bluuebunny/crossref_metadata_2025_split huggingface dataset:
CA-125 ELIMination Rate Constant K (KELIM) Is a Marker of Chemosensitivity in Patients with Ovarian Cancer: Results from the Phase II CHIVA Trial
Authors: You Benoit , Robelin Patrick , Tod Michel , Louvet Christophe , Lotz Jean-Pierre , Abadie-Lacourtoisie Sophie , Fabbro Michel , Desauw Christophe , Bonichon-Lamichhane Nathalie , Kurtz Jean-Emmanuel , Follana Philippe , Leheurteur Marianne , Piano Francesco Del , Ferron Gwénael , De Rauglaudre Gaëtan , Ray-Coquard Isabelle , Combe Pierre , Chevalier-Place Annick , Joly Florence , Leary Alexandra , Pujade-Lauraine Eric , Freyer Gilles , Colomban Olivier 
Published: March 2020

Abstract

Purpose:
In patients with ovarian cancer receiving neoadjuvant chemotherapy, the first-line treatment success will depend on both the tumor-primary chemosensitivity and the completeness of interval debulking surgery (IDS). The modeled CA-125 ELIMination rate constant K (KELIM), calculated with the CA-125 longitudinal kinetics during the first 100 chemotherapy days, is a validated early marker of tumor chemosensitivity. The objective was to investigate the role of the chemosensitivity relative to the success of first-line medical–surgical treatment.

Experimental Design:
The CA-125 concentrations were prospectively measured in the randomized phase II trial CHIVA (NCT01583322, carboplatin–paclitaxel regimen ± nintedanib, and IDS, n = 188 patients). The KELIM predictive value regarding the tumor response rate, likelihood of complete IDS, risk of subsequent platinum-resistant relapse (PtRR), progression-free survival (PFS), and overall survival (OS) was assessed using univariate and multivariate tests.

Results:
The data from 134 patients were analyzed. KELIM was an independent and major predictor of subsequent PtRR risk, and of survivals. The final logistic regression model, including KELIM [OR = 0.13; 95% confidence interval (CI), 0.03–0.49] and complete IDS (no vs. yes, OR = 0.30; 95% CI, 0.11–0.76) highlights the preponderant role of chemosensitivity on the success of the first-line treatment. In patients with highly chemosensitive diseases, the patient prognosis was driven more by the chemotherapy-induced antitumor effects than by the surgery.

Conclusions:
The tumor-primary chemosensitivity, assessed by the modeled CA-125 KELIM calculated during neoadjuvant chemotherapy (http://www.biomarker-kinetics.org/CA-125-neo), may be a major parameter to consider for decision-making regarding IDS attempt, and selecting patients for treatments meant to reverse the primary chemoresistance.
See related commentary by May and Oza, p. 4432
Diversity, Inclusion, and Equity: Evolution of Race and Ethnicity Considerations for the Cardiology Workforce in the United States of America From 1969 to 2019
Authors: Wang Norman C. 
Published: March 2020

Abstract
Since 1969, racial and ethnic preferences have existed throughout the American medical academy. The primary purpose has been to increase the number of blacks and Hispanics within the physician workforce as they were deemed to be “underrepresented in medicine.” To this day, the goal continues to be population parity or proportional representation. These affirmative action programs were traditionally voluntary, created and implemented at the state or institutional level, limited to the premedical and medical school stages, and intended to be temporary. Despite these efforts, numerical targets for underrepresented minorities set by the Association of American Medical Colleges have consistently fallen short. Failures have largely been attributable to the limited qualified applicant pool and legal challenges to the use of race and ethnicity in admissions to institutions of higher education. In response, programs under the appellation of diversity, inclusion, and equity have recently been created to increase the number of blacks and Hispanics as medical school students, internal medicine trainees, cardiovascular disease trainees, and cardiovascular disease faculty. These new diversity programs are mandatory, created and implemented at the national level, imposed throughout all stages of academic medicine and cardiology, and intended to be permanent. The purpose of this white paper is to provide an overview of policies that have been created to impact the racial and ethnic composition of the cardiology workforce, to consider the evolution of racial and ethnic preferences in legal and medical spheres, to critically assess current paradigms, and to consider potential solutions to anticipated challenges.
The Role of Family Institutions and Deregulation Policies in Explaining Unemployment Risks in Households of Europe
Authors: Krutova Oxana 
Published: March 2020

Abstract
This research deals with the old, but unsettled, question of the extent to which different European welfare regimes and household strategies minimize the risk of unemployment. The author statistically processed the EU Labour Force Survey microdata for 29 European countries, covering the period from 2006 to 2016. Utilizing representative data and multilevel analysis, this research redresses the lack of understanding of how different household types buffer and mediate the risks of unemployment. The evidence suggests that choosing the strategy of breadwinning, familization of care or decommodification of labour, male-breadwinner households are more liable to increasing risks of unemployment than other types of households. However, male-breadwinner households remain more resilient against the influence of macro-economic shocks.
Stalinism and Revolution in Universities: Democratization of Higher Education from Above, 1947–1956
Authors: Zysiak Agata 
Published: March 2020

The first postwar decade in Poland saw a rebuilding of the whole country, including the school system and higher education. Higher education institutions were to mold a new intelligentsia, coming from a wider social background. Initial grassroots efforts to change the elite character of universities were eclipsed from 1947 by a reform introduced from above. On the one hand, the reform curtailed the autonomy of universities and increased censorship and political control; on the other hand, however, its aim was to make university education available on an unprecedented scale to people from the working and peasant classes. This article offers a survey of tools through which this “democratization” of access to higher education was implemented, such as a new admissions process, the induction year and preparatory courses. It also shows how these tools changed the students’ social backgrounds, albeit without permanently altering the general picture of higher education in Poland.
Impact of Lateral Groundwater Flow and Subsurface Lower Boundary Conditions on Atmospheric Boundary Layer Development over Complex Terrain
Authors: Forrester Mary M. , Maxwell Reed M. 
Published: March 2020

AbstractCredible soil moisture redistribution schemes are essential to meteorological models, as lower boundary moisture influences the balance of surface turbulent fluxes and atmospheric boundary layer (ABL) development. While land surface models (LSMs) have vastly improved in their hydrologic representation, several commonly held assumptions, such as free-draining lower boundary, one-dimensional moisture flux, and lack of groundwater representation, can bias the terrestrial water balance. This study explores the impact of LSM hydrology representation on ABL development in the Weather Research and Forecasting (WRF) meteorological model. The results of summertime WRF simulations with Noah LSM, characterized by 2-m-thick soil and one-dimensional flow, are shown for a domain in the Colorado Rocky Mountain headwaters region. A reference WRF simulation is compared to 1) the same model with soil moisture initialized by the hydrologic model ParFlow; 2) a deep, free-draining simulation; and 3) WRF coupled to ParFlow, a three-dimensional, integrated groundwater-surface water model. Results show that both lateral transport of groundwater and the rate of drainage from the lower soil layer can weaken or reverse the coupling strength between evaporative fraction and ABL over a 5-month summer period. The resulting shifts in low-level moist convection in river valleys and thermally driven airflows yield strengthened anabatic upslope winds and perturbations to regional precipitation.
Audiometric Outcomes and Middle Ear Disease following Cerebrospinal Fluid Leak Repair
Authors: Yancey Kristen L. , Manzoor Nauman F. , Haynes David S. , Bennett Marc L. , O’Malley Matthew , Rivas Alejandro 
Published: March 2020

ObjectiveTo investigate audiometric outcomes and incidence of chronic ear disease following lateral skull base repair (LSBR) of cerebrospinal fluid (CSF) leaks.Study DesignRetrospective review.SettingTertiary skull base center.Subjects and MethodsConsecutive adults undergoing LSBR of CSF leaks between 2012 and 2018 were reviewed. Audiometric data included mean air conduction pure‐tone average (PTA), air‐bone gap (ABG), speech recognition threshold (SRT), and word recognition score (WRS). The incidence and management of the following were collected: effusion, retraction, otitis media and externa, perforation, and cholesteatoma.ResultsSeventy‐three patients underwent transmastoid (n = 5), middle cranial fossa (n = 2), or combined approach (n = 67) for repair of spontaneous leaks (sCSFLs, n = 41) and those occurring in the setting of chronic ear disease (ceCSFLs, n = 32). ABG decreased 7.23 dB (P =. 01) in sCSFL patients. Perforations (P =. 01) were more likely in ceCSFL. No sCSFL patient developed a cholesteatoma, perforation, or infection. Effusions (n = 7) were transient, and retractions (n = 2) were managed conservatively in the sCSFL cohort. Eight ceCSFL patients required tubes, 3 underwent tympanoplasties with (n = 2) and without (n = 1) ossicular chain reconstruction (OCR), and 1 had tympanomastoidectomy with OCR.ConclusionLateral skull base repair of CSF leaks maintained or improved hearing. Patients with preexisting chronic ear disease were more likely to require additional intervention to sustain adequate middle ear aeration compared to the sCSFL cohort. LSBR of sCSFL does not appear to increase risk for developing chronic ear disease.
Transoral Robotic Surgery versus Plasma Ablation for Tongue Base Reduction in Obstructive Sleep Apnea: Meta‐analysis
Authors: Lee Joshua A. , Byun Young Jae , Nguyen Shaun A. , Lentsch Eric J. , Gillespie M. Boyd 
Published: March 2020

ObjectivesTo compare the effectiveness of transoral robotic surgery (TORS) versus plasma ablation (PA) in tongue base reduction surgery for obstructive sleep apnea (OSA).Data SourcesPubMed, Scopus, Cochrane Library, OVID.Review MethodsKeywords searched included OSA, tongue base surgery, TORS, and coblation. Outcomes included pre‐ to postoperative apnea‐hypopnea index, Epworth Sleepiness Scale (ESS), and lowest oxygen saturation. Additional outcomes included surgical success rate, postoperative bleeding, operative time, and length of stay.ResultsA total of 690 unique articles were identified, of which 60 underwent full‐text review. Twenty‐six articles were included in final analysis, comprising 18 studies on TORS (834 patients) and 11 studies on PA (294 patients). Mean differences of apnea‐hypopnea index, ESS, and lowest oxygen saturation for TORS were –23.92, –7.6, and 5.83% (all P <. 01). Corresponding values for PA were –22.07, –4.14, and 5.48% (all P <. 00001). TORS had greater ESS reduction than PA (P =. 02). Follow‐up duration was shorter in TORS than PA (mean ± SD: 4.2 ± 2.6 vs 4.6 ± 1.4 months, P =. 0482). Surgical success rates in TORS and PA were similar (57.6% vs 60.3%, P =. 4474). Postoperative bleeding occurred less frequently in TORS versus PA (3.3% vs 7.5%, P =. 0103). Operative time was longer for TORS than PA (77.9 ± 16.4 minutes vs 44.0 ± 12.9 minutes, P <. 0001). Length of stay was similar between TORS and PA (3.9 ± 1.6 days vs 3.9 ± 2.5 days, P =. 9047).ConclusionTongue base reduction with TORS or PA each effectively treats OSA and provides comparable results. The choice between techniques might depend on patient factors, availability of technology, and associated costs.
Evaluation of a staff behaviour change intervention to increase the use of ward-based practice books and active practice during inpatient stroke rehabilitation: a phase-1 pre–post observational study
Authors: Stewart Claire , Power Emma , McCluskey Annie , Kuys Suzanne , Lovarini Meryl 
Published: March 2020

Objective: The aim of this study was to evaluate a staff behaviour change intervention to increase the use of ward-based practice books and active practice by stroke inpatients. Design: This is a pre–post observational study. Setting: This study was conducted in a inpatient rehabilitation unit in Australia. Subjects: Stroke inpatients participated in the study. Intervention: A staff behaviour change intervention was designed to support staff to implement practice books. The intervention included staff training on motivation and coaching, and weekly audit and feedback for six months. The environment was restructured to bring staff together weekly at the bedside to review audit data and share skills. Main measures: Medical record audit and behavioural mapping were used to compare the number of stroke participants with/using a practice book pre- and post-intervention. Pre- and post-intervention, the percentage of observations where a stroke participant was actively practising, repetitions of practice recorded and type of supervision were compared. Results: A total of 24 participants were observed ( n = 12 pre, n = 12 post). Post-intervention, the number of participants with practice books increased from one to six (OR = 11, 95% CI = (0.9, 550.7)), but this change was not statistically significant ( P = 0.069). Five participants recorded repetitions in their practice books post-intervention, three were observed using practice books. There was no change in median repetitions recorded ( rpbs = 0.00, 95% CI = (−0.4, 0.4), P = 1.000) or observed active practice ( rpbs = –0.02, 95% CI = (−0.4, 0.4), P = 0.933). Active practice was often fully supervised by a therapist. Conclusion: A staff behaviour change intervention has the potential to increase the number of stroke survivors receiving ward-based practice books but did not increase active practice.
Prosthetic joint infection by Bordetella holmesii: Case report and a review of the literature
Authors: Fernandez-Pittol Mariana , Bosch Jordi , Morata Laura , Lozano Luis , Martínez Pastor Juan Carlos , Soriano Alex 
Published: March 2020

Introduction: Bordetella holmesii is a Gram-negative coccobacillus involved in different infections mostly described in case reports. Prosthetic joint infections in relation to this pathogen are rare. Here, we present the third case of B. holmesii in a patient without anatomical or functional spleen dysfunction. Case report: The patient was a 62-year-old female with a total knee prosthesis implanted in 1997 that required multiple replacements of the femoral component due to aseptic loosening in the past years. The patient was admitted to our hospital for an elective replacement surgery due to new radiological signs of loosening. B. holmesii was isolated from synovial fluid obtained during surgery. The identification was performed by matrix-assisted laser desorption ionization–time of flight mass spectrometry and confirmed by 16S rRNA gene amplification and sequencing. Antibiotic treatment was started but 14 days after surgery the patient presented pain and joint effusion. An arthrocentesis was performed and synovial fluid culture was positive again for B. holmesii. Surgical debridement including polyethylene replacement was performed and antibiotic treatment was continued for 3 months. After a 2-year follow-up period, the patient remained asymptomatic and physical examination showed normal function of the prosthesis. Conclusion: B. holmesii is an uncommon cause of bone and joint infections. This case indicates that this microorganism is a potential pathogen of prosthetic or native arthritis, and it should be considered when cultures are negative and in cases presenting torpid evolution.
Solar retinopathy: a new setting of red, green, and blue channels
Authors: Borroni Davide , Erts Renars , Vallabh Neeru A , Bonzano Chiara , Sepetiene Svetlana , Krumina Zita , Romano Vito , Parekh Mohit , Iannetta Danilo 
Published: March 2020

Purpose: To introduce a new color imaging technique using improved settings of red, green, and blue channels for improved delineation of retinal damage in patients with solar retinopathy. Method: A retrospective case series of patients with poor vision secondary to solar retinopathy were analyzed. All patients underwent visual acuity, refraction, and dilated fundus examination. A spectral domain–optical coherence tomography of the macula and color fundus imaging using optimized red, green, and blue color setting was performed. Patients were reviewed over a 6-month period. The data were analyzed for statistical significance using an independent t test and a receiver operating characteristic curve. Results: In total, 20 eyes of 10 patients were included between 2009 and 2017. The mean age was 24.9 ± 18.1 years. Best corrected visual acuity at first consultation was 0.78 ± 0.11 and after 6 months was 0.83 ± 0.09. Spectral domain–optical coherence tomography demonstrated retinal abnormalities at the myoid zone, ellipsoid zone, and the outer segment of photoreceptors. Receiver operating characteristic curve analysis showed an improving effect (area under the curve = 0.62; 95% confidence interval = 0.42–0.79). The color channels parameters, which improve visualization of the lesions were found to be 67-0.98-255 for the R-guided setting, 19-0.63-121 for the B-guided setting, and 7-1.00-129 for the G-guided setting. The ideal red, green, and blue setting was in 24-0.82-229. Conclusion: The use of a new setting of red, green, and blue channels could improve the diagnosis and monitoring of solar retinopathy, hence improving patient care.
Nitinol stent–assisted maturation of the dysfunctional cannulation zone in the immature arteriovenous fistula
Authors: Aslam Anoosha , Thomas Shannon D , Vijayan Vikram , Crowe Phillip , Varcoe Ramon L , Swinnen John 
Published: March 2020

Introduction: The native arteriovenous fistula may remain immature despite adequate arterial inflow after formation. This may occur when the puncturable vein segment (cannulation zone) is too small to be reliably punctured, occluded or too deep under the skin for needle access. We performed stenting (stent-assisted maturation) of arteriovenous fistulas with an immature cannulation zone, allowing for a large subcutaneous channel which could then be immediately punctured for dialysis. Methods: We performed a retrospective review of 49 patients (mean age was 58.7 ± 16.09 (12–83) years, mean arteriovenous fistula age of 162.6 ± 27.28 days) with end-stage renal failure who underwent balloon dilatation and bare-metal stent implantation (1.6 ± 0.67 (1–3) stents, median diameter and length of 8 (5–14) mm and 80 (40–150) mm, respectively) through their cannulation zone (forced maturation). Radiocephalic (35 arteriovenous fistulas), brachiocephalic (10 arteriovenous fistulas) and autogenous loop arteriovenous fistulas (4 arteriovenous fistulas) were included with 30 patients (61.2%) having an inadequate cannulation zone venous diameter, 9 patients (18.4%) having an absent cannulation zone and 10 patients (20.4%) having a patent cannulation zone deeper than 1 cm which was not reliably puncturable. The study was conducted over 9 years (January 2008–December 2016) with implantation of the SMART® stent and Absolute Pro® stent in 61.2% and 38.8%, respectively. Long-term outcomes including primary useable segmental and access circuit patency as well as assisted primary access circuit patency, rate of re-intervention, technical success and complications were analysed. Results: At 6 months, 12 months and 4 years, respectively, cannulation zone primary patency was 84.4%, 74.4% and 56.1% and access circuit primary patency was 62.2%, 45.3% and 23.2%; however, assisted primary access circuit patency was 95.6%, 91.1% and 83.8%, achieved with an endovascular re-intervention rate of 0.53 procedures/year with only four thrombosed circuits occurring. Discussion: Forced maturation using nitinol stents allows for long-term haemodialysis access with a low rate of re-intervention.
Predicting Penetration of the Project Buffer Time of Critical Chain Project Management (CCPM) Using a Linear Programming Approach
Authors: Jagtap Milind 
Published: March 2020

Managing the disruptions in projects is a challenging task for project managers. In this respect, critical chain project management (CCPM) has been considered as a promising methodology in expediting projects. However, the effectiveness of this methodology is often lost in search of optimal use of project buffers to hedge against delays occurring in the critical chain. The more critical chain activity gets delayed, the greater is the likelihood of penetration of project buffer time. The resource constraints of critical chains have been considered as a major determinant of project buffer penetration. Although a project buffer is provided to protect the critical chain, to keep the CCPM project schedule competitive, it is the priority of the project manager to minimize the blatant consumption of project buffer time by multiple critical chain activities. Historically, resource constraints within the critical chain have been associated with penetration of project buffer time. The literature suggests that the productivity of resources deployed in the critical chain can predict the penetration of project buffer time. Based on the premise that delays are omnipresent and unavoidable but predictable, this research aims to consider the post-facto measures of delays instead of pre-facto measures. Pre-facto measures are resources productivity and resources availability while post-facto measures are the compensation paid by the client and the cost of liquidity damages incurred by the contractor. It is assumed that pre-facto measures are convertible into post-facto measures. A linear programming model is formulated and tested using the case of Botanical Garden Construction Project in Pune city. Sensitivity analysis revealed that the propensity of project buffer penetration on a critical chain varies with the compensation matrix. Varieties of scenario are developed and the optimal solution is validated with the case study.