, maternal and neonatal sepsis, pyelonephritis, spontaneous abortion, preterm delivery, low birth weight and serious adverse events. Valuation of outcomes for patient preferences.

Results

Four studies compared outcomes before and after the introduction of a screening programme or between different screening programmes. All evidence on screening effectiveness was considered very low quality. Women have conflicting opinions about antibiotic use during pregnancy. Fifteen trials compared antibiotic treatment with no treatment or placebo in women with confirmed bacteriuria. Low-quality evidence found that treatment lowered rates of pyelonephritis (12 trials, relative risk [RR] 0.24; 95% CI 0.13 to 0.42; absolute risk reduction [ARR] 17.6%; number needed to treat [NNT] 6, 95% CI 5 to 7) and low birth weight (seven trials, RR 0.63; 95% CI 0.45 to 0.90; ARR 4.4%; NNT 23, 95% CI 15 to 85).

Conclusions

Antibiotic treatment for women having significant bacteriuria likely reduces the incidence of pyelonephritis and low birth weight, but we are uncertain about the magnitude of the effect and about the extent to which we can apply these results to asymptomatic populations and screening programmes.

PROSPERO registration number

CRD42016045263.
Factors determining intention to leave among physicians in tertiary hospitals in China: a national cross-sectional study
Authors: Zhang Chunyu , Hu Linlin , Ma Jing , Wu Shichao , Guo Jing , Liu Yuanli
Published: March 2019

Objective

The reasons that physicians leave the institutions have not been extensively studied. We aimed to evaluate these reasons, which include the desire to work at another hospital or the intention to make a career change, among physicians in tertiary hospitals in China and explore the associations between the individual-level and organizational-level factors related to these two reasons for leaving.

Methods

We conducted a national survey of 136 tertiary hospitals across all 31 provinces in China between December 2017 and January 2018. A total of 20 785 physicians were selected to self-report on the two evaluated reasons related to physicians’ intent to leave. A univariate analysis and multilevel regression model were applied to evaluate the factors associated with intention to leave.

Result

In all, 10.4% of the participating physicians had thought about working at another hospital, and 20.5% intended to leave to make a career change. At the hospital level, the government subsidy per bed (OR=0.88, 95% CI: 0.86 to 0.98 and OR=0.91, 95% CI: 0.90 to 0.99), personnel funding per capita (OR=0.86, 95% CI: 0.76 to 0.96 and OR=0.80, 95% CI: 0.73 to 0.88) and the number of physicians per bed (OR=0.83, 95% CI: 0.81 to 0.86 and OR=0.89, 95% CI: 0.81 to 0.92) were negatively associated, while the number of hospital-level medical disputes (OR=1.04, 95% CI: 1.03 to 1.05 and OR=1.06, 95% CI: 1.01 to 1.11) was positively associated with both reasons for leaving. At the individual level, income (OR=0.74, 95% CI: 0.71 to 0.79 and OR=0.88, 95% CI:0.83 to 0.92) and job satisfaction (OR=0.18, 95% CI: 0.17 to 0.20 and OR=0.16, 95% CI: 0.15 to 0.18) acted as preventive factors against both reasons for leaving, while work hours per week (OR=1.11, 95% CI: 1.06 to 1.17 and OR=1.23, 95% CI: 1.19 to 1.28) and medical dispute (OR=1.49, 95% CI:1.35 to 1.65 and OR=1.77, 95% CI: 1.64 to 1.91) acted as promotive factors.

Conclusions

Although the intention to leave is not prevalent among physicians in tertiary hospitals in China, providing more organisational support and a better occupational environment may promote retention among physicians.
Tramadol and the risk of seizure: nested case-control study of US patients with employer-sponsored health benefits
Authors: Morrow Richard L , Dormuth Colin R , Paterson Michael , Mamdani Muhammad M , Gomes Tara , Juurlink David N
Published: March 2019

Objectives

Tramadol is a widely prescribed analgesic that influences both opioid and monoamine neurotransmission. While seizures have been reported with its use, the risk in clinical practice has not been well characterised. We examined risk of seizure with tramadol relative to codeine, a comparable opioid analgesic.

Design

Retrospective nested case-control study. For each case, we identified up to 10 controls matched on age, sex, US state of residence and date of cohort entry (±365 days). We calculated ORs to determine the association between seizure and exposure to tramadol, codeine (≥15 mg), both or neither, in the preceding 30 days.

Setting

Cohort of patients, who had continuous health coverage and resided in the same state for≥3 years, identified from linked administrative health data in US MarketScan databases from 2009 to 2012.

Participants

We identified 96 753 patients with seizure and 888 540 matched controls.

Primary and secondary outcome measures

In the primary analysis, we defined cases using a broad definition of seizure (based on either an outpatient physician claim for seizure disorder or a seizure-related emergency department visit or hospitalisation). In a secondary analysis, we used a more specific definition of seizure restricted to a hospital visit with a principal diagnosis of seizure.

Results

In the primary analysis, we found no association between risk of seizure and exposure to tramadol compared with codeine (OR 1.03, 95% CI 0.93 to 1.15). However, in the secondary analysis (using a more specific definition of seizure), this association was statistically significant (OR 1.41, 95% CI 1.11 to 1.79).

Conclusions

Tramadol was not associated with an increased risk of seizure defined by inpatient and outpatient diagnoses. However, this finding was sensitive to the outcome definition used and requires further study.
Cardiovascular risk in 159 934 frequent blood donors while addressing the healthy donor effect
Authors: Peffer Karlijn , den Heijer Martin , de Kort Wim L A M , Verbeek André L M , Atsma Femke
Published: March 2019

Objective

To investigate whether regular blood donation decreases cardiovascular risk.

Methods

All 159 934 Dutch whole-blood donors with an active donation career of at least 10 years were categorised into sex-specific donation tertiles based on the number of donations during this 10-year qualification period. Cardiovascular endpoints were based on hospital discharge diagnoses and death certificates from Dutch Hospital Data and Statistics Netherlands and occurring after the 10-year qualification period. Cox regression was used to estimate the age-adjusted and starting year-adjusted hazard rate ratio (HRR).

Results

Female high-frequency blood donors had a reduced cardiovascular morbidity (HRR=0.91, 95% CI 0.85 to 0.98) compared with low-frequency blood donors. No effect was observed in men (HRR=1.00, 95% CI 0.95 to 1.05). To rule out a residual healthy donor effect (HDE), additional sensitivity analyses using a 5-year qualification period were conducted. The results supported the absence of a residual HDE.

Conclusions

This study showed a protective effect of long-term, high-frequency blood donation against cardiovascular disease. This effect was only observed in women and not in men.
Treatment with hydrogen sulfide donor attenuates bone loss induced by modeled microgravity
Authors: Yang Ming , Zhang Ke , Zhang Xuefang , Zhang Zhen , Yin Xinhua , He Gaole , Li Liang , Yang Xiaobin , He Baorong
Published: March 2019

The present study was undertaken to explore the therapeutic potential of hydrogen sulfide against bone loss induced by modeled microgravity. Hindlimb suspension (HLS) and rotary wall vessel bioreactor were applied to model microgravity in vivo and in vitro, respectively. Treatment of rats with GYY4137 (a water soluble donor of hydrogen sulfide, 25 mg/kg per day, i.p.) attenuated HLS-induced reduction of bone mineral density in tibiae, and preserved bone structure in tibiae and mechanical strength in femurs. In HLS group, GYY4137 treatment significantly increased levels of osteocalcin in sera. Interestingly, treatment of HLS rats with GYY4137 enhanced osteoblast surface, but had no significant effect on osteoclast surface of proximal tibiae. In MC3T3-E1 cells exposed to modeled microgravity, GYY4137 stimulated transcriptional levels of runt-related transcription factor 2 and enhanced osteoblastic differentiation, as evidenced by increased mRNA expression and activity of alkaline phosphatase. HLS in rats led to enhanced levels of interleukin 6 in sera, skeletal muscle, and tibiae, which could be attenuated by GYY4137 treatment. Our study showed that GYY4137 preserved bone structure in rats exposed to HLS and promoted osteoblastic differentiation in MC3T3-E1 cells under modeled microgravity.
Outcome-Oriented Predictive Process Monitoring
Authors: Teinemaa Irene , Dumas Marlon , Rosa Marcello La , Maggi Fabrizio Maria
Published: March 2019

Predictive business process monitoring refers to the act of making predictions about the future state of ongoing cases of a business process, based on their incomplete execution traces and logs of historical (completed) traces. Motivated by the increasingly pervasive availability of fine-grained event data about business process executions, the problem of predictive process monitoring has received substantial attention in the past years. In particular, a considerable number of methods have been put forward to address the problem of outcome-oriented predictive process monitoring, which refers to classifying each ongoing case of a process according to a given set of possible categorical outcomes—e.g., Will the customer complain or not? Will an order be delivered, canceled, or withdrawn? Unfortunately, different authors have used different datasets, experimental settings, evaluation measures, and baselines to assess their proposals, resulting in poor comparability and an unclear picture of the relative merits and applicability of different methods. To address this gap, this article presents a systematic review and taxonomy of outcome-oriented predictive process monitoring methods, and a comparative experimental evaluation of eleven representative methods using a benchmark covering 24 predictive process monitoring tasks based on nine real-life event logs.