bluuebunny/crossref_metadata_2025_split huggingface dataset:
Submammary placement of neurostimulator devices: broadening the spectrum of cosmetic techniques
Authors: Petrou Ilias G. , Momjian Shahan , Modarressi Ali 
Published: April 2020

AbstractDeep brain neurostimulators (DBS) have enabled thousands of individuals to overcome movement disorders, thus offering them a new chance for social integration while enhancing their self-esteem. A classic DBS consists of a central implantable pulse generator (IPG) and its respective wires and leads that extend to the scalp to reach the brain. The classic positioning of the generator is currently subcutaneous, usually just below the clavicle or in the abdominal wall. As DBS systems are of a substantial size, this subcutaneous placement leads to unsightly and visible devices, particularly in thin patients. We report two cases of female patients who benefited from our technique to hide the IPG under the breast parenchyma. IPGs were placed through an inframammary incision in a subglandular pocket, similar to the technique used for implant-based breast augmentation. In the first case, the devices were implanted in a subglandular pocket and replaced 5 years later due to battery life limitation. In the second case, the devices were replaced from a subclavicular position to a submammary one. No major or minor complications were observed. Both patients reported an excellent level of satisfaction with the aesthetic and functional outcome. Despite the significant quality of life improvement of patients with DBS, the ideal implantation of the generator should also take into consideration the comfort and cosmetic aspects. Our approach has the potential to markedly improve the aesthetic outcome of such an intervention.Level of evidence: Level V, therapeutic study.
A Survey of Perceptions of Surgical Trainees on Feedback During Training in West Africa
Authors: Nasir Abdulrasheed A. , Ameh Emmanuel A. , Ojo Emmanuel O. 
Published: April 2020

AbstractBackgroundFeedback has become an integral part of learning within the medical profession, particularly as training becomes more trainees’‐centered. Feedback from the trainees about their training and trainers is essential for effective and high‐quality training. The purpose of this survey was to evaluate trainees’ perceptions on feedback on their postgraduate training and trainers in West Africa.
MethodsCross‐sectional self‐administered written survey of junior and senior registrar attending the annual revision and update course of the West African College of Surgeons. Information sought included sociodemographic variables, perception on feedback, opportunity to give feedback, trainee–trainers relationship and their opinion on different aspects of the postgraduate program where they would like to give feedback.ResultsThe response rate was 81.5% (66/81). Median age was 33 years. Sixty trainees (90.9%) were junior registrars. Sixty‐four (97%) trainees would like to give feedback about their training and trainers. Only 18 (27.3%) trainees have had opportunity of giving feedback about their training. Most trainees (90.9%) would like to give feedback on patient care and learning environment; 89.4% would like to give feedback on their training curriculum and 87.9% would like to give feedback on their operating room experiences. Most trainees (81.8%) believed trainee feedback is of critical importance to training. With regard to trainees‐trainer relationship, 39 (59.1%) trainees were either unsatisfied or reported just a fair relationship.ConclusionsThis study has shown that many of the trainees lack opportunity of giving feedback on their training but considered feedback critical to their training. Trainees would like to give feedback on patient care, curriculum, learning environment and operative room experience. Trainee feedback should be encouraged in surgical training in West Africa.
Imaging dopamine function and microglia in asymptomatic LRRK2 mutation carriers
Authors: Gersel Stokholm Morten , Garrido Alicia , Tolosa Eduardo , Serradell Mónica , Iranzo Alex , Østergaard Karen , Borghammer Per , Møller Arne , Parbo Peter , Stær Kristian , Brooks David J. , Martí Maria José , Pavese Nicola 
Published: April 2020

AbstractNeuroinflammation (microglial activation) and subclinical nigrostriatal dysfunction have been reported in subjects at risk of Parkinsonism. Eight non-manifesting carriers (NMCs) of LRRK2 G2019S mutation had 11C-PK11195 and 18F-DOPA PET to assess microglial activation and striatal dopamine system integrity, respectively. Comparisons were made with healthy controls. Five LRRK2-NMCs had subclinical reductions of putaminal 18F-DOPA uptake. Three of them had significantly raised nigral 11C-PK11195 binding bilaterally. These findings indicate that nigrostriatal dysfunction and neuroinflammation occur in LRRK2-NMCs. Studies in larger cohorts with appropriate follow-up are needed to elucidate the significance of neuroinflammation in the premotor phase of LRRK2-PD.
Effectiveness of fingolimod in real-world relapsing-remitting multiple sclerosis Italian patients: the GENIUS study
Authors: Comi Giancarlo , Pozzilli Carlo , Morra Vincenzo Brescia , Bertolotto Antonio , Sangalli Francesca , Prosperini Luca , Carotenuto Antonio , Iaffaldano Pietro , Capobianco Marco , Colombo Delia , Nica Mihaela , Rizzoli Sara , Trojano Maria 
Published: April 2020

AbstractBackgroundFingolimod is the first oral agent approved for treatment of relapsing-remitting multiple sclerosis (RRMS). We aimed to evaluate fingolimod effectiveness in a real-world sample of RRMS patients.MethodsA retrospective, multicentre study in patients treated with fingolimod, whom clinical and radiological data were collected in the 2 years preceding and following the initiation of fingolimod.ResultsOut of 414 patients, 56.8% received prior first-line injectable disease-modifying therapies, 25.4% were previously treated with natalizumab, 1.2% with immunosuppressant agents, and 16.7% were treatment naive. The annualized relapse rate decreased by 65% in the first year and by 70% after two years of treatment. Age ≤ 40 years, ≥ 1 relapse in the 24 months before fingolimod initiation and previous treatment with natalizumab were risk factors for relapses. Overall, 67.9% patients had no evidence of disease activity (NEDA-3) after 1 year and 54.6% after 2 years of treatment. A higher proportion of naïve (81.2% in 1 year and 66.7% after 2 years) or first-line injected patients (70.2% and 56.6%) achieved NEDA-3 than those previously treated with natalizumab (54.3% and 42.9%).ConclusionsFingolimod appeared to be effective in naive patients and after first-line treatment failure in reducing risk of relapse and disease activity throughout the 2-year follow-up.
Too Much Feeling: S.E. Hinton’s The Outsiders (1967), Conflicting Emotions, Identity, and Socialization
Authors: Wistisen Lydia 
Published: April 2020

AbstractThis article argues that emotions are utilized for norm breaking, identity formation, and socialization in S.E. Hinton’s YA novelThe Outsiders(1967). Drawing on the history of emotions studies, it investigates how emotional expressions are utilized to negotiate and contest given emotional norms on the one hand, and Young Adult literary conventions on the other. The point of departure is intersectional and focuses on the relationship between emotion, power, and socialization. In particular, the article considers how intersections of age, gender, and class relate to depictions of feeling and establishing of new emotional norms. The article shows that the feelings that the main character Pony expresses are part of a reiterative process of negotiation of power; they work as instruments for changing emotional norms connected to his age, class, and gender.
Cost-effectiveness of Practice Team-Supported Exposure Training for Panic Disorder and Agoraphobia in Primary Care: a Cluster-Randomized Trial
Authors: Brettschneider Christian , Gensichen Jochen , Hiller Thomas S , Breitbart Jörg , Schumacher Ulrike , Lukaschek Karoline , Teismann Tobias , Margraf Jürgen , König Hans-Helmut 
Published: April 2020

Abstract
Background
Primary care is the main treatment setting for panic disorder and should be supplemented by collaborative care programs. However, shortage of mental health professionals prevents collaborative care programs from being effectively implemented. The PARADISE study showed the efficacy of a self-managed, cognitive-behavioural therapy (CBT)-oriented exposure training for patients with panic disorder with or without agoraphobia in primary care delivered by the family practice team.

Objective
To assess the cost-effectiveness of the PARADISE intervention.

Design
Cost-effectiveness analysis from the societal perspective based on data from a cluster-randomized controlled trial over a time horizon of 12 months.

Participants
Four hundred nineteen adult panic disorder patients with or without agoraphobia.

Interventions
A self-managed, CBT-oriented exposure training for patients with panic disorder with or without agoraphobia in primary care delivered by the primary care practice team in comparison to routine care.

Main Measures
Total costs from the societal perspective. Direct costs and disease-specific costs. Quality-adjusted life years based on the EQ-5D-3L. Incremental cost-effectiveness ratios and cost-effectiveness acceptability curves.

Key Results
Patients in the intervention group caused lower costs (mean, €1017; 95% confidence interval [-€3306; €1272]; p = 0.38) and gained on average more QALY (mean, 0.034 QALY (95% confidence interval [0.005; 0.062]; p = 0.02). Therefore, the intervention dominated the control treatment. The probability of cost-effectiveness of the intervention at a willingness-to-pay margin of €50,000 per QALY was 96%. Results from supplementary analyses considering direct or disease-specific costs instead of total costs showed comparable results.

Conclusion
The PARADISE intervention is cost effective. This conclusion is valid for total costs, generic health care (direct) costs, disease-specific health care costs.

Trial Registration
German Clinical Trials Register: DRKS00004386
Current Controlled Trials: ISRCTN64669297
Dry Metal Forming Using Volatile Lubricants Injected into the Forming Tool Through Flow-Optimized, Laser-Drilled Microholes
Authors: Henn Manuel , Reichardt Gerd , Weber Rudolf , Graf Thomas , Liewald Mathias 
Published: April 2020

AbstractA novel tribologic system was developed in which volatile lubricants (carbon dioxide—CO2 or nitrogen—N2) were used as a substitute for mineral oil-based lubricants in deep drawing processes. This process allows an intermediate medium to be introduced into the tool contact surfaces under high pressure by flow-optimized, laser-drilled microholes. This eliminates the need for subsequent cost-intensive cleaning processes as volatile lubricants evaporate while expanding to ambient pressure without leaving any residue. This article gives an overview of the current findings to enable and characterize the novel tribologic system. The areas of microhole laser drilling by ultrashort pulsed laser radiation, characterization of the novel tribologic system and realization of the system using a prototype tool will be described.
Discussion on the Hot-Spot and Notch Stress Based Fatigue Assessment Methods Based on Test Results
Authors: Mecséri B. J. , Kövesdi B. 
Published: April 2020

AbstractThe focus of the current paper is the investigation of different local stress calculation methods for fatigue design. To evaluate the accuracy and applicability of the hot-spot and effective notch stress (ENS) fatigue assessment methods an experimental and numerical research program is carried out at the BME Department of Structural Engineering, in Hungary. Two types of structural details are tested using 32 test specimens, a cruciform and a gusset plate type joint. The test results and the accompanying numerical calculation results are statistically evaluated and compared. Analysing the results of the fatigue tests and numerical calculations, it is concluded, that both the hot-spot and the ENS method could be used for fatigue design of the cruciform joints according to the recommendation of the IIW (Hobbacher in Recommendations for fatigue design, Springer, Paris, 2004). However, the rules of the ENS method needs improvement, if used for the design of gusset plate type joint. According to the current results, the ENS method can be adjusted to make applicable for the gusset plate joints as well, recommendation for that is presented in the current paper.
Printing Dynamics: Nip Pressure and Its Relationship with Materials’ Viscoelasticity
Authors: Yang Li 
Published: April 2020

AbstractA theoretical framework of nip dynamics of conventional printing, including dynamic models deducted from nip geometry, printing speed, and physics laws, is proposed. Different from previous works, the present work focuses at obtaining the nip pressure from a given nip geometric setting, the common way in full-scale printing. The effects of viscoelastic characteristics of paper substrate and print form (rubber and/or polymer) on the nip pressure, which become pronounced in a full-scale printing process due to high speed, are accounted and illustrated by three physical models, e.g., Maxwell model, Kelvin–Voigt model, and Burgers model. Details of the nip dynamic features, shape, amplitude, duration, and effective nip width, etc., have been worked out. The viscoelastic nature of the materials was found to be responsible for the so-called speed-hardening, asymmetric nip profile, variations in the nip amplitude and effective nip width, etc. It was also found that how the viscoelastic properties of the materials affect the nip dynamics depend on the how the elastic components and the viscos count parts are connected with each other. The framework is applicable to calendaring, gravure, offset, and flexography.
Climate-Related Hazards and Internal Migration Empirical Evidence for Rural Vietnam
Authors: Berlemann Michael , Tran Thi Xuyen 
Published: April 2020

AbstractIn this paper we employ commune-level data from Vietnam to study whether three types of natural disasters have an impact on emigration figures. We thereby distinguish between temporary and permanent emigration and also differentiate between the effects of recently occurring disaster events and changes in medium-term disaster trends. We find that episodic droughts and flood events tend to cause emigration from the affected communes. While droughts primarily cause temporary migration, flood events tend to induce permanent moves out of the affected regions. Whenever drought or flood events are perceived to have become more severe over the last decade, we also find systematically higher emigration from the affected communes. Episodic typhoons or worsening typhoon trends remain without any significant effect in both the short- and the long-run.
Trends in Snakebites Related to Texas Tropical Storms and Hurricanes, 2000–2017
Authors: Schulte Joann , Haynes Ashley , Smith Eric Anthony , Fleming John , Kleinschmidt Kurt , Roth Brett 
Published: April 2020

Introduction Anecdotal media reports suggest an increase in snakebites after hurricanes. After Hurricane Harvey, several households called Texas poison control centers to report snakebites that occurred when rising water flooded homes. Patterns of snakebite before and after hurricane landfalls have not been well studied. Methods We reviewed retrospective surveillance data from the Texas Poison Control Network to examine snakebites possibly related to tropical storms/hurricanes that hit Texas between 2000 and 2017. For that assessment, we compared 2 groups of counties: those designated for individual assistance (impact counties) by the Federal Emergency Management Agency and all others (nonimpact counties). Typically, counties with individual assistance declarations are those in which damage is worse and resident return may be delayed. Results Eleven named tropical storms/hurricanes struck Texas between 2000 and 2017; 9 received individual assistance declarations. During the 18 y, 2037 snakebites were reported in the 30 d after and the 30 d before landfalls in 9 storms; 132 (6%) occurred poststorm in impact counties, and 13 of 132 (9%) of the case narratives mentioned hurricanes as a contributing factor. Impact counties were not statistically more likely to report snakebites in the 30 d after landfall for any of the 9 storms or overall, nor did we find differences in patient demographic characteristics, type of snake, and care patterns post- and prestorm. Conclusions There was no evidence of increases in snakebites after hurricanes in Texas during the study period. More detailed evaluations may be warranted in other regions that experience hurricanes and have venomous snake populations.
Impact of sea-ice thickness initialized in April on Arctic sea-ice extent predictability with the MIROC climate model
Authors: Ono Jun , Komuro Yoshiki , Tatebe Hiroaki 
Published: April 2020

AbstractThe impact of April sea-ice thickness (SIT) initialization on the predictability of September sea-ice extent (SIE) is investigated based on a series of perfect model ensemble experiments using the MIROC5.2 climate model. Ensembles with April SIT initialization can accurately predict the September SIE for greater lead times than in cases without the initialization – up to 2 years ahead. The persistence of SIT correctly initialized in April contributes to the skilful prediction of SIE in the first September. On the other hand, errors in the initialization of SIT in April cause errors in the predicted sea-ice concentration and thickness in the Pacific sector from July to September and consequently influence the predictive skill with respect to SIE in September. The present study suggests that initialization of the April SIT in the Pacific sector significantly improves the accuracy of the September SIE forecasts by decreasing the errors in sea-ice fields from July to September.
Development of a Mobile Laboratory for Sudden Onset Disasters
Authors: Marr Ian , Francis Joshua R. , Stephens Dianne P. , Marshall Kristy , Read David J. , Baird Rob W. , Coatsworth Nicholas 
Published: April 2020

ABSTRACTObjectives:Clinical diagnostics in sudden onset disasters have historically been limited. We set out to design, implement, and evaluate a mobile diagnostic laboratory accompanying a type 2 emergency medical team (EMT) field hospital.Methods:Available diagnostic platforms were reviewed and selected against in field need. Platforms included HemoCue301/WBC DIFF, i-STAT, BIOFIRE FILMARRAY multiplex rt-PCR, Olympus BX53 microscopy, ABO/Rh grouping, and specific rapid diagnostic tests. This equipment was trialed in Katherine, Australia, and Dili, Timor-Leste.Results:During the initial deployment, an evaluation of FilmArray tests was successful using blood culture identification, gastrointestinal, and respiratory panels. HemoCue301 (n = 20) hemoglobin values were compared on Sysmex XN 550 (r = 0.94). HemoCue WBC DIFF had some variation, dependent on the cell, when compared with Sysmex XN 550 (r = 0.88-0.16). i-STAT showed nonsignificant differences against Vitros 250. Further evaluation of FilmArray in Dili, Timor-Leste, diagnosed 117 pathogens on 168 FilmArray pouches, including 25 separate organisms on blood culture and 4 separate cerebrospinal fluid pathogens.Conclusion:This mobile laboratory represents a major advance in sudden onset disaster. Setup of the service was quick (< 24 hr) and transport to site rapid. Future deployment in fragmented health systems after sudden onset disasters with EMT2 will now allow broader diagnostic capability.
Do infants of breast-feeding mothers benefit from additional long-chain PUFA from fish oil? A 6-year follow-up
Authors: Meldrum Suzanne J. , Heaton Alexandra E. , Foster Jonathan K. , Prescott Susan L. , Simmer Karen 
Published: April 2020

AbstractFish-oil supplements are marketed as enhancing intelligence and cognitive performance. However, empirical data concerning the utility of these products in healthy term infants are mixed, particularly with respect to lasting effects into childhood. We evaluated whether fish-oil supplementation during infancy leads to better neurocognitive/behavioural development at 6 years. We conducted a double-blind randomised controlled trial of supplementation with n-3 long-chain PUFA in 420 healthy term infants. Infants received either fish oil (containing at least 250 mg DHA and at least 60 mg EPA) or placebo (olive oil) daily from birth to 6 months of age. Neurodevelopmental follow-up was conducted at a mean age of 6 years (sd 7 months), whereby 335 children were assessed for language, executive functioning, global intelligence quotient and behaviour. No significant differences were observed between the groups for the main neurocognitive outcomes. However in parent-report questionnaire, fish-oil supplementation was associated with negative externalising (P = 0·035, d = 0·24) and oppositional/defiant behaviour (P = 0·006, d = 0·31), particularly in boys (P = 0·01, d = 0·45; P = 0·004, d = 0·40). Our results provide evidence that fish-oil supplementation to predominantly breast-fed infants confers no significant cognitive or behavioural benefit to children at 6 years.
A reworked isolated deposit of the Kos Plateau Tuff and its significance for dating raised marine terraces, Kos, Greece
Authors: Piper David J.W. , Pe-Piper Georgia 
Published: April 2020

AbstractThe 161-ka Kos Plateau Tuff (KPT) eruption deposited widespread unwelded ignimbrites, but the Dikeos and Sympetro mountains on the SE of Kos Island blocked all but the most energetic pyroclastic flows. KPT remnants north of Sympetro mountain comprise reworked tuffite containing pumice and lithic clasts that petrologically and geochemically resemble those found in KPT unit E tephra, and reworked accretionary lapilli similar to those in KPT unit F. Tuffite is found only downslope from a 375-m-high pass between the Dikeos and Sympetro mountains, which was breached at the eruption climax by pyroclastic flows that then accelerated down the 10° north slope of Sympetro. The tuffite crops out in the palaeocliffs of a prominent terrace at an elevation of 75 m, interpreted as the transgressive ravinement surface of the first interglacial marine highstand after the KPT eruption during marine isotope stage (MIS) 5e. A similar ravinement surface cuts KPT deposits in central Kos at elevations of up to 135 m and implies post-MIS 5e uplift rates of 0.7–1.0 m ka−1, confirmed by the elevation of a previously reported raised beach beneath the KPT. A Holocene raised beach on the east coast of Kos contains pumice clasts from the Yali-4 eruption at 4–3 ka. Its elevation of 2 m above sea level is consistent with the elevation of the local MIS 5e terrace. Its present erosion results from the blocking of discharge from ephemeral streams by human infrastructure. Our study provides the first integrated chronologic and neotectonic interpretation of the prominent plateau and terrace surfaces on Kos Island.
The Enemy of My Enemy: When Firms Support Climate Change Regulation
Authors: Kennard Amanda 
Published: April 2020

AbstractPolicies to mitigate global climate change entail significant economic costs. Yet a growing number of firms lobby in favor of regulation to mitigate carbon emissions. Why do firms support environmental regulations that directly increase production costs? This question is all the more puzzling in a globalized economy where regulation may undermine the competitiveness of domestic firms at home and abroad. By imposing differential costs on participants in the domestic market, policies designed to mitigate carbon emissions shift market share toward firms with low anticipated adjustment costs. I develop and test a model of climate change policymaking in the presence of market competition and open borders. Heterogeneity in adjustment costs induces a preference for regulation among low-cost firms. Firms facing import pressure—or export competition—may prefer stringent regulation if costs are sufficiently asymmetric. Firms embedded in global value chains also benefit if regulation raises the costs of domestically produced intermediate goods.