bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in channel and hillslope geometry record a migrating uplift wave at the Mendocino triple junction, California, USA
Authors: Clubb Fiona J. , Mudd Simon M. , Hurst Martin D. , Grieve Stuart W.D. 
Published: December 2019

AbstractTectonic plate motion, and the resulting change in land surface elevation, has been shown to have a fundamental impact on landscape morphology. Changes to uplift rates can drive a response in fluvial channels, which then drives changes to hillslopes. Because hillslopes respond on different time scales than fluvial channels, investigating the geometry of channels and hillslopes in concert provides novel opportunities to examine how uplift rates may have changed through time. Here we perform coupled topographic analysis of channel and hillslope geometry across a series of catchments at the Mendocino triple junction (MTJ) in northern California, USA. These catchments are characterized by an order-of-magnitude difference in uplift rate from north to south. We find that dimensionless hillslope relief closely matches the uplift signal across the area and is positively correlated with channel steepness. Furthermore, the range of uncertainty in hillslope relief is lower than that of channel steepness, suggesting that it may be a more reliable recorder of uplift in the MTJ region. We find that hilltop curvature lags behind relief in its response to uplift, which in turn lags behind channel response. These combined metrics show the northward migration of the MTJ and the corresponding uplift field from topographic data alone.
Changes in secondhand smoke exposure levels and risk of type 2 diabetes in middle age: the Korean Genome and Epidemiology Study (KoGES)
Authors: Jeon Jooeun , Jung Keum Ji , Kimm Heejin , Jee Sun Ha 
Published: December 2019

ObjectivesSecondhand smoke (SHS) was known as one of the risk factors for type 2 diabetes. So far, some studies revealed the association of SHS exposure and type 2 diabetes, however, no studies to show the relationship of cumulative SHS exposure with type 2 diabetes exist. Therefore, the objectives of this study were to identify subgroups of participants who share similar trajectories in SHS exposure levels in middle age by using latent class growth modeling, and determine the independent association of these SHS exposure level trajectories with risk of incident type 2 diabetes.MethodsIn Korean Genome and Epidemiology Study (2001–2014), 2079 participants aged 40 years and above who received biennially health check-up to follow-up and with available information of SHS exposure were selected. Four distinct trajectory groups (low-stable, moderate to low, moderate, and high to low) were identified for SHS exposure levels using trajectory modeling methods. Multivariable Cox proportional hazards model was used to examine the association of trajectories with risk of type 2 diabetes.ResultsDuring 24 083.3 person-years of follow-up (mean follow-up duration, 11.6 years), 200 incident cases of type 2 diabetes and 640 incident cases of impaired fasting glucose (IFG) were identified. In multivariable Cox model, ‘High to low’ trajectory was significantly associated with risk of type 2 diabetes (OR 1.9; 95% CI 1.3 to 2.8) compared with ‘Low-stable’. For IFG, all trajectories had significantly 30%–30% higher risk of type 2 diabetes compared with the ‘Low-stable’ trajectory.ConclusionsChanges in SHS exposure levels have been shown to associate with subsequent type 2 diabetes risk. Reversing high exposure level of SHS in middle-aged adulthood may still lead to worse progressions of type 2 diabetes than remaining stable exposure level.
Incomplete stent apposition of low-profile visualized intraluminal support stents in the treatment of cerebral aneurysms
Authors: Zhang Huan , Gao Xiaoping , Liang Hui , Ren Yi 
Published: December 2019

ObjectiveThis study retrospectively analyzed the risk factors, management strategies, and complications of incomplete stent apposition (ISA) of low-profile visualized intraluminal support (LVIS) stents after initial deployment in the treatment of cerebral aneurysms.MethodsThe clinical characteristics of ISA or wall apposition (WA) of LVIS stent after initial deployment were analyzed. The risk factors of ISA were identified using univariate logistic regression analysis and multivariate logistic regression analysis. The clinical characteristics of ISA following different management strategies were also shown.ResultsThe retrospective study enrolled 303 patients with 315 LVIS stent-assisted aneurysms. Fifty-nine patients with 59 stents showed ISA after initial deployment. At the end of the study, the presence of ISA was only observed in eight patients (2.5%). The stent-subtended arc angle (>90) and the aneurysm of the internal carotid artery (ICA) were associated with ISA. The stent-subtended arc angle (>90) and stent size (4.5*20 mm) were independent risk factors of ISA. The incidence of thromboembolic events in the ISA group was significantly higher than that in the WA group. After the treatment of ISA, there was no significant difference in good outcomes between patients with ISA and those with WA after initial deployment.ConclusionsISA is more likely to occur at tortuous vessels. The stent-subtended arc angle (>90) and LVIS size (4.5*20 mm) were independent risk factors of ISA. ISA led to significantly increased incidence of thromboembolic events. However, ISA after initial deployment did not affect the patient's prognosis.
Controlling Interactions with Libraries in Android Apps Through Runtime Enforcement
Authors: Riganelli Oliviero , Micucci Daniela , Mariani Leonardo 
Published: December 2019

Android applications are executed on smartphones equipped with a variety of resources that must be properly accessed and controlled, otherwise the correctness of the executions and the stability of the entire environment might be negatively affected. For example, apps must properly acquire, use, and release microphones, cameras, and other multimedia devices, otherwise the behavior of the apps that use the same resources might be compromised.
Unfortunately, several apps do not use resources correctly, for instance, due to faults and inaccurate design decisions. By interacting with these apps, users may experience unexpected behaviors, which in turn may cause instability and sporadic failures, especially when resources are accessed.

In this article, we present an approach that lets users
protect
their environment from the apps that use resources improperly by enforcing the correct usage protocol. This is achieved by using
software enforcers
that can observe executions and change them when necessary. For instance, enforcers can detect that a resource has been acquired but not released and automatically perform the release operation, thus giving the possibility to use that same resource to the other apps.

The main idea is that software libraries, in particular, the ones controlling access to resources, can be augmented with enforcers that can be activated and deactivated on demand by users to protect their environment from unwanted app behaviors. We call the software libraries augmented with one or more enforcers
proactive libraries
, because the activation of the enforcer decorates the library with
proactive behaviors
that can guarantee the correctness of the execution despite the invocation of the operations implemented by the library. For example, enforcers can detect that a resource has not been released on time and proactively release it.

Our experimental results with 27 possible misuses of resources in real Android apps reveal that proactive libraries are able to effectively correct library misuses with negligible runtime overheads.
Brain Natriuretic Peptide and Discovery of Atrial Fibrillation After Stroke
Authors: Wasser Katrin , Weber-Krüger Mark , Gröschel Sonja , Uphaus Timo , Liman Jan , Hamann Gerhard F. , Kermer Pawel , Seegers Joachim , Binder Lutz , Gelbrich Götz , Gröschel Klaus , Wachter Rolf 
Published: December 2019

Background and Purpose—
Diagnosing paroxysmal atrial fibrillation (pAF) can be challenging after acute ischemic stroke. Enhanced and prolonged Holter-ECG monitoring (EPM) improves the detection rate but is not feasible for all patients. We hypothesized that brain natriuretic peptide (BNP) may help to identify patients with stroke at high risk for pAF to select patients for EPM more effectively.

Methods—
Patients with acute cerebral ischemia ≥60 years presenting in sinus rhythm and without history of AF were included into a prospective, randomized multicenter study to receive either EPM (3× 10-day Holter-ECG) or usual stroke care diagnostic work-up. BNP plasma levels were measured on randomization and 3 months thereafter. Levels were compared between patients with and without pAF detected by means of EPM or usual care. Furthermore, the number needed to screen for EPM depending on BNP cut offs was calculated.

Results—

A total of 398 patients were analyzed. In 373 patients (93.7%), BNP was measured at baseline and in 275 patients (69.1%) after 3 months. pAF was found in 27 patients by means of EPM and in 9 patients by means of usual care (
P
=0.002). Median BNP was higher in patients with pAF as compared to patients without AF in both study arms at baseline (57.8 versus 28.3 pg/mL in the EPM arm,
P
=0.0003; 46.2 versus 27.7 pg/mL,
P
=0.28 in the control arm) and after 3 months (74.9 versus 31.3 pg/mL,
P
=0.012 in the EPM arm, 99.3 versus 26.3 pg/mL,
P
=0.02 in the control arm). Applying a cut off of 100 pg/mL, the number needed to screen was reduced from 18 by usual care to 3 by EPM.

Conclusions—
BNP measured early after ischemic stroke identifies a subgroup of patients with stroke at increased risk for AF, in whom EPM is particularly efficacious.

Registration—

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01855035.
Protecting Breastfeeding From Conflicts of Interest
Authors: Lhotska Lida , Richter Judith , Arendt Maryse 
Published: December 2019

In order to maximize profits from sales of breastmilk substitutes, manufacturers use a whole gamut of strategies to interfere with the effective implementation of policies that protect, promote, and support breastfeeding (e.g., the International Code of Marketing of Breastmilk Substitutes with its subsequent World Health Assembly resolutions and the Global Strategy on Infant and Young Child Feeding). Their strategies create, among other problems, personal and institutional conflicts of interest. Effective Conflict of Interest policies are therefore needed for ensuring that governments, international organizations, non-governmental organizations, and health professionals can protect their independence, integrity, and credibility in order to work in the best interests of children. Conflicts of interest are discussed by Dr Lida Lhotska and Dr Judith Richter, who have been actively involved in these issues internationally. Lida Lhotska holds a BSc in Biology and a PhD in Anthropology. Her international work spans over 25 years. She headed the Infant Feeding and Care team for UNICEF and subsequently joined the IBFAN-Geneva Infant Feeding Association team, always focusing on advancing the protection of breastfeeding through legal and other policy measures. Judith Richter has a multidisciplinary background combining knowledge in the humanities with health sciences (PhD Social Sciences; MA Development Studies; MSc Pharmaceutical Sciences). Her work as a freelance researcher for United Nations agencies, governments, and civil society organizations and networks has centered on safeguarding their capacity to hold transnational corporations accountable. In her interview, Judith Richter explains why conflict of interest regulation matters to health professionals working in the field of lactation. (MA = Maryse Arendt; LL = Lida Lhotska; JR = Judith Richter)
An Analysis of the Decision-Making Process After “Decision not to Operate” in Acutely Unwell, High-Risk General Surgery Patients
Authors: Pinto-Lopes Rui , Thahir Azeem , Halahakoon V. Chandima 
Published: December 2019

Objectives: The purpose of this study was to analyze the decision-making process in emergency general surgery in an attempt to ascertain whether surgeons make the correct decision when decisions not to operate in high-risk acutely unwell surgical patients are taken. Background: A decision not to operate is sometimes associated with a certain degree of uncertainty as to the accuracy of the decision. Difficulty lies with the fact that the decisions are made on assumptions, and the tools available are not fool proof. Methods: We retrospectively evaluated “decisions not to operate” over a period of 32 months from April 2013 to August 2015 in a district general hospital in United Kingdom and compared with consecutive similar number of patients who had an operation as recorded in the National Emergency Laparotomy Audit (NELA) database (from January 2014 to August 2015). We looked at the demographics, American Society of Anesthesiologists grade, Portsmouth–Physiological and Operative Severity Score for enumeration of Mortality and Morbidity (P-POSSUM) score, functional status, and 30-day mortality. Results: Two groups (operated [n = 43] and conservative [n = 42]) had similar characteristics. Patients for conservative management had a higher P-POSSUM score ( P < .001) and a poorer functional status ( P < .001) at the time of decision-making compared to those who had surgery. Mortality at 30 days was significantly higher for patients decided for conservative management when compared with those who had surgery (76.2% and 18.6%, respectively). Conclusions: Elderly patients with poorer functional status and predicted risks more often drive multidisciplinary discussions on whether to operate. Within the limitations of not knowing the outcome otherwise, it appears surgeons take a reasonable approach when deciding not to operate.
Results of Tibia and Fibula Osteotomies Performed Concomitant to Total Ankle Replacement
Authors: Adams Samuel B. , Steele John R. , Demetracopoulos Constantine A. , Nunley James A. , Easley Mark E. , DeOrio James K. 
Published: December 2019

Background: Neutral ankle alignment along with medial and lateral support are paramount to the success of total ankle replacement (TAR). Fibula, intra-articular medial malleolus, and supramalleolar tibia osteotomies have been described to achieve these goals; however, the literature is scant with outcomes and union rates of these osteotomies performed concomitant to TAR. The purpose of this study was to describe our results. Methods: A retrospective review was performed to identify patients who had a concomitant tibia, fibula, or combined tibia and fibula osteotomy at the same time as TAR. Routine radiographs were used to assess osteotomy union rates and changes in alignment. Outcomes questionnaires were evaluated preoperatively and at most recent follow-up. Twenty-six patients comprising 4% of the total TAR cohort were identified with a mean follow-up of 3.9 years. Results: There were 12 combined tibia and fibula osteotomies, 9 isolated tibia osteotomies, and 5 isolated fibula osteotomies. The union rate for these osteotomies was 92%, 100%, and 100%, respectively. Mean coronal alignment improved from 15.2 to 2.1 degrees ( P < .001). There was significant improvement in patient-reported outcome scores, including Short Form-36, Short Musculoskeletal Function Assessment, and visual analog scale pain. There was 1 failure in the study. Conclusion: These data demonstrate successful use of tibia, fibula, or combined tibia and fibula osteotomies at the same time as TAR in order to gain neutral ankle alignment. The overall union rate was 96% with significant improvement in alignment, pain, and patient-reported outcomes. We believe concomitant osteotomies can be considered a successful adjunctive procedure to TAR. Level of Evidence: Level III, retrospective comparative series.
Patients Prescribed Anakinra for Acute Gout Have Baseline Increased Burden of Hyperuricemia, Tophi, and Comorbidities, and Ultimate All-Cause Mortality
Authors: Sharma Ena , Pedersen Brian , Terkeltaub Robert 
Published: December 2019

Objective: The interleukin-1 (IL-1) receptor antagonist anakinra is an effective, off-label option in acute gout flares, when conventional therapy options are narrowed. We performed a retrospective, randomized, case-controlled study to gain clinical insight on baseline factors for gout patients most likely to receive anakinra, and ultimate mortality of those who received anakinra. Methods: Of 1451 gout patients seen between January 2003 and January 2015 in a Veterans Affairs (VA) rheumatology group practice, under stringent managed care principles, 13 (100% male), who received anakinra at least once for flares, were compared with 1:4 age- and sex-matched gout controls. Each patient’s first rheumatology encounter was studied by factor analysis for variables associated with later anakinra. Results: At baseline, patients that received anakinra had higher urate burden (palpable tophi [10/13] vs controls [16/52], P = .003), serum urate ([10.6 mg/dL] vs controls [7.6 mg/dL], P < .0001), and East Asian descent ([7/13] vs [16/52], P = .041). The anakinra group had higher ultimate all-cause mortality ([6/13] vs controls [7/52], relative risk [RR] = 3.43, 95% confidence interval [CI] = 1.39-8.48, P = .0076). Factor analysis showed baseline visit palpable tophus and statin use to be most strongly associated with later anakinra use. Increased mortality of anakinra users, as per a factorial analysis, was linked more strongly to comorbidities than to anakinra. Conclusions: At baseline rheumatology gout encounter, higher urate, palpable tophi, statin prescription, and East Asian descent were associated with later anakinra use for flares. Mortality was more closely associated to the presence of comorbidities at baseline rheumatology visit than to anakinra prescription.
Interaction rituals in an open drug scene
Authors: Grønnestad Trond E , Sagvaag Hildegunn , Lalander Philip 
Published: December 2019

Aims: Open drug scenes can be found in most major cities in Europe. Despite often being closed down by the police, the drug community continues to exist, and the drug scenes reappear elsewhere. There seem to be forces that hold these communities together, regardless of the substances used. In this study we explore whether interaction rituals have an impact on the decision by people to stay in the drug scene or to return after quitting their drug use. Method: In this ethnographic study, one of the researchers spent time in an open drug scene in a Norwegian city over a one-year span and gathered data on the human interactions hosted by this scene. In addition, the researcher interviewed eight people from the scene to obtain greater insight into their lives and perceptions of the scene, drawing on Goffman’s and Collins’s theories about rituals. Findings: Three themes emerged. First, drug users bonded as a group and resisted what they called “normal people” passing by. Second, users demonstrated the importance of sharing drugs and services and adhering to the scene’s rules of conduct. The third and final theme is the focus of attention and the production of emotional energy. Conclusion: The experience of being outsiders and the need to hide some of their activities seemed to make it necessary for persons in the drug scene to have their own rules and rituals. These rules and rituals can be regarded as “interaction rituals”. They provide participants with the symbols of group membership, emotional energy, and group solidarity. This makes it hard to leave the scene and might explain why those who do often return.
Long-term exposure to air pollution and the risk of non-lung cancer: a meta-analysis of observational studies
Authors: Kim H-B , Shim J-Y , Park B , Lee Y-J 
Published: December 2019

Aims: Several meta-analyses of observational studies report a long-term correlation between air pollution and the risk of cancer, particularly lung carcinoma. The aim of this study was to review and quantify evidence for an association between air pollution and the risk of developing non-lung cancers. Methods: We searched PubMed, EMBASE, Cochrane Library, and the reference lists of the included studies as well as those recorded in previous meta-analyses conducted before January 2019. A random-effects model was used to derive overall risk estimates per pollutant. Results: A total of 20 studies, including 5 case-control and 15 prospective cohort studies, were used in the final analysis. The risk of developing non-lung cancer was 1.09 (95% confidence interval (CI): 1.01–1.18, I2 = 72.9%) per NO2 increases of 10 µg/m3. There was also a significant association between exposure to PM2.5 and PM10 and the risk of non-lung cancer when the male and female populations were combined (pooled odds ratio/relative risk (OR/RR) = 1.22, 95% CI: 1.11–1.34; I2 = 0.0% and pooled OR/RR = 1.26, 95% CI: 1.05–1.52; I2 = 43.9%, respectively). Regarding the type of cancer, significant harmful effects of PM2.5 were observed for liver cancer populations (pooled OR/RR = 1.21, 95% CI: 1.10–1.32; I2 = 0.0%). Different types of cancer were positively associated with the incidence of non-lung cancer and PM10 in the random-effect meta-regression analysis. Conclusions: Long-term exposure to air pollutants appears to be associated with an increased risk of non-lung cancer. Care should be taken in interpretation, because the results for specific cancers were restricted.
Testicular rupture: Simplifying the diagnosis
Authors: Leung Lap Yan , Seth Jai , Gonsalves Michael , Watkin Nick , Sharma Davendra 
Published: December 2019

Objective: To review the use of ultrasound imaging in the diagnosis of testicular rupture and in relation to current guidelines. Methods: Data was retrospectively collected for all patients diagnosed with testicular rupture at a major trauma centre between 2011 and 2018. Data included patient demographics, mechanism of trauma, specific findings on ultrasound and outcomes. On review of ultrasound imaging, specific findings identified include a breach in the tunica albuginea (currently advised in guidelines), heterogenicity and contour loss. Results: Eight patients were identified with average age 37 years old, mechanism of trauma was 50%, 37.5% and 12.5% for motorcycle road traffic collision, sporting injury and workplace injury respectively. A breach of tunica albuginea was identified on ultrasound in 65% of cases, compared with 100% of cases showing contour loss and heterogenicity. Of the 87.5% patients who were managed surgically one needed orchidectomy (and later testosterone replacement). Conclusion: Guidelines have varied on how to use ultrasound imaging in diagnosing a clinically difficult condition. Our case series demonstrates that diagnosing testicular rupture by looking for more easily identifiable characteristics (heterogenicity and contour loss) than currently recommended in the guidelines (breech in the tunica albuginea) will aid diagnosis and patient pathway and improve outcomes. Level of evidence: 5