bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computational Modeling of the Effects of Sleep Deprivation on the Vigilance Decrement
Authors: Patterson Robert Earl , Lochtefeld Darrell , Larson Kathleen G. , Christensen-Salem Amanda 
Published: March 2019

Objective: We developed a computational model of the effects of sleep deprivation on the vigilance decrement by employing the methods of system dynamics modeling. Background: Situations that require sustained attention for a prolonged duration can cause a decline in cognitive performance, the so-called vigilance decrement. One factor that should influence the vigilance decrement is fatigue in the form of sleep deprivation. Method: We employed the methods of system dynamics modeling (numerical-integration techniques for modeling complex feedback systems) to create a computational model of the vigilance decrement. We then simulated the computational effects of sleep deprivation on the behavior of that model, using empirical data obtained from the literature for calibrating such effects. Results: Sleep deprivation of 2 hr over a 14-day period should produce an additional decline of 9% in detection performance over that found with the typical vigilance decrement, whereas 4 hr of sleep deprivation over 14 days should produce an additional decline of 14% in detection performance. Conclusion: With respect to dual-process theory, it is through its deleterious effects on analytical cognition that sleep deprivation should impact the vigilance decrement. Application: Such computational modeling may be advantageous for human-machine teaming by theoretically allowing a future autonomous software agent to anticipate the decline of human performance and compensate accordingly.
Paralyzed by Prices: An Analysis of Price Theory within the Context of Health Care
Authors: Babcock Paul 
Published: March 2019

This article examines the structure of pricing within health care. The price mechanism within health care does not function as it does in other sectors of the economy. The author examines the price theories of capitalism, socialism, and solidarism to illuminate the purpose of prices relevant to health care. Drawing points from each system, the author argues in favor of a solidarist approach to prices relying on principles set forth in Catholic social teaching, with the caveat that the capitalist natural price must first be determined. The unique features of healthcare pricing and prioritization indicate that moral principles must guide the economics of health care, not merely supply and demand. Summary: This article discusses the problems with creating useful prices in health care. It examines the price theories of capitalism, socialism, and solidarism to see which would be most useful for health care price formation.
Dedifferentiated liposarcoma of the musculoskeletal system: expanded MR imaging spectrum from predominant fatty mass to non-fatty mass
Authors: Yun Jae Sung , Chung Hye Won , Song Joon Seon , Lee Sang Hoon , Lee Min Hee , Shin Myung Jin 
Published: March 2019

Background The morphology of musculoskeletal dedifferentiated liposarcoma was previously reported as well-defined non-lipomatous masses juxtaposed with fatty tumors. Purpose To establish a new spectrum of magnetic resonance imaging (MRI) findings for dedifferentiated liposarcoma according to the quantity and distribution of the non-fatty component in the tumor. Material and Methods This study consisted of a retrospective review of MRI of 14 patients with a total of 18 histopathologically proven dedifferentiated liposarcoma lesions in the musculoskeletal area. Tumors were classified into four categories (I–IV) according to MR features: I = a well-defined fatty mass and juxtaposed well-defined non-fatty mass; II = a non-fatty component within a predominant fatty mass; III = a focal fatty component within a large non-fatty mass; and IV = a non-fatty mass. Tumor size and depth were also analyzed. Results The MR categorizations of the tumors were as follows: Category I, n = 3; Category II, n = 1; Category III, n = 7; and Category IV, n = 7. The mean tumor size was 11.9 cm (range = 5.0–22.2 cm). Most of the tumors showed a predominant non-fatty area and were deeply located at the intra- or intermuscular space. Conclusion Dedifferentiated liposarcoma lesions showed a diverse spectrum of MRI findings. Although the presence of a non-fatty region within or adjacent to a well-defined fatty mass can suggest dedifferentiated liposarcoma, non-fatty masses without a fatty component were frequent on MRI.
Survival benefit of first-generation epidermal growth factor receptor–tyrosine kinase inhibitors in female with advanced lung cancer
Authors: Kwon Byoung Soo , Park Ji Hyun , Kim Seulgi , Park Sojung , Ji Wonjun , Kim Woo Sung , Lee Jae Cheol , Park Yu Rang , Choi Chang-Min 
Published: March 2019

Background: This study aimed to estimate therapeutic effects of first-generation epidermal growth factor receptor–tyrosine kinase inhibitors (EGFR-TKIs) in real-world practice, by analyzing survival outcomes in an unselected, Korean female population with advanced lung cancer based on the National Health Insurance Service database. Methods: We identified women with newly diagnosed advanced lung cancer from January 2004 to December 2013. For progression-free survival (PFS) and overall survival (OS) analyses, patients were defined into the following subgroups: group A, treated with first-generation EGFR-TKI ⩾6 months; group B, treated with EGFR-TKIs <6 months but at least >1 month; and group C, treated with cytotoxic chemotherapy as follows: monotherapy or combination therapy with gemcitabine or pemetrexed; or monotherapy with docetaxel, paclitaxel, or vinorelbine. Results: Among 11,045 enrolled patients, 6170 (55.8%) were treated with first-generation EGFR-TKIs for at least 1 month. The median OS for patients treated with EGFR-TKIs was significantly longer than that of EGFR-TKI-naive patients (19.1 months [95% confidence interval (CI) 18.5–19.7] vs 9.5 months [95% CI 9.1–9.8], P<0.001). In subgroup analysis, group A had a significantly longer median OS compared with group B (30.3 months [95% CI 29.5–31.2] vs 12.3 months [95% CI 11.9–12.7], P<0.001). The median PFS of group A was significantly longer than that of group B (15.8 vs 3.7 months, P<0.001). Conclusions: Our analysis demonstrates that EGFR-TKIs confer significant PFS and OS benefits in the real-world practice for Korean female with advanced lung cancer.
Solutes removal characteristics at various effluent rates during different continuous renal replacement therapy modalities
Authors: Yu Wenyan , Zhuang Feng , Ma Shuai , Zhu Mingli , Ding Feng 
Published: March 2019

Background: Some studies suggest the effluent as a surrogate solute removal indicator in continuous hemodialysis or hemofiltration, but the delivered clearance is frequently smaller than prescribed. This study aims at testing whether the effluent, represented by mL/kg/h, could measure solute clearance and whether increasing effluent increases clearance proportionately in continuous hemodialysis or hemofiltration. Methods: Patients treated with continuous renal replacement therapy for various diagnoses were included. The range of dialysate flow rate or substitution fluid flow rate was 1–5 L/h; solutes in the effluent and in the plasma entering the filter were measured, and the ratio of solutes in the effluent and in the plasma entering the filter and the clearance of blood urea nitrogen, creatinine, phosphate, and β2-microglobulin were calculated. Results: The ratio of solutes in the effluent and in the plasma entering the filter showed a decreasing trend with increased dialysate flow rate or substitution fluid flow rate ( p  < 0.05), but solute clearance showed an increasing trend. The increase in solute clearance was less than expected from the increased effluent ( p < 0.01), and actual delivered clearance was always below the corresponding prescribed clearance ( p < 0.001). Conclusion: With increasing prescribed clearance of continuous renal replacement therapy, effluent rate overestimated the delivered clearance.
Symptom Assessment and Early Access to Supportive and Palliative Care for Patients With Advanced Solid Tumors in Mexico
Authors: Alcalde-Castro Mirza Jacqueline , Soto-Perez-de-Celis Enrique , Covarrubias-Gómez Alfredo , Sánchez-Román Sofía , Quiróz-Friedman Paulina , Navarro-Lara África , Ramos-Lopez Wendy Alicia , Moreno-García María Luisa , Contreras-Garduño Sergio , Perez-Montessoro Viridiana , Goss Paul E. , Chávarri-Guerra Yanin 
Published: March 2019

Background: Early specialized palliative care improves quality of life of patients with advanced cancer, and guidelines encourage its integration into standard oncology care. However, many patients fail to obtain timely palliative/supportive care evaluations, particularly in limited-resource settings. We aimed to determine the proportion of patients with advanced cancer who received an assessment of symptoms and were referred to supportive and palliative care services during the first year after diagnosis in a Mexican hospital. Methods: Individuals with newly diagnosed advanced solid tumors and 1 year of follow-up at the oncology clinics in the Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran in Mexico City from October 2015 to April 2016 were included in this retrospective study. Results: Seventy-seven patients were included. Forty-two (54.5%) were referred to the various supportive care services during the first year after diagnosis, and 23 (29.8%) were referred to the palliative care clinic. The most commonly assessed symptoms by oncologists were pain (77.9%), anorexia (74.0%), fatigue (68.8%), and nausea (55.8%), while depression/anxiety were evaluated in 10 (12.9%) patients. The oncologist offered to clarify treatment goals in 39 (50.6%) cases and evaluated the understanding of diagnosis/illness and prognosis in 22 (28.5%). Conclusion: Palliative and supportive care services were widely underutilized, which may be related to a lack of standardized symptom assessments and poor end-of-life communication. Novel strategies are needed to improve the implementation of tools for systematic symptom assessment and to optimize the integration of supportive care interventions into oncology care in developing countries.
Public–Private Wage Gap in the Indian Mining and Quarrying Industry
Authors: Mohanty Chandan Kumar , Mohanty Smrutirekha 
Published: March 2019

This article examines if there is a wage gap between public and private mining (and quarrying) workers in India, using the NSS data (2004–2005, 2009–2010 and 2011–2012). We employ linear and quantile regressions to estimate the wage gap. The ordinary least squares (OLS) results suggest that workers in the public sector mines (and quarries) earn 59 per cent more than their private sector counterparts. However, the wage gap is not uniform across the conditional wage distribution. The quantile regression estimates show that the magnitude of the wage gap is larger at the bottom quantile than at the top; the gap reduces as we move up the wage distribution. Observations drawn from our sub-sample analysis concur with these findings. JEL Classification: J21, J31, J45
Export Composition and Long-run Economic Growth Impact: A Cointegration Analysis for ASEAN ‘Latecomer’ Economies
Authors: Vogiatzoglou Klimis 
Published: March 2019

Export expansion can be a significant engine of economic growth for developing economies. The size of the growth effect of exports depends not only on volume but also on the sectoral composition of exports. By explicitly considering the sectoral export composition, this article examines over a 31-year period the long-run growth impact of exports in four transition and emerging economies of the Association of Southeast Asian Nations (ASEAN), namely Cambodia, Laos, Myanmar and Vietnam. More specifically, for each country, a long-run equilibrium analysis within a cointegration framework is conducted for three broad sectors (agriculture, mining/natural resources and manufacturing) as well as for 22 manufacturing industries during 1987–2017. The results indicate that there has been sizeable export expansion (especially in Vietnam), but export composition differs substantially across economies, which has an effect on the overall growth impact of the country’s exports. Clear evidence of export-led growth is found only for some sectors. Countries that rely heavily on primary goods have experienced relatively lower export-led growth. Export restructuring in manufacturing industries is associated with a larger long-run growth effect for a country’s exports. Our findings suggest that policies encouraging diversification away from traditional export sectors would be expected to lead to higher long-run growth effects of exports. Furthermore, our analysis implies a steady strengthening of export dynamism in ASEAN ‘latecomer’ economies and their rising significance in the global trade system. JEL Classification: F14, F43, F63, O11, O47
Functional neuroplasticity in response to cerebello-thalamic injury underpins the clinical presentation of tremor in multiple sclerosis
Authors: Boonstra Frederique MC , Noffs Gustavo , Perera Thushara , Jokubaitis Vilija G , Vogel Adam P , Moffat Bradford A , Butzkueven Helmut , Evans Andrew , van der Walt Anneke , Kolbe Scott C 
Published: March 2019

Background: Tremor is present in almost half of multiple sclerosis (MS) patients. The lack of understanding of its pathophysiology is hampering progress in development of treatments. Objectives: To clarify the structural and functional brain changes associated with the clinical phenotype of upper limb tremor in people with MS. Methods: Fifteen healthy controls (46.1 ± 15.4 years), 27 MS participants without tremor (46.7 ± 11.6 years) and 42 with tremor (46.6 ± 11.5 years) were included. Tremor was quantified using the Bain score (0–10) for overall severity, handwriting and Archimedes spiral drawing. Functional magnetic resonance imaging activations were compared between participants groups during performance of a joystick task designed to isolate tremulous movement. Inflammation and atrophy of cerebello-thalamo-cortical brain structures were quantified. Results: Tremor participants were found to have atrophy of the cerebellum and thalamus, and higher ipsilateral cerebellar lesion load compared to participants without tremor ( p < 0.020). We found higher ipsilateral activation in the inferior parietal lobule, the premotor cortex and supplementary motor area in MS tremor participants compared to MS participants without tremor during the joystick task. Finally, stronger activation in those areas was associated with lower tremor severity. Conclusion: Subcortical neurodegeneration and inflammation along the cerebello-thalamo-cortical and cortical functional neuroplasticity contribute to the severity of tremor in MS.
Antiplatelet vs. R-tPA for acute mild ischemic stroke: A prospective, random, and open label multi-center study
Authors: Wang Xin-Hong , Tao Lin , Zhou Zhong-He , Li Xiao-Qiu , Chen Hui-Sheng 
Published: March 2019

Rationale The evidence of intravenous thrombolysis in patients with not clearly disabling minor stroke (low National Institutes of Health Stroke Scale of 0–5) is still insufficient. Recent early terminated PRISMS trial could not provide definitive conclusion, although suggesting the similar functional outcome between alteplase and aspirin groups. Recent two clinical trials provide a definitive evidence for the superiority of dual antiplatelet to mono-antiplatelet in minor stroke. However, the efficacy and safety of dual antiplatelet vs. alteplase in the treatment of acute minor stroke are not known. Aim To explore the efficacy and safety of dual antiplatelet with aspirin and clopidogrel vs. alteplase in the treatment of acute minor stroke. Sample size estimates A maximum of 760 subjects are required to test the non-inferiority hypothesis with 80% power according to a one-sided 0.025 level of significance, stratified by age, diabetes, time from onset to treatment, stroke etiology, degree of vascular stenosis, location of index vessel. Methods and design ARAMIS is a prospective, randomized, open label, blinded assessment of endpoints (PROBE) and multicenter clinical trial in China. The subjects are randomized to the control arm (intravenous alteplase with standard dose of 0.9 mg/kg, followed by guideline-based treatment 24 h after thrombolysis) or the experiment arm (clopidogrel: loading dose of 300 mg on the first day, followed by 75 mg daily for 10–14 days; aspirin: 100 mg on the first day, followed by 100 mg daily for 10–14 days; after the combination, antiplatelet will be given based on guideline till 90 days). Study outcome The primary efficacy endpoint is favorable functional outcome, defined as a mRS 0–1 assessed at 90-day post-randomization.
IER-START nomogram for prediction of three-month unfavorable outcome after thrombectomy for stroke
Authors: Cappellari Manuel , Mangiafico Salvatore , Saia Valentina , Pracucci Giovanni , Nappini Sergio , Nencini Patrizia , Konda Daniel , Sallustio Fabrizio , Vallone Stefano , Zini Andrea , Bracco Sandra , Tassi Rossana , Bergui Mauro , Cerrato Paolo , Pitrone Antonio , Grillo Francesco , Saletti Andrea , De Vito Alessandro , Gasparotti Roberto , Magoni Mauro , Puglielli Edoardo , Casalena Alfonsina , Causin Francesco , Baracchini Claudio , Castellan Lucio , Malfatto Laura , Menozzi Roberto , Scoditti Umberto , Comelli Chiara , Duc Enrica , Comai Alessio , Franchini Enrica , Cosottini Mirco , Mancuso Michelangelo , Peschillo Simone , De Michele Manuela , Giorgianni Andrea , Luisa Delodovici Maria , Lafe Elvis , Denaro Maria F , Burdi Nicola , Internò Saverio , Cavasin Nicola , Critelli Adriana , Chiumarulo Luigi , Petruzzellis Marco , Doddi Marco , Carolei Antonio , Auteri William , Petrone Alfredo , Padolecchia Riccardo , Tassinari Tiziana , Pavia Marco , Invernizzi Paolo , Turcato Gianni , Forlivesi Stefano , Francesca Maria Ciceri Elisa , Bonetti Bruno , Inzitari Domenico , Toni Danilo 
Published: March 2019

Background The applicability of the current models for predicting functional outcome after thrombectomy in strokes with large vessel occlusion (LVO) is affected by a moderate predictive performance. Aims We aimed to develop and validate a nomogram with pre- and post-treatment factors for prediction of the probability of unfavorable outcome in patients with anterior and posterior LVO who received bridging therapy or direct thrombectomy <6 h of stroke onset. Methods We conducted a cohort study on patients data collected prospectively in the Italian Endovascular Registry (IER). Unfavorable outcome was defined as three-month modified Rankin Scale (mRS) score 3–6. Six predictors, including NIH Stroke Scale (NIHSS) score, age, pre-stroke mRS score, bridging therapy or direct thrombectomy, grade of recanalization according to the thrombolysis in cerebral ischemia (TICI) grading system, and onset-to-end procedure time were identified a priori by three stroke experts. To generate the IER-START, the pre-established predictors were entered into a logistic regression model. The discriminative performance of the model was assessed by using the area under the receiver operating characteristic curve (AUC-ROC). Results A total of 1802 patients with complete data for generating the IER-START was randomly dichotomized into training ( n = 1219) and test ( n = 583) sets. The AUC-ROC of IER-START was 0.838 (95% confidence interval [CI]): 0.816–0.869) in the training set, and 0.820 (95% CI: 0.786–0.854) in the test set. Conclusions The IER-START nomogram is the first prognostic model developed and validated in the largest population of stroke patients currently candidates to thrombectomy which reliably calculates the probability of three-month unfavorable outcome.
Some Biological Properties of Curcumin: A Review
Authors: Ali Badreldin H. , Marrif Husnia , Noureldayem Salwa A. , Bakheit Amel O. , Blunden Gerald 
Published: March 2019

Curcumin (diferuloyl methane), a small-molecular weight compound isolated from the roots of Curcuma longa L. (family Zingiberaceae), has been used traditionally for centuries in Asia for medicinal, culinary and other purposes. A large number of in vitro and in vivo studies in both animals and man have indicated that curcumin has strong antioxidant, anti-carcinogenic, anti-inflammatory, anti-angiogenic, antispasmodic, antimicrobial, anti-parasitic and other activities. The mechanisms of some of these actions have recently been intensively investigated. Curcumin inhibits the promotion/ progression stage of carcinogenesis by induction of apoptosis and the arrest of cancer cells in the S, G2/M cell cycle phase. The compound inhibits the activity of growth factor receptors. The anti-inflammatory properties of curcumin are mediated through their effects on cytokines, lipid mediators, eicosanoids and proteolytic enzymes. Curcumin scavenges the superoxide radical, hydrogen peroxide and nitric oxide, and inhibits lipid peroxidation. These actions may be the basis for many of its pharmacological and therapeutic properties. Curcumin is a nutraceutical of low toxicity, which has been used successfully in a number of medical conditions that include cataracts, cystic fibrosis, and prostate and colon cancers.
Metabolomic Studies on the Chemical Ecology of the Xylariaceae (Ascomycota)
Authors: Stadler Marc , Fournier Jacques , Quang Dang N. , Akulov Alexander Y. 
Published: March 2019

Fruiting bodies collected in the field during the vegetation period in different developmental stages and mycelial cultures of 50 representatives of xylariaceous fungi were tested for antimicrobial and nematicidal activities, and 50 of their characteristic metabolites were studied for comparison. Furthermore, analytical HPLC profiling using diode array and electrospray mass spectrometric detection was performed to identify and quantify the major constituents, revealing that up to 10% of the dry fruiting body biomass may be composed of secondary metabolites. In several species, significant antimicrobial effects were noted upon incubation of the fruiting bodies in an agar diffusion assay, i.e., without any need for extraction and concentration of active constituents. These results suggest that most of the characteristic constituents of subfamily Hypoxyloideae (i.e. Hypoxylon and related genera) are involved in non-specific defense reactions that underwent specific permutations in the course of evolutionary processes, resulting in a broad diversity of unique polyketides and other secondary metabolites. In contrast, the fruiting bodies of representative species of Biscogniauxia and subfamily Xylarioideae generally contained no significant activities. Only cultures of most Xylarioideae exhibited antimicrobial effects, due to the presence of cytochalasins and other toxins, while extracts from cultures of Hypoxyloideae, except for Daldinia and Entonaema, were only weakly active. Cytochalasins and other yet unidentified compounds that do not constitute pigments are responsible for enhanced biological activity in maturing stromata of H. howeanum, H. rubiginosum, and H. fuscum from Alnus, whereas in H. fuscum from Corylus and further species of Hypoxylon and Annulohypoxylon, merely the concentrations of major metabolites varied during the vegetation period. Usually, the highest yields of secondary metabolites and the strongest activities were observed in the growing stromata of Hypoxyloideae, prior to or concurrent with the production of the sexual stage. These results are discussed with regard to current hypotheses on the evolution and phylogeny of the Xylariaceae.