bluuebunny/crossref_metadata_2025_split huggingface dataset:
Politicization, Bureaucratic Legalism, and Innovative Attitudes in the Public Sector
Authors: Lapuente Victor , Suzuki Kohei 
Published: March 2020

Abstract
Previous studies have identified institutional, organizational, and individual factors that promote innovation in public organizations. Yet they have overlooked how the type of public administration—and the type of administrators—is associated with innovative attitudes. Using two large, unique comparative data sets on public bureaucracies and public managers, this article examines how bureaucratic politicization and legalistic features are associated with senior public managers’ attitudes toward innovation in 19 European countries. Results of multilevel analysis indicate that the bureaucratic politicization of an administration and the law background of public managers matter. Public managers working in politicized administrations and those whose education includes a law degree exhibit lower pro‐innovation attitudes (i.e., receptiveness to new ideas and creative solutions and change orientation).
A Functional Approach to Small Area Estimation of the Relative Median Poverty Gap
Authors: Fabrizi Enrico , Ferrante Maria Rosaria , Trivisano Carlo 
Published: March 2020

SummaryWe consider the estimation of the relative median poverty gap (RMPG) at the level of Italian provinces by using data from the European Union Survey on Income and Living Conditions. The overall sample size does not allow reliable estimation of income-distribution-related parameters at the provincial level; therefore, small area estimation techniques must be used. The specific challenge in estimating the RMPG is that, as it summarizes the income distribution of the poor, samples for estimating it for small subpopulations are even smaller than those available in other parameters. We propose a Bayesian strategy where various parameters summarizing the distribution of income at the provincial level are modelled by means of a multivariate small area model. To estimate the RMPG, we relate these parameters to a distribution describing income, namely the generalized beta distribution of the second kind. Posterior draws from the multivariate model are then used to generate draws for the distribution's area-specific parameters and then of the RMPG defined as their functional.
The relationship between cam morphology and hip and groin symptoms and signs in young male football players
Authors: van Klij Pim , Ginai Abida Z. , Heijboer Marinus P. , Verhaar Jan A. N. , Waarsing Jan H. , Agricola Rintje 
Published: March 2020

BackgroundConflicting and limited high‐quality prospective data are available on the associations between cam morphology and hip and groin symptoms and range of motion (ROM).ObjectivesThis cross‐sectional cohort study investigated associations between cam morphology presence, size and duration and symptoms and ROM.MethodsAcademy male football players (n = 49, 17‐24 years) were included. Standardized antero‐posterior pelvic and frog‐leg lateral radiographs were obtained at baseline, 2.5‐ and 5‐year follow‐up. The femoral head‐neck junction was quantified by:

Visual score. Cam morphology (flattening or prominence), large cam (prominence).
Alpha angle. Cam morphology (≥60°), large cam (≥78°).
Cam morphology duration was defined as long (first present at baseline) or short (only from 2.5‐ to 5‐year follow‐up). Current symptoms at 5‐year follow‐up were assessed using a hip and groin pain question and by the “Hip and Groin Outcome Score” (HAGOS). HAGOS scores were categorized into: most symptoms (≥2 domains in lowest interquartile range [IQR]), least symptoms (≥2 domains in highest IQR). Hip ROM was measured by goniometry at 5‐year follow‐up.ResultsLarge cam morphology based on visual score was associated with hip and groin pain (23.8% vs. 7.1%, OR: 3.17, CI: [1.15‐8.70], P = .026), but not with HAGOS scores. Cam morphology presence, size, and duration were associated with limited flexion of around 6° and/or 3° to 6° for internal rotation.ConclusionCam morphology presence, size, and duration were associated with limited hip flexion and/or internal rotation, but differences might not exceed the minimal clinical important difference. Whether cam morphology results in symptoms is uncertain.
Child safety in policy: Who is being kept safe and from what?
Authors: Powell Mary Ann , Graham Anne , Canosa Antonia , Anderson Donnah , Moore Tim , Robinson Sally , Thomas Nigel P. , Taylor Nicola 
Published: March 2020

AbstractKeeping children safe from harm is a national policy priority in Australia. Extensive inquiries and reviews have highlighted institutions' persistent failures to respond ethically and appropriately to child abuse and its life‐long impacts on survivors. Policy efforts now reflect considerable emphasis on safeguarding children, including through the development of ‘child safe’ organisations. The realisation of these policy aspirations requires close attention to how ‘child safe’ is conceptualised and operationalised in different organisational contexts. Drawing on an analysis of policy in Australia and other international jurisdictions, namely New Zealand, the United Kingdom and Ireland, this article engages critically with the notion of ‘child safe’ in policy, to explore who is to be safe, from what and how, in organisational settings. The findings suggest emergent discourses of ‘child safe’ are bound up with particular constructions of both children and safety, reflect current social and political understandings and agendas, and have implications for organisations' approaches to safety. Ensuring the safety of children in Australia and other jurisdictions requires continuing scrutiny of policy implementation to make sure current policy efforts are not reduced to compliance‐based imperatives that protect organisations, but fail to create the cultural conditions that enhance children's wellbeing and safety.
Characterization of GYP*Mur and novel GYP*Bun‐like hybrids in Thai blood donors reveals a qualitatively altered s antigen
Authors: Jongruamklang Philaiphon , Grimsley Shane , Thornton Nicole , Robb Janine , Olsson Martin L. , Storry Jill R. 
Published: March 2020

Background and objectivesThe Mi(a+) GP(B‐A‐B) hybrid phenotypes occur with a prevalence of 2%–23% across Southeast Asia. While the s antigen is alleged to be altered, no evidence for specific variants is known. Screening using a monoclonal IgM anti‐s mistyped six S‒s+ RBC units as S‒s‒. Further, alloanti‐s was identified in an S+s+ patient. Our objective was to investigate the s antigen further.Materials and methodsDNA from 63 Thai blood donor samples PCR‐positive for a GYP(B‐A‐B) hybrid was sequenced with primers spanning GYPB exons 3–4. Flow cytometry was used for semiquantitative analysis of s expression and correlated with the glycophorin genotype.ResultsDNA sequencing showed that GYP*Mur was carried by 56/63 samples (88·9%) of which 5/56 lacked normal GYPB: three of these were GYP*Mur homozygotes, one was a compound heterozygote carrying GYP*Mur and a GYP*Bun‐like allele (designated GYP*Thai), and the fifth sample carried GYP*Mur and another GYP*Bun‐like allele. Seven samples (7/63) were GYP*Thai heterozygotes. IgM monoclonal anti‐s (P3BER) did not react with the s antigen carried by GP.Mur or GP.Bun, whereas two IgG anti‐s showed enhanced reactivity.ConclusionsWe confirmed that GYP*Mur is the most frequent variant in Thai blood donors and also identified GYP*Thai with a frequency of 1·1%. We showed that s antigen on Mi(a+) GP(B‐A‐B) hybrids is qualitatively altered and should be considered when selecting reagents for phenotyping where such hybrids are prevalent, endemically and in blood centres worldwide.
Contractile Properties of Vaginal Tissue
Authors: Huntington Alyssa , Donaldson Kandace , De Vita Raffaella 
Published: March 2020

Abstract
The vagina is an important organ of the female reproductive system that has been largely understudied in the field of biomechanics. In recent years, some research has been conducted to evaluate the mechanical properties of the vagina, but much has focused on characterizing the passive mechanical properties. Because vaginal contractions play a central role in sexual function, childbirth, and development and treatment of pelvic floor disorders, the active mechanical properties of the vagina must be also quantified. This review surveys and summarizes published experimental studies on the active properties of the vagina including the differences in such properties determined by anatomic regions and orientations, neural pathways, life events such as pregnancy and menopause, pelvic floor disorders such as prolapse, and surgical mesh treatment. Conflicting experimental findings are presented, illustrating the need for further research on the active properties of the vagina. However, consensus currently exists regarding the negative impact of surgical mesh on vaginal contractility. This review also identifies knowledge gaps and future research opportunities, thus proving a firm foundation for novice and experienced researchers in this emerging area of biomechanics and encouraging more activity on women's sexual and reproductive health research.
Online patient feedback is positive, but not used effectively
Authors: Cook Rob , Davidson Peter , White Alicia 
Published: March 2020

The studyPowell J, Atherton H, Williams V, et al. Using online patient feedback to improve NHS services: the INQUIRE multimethod study. Health Serv Deliv Res 2019;7:38.This project was funded by the NIHR Health Services and Delivery Research programme (project number HS&DR 14/04/48).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000861/online-patient-feedback-is-mostly-positive-but-is-not-being-used-effectively
Conditions, pathogenesis, and progression of diabetic kidney disease and early decliner in Japan
Authors: Yoshida Yui , Kashiwabara Kosuke , Hirakawa Yosuke , Tanaka Tetsuhiro , Noso Shinsuke , Ikegami Hiroshi , Ohsugi Mitsuru , Ueki Kohjiro , Mita Tomoya , Watada Hirotaka , Koya Daisuke , Mise Koki , Wada Jun , Shimizu Miho , Wada Takashi , Ito Yumi , Narita Ichiei , Kashihara Naoki , Nangaku Masaomi , Matsuyama Yutaka 
Published: March 2020

ObjectiveGlomerular filtration rate (GFR) decreases without or prior to the development of albuminuria in many patients with diabetes. Therefore, albuminuria and/or a low GFR in patients with diabetes is referred to as diabetic kidney disease (DKD). A certain proportion of patients with diabetes show a rapid progressive decline in renal function in a unidirectional manner and are termed early decliners. This study aimed to elucidate the prevalence of DKD and early decliners and clarify their risk factors.Research design and methodsThis combination cross-sectional and cohort study included 2385 patients with diabetes from 15 hospitals. We defined DKD as a urinary albumin to creatinine ratio (ACR) ≥30 mg/gCr and/or estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m². We classified patients into four groups based on the presence or absence of albuminuria and a decrease in eGFR to reveal the risk factors for DKD. We also performed a trajectory analysis and specified the prevalence and risk factors of early decliners with sequential eGFR data of 1955 patients in five facilities.ResultsOf our cohort, 52% had DKD. Above all, 12% with a low eGFR but no albuminuria had no traditional risk factors, such as elevated glycated hemoglobin, elevated blood pressure, or diabetic retinopathy in contrast to patients with albuminuria but normal eGFR. Additionally, 14% of our patients were early decliners. Older age, higher basal eGFR, higher ACR, and higher systolic blood pressure were significantly associated with early decliners.ConclusionsThe prevalence of DKD in this cohort was larger than ever reported. By testing eGFR yearly and identifying risk factors in the early phase of diabetes, we can identify patients at high risk of developing end-stage renal disease.
Response evaluation of SGLT2 inhibitor therapy in patients with type 2 diabetes mellitus using18F-FDG PET/MRI
Authors: Rasul Sazan , Geist Barbara Katharina , Brath Helmut , Baltzer Pascal , Sundar Lalith Kumar Shiyam , Pichler Verena , Mitterhauser Markus , Kautzky-Willer Alexandra , Hacker Marcus 
Published: March 2020

IntroductionInhibitors of sodium-glucose linked transporter-2 (SGLT2i) are enhancing glucose excretion in the proximal renal tubules, and thus are increasingly used to lower blood glucose levels in patients with type 2 diabetes mellitus (T2DM). The glucose analog 2-deoxy-2-(18F) fluoro-D-glucose (FDG) can be used to quantify renal function in vivo, and due to an affinity for SGLT2 could also provide information about SGLT2 transporter function. Our objectives in this study were, therefore, to assess the impact of SGLT2i on renal function parameters in patients with T2DM and identify predictive parameters of long-term response to SGLT2i using dynamic FDG positron emission tomography (PET)/MRI.MethodsPET FDG renal function measures such as mean transit time (MTT) and general renal performance (GRP) together with glomerular filtration rate (GFR) were determined in 20 patients with T2DM before (T2DMbaseline) and 2 weeks after initiation of therapy with SGLT2i (T2DMSGLT2i). Additionally, dynamic FDG PET data of 24 healthy subjects were used as controls.ResultsMTT in T2DMbaselinewas significantly higher than in healthy controls (5.7 min vs 4.3 min, p=0.012) and significantly decreased to 4.4 min in T2DMSGLT2i(p=0.004). GRP of T2DMSGLT2iwas higher than of T2DMbaseline(5.2 vs 4.7, p=0.02) and higher but not significantly than of healthy individuals (5.2 vs 5.1, p=0.34). Expectedly, GFR of healthy participants was significantly higher than of T2DMbaselineand T2DMSGLT2i(122 vs 92 and 86 mL/min/1.73 m², respectively; p<0.001). The higher the GRP value in kidneys of T2DMSGLT2i, the lower was the glycated hemoglobin level 3 months after therapy initiation.ConclusionMTT and GRP values of patients with T2DM shifted significantly toward values of healthy control 2 weeks after therapy with SGLT2i begins. GRP in T2DMSGLT2iwas associated with better long-term glycemic response 3 months after initiation of therapy.Trial registration numberNCT03557138.
Determining the psychophysiological responses of military aircrew when exposed to acute disorientation stimuli
Authors: Tornero Aguilera José Francisco , Gil-Cabrera J , Clemente-Suárez V J 
Published: March 2020

IntroductionExposure to enviromental flight conditions may impair performance and physical integrity, thus training in simulated environments it is a key factor. This research aimed to study the psychophysiological response, cortical arousal and autonomic modulation of pilots and medical aircrew personnel during disorientation exposure, considering gender, experience, flying hours and body mass index (BMI) as influencial variables.MethodsA total of 47 soldiers (37 men and 10 women, 22 medical aircrew personnel and 25 fighter pilots) of Spanish Air Forces faced 25 min of vestibular, proprioceptive and visual disorientation.ResultsDisorientation exposure elicited an increased psychophysiological response, significant increases in isometric hand strength, cortical arousal, autonomic modulation, perceived stress and effort in both groups while a significant decrease in respiratory muscle capacity and blood oxygen saturation in the medical aircrew group were found. Cross-sectional analysis showed gender differences, males presented greater parasympathetic activity and strength. Larger BMI was associated with greater levels and perception of stress as well as lower cardiovascular performance and sympathetic modulation. Furthermore, experience, previous training and larger flying hours correlated with greater parasympathetic modulation.ConclusionDisorientation exposure produces an increase in cortical arousal and decrease in the parasympathetic nervous system either in pilots and medical aircrew personnel. In addition, medical aircrew personnel are less adapted to disorientation stimulus presenting significantly higher psychophysiological stress response, thus complementary physical training should be mandatory.
Reporting quality of studies using machine learning models for medical diagnosis: a systematic review
Authors: Yusuf Mohamed , Atal Ignacio , Li Jacques , Smith Philip , Ravaud Philippe , Fergie Martin , Callaghan Michael , Selfe James 
Published: March 2020

AimsWe conducted a systematic review assessing the reporting quality of studies validating models based on machine learning (ML) for clinical diagnosis, with a specific focus on the reporting of information concerning the participants on which the diagnostic task was evaluated on.MethodMedline Core Clinical Journals were searched for studies published between July 2015 and July 2018. Two reviewers independently screened the retrieved articles, a third reviewer resolved any discrepancies. An extraction list was developed from the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis guideline. Two reviewers independently extracted the data from the eligible articles. Third and fourth reviewers checked, verified the extracted data as well as resolved any discrepancies between the reviewers.ResultsThe search results yielded 161 papers, of which 28 conformed to the eligibility criteria. Detail of data source was reported in 24 of the 28 papers. For all of the papers, the set of patients on which the ML-based diagnostic system was evaluated was partitioned from a larger dataset, and the method for deriving such set was always reported. Information on the diagnostic/non-diagnostic classification was reported well (23/28). The least reported items were the use of reporting guideline (0/28), distribution of disease severity (8/28 patient flow diagram (10/28) and distribution of alternative diagnosis (10/28). A large proportion of studies (23/28) had a delay between the conduct of the reference standard and ML tests, while one study did not and four studies were unclear. For 15 studies, it was unclear whether the evaluation group corresponded to the setting in which the ML test will be applied to.ConclusionAll studies in this review failed to use reporting guidelines, and a large proportion of them lacked adequate detail on participants, making it difficult to replicate, assess and interpret study findings.PROSPERO registration numberCRD42018099167.
Cardiac catheter intervention complexity and safety outcomes in adult congenital heart disease
Authors: Brida Margarita , Diller Gerhard Paul , Nashat Heba , Barracano Rosaria , Kempny Aleksander , Uebing Anselm , Rigby Michael L , Gatzoulis Michael A 
Published: March 2020

ObjectiveTo describe the intervention spectrum, complexity, and safety outcomes of catheter-based interventions in a contemporary adult congenital heart disease (ACHD) tertiary cohort.MethodsAll patients over 16 years who underwent a catheter-based intervention for ACHD in our centre between 2000 and 2016 were included. Baseline demographics, clinical characteristics, indications for and complexity of intervention, procedural complications and early and mid-term mortality were analysed.ResultsOverall, 1644 catheter-based interventions were performed. Intervention complexity ranged from simple (67.5%) to intermediate (26.4%) and to high (6.1%). Commonly performed procedures were atrial septal defect (33.4%) and patent foramen ovale closure (26.1%) followed by coarctation of the aorta (11.1%) and pulmonary artery interventions (7.0%). Age at index intervention was 40±16 years, 758 (46.1%) patients were male, 73.2% in New York Heart Association (NYHA) class I, 20.2% in NYHA class II, whereas 6.6% in NYHA class III/IV. In-hospital mortality was 0.7%. Median postinterventional length of stay was 1 day. Complications occurred in 129 (7.9%) with major adverse events in 21 (1.3%). One-year postintervention survival rates were 98.7% (95% CI 98.2 to 99.2). Over the study period, there was a notable shift in intervention complexity, with a predominance of simple procedures performed in early years and more complex procedures in later years. Furthermore, the case mix during the study broadened (p<0.001) with new catheter-based interventions and a more individualised approach to therapy.ConclusionThis study shows an increasing complexity and expanding variability of ACHD catheter-based interventions, associated with low major complications, short hospital stays and low early and mid-term mortality. Ongoing investment in ACHD catheter interventions is warranted.
Determination of minimal recording period to assess resting heart rate variability during pregnancy
Authors: da Silva Danilo Fernandes , Mohammad Shuhiba , Hutchinson Kelly Ann , Adamo Kristi Bree 
Published: March 2020

Traditionally, resting heart rate variability (rHRV) is measured for 10 min using the last 5 min for analyses (e.g., criterion period). It is unknown whether the measurement period can be shortened in pregnant women as there are currently no established standards. We aimed to compare shorter time segments (e.g., from the 1st to 10th minutes) of the parasympathetic index natural logarithm transformation of root mean square of successive R–R differences (Ln rMSSD) with the criterion period in pregnant and nonpregnant women. Twelve pregnant (age: 30.8 ± 3.4 years; gestational age: 20.1 ± 5.0 weeks) and 15 nonpregnant women (age: 29.8 ± 4.0 years) were included. rHRV was measured using a portable heart rate monitor for 10 min while sitting. Ln rMSSD difference/agreement between shorter time segments and criterion period was analyzed. The result observed between the 4th–5th minutes was the shortest time segment not different from/highly agreed with the criterion period in pregnant women (difference [95% confidence interval (CI)]: −0.10 [−0.22 to 0.02]/bias ± 1.96 × SD: −0.06 [−0.38 to 0.25]). In nonpregnant women, the 2nd–3rd-minute segment was the shortest with similar results (difference [95% CI]: −0.04 [−0.15 to 0.07]/bias ± 1.96 × SD: −0.03 [−0.39 to 0.32]). The Ln rMSSD was found to be stable from the 5th–10th minutes and the 3rd–10th minutes in pregnant and nonpregnant women, respectively. A shortened rHRV assessment can increase its applicability in clinical/exercise-training settings.Novelty Ln rMSSD can be measured for 5 min in pregnant women, with the last 1-min segment analyzed. The last 1-min segment from 3 min can be used for rHRV measurement in nonpregnant women. The shortened rHRV assessment can facilitate its applicability in clinical/exercise-training settings.