bluuebunny/crossref_metadata_2025_split huggingface dataset:
Switching from vitamin K antagonist to dabigatran in atrial fibrillation: differences according to dose
Authors: Vinding Naja Emborg , Staerk Laila , Gislason Gunnar Hilmar , Torp-Pedersen Christian , Bonde Anders Nissen , Rørth Rasmus , Lee Christina J -Y , Olesen Jonas Bjerring , Køber Lars , Fosbøl Emil Loldrup 
Published: November 2019

Abstract

Aims
In atrial fibrillation (AF) patients 150 mg b.i.d. dabigatran is the standard dose, yet guidelines recommend 110 mg b.i.d. when bleeding risk is high. It is unknown to which extend these recommendations are followed in patients switching from vitamin K antagonist (VKA) to dabigatran. The aim of this study was to investigate if AF patients are switched from VKA to the appropriate dose of dabigatran.

Methods and results
Using nationwide registries (22 August 2011 to 31 December 2012), we identified VKA-experienced AF patients with available creatinine values who switched to dabigatran. European guidelines criteria 2012 on dabigatran dosing were examined: age ≥80 years, HAS-BLED ≥3, estimated glomerular filtration rate (eGFR)&lt;50 mL/min/1.73 m2, or use of interacting drugs. We identified 1626 VKA-experienced AF patients who switched to dabigatran 110 mg (820 patients) or 150 mg (806 patients). Patients who switched to 110 mg compared with 150 mg were older [median age 82 years (Q1–Q3: 77–86) vs. 68 years (Q1–Q3: 64–74)], more often females (54% vs. 35%), had a higher comorbidity burden, higher proportion with CHA2DS2–VASc score ≥2 (98% vs. 80%), and more with a HAS-BLED score ≥3 (46% vs. 28%). Patients switched to 110 mg had a higher absolute risk of mortality compared with patients switched to 150 mg. Overall, 26% were inappropriately dosed and 14% were switched to 110 mg although the higher dose was indicated. Furthermore, 39% of patients switched to 150 mg fulfilled one or more criteria for 110 mg, this mostly driven by high HAS-BLED scores (28.2% of patients on 150 mg). Female sex, age ≥80 years, eGFR &lt; 50 mL/min/1.73 m2, drugs interacting with dabigatran, and prior bleeding were associated with switch to 110 mg. Patients inappropriately dosed had similar risk of mortality as patients appropriately dosed.

Conclusion
Among VKA-experienced AF patients one in four were switched to a dabigatran dose contrary to guideline recommendations.
Fault dip variations related to elastic layering
Authors: Nespoli M , Belardinelli M E , Bonafede M 
Published: November 2019

Summary
In this paper we model the crack growth in an elastic medium constituted by two welded half-spaces with different rigidities. We implement a 2D Boundary Element Method (BEM) computing shear and normal tractions acting on the crack and the slip accommodating stress drop from an arbitrary initial configuration to a final frictional configuration. The direction of crack growth follows the criterion of maximum energy release (strain and gravitational energy) provided that it overcomes the surface fracture energy and the work dissipated by friction. The energetic criterion leads to estimates of the dip angle of seismic faults depending on the amplitude of the initial stress and it includes the classical Anderson's results as a particular case. Moreover, in presence of a sharp rigidity contrast, the direction of crack growth is strongly deflected. The model simulates non-planar, complex, fault geometries, as in the case of detachment and listric faults and it explains the increase of dip angles for both normal and reverse faults, when they enter soft sedimentary layers.
Feeding and growth of Atlantic cod (Gadus morhua L.) in the eastern Baltic Sea under environmental change
Authors: Neuenfeldt Stefan , Bartolino Valerio , Orio Alessandro , Andersen Ken H , Andersen Niels G , Niiranen Susa , Bergström Ulf , Ustups Didzis , Kulatska Nataliia , Casini Michele 
Published: November 2019

AbstractFive decades of stomach content data allowed insight into the development of consumption, diet composition, and resulting somatic growth of Gadus morhua (Atlantic cod) in the eastern Baltic Sea. We show a recent reversal in feeding level over body length. Present feeding levels of small cod indicate severe growth limitation and increased starvation-related mortality. For young cod, the low growth rate and the high mortality rate are manifested through a reduction in size-at-age. The low feeding levels are likely the result of a decrease in benthic prey abundance due to increased hypoxic areas, while decreasing abundances of pelagic species in the area of cod distribution have prevented a compensatory shift in diet. Our study emphasizes that environmental forcing and the decline in pelagic prey caused changes in consumption and growth rates of small cod. The food reduction is amplified by stunted growth leading to high densities of cod of smaller size competing for the scarce resources. The average growth rate is negative, and only individuals with feeding levels well above average will survive, though growing slowly. These results suggest that the relation between consumption rate, somatic growth and predatorprey population densities is strongly environmentally mediated.
Foreign Policy Preferences in Ukraine: Trade and Ethnolinguistic Identity
Authors: Beesley Celeste 
Published: November 2019

ABSTRACT
Individuals tend to favor important trade partners in their foreign policy preferences. Cultural affinity is also known to influence individuals’ foreign policy stances. This study examines how citizens prioritize international relations with trading partners in the face of ethnolinguistic divisions. Using survey data on foreign policy preferences paired with data on bilateral trade between Ukraine and its two largest trade partners (Russia and the European Union [EU]), I find that ethnolinguistic identity and relative trade exposure both affect foreign policy preferences and that these effects introduce cross-cutting cleavages. Ukrainian-speaking Ukrainians in regions where the economic importance of trade with Russia is relatively higher are more likely to favor foreign policy oriented toward Russia than Ukrainian speakers elsewhere. Similarly, Russian speakers in areas with high levels of trade with the EU have more EU-oriented foreign policy preferences.
A Comparison of Acute Toxicity Endpoints for Adult Honey Bees with Technical Grade Active Ingredients and Typical End-use Products as Test Substance
Authors: Spruill Susan E , O'Neill Bridget F , Hinarejos Silvia , Cabrera Ana R 
Published: November 2019

Abstract
The honey bee, Apis mellifera L. (Hymenoptera: Apidae), is a model organism for pollinators in risk assessment frameworks globally. The acute toxicity tests with adult honey bees for contact and oral exposure are part of the requirements for pesticide registration and are typically conducted with the active ingredient. A question often asked is if the typical end-use product (TEP) is more toxic than the technical grade active ingredient (TGAI) to honey bees. We explored this question by mining publicly available databases from regulatory agencies worldwide, where testing with the TEP is required. The objective of this study was to determine whether TEPs are comparable in toxicity to the TGAI. The dataset was analyzed via a 3 × 3 contingency table with toxicity categories, as the data cannot be computed for regression analysis. Of the 151 active ingredients with reported endpoints for contact exposure, 28 were classified as either moderately or highly toxic, 123 were classified as practically nontoxic, and 3 were inconclusive. Only two (1.3%) were reclassified from nontoxic to moderately toxic as the TEP. Of the 141 active ingredients with reported endpoints for oral exposure, 23 were classified as moderately or highly toxic, 113 were classified as practically nontoxic, and 5 were inconclusive. Only five (3.6%) were reclassified from nontoxic to moderately toxic as the TEP. Fewer than 5% of the total TEPs evaluated (contact and oral) were shown to be more toxic than the TGAI, suggesting that the risk assessments of TGAIs would be sufficiently protective to pollinators at the screening laboratory level.
The great collector and his man in Rome
Authors: Dall’Aglio Stefano 
Published: November 2019

Abstract
This article analyses the relationship between one of early modern Italy’s most illustrious collectors, Prince and Cardinal Leopoldo de’ Medici (1617–1675), and his principal agent in Rome, Ottavio Falconieri (1636–1675). It draws on an extraordinary new source: a volume containing 350 original letters sent by Leopoldo to Ottavio, never before seen by any other scholar. Letters written by Leopoldo are rare documents: they provide a unique insight into his expectations, instructions and reactions, showing the active role he always played in the collecting process. These new letters also demonstrate that Falconieri was far more than just an art agent: he was Leopoldo’s point of reference in Rome, a man with whom the cardinal shared many interests, ranging from literature to astronomy, from poetry to natural science, and Falconieri’s indefatigable collecting work went well beyond antiquities to include books, scientific instruments, curiosities and much more.
The Eolian Harp: Coleridge’s Middle Voice?
Authors: Allen Blake 
Published: November 2019

Abstract
Samuel Taylor Coleridge’s conversation poem, The Eolian Harp, configures a complex and highly significant relationship between activity and passivity. A merely passive poet, under the influence of natural or divine inspiration, would in Coleridge’s view be reduced to a mere automaton. Yet the poem is often thought to represent just such a poet. Similarly, it is thought to represent Sara, the speaker’s interlocutor, as a surrogate self. I shall argue, instead, that the poem presents the self in a ‘middle voice’, at once active and passive, such that inspiration does not efface human agency. I shall also consider the senses in which Sara evinces a middle voice and thus a distinct and substantial subjectivity. The implications of this argument for Coleridge’s broader corpus, and for some recent critiques of his aesthetics, will be suggested.
A guide to computational methods for G-quadruplex prediction
Authors: Puig Lombardi Emilia , Londoño-Vallejo Arturo 
Published: November 2019

AbstractGuanine-rich nucleic acids can fold into the non-B DNA or RNA structures called G-quadruplexes (G4). Recent methodological developments have allowed the characterization of specific G-quadruplex structures in vitro as well as in vivo, and at a much higher throughput, in silico, which has greatly expanded our understanding of G4-associated functions. Typically, the consensus motif G3+N1–7G3+N1–7G3+N1–7G3+ has been used to identify potential G-quadruplexes from primary sequence. Since, various algorithms have been developed to predict the potential formation of quadruplexes directly from DNA or RNA sequences and the number of studies reporting genome-wide G4 exploration across species has rapidly increased. More recently, new methodologies have also appeared, proposing other estimates which consider non-canonical sequences and/or structure propensity and stability. The present review aims at providing an updated overview of the current open-source G-quadruplex prediction algorithms and straightforward examples of their implementation.
Unmet needs and recommendations to improve meningioma care through patient, partner, and health care provider input: a mixed-method study
Authors: Zamanipoor Najafabadi Amir H , van de Mortel Johannes P M , Lobatto Daniel J , Brandsma Dieta R , Peul Wilco C , Biermasz Nienke , Taphoorn Martin J B , Dirven Linda , van Furth Wouter R 
Published: November 2019

AbstractBackgroundIt has been suggested that lack of ongoing registration of patient-centered outcomes has resulted in existing care trajectories that have not been optimized for sequelae experienced by meningioma patients. This study aimed to evaluate the structure of current meningioma care and identify issues and potential high-impact improvement initiatives.MethodsUsing the grounded theory approach, a thematic framework was constructed based on the Dutch Comprehensive Cancer Organisation survey about issues in meningioma care trajectories. This framework was used during 3 semistructured interviews and 2 focus groups with patient-partner dyads (n = 16 participants), and 2 focus groups with health care providers (n = 11 participants) to assess issues in current meningioma care trajectories and possible solutions, including barriers to and facilitators for implementation.ResultsIdentified issues (n = 18 issues) were categorized into 3 themes: availability and provision of information, care and support, and screening for (neurocognitive) rehabilitation. A lack of information about the intervention and possible outcomes or complications, lack of support after treatment focusing on bodily and psychological functions, and reintegration into society were considered most important. Sixteen solutions were suggested, such as appointment of case managers (solution for 11/18 issues, 61%), assessment and treatment by physiatrists (22%), and routine use of patient-reported outcome measures for patient monitoring (17%). Barriers for these solutions were lack of budget, capacity, technology infrastructure, and qualified personnel with knowledge about issues experienced by meningioma patients.ConclusionsThis study identified issues in current multidisciplinary meningioma care that are considered unmet needs by patients, partners, and health care providers and could guide innovation of care.
A Counterfactual Approach to Explanation in Mathematics
Authors: Baron Sam , Colyvan Mark , Ripley David 
Published: November 2019

ABSTRACTOur goal in this paper is to extend counterfactual accounts of scientific explanation to mathematics. Our focus, in particular, is on intra-mathematical explanations: explanations of one mathematical fact in terms of another. We offer a basic counterfactual theory of intra-mathematical explanations, before modelling the explanatory structure of a test case using counterfactual machinery. We finish by considering the application of counterpossibles to mathematical explanation, and explore a second test case along these lines.
Hypoxia decreases the T helper cell-suppressive capacity of synovial fibroblasts by downregulating IDO1-mediated tryptophan metabolism
Authors: Kaul Nathalie-Christin , Mohapatra Soumya R , Adam Isabell , Tucher Christine , Tretter Theresa , Opitz Christiane A , Lorenz Hanns-Martin , Tykocinski Lars-Oliver 
Published: November 2019

AbstractObjectiveThe development of RA is linked to local infiltration of immune cells and to changes in the phenotype of synovial fibroblasts. Synovial fibroblasts possess the capacity to suppress T cell responses through indoleamine 2, 3-dioxygenase 1 (IDO1)-mediated tryptophan metabolism. However, synovial fibroblasts from RA patients are restricted in this immune-modulatory function. Moreover, hypoxic conditions are detected within synovial tissues of RA patients, with oxygen tensions of only 3.2% O2. This study aims at investigating the effects of hypoxia on the interaction between T cells and synovial fibroblasts, particularly on the T cell-suppressive capacities of synovial fibroblasts.MethodsSynovial fibroblasts were cultured with Th cells under normoxic and hypoxic conditions (3% O2). Th cell proliferation was detected by flow cytometry. Tryptophan and kynurenine amounts were measured by HPLC. IDO1 expression and signal transducer and activator of transcription 1 (STAT1) phosphorylation were quantified by real-time PCR or western blot, and cytokine secretion by ELISA.ResultsHypoxic conditions strongly diminished the Th cell-suppressive capacities of both OA synovial fibroblasts and RA synovial fibroblasts. Accordingly, IDO1 mRNA and protein expression, STAT1 phosphorylation and tryptophan metabolism were greatly reduced in OA synovial fibroblasts by hypoxia. MMP-3, IL-6, IL-10 and IFNγ secretion were significantly decreased under hypoxia in synovial fibroblast-Th cell co-cultures, while IL-17A levels were elevated. Supplementation with IFNγ, a well-known inducer of IDO1 expression, could rescue neither IDO1 expression nor Th cell suppression under hypoxic conditions.ConclusionHypoxia strongly affected the crosstalk between synovial fibroblasts and Th cells. By reducing the efficiency of synovial fibroblasts to restrict Th cell proliferation and by increasing the expression of IL-17A, hypoxia might have implications on the pathophysiology of RA.
Behavioral interventions for pediatric insomnia: one treatment may not fit all
Authors: Kahn Michal , Juda-Hanael Michal , Livne-Karp Efrat , Tikotzky Liat , Anders Thomas F , Sadeh Avi 
Published: November 2019

Abstract

Study Objectives
Behavioral interventions for pediatric insomnia are cost-effective and benefit most families, but there is no evidence indicating which treatments are most suitable for specific patient populations. This randomized controlled trial evaluated the moderating role of infant separation anxiety in two brief interventions for infant sleep problems.

Methods
Ninety-one infants aged 9–18 months (61% boys) with pediatric insomnia were randomized to either Checking-in, a Graduated extinction protocol which involves gradual separation from parents, or to the Camping-out intervention, in which parental presence is maintained. Sleep was measured using actigraphy and parent reports. Infant separation anxiety was observed in the laboratory. Assessments were completed at baseline, post-treatment and 6-month follow-up.

Results
Improvement in sleep was demonstrated following both interventions and maintained at follow-up. Separation anxiety did not change significantly following treatment. Infant separation anxiety moderated treatment efficacy, with greater benefit for infants with high separation anxiety in the Camping-out compared to the Checking-in intervention.

Conclusions
This study provides support for considering infant separation anxiety in the effort to personalize treatment for pediatric insomnia. Pediatricians should incorporate evaluation of infant separation anxiety to assessment processes, and favor more gentle treatment approaches, such as Camping-out, over Graduated extinction for highly anxious infants.

Clinical Trial Registration
NCT01489215.
Elevated Serum Titanium Levels in Children With Early Onset Scoliosis Treated With Growth-friendly Instrumentation
Authors: Li Ying , Graham Chelsea K. , Robbins Christopher , Caird Michelle S. , Farley Frances A. 
Published: November 2019

Background:
A previous study showed significantly higher serum titanium levels in patients with early-onset scoliosis (EOS) treated with traditional growing rods (TGR) and magnetically controlled growing rods (MCGR) compared with controls. Children with vertical expandable prosthetic titanium rib (VEPTR) were not assessed. The purpose of this study was to compare serum titanium levels in EOS patients treated with TGR, MCGR, and VEPTR. We hypothesized that EOS patients treated with all forms of growth-friendly instrumentation (GFI) have elevated serum titanium levels.

Methods:
This was a prospective cross-sectional case series. Serum titanium levels were collected from patients with GFI who were enrolled in an EOS database. Blood samples were collected at a clinic visit or lengthening/exchange procedure between April and December 2018. The normal range for serum titanium is 0 to 1 ng/mL. Analyses were conducted using analysis of variance and Bonferroni post hoc test.

Results:
A total of 23 patients (2 TGR, 8 MCGR, 13 VEPTR) were analyzed. There was a significant difference in age at the time of blood sample collection (12.5 vs. 9.8 vs. 7.5 y, P=0.015) and serum titanium level (1.5 vs. 4.5 vs. 7.6 ng/mL, P=0.021) between TGR, MCGR, and VEPTR, respectively. All of the MCGR and VEPTR patients had a serum titanium level ≥2 ng/mL. Binary comparisons showed that VEPTR had a significantly higher serum titanium level than TGR (P=0.046). There was no difference in serum titanium level when MCGR was compared with TGR and VEPTR. Time from implant insertion to blood sample collection, number of rods currently implanted, total number of rods implanted throughout treatment, and number of lengthenings per patient was similar between the groups.

Conclusions:
Elevated serum titanium levels may be present in EOS patients treated with all forms of GFI. Although our TGR patients had indwelling implants for the longest period of time, they had the lowest serum titanium level. Repetitive chest wall motion during respiration may lead to continued wear and metal ion release with VEPTR.

Level of Evidence:
Level II—therapeutic.
A Review of the Use of Telemedicine in Dermatologic Surgery
Authors: Sohn Grace K. , Wong David J. , Yu Siegrid S. 
Published: November 2019

BACKGROUND
Telemedicine is an emerging field with numerous applications within medicine. Previous review articles describe its use within plastic surgery and otolaryngology but none, to the authors' knowledge, within dermatologic surgery.

OBJECTIVE
To provide a review of the applications of telemedicine within dermatologic surgery.

MATERIALS AND METHODS
A PubMed search of articles published on teledermatology was conducted in July 2018. Articles were selected based on their relevance to dermatologic surgery and reviewed for their discussion of the applications of telemedicine in surgical and cosmetic dermatology.

RESULTS
The initial search resulted in 156 articles. Eleven ultimately met inclusion criteria: 2 in referral and consultation, 5 in telepathology, 2 in intraoperative uses, and 2 in postprocedural care.

CONCLUSION
For preoperative consultation, teledermatology enables the surgeon to plan ahead and increases access to care by reducing the number of clinic visits. Telepathology has the potential to allow intraoperative consultation with a dermatopathologist to achieve accurate tumor clearance without delay. Smartglasses represent a promising technology for greater care coordination and a teaching tool. Postprocedural monitoring via text messaging provides convenient access to expert advice and early detection of postoperative complications. With increasing technologic advancements, telemedicine holds great potential to augment the dermatologic surgeon's daily practice.
Simple Effective Ways to Care for Skin Wounds and Incisions
Authors: Lalonde Don , Joukhadar Nadim , Janis Jeff 
Published: November 2019

Summary
Plastic surgeons are medicine’s wound experts. Many of the world’s poor cannot afford expensive wound management programs. All humans suffer open and closed wounds at some point in their life and must look after them. The purpose of this paper is to provide basic information to the public in very simple terms on how to safely and inexpensively manage wounds. This paper is directed to all nonmedical people, medical students, and other doctors who may not be content experts in this field.