bluuebunny/crossref_metadata_2025_split huggingface dataset:
Forecasting the progression of Alzheimer's disease using neural networks and a novel preprocessing algorithm
Authors: Albright Jack ,   Alzheimer's Disease Neuroimaging Initiative
Published: September 2019

AbstractIntroductionThere is a 99.6% failure rate of clinical trials for drugs to treat Alzheimer's disease, likely because Alzheimer's disease (AD) patients cannot be easily identified at early stages. This study investigated machine learning approaches to use clinical data to predict the progression of AD in future years.MethodsData from 1737 patients were processed using the “All‐Pairs” technique, a novel methodology created for this study involving the comparison of all possible pairs of temporal data points for each patient. Machine learning models were trained on these processed data and evaluated using a separate testing data set (110 patients).ResultsA neural network model was effective (mAUC = 0.866) at predicting the progression of AD, both in patients who were initially cognitively normal and in patients suffering from mild cognitive impairment.DiscussionSuch a model could be used to identify patients at early stages of AD and who are therefore good candidates for clinical trials for AD therapeutics.
The Effects of Female Leadership on Women's Voice in Political Debate
Authors: Blumenau Jack 
Published: September 2019

AbstractDo female leaders amplify the voices of other women in politics? The author addresses this question by examining parliamentary debates in the UK House of Commons. In the context of a difference-in-differences design that exploits over-time variation in the gender of cabinet ministers, the article demonstrates that female ministers substantially increase the participation of other female MPs in relevant debates, compared to when the minister is male. It also uses a measure of debate influence, based on the degree to which words used by one legislator are adopted by other members, to show that female ministers also increase the influence of female backbenchers. To explore the mechanisms behind these results, the author introduces a new metric of ministerial responsiveness and shows that female ministers are significantly more responsive than their male counterparts to the speeches of female backbenchers.
The role of childhood generalized anxiety in the internalizing cluster
Authors: Lee Kirsty S. , Vaillancourt Tracy 
Published: September 2019

AbstractBackgroundAnxiety, depression and somatization (the internalizing cluster) are highly comorbid, prevalent and associated with significant individual and societal costs. Although prior studies have examined their natural course, there has been a little investigation into how symptoms unfold at the individual level. We examined the intraindividual (within-person) temporal patterning of symptom development and the impact of risk factors (sex, ethnicity, socioeconomic indicators, bullying victimization, child maltreatment) on symptom means and trajectories (between-person), comparing youth and parent reports.MethodOver a 7-year interval from age 11 to 17, children (n= 669; 54% girls; 79% White) and parents (89% mothers) reported on symptoms of anxiety and depression from age 11 and somatization from age 13. Autoregressive latent trajectory models with structured residuals were used to uncouple within- and between-person sources of variance.ResultsAccording to self-reports, generalized anxiety consistently predicted depression, while anxiety and depression consistently predicted somatization. Anxiety also had an indirect effect on somatization via depression. According to parent reports, there were several bidirectional effects between anxiety and depression and between depression and somatization. Experiences of abuse were consistent risk factors for self-reported internalizing symptoms, and across informants, girls had higher symptom means and rising trajectories compared to boys.ConclusionGeneralized anxiety plays an important role in adolescent depressive and somatic symptoms. Primary prevention of anxiety may be warranted to curb symptom continuity and the development of comorbidity. Research is needed to determine whether self-reports of anxiety should be prioritized over parent reports and continued efforts are needed to reduce bullying and child maltreatment.
Enhanced wheat competition effects on the growth, seed production, and seed retention of major weeds of Australian cropping systems
Authors: Walsh Michael J. 
Published: September 2019

AbstractThe loss of herbicide options due to resistance and lack of new chemistries have delivered the realization that herbicides are a finite resource and weed control alternatives are desperately needed. In Australian conservation cropping, the only available alternatives suited to routine use are the recently introduced harvest weed seed control (HWSC) and the ever-present but undervalued crop competition. Target-neighbor design pot studies examined wheat (Triticum aestivum L.) competition effects on biomass and seed production of rigid ryegrass (Lolium rigidum Gaudin), wild radish (Raphanus raphanistrum L.), ripgut brome (Bromus diandrus Roth), and wild oat (Avena fatua L.). The influence of wheat competition on crop canopy distribution of weed biomass and seed production was also examined. At the current commercially targeted wheat density (120 plants m−2) weed biomass was reduced by 69%, 73%, 72%, and 49% and seed production by 78%, 78%, 77%, and 50% for L. rigidum, R. raphanistrum, B. diandrus, and A. fatua, respectively, when compared with no competition. These results highlighted the importance of uniform wheat crop establishment in minimizing the ongoing impact of weeds. Enhanced what competition (from 120 to 400 plants m−2) resulted in further smaller, but substantial, reductions in biomass (19%, 13%, 20%, and 39%) and seed production (12%, 13%, 17%, and 45%) for L. rigidum, R. raphanistrum, B. diandrus, and A. fatua, respectively. This enhanced competition also increased weed seed retention in the upper crop canopy (>40 cm) by 35% and 31% for L. rigidum and B. diandrus, respectively, but not for A. fatua and R. raphanistrum, for which weed seed retention was already >80% at the wheat density of 120 plants m−2. Enhanced wheat crop competition, then, has the dual effect of restricting the growth and development of L. rigidum, R. raphanistrum, B. diandrus, and A. fatua as well increasing the susceptibility of these weed species to HWSC.
Long-term phase 3 study of esaxerenone as mono or combination therapy with other antihypertensive drugs in patients with essential hypertension
Authors: Rakugi Hiromi , Ito Sadayoshi , Itoh Hiroshi , Okuda Yasuyuki , Yamakawa Satoru 
Published: September 2019

AbstractThis study investigated the long-term antihypertensive effects of esaxerenone, a novel nonsteroidal mineralocorticoid receptor blocker, alone or in combination with a calcium channel blocker (CCB) or a renin–angiotensin system (RAS) inhibitor, in Japanese patients with essential hypertension. Patients were treated with esaxerenone starting at 2.5 mg/day increasing to 5 mg/day if required to achieve blood pressure (BP) targets as a monotherapy or with a CCB or RAS inhibitor. After the first 12 weeks of treatment, an additional antihypertensive agent could be added if required to achieve the target BP; the total treatment period was 28 or 52 weeks. The primary endpoint was a change from baseline in sitting BP. Of the 368 enrolled patients, 245 received monotherapy, and 59 and 64, respectively, took a CCB or RAS inhibitor concurrently. Mean changes from baseline in sitting systolic/diastolic BP (95% confidence intervals) at weeks 12, 28 and 52 were −16.1 (−17.3, −14.9)/−7.7 (−8.4, −6.9), −18.9 (−20.2, −17.7)/−9.9 (−10.7, −9.2), and −23.1 (−25.0, −21.1)/−12.5 (−13.6, −11.3) mmHg, respectively (all P < 0.0001 vs baseline). Similar BP reductions at these weeks were observed between all patient subgroups stratified by age, and the observed decreases in 24-h ambulatory BP were consistent with the efficacy observed in sitting BP. Esaxerenone was also well-tolerated with a rate of hyperkalemia at 5.4% (serum potassium ≥5.5 mEq/L), indicating a good safety profile for treatment over the long-term or in combination with a CCB or RAS inhibitor. In conclusion, esaxerenone may be a promising treatment option for patients with hypertension.
Transient Mitomycin C-treatment of human corneal epithelial cells and fibroblasts alters cell migration, cytokine secretion, and matrix accumulation
Authors: Pal-Ghosh Sonali , Tadvalkar Gauri , Lieberman Verna Rose , Guo Xiaoqing , Zieske James D. , Hutcheon Audrey , Stepp Mary Ann 
Published: September 2019

AbstractA single application of Mitomycin C (MMC) is used clinically in ophthalmology to reduce scarring and enhance wound resolution after surgery. Here we show in vitro that a 3-hour MMC treatment of primary and telomerase immortalized human corneal limbal epithelial (HCLE) cells impacts their migration and adhesion. Transient MMC treatment induces HCLE expression of senescence associated secretory factors, cytokine secretion, and deposition of laminin 332 for several days. Transient MMC treatment also reduces migration and deposition of transforming growth factor-β1 (TGFβ1)-stimulated collagen by corneal fibroblasts. Using conditioned media from control and MMC treated cells, we demonstrate that factors secreted by MMC-treated corneal epithelial cells attenuate collagen deposition by HCFs whereas those secreted by MMC-treated HCFs do not. These studies are the first to probe the roles played by corneal epithelial cells in reducing collagen deposition by corneal fibroblasts in response to MMC.
High energy proton micro-bunches from a laser plasma accelerator
Authors: Sharma Ashutosh , Kamperidis Christos 
Published: September 2019

AbstractRecent advances on laser-driven ion accelerators have sparked an increased interest in such energetic particle sources, particularly towards the viability of their usage in a breadth of applications, such as high energy physics and medical applications. Here, we identify a new ion acceleration mechanism and we demonstrate, via particle-in-cell simulations, for the first time the generation of high energy, monochromatic proton micro-bunches while witnessing the acceleration and self-modulation of the accelerated proton beam in a dual-gas target, consisting of mixed ion species. In the proposed ion acceleration mechanism due to the interaction of an ultra-short, ultra-intense (2 PW, 20 fs) laser pulses with near-critical-density partially ionized plasmas (C & H species), we numerically observed high energy monochromatic proton microbunches of high quality (peak proton energy 350 MeV, laser to proton conversion efficiency ~10−4 and angular divergence <10 degree), which can be of high relevance for medical applications. We envisage that through this scheme, the range of attained energies and the monochromaticity of the accelerated protons can be increased with existing laser facilities or allow for laser-driven ion acceleration investigations to be pursued at moderate energies in smaller scale laser laboratories, hence reducing the size of the accelerators. The use of mixed-gas targets will enable high repetition rate operation of these accelerators, free of plasma debris and electromagnetic pulse disruptions.
Clemens, Carl und Friedrich von Bönninghausen
Authors: Baschin Marion 
Published: September 2019

ZusammenfassungIm vorliegenden Artikel werden die Homöopathen Clemens, Carl und Friedrich von Bönninghausen porträtiert. Deren homöopathische praktische Tätigkeit wird anhand der geführten Krankenjournale dargestellt. Zudem wird beleuchtet, welche Verdienste sie um die Homöopathie erworben haben.
The strategic use of argumentation from example in re-evaluating a people
Authors: Omar Ahmed Abdulhameed 
Published: September 2019

AbstractWith the help of the extended pragma-dialectical theory, this paper aims to analyze how Al Aswany, an Egyptian political columnist who argued in favor of the feasibility of democratization before the Arab Spring, maneuvered strategically by argumentation from example in two of his columns in supporting the standpoint that the Egyptian people had become no longer politically inactive. The analysis is conducted in view of the institutional preconditions of political columns and the specific rhetorical exigency a columnist may face in this specific argumentative situation.
Deconstructing Poststroke Delirium in a Prospective Cohort of Patients With Intracerebral Hemorrhage*
Authors: Reznik Michael E. , Drake Jonathan , Margolis Seth A. , Moody Scott , Murray Kayleigh , Costa Samantha , Mahta Ali , Wendell Linda C. , Thompson Bradford B. , Rao Shyam S. , Barrett Anna M. , Boukrina Olga , Daiello Lori A. , Asaad Wael F. , Furie Karen L. , Jones Richard N. 
Published: September 2019

Objectives:
Poststroke delirium may be underdiagnosed due to the challenges of disentangling delirium symptoms from underlying neurologic deficits. We aimed to determine the prevalence of individual delirium features and the frequency with which they could not be assessed in patients with intracerebral hemorrhage.

Design:
Prospective observational cohort study.

Setting:
Neurocritical Care and Stroke Units at a university hospital.

Patients:
Consecutive patients with intracerebral hemorrhage from February 2018 to May 2018.

Interventions:
None.

Measurements and Main Results:
An attending neurointensivist performed 257 total daily assessments for delirium on 60 patients (mean age 68.0 [sd 18.4], 62% male, median intracerebral hemorrhage score 1.5 [interquartile range 1–2], delirium prevalence 57% [n = 34]). Each assessment included the Confusion Assessment Method for the ICU, Intensive Care Delirium Screening Checklist, a focused bedside cognitive examination, chart review, and nurse interview. We characterized individual symptom prevalence and established delirium diagnoses using Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria, then compared performance of the Confusion Assessment Method for the ICU and Intensive Care Delirium Screening Checklist against reference-standard expert diagnosis. Symptom fluctuation (61% of all assessments), psychomotor changes (46%), sleep-wake disturbances (46%), and impaired arousal (37%) had the highest prevalence and were never rated “unable to assess,” while inattention (36%), disorientation (27%), and disorganized thinking (18%) were also common but were often rated "unable to assess" (32%, 43%, and 44% of assessments, respectively), most frequently due to aphasia (32% of patients). Including nonverbal assessments of attention decreased the frequency of "unable to assess" ratings to 11%. Since the Intensive Care Delirium Screening Checklist may be positive without the presence of symptoms that require verbal assessment, it was more accurate (sensitivity = 77%, specificity = 97%, area under the receiver operating characteristic curve, 0.87) than the Confusion Assessment Method for the ICU (sensitivity = 41%, specificity = 88%, area under the receiver operating characteristic curve, 0.64).

Conclusions:
Delirium is common after intracerebral hemorrhage, but severe neurologic deficits may confound its assessment and lead to underdiagnosis. The Intensive Care Delirium Screening Checklist’s inclusion of nonverbal features may make it more accurate than the Confusion Assessment Method for the ICU in patients with neurologic deficits, but novel tools designed for such patients may be warranted.
Predictive Value of Sentinel Lymph Node Biopsy in Cutaneous Squamous Cell Carcinoma Based on the AJCC-8 and Brigham and Women's Hospital Staging Criteria
Authors: Tejera-Vaquerizo Antonio , Cañueto Javier , Llombart Beatriz , Martorell-Calatayud Antonio , Sanmartín Onofre 
Published: September 2019

BACKGROUND
Recommendations on when to perform sentinel lymph node (SLN) biopsy in cutaneous squamous cell carcinoma (cSCC) are lacking despite the tumor's clear predilection for lymphatic spread.

OBJECTIVE
To analyze the frequency of SLN metastasis in published series of cSCC in the context of the eighth edition of the American joint Committee on Cancer (AJCC-8) and the Brigham and Women's Hospital (BWH) staging criteria.

METHODS
Systematic review of studies of patients with cSCC who underwent SLN biopsy that described biopsy results.

RESULTS
In total, 153 patients with 24 positive SLN biopsies (15.7%) were included. Based on the AJCC-8 criteria positivity rates in the T2 and T3 categories were 8.3% (1/12 patients) and 25% (8/32), respectively. Using the BWH system there were, 2/33 in category T2a (6.5%), and 5/17 in category T2b (29.8%). On applying the same criteria to tumors of the trunk and extremities the results were similar.

CONCLUSION
It would seem reasonable to recommend SLN biopsy for patients with AJCC-8 Stage T3+ disease or BWH Stage T2b/T3 disease. Both the AJCC-8 and the BWH systems would appear to be useful for staging cSCC of the trunk and extremities.
Project Five Wishes: promoting advance directives in primary care
Authors: Atherton Kahla N. 
Published: September 2019

ABSTRACT

Background:
Despite the widely known and well-established benefits of advance care planning, it is estimated that 15–30% of American adults have completed advance directives (ADs). Evidence suggests that the best place for advance care planning (ACP) is in primary care, but many barriers to this practice exist.

Local problem:
Providers in a Northern Arizona private practice primary care clinic expressed frustration with their current ability and standard of care regarding ADs. Only 0.8% of their established adult patients had ADs.

Methods:
Project Five Wishes was a 16-week trial designed to increase the number of ADs recorded at a Northern Arizona primary practice. The secondary purpose was to increase primary care provider knowledge, comfort, confidence, perceived importance, and frequency of discussions about ADs with patients.

Interventions:
Interventions used in this project aimed to eliminate common barriers to ACP through a 30-minute presentation for providers and by integrating a user-friendly AD form into the office workflow.

Results:
The number of ADs recorded increased by 25.4%. There were no statistically significant changes in the providers' reported knowledge, comfort, confidence, perceived importance, and frequency of discussions regarding ADs.

Conclusions:
The feasibly reproducible process used in Project Five Wishes was successful at increasing the number of patients with ADs in this 16-week trial and could lead to improvement in this area for other clinics as well.
Analysis and Evaluation of Reviews on Lean and Six Sigma in Health Care
Authors: Peimbert-García Rodrigo E. 
Published: September 2019

Background and Objectives:
Health care is a complex industry in which professionals are facing the challenge of balancing lower costs with better health and quality of care. To remain competitive, health care organizations have promoted the use of Lean and Six Sigma in various settings. More than 300 refereed English-language articles about Lean and/or Six Sigma in health care are found in the literature, and many reviews have been published on this subject.

Methods:
This article characterizes the literature by evaluating and classifying 22 reviews, based on year of publication, country, taxonomy, health care setting, outcome, tools, and enabling factors, in order to identify gaps in the literature and set new directions for research.

Results:
Findings indicate that 90% of reviews are characterized by restrictive inclusion criteria that result in the inclusion of only 3% to 66% of the literature at the corresponding time. Furthermore, there is no full comprehensive literature review available on Lean and Six Sigma in health care. Other gaps in the literature include more studies with better research design, broader applications in various health care settings and various countries, sustainability assessment and long-term effects, and evidence of failed Lean and Six Sigma implementations.

Conclusion:
This study provides an updated starting point for future research to researchers and practitioners in the field.
Exploring the Business Case for Improving Quality of Care for Patients With Chronic Rotator Cuff Tears
Authors: Eubank Breda H. , Emery J. C. Herbert , Lafave Mark R. , Wiley J. Preston , Sheps David M. , Mohtadi Nicholas G. 
Published: September 2019

Background and Objectives:Currently, management of patients presenting with chronic rotator cuff tears in Alberta is in need of quality improvements. This article explores the potential impact of a proposed care pathway whereby all patients presenting with chronic rotator cuff tears in Alberta would adopt an early, conservative management plan as the first stage of care; ultrasound investigation would be the preferred tool for diagnosing a rotator cuff tear; and only patients are referred for surgery once conservative measures have been exhausted.Methods:We evaluate evidence in support of surgery and conservative management, compare care in the current state with the proposed care pathway, and identify potential solutions in moving toward optimal care.Results:A literature search resulted in an absence of indications for either surgical or conservative management. Conservative management has the potential to reduce utilization of public health care resources and may be preferable to surgery. The proposed care pathway has the potential to avoid nearly Can $87 000 in public health care costs in the current system for every 100 patients treated successfully with conservative management.Conclusion:The proposed care pathway is a low-cost, first-stage treatment that is cost-effective and has the potential to reduce unnecessary, costly surgical procedures.