bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative Navigated Transcranial Magnetic Stimulation Improves Gross Total Resection Rates in Patients with Motor-Eloquent High-Grade Gliomas: A Matched Cohort Study
Authors: Hendrix Philipp , Dzierma Yvonne , Burkhardt Benedikt W , Simgen Andreas , Wagenpfeil Gudrun , Griessenauer Christoph J , Senger Sebastian , Oertel Joachim 
Published: October 2020

Abstract

BACKGROUND
Navigated transcranial magnetic stimulation (nTMS) is an established, noninvasive tool to preoperatively map the motor cortex. Despite encouraging reports from few academic centers with vast nTMS experience, its value for motor-eloquent brain surgery still requires further exploration.

OBJECTIVE
To further elucidate the role of preoperative nTMS in motor-eloquent brain surgery.

METHODS
Patients who underwent surgery for a motor-eloquent supratentorial glioma or metastasis guided by preoperative nTMS were retrospectively reviewed. The nTMS group (n = 105) was pair-matched to controls (non-nTMS group, n = 105). Gross total resection (GTR) and motor outcome were evaluated. Subgroup analyses including survival analysis for WHO III/IV glioma were performed.

RESULTS
GTR was significantly more frequently achieved in the entire nTMS group compared to the non-nTMS group (P = .02). Motor outcome did not differ (P = .344). Bootstrap analysis confirmed these findings. In the metastases subgroup, GTR rates and motor outcomes were equal. In the WHO III/IV glioma subgroup, however, GTR was achieved more frequently in the nTMS group (72.3%) compared to non-nTMS group (53.2%) (P = .049), whereas motor outcomes did not differ (P = .521). In multivariable Cox-regression analysis, prolonged survival in WHO III/IV glioma was significantly associated with achievement of GTR and younger patient age but not nTMS mapping.

CONCLUSION
Preoperative nTMS improves GTR rates without jeopardizing neurological function. In WHO III/IV glioma surgery, nTMS increases GTR rates that might translate into a beneficial overall survival. The value of nTMS in the setting of a potential survival benefit remains to be determined.
Improved risk stratification in youngerIDHwild-type glioblastoma patients by combining a 4-miRNA signature withMGMTpromoter methylation status
Authors: Unger Kristian , Fleischmann Daniel F , Ruf Viktoria , Felsberg Jörg , Piehlmaier Daniel , Samaga Daniel , Hess Julia , Suresh Marian Preetham , Mittelbronn Michel , Lauber Kirsten , Budach Wilfried , Sabel Michael , Rödel Claus , Reifenberger Guido , Herms Jochen , Tonn Jörg-Christian , Zitzelsberger Horst , Belka Claus , Niyazi Maximilian 
Published: October 2020

AbstractBackgroundThe potential benefit of risk stratification using a 4-miRNA signature in combination with MGMT promoter methylation in IDH1/2 wild-type glioblastoma patients was assessed.MethodsPrimary tumors from 102 patients with comparable treatment from the LMU Munich (n = 37), the University Hospital Düsseldorf (n = 33), and The Cancer Genome Atlas (n = 32) were included. Risk groups were built using expressions of hsa-let-7a-5p, hsa-let-7b-5p, hsa-miR-615-5p, and hsa-miR-125a-5p to assess prognostic performance in overall survival (OS). MGMT promoter methylation and age were considered as cofactors. Integrated miRNA, DNA methylome, and transcriptome analysis were used to explore the functional impact of signature miRNAs.ResultsThe 4-miRNA signature defined high-risk (n = 46, median OS: 15.8 months) and low-risk patients (n = 56, median OS: 20.7 months; univariable Cox proportional hazard analysis: hazard ratio [HR]: 1.8, 95% confidence interval [CI]: 1.14–2.83, P = .01). The multivariable Cox proportional hazard model including the 4-miRNA signature (P = .161), MGMT promoter methylation (P &lt; .001), and age (P = .034) significantly predicted OS (Log-rank P &lt; .0001). Likewise to clinical routine, analysis was performed for younger (≤60 years, n = 50, median OS: 20.2 months) and older patients (&gt;60 years, n = 52, median OS: 15.8) separately. In younger patients, the 4-miRNA signature had prognostic value (HR: 1.92, 95% CI: 0.93–3.93, P = .076). Particularly, younger, MGMT methylated, 4-miRNA signature low-risk patients (n = 18, median OS: 37.4 months) showed significantly improved survival, compared to other younger patients (n = 32, OS 18.5 months; HR: 0.33, 95% CI: 0.15–0.71, P = .003). Integrated data analysis revealed 4-miRNA signature-associated genes and pathways.ConclusionThe prognostic 4-miRNA signature in combination with MGMT promoter methylation improved risk stratification with the potential for therapeutic substratification, especially of younger patients.
Pharmacology, Dosing, and Side Effects of Rifabutin as a Possible Therapy for Antibiotic-Resistant Acinetobacter Infections
Authors: Phillips Matthew C , Wald-Dickler Noah , Loomis Katherine , Luna Brian M , Spellberg Brad 
Published: October 2020

Abstract
Acinetobacter baumannii has among the highest rates of antibiotic resistance encountered in hospitals. New therapies are critically needed. We found that rifabutin has previously unrecognized hyperactivity against most strains of A. baumannii. Here we review the pharmacology and adverse effects of rifabutin to inform potential oral dosing strategies in patients with A. baumannii infections. Rifabutin demonstrates dose-dependent increases in blood levels up to 900 mg per day, but plateaus thereafter. Furthermore, rifabutin induces its own metabolism after prolonged dosing, lowering its blood levels. Pending future development of an intravenous formulation, a rifabutin oral dose of 900–1200 mg per day for 1 week is a rational choice for adjunctive therapy of A. baumannii infections. This dosage maximizes AUC24 to drive efficacy while simultaneously minimizing toxicity. Randomized controlled trials will be needed to definitively establish the safety and efficacy of rifabutin to treat A. baumannii infections.
Analytic solutions for neutrino-light curves of core-collapse supernovae
Authors: Suwa Yudai , Harada Akira , Nakazato Ken’ichiro , Sumiyoshi Kohsuke 
Published: October 2020

Abstract
Neutrinos are a guaranteed signal from supernova explosions in the Milky Way, and a most valuable messenger that can provide us with information about the deepest parts of supernovae. In particular, neutrinos will provide us with physical quantities, such as the radius and mass of protoneutron stars (PNS), which are the central engine of supernovae. This requires a theoretical model that connects observables such as neutrino luminosity and average energy with physical quantities. Here, we show analytic solutions for the neutrino-light curve derived from the neutrino radiation transport equation by employing the diffusion approximation and the analytic density solution of the hydrostatic equation for a PNS. The neutrino luminosity and the average energy as functions of time are explicitly presented, with dependence on PNS mass, radius, the total energy of neutrinos, surface density, and opacity. The analytic solutions provide good representations of the numerical models from a few seconds after the explosion and allow a rough estimate of these physical quantities to be made from observational data.
Design and characterization of plasticized bacterial cellulose/waterborne polyurethane composite with antibacterial function for nasal stenting
Authors: Feng Zhaoxuan , Li Minglu , Jin Xing , Zheng Yudong , Liu Junxiu , Zhao Liang , Wang Yansen , Li Hao , Zuo Danlin 
Published: October 2020

AbstractA nasal stent capable of preventing adhesions and inflammation is of great value in treating nasal diseases. In order to solve the problems of tissue adhesion and inflammation response, we prepared plasticized bacterial cellulose (BCG) and waterborne polyurethane (WPU) composite with antibacterial function used as a novel nasal stent. The gelation behavior of BCG could contribute to protecting the paranasal sinus mucosa; meanwhile, the WPU with improved mechanical property was aimed at supporting the narrow nasal cavity. The thickness, size and the supporting force of the nasal stent could be adjusted according to the specific conditions of the nasal. Thermogravimetric analysis, contact angle and water absorption test were applied to investigate the thermal, hydrophilic and water absorption properties of the composite materials. The composite materials loaded with poly(hexamethylene biguanide) hydrochloride maintained well antibacterial activity over 12 days. Animal experiments further revealed that the mucosal epithelium mucosae damage of BCG−WPU composite was minor compared with that of WPU. This new type of drug-loaded nasal stent can effectively address the postoperative adhesions and infections while ensuring the health of nasal mucosal, and thus has an immense clinical application prospects in treating nasal diseases.
Balance Sheet Channel with Information-Trading Frictions in Secondary Markets
Authors: Asriyan Vladimir 
Published: October 2020

AbstractThis article develops a theory of the balance sheet channel that places a central emphasis on the liquidity of secondary markets for macro-contingent claims. We show that the presence of dispersed information and imperfect competition in secondary markets, interacted with financial constraints, results in mispricing and misallocation of aggregate risk, distorts aggregate investment, and exacerbates asset price and output volatility. The magnitude of balance sheet amplification effects becomes endogenously tied to the severity of market frictions, which likely vary over time and across economies. The laissez-faire equilibrium is constrained inefficient due to a novel externality originating from rent-extracting behaviour of agents in secondary markets. Optimal corrective policy boosts secondary market liquidity through subsidies to trade in macro-contingent claims, which enhances aggregate risk-sharing and stabilizes the business cycle.
CT DOSIMETRY FOR THE AUSTRALIAN COHORT DATA LINKAGE STUDY
Authors: Brady Zoe , Forsythe Anna , McBain-Miller Jasmine , Scurrah Katrina J , Smoll Nicolas , Lin Yaqi , Lee Choonsik , Berrington de Gonzalez Amy , Roberts Leo J , Mathews John D 
Published: October 2020

Abstract
Children undergoing computed tomography (CT) scans have an increased risk of cancer in subsequent years, but it is unclear how much of the excess risk is due to reverse causation bias or confounding, rather than to causal effects of ionising radiation. An examination of the relationship between excess cancer risk and organ dose can help to resolve these uncertainties. Accordingly, we have estimated doses to 33 different organs arising from over 900 000 CT scans between 1985 and 2005 in our previously described cohort of almost 12 million Australians aged 0–19 years. We used a multi-tiered approach, starting with Medicare billing details for government-funded scans. We reconstructed technical parameters from national surveys, clinical protocols, regulator databases and peer-reviewed literature to estimate almost 28 000 000 individual organ doses. Doses were age-dependent and tended to decrease over time due to technological improvements and optimisation.
Using the Design Sprint process to enhance and accelerate behavioral medicine progress: a case study and guidance
Authors: Jake-Schoffman Danielle E , McVay Megan A 
Published: October 2020

Abstract
While challenges in the translation of behavioral medicine knowledge from academic settings to real-world use are well documented, they could potentially be reduced through the use of the Design Sprint process, a roadmap that facilitates progression from an idea to a product in 5 days via agile design and user-centered design principles. The Design Sprint is well aligned with several priorities of and methods common in behavioral medicine, including obtaining end-user feedback and thinking about implementation during intervention development. The Design Sprint could be used by behavioral medicine researchers for the development of research tools, implementation strategies, and behavior change interventions. The process may encourage creative and focused thinking, speed product development, and facilitate early user input. However, translating the Design Sprint to behavioral medicine research may present challenges, such as difficulty getting buy-in from team members, inconsistencies between the Design Sprint timeline, the need to obtain institutional review board approval for user testing, and the lack of traditional research processes (e.g., incorporating scientific research into intervention design). Several solutions and adaptations are possible to overcome these challenges while still maintaining the core features of the Design Sprint process. To demonstrate the use of the Design Sprint and potential adaptations, we present a case study of the development of a patient-facing digital tool for weight management and an accompanying implementation strategy. In conclusion, the Design Sprint offers behavioral medicine researchers an approach to developing new products with numerous potential benefits to researchers and to the individuals and communities we seek to impact.
Availability and Accessibility of Emergency Contraception: Misunderstood, Understocked and in Need of Plan A [7G]
Authors: Bunkis Brittany , Liongson Franzes , Tuckfield Lynnia , Anasti James N. 
Published: October 2020

INTRODUCTION:
For emergency contraception (EC) to be effective, it has to be readily available. Thus, in 2013 the FDA approved EC Levonorgestrel (LNG) for sale over-the-counter (OTC) without a prescription or age limit. Although requiring a prescription, Ulipristal acetate (UPA) approved in 2010 for EC may be more effective than LNG in certain circumstances. We sought to determine the accessibility of these EC medications at pharmacies in the Lehigh Valley Area of Pennsylvania (population 850,000).

METHODS:
Phone surveys were conducted of Corporate and Independent pharmacies. Only the pharmacist or pharmacy tech provided information about availability, age requirements and accessibility of EC. Corporate and Independent pharmacies were compared using chi squared test with appropriate correction.

RESULTS:
The EC survey included 104 Corporate (CorP) and 26 Independent pharmacies (IndP) in the prescribed area. EC was in stock in 95/104 (91%) of CorP and 14/26 (54%) of IndP (p<.001). UPA was in stock at 12/104 (11%) of CorP and none of the IndP (p=.15). Age restriction was noted in 24/104 (23%) of CorP and 8/26 (31%) of IndP (p=.58). LNG over the counter location was found in 75/104 (72%) of CorP and 2/26 (8%) of IndP (p<.001).

CONCLUSION:
Although regional differences may apply, the availability/accessibly of EC is not ideal. Although the corporate pharmacies appear better than independents, the lack of UPA is a concern. Physicians should be aware of the availability of EC in their area.
Contraception Use and Attitudes Among Women Seeking Pregnancy Termination [9G]
Authors: Rivet Dana Lynn , Ross Sue , Robinson Heather E. 
Published: October 2020

INTRODUCTION:
Unintended pregnancies pose negative health and social outcomes to mother and child. North America's unplanned pregnancy rate of 51% is higher than the worldwide rate of 40%. The purpose of this research is to investigate contraceptive use and future contraceptive plans among women presenting for pregnancy termination.

METHODS:
For this descriptive study, women presenting for pregnancy termination were recruited by clinic counsellors. Consenting women completed a self-administered anonymous survey. Ethics approval was obtained. Data were entered using REDCap and analyzed using descriptive statistics.

RESULTS:
Of the 334 participants, 45% used contraception at the time of conception including condoms (54%), combined hormonal contraception (CHC) (35%), withdrawal (30%), rhythm (6%) and intrauterine device (IUD) (3%). Among contraceptive users (n=149) the most common reason for method failure was imperfect use (50%). Among contraceptive non-users (n=185) the most common reason for non-use was perceived low risk of pregnancy (60%). Awareness of emergency contraception (EC) was 97% for Plan B, 33% for copper IUD and 6% for Ulipristal acetate, yet only 53% had ever used EC. 93% of women planned to use contraception in the future, including IUD (32%), CHC (34%), condoms (8%), rhythm (1%) and withdrawal (0.3%).

CONCLUSION:
This study suggests that educating women on the risk of pregnancy and proper use of contraceptive methods would provide the highest yield in reducing unplanned pregnancies. Widespread awareness of EC is not sufficient to ensure its use in the population at risk of unplanned pregnancy. Furthermore, pregnancy termination presents an opportunity to initiate highly effective methods of contraception.
Pediatric Subspecialists and Contraception for Adolescent Women With Chronic Diseases [8P]
Authors: Stanton Taylor Alise , Proussaloglou Ellie , Haider Sadia 
Published: October 2020

INTRODUCTION:
Adolescent women with chronic diseases need effective contraception as pregnancy may exacerbate their disease. Additionally, they often take teratogenic medications that may harm a developing fetus. This study aims to understand current practices of pediatric subspecialists caring for adolescents with regards to contraception counseling and provision.

METHODS:
Pediatric subspecialists at a Chicago based academic center completed a Qualtrics survey assessing current practices and knowledge about contraception.

RESULTS:
A total of 37 pediatric subspecialists routinely caring for adolescent women were surveyed. Nearly all stated their patients were on teratogens (78.1%). Many reported that none (40.6%) or few (21.9%) of their patients desired pregnancy. They were comfortable talking to their patients (81.3%) and parents (72.0%) about contraception, however only a minority believed that pediatric subspecialists should be the ones to provide contraceptive counseling (41.4%) or initiate contraception (17.2%). Physicians surveyed refer patients to gynecologists (65.2%), adolescent medicine (17.4%), and general pediatricians (8.7%) for prescription or placement of contraceptives. However, some never refer patients to gynecologists (25.0%) or refer at ages 15 and above (56.3%). 75.9% of subspecialists note barriers to providing contraception to their patients, including lack of time and inadequate training.

CONCLUSION:
Pediatric subspecialists generally recognize contraception as important to their patients. However, self-reported referral for contraception is often later in the teenage years and a sizeable minority of physicians never refer adolescents, despite having a significant proportion of patients on teratogens. Increased training of pediatric subspecialists about contraception and facilitating referral for contraception services could decrease barriers for adolescent women with chronic diseases.
Perinatal Outcomes in Persistent Fetal Growth Restriction and Growth Restriction Based Upon Growth Velocity [34S]
Authors: Sun Chenchen , Hoffman Mallory Michelle , Lash Kayla Alene , Vowels Patricia C. , Chauhan Suneet P. , Sibai Baha M. 
Published: October 2020

INTRODUCTION:
Fetal growth restriction (FGR) is associated with adverse perinatal outcomes. The aim of our study was to assess NICU admission rates and composite neonatal morbidity (CNM) in pregnancies with persistent FGR, and to evaluate fetal outcomes based on FGR associated with negative growth velocity.

METHODS:
We conducted a retrospective cohort study of women with non-anomalous singleton pregnancies complicated by FGR who delivered at our institution. Growth velocity was calculated by subtracting the EFW percentile at the final growth scan from the percentile at the first growth scan and dividing by the number of weeks between the scans.

RESULTS:
124 women with pregnancies complicated by FGR were identified. 82 women met inclusion criteria for growth velocity evaluation, 91 women met criteria for assessment of perinatal outcomes of interest. Patients with persistent FGR had an earlier gestational age at time of delivery (36.2 vs. 37.7 wks, p= 0.01), and lower birth weight (2150 gm vs 2601 gm, p=0.005). NICU admission and CNM were higher in pregnancies with persistent FGR (40.3% vs. 13.6%, p=0.036, 37.7% vs. 13.6, p=0.039). Neonates with negative growth velocity more likely delivered at an earlier gestational age (36.2 vs 37.6 weeks, p=0.027), delivered by cesarean section (59.1% vs 36.8%, p=0.044) and had lower birthweight (2154 vs 2475 grams, p=0.020).

CONCLUSION:
Pregnancies with persistent FGR are associated with increased NICU admissions, and composite neonatal morbidity. Similarly, pregnancies with FGR and negative growth velocity are more likely to deliver early, have lower birthweight, and deliver by cesarean section compared to those with growth.
Urologic Injury and Fistula Following Hysterectomy for Benign Indications [37S]
Authors: Dallas Kai B. , Rogo-Gupta Lisa , Elliott Christopher 
Published: October 2020

INTRODUCTION:
Genitourinary injury is a rare but devastating complication following hysterectomy. Literature regarding this topic is limited, so we explored genitourinary injury rates (and risk factors for injury) in a population based dataset with long term follow-up.

METHODS:
All women who underwent a hysterectomy for benign indications were identified using data from the Office of Statewide Health Planning and Development in California from 2005-2011. Cases of genitourinary injury were identified (either identified intraoperatively or missed).

RESULTS:
Of the 296,130 women who underwent hysterectomy, 5,455 (1.8%) suffered at least one urologic injury: 2,817 (1.0%) ureteral, 2,058 (0.70%) bladder and 831 (0.3%) fistulas. Sustaining an injury increased the risk of future fistula (1.1% and 2.7% versus 0.3%, p<0.001), however immediate identification and repair of the injury decreased this risk for both ureteral (0.7% versus 3.4%, p<0.001) and bladder (2.5% versus 6.5%, p<0.001) injuries. Multivariate modeling revealed that concomitant POP repair (OR 1.12, p=0.019), a diagnosis of endometriosis (OR 1.40 p<0.001) and surgery at a facility in the bottom 25% of hysterectomy volume (OR 1.37, p=0.049) were associated with increased likelihood of injury, while vaginal (OR 0.85, p=<0.001) or laparoscopic (OR 0.81, p<0.001) approach and diagnosis of endometrial hyperplasia/abnormal uterine bleeding (OR 0.91, p=0.004) were associated with a decreased risk of injury.

CONCLUSION:
Benign hysterectomy carries a ∼1.8% risk of genitourinary injury. Although injury increases the chance of fistula formation, recognizing the injury immediately reduces this risk. We identify several factors that are associated with injury, providing insight where a higher index of suspicion might be held.