bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations of Perioperative Variables With the 30-Day Risk of Stroke or Death in Carotid Endarterectomy for Symptomatic Carotid Stenosis
Authors: Knappich Christoph , Kuehnl Andreas , Haller Bernhard , Salvermoser Michael , Algra Ale , Becquemin Jean-Pierre , Bonati Leo H. , Bulbulia Richard , Calvet David , Fraedrich Gustav , Gregson John , Halliday Alison , Hendrikse Jeroen , Howard George , Jansen Olav , Malas Mahmoud B. , Ringleb Peter A. , Brown Martin M. , Mas Jean-Louis , Brott Thomas G. , Morris Dylan R. , Lewis Steff C. , Eckstein Hans-Henning ,   on behalf of the Carotid Stenosis Trialists’ Collaboration
Published: November 2019

Background and Purpose—
This analysis was performed to assess the association between perioperative and clinical variables and the 30-day risk of stroke or death after carotid endarterectomy for symptomatic carotid stenosis.

Methods—
Individual patient-level data from the 5 largest randomized controlled carotid trials were pooled in the Carotid Stenosis Trialists’ Collaboration database. A total of 4181 patients who received carotid endarterectomy for symptomatic stenosis per protocol were included. Determinants of outcome included carotid endarterectomy technique, type of anesthesia, intraoperative neurophysiological monitoring, shunting, antiplatelet medication, and clinical variables. Stroke or death within 30 days after carotid endarterectomy was the primary outcome. Adjusted risk ratios (aRRs) were estimated in multilevel multivariable analyses using a Poisson regression model.

Results—
Mean age was 69.5±9.2 years (70.7% men). The 30-day stroke or death rate was 4.3%. In the multivariable regression analysis, local anesthesia was associated with a lower primary outcome rate (versus general anesthesia; aRR, 0.70 [95% CI, 0.50–0.99]). Shunting (aRR, 1.43 [95% CI, 1.05–1.95]), a contralateral high-grade carotid stenosis or occlusion (aRR, 1.58 [95% CI, 1.02–2.47]), and a more severe neurological deficit (mRS, 3–5 versus 0–2: aRR, 2.51 [95% CI, 1.30–4.83]) were associated with higher primary outcome rates. None of the other characteristics were significantly associated with the perioperative stroke or death risk.

Conclusions—
The current results indicate lower perioperative stroke or death rates in patients operated upon under local anesthesia, whereas a more severe neurological deficit and a contralateral high-grade carotid stenosis or occlusion were identified as potential risk factors. Despite a possible selection bias and patients not having been randomized, these findings might be useful to guide surgeons and anesthetists when treating patients with symptomatic carotid disease.
Prevalence of Intracranial Aneurysms in Patients With Systemic Vessel Aneurysms
Authors: Song Jihye , Lim Yong Cheol , Ko Inseok , Kim Jong-Yeup , Kim Dong-Kyu 
Published: November 2019

Background and Purpose—
Most aneurysms are a focal manifestation of a systemic condition. Some reports have suggested genetic and environmental factors may play a role in pathogenesis. The aim of the present study was to evaluate the prevalence of intracranial aneurysms (IA) in a large cohort of patients with other systemic vessel aneurysms and dissections (OVAD) and identify potential risk factors for IA in this population.

Methods—

We defined OVAD as systemic vessel aneurysms, excluding aortic dissections and aneurysms. A cohort of 1.1 million patients was extracted from the population-based cohort from the Korea National Health Insurance Service, which holds almost all medical data including diagnostic codes, procedures, and personal information. Using χ
2
or Fisher exact test, the prevalence of the IA concerning OVAD status was analyzed.

Results—

In OVAD individuals, 25.7% (261/1017) of patients had been concurrently diagnosed with IA. The odds ratios for having concurrent IA in patients with OVAD were 56.31 (95% CI, 48.821–64.949;
P
=0.000). OVAD patients with dyslipidemia were >7× likely to be affected by IA (adjusted odds ratio, 7.7 [95% CI, 6.59–9.01];
P
=0.000). Hypertension, diabetes mellitus, old age (>60 years), and male sex had increased odds for having concurrent IA by 5.89, 3.48, 1.83, and 1.35, respectively. Subgroup analysis with socioeconomic or disability revealed that the prevalence of IA was significantly higher in all groups. Uncertainty regarding the temporal sequence of onset and lack of detail on disease severity and subtype prevented more conclusive results.

Conclusions—
Patients with OVAD have a higher prevalence of IA than control groups. Therefore, we may approach aneurysms as systemic disease, and further investigations about their pathophysiology must follow.
Pulling Apollo Apart
Authors: Hunter Richard , Laemmle Rebecca 
Published: November 2019

Abstract
This paper considers the etymologising of the names of Apollo in Plato, Cratylus and Plutarch, The E at Delphi. It is argued that the richness of the god’s etymologies in these texts and in classical literature more generally suggests that a special connection was seen between the nature of Apollo and the practices of etymologising; this connection is in part owed to the similarities between etymologising and prophetic speech and practice and in part to the fact that ancient etymology reveals settled, unchanging truths about language, just as Apollo manifests the settled, unchanging order of the world. The paper sheds light not just upon ancient etymological practice from Homer onwards but also on certain conceptions of the nature of Apollo.
Becoming Chinese Buddhas: Claims to Authority and the Making of Chan Buddhist Identity
Authors: Buckelew Kevin 
Published: November 2019

AbstractAccording to many recent scholars, by the Song dynasty Chan Buddhists had come to identify not primarily as meditation experts—following the literal meaning of chan—but rather as full-fledged buddhas. This article pursues a deeper understanding of how, exactly, Chan Buddhists claimed to be buddhas during the eighth through eleventh centuries, a critical period in the formation of Chan identity. It also addresses the relationship between Chan Buddhists’ claims to the personal status of buddhahood, their claims to membership in lineages extending back to the Buddha, and their appeals to doctrines of universal buddhahood. Closely examining Chan Buddhists’ claims to be buddhas helps explain the tradition’s rise to virtually unrivaled elite status in Song-era Buddhist monasticism, and illuminates the emergence of new genres of Chan Buddhist literature—such as “discourse records” (yulu)—that came to be treated with the respect previously reserved for canonical Buddhist scriptures.
Call and Response: Antiphonal Elements in Jewish Palestinian Aramaic Poetry
Authors: Lieber Laura S. 
Published: November 2019

Abstract
In this essay, the varieties of refrain structures used in the body of Jewish Palestinian Aramaic poetry from late antiquity provide a laboratory for examining the intersection of acclamation structures and piyyutim. The fact that these poems were written in the vernacular of the community rather than in Hebrew complicates our understanding of their performative setting but at the same time may make it easier to consider a variety of potential modes of community engagement, as we are not constrained by the potential norms of a fixed liturgical setting. The analysis offered here, tentative as it may be, helps us understand both the auditory world of Late Antiquity and the active participation of Jews in the shaping of their soundscape.
The Boreal Summer Madden–Julian Oscillation and Moist Convective Morphology over the Maritime Continent
Authors: Toms Benjamin A. , van den Heever Susan C. , Riley Dellaripa Emily M. , Saleeby Stephen M. , Maloney Eric D. 
Published: November 2019

Abstract
While the boreal summer Madden–Julian oscillation (MJO) is commonly defined as a planetary-scale disturbance, the convective elements that constitute its cloud dipole exhibit pronounced variability in their morphology. We therefore investigate the relationship between the intraseasonal cloud anomaly of the MJO and the convective elements that populate its interior by simulating a boreal summer MJO event over the Maritime Continent using a cloud-resolving model. A progressive relationship between convective cell morphology and the MJO within the convectively enhanced region of the MJO was identified and characterized as follows: anomalously long-lasting cells in the initial phases, followed by an increased number of cells in the intermediate phases, progressing into more expansive cells in the terminal phases. A progressive relationship does not seem to exist within the convectively suppressed region of the MJO within the simulated domain, however. Within the convectively enhanced region of the MJO, the progressive relationship is partially explained by the evolution of bulk atmospheric characteristics, such as instability and wind shear. Positive midlevel moisture anomalies coincide with anomalously long-lasting convective cells, which is hypothesized to further cascade into an increase in convective cell volume, although variability in the number of convective cells seems to be related to an unidentified variable. This intraseasonal relationship between convective cell morphology and the boreal summer MJO within the Maritime Continent may have broader implications for the large-scale structure and evolution of the MJO, related to both convective moistening and cloud-radiative feedbacks.
Pediatric Thyroidectomy: NSQIP-P Analysis of Adverse Perioperative Outcomes
Authors: Patel Vijay A. , Khaku Aliasgher , Carr Michele M. 
Published: November 2019

Background: This study identifies risk factors and 30-day adverse outcomes of pediatric patients undergoing thyroidectomy. Methods: Retrospective analysis utilizing the American College of Surgeons National Surgical Quality Improvement–Pediatric Database (2015-2016). Study population includes pediatric patients (≤18 years) who underwent hemithyroidectomy (HT), total thyroidectomy (TT), and total thyroidectomy with central neck dissection (TT+ND). Results: A total of 720 cases were identified; mean age at time of surgery was 14.1 years, with a female-to-male ratio of 3.4:1. Following hospital discharge, there were 10 related readmissions, with 1 patient requiring reoperation for neck hematoma evacuation. Regression analysis revealed anesthesia time had a significant impact on total length of stay ( P = .0020). Conclusion: Contemporary pediatric thyroidectomy has a low incidence of 30-day general surgical postoperative complications. Future research efforts are necessary once thyroidectomy specific variables are incorporated into ACS-NSQIP-P, which will provide further insights into managing this unique patient population.
Utility of Audiometry in the Evaluation of Patients Presenting with Dysphonia
Authors: Ross Justin , Valentino William L. , Calder Alyssa , Bigly David , Othman Sammy , McKinnon Brian , Sataloff Robert T. 
Published: November 2019

Objectives: Hearing loss has been implicated in dysphonia secondary to voice misuse, although the data supporting this claim are scant. Determining the prevalence of hearing loss in patients with dysphonia and correlating it with self-perception of vocal handicap may help clarify the value of audiometry in evaluation of patients with dysphonia. Methods: This is a retrospective chart review of all new voice patients (n = 405) presenting with dysphonia to the primary investigator between 2015 and 2018. Each new patient routinely undergoes audiometric and voice objective analyses. Main outcomes measured include prevalence, severity of hearing loss, and voice handicap index-10 (VHI-10). Results: Of the 405 subjects reviewed, mean age was 49.0 years (SD = 17.4). 60.7% of subjects were female and 39.3% male. Patients with hearing loss defined as >25 dB in worse ear with pure tone average (PTA) thresholds at 0.5, 1, 2, and 3 kHz (PTA-S) accounted for 18% of the total cohort. The prevalence of previously undiagnosed hearing loss in this cohort was 13.1% (53 of 405 subjects). Of these subjects, 62.3% (33 subjects) reported no perception of hearing loss while 37.7% (20 subjects) suspected they had some hearing loss, yet never sought evaluation. Only increased PTA-S, speech discrimination, Reflux Symptom Index, and female gender demonstrated a significant relationship with VHI-10 when analyzed with multivariate linear regression analysis. Conclusions: The prevalence of hearing loss in patients presenting with dysphonia in this cohort is similar to normative population data. This study has also demonstrated that the majority of these patients did not perceive any hearing loss. The reasons behind this may be a result of or associated with the patients’ dysphonia. Furthermore, clinicians should consider performing audiometric evaluation in patients with abnormal VHI-10 scores in the appropriate clinical context.
Standard Setting of Competency in Mastoidectomy for the Cross-Institutional Mastoidectomy Assessment Tool
Authors: Kerwin Thomas , Wiet Gregory , Hittle Brad , Stredney Don , De Boeck Paul , Moberly Aaron , Andersen Steven Arild Wuyts 
Published: November 2019

Objective: Competency-based surgical training involves progressive autonomy given to the trainee. This requires systematic and evidence-based assessment with well-defined standards of proficiency. The objective of this study is to develop standards for the cross-institutional mastoidectomy assessment tool to inform decisions regarding whether a resident demonstrates sufficient skill to perform a mastoidectomy with or without supervision. Methods: A panel of fellowship-trained content experts in mastoidectomy was surveyed in relation to the 16 items of the assessment tool to determine the skills needed for supervised and unsupervised surgery. We examined the consensus score to investigate the degree of agreement among respondents for each survey item as well as additional analyses to determine whether the reported skill level required for each survey item was significantly different for the supervised versus unsupervised level. Results: Ten panelists representing different US training programs responded. There was considerable consensus on cut-off scores for each item and trainee level between panelists, with moderate (0.62) to very high (0.95) consensus scores depending on assessment item. Further analyses demonstrated that the difference between supervised and unsupervised skill levels was significantly meaningful for all items. Finally, minimum-passing scores for each item was established. Conclusion: We defined performance standards for the cross-institutional mastoidectomy assessment tool using the Angoff method. These cut-off scores that can be used to determine when trainees can progress from performance under supervision to performance without supervision. This can be used to guide training in a competency-based training curriculum.
Wnt receptor gene FZD1 was associated with schizophrenia in genome-wide SNP analysis of the Australian Schizophrenia Research Bank cohort
Authors: Liu Xiaoman , Low Siew-Kee , Atkins Joshua R , Wu Jing Qin , Reay William R , Cairns Heath M , Green Melissa J , Schall Ulrich , Jablensky Assen , Mowry Bryan , Michie Patricia T , Catts Stan V , Henskens Frans , Pantelis Christos , Loughland Carmel , Boddy Alan V , Tooney Paul A , Scott Rodney J , Carr Vaughan J , Cairns Murray J 
Published: November 2019

Objectives: Large-scale genetic analysis of common variation in schizophrenia has been a powerful approach to understanding this complex but highly heritable psychotic disorder. To further investigate loci, genes and pathways associated more specifically in the well-characterized Australian Schizophrenia Research Bank cohort, we applied genome-wide single-nucleotide polymorphism analysis in these three annotation categories. Methods: We performed a case–control genome-wide association study in 429 schizophrenia samples and 255 controls. Post-genome-wide association study analyses were then integrated with genomic annotations to explore the enrichment of variation at the gene and pathway level. We also examine candidate single-nucleotide polymorphisms with potential function within expression quantitative trait loci and investigate overall enrichment of variation within tissue-specific functional regulatory domains of the genome. Results: The strongest finding ( p = 2.01 × 10−6, odds ratio = 1.82, 95% confidence interval = [1.42, 2.33]) in genome-wide association study was with rs10252923 at 7q21.13, downstream of FZD1 (frizzled class receptor 1). While this did not stand alone after correction, the involvement of FZD1 was supported by gene-based analysis, which exceeded the threshold for genome-wide significance ( p = 2.78 × 10−6). Conclusion: The identification of FZD1, as an independent association signal at the gene level, supports the hypothesis that the Wnt signalling pathway is altered in the pathogenesis of schizophrenia and may be an important target for therapeutic development.
Improvement in cognitive function in young people with bipolar disorder: Results from participants in an 18-month randomised controlled trial of adjunctive psychotherapy
Authors: Porter Richard J , Inder Maree , Douglas Katie M , Moor Stephanie , Carter Janet D , Frampton Christopher MA , Crowe Marie 
Published: November 2019

Objective: To examine the effects of 18 months of intensive stabilisation with medication management and Interpersonal and Social Rhythm Therapy or Non-specific Supportive Clinical Management on cognitive function in young people with bipolar disorder. Determinants of change in cognitive function over the 18 months of the trial were also examined. Method: Patients aged 15–36 years with Bipolar I Disorder, Bipolar II Disorder and Bipolar Not Otherwise Specified were recruited. From a battery of cognitive tests, change scores for pre-defined domains of cognitive function were created based on performance at baseline and follow-up. Change was compared between the two therapy groups. Regression analysis was used to determine the impact of a range of clinical variables on change in cognitive performance between baseline and follow-up. Results: One hundred participants were randomised to Interpersonal and Social Rhythm Therapy ( n = 49) or Non-specific Supportive Clinical Management ( n = 51). Seventy-eight patients underwent cognitive testing at baseline and 18 months. Across both groups, there were significant improvements in a Global Cognitive Composite score, Executive Function and Psychomotor Speed domains from baseline to 18 months. Lower scores at baseline on all domains were associated with greater improvement over 18 months. Overall, there was no difference between therapies in change in cognitive function, either in a global composite score or change in domains. Conclusion: While there was no difference between therapy groups, intensive stabilisation with psychological therapy was associated with improved cognitive function, particularly in those patients with poorer cognitive function at baseline. However, this was not compared with treatment as usual so cannot be attributed necessarily to the therapies.
Systemic Inflammation and Nutritional Status in Patients on Palliative Cancer Care: A Systematic Review of Observational Studies
Authors: Cordeiro Luisa de Araújo Fonseca , Silva Thiago Huaytalla , de Oliveira Lívia Costa , Neto José Firmino Nogueira 
Published: November 2019

Objective: This systematic literature review explores the results of studies that have analyzed the association between inflammation and nutritional status in patients with cancer in palliative care. Methods: The bibliographic research was performed in May 2019, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Group guidelines. The inclusion criteria were papers that (1) had an online abstract available, (2) were original, (3) used a cohort or cross-sectional design, (4) involved patients with advanced cancer in palliative care, and (5) assessed the association between inflammation and nutritional status. The quality assessment was performed using the Newcastle-Ottawa Scale. Results: Nine studies were selected. Weight loss (WL; n = 7) was the most common nutritional marker employed and C-reactive protein (CRP; n = 6) was the most common inflammatory marker. There was considerable variability (39.0%-92.2%) in the proportion of patients who had WL in a 6-month period, while CRP >5 mg/dL was common in 45.3% to 73.9% of patients. Systemic inflammation was related to nutritional status, highlighting the relationship between CRP and WL and lean mass (LM). Patients with CRP >10 mg/L have been found to have a lower LM ( P < .001) and a faster rate of loss of LM at a faster rate during the disease trajectory ( P = .030). Conclusion: Nutritional status is associated with systemic inflammatory response. Inflammatory markers should be considered an additional parameter for the nutritional diagnosis of patients with cancer in palliative care.
Pre conception use of cannabis and cocaine among men with pregnant partners
Authors: Munch Elisabeth Lobben , Skurtveit Svetlana , Handal Marte , Skovlund Eva 
Published: November 2019

Background: Paternal lifestyle during sperm development can have an impact on foetal development. This study surveys demographic characteristics and lifestyle factors among expectant fathers who reported use of cannabis and cocaine in the six-month period before conception. We also study the associations between mothers’ and fathers’ use of cannabis and cocaine. Methods: This is a cross-sectional study from the Norwegian Mother and Child Cohort Study (MoBa) using self-reported data on demographic variables and cannabis and cocaine use six months before conception. Associations were assessed using logistic regression and chi-square tests. Results: A strong association was found between use of cannabis and cocaine and lifestyle habits such as alcohol and cigarette use. Alcohol consumption four or more times a week gave an adjusted odds ratio (a OR) of 9.7 (95% CI 7.2–13.0) for cannabis and an a OR 21.6 (95% CI 11.5–40.3) for cocaine. There was also a strong association between maternal and paternal use of cannabis and cocaine. Conclusion: Use of cannabis and cocaine close to pregnancy seems to be closely linked to other risk factors, and further studies on how paternal drug use affects the foetus are warranted. The strong association between maternal and paternal use of cannabis and cocaine may be used to inform healthcare workers to make good risk assessments.