bluuebunny/crossref_metadata_2025_split huggingface dataset:
Practice-, provider- and patient-level facilitators of and barriers to HPV vaccine promotion and uptake in Georgia: a qualitative study of healthcare providers’ perspectives
Authors: Vu Milkie , King Adrian R , Jang Hyun Min , Bednarczyk Robert A 
Published: July 2020

Abstract
Georgia experiences higher human papillomavirus (HPV)-associated cancer burden and lower HPV vaccine uptake compared with national estimates. Using the P3 model that concomitantly assesses practice-, provider- and patient-level factors influencing health behaviors, we examined facilitators of and barriers to HPV vaccine promotion and uptake in Georgia. In 2018, we conducted six focus groups with 55 providers. Questions focused on multilevel facilitators of and barriers to HPV vaccine promotion and uptake. Our analysis was guided by the P3 model and a deductive coding approach. We found that practice-level influences included organizational priorities of vaccinations, appointment scheduling, immunization registries/records, vaccine availability and coordination with community resources. Provider-level influences included time constraints, role, vaccine knowledge, self-efficacy to discuss HPV vaccine and vaccine confidence. Patient-level influences included trust, experiences with vaccine-preventable diseases, perceived high costs, perceived side effects and concerns with sexual activity. Findings suggest that interventions include incentives to boost vaccine rates and incorporate appointment scheduling technology. An emphasis should be placed on the use of immunization registries, improving across-practice information exchange, and providing education for providers on HPV vaccine. Patient–provider communication and trust emerge as intervention targets. Providers should be trained in addressing patient concerns related to costs, side effects and sexual activity.
Demand-led catch-up: a history-friendly model of latecomer development in the global green economy
Authors: Landini Fabio , Lema Rasmus , Malerba Franco 
Published: July 2020

AbstractThis article examines the role played by demand in catching up and in leadership changes in green industries, motivated by the belief that demand-led catch-up is a prevalent pathway in such industries. The article first examines stylized cases of sectoral green catch-up by China in which the local market and domestic demand played an important role before the sector started expanding globally. In particular, the focus is on three industries: wind, biomass and hydropower. Then, it uses a history-friendly model to study the effects of a major increase in domestic demand (a “demand window”) in a green industry. The baseline simulation first examines the effects of a demand window in promoting learning and capability building by latecomers and in triggering a catch-up process. Then, the counterfactual simulations show that (i) a technological discontinuity which takes place after the demand window could reduce the effectiveness of the demand window in the catch-up process; (ii) the specific timing of the demand window could significantly alter the dynamic patterns of catch-up; (iii) protectionism is a necessary condition for the demand window to have its effect; and (iv) regimes of slow capability accumulation could turn out to be beneficial for the latecomer when a technological discontinuity follows the demand window. These results can help policymakers in identifying key conditions related to demand-led catch-up strategies.
To AB or Not to AB? Dispute Settlement in WTO Reform
Authors: Hoekman Bernard M , Mavroidis Petros C 
Published: July 2020

ABSTRACT
Recent debates on the operation of the World Trade Organization’s dispute resolution mechanism have focused primarily on the appellate body. We argue that this neglects the first-order issue confronting the rules-based trading system: sustaining the principle of depoliticized conflict resolution that is reflected in the negative consensus rule for the adoption of dispute settlement findings. Improving the quality of the work of panels by appointing a roster of full-time professional adjudicators, complemented by reforms to World Trade Organization working practices that reduce incentives to resort to formal dispute settlement, can resolve the main issues that led to the appellate body crisis. Effective, coherent, and consistent World Trade Organization dispute resolution need not include an appellate body. An appropriately redesigned single-stage process can serve just as well, if not better.
Fully automated hybrid approach to predict theIDHmutation status of gliomas via deep learning and radiomics
Authors: Choi Yoon Seong , Bae Sohi , Chang Jong Hee , Kang Seok-Gu , Kim Se Hoon , Kim Jinna , Rim Tyler Hyungtaek , Choi Seung Hong , Jain Rajan , Lee Seung-Koo 
Published: July 2020

AbstractBackgroundGlioma prognosis depends on isocitrate dehydrogenase (IDH) mutation status. We aimed to predict the IDH status of gliomas from preoperative MR images using a fully automated hybrid approach with convolutional neural networks (CNNs) and radiomics.MethodsWe reviewed 1166 preoperative MR images of gliomas (grades II–IV) from Severance Hospital (n = 856), Seoul National University Hospital (SNUH; n = 107), and The Cancer Imaging Archive (TCIA; n = 203). The Severance set was subdivided into the development (n = 727) and internal test (n = 129) sets. Based on T1 postcontrast, T2, and fluid-attenuated inversion recovery images, a fully automated model was developed that comprised a CNN for tumor segmentation (Model 1) and CNN-based classifier for IDH status prediction (Model 2) that uses a hybrid approach based on 2D tumor images and radiomic features from 3D tumor shape and loci guided by Model 1. The trained model was tested on internal (a subset of the Severance set) and external (SNUH and TCIA) test sets.ResultsThe CNN for tumor segmentation (Model 1) achieved a dice coefficient of 0.86–0.92 across datasets. Our hybrid model achieved accuracies of 93.8%, 87.9%, and 78.8%, with areas under the receiver operating characteristic curves of 0.96, 0.94, and 0.86 and areas under the precision-recall curves of 0.88, 0.82, and 0.81 in the internal test, SNUH, and TCIA sets, respectively.ConclusionsOur fully automated hybrid model demonstrated the potential to be a highly reproducible and generalizable tool across different datasets for the noninvasive prediction of the IDH status of gliomas.
Late effects of cancer treatment: consequences for long-term brain cancer survivors
Authors: Alemany Montse , Velasco Roser , Simó Marta , Bruna Jordi 
Published: July 2020

AbstractLate adverse effects of cancer treatments represent a significant source of morbidity and also financial hardship among brain tumor patients. These effects can be produced by direct neurologic damage of the tumor and its removal, and/or by complementary treatments such as chemotherapy and radiotherapy, either alone or combined. Notably, young adults are the critical population that faces major consequences because the early onset of the disease may affect their development and socioeconomic status.The spectrum of these late adverse effects is large and involves multiple domains. In this review we classify the main long-term adverse effects into 4 sections: CNS complications, peripheral nervous system complications, secondary neoplasms, and Economic impact. In addition, CNS main complications are divided into nonfocal and focal symptoms.Owing to all the secondary effects mentioned, it is essential for physicians to have a high level of clinical suspicion to prevent and provide early intervention to minimize their impact.
Amplifying feedback loop between growth and wood anatomical characteristics ofFraxinus excelsiorexplains size-related susceptibility to ash dieback
Authors: Klesse Stefan , von Arx Georg , Gossner Martin M , Hug Christian , Rigling Andreas , Queloz Valentin 
Published: July 2020

AbstractSince the 1990s the invasive fungus Hymenoscyphus fraxineus has caused severe crown dieback and high mortality rates in Fraxinus excelsior in Europe. In addition to a strong genetic control of tolerance to the fungus, previous studies have found landscape heterogeneity to be an additional driver of variability in the severity of dieback symptoms. However, apart from climatic conditions related to heat and humidity influencing fungal infection success, the mechanistic understanding of why smaller or slower-growing trees are more susceptible to dieback remains less well understood. Here, we analyzed three stands in Switzerland with a unique setting of 8 years of data availability of intra-annual diameter growth and annual crown health assessments. We complemented this by ring width and quantitative wood anatomical measurements extending back before the monitoring started to investigate if wood anatomical adjustments can help better explain the size-related dieback phenomenon. We found that slower-growing trees or trees with smaller crowns already before the arrival of the fungus were more susceptible to dieback and mortality. Defoliation directly reduced growth as well as maximum earlywood vessel size, and the positive relationship between vessel size and growth rate caused a positive feedback amplifying and accelerating crown dieback. Measured non-structural carbohydrate (NSC) concentrations in the outermost five rings did not significantly vary between healthy and weakened trees, which translate into large differences in absolute available amount of NSCs. Thus, we hypothesize that a lack of NSCs (mainly sugars) leads to lower turgor pressure and smaller earlywood vessels in the following year. This might impede efficient water transport and photosynthesis, and be responsible for stronger symptoms of dieback and higher mortality rates in smaller and slower-growing trees.
Foliar traits of sessile oak (Quercus petraea Liebl) seedlings are largely determined by site properties rather than seed origin
Authors: Arab Leila , Seegmueller Stefan , Dannenmann Michael , Eiblmeier Monika , Albasher Ghada , Alfarraj Saleh , Rennenberg Heinz 
Published: July 2020

Abstract
Due to climate change, sessile oak (Quercus petraea) seedlings experience an increasing risk of drought during regeneration of forest stands by management practices. The present study was aimed at elucidating the potential of sessile oak seedlings originating from sites with different aridity and nitrogen (N) supply to acclimate to contrasting water availability. For this purpose, a free-air cross-exchange experiment was conducted between a dry and a humid forest stand with high and low soil N contents, respectively, during two consecutive years differing in aridity before harvest. Almost all structural and physiological foliar traits analyzed did not differ consistently between seed origins during both years, when cultivated at the same site. As an exception, the arid provenance upregulated foliar ascorbate contents under drought, whereas the humid provenance accumulated the phenolic antioxidants vescalagin and castalagin (VC) under favorable weather conditions and consumed VC upon drought. Apparently, differences in long-term aridity at the forest sites resulted in only few genetically fixed differences in foliar traits between the provenances. However, structural and physiological traits strongly responded to soil N contents and weather conditions before harvest. Foliar N contents and their partitioning were mostly determined by the differences in soil N availability at the sites, but still were modulated by weather conditions before harvest. In the first year, differences in aridity before harvest resulted in differences between most foliar traits. In the second year, when weather conditions at both sites were considerably similar and more arid compared to the first year, differences in foliar traits were almost negligible. This pattern was observed irrespective of seed origin. These results support the view that leaves of sessile oak seedlings generally possess a high plasticity to cope with extreme differences in aridity by immediate acclimation responses that are even better developed in plants of arid origin.
Long-Term Outcomes of Fasciotomy for Acute Compartment Syndrome After a Fracture of the Tibial Diaphysis
Authors: MacKenzie Samuel A. , Carter Thomas H. , MacDonald Deborah , White Timothy O. , Duckworth Andrew D. 
Published: July 2020

Objectives:
To evaluate the short- and long-term patient-reported outcomes of acute compartment syndrome (ACS) complicating a fracture of the tibial diaphysis.

Design:
A retrospective review.

Setting:
Academic orthopaedic trauma center.

Patients:
We retrospectively identified 559 patients from a trauma database over a 7-year period. Forty-one patients (7.3%) underwent fasciotomies for ACS and were included in the study. A matched cohort of 185 patients who did not develop ACS was used as controls.

Intervention:
Fasciotomy for ACS.

Main Outcome Measurements:
The primary short-term outcome measure was the development of complications, including infection, nonunion, and further surgery. The primary long-term outcome measure was the patient-reported EuroQol-5D-3L (EQ-5D). Secondary long-term outcomes included the Oxford Knee Score, the Manchester–Oxford Foot Questionnaire, and satisfaction.

Results:
There was no significant difference between ACS and non-ACS groups in the overall rate of infection (17% vs. 9.2%, respectively; P = 0.14), deep infection (4.9% vs. 3.8%; P = 0.67), or nonunion (4.9% vs. 7.0%; P = 1.00). There were 206 patients (21 ACS) with long-term outcome data at a mean of 5 years (1–9). There was no significant difference between groups about the EQ-5D (P = 0.81), the Oxford Knee Score (P = 0.24), or the Manchester–Oxford Foot Questionnaire (P = 0.63). Patient satisfaction was reduced in patients who developed ACS (77 vs. 88; P = 0.039).

Conclusion:
These data suggest that when managed with urgent decompressive fasciotomies, ACS does not seem to have a significant impact on the long-term patient-reported outcome although patient satisfaction is reduced.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Characterization of resting and exercise inter-arm differences in SBP to isometric handgrip exercise in males and females
Authors: Jensen Brock T. , Gordon Benjamin D.H. , Neuscheler Lance S. , Ace Stephanie N. , Borland Rachel K. , Holmstrup Michael E. 
Published: July 2020

A large inter-arm difference (IAD; ≥10 mmHg) in SBP is linked to cardiovascular and peripheral vascular disease, hypertension, and premature mortality. Exercise-induced IAD (eIAD) is related to resting IAD, and acute aerobic activity alters eIAD and reduces IAD in recovery. Isometric handgrip exercise (IHE) affects blood pressure (BP), though the eIAD response to IHE is unknown. Further, the eIAD response may differ between males and females.

Objectives
To characterize the eIAD response to IHE in males and females.

Methods
On visit 1, participants (16 females and 15 males, aged 18–35 years) completed three maximal voluntary isometric contractions (MVIC) per arm. On visit 2, before IHE, a series of three simultaneous, bilateral BP measures were averaged at rest. During IHE, participants maintained handgrip at 20% of MVIC for 2 minutes (arm randomly assigned), at which time bilateral BP was measured (IHE) during exercise and subsequent recovery (REC1 and REC2). Repeated-measures analysis of variance assessed eIAD and SBP (time × sex).

Results
IHE increased absolute eIAD (4 mmHg). Differences in relative eIAD were observed at IHE and REC2 based on resting IAD status (P < 0.05). Females only had an exaggerated SBP and pulse pressure response in the working arm.

Conclusion
Acute IHE was shown to augment eIAD. Further eIAD and resting IAD were related. Acute IHE induced different bilateral responses between males and females, though the impact of sex on eIAD warrants further investigation. Future studies should address the effects of repeated bouts of IHE, which may benefit individuals with a large resting IAD.
Combining Postmortem Cerebrospinal Fluid Biochemistry With Lung-to-Body Ratio to Aid the Diagnosis of Salt Water Drowning
Authors: Garland Jack , Ondruschka Benjamin , Palmiere Cristian , Hu Mindy , Philcox Winston , Hensby-Bennett Sarah , Stables Simon , Kesha Kilak , Glenn Charley , Morrow Paul , Tse Rexson 
Published: July 2020

Abstract
Diagnosing drowning as a cause of death can pose many challenges for the forensic pathologist and a number of ancillary tests have been proposed to assist in the diagnosis, whether the body was in salt water or fresh water. Although elevated vitreous humor sodium and chloride is a reliable marker, its limitation to prolonged immersion has resulted in the recent investigation of cerebrospinal fluid (CSF) sodium and chloride as alternative matrix in cases of longer or unknown immersion times. This study investigated postmortem CSF from lumbar puncture (CSF_L_Na_Cl) and ventricular aspiration (CSF_Vent_Na_Cl), as well as lung/body (LB) ratio in the diagnosis of salt water drowning and performed comparison and combination testing of methods to improve diagnostic accuracy of the drowning diagnosis. This study found that CSF_L_Na_Cl was the most accurate method (89%) in the given cohort, but that CSF_Vent_Na_Cl and LB combined was the second most accurate method (83%), exceeding CSF_Vent_Na_Cl (77%) and LB (81%) used alone. These findings are useful for stratifying and prioritizing postmortem samples in the investigation of salt water drowning and also have significance for future studies using this methodology to combine and compare the accuracy of different investigations.
Assessment of a Nine-Item Patient-Reported Outcomes Measurement Information System Upper Extremity Instrument Among Individuals With Upper Limb Amputation
Authors: England Dwiesha L. , Miller Taavy A. , Stevens Phillip M. , Campbell James H. , Wurdeman Shane R. 
Published: July 2020

ObjectiveThe aim of the study was to assess the validity of a customized nine-item Patient-Reported Outcomes Measurement Information System Upper Extremity instrument being used with individuals with upper extremity amputation to inform potential modifications for clinical efficiency.DesignA sample of 239 adults with upper extremity amputation (mean age = 48 ± 16 yrs; female = 69; prosthesis users = 150) were included. After clinical implementation of the nine-item Patient-Reported Outcomes Measurement Information System Upper Extremity, the following psychometric properties were examined: structural and known-groups validity, differential item functioning, and reliability.ResultsThe nine-item Patient-Reported Outcomes Measurement Information System Upper Extremity short form demonstrated satisfactory psychometric properties. Convincing evidence of structural validity included no violation of unidimensionality, local independence (all local dependence χ2< 10), monotonicity (Hij > 0, Hi > 0.3, and H = 0.57), and adequate model fit (P> 0.006). Known-groups analysis demonstrated that the nine-item Patient-Reported Outcomes Measurement Information System Upper Extremity instrument was able to discriminate between prosthesis users and nonprosthesis users and amputation level. The Cronbach’s α and item response theory reliability at the selected range ofTscores were greater than 0.9 indicating high reliability. No items were flagged for age in differential item functioning.ConclusionsThe customized nine-item Patient-Reported Outcomes Measurement Information System Upper Extremity met the minimum criteria, according to the Patient-Reported Outcomes Measurement Information System plan, for psychometric validity supporting its use within the population of individuals with upper extremity amputation.
Brief Report: Durable Suppression and Low Rate of Virologic Failure 3 Years After Switch to Dolutegravir + Rilpivirine 2-Drug Regimen: 148-Week Results From the SWORD-1 and SWORD-2 Randomized Clinical Trials
Authors: van Wyk Jean , Orkin Chloe , Rubio Rafael , Bogner Johannes , Baker David , Khuong-Josses Marie-Aude , Parks David , Angelis Konstantinos , Kahl Lesley P. , Matthews Jessica , Wang Ruolan , Underwood Mark , Wynne Brian , Nascimento Maria-Claudia , Vandermeulen Kati , Gartland Martin , Smith Kimberly Y. 
Published: July 2020

Background:
The SWORD trials showed that in participants who achieved virologic suppression taking 3-drug or 4-drug regimens, switching to the 2-drug regimen dolutegravir plus rilpivirine was noninferior in maintaining HIV-1 RNA <50 copies/mL at the week 48 primary endpoint. We present pooled week 148 analysis results from both studies.

Setting:
SWORD-1: 65 centers, 13 countries; SWORD-2: 60 centers, 11 countries.

Methods:
SWORD-1 and SWORD-2 are identical, open-label, phase III studies. Participants with screening HIV-1 RNA <50 copies/mL for ≥6 months; no prior virologic failure; and no documented resistance-associated major protease inhibitor, integrase inhibitor, nucleoside reverse transcriptase inhibitor (NRTI), or non-NRTI mutations or integrase resistance-associated substitution R263K were randomly assigned 1:1 to switch to once-daily dolutegravir 50 mg plus rilpivirine 25 mg on day 1 (early-switch group) or to continue their current antiretroviral regimen and, if virologically suppressed at week 48, switch to dolutegravir plus rilpivirine at week 52 (late-switch group) until week 148.

Results:
Using snapshot algorithm at week 148, 432 of 513 (84%) early-switch participants (148 weeks of exposure) and 428 of 477 (90%) late-switch participants (96 weeks of exposure) maintained HIV-1 RNA <50 copies/mL. Eleven participants (1%) on dolutegravir plus rilpivirine met the confirmed virologic withdrawal criterion through week 148 (early-switch group, n = 8; late-switch group, n = 3) with no integrase resistance identified. Non-NRTI resistance-associated mutations were identified in 6 participants (<1%). Drug-related adverse events (grades 2–4) were observed in 31 (6%) early-switch and 16 (3%) late-switch participants. Significant improvements in bone biomarkers were observed. Significant improvements were observed in renal biomarkers in participants taking tenofovir disoproxil fumarate pre‐switch.

Conclusion:
Switching to the 2-drug regimen dolutegravir plus rilpivirine maintained virologic suppression for a high proportion of participants through 3 years, with low rates of virologic failure and a well-tolerated safety profile.
A Systematic Review and Meta-analysis of the Use of High-Fidelity Simulation in Obstetric Ultrasound
Authors: Dromey Brian P. , Peebles Donald M. , Stoyanov Danail V. 
Published: July 2020

Summary Statement
There is little global consensus on how to train, assess, and evaluate skills in obstetric ultrasound. The outcomes of curricula, where present, are often based on the number of clinical cases completed, rather than objective outcomes. The central question in this review is whether simulation enhances training and prepares trainees for clinical practice. A systematic review was conducted of the currently available literature in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies considering the use of simulators in training or assessment of sonographers were eligible for inclusion. We conclude that simulation is best used for acquisition of technical skills and image optimization. Best outcomes are observed when simulation augments traditional learning, with a strong focus on specific, objective, and measurable skills. Integrating simulation into training curricula could allow trainees to contribute to clinical service while learning. How skills learned in a simulated environment translate to the clinic is poorly addressed by the literature.