bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acoustic emission characteristics of pre-cracked specimens under biaxial compression
Authors: Liu Xuewei , Liu Quansheng , Liu Bin , Liu Qi 
Published: October 2019

AbstractThis paper presents an experimental study in which molded gypsum pre-cracked specimens with two types of flaw (single and X-shaped cross flaws) were tested under biaxial compression. Results show that acoustic emission (AE) energy rate curves can be divided into three different periods during uniaxial compression, which correspond to crack closure, linear elastic and unstable failure stages of specimens. However, only two periods are observed during biaxial compression, which correspond to linear elastic deformation and unstable failure. Furthermore, two proposed AE parameters, namely the AE energy ratio and AE energy release ratio, and a classical AE parameter b-value were used to analyze the influence of biaxial compression loading on AE energy, respectively. With increasing confining pressure, the AE energy release ratio, as well as AE b-value decreases gradually while AE energy ratio increases. Moreover, maximum and average AE energy rate values decrease as confining pressure increases. Data presented herein is useful to study the AE characteristics of pre-cracked specimens under biaxial compression.
Oxybutynin vs Placebo for Hot Flashes in Women With or Without Breast Cancer: A Randomized, Double-Blind Clinical Trial (ACCRU SC-1603)
Authors: Leon-Ferre Roberto A , Novotny Paul J , Wolfe Eric G , Faubion Stephanie S , Ruddy Kathryn J , Flora Daniel , Dakhil Christopher S R , Rowland Kendrith M , Graham Mark L , Le-Lindqwister Nguyet , Smith Thomas J , Loprinzi Charles L 
Published: October 2019

Abstract

Background
Hot flashes (HFs) negatively affect quality of life among perimenopausal and postmenopausal women. This study investigated the efficacy of oxybutynin vs placebo in decreasing HFs.

Methods
In this randomized, multicenter, double-blind study, women with and without breast cancer with 28 or more HFs per week, lasting longer than 30 days, who were not candidates for estrogen-based therapy, were assigned to oral oxybutynin (2.5 mg twice a day or 5 mg twice a day) or placebo for 6 weeks. The primary endpoint was the intrapatient change from baseline in weekly HF score between each oxybutynin dose and placebo using a repeated-measures mixed model. Secondary endpoints included changes in weekly HF frequency, HF-related daily interference scale questionnaires, and self-reported symptoms.

Results
We enrolled 150 women. Baseline characteristics were well balanced. Mean (SD) age was 57 (8.2) years. Two-thirds (65%) were taking tamoxifen or an aromatase inhibitor. Patients on both oxybutynin doses reported greater reductions in the weekly HF score (5 mg twice a day: −16.9 [SD 15.6], 2.5 mg twice a day: −10.6 [SD 7.7]), placebo −5.7 (SD 10.2); P &lt; .005 for both oxybutynin doses vs placebo), HF frequency (5 mg twice a day: −7.5 [SD 6.6], 2.5 mg twice a day: −4.8 [SD 3.2], placebo: −2.6 [SD 4.3]; P &lt; .003 for both oxybutynin doses vs placebo), and improvement in most HF-related daily interference scale measures and in overall quality of life. Patients on both oxybutynin arms reported more side effects than patients on placebo, particularly dry mouth, difficulty urinating, and abdominal pain. Most side effects were grade 1 or 2. There were no differences in study discontinuation because of adverse effects.

Conclusion
Oxybutynin is an effective and relatively well-tolerated treatment option for women with HFs.
Astrocytic Tau Deposition Is Frequent in Typical and Atypical Alzheimer Disease Presentations
Authors: Nolan Amber , De Paula Franca Resende Elisa , Petersen Cathrine , Neylan Kyra , Spina Salvatore , Huang Eric , Seeley William , Miller Zachary , Grinberg Lea T 
Published: October 2019

AbstractTypical Alzheimer disease (AD) features an amnestic syndrome that reflects the progression of pathology through specific neural networks. However, a subset of patients exhibits atypical onset with prominent language, behavioral, or visuospatial deficits that are not explained by current neuropathological staging schemes. Astrogliopathy featuring tau inclusions with thorn-shaped and granular fuzzy morphologies is common in the aging brain and collectively known as aging-related tau astrogliopathy (ARTAG). Prior studies have identified tau-positive thorn-shaped astrocytes in the white matter that associate with a primary progressive aphasia phenotype in an AD cohort. However, a possible contribution of ARTAG copathology to AD clinical heterogeneity has yet to be systematically examined. To investigate whether ARTAG pathology contributes to atypical presentations, we mapped the presence and density of ARTAG subtypes throughout cortical and subcortical regions in a well-characterized cohort of AD cases enriched for atypical presentations. In our cohort, ARTAG pathology is frequent and correlates with older age and higher Braak stage. ARTAG subtypes exhibit distinct distribution patterns with subpial and subependymal deposition occurring in the amygdala, while white and grey matter astrocytic deposition are distributed throughout cortical regions. However, ARTAG pathology is equally prevalent in cases with typical and atypical clinical presentations.
The DisGeNET knowledge platform for disease genomics: 2019 update
Authors: Piñero Janet , Ramírez-Anguita Juan Manuel , Saüch-Pitarch Josep , Ronzano Francesco , Centeno Emilio , Sanz Ferran , Furlong Laura I 
Published: October 2019

Abstract
One of the most pressing challenges in genomic medicine is to understand the role played by genetic variation in health and disease. Thanks to the exploration of genomic variants at large scale, hundreds of thousands of disease-associated loci have been uncovered. However, the identification of variants of clinical relevance is a significant challenge that requires comprehensive interrogation of previous knowledge and linkage to new experimental results. To assist in this complex task, we created DisGeNET (http://www.disgenet.org/), a knowledge management platform integrating and standardizing data about disease associated genes and variants from multiple sources, including the scientific literature. DisGeNET covers the full spectrum of human diseases as well as normal and abnormal traits. The current release covers more than 24 000 diseases and traits, 17 000 genes and 117 000 genomic variants. The latest developments of DisGeNET include new sources of data, novel data attributes and prioritization metrics, a redesigned web interface and recently launched APIs. Thanks to the data standardization, the combination of expert curated information with data automatically mined from the scientific literature, and a suite of tools for accessing its publicly available data, DisGeNET is an interoperable resource supporting a variety of applications in genomic medicine and drug R&D.
Impact of EGFR mutation and ALK rearrangement on the outcomes of non–small cell lung cancer patients with brain metastasis
Authors: Balasubramanian Suresh K , Sharma Mayur , Venur Vyshak A , Schmitt Philipp , Kotecha Rupesh , Chao Samuel T , Suh John H , Angelov Lilyana , Mohammadi Alireza M , Vogelbaum Michael A , Barnett Gene H , Jia Xuefei , Pennell Nathan A , Ahluwalia Manmeet S 
Published: October 2019

Abstract

Background
The impact of activating alterations in non–small cell lung cancer (NSCLC) (epidermal growth factor receptor [EGFR] mutation/anaplastic lymphoma kinase [ALK] translocation) in prognosticating patients with brain metastasis (BM) is not well defined. This study was sought to identify this impact in NSCLC patients with BM accounting for the known validated variables.

Methods
Among 1078 NSCLC-BM patients diagnosed/treated between January 1, 2000 and December 31, 2015, three hundred and forty-eight with known EGFR/ALK status were analyzed. Overall survival (OS) and intracranial progression-free survival (PFS) were measured from the time of BM.

Results
Ninety-one patients had either ALK (n = 23) alterations or EGFR (n = 68) mutation and 257 were wild type (WT; negative actionable mutations/alterations). Median age of EGFR/ALK+ NSCLC BM patients was 60 years (range 29.8–82.6 y) and ~50% (n = 44) had Karnofsky performance status (KPS) score >80. Median number of BM was 2 (1 to ≥99). The median OS for the ALK/EGFR+ NSCLC BM was 19.9 versus 10.1 months for the WT (P = 0.028). The number of BM in the EGFR/ALK+ group did not impact OS (BM = 1 with 21.1 months vs 2–3 with 19.1 months and >3 with 23.7 months, P = 0.74), whereas fewer BM in the WT cohort had significantly better OS (BM = 1 with 13.8 mo, 2–3 with 11.0 mo and >3 with 8.1 mo; P = 0.006) with the adjustment of age, KPS, symptoms from BM and synchronicity.

Conclusions
Number of BM does not impact outcomes in the EGFR/ALK+ NSCLC patients, implying that targeted therapy along with surgery and/or radiation may improve OS irrespective of the number of BM. Number of BM, extracranial metastasis (ECM), and KPS independently affected OS/PFS in WT NSCLC BM, which was consistent with the known literature.
A Compendium of Modern Minimally Invasive Intracerebral Hemorrhage Evacuation Techniques
Authors: Pan Jonathan , Chartrain Alexander G , Scaggiante Jacopo , Spiotta Alejandro M , Tang Zhouping , Wang Wenzhi , Pradilla Gustavo , Murayama Yuichi , Mori Ryosuke , Mocco J , Kellner Christopher P 
Published: October 2019

Abstract

Background
Minimally invasive intracerebral hemorrhage (ICH) evacuation has gained popularity with success in early-phase clinical trials. This procedure, however, is performed in very different ways around the world.

Objective
To provide a technical description of these strategies that facilitates comparison and aids decisions in which surgery to perform, and to inform further improvements in minimally invasive ICH evacuation.

Methods
Major authors of clinical trials evaluating each of the main techniques were contacted and asked to supply a case example and technical description of their respective surgeries.

Results
Five major techniques are presented including stereotactic thrombolysis, craniopuncture, endoscopic, endoscope-assisted, and endoport-mediated. Techniques differ in numerous ways including the size of the cranial access, the size of the access corridor through the brain to the hematoma, and the evacuation strategy. Regarding cranial access, a burr hole is created in stereotactic thrombolysis and craniopuncture, a small craniectomy in endoscopic, and a small craniotomy in the other 2. Access corridors through the parenchyma range from 3 mm in craniopuncture to 13.5 mm in the endoport-mediated evacuation. Regarding evacuation strategies, stereotactic thrombolysis and craniopuncture rely on passive drainage from a catheter placed during surgery that remains in place for multiple days, while the other 3 techniques rely on active evacuation with suction and bipolar cautery.

Conclusion
Future comparative clinical trials may identify the advantageous components of each strategy and contribute to improved outcomes in this patient population.
‘The Harmony of One Choir’? Music and Social Unity in Reformation Heidelberg*
Authors: Laube Matthew 
Published: October 2019

Abstract:
From early in the Reformation, Protestant leaders viewed music as a powerful tool not only for educating their followers, but also for forging unity within diverse and dispersed communities. Such a belief found expression in official and unofficial religious contexts, and left its mark on printed devotional material, congregational hymn books, public policies of church authorities, and the musical activities of individual churches. At the same time, the manner in which a person accessed, experienced and produced music in a Reformation urban environment was conditioned as much by social factors such as age, gender, social station and personal contacts, as by confessional affiliation and policy. Using a corpus of previously unexploited sources from the Protestant city of Heidelberg, this article challenges the rhetorical and outdated binary notions of social ‘harmony’ and ‘discord’. It argues that music in a Reformation city — whether congregational song in churches, secular song in taverns, inns and streets, or domestic devotional song — could function as a powerful platform for emphasizing rather than dissolving a range of meaningful social differences, even as it created new kinds of unity across urban society.
From Object to Subject: Intersex Activism and the Rise and Fall of the Gender Binary in Germany
Authors: von Wahl Angelika 
Published: October 2019

AbstractIn several states, the universal gender binary has been challenged by the introduction of an official third sex. This article explains that paradigm shift in Germany by analyzing the successful introduction of a third sex category in 2018. Historical legacies of gender variance in the pre-modern and modern states are compared with the contemporary (re-)introduction of a third sex. I show that intersex activists and their transnational advocacy at the United Nations reframed the discourse from medical correction to legal protection. This study offers critical insights into the changing dynamics and meanings of gender, state power, and social movements.
Safeguarding trustees’ interests
Authors: Hayton David 
Published: October 2019

Abstract
The recent Sofer case shows how trustees can safeguard their interests via exoneration clauses, deeds of indemnity and even estoppel by convention. It also makes clear how beneficiaries faced with an exoneration clause, which they seek to oust due to the dishonesty of the trustee, bear the onus of fully particularising the dishonesty or their claims may be struck out.
Clinical Impact of an Electronic Dashboard and Alert System for Sedation Minimization and Ventilator Liberation: A Before-After Study
Authors: Anderson Brian J. , Do David , Chivers Corey , Choi Katherine , Gitelman Yevgeniy , Mehta Shivan J. , Panchandam Venkat , Gudowski Steve , Pierce Margie , Cereda Maurizio , Christie Jason D. , Schweickert William D. , Gabrielli Andrea , Huffenberger Ann , Draugelis Mike , Fuchs Barry D. 
Published: October 2019

Objectives:
Sedation minimization and ventilator liberation protocols improve outcomes but are challenging to implement. We sought to demonstrate proof-of-concept and impact of an electronic application promoting sedation minimization and ventilator liberation.

Design:
Multi-ICU proof-of-concept study and a single ICU before-after study.

Setting:
University hospital ICUs.

Patients:
Adult patients receiving mechanical ventilation.

Interventions:
An automated application consisting of 1) a web-based dashboard with real-time data on spontaneous breathing trial readiness, sedation depth, sedative infusions, and nudges to wean sedation and ventilatory support and 2) text-message alerts once patients met criteria for a spontaneous breathing trial and spontaneous awakening trial. Pre-intervention, sedation minimization, and ventilator liberation were reviewed daily during a multidisciplinary huddle. Post-intervention, the dashboard was used during the multidisciplinary huddle, throughout the day by respiratory therapists, and text alerts were sent to bedside providers.

Measurements and Main Results:
We enrolled 115 subjects in the proof-of-concept study. Spontaneous breathing trial alerts were accurate (98.3%), usually sent while patients were receiving mandatory ventilation (88.5%), and 61.9% of patients received concurrent spontaneous awakening trial alerts. We enrolled 457 subjects in the before-after study, 221 pre-intervention and 236 post-intervention. After implementation, patients were 28% more likely to be extubated (hazard ratio, 1.28; 95% CI, 1.01–1.63; p = 0.042) and 31% more likely to be discharged from the ICU (hazard ratio, 1.31; 95% CI, 1.03–1.67; p = 0.027) at any time point. After implementation, the median duration of mechanical ventilation was 2.20 days (95% CI, 0.09–4.31 d; p = 0.042) shorter and the median ICU length of stay was 2.65 days (95% CI, 0.13–5.16 d; p = 0.040) shorter, compared with the expected durations without the application.

Conclusions:
Implementation of an electronic dashboard and alert system promoting sedation minimization and ventilator liberation was associated with reductions in the duration of mechanical ventilation and ICU length of stay.
Rare Case Report of Pilomatrical Carcinosarcoma in a Pediatric Patient
Authors: Gates Gregory A. , Nguyen Johnny , Binder Scott W. 
Published: October 2019

Abstract:
We present a case report of the exceptionally rare pilomatrical carcinosarcoma in an even rarer pediatric age group, a 9-year-old female patient. The tumor showed biphasic pilomatrical carcinoma and malignant sarcomatous transformation. To date, the patient is healing well without signs of recurrence. Although limited clinical follow-up is available due to the recent diagnosis, this case may provide a rare look at the clinical outcome of this very rare tumor.
Jet Ventilation Decreases Target Motion and Increases Yield of ENB Especially in Lesions With Negative Bronchus Sign
Authors: Webb Tracey N. , Bonta Dacian V. , Masters Roger , Parks Christopher , Bechara Rabih 
Published: October 2019

Background:
Electromagnetic navigational bronchoscopy (ENB) is used to obtain peripheral lung tissue samples for evaluation and staging of central and peripheral lung lesions. Jet ventilation delivers and maintains a sustained airway pressure at high frequency, chest wall and diaphragmatic movement is drastically reduced compared with traditional ventilation. The current study looks to examine the effectiveness of tissue sampling (diagnostic yield) while using jet ventilation on target-lesion movement when compared with traditional ventilation.

Methods:
A total of 36 patients received total intravenous anesthesia with both jet and traditional ventilation during ENB procedure where sensor to lesion displacement was recorded. When planning the ENB procedure, the presence or absence of a viable airway to the lesion was recorded. Sensor to lesion movement was recorded and compared for significance using χ2 and t tests, utilizing stringent P-values.

Results:
Overall patients with an airway to the lesion (n=23) had a higher proportion of successful diagnostic biopsies, 83% compared with those patients that lacked an airway to the lesion (n=13) 70% proportion of successful diagnostic biopsies. When using jet ventilation, the chance of nonzero displacement was 8.3% (0.14 mm), regardless of the presence of an airway. Compared with traditional ventilation, the chance of a nonzero displacement between the sensor and target-lesion was 83% (6.4 mm), independent of airway presence to the lesions.

Conclusion:
In patients without an airway, jet ventilation significantly decreased target displacement when compared with traditional ventilation (2 vs. 17 mm). In patients with direct airway to the lesion, jet ventilation did not significantly decrease target displacement when compared with the traditional approach.
Comparison of two blood pressure oscillometric devices: Datascope Accutorr Plus and Mobil-O-Graph PWA and conversion of blood pressure values from one device to the other
Authors: Sarganas Giselle , Kuhnert Ronny , Gohlisch Christopher , van der Giet Markus , Neuhauser Hannelore 
Published: October 2019

Objective
This study aims to compare two oscillometric devices used in national health surveys in Germany, Datascope Accutorr Plus and Mobil-O-Graph PWA and to develop formulas for the conversion of blood pressure (BP) values.

Methods
One hundred and four adults aged 21–86 years had nine alternate same-arm BP measurements according to the International Protocol revision 2010 for the validation of BP measuring devices in adults of the European Society of Hypertension. Measurements 2–8 yielded six pairs of measurements at 30- to 60-second interval with the two devices, totaling 743 pairs used for analysis.

Results
Mean Mobil-O-Graph SBP and DBP were higher than those from Datascope. Mean differences (Mobil-O-Graph minus Datascope) increased within BP ranges (optimal, normal, high normal, hypertensive stage 1, stage 2 and stage 3): SBP 0.5 ± 8.5, 3.1 ± 8.2, 3.7 ± 8.0, 5.3 ± 8.8, 13.8 ± 10.2 and 15.0 ± 25.9, respectively, and DBP 2.6 ± 5.6, 6.0 ± 4.9, 6.6 ± 5.2, 8.4 ± 4.8, 12.3 ± 4.6 and 20.4 ± 4.2, respectively. For Mobil-O-Graph pulse pressure less than 43 mm Hg, the DBP difference was 6.3 ± 5.5, and for Mobil-O-Graph pulse pressure more than 50 mm Hg, the SBP difference was 7.4 ± 9.3. The prevalence of BP at least 140/90 mm Hg was 28.8% with Mobil-O-Graph and 20.5% with Datascope. Bidirectional conversion models of SBP and DBP adjusting for BP, pulse pressure, sex, age and cuff width to arm circumference ratio were developed.

Conclusion
The disagreement in oscillometric devices can reach a magnitude that can be relevant for clinical and epidemiological contexts. The here generated conversion formulas may help to improve comparability.
Gastro‐esophageal Reflux After Laparoscopic Gastrostomy Placement in Children
Authors: Franken Josephine , Stellato Rebecca K. , Tytgat Stefaan H.A.J. , Van der Zee David C. , Mauritz Femke A. , Lindeboom Maud Y.A. 
Published: October 2019

ABSTRACTObjectives:Gastrostomy placement is frequently performed in pediatric patients who require long‐term enteral tube feeding. Evidence on the influence of gastrostomy placement on gastro‐oesophageal reflux disease has been inconsistent. The aim of this study was to investigate the influence of gastrostomy on gastro‐oesophageal reflux.Methods:A prospective, longitudinal cohort study was performed including 50 patients who underwent laparoscopic gastrostomy between May 2012 and April 2014. Before and 3 months after surgery 24‐hour multichannel intraluminal impedance pH monitoring was performed and caregivers filled out reflux symptom questionnaires.Results:Gastro‐oesophageal reflux symptoms were present in a comparable number of patients before (44%) and after gastrostomy placement (40%; P = 0.73). Twenty‐five of the patients (50%) underwent both the preoperative and postoperative tests and were included in impedance‐pH analysis. Acid exposure time (percentage of time with pH below 4) did not change significantly after gastrostomy placement: from 6.2% (3.0–18.1) to 6.1% (2.6–14.9). The number of reflux episodes did not significantly change, for either liquid [mean difference 4.3 (−4.5 to 13.2)] or mixed liquid‐gas reflux [mean difference 2.0 (−9.3 to 13.3)]. Before gastrostomy placement, 18 out of 25 patients had pathological reflux (72%) on pH‐impedance measurement. In 4 patients, pathological reflux dissolved, whereas 4 patients newly developed pathological reflux. A low preoperative weight‐for‐height percentile was associated with increased acid exposure after gastrostomy placement.Conclusions:Overall, gastrostomy placement was not associated with an increase in acid exposure on 24‐hour multichannel intraluminal impedance pH monitoring. Similarly, the prevalence of gastro‐oesophageal reflux‐related symptoms did not change after gastrostomy.