bluuebunny/crossref_metadata_2025_split huggingface dataset:
Critical patient insights from the same-day feedback programme at Stanford Health Care
Authors: Luna Alessandro , Price Amy , Srivastava Ujwal , Chu Larry F 
Published: August 2020

Patient-centered organisationsHealthcare organisations now integrate patient feedback into value-based compensation formulas. This research considered Stanford Healthcare’s same-day feedback, a programme designed to evaluate the patient experience. Specifically, how did patients with cancer interviewed in the programme assess their physicians? Furthermore, how did assessments differ across emotional, physical, practical and informational needs when interviewed by volunteer patient and family partners (PAFPs) versus hospital staff?Patient–physician communication barriersIntegral to this research was Communication Accommodation Theory (CAT), which suggests individuals adjust interactions based on conversational roles, needs and understanding. Previous influential research was conducted by Froschet al(2012) and Di Bartoloet al(2017), who revealed barriers to patient–physician communication, and Bakeret al(2011) who associated CAT with these interactions. However, we still did not know if patients alter physician assessments between interviewers.Volunteers collect patient needsThis mixed methods study worked with 190 oncology unit patient interviews from 2009 to 2017. Open-ended interview responses underwent thematic analysis. When compared with hospital staff, PAFPs collected more practical and informational needs from patients. PAFPs also collected more verbose responses that resembled detailed narratives of the patients’ hospital experiences. This study contributed insightful patient perspectives of physician care in a novel hospital programme.
Prevalence of cognitive dysfunction, psychological morbidity and abuse in the community-based elderly population in India
Authors: Bhatia Manjeet Singh , Srivastava Shruti , Moond Vishali 
Published: August 2020

BackgroundThe elderly population in India is expected to grow enormously by 2050 owing to an increase in life expectancy. Community-based data on the prevalence of psychological morbidity, abuse and cognitive dysfunction are scarce.AimsTo determine the prevalence of cognitive dysfunction, psychological morbidity and abuse in the elderly population in a resettlement colony from East Delhi, India.MethodsA cross-sectional study was conducted on the elderly population of a resettlement colony, in East Delhi, comprising 5 blocks and 12 subblocks with a total population of 65 000. The study was carried out within 2 months from April to August 2017. The self-reported questionnaires were administered to detect cognitive dysfunction, psychological morbidity, social support and pattern of abuse.ResultsThe mean age of the study subjects was 70.29 years (53.8% were males, 78.8% were married, 86.9% were Hindus and 75% were living with children). A total of 106 subjects (66.6%) belonged to the lower socioeconomic strata with 120 (75%) living with children. Most of the subjects (70.6%) studied below the primary level of education. As detected on Goldberg General Health Questionnaire-12, 56.9% of the subjects had psychological morbidity. On Dementia Assessment by Rapid Test, 33.1% of subjects were screened positive. The pattern of abuse reported was as follows: emotional abuse (16.9%), physical abuse (7.5%), sexual abuse (1.9%) and social neglect (18.1%). The social support score was found to be 46.22 (12.22).ConclusionThe results of this community-based study signify that appropriate steps at the policy level need to be undertaken so that abuse as well as neglect can be prevented. In addition, screening the elderly population helps to detect early cognitive dysfunction, psychological morbidity, abuse victims and individuals with poor support.
Transvenous embolization of a posterior condylar canal fistula causing pulsatile tinnitus
Authors: Brinjikji Waleed , Lanzino Giuseppe , Cloft Harry J 
Published: August 2020

Dural arteriovenous fistulas of the skull base commonly present with pulsatile tinnitus. In our experience, transvenous embolization of dural arteriovenous fistulas of the skull base represents a safe and effective treatment modality due to its precision in treatment of the site of convergence of all feeding arteries and the low risk of ischemic complications. We present a case of an adult patient who presented to our institution with pulsatile tinnitus several months following a motor vehicle accident. Cerebral angiography demonstrated a dural arteriovenous fistula at the junction of the posterior condylar vein and suboccipital venous plexus supplied by branches of the vertebral artery, occipital artery, and ascending pharyngeal artery. In this operative video we demonstrate this technique and provide an in-depth discussion of our treatment decision-making process and the anatomical considerations involved in treating this lesion.Video 1
Validation of phlebotomy performance metrics developed as part of a proficiency-based progression initiative to mitigate wrong blood in tube
Authors: O’Herlihy Noirin , Griffin Sarah , Henn Patrick , Gaffney Robert , Cahill Mary Rose , Gallagher Anthony G 
Published: August 2020

ABSTRACTAimsThe purpose of this study was to (1) characterise the procedure of phlebotomy, deconstruct it into its constituent parts and develop a performance metric for the purpose of training healthcare professionals in a large teaching hospital and to (2) evaluate the construct validity of the phlebotomy metric and establish a proficiency benchmark.MethodBy engaging with a multidisciplinary team with a wide range of experience of preanalytical errors in phlebotomy and observing video recordings of the procedure performed in the actual working environment, we defined a performance metric. This was brought to a modified Delphi meeting, where consensus was reached by an expert panel. To demonstrate construct validity, we used the metric to objectively assess the performance of novices and expert practitioners.ResultsA phlebotomy metric consisting of 11 phases and 77 steps was developed. The mean inter-rater reliability was 0.91 (min 0.83, max 0.95). The expert group completed more steps of the procedure (72 vs 69), made fewer errors (19 vs 13, p=0.014) and fewer critical errors (1 Vs 4, p=0.002) than the novice group.ConclusionsThe metrics demonstrated construct validity and the proficiency benchmark was established with a minimum observation of 69 steps, with no critical errors and no more than 13 errors in total.
Anomalous internal pair creation
Authors: Kálmán Péter , Keszthelyi Tamás 
Published: August 2020

AbstractIn recent electron-positron angular correlation measurements the observed significant enhancements relative to the internal pair creation at large angles was interpreted as indication of the creation of $$J^{\pi }=1^{+}$$

J
π

=

1
+

boson called X17 particle. In this paper it is brought up that such enhancements can be generated by higher order processes. It is found that nuclear transitions, the transition energy of which is significantly lower than the whole transition energy, can cause peaked angle dependence in electron-positron angular correlation.
Charged particle dynamics in the surrounding of Schwarzschild anti-de Sitter black hole with topological defect immersed in an external magnetic field
Authors: Shafiq Sidra , Hussain Saqib , Ozair Muhammad , Aslam Adnan , Hussain Takasar 
Published: August 2020

AbstractIn this paper, geodesic motion of the charged particles in the vicinity of event horizon of Schwarzschild anti-de-Sitter black hole (BH) with topological defects has been investigated. Weakly magnetized environment is considered in the surrounding of BH which only effects the motion of the particles and doesn’t effect the geometry of the BH. Hence, particles are under the influence of gravity and electromagnetic forces. We have explored the effect of magnetic field on the trajectories of the particles and more importantly on the position of the innermost stable circular orbit. It is observed that the trajectories of the particles in the surrounding of BH are chaotic. Escape conditions of the particles under the influence of gravitomagnetic force are also discussed. Moreover, the escape velocity of particles and its different features have been investigated in the presence and absence of magnetic field. Effect of dark energy on the size of event horizon, mass of the BH and stability of the orbits of the particles have also been explored in detail. These studies can be used to estimate the power of relativistic jets originated from the vicinity of BH.
Chaotic motion around a black hole under minimal length effects
Authors: Guo Xiaobo , Liang Kangkai , Mu Benrong , Wang Peng , Yang Mingtao 
Published: August 2020

AbstractWe use the Melnikov method to identify chaotic behavior in geodesic motion perturbed by the minimal length effects around a Schwarzschild black hole. Unlike the integrable unperturbed geodesic motion, our results show that the perturbed homoclinic orbit, which is a geodesic joining the unstable circular orbit to itself, becomes chaotic in the sense that Smale horseshoes chaotic structure is present in phase space.
Complexity of phase distribution in two-phase flow using composite multiscale entropy
Authors: Rafałko Gabriela , Mosdorf Romuald , Litak Grzegorz , Górski Grzegorz 
Published: August 2020

AbstractMultiphase flow in a minichannel is a complex phenomenon which shows various patterns dynamics including slugs and bubbles depending on gas/fluid component flow rates. In this paper, air and water–glycerol mixed fluid flow has been studied. In the experiment, the volume flow rates of air and water–glycerol were changing. We studied transition of bubbles to slugs two-phase flow patterns by using multiscale entropy approach to digital camera signals and identified various patterns. The results clearly indicate that the multiscale entropy is an important complexity measure dependent on the flow distribution of the gas phase in a water–glycerol content.
Methylomic Landscapes of Ovarian Cancer Precursor Lesions
Authors: Pisanic Thomas R. , Wang Yeh , Sun Hanru , Considine Michael , Li Lihong , Wang Tza-Huei , Wang Tian-Li , Shih Ie-Ming 
Published: August 2020

AbstractPurpose:The current paradigm in the development of high-grade serous ovarian carcinoma (HGSC) proposes that the majority of HGSCs arise from precursor serous tubal intraepithelial carcinoma (STIC) lesions of the fallopian tube. Here we survey genome-wide methylation in HGSC precursor lesions to identify genomic regions that exhibit high-specificity differential hypermethylation for potential use as biomarkers for detecting STIC and HGSC at stages when curative intervention likely remains feasible.Experimental Design:We first identified quality control criteria for performing reliable methylomic analysis of DNA-limited tubal precursor lesions with the Illumina Infinium MethylationEPIC array. We then used this platform to compare genome-wide methylation among 12 STICs with paired adjacent-normal epithelia, one p53 signature lesion and two samples of concurrent HGSC. The resulting methylomic data were analyzed by unsupervised hierarchical clustering and multidimensional analysis. Regions of high-confidence STIC-specific differential hypermethylation were identified using selective bioinformatic criteria and compared with published MethylationEPIC data from 23 HGSC tumors and 11 healthy fallopian tube mucosae.Results:Unsupervised analysis showed that STICs largely clustered with HGSCs, but were clearly distinct from adjacent-normal fallopian tube epithelia. Forty-two genomic regions exhibited high-confidence STIC-specific differential hypermethylation, of which 17 (40.5%) directly overlapped with HGSC-specific differentially methylated regions. Methylation at these shared loci was able to completely distinguish STIC and HGSC samples from normal and adjacent-normal specimens.Conclusions:Our results suggest that most STICs are epigenetically similar to HGSCs and share regions of differential hypermethylation that warrant further evaluation for potential use as biomarkers for early detection of ovarian HGSC.See related commentary by Ishak and De Carvalho, p. 6083
Efficacy and Tolerability of High- versus Low-dose Lenalidomide Maintenance Therapy of Multiple Myeloma after Autologous Blood Stem Cell Transplantation
Authors: Fenk Roland , Giagounidis Aristoteles , Goldschmidt Hartmut , Heinsch Michael , Rummel Mathias , Kroger Nicolaus , Boquoi Amelie , Lopez David , Gerrlich Celina , Baier Julia , Liesenjohann Svenja , Hauck Katarzyna , Savickaite Ingrida , Mai Elias K. , Aul Carlo , Strapatsas Judith , Dienst Ariane , Kondakci Mustafa , Haas Rainer , Kobbe Guido 
Published: August 2020

Abstract

Purpose:
For multiple myeloma, high-dose chemotherapy and autologous blood stem-cell transplantation (ASCT) followed by lenalidomide maintenance (LenMT) at 10–15 mg/day is considered standard of care. However, dose reductions due to side effects are common and median LenMT doses achieved over time may remain lower. Dose response during LenMT has never been investigated.

Patients and Methods:
In a multicenter, randomized, open-label trial, patients with multiple myeloma after ASCT and high-dose lenalidomide consolidation therapy (CT) at 25 mg/day were randomized to receive LenMT at either 25 or 5 mg/day. Primary endpoint was progression-free survival (PFS).

Results:
Ninety-four patients (median age, 58 years) were randomized to either arm, with 22% having International Staging System (ISS) stage 3 and 22% being in complete remission (CR). After median follow-up of 46.7 months, median doses of 14.5 and 5 mg/day were achieved in the two arms; 53% of dose reductions occurring during CT. In the high- and the low-dose arm, median PFS was 44.8 and 33.0 months (HR, 0.65; 95% CI, 0.44–0.97; P = 0.032), 36% and 23% of patients had stringent CR as best response (P = 0.08), and 4-year OS was 79% and 67% (P = 0.16), respectively. Hematologic toxicity, grade ≥3 neutropenia, and infections were initially more common with LenMT 25 mg, but decreased after dose adjustments. SPM incidence and quality-of-life (QoL) scores in both arms were similar.

Conclusions:
LenMT dose correlated with efficacy and toxicity. High rates of dose reductions during CT argue against a high starting dose. However, continuous up- and down-titration for each patient to the current maximum tolerated dose is prudent.
Integrative Analysis of Pleomorphic Dermal Sarcomas Reveals Fibroblastic Differentiation and Susceptibility to Immunotherapy
Authors: Klein Sebastian , Quaas Alexander , Noh Ka-Won , Cartolano Maria , Abedpour Nima , Mauch Cornelia , Quantius Jennifer , Reinhardt Hans Christian , Buettner Reinhard , Peifer Martin , Helbig Doris 
Published: August 2020

AbstractPurpose:Pleomorphic dermal sarcoma (PDS) is a rare malignant cutaneous tumor with an unknown cell of origin. Locally defined tumors can be treated by curative excisions, whereas advanced stages of the disease are difficult to treat, using standard regimens.Experimental Design:We performed whole-exome sequencing on a cohort of 28 individuals and corresponding transcriptomic analysis on 21 patients, as well as quantitative IHC image analysis on 27 patients.Results:PDS exhibits a universally high mutational load (42.7 mutations/mega base) with an inflamed, immunogenic tumor microenvironment. Three cases of PDS showed response to immune checkpoint blockade. Local mutation rate variation together with mRNA expression data demonstrate that PDS form a distinct entity, with PDGFRB as a lineage marker. In addition, we found that PDS is of mesenchymal, fibroblastic differentiation.Conclusions:PDS is of fibroblastic differentiation and exhibits a strong susceptibility to immunotherapy, including a high mutational burden and an inflamed tumor microenvironment.
Conceito constitucional dos Serviços Sociais Autônomos
Authors: Almeida Edvaldo Nilo de 
Published: August 2020

O objeto de estudo são os serviços sociais autônomos e o conceito constitucional fundado no art. 6° da Constituição Federal de 1988. Por certo, a delimitação do estudo são os serviços sociais autônomos, especificadamente o seu conceito constitucional. Com esse propósito, busca-se responder se o fenômeno da criação e atuação dos serviços sociais conflita com a Constituição Federal de 1988.
Spatiotemporal Variability of Precipitation and Its Statistical Relations to ENSO in the High Andean Rio Bogotá Watershed, Colombia
Authors: Anselm Norbert , Rojas Oscar , Brokamp Grischa , Schütt Brigitta 
Published: August 2020

AbstractSustainable management of biodiversity requires a thorough understanding of local climate and weather, particularly in areas where ecosystems have been degraded and where life is highly adapted to or dependent on narrow ecological niches. Furthermore, society, economy, and culture of urban agglomerations are directly affected by the quality and quantity of services provided by adjacent ecosystems, which makes knowledge of regional characteristics and impact of climate variability crucial. Here, we present precipitation data from six meteorological stations spread across several orographic zones of the eastern Andes in the surroundings of Bogotá, Colombia’s biggest urban agglomeration. The time series of rainfall data are analyzed statistically, examined regarding the occurrence of cyclicity in relation to ENSO, and correlated to the multivariate El Niño–Southern Oscillation index (MEI). Results offer no conclusive ENSO-related cycles but show that data of most of the stations are marked by annual or semestral cyclicity. There is no straightforward correlation between MEI and monthly precipitation values, and neither filtered nor lagged values showed any conclusive and significant correlation. Stations within the same orographic zones do not necessarily bring forth comparable statistical results. Temporal and spatial properties of precipitation appear to result from micro- and mesoscale topoclimates rather than from ENSO variability.
Evaluation of Orographic Cloud Seeding Using a Bin Microphysics Scheme: Three-Dimensional Simulation of Real Cases
Authors: Geresdi István , Xue Lulin , Sarkadi Noémi , Rasmussen Roy 
Published: August 2020

AbstractThe University of Pécs and NCAR Bin (UPNB) microphysical scheme was implemented into the mesoscale Weather Research and Forecast (WRF) Model that was used to study the impact of silver iodide (AgI) seeding on precipitation formation in winter orographic clouds. Four different experimental units were chosen from the Wyoming Weather Modification Pilot Project to simulate the seeding effect. The results of the numerical experiments show the following: (i) Comparisons with the soundings, snow gauges, and microwave radiometer data indicate that the three-dimensional simulations with detailed microphysics reasonably represent both the dynamics and the microphysics of real clouds. (ii) The dispersion of the AgI particles from the simulated ground-based seeding was effective because of turbulent mixing. (iii) In the investigated cases (surface temperature is less than 0°C), surface precipitation and precipitation efficiency show low susceptibility to the concentrations of cloud condensation nuclei and natural ice nucleating particles. (iv) If the available liquid water content promotes the enhancement of the number of snowflakes by diffusional growth, the surface precipitation can be increased by more than 5%. A novel parameter relevant to orographic clouds, horizontally integrated liquid water path (LWP), was evaluated to find the relation between seeding efficiency and liquid water content. The impact of seeding is negligible if the horizontal LWP is less than 0.1 mm and is apparent if the horizontal LWP is larger than 1 mm, as based on the cases investigated in this study.
A Comparison of Low-Cost Collector Configurations for Quantifying Ice Accretion
Authors: Campbell John L. , Rustad Lindsey E. , Garlick Sarah , Newman Noah , Stanovick John S. , Halm Ian , Driscoll Charles T. , Barjenbruch Brian L. , Burakowski Elizabeth , Hilberg Steven D. , Sanders Kristopher J. , Shafer Jason C. , Doesken Nolan J. 
Published: August 2020

AbstractIce storms are important winter weather events that can have substantial environmental, economic, and social impacts. Mapping and assessment of damage after these events could be improved by making ice accretion measurements at a greater number of sites than is currently available. There is a need for low-cost collectors that can be distributed broadly in volunteer observation networks; however, use of low-cost collectors necessitates understanding of how collector characteristics and configurations influence measurements of ice accretion. A study was conducted at the Hubbard Brook Experimental Forest in New Hampshire that involved spraying water over passive ice collectors during freezing conditions to simulate ice storms of different intensity. The collectors consisted of plates composed of four different materials and installed horizontally; two different types of wires strung horizontally; and rods of three different materials, with three different diameters, and installed at three different inclinations. Results showed that planar ice thickness on plates was 2.5–3 times as great as the radial ice thickness on rods or wires, which is consistent with expectations based on theory and empirical evidence from previous studies. Rods mounted on an angle rather than horizontally reduced the formation of icicles and enabled more consistent measurements. Results such as these provide much needed information for comparing ice accretion data. Understanding of relationships among collector configurations could be refined further by collecting data from natural ice storms under a broader range of weather conditions.
Differential Credibility Assessment for Statistical Downscaling
Authors: Pryor S. C. , Schoof J. T. 
Published: August 2020

AbstractClimate science is increasingly using (i) ensembles of climate projections from multiple models derived using different assumptions and/or scenarios and (ii) process-oriented diagnostics of model fidelity. Efforts to assign differential credibility to projections and/or models are also rapidly advancing. A framework to quantify and depict the credibility of statistically downscaled model output is presented and demonstrated. The approach employs transfer functions in the form of robust and resilient generalized linear models applied to downscale daily minimum and maximum temperature anomalies at 10 locations using predictors drawn from ERA-Interim reanalysis and two global climate models (GCM; GFDL-ESM2M and MPI-ESM-LR). The downscaled time series are used to derive several impact-relevant Climate Extreme (CLIMDEX) temperature indices that are assigned credibility based on 1) the reproduction of relevant large-scale predictors by the GCMs (i.e., fraction of regression beta weights derived from predictors that are well reproduced) and 2) the degree of variance in the observations reproduced in the downscaled series following application of a new variance inflation technique. Credibility of the downscaled predictands varies across locations and between the two GCM and is generally higher for minimum temperature than for maximum temperature. The differential credibility assessment framework demonstrated here is easy to use and flexible. It can be applied as is to inform decision-makers about projection confidence and/or can be extended to include other components of the transfer functions, and/or used to weight members of a statistically downscaled ensemble.