bluuebunny/crossref_metadata_2025_split huggingface dataset:
Basic considerations for the observability of kinematically offset binary AGN
Authors: Kelley Luke Zoltan 
Published: October 2020

ABSTRACT
The gravitational waves from massive black hole (MBH) binaries are expected to be detected by pulsar timing arrays in the next few years. While they are a promising source for multimessenger observations as binary active galactic nuclei (AGNs), few convincing candidates have been identified in electromagnetic surveys. One approach to identifying candidates has been through spectroscopic surveys searching for offsets or time-dependent offsets of broad emission lines (BLs), which may be characteristic of Doppler shifts from binary orbital motion. In this study, we predict the parameter space of MBH binaries that should be kinematically detectable. There is a delicate trade-off between requiring binary separations to be large enough for BL regions to remain attached to one of the AGNs, but also small enough such that their orbital velocity is detectable. We find that kinematic signatures are only observable for the lower mass secondary AGN, for binaries with total masses above about $10^8 \, \textrm {M}_{\odot }$, and separations between 0.1 and 1 pc. We motivate our usage of a kinematic offset sensitivity of 103 km s−1, and a sensitivity to changing offsets of 102 km s−1. With these parameters, and an Eddington ratio of 0.1, we find that $0.5{{\ \rm per\ cent}}$ of binaries have detectable offsets, and only $0.03{{\ \rm per\ cent}}$ have detectable velocity changes. Overall, kinematic binary signatures should be expected in fewer than one in 104 AGNs. Better characterizing the intrinsic variability of BLs is crucial to understanding and vetting MBH binary candidates. This requires multi-epoch spectroscopy of large populations of AGNs over a variety of time-scales.
John Heil’s General Ontology
Authors: Bisconti Matthew 
Published: October 2020

Abstract
A categorial dualist, John Heil includes substance and property in his ontology. But in his case for dualism, there are pressures to drop substance or property and endorse monism, as well as pressures to include both. Rather than defend monism or dualism, I introduce a distinction. If a category is a kind of entities, then substance is the only category. If an accounting of categories is to include property, then property must enter not as a kind of entities but (to coin a term) a kind of aspects of reality. The distinction is worth deploying for two main reasons. First, it makes plain an important difference between substances and properties, which categorial dualism obscures. Second, the distinction reduces puzzlement about whether and how to include relation in an accounting of categories.
Nietzschean Monism? A Pandispositionalist Proposal
Authors: Riccardi Mattia 
Published: October 2020

AbstractI argue that Nietzsche puts forward a pandispositionalist view that can be seen as the conjunction of two basic claims: that powers are the basic constituents of reality, on the one hand, and that the only properties things possess are relational qua dispositional, on the other hand. As I believe that such a view is, at least in part, motivated by his rejection of Kant’s notion of things in themselves, I start by sketching the metaphysics of Kant’s transcendental idealism (section 2) and by presenting Nietzsche’s critical reaction to it (section 3). After that, I start to work out Nietzsche’s pandispositionalist view by considering first the case of physical reality (section 3) and second that of psychological reality (section 5). I then argue that in both cases that view does not conflict with Nietzsche’s naturalism (section 6). In the last part of the paper I explore how his notion of will to power fits into such a pandispositionalist picture. Here, I shall argue, some serious tension does arise, for the claim that Nietzsche sometimes makes to the effect that the will to power is a fundamental physical force seems to clash with central aspects of his mature thought (section 7). However, whereas he repeatedly entertains that claim in his unpublished notes, it is far from clear that he ever meant to endorse it in his published work. Thus, I conclude that the available textual evidence only justifies attributing to Nietzsche the kind of pandispositionalist view spelled out in the first sections of the present paper, and not also the further claim that the will to power is a fundamental physical force (section 8).
The role of VEGF receptor inhibitors in preventing cerebral radiation necrosis: a retrospective cohort study
Authors: Alnahhas Iyad , Rayi Appaji , Palmer Joshua D , Raval Raju , Folefac Edmund , Ong Shirley , Giglio Pierre , Puduvalli Vinay 
Published: October 2020

AbstractBackgroundRadiation necrosis (RN) is a potential complication after radiation therapy for brain tumors. It is hypothesized that VEGF plays an important role in the pathophysiology of RN. Bevacizumab, a monoclonal antibody against VEGF-A, is often successful in the management of RN. The objective of this study is to assess whether VEGF receptor (VEGFR) inhibitors, a group of oral tyrosine kinase inhibitors (TKIs), can prevent or reverse RN.MethodsWe retrospectively studied a cohort of 102 patients with renal cell carcinoma and brain metastases seen at The Ohio State University James Cancer Center between January 1, 2011 and April 30, 2019. We identified those who developed RN and analyzed the temporal relationship between the use of VEGFR TKIs and the development of RN.ResultsThe cumulative incidence of RN is 13.7% after radiation treatments that included LINAC-based stereotactic radiosurgery, fractionated stereotactic radiotherapy, or Gamma Knife radiosurgery. There was no statistically significant difference in the cumulative incidence of RN between patients taking TKIs and patients who were off TKIs (9.9% and 11.5% respectively, P = .741). The median time to development of RN was only numerically shorter in patients taking TKIs (151 vs 315 days, P = .315). One patient developed RN after stopping cabozantinib. Eight patients developed RN while on cabozantinib, pazopanib, or sunitinib. One patient was started on axitinib during active RN without significant improvement subsequently.ConclusionsVEGFR TKIs do not consistently prevent RN. The therapeutic effects of VEGFR TKIs against RN warrant further research.
Field Evaluation of Cholkit Rapid Diagnostic Test forVibrio Cholerae O1During a Cholera Outbreak in Malawi, 2018
Authors: Chibwe Innocent , Kasambara Watipaso , Kagoli Mathews , Milala Harry , Gondwe Charity , Azman Andrew S 
Published: October 2020

AbstractRapid diagnostic tests (RDTs) for cholera are an important emerging tool for surveillance, yet the currently available tests have several limitations. We assess the performance of a new RDT, Cholkit, during a cholera outbreak in Malawi compared with culture and find a sensitivity of 93.0% (95% CI, 83.0%–98.1%) and a specificity of 95.7% (95% CI, 78.1%–100.0%).
Associations Between Relative Viral Load at Diagnosis and Influenza A Symptoms and Recovery
Authors: McKay Brian , Ebell Mark , Billings Wesley Zane , Dale Ariella Perry , Shen Ye , Handel Andreas 
Published: October 2020

Abstract

Background
Rapid point-of-care polymerase chain reaction (PCR) diagnostic tests generally provide a qualitative result of positive or negative only. Additional information about the relative viral load could be calculated. Such quantitative information might be useful for making treatment decisions.

Methods
We enrolled students at a university health center who presented with cough and 1 additional flu-like symptom from December 2016 to February 2017. Data were collected before, during, and 5 days after the clinic visit. All those enrolled in the study received a point-of-care PCR test (cobas Liat). For those patients that tested positive for influenza A, we investigated correlations between the relative viral load and measures of disease severity and recovery.

Results
One hundred thirty-five students tested positive for influenza A. We found a positive correlation between viral load and body temperature. Time since symptom onset seemed to have a negative correlation but was not statistically significant. We did not find any correlations between viral load and overall symptom severity or outcomes related to recovery.

Conclusions
Although we found a correlation between relative viral load and body temperature, for our study population of young, overall healthy adults, we did not find that relative viral load provided additional information that could help in determining treatment and disease outcomes. It could be that viral load does provide useful additional information for other groups of patients, such as young children or older adults. Further studies on those populations are warranted.
Surgery for Degenerative Cervical Myelopathy
Authors: Gembruch Oliver , Jabbarli Ramazan , Rashidi Ali , Chihi Mehdi , Hetze Susann , Barthel Lennart , Toplak Adrian , El Hindy Nicolai , Sure Ulrich , Dammann Philipp , Özkan Neriman 
Published: October 2020

Study Design.
Retrospective study (data analysis).

Objective.
The purpose of this study was to assess the role of different factors on postoperative outcome of patients with degenerative cervical myelopathy (DCM).

Summary of Background Data.
Ongoing degenerative changes of DCM lead to progressive neurological deficits. The optimal timing of surgical treatment is still unclear, especially in patients with mild DCM.

Methods.
Patients with DCM treated in our clinic between 2007 and 2016 were retrospectively analyzed. Pre- and postoperative neurological function was assessed by the modified Japanese Orthopaedic Association Score (mJOA Score) at different stages. The minimum clinically important difference (MCID) was used to evaluate the improvement after surgery. The comorbidities were recorded using the Charlson Comorbidity Index (CCI). Possible associations between age, sex, CCI, preoperative symptoms duration, high signal intensity (SI) on T2-weighted magnetic resonance imaging (MRI) with mJOA Score and MCID were analyzed using univariate analysis and multivariate regression models. Additionally, subgroup analysis was performed according to the severity of DCM (mild: mJOA Score ≥15 points; moderate: mJOA Score of 12–14 points; and severe: mJOA Score <12 points).

Results.
The mean age of the final cohort (n = 411) was 62.6 years (range: 31–96 years), 36.0% were females. High SI on T2-weighted MRI was detected in 60.3% of the cases. In the multivariate analysis, patients’ age (P = 0.005), higher CCI (P = 0.001), and presence of high SI on T2-weighted MRI (P = 0.0005) were associated independently with lower pre- and postoperative mJOA Score and postoperative MCID. Subgroup analysis revealed age and high SI on T2-weighted MRI as predictors of pre- and postoperative mJOA. However, symptom duration did not influence neurological outcome according to the severity of DCM.

Conclusion.
Surgery for DCM leads to significant functional improvement. However, better outcome was observed in younger individuals with lower CCI and absence of radiographic myelopathy signs. Therefore, DCM surgery, particularly before occurrence of high SI on MRI, seems to be essential for postoperative functional improvement regardless the above-mentioned confounders.

Level of Evidence: 3
Cervical Spinal Fusion in Adult Patients With Rheumatoid Arthritis
Authors: Fields Michael W. , Lee Nathan J. , Hong Daniel Y. , Para Ashok , Boddapati Venkat , Mathew Justin , Kim Jun S. , Lombardi Joseph , Lehman Ronald A. , Riew K. Daniel 
Published: October 2020

Study Design.
Retrospective cohort study.

Objective.
The purpose of this study was to utilize the National Readmission Database to determine the national estimates of complication and 90-day readmission rates associated with cervical spinal fusion in adult patients with rheumatoid arthritis (RA).

Summary of Background.
RA patients who undergo cervical spine surgery are known to be at high risk for readmissions, which are costly and may not be reimbursed by Medicare.

Methods.
The National Readmission Database was queried for adults (>18 years) diagnosed with RA undergoing cervical spine fusion. Patient, operative, and hospital factors were assessed in bivariate analyses. Independent risk factors for readmissions were identified using stepwise multivariate logistic regression.

Results.
From 2013 to 2014, a total of 5597 RA patients (average age: 61.5 ± 11.2 years, 70.9% female) underwent cervical spine fusion. A total of 691 (12.3%) patients were readmitted within 90 days (Table 1). Index inpatient complications included dysphagia (readmitted: 7.9% vs. non-readmitted: 5.1%; P = 0.003), urinary tract infection (UTI) (8.8% vs. 3.7%; P < 0.001), respiratory-related complications (7.6% vs. 3.4%; P < 0.001), and implant-related complications (5.4% vs. 2.7%; P < 0.001). Multivariate logistic regression demonstrated the following as the strongest independent predictors for 90-day readmission: intraoperative bleeding (odds ratio [OR]: 3.6, P = 0.001), inpatient Deep Vein Thrombosis (DVT) (OR 4.1, P = 0.004), and patient discharge against medical advice (OR 33.5, P = 0.001).

Conclusion.
Readmission rates for RA patients undergoing cervical spine surgery are high and most often due to postoperative infection (septicemia, UTI, pneumonia, wound). Potential modifiable factors which may improve outcomes include minimizing intraoperative blood loses, postoperative DVT prophylaxis, and discharge disposition.

Level of Evidence: 3
Long-term Radiographic Outcome of Occipitocervical Fixation
Authors: Shimizu Takayoshi , Fujibayashi Shunsuke , Otsuki Bungo , Takemoto Mitsuru , Murata Koichi , Matsuda Shuichi 
Published: October 2020

Study Design.
Retrospective case series

Objective.
The aim of this study was to investigate the long-term radiographic outcome of patients who underwent occipitocervical fixation (OCF) using a modern screw/rod system.

Summary of Background Data.
Few studies have reported fusion rates and radiographic alignment changes in unfused subaxial segments after OCF at a long-term follow-up.

Methods.
We retrospectively reviewed 22 patients who underwent OCF with a modern screw-based construct. The patients satisfied the minimum 2-year radiographic follow-up. Baseline demographics and the following pre- and postoperative sagittal alignment parameters were investigated. McGregor slope, O-C2 angle (OC2A), and C2-7 Cobb angle (CL). We grouped patients into those whose OC2A increased postoperatively (OC2A-increase group) and those whose OC2A decreased postoperatively (OC2A-decrease group). The postoperative sagittal alignment change was compared between the 2 groups at the final follow-up. The perioperative complications as well as fusion status based on computed tomography (CT) were investigated.

Results.
The average follow-up period was 89.7 months. The lowest instrumented vertebra was at C2 (63.6%), C3 (18.1%), or C4 (18.1%). The fusion rate at the final follow-up was 77.2%. Postoperative dysphasia occurred in two patients (16.6%) in the OC2A-decrease group, whereas distal junctional kyphosis was observed in two patients (20.0%) in the OC2A-increase group. The OC2A-increase group demonstrated a mean 4.8° decrease in CL as a compensation for the 5.1° increase in OC2A. In contrast, the OC2A-decrease group showed a mean 9.2° increase in CL as a compensation for the 6.3° decrease in OC2A.

Conclusion.
The CT-confirmed fusion rate of OCF was 77.2% over an average 89.7-month follow-up. Compensatory sagittal alignment change can occur in the unfused subaxial segments in conjunction with the alignment change in the instrumented OC segments, whereas the horizontal gaze was maintained. Strong consideration for the intraoperative measurement of the OC2A should be given during OCF to minimize both early and long-term complications.

Level of Evidence: 4
Impact of CYP2D6, CYP3A5, and ABCB1 Polymorphisms on Plasma Concentrations of Donepezil and Its Metabolite in Patients With Alzheimer Disease
Authors: Kagawa Yoshiyuki , Yamamoto Yoshiaki , Ueno Ayami , Maeda Toshio , Obi Tomokazu 
Published: October 2020

Background:
Donepezil is one of the most commonly prescribed drugs for the treatment of Alzheimer disease. It is predominantly metabolized through CYP2D6 and to a lesser extent by CYP3A4/5. There are conflicting reports regarding the influence of CYP2D6, CYP3A5, and ABCB1 polymorphisms on the plasma concentration of donepezil. This study investigated the influence of these polymorphisms and sex on the plasma concentrations of donepezil and its active metabolite, 6-O-desmethyl donepezil (6ODD), in 47 patients with Alzheimer disease.

Methods:
Plasma donepezil and 6ODD concentrations were measured using liquid chromatography tandem mass spectrometry. Sex, the concomitant use of psychotropics, and CYP2D6, CYP3A5, and ABCB1 polymorphisms were analyzed as possible influencers.

Results:
The mean plasma concentrations of donepezil and 6ODD were well correlated (R2 = 0.418). The mean plasma concentration ratio of donepezil to 6ODD (metabolic ratio) was significantly lower in intermediate metabolizers of CYP2D6 than in extensive metabolizers. The metabolic ratio in patients receiving psychotropics was significantly lower than in those not receiving psychotropics. Among intermediate metabolizers, patients positive for CYP3A5 *3/*3 showed a significant increase in plasma mean 6ODD concentrations when compared with those who did not express this gene (CYP3A5 *1/*1 or *1/*3).

Conclusions:
Results indicate that the mean plasma concentration ratio of donepezil to 6ODD is associated with CYP2D6 polymorphism and the concomitant use of psychotropics in patients with Alzheimer disease. In intermediate metabolizers, CYP3A5 may play a significant role in the metabolism of donepezil.
Medical Cost of Workers’ Compensation Claims Related to Patient Handling and Mobility Tasks Within Skilled Nursing Facilities, Continuing Care Retirement Communities and Assisted Living Facilities
Authors: Pieretti Luis F. , Sylvester Robert A. , Siegfried Karl V. 
Published: October 2020

Objective:
Evaluate the medical costs related to patient handling & mobility (PH&M) claims.

Methods:
Closed medical only and indemnity workers’ compensation claims were utilized for this exploratory study. In addition to the PH&M tasks, the claimants’ gender, age, tenure, and the claim lag time were also analyzed.

Results:
Generalized linear models indicated that variables related to tasks, claims’ number of open days and age of the claimants had meaningful effects on the adjusted medical costs for medical only claims. For indemnity claims, the number of open days of claims, age and tenure had meaningful effects. Gender had meaningful effects only for indemnity claims when classifying the claims by patient handling tasks versus non-patient handling tasks.

Conclusions:
Results showed that factors, other than the type of injury; meaningfully influenced the adjusted medical costs of indemnity claims.
PROBE Study: A Sentinel Surveillance System to Monitor Exposure of Belgian Employees to Hazardous Chemicals
Authors: Pauwels Sara , Swinnen Celien , Temmerman Anne-Marie , Ronsmans Steven , Rusu Dorina , De Schryver Antoon , Braeckman Lutgart , Godderis Lode 
Published: October 2020

Objective:
To test the feasibility of collecting reliable and representative data on exposure of Belgian employees to a selection of hazardous chemicals by using a sentinel surveillance method.

Method:
In PROBE (Hazardous chemical Products Register for Occupational use in Belgium), 47 occupational physicians were recruited as a sentinel network. Employees answered a web-based survey assessing their past week exposure to 22 chemicals.

Results:
47% employees were exposed to at least one chemical. The most frequently reported exposures was to diesel exhaust (14%). The exposed employees were mostly older men, with most exposed during production and manufacturing, and working in smaller companies. For diesel exhaust, wood dust, and crystalline silica, 54%, 32%, and 20% of the exposed employees, did not use collective/personal protective equipment.

Conclusion:
Sentinel surveillance is a feasible method for obtaining high-quality data on the exposure of Belgian employees to hazardous chemicals.
Decision Making in Patients With Concomitant Otosclerosis and Superior Semicircular Canal Dehiscence: A Systematic Review of the Literature
Authors: Fernandez Ignacio J. , Molinari Giulia , Presutti Livio 
Published: October 2020

Objective:
Concomitant otosclerosis (OTS) and superior semicircular canal dehiscence (SSCD) is a rare, but difficult-to-identify and treat diagnosis. A systematic review of the literature was performed to analyze the diagnostic and therapeutic approaches of concurrent OTS and SSCD cases and to identify possible factors that may help in predicting the surgical outcome.

Data Sources:
PubMed, Scopus, Medscape, Ovid databases.

Study Selection:
Studies showing diagnosis of OTS documented by audiometric test with or without associated radiological signs (computed tomography), and concomitant diagnosis of SSCD, documented at least by high-resolution computed tomography (and possibly supported by neurophysiological testing) were included. Both surgically treated and untreated patients were considered for data analysis.

Data Extraction:
The general characteristics of each study were recorded, when available. Clinical, audiological, vestibular testing, surgical, and radiological data were extracted from the published case reports and series, and recorded on a database. For each case, the diagnostic steps that confirmed OTS and concomitant SSCD in the same ear were extracted.

Data Synthesis:
Twelve studies were included in the review and 18 cases affected simultaneously by the 2 conditions were extracted and analyzed. Seven of 12 ears (58.3%) undergoing stapes surgery experienced a hearing improvement. In four (33.3%) cases, vestibular symptoms (with or without associated acoustic symptoms) of SSCD were unmasked or worsened by stapes surgery.

Conclusions:
A reliable preoperative diagnosis of the two concomitant conditions is possible with a proper interpretation of clinical signs, audiometric, and vestibular testing, in association with the radiologic assessment. Despite that the length and the location of the dehiscence may guide the surgical decision, definitive conclusions regarding the appropriate indications for surgical treatment cannot be drawn due to the limited number of cases with adequate data reported in the literature.