bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do ethnic inequalities in multimorbidity reflect ethnic differences in socioeconomic status? The HELIUS study
Authors: Verest Wim J G M , Galenkamp Henrike , Spek Bea , Snijder Marieke B , Stronks Karien , van Valkengoed Irene G M 
Published: January 2019

Abstract

Background
The burden of multimorbidity is likely higher in ethnic minority populations, as most individual diseases are more prevalent in minority groups. However, information is scarce. We examined ethnic inequalities in multimorbidity, and investigated to what extent they reflect differences in socioeconomic status (SES).

Methods
We included Healthy Life in an Urban Setting study participants of Dutch (N = 4582), South-Asian Surinamese (N = 3258), African Surinamese (N = 4267), Ghanaian (N = 2282), Turkish (N = 3879) and Moroccan (N = 4094) origin (aged 18–70 years). Educational level, employment status, income situation and multimorbidity were defined based on questionnaires. We described the prevalence and examined age-adjusted ethnic inequalities in multimorbidity with logistic regression analyses. To assess the contribution of SES, we added SES indicators to the age-adjusted model.

Results
The prevalence of multimorbidity ranged from 27.1 to 53.4% in men and from 38.5 to 69.6% in women. The prevalence of multimorbidity in most ethnic minority groups was comparable to the prevalence among Dutch participants who were 1–3 decades older. After adjustment for SES, the odds of multimorbidity remained significantly higher in ethnic minority groups. For instance, age-adjusted OR for multimorbidity for the Turkish compared to the Dutch changed from 4.43 (3.84–5.13) to 2.34 (1.99–2.75) in men and from 5.35 (4.69–6.10) to 2.94 (2.54–3.41) in women after simultaneous adjustment for all SES indicators.

Conclusions
We found a significantly higher prevalence of multimorbidity in ethnic minority men and women compared to Dutch, and results pointed to an earlier onset of multimorbidity in ethnic minority groups. These inequalities in multimorbidity were not fully accounted for by differences in SES.
Frailty Screening Using the Electronic Health Record Within a Medicare Accountable Care Organization
Authors: Pajewski Nicholas M , Lenoir Kristin , Wells Brian J , Williamson Jeff D , Callahan Kathryn E 
Published: January 2019

Abstract

Background
The accumulation of deficits model for frailty has been used to develop an electronic health record (EHR) frailty index (eFI) that has been incorporated into British guidelines for frailty management. However, there have been limited applications of EHR-based approaches in the United States.

Methods
We constructed an adapted eFI for patients in our Medicare Accountable Care Organization (ACO, N = 12,798) using encounter, diagnosis code, laboratory, medication, and Medicare Annual Wellness Visit (AWV) data from the EHR. We examined the association of the eFI with mortality, health care utilization, and injurious falls.

Results
The overall cohort was 55.7% female, 85.7% white, with a mean age of 74.9 (SD = 7.3) years. In the prior 2 years, 32.1% had AWV data. The eFI could be calculated for 9,013 (70.4%) ACO patients. Of these, 46.5% were classified as prefrail (0.10 < eFI ≤ 0.21) and 40.1% frail (eFI > 0.21). Accounting for age, comorbidity, and prior health care utilization, the eFI independently predicted all-cause mortality, inpatient hospitalizations, emergency department visits, and injurious falls (all p < .001). Having at least one functional deficit captured from the AWV was independently associated with an increased risk of hospitalizations and injurious falls, controlling for other components of the eFI.

Conclusions
Construction of an eFI from the EHR, within the context of a managed care population, is feasible and can help to identify vulnerable older adults. Future work is needed to integrate the eFI with claims-based approaches and test whether it can be used to effectively target interventions tailored to the health needs of frail patients.
Comparison of Treadmill Trip-Like Training Versus Tai Chi to Improve Reactive Balance Among Independent Older Adult Residents of Senior Housing: A Pilot Controlled Trial
Authors: Aviles Jessica , Allin Leigh J , Alexander Neil B , Van Mullekom Jennifer , Nussbaum Maury A , Madigan Michael L 
Published: January 2019

Abstract

Background
There is growing interest in using perturbation-based balance training to improve the reactive response to common perturbations (eg, tripping and slipping). The goal of this study was to compare the efficacy of treadmill-based reactive balance training versus Tai Chi performed at, and among independent residents of, older adult senior housing.

Methods
Thirty-five residents from five senior housing facilities were allocated to either treadmill-based reactive balance training or Tai Chi training. Both interventions were performed three times per week for 4 weeks, with each session lasting approximately 30 minutes. A battery of balance tests was performed at baseline, and again 1 week, 1 month, 3 months, and 6 months post-training. The battery included six standard clinical tests of balance and mobility, and a test of reactive balance performance.

Results
At baseline, no significant between-group differences were found for any balance tests. After training, reactive balance training participants had better reactive balance than Tai Chi participants. Maximum trunk angle was 13.5° smaller among reactive balance training participants 1 week after training (p = .01), and a reactive balance rating was 24%–31% higher among reactive balance training participants 1 week to 6 months after training (p &lt; .03). Clinical tests showed minimal differences between groups at any time point after training.

Conclusion
Trip-like reactive balance training performed at senior housing facilities resulted in better rapid balance responses compared with Tai Chi training.
Distributive Justice at War: Displacement and Its Afterlives in the Central African Republic
Authors: Lombard Louisa , Picco Enrica 
Published: January 2019

AbstractOne of the defining features of the crisis in the Central African Republic (CAR) since 2013 has been massive displacement. Currently, about a quarter of the country’s population is displaced. People who have been forcibly displaced, whether internally or abroad, and people who stayed behind this time (but frequently have their own memories of displacement) provide particular kinds of information about war and its not particularly peaceful aftermath. In this article, based on interviews with a broad range of people affected by displacement, we show that Central African views about the prospects for peace are deeply affected by how displacement has shaped tensions over the political senses of distribution (who has a right to what, and on what basis). Who should pay for war, in senses both material and otherwise, and who should be compensated? However, distribution and belonging are not the issues prioritized in the aftermath of war, when elite deals, punitive justice and technocratic recovery plans crowd out treatment of the material justice and belonging questions that dominate neighbourhoods. The political dimensions of material justice in the aftermath of war require more thorough treatment, as listening to people who have experienced displacement makes abundantly clear.
Stoichiometric evolutions of PH3 under high pressure: implication for high-Tc superconducting hydrides
Authors: Yuan Ye , Li Yinwei , Fang Guoyong , Liu Guangtao , Pei Cuiying , Li Xin , Zheng Haiyan , Yang Ke , Wang Lin 
Published: January 2019

Abstract
The superconductivity of hydrides under high pressure has attracted a great deal of attention since the recent observation of the superconducting transition at 203 K in strongly compressed H2S. It has been realized that the stoichiometry of hydrides might change under high pressure, which is crucial in understanding the superconducting mechanism. In this study, PH3 was studied to understand its superconducting transition and stoichiometry under high pressure using Raman, IR and X-ray diffraction measurements, as well as theoretical calculations. PH3 is stable below 11.7 GPa and then it starts to dehydrogenate through two dimerization processes at room temperature and pressures up to 25 GPa. Two resulting phosphorus hydrides, P2H4 and P4H6, were verified experimentally and can be recovered to ambient pressure. Under further compression above 35 GPa, the P4H6 directly decomposed into elemental phosphorus. Low temperature can greatly hinder polymerization/decomposition under high pressure and retains P4H6 up to at least 205 GPa. The superconductivity transition temperature of P4H6 is predicted to be 67 K at 200 GPa, which agrees with the reported result, suggesting that it might be responsible for superconductivity at higher pressures. Our results clearly show that P2H4 and P4H6 are the only stable P–H compounds between PH3 and elemental phosphorus, which is helpful for shedding light on the superconducting mechanism.
100 Steps of a DIEP Flap—A Prospective Comparative Cohort Series Demonstrating the Successful Implementation of Process Mapping in Microsurgery
Authors: Sharma Hrsikesa R. , Rozen Warren M. , Mathur Bhagwat , Ramakrishnan Venkat 
Published: January 2019

Background:
The demand to improve the efficiency of microsurgical breast reconstruction is driven by increasing number of breast cancer and risk reducing cases, and the concurrent requirement for hospitals to cut costs. Businesses have successfully used process mapping as a tool to improve efficiency; however, process mapping has been sparsely used in surgery. This prospective cohort study has used process mapping to break down the individual components of a deep inferior epigastric artery perforator (DIEP) flap operation into a template of 100 streamlined steps.

Methods:
Through observation of the senior author’s uniform technique, refined from experience of over 5,000 cases, the DIEP flap operation was broken down into 100 individual steps, all arranged in a logical sequence with which to maximize efficiency and outcome. This created a 100-step process-mapped template. Subsequently, 2 cohorts of 10 unilateral DIEP cases were prospectively timed. One cohort following this process mapped template and the other control group was blinded to the template.

Results:
The process-mapped cohort was 56.1 minutes quicker than the control cohort, despite the addition of symmetrizing surgery being performed concurrently in 4 out of the 10 cases. Furthermore, there was no return to theater in the process-mapped cohort versus 1 return to theater in the control cohort with no flap loss in either group.

Conclusions:
This study uniquely presents an approach to process map the DIEP flap operation and demonstrates its utility in improving operative efficiency, without compromising outcomes. It also illustrates the possibility of symmetrizing surgery being carried out through parallel operating processes, without affecting overall operative times.
Cutaneous Mucormycosis in Solid Organ Transplant Recipients after Hurricane Harvey: Short- and Long-term Management
Authors: Kueht Michael , Villarreal Joshua A. , Reece Edward , Galvan N. Thao N. , Mysore Krupa , Restrepo Alejandro , Quintanilla Norma , Rana Abbas , Goss John 
Published: January 2019

Summary:
In the fall of 2017, Hurricane Harvey, one of the most costly hurricanes in American history, ravaged the Texas Gulf Coast, interrupting basic sanitation systems to hundreds of thousands of Texas residents. In the aftermath of Hurricane Harvey, our Houston hospitals noted an uptick in the incidence of cases of mucormycosis. Among the most vulnerable and affected have been immunocompromised transplant recipients. Here, we describe the successful management of 2 patients with atypical presentations of mucormycosis, 2 cutaneous infections after liver transplantation. Our comprehensive treatment strategy based upon guidelines and experience included coordinating aggressive surgical and medical therapies. We discuss our approach to surgical management including the extent and frequency of debridement, the methods of assessing disease-free margins, and minimizing the morbidity of radical debridement with temporary coverage and forethought to long-term reconstruction. Additionally, we describe the concurrent medical management, including type, route, and duration of antifungal therapy, minimizing suppression of the innate immune system, and optimizing the wound healing environment through maintaining nutritional status.
Epidural Nerve Blocks Increase Intraoperative Vasopressor Consumption and Delay Surgical Start Time in Deep Inferior Epigastric Perforator Free Flap Breast Reconstruction
Authors: Cormier Nicholas S. , Stein Michael J. , Zhang Tinghua , Lee Haemi , Zhang Jing 
Published: January 2019

Background:
Epidural nerve blocks (EA) have been widely used in abdominal and thoracic surgery as an adjunct to general anesthesia (GA). The role for EA in microsurgical free flap breast reconstruction remains unclear with concerns regarding its impact on flap survival and operating room efficiency. The purpose of this study was to examine the effectiveness of epidural blocks in patients undergoing deep inferior epigastric perforator (DIEP) flap breast reconstruction.

Methods:
A retrospective analysis of patients undergoing DIEP breast reconstruction under GA alone was compared with those receiving EA/GA. Electronic records were analyzed for patient demographics, intraoperative data, and postoperative outcomes. The primary outcome was 48-hour narcotic usage and secondary outcomes were intraoperative vasopressor consumption, surgical delay, and safety profile.

Results:
Sixty-one patients underwent DIEP reconstruction, 46 (75%) underwent EA/GA and 15 (25%) underwent GA alone. Epidural blocks were associated with a significant delay in operating room start time (67.8 min versus 45.6 min; P = 0.0004.) Patients in the EA/GA group also had a significant increase in vasopressor use (n = 38 versus n = 8; P = 0.037); however, there was no difference in flap complication rate [1 (2%) versus 2 (13%); P = 0.15]. Postoperatively, patients who received an epidural block had a reduced average pain score (1.1 versus 2.2; P = 0.0235), but there was no difference in 48-hour narcotic usage.

Conclusions:
Although epidural blocks reduce postoperative pain following DIEP flap breast reconstruction, they increase intraoperative vasopressor use and delay the start time of the case. Further studies are required to elucidate whether the benefits of improved pain control outweigh the potential risk for increased surgical complications and increased health care costs.
Decreased Fecal Calprotectin Levels in Cystic Fibrosis Patients After Antibiotic Treatment for Respiratory Exacerbation
Authors: Schnapp Zeev , Hartman Corina , Livnat Galit , Shteinberg Michal , Elenberg Yigal 
Published: January 2019

ABSTRACTObjectives:In all patients with cystic fibrosis (CF), gastrointestinal (GI) tract CF transmembrane conductance regulator dysfunction occurs early in life. The identical pathophysiological triad of obstruction, infection, and inflammation causes disease of the airways and in the intestinal tract (CF enteropathy). Mucus accumulation within GI tract is a niche for abnormal microbial colonization, leading to dysbiosis. Fecal calprotectin (FC) is a neutrophil cytosolic protein released during apoptosis and necrosis and reflects inflammatory status. Systemic antibiotic treatment for pulmonary exacerbations has been shown to improve systemic inflammatory markers and serum and sputum calprotectin. Antibiotic treatment aimed at pulmonary complaints may improve GI tract inflammatory status. We hypothesized that high levels of FC present during pulmonary exacerbation are due, in part, to multiorgan dysbiosis and thus should diminish with systemic antibiotic treatment.Methods:This prospective pilot study enrolled 14 patients with CF, with no current GI symptoms. FC levels and lung function were measured at the beginning and end of systemic antibiotic treatment.Results:Compared to preantibiotic treatment baseline values, end of treatment FC levels declined significantly after antibiotic treatment, P = 0.004 and similarly, there was significant improvement in forced expiratory volume in 1 second, P = 0.002.Conclusions:High levels of FC during respiratory exacerbation may reflect a systemic exacerbation rather than solely pulmonary. Antibiotic treatment lowered the FC levels possibly by its impact on the intestinal microbiome.
Visual thinking and simplicity of proof
Authors: Cain Alan J. 
Published: January 2019

This paper studies how spatial thinking interacts with simplicity in [informal] proof, by analysing a set of example proofs mainly concerned with Ferrers diagrams (visual representations of partitions of integers) and comparing them to proofs that do not use spatial thinking. The analysis shows that using diagrams and spatial thinking can contribute to simplicity by (for example) avoiding technical calculations, division into cases, and induction, and creating a more surveyable and explanatory proof (both of which are connected to simplicity). In response to one part of Hilbert's 24th problem, the area between two proofs is explored in one example, showing that between a proof that uses spatial reasoning and one that does not, there is a proof that is less simple yet more impure than either. This has implications for the supposed simplicity of impure proofs.This article is part of the theme issue ‘The notion of ‘simple proof’ - Hilbert's 24th problem’.
The problem of proof identity, and why computer scientists should care about Hilbert's 24th problem
Authors: Straßburger Lutz 
Published: January 2019

In this short overview article, I will discuss the problem of proof identity and explain how it is related to Hilbert's 24th problem. I will also argue that not knowing when two proofs are ‘the same’ has embarrassing consequences not only for proof theory but also for certain areas of computer science where formal proofs play a fundamental role, in particular, the formal verification of software. Then I will formulate a set of four objectives that a satisfactory notion of proof identity should obey. And finally, I discuss Hughes'combinatorial proofsand argue that they can be seen as a first step towards a possible solution to the problem of proof identity.This article is part of the theme issue ‘The notion of ‘simple proof’ - Hilbert's 24th problem’.
Mathematical proof: from mathematics to school mathematics
Authors: Rocha Helena 
Published: January 2019

Proof plays a central role in developing, establishing and communicating mathematical knowledge. Nevertheless, it is not such a central element in school mathematics. This article discusses some issues involving mathematical proof in school, intending to characterize the understanding of mathematical proof in school, its function and the meaning and relevance attributed to the notion of simple proof. The main conclusions suggest that the idea of addressing mathematical proof at all levels of school is a recent idea that is not yet fully implemented in schools. It requires an adaptation of the understanding of proof to the age of the students, reducing the level of formality and allowing the students to experience the different functions of proof and not only the function of verification. Among the different functions of proof, the function of explanation deserves special attention due to the illumination and empowerment that it can bring to the students and their learning. The way this function of proof relates to the notion of simple proof (and the related aesthetic issues) seems relevant enough to make it, in the future, a focus of attention for the teachers who address mathematical proof in the classroom.
This article is part of the theme issue ‘The notion of ‘simple proof’ - Hilbert's 24th problem’.
Explanation in mathematical conversations: an empirical investigation
Authors: Pease Alison , Aberdein Andrew , Martin Ursula 
Published: January 2019

Analysis of online mathematics forums can help reveal how explanation is used by mathematicians; we contend that this use of explanation may help to provide an informal conceptualization of simplicity. We extracted six conjectures from recent philosophical work on the occurrence and characteristics of explanation in mathematics. We then tested these conjectures against a corpus derived from online mathematical discussions. To this end, we employed two techniques, one based on indicator terms, the other on a random sample of comments lacking such indicators. Our findings suggest that explanation is widespread in mathematical practice and that it occurs not only in proofs but also in other mathematical contexts. Our work also provides further evidence for the utility of empirical methods in addressing philosophical problems.
This article is part of the theme issue ‘The notion of ‘simple proof’ - Hilbert's 24th problem’.
Reshaping the metaphor of proof
Authors: Vavilov Nikolai 
Published: January 2019

The simplistic view of Mathematics as a logical system of formal truths deduced from a limited set of axioms by a limited set of inference rules immediately shatters when confronted with the history of Mathematics, or current mathematical practice. To become useful, mathematical Philosophy should contemplate what Mathematics actually was, over centuries, and what it is now, rather than speculate what it should be according to the philosophical orthodoxy. The first dogma that must be completely revised is the idea of proof as a text, rather than what it is for mathematicians themselves: a process, a plethora of interwoven arguments, a multi-dimensional structure.
This article is part of the theme issue ‘The notion of ‘simple proof’ - Hilbert's 24th problem’.
Visual processing and attention rather than face and emotion processing play a distinct role in ASD: an EEG study
Authors: Khuntia Adyasha Tejaswi , Divakar Rechu , Apicella Fabio , Muratori Filippo , Das Koel 
Published: January 2019

AbstractAutism Spectrum Disorder results in deficit in social interaction, non-verbal communication and social reciprocity. Cognitive tasks pertaining to emotion processing are often preferred to distinguish the ASD children from the typically developing ones. We analysed the role of face and emotion processing in ASD and explored the feasibility of using EEG as a neural marker for detecting ASD. Subjects performed a visual perceptual task with face and nonface stimuli. Successful ASD detection was possible as early as 50 ms. post stimulus onset. Alpha and Beta oscillations seem to best identify autistic individuals. Multivariate pattern analysis and source localization studies points to the role of early visual processing and attention rather than emotion and face processing in detecting autism.
Neither global nor consistent: a technical comment on the tree diversity-productivity analysis of Liang et al. (2016)
Authors: Dormann Carsten F. , Schneider Helge , Gorges Jonas 
Published: January 2019

AbstractThe publication of Liang et al. (2016, Science) seems to demonstrate very clearly that increasing tree species richness substantially increases forest productivity. To combine data from very different ecoregions, the authors constructed a relative measure of tree species richness. This relative richness however confounds plot-level tree species richness and the polar-tropical gradient of tree species richness. We re-analysed their orginal data, computing a regional measure of tree species richness and addressing several other issues in their analysis. We find that there is virtually no effect of relative tree species richness on productivity when computing species richness at the local scale. Also, different ecoregions have very different relationships between tree species richness and productivity. Thus, neither the “global” consistency nor the actual effect can be confirmed.