bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Government Pay Attention to the Public? The Dynamics of Public Opinion and Government Attention in Posthandover Hong Kong
Authors: Xia Chuanli , Shen Fei 
Published: November 2019

AbstractGovernment response to public opinion is essential to democratic theory and practice. However, previous research on the relationship between public opinion and government attention predominantly focuses on western societies. Little is known about such relationship in nonwestern or nondemocratic societies. Drawing upon time-series data of public opinion polls and government press releases, this study examines the dynamic relationships between public opinion and government attention in posthandover Hong Kong. The findings reveal that the responsiveness of the Hong Kong government to public opinion varies across issue domains and is constrained by the political power from the central government in Beijing.
Discordant Zika Virus Findings in Twin Pregnancies Complicated by Antenatal Zika Virus Exposure: A Prospective Cohort
Authors: Sobhani Nasim C , Avvad-Portari Elyzabeth , Nascimento Aline C M , Machado Heloisa N , Lobato Daniel S S , Pereira Jose Paulo , Esquivel Mikaela S , Vasconcelos Zilton C , Zin Andrea A , Tsui Irena , Adachi Kristina , Brickley Elizabeth B , Fisher Susan J , Nielsen-Saines Karin , Brasil Patricia , Moreira Maria E , Gaw Stephanie L 
Published: November 2019

Abstract

Background
There are limited data on the natural history of antenatal Zika virus (ZIKV) exposure in twin pregnancies, especially regarding intertwin concordance of prenatal, placental, and infant outcomes.

Methods
This prospective cohort study included twin pregnancies referred to a single institution from September 2015 to June 2016 with maternal ZIKV. Polymerase chain reaction (PCR) testing of maternal, placental, and neonatal samples was performed. Prenatal ultrasounds were completed for each twin, and histomorphologic analysis was performed for each placenta. Abnormal neonatal outcome was defined as abnormal exam and/or abnormal imaging. Two- to three-year follow-up of infants included physical exams, neuroimaging, and Bayley-III developmental assessment.

Results
Among 244 pregnancies, 4 twin gestations without coinfection were identified. Zika virus infection occurred at 16–33 weeks gestation. Zika virus PCR testing revealed discordance between dichorionic twins, between placentas in a dichorionic pair, between portions of a monochorionic placenta, and between a neonate and its associated placenta. Of the 8 infants, 3 (38%) had an abnormal neonatal outcome. Of 6 infants with long-term follow-up, 3 (50%) have demonstrated ZIKV-related abnormalities.

Conclusions
Neonatal PCR testing, placental findings, and infant outcomes can be discordant between co-twins with antenatal ZIKV exposure. These findings demonstrate that each twin should be evaluated independently for vertical transmission.
CAFE2: an upgrade to the CAFE high-resolution spectrograph. Commissioning results and new public pipeline
Authors: Lillo-Box J , Aceituno J , Pedraz S , Bergond G , Galadí-Enríquez D , Azzaro M , Arroyo-Torres B , Fernández-Martín A , Guijarro A , Hedrosa R P , Hermelo I , Hoyo F , Martín-Fernández P 
Published: November 2019

ABSTRACT
CAFE is a high-resolution spectrograph with high-precision radial velocity capabilities mounted at the 2.2 m telescope of Calar Alto Observatory. It suffered from strong degradation after 4 yr of operations and it has now been upgraded. The upgrades of the instrument (now named CAFE2) aimed at recovering the throughput and improving the stability due to the installation of a new grating, an active temperature control in the isolated coudé room, and a new scrambling system. In this paper, we present the results of the new commissioning of the instrument and a new pipeline (CAFExtractor) that provides the user with fully reduced data including radial velocity measurements of FGK dwarf stars. The commissioning results show a clear improvement in the instrument performance. The room temperature is now stabilized down to 5 mK during one night and below 50 mK over two months. CAFE2 now provides 3 m s−1 precision on the reference ThAr frames and the on-sky tests provide a radial velocity precision of 8 m s−1 during one night (for S/N &gt; 50). The throughput of the instrument is now back to nominal values with an efficiency of around 15 per cent at 550 nm. The limiting magnitude of the instrument for a 1 h exposure and S/N = 20 is V = 15. With all these properties, CAFE enters into the small family of high-resolution spectrographs at 2–4 m telescopes capable of reaching radial velocity precisions below 10 m s−1.
Blue galaxies: modelling nebular He ii emission in high redshift galaxies
Authors: Barrow Kirk S S 
Published: November 2019

ABSTRACT
Using cosmological simulations to make useful, scientifically relevant emission line predictions is a relatively new and rapidly evolving field. However, nebular emission lines have been particularly challenging to model because they are extremely sensitive to the local photoionization balance, which can be driven by a spatially dispersed distribution of stars amidst an inhomogeneous absorbing medium of dust and gas. As such, several unmodelled mysteries in observed emission line patterns exist in the literature. For example, there is some question as to why He ii λ4686/H β ratios in observations of lower metallicity dwarf galaxies tend to be higher than model predictions. Since hydrodynamic cosmological simulations are best suited to this mass and metallicity regime, this question presents a good test case for the development of a robust emission line modelling pipeline. The pipeline described in this work can model a process that produces high He ii λ4686/H β ratios and eliminate some of the modelling discrepancy for ratios below 3 per cent without including AGNs, X-ray binaries, high mass binaries, or a top-heavy stellar initial mass function. These ratios are found to be more sensitive to the presence of 15 Myr or longer gaps in the star formation histories than to extraordinary ionization parameters or specific star formation rates. They also closely correspond to the WR phase of massive stars. In addition to the investigation into He ii λ4686/H β ratios, this work charts a general path forward for the next generation of nebular emission line modelling studies.
The Acute Kidney Outreach to Prevent Deterioration and Death trial: a large pilot study for a cluster-randomized trial
Authors: Thomas Mark E , Abdelaziz Tarek S , Perkins Gavin D , Sitch Alice J , Baharani Jyoti , Temple R Mark 
Published: November 2019

Abstract

Background and Objectives
The Acute Kidney Outreach to Reduce Deterioration and Death trial was a large pilot study for a cluster-randomized trial of acute kidney injury (AKI) outreach.

Methods
An observational control (before) phase was conducted in two teaching hospitals (9 miles apart) and their respective catchment areas. In the intervention (after) phase, a working-hours AKI outreach service operated for the intervention hospital/area for 20 weeks, with the other site acting as a control. All AKI alerts in both hospital and community patients were screened for inclusion. Major exclusion criteria were patients who were at the end of life, unlikely to benefit from outreach, lacking mental capacity or already referred to the renal team. The intervention arm included a model of escalation of renal care to AKI patients, depending on AKI stage. The 30-day primary outcome was a combination of death, or deterioration, as shown by any need for dialysis or progression in AKI stage. A total of 1762 adult patients were recruited; 744 at the intervention site during the after phase.

Results
A median of 3.0 non-medication recommendations and 0.5 medication-related recommendations per patient were made by the outreach team a median of 15.7 h after the AKI alert. Relatively low rates of the primary outcomes of death within 30 days (11–15%) or requirement for dialysis (0.4–3.7%) were seen across all four groups. In an exploratory analysis, at the intervention hospital during the after phase, there was an odds ratio for the combined primary outcome of 0.73 (95% confidence interval 0.42–1.26; P = 0.26).

Conclusions
An AKI outreach service can provide standardized specialist care to those with AKI across a healthcare economy. Trials assessing AKI outreach may benefit from focusing on those patients with ‘mid-range’ prognosis, where nephrological intervention could have the most impact.
Prognostic Utility of the New Definition of Difficult-to-Treat Resistance Among Patients With Gram-Negative Bloodstream Infections
Authors: Giannella Maddalena , Bussini Linda , Pascale Renato , Bartoletti Michele , Malagrinò Matteo , Pancaldi Livia , Toschi Alice , Ferraro Giuseppe , Marconi Lorenzo , Ambretti Simone , Lewis Russell , Viale Pierluigi 
Published: November 2019

Abstract

Background
To compare the prognostic utility of the new definition of difficult-to-treat resistance (DTR) vs established definitions in a cohort of patients with Gram-negative bloodstream infections (GNBSIs).

Methods
This was a retrospective single-center study of adult patients with monomicrobial GNBSI, hospitalized from 2013 to 2016. DTR was defined as isolate demonstrating intermediate or resistant phenotype to all reported agents in the carbapenem, beta-lactam, and fluoroquinolone classes. Carbapenem resistance (CR) was defined according to 2015 Centers for Disease Control and Prevention criteria. Each isolate was further classified according to the Magiorakos et al. criteria as non-multidrug-resistant (non-MDR), MDR, extensively drug-resistant (XDR), or pan-drug-resistant (PDR). The primary outcome was all-cause 30-day mortality.

Results
Overall, 1576 patients were analyzed. Enterobacteriaceae accounted for 88.7% of BSIs, with Escherichia coli (n = 941) and Klebsiella pneumoniae (n = 326) being the most common pathogens. Pseudomonas aeruginosa was the most common nonfermentative bacteria (n = 130, 8.2%). Overall, 11% of strains were defined as DTR and 13% as CR. Episodes were further classified as non-MDR (68.8%), MDR (21.9%), XDR (8.8%), and PDR (0.4%). The prevalence rates of DTR, CR, and XDR were similar among Enterobacteriaceae and Acinetobacter baumannii, whereas they differed in P. aeruginosa. All the analyzed resistance definitions significantly improved prediction of 30-day mortality when introduced into a baseline multivariate model, to a similar degree: 9%, 10%, and 11% for DTR, Magiorakos, and CR definitions, respectively.

Conclusions
DTR seems a promising tool to identify challenging GNBSIs, mainly those due to P. aeruginosa. With the availability of new agents for CR infections, further multicenter assessments of DTR are needed.
Exchange Rate Policies at the Zero Lower Bound
Authors: Amador Manuel , Bianchi Javier , Bocola Luigi , Perri Fabrizio 
Published: November 2019

Abstract
We study the problem of a monetary authority pursuing an exchange rate policy that is inconsistent with interest rate parity because of a binding zero lower bound constraint. The resulting violation in interest rate parity generates an inflow of capital that the monetary authority needs to absorb by accumulating foreign reserves. We show that these interventions by the monetary authority are costly, and we derive a simple measure of these costs: they are proportional to deviations from the covered interest parity (CIP) condition and the amount of accumulated foreign reserves. Our framework can account for the recent experiences of “safe-haven” currencies and the sign of their observed deviations from CIP.
Leveraging the Medical School Admissions Process to Foster a Smart, Humanistic, and Diverse Physician Workforce
Authors: Schwartzstein Richard M. 
Published: November 2019

An excellent physician has a range of talents, including the knowledge and critical thinking abilities to work with the rapidly changing biomedical and social science content of the profession as well as the interpersonal and communication skills to build meaningful relationships with patients and families. The Medical College Admission Test (MCAT) was revised in 2015 to focus more on analytical reasoning skills and behavioral and social sciences knowledge to ensure that future physicians have the capabilities needed to care for patients in the 21st century and to allow admissions committees to identify applicants who have demonstrated proficiency in these areas. With these changes, scores continue to be predictive of student performance in the preclerkship curriculum.
In this Invited Commentary, the author argues that, as educators struggle to define the characteristics of the “right” candidates for medical school and design processes to identify and admit those applicants, it is important to consider the message being sent by calls for the MCAT exam to play a reduced role in admissions decisions. Educators must avoid diminishing the importance of intellectual rigor and, while pursuing goals for a more diverse physician workforce, maintain standards that ensure medicine’s commitment to patients. The author concludes with suggestions for how educators can work with under-resourced colleges and premedical programs to help disadvantaged students get the preparation they need to succeed in medical school and throughout their careers. Taking these steps will allow educators to support students, prepare them for practice, and fulfill their obligation to the public to produce excellent physicians.
Parents Reliably Identify Pain Dismissal by Pediatric Providers
Authors: Igler Eva , Lang Amy , Balistreri Kathryn , Sejkora Ellen , Drendel Amy , Davies William H. 
Published: November 2019

Objectives:
Approximately 40% of children and adolescents with chronic pain report at least 1 dismissal experience, citing medical providers and parents as the primary and most distressing dismissers. Previous research indicates sex differences in pain dismissal experience and observer pain perception. This study examined parental reactions to dismissive provider-child scenarios and the influence of provider and patient sex on perceptions.

Methods:
Community parents (N=326) completed an online survey. Parents were randomized to listen to 1 of 8 vignettes of a provider-child chronic pain scenario. Vignettes varied by type of scenario (appropriate vs. dismissive)×provider sex×patient sex.

Results:
Overall, parents rated the dismissive scenario more negatively. There was a significant interaction between provider sex and scenario regarding likelihood to bring their own child to this provider and a significant 3-way interaction regarding provider belief of the pain complaint. When asked how they would feel if this was their own child, parents who heard the dismissive scenario reported more negative reactions. When asked what they would say to the provider, parents in the dismissive condition were more likely to defend their child and request a second opinion.

Discussion:
Parents consistently identified the dismissive language in a child and provider scenario. Female providers and sex-matched dyads seem to be more polarizing in terms of likelihood to bring their child to the provider and belief of pain, respectively. Providers within these groups may need to be especially cautious with their language when responding to pediatric chronic pain complaints.
Neonatal Intensive Care Unit-Specific Lactation Support and Mother's Own Breast Milk Availability for Very Low Birth-Weight Infants
Authors: Mercado Kathryn , Vittner Dorothy , Drabant Bradlee , McGrath Jacqueline 
Published: November 2019

Background:
Mother's own milk (MOM) is the preferred nutrition for premature infants, particularly for the very low birth-weight (VLBW) cohort. Benefits are well documented; yet, numerous barriers exist for provision of MOM in the neonatal intensive care unit (NICU). Lactation consultants (LCs) can optimize breastfeeding support for NICU mothers; however, understanding of the impact of NICU-dedicated LCs is limited.

Purpose:
Evaluate the effectiveness of NICU-dedicated LCs in improving breastfeeding outcomes and MOM provision in VLBW infants.

Methods:
A retrospective chart review of 167 VLBW infants comparing breastfeeding outcomes between 2 NICUs, one with NICU-dedicated LCs (hospital A; n = 48) and one without (hospital B; n = 119). Primary outcome measures included feeding percentages of MOM received by infants at 3 intervals, throughout hospitalization, and number of direct breastfeeding events. Secondary outcome measures included number of days to first enteral feed, days to reach full feeds, days of nil per os, days on total parenteral nutrition, and length of stay.

Findings:
Neonatal intensive care unit–specific lactation support increased the number of direct breastfeeding events on day of discharge (P = .048). No statistical significance was found at each of the 3 time intervals, or throughout hospitalization (week 1: P = .18; midpoint: P = .40; discharge: P = .16; total hospitalization: P = .19). No statistical significance was demonstrated in secondary outcome measures (days to first enteral feed: P = .22; days to full feeds: P = .25; nil per os days: P = .27; total parenteral nutrition days: P = .34; length of stay: P = .01). Length of stay not found to be significant after correcting for confounding variables.

Implication for Practice:
Increased direct breastfeeding events on day of discharge with exposure to NICU-dedicated LCs in the VLBW population.

Implication for Research:
Prospective studies regarding NICU-specific lactation support with larger samples are warranted.
Advances in the Preoperative Planning of Revision Trauma Surgery Using 3D Printing Technology
Authors: Horas Konstantin , Hoffmann Reinhard , Faulenbach Miriam , Heinz Simon M. , Langheinrich Alexander , Schweigkofler Uwe 
Published: November 2019

Summary:
The management of complex fractures at the time of revision surgery remains one of the most challenging tasks for orthopaedic trauma surgeons. As the major principle of treatment remains to achieve an anatomic reduction and a stable fixation, precise preoperative diagnostics and treatment planning are of utmost importance. Thus, knowledge of the 3-dimensional anatomy of the fracture site and its surrounding tissue is indispensable. However, radiographic tools have thus far mostly been unable to recapitulate the complexity of the fracture site in toto. In recent years, the development of 3-dimensional (3D) printers has led to novel opportunities in preoperative planning of complex operative procedures. Although the application of 3D printers has become increasingly popular in orthopaedic surgery, its implementation in trauma surgery is so far mostly limited to the preoperative planning of surgery in patients with pelvic and acetabular fractures/defects. Moreover, reports describing the advantages using this sophisticated methodology in revision trauma surgery are sparse. In this article, we report our experience using novel 3D printing technologies for the management of revision surgery in orthopaedic trauma. In particular, we describe the benefit of using 3D printing technologies in the preoperative planning of complex revision surgery of the proximal tibia, the elbow joint, the distal femur, the ankle joint, and several others. With the advantage to preoperatively plan the optimal surgical approach, implant placement, and contouring as well as the possibility to anticipate intraoperative difficulties, we believe that this emerging technology is of significant value for revision surgery in orthopaedic trauma.
Establishment and application of an artificial intelligence diagnosis system for pancreatic cancer with a faster region-based convolutional neural network
Authors: Liu Shang-Long , Li Shuo , Guo Yu-Ting , Zhou Yun-Peng , Zhang Zheng-Dong , Li Shuai , Lu Yun 
Published: November 2019

Abstract

Background:
Early diagnosis and accurate staging are important to improve the cure rate and prognosis for pancreatic cancer. This study was performed to develop an automatic and accurate imaging processing technique system, allowing this system to read computed tomography (CT) images correctly and make diagnosis of pancreatic cancer faster.

Methods:
The establishment of the artificial intelligence (AI) system for pancreatic cancer diagnosis based on sequential contrast-enhanced CT images were composed of two processes: training and verification. During training process, our study used all 4385 CT images from 238 pancreatic cancer patients in the database as the training data set. Additionally, we used VGG16, which was pre-trained in ImageNet and contained 13 convolutional layers and three fully connected layers, to initialize the feature extraction network. In the verification experiment, we used sequential clinical CT images from 238 pancreatic cancer patients as our experimental data and input these data into the faster region-based convolution network (Faster R-CNN) model that had completed training. Totally, 1699 images from 100 pancreatic cancer patients were included for clinical verification.

Results:
A total of 338 patients with pancreatic cancer were included in the study. The clinical characteristics (sex, age, tumor location, differentiation grade, and tumor-node-metastasis stage) between the two training and verification groups were insignificant. The mean average precision was 0.7664, indicating a good training effect of the Faster R-CNN. Sequential contrast-enhanced CT images of 100 pancreatic cancer patients were used for clinical verification. The area under the receiver operating characteristic curve calculated according to the trapezoidal rule was 0.9632. It took approximately 0.2 s for the Faster R-CNN AI to automatically process one CT image, which is much faster than the time required for diagnosis by an imaging specialist.

Conclusions:
Faster R-CNN AI is an effective and objective method with high accuracy for the diagnosis of pancreatic cancer.

Trial Registration:
ChiCTR1800017542; http://www.chictr.org.cn.
Frozen-Section Tissue Processing in Mohs Surgery
Authors: Aslam Arif , Aasi Sumaira Z. 
Published: November 2019

BACKGROUND
Mohs micrographic surgery (MMS) is the most reliable tissue-sparing technique in the management of cutaneous malignancies. Although the concept is simple, there is considerable variability in the mapping and processing techniques used by Mohs surgeons and histotechnicians.

OBJECTIVE
This review article aims to examine the frozen-section tissue processing techniques. Existing variations will be discussed and pearls offered to optimize the frozen processing technique.

METHODS
A PubMed search was performed for publications on methods of tissue processing in MMS.

RESULTS
Our review highlights variations in debulking, embedding, processing adipose tissue, cartilage, and wedge resections. We offer pearls on how to avoid false-positive and false-negative margins and discuss advances in immunohistochemistry.

CONCLUSION
Our article provides a how-to format on the different stages of tissue processing with pearls and techniques to optimize practice and improve accuracy.
Trabecula: A Random Generator of Computational Phantoms for Bone Marrow Dosimetry
Authors: Shishkina E.A. , Timofeev Y.S. , Volchkova A.Y. , Sharagin P.A. , Zalyapin V.I. , Degteva M.O. , Smith M.A. , Napier B.A. 
Published: November 2019

Abstract
This study was motivated by the efforts to evaluate radiation risk for leukemia incidence in the Techa River cohort, where the main bone marrow dose contributors were 89,90Sr (bone-seeking beta emitters). Energy deposition in bone marrow targets was evaluated by simulating radiation particle transport using computational phantoms. The present paper describes the computer program Trabecula implementing an algorithm for parametric generation of computational phantoms, which serve as the basis for calculating bone marrow doses. Trabecula is a user-friendly tool that automatically converts analytical models into voxelized representations that are directly compatible as input to Monte Carlo N Particle code.