bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safe Approach of Trains Into Terminal Stations
Authors: Moturu Sahith , Utterback Jeff 
Published: June 2018

This paper focuses on the safety aspect of passenger trains approaching a terminal station with a bumper block/post. As evidenced by the recent collision of a commuter train at Hoboken terminal on September 29, 2016, the consequences of a collision with a bumper post could be catastrophic, however, railroads can take preventative measures to reduce the element of risk. Case studies obtained from the National Transportation Safety Board (NTSB) involving similar bumper block accidents are analyzed to identify any potential common denominator.
The objective of this paper is to comprehensively present the various mitigation techniques that railroads can adopt to safeguard their systems against these types of accidents. Although some of the mitigation techniques presented in the paper may already be known in the industry generically, their application to specifically mitigating the hazard of bumper collisions is a novel attempt to focus systematically on this topic. Examples of mitigation techniques discussed here in include speed restricting devices, driver alerted features, bumper blocks with more impact tolerance, and organizational safety culture. The effect of newer technologies such as PTC (in USA only) and CBTC towards mitigating this hazard as well as the unique constraints presented at terminal stations is also assessed.
Should women aged 70–74 be invited to participate in screening mammography? A report on two Australian community juries
Authors: Degeling Chris , Barratt Alexandra , Aranda Sanchia , Bell Robin , Doust Jenny , Houssami Nehmat , Hersch Jolyn , Sakowsky Ruben , Entwistle Vikki , Carter Stacy M 
Published: June 2018

ObjectiveTo elicit informed views from Australian women aged 70–74 regarding the acceptability of ceasing to invite women their age to participate in government-funded mammography screening (BreastScreen).DesignTwo community juries held in 2017.SettingGreater Sydney, a metropolis of 4.5 million people in New South Wales, Australia.Participants34 women aged 70–74 with no personal history of breast cancer, recruited by random digit dialling and previously randomly recruited list-based samples.Main outcomes and measuresJury verdict and rationale in response to structured questions. We transcribed audio-recorded jury proceedings and identified central reasons for the jury’s decision.ResultsThe women’s average age was 71.5 years. Participants were of diverse sociocultural backgrounds, with the sample designed to include women of lower levels of educational attainment. Both juries concluded by majority verdict (16–2 and 10–6) that BreastScreen should continue to send invitations and promote screening to their age group. Reasons given for the majority position include: (1) sending the invitations shows that society still cares about older women, empowers them to access preventive health services and recognises increasing and varied life expectancy; (2) screening provides women with information that enables choice and (3) if experts cannot agree, the conservative approach is to maintain the status quo until the evidence is clear. Reasons for the minority position were the potential for harms through overdiagnosis and misallocation of scarce health resources.ConclusionsPreventive programmes such as mammography screening are likely to have significant symbolic value once they are socially embedded. Arguments for programme de-implementation emphasising declining benefit because of limited life expectancy and the risks of overdiagnosis seem unlikely to resonate with healthy older women. In situations where there is no consensus among experts on the value of established screening programmes, people may strongly prefer receiving information about their health and having the opportunity make their own choices.
Increasing HIV testing engagement through provision of home HIV self-testing kits for patients who decline testing in the emergency department: a pilot randomisation study
Authors: Patel Anuj V , Abrams Samuel M , Gaydos Charlotte A , Jett-Goheen Mary , Latkin Carl A , Rothman Richard E , Hsieh Yu-Hsiang 
Published: June 2018

ObjectiveUp to 60% of patients decline routine HIV testing offer in US emergency departments (EDs). The objective of this study is to determine whether the provision of HIV self-testing (HIVST) kit would increase engagement of HIV testing among these HIV test ‘Decliners’.MethodsPatients who declined a test offered in an ED-based triage nurse-driven HIV screening programme were enrolled and randomised to either the HIVST or the control group. The patients in the HIVST group received HIVST kits to take home, were encouraged to report test results to an established internet-based STI/HIV testing recruitment website ‘I Want the Kit’ (IWTK) and received five referral cards for their peers to request HIVST kits from IWTK. The control group received pamphlets about publicly available HIV testing sites. HIV testing from both groups after enrolment was determined via telephone follow-up at 1 month. Testing rate ratio (RR) was determined using χ2tests.ResultsFifty-two patients were randomised to the HIVST group and 48 to the control group. Among all 64 patients completing any follow-up, 14/29 (48%) patients in the HIVST group tested themselves at home with the provided kit. Four of these had never had an HIV test. Only 2/35 (6%) in the control group reported having an HIV test after enrolment (RR: 8.45 (95% CI: 2.09 to 34.17)). 57% (8/14) in the HIVST group reported test results to IWTK.ConclusionProvision of HIVST kits supplements ED-based screening programme and significantly improved engagement of HIV testing among those test ‘Decliners’ in the ED.Trial registration numberNCT03021005, results.
Novel Approaches to Acute Myeloid Leukemia Immunotherapy
Authors: Beyar-Katz Ofrat , Gill Saar 
Published: June 2018

Abstract
Acute myeloid leukemia (AML) is a rapidly progressive, poor-prognosis malignancy arising from hematopoietic stem/progenitor cells. The long history of successful use of allogeneic hematopoietic cell transplantation (alloHCT) in AML indicates that this disease is immunoresponsive, leading to optimism that novel immunotherapies such as bispecific antibodies, chimeric antigen receptor T cells, and immune checkpoint inhibitors will generate meaningful disease control. However, emerging data on the immunoevasive tactics employed by AML blasts at diagnosis and at relapse indicate that optimism must be tempered by an understanding of this essential paradox. Furthermore, AML has a low mutational burden, thus presenting few neoantigens for attack by autologous T cells, even after attempted reversal of inhibitory receptor/ligand interactions. In this review, we outline the known AML targets, explore immune evasion mechanisms, and describe recent data and current clinical trials of single and combination immunotherapies. Clin Cancer Res; 24(22); 5502–15. ©2018 AACR.
Dual MAPK Inhibition Is an Effective Therapeutic Strategy for a Subset of Class II BRAF Mutant Melanomas
Authors: Dankner Matthew , Lajoie Mathieu , Moldoveanu Dan , Nguyen Tan-Trieu , Savage Paul , Rajkumar Shivshankari , Huang Xiu , Lvova Maria , Protopopov Alexei , Vuzman Dana , Hogg David , Park Morag , Guiot Marie-Christine , Petrecca Kevin , Mihalcioiu Catalin , Watson Ian R. , Siegel Peter M. , Rose April A.N. 
Published: June 2018

Abstract

Purpose:
Dual MAPK pathway inhibition (dMAPKi) with BRAF and MEK inhibitors improves survival in BRAF V600E/K mutant melanoma, but the efficacy of dMAPKi in non-V600 BRAF mutant tumors is poorly understood. We sought to characterize the responsiveness of class II (enhanced kinase activity, dimerization dependent) BRAF mutant melanoma to dMAPKi.

Experimental Design:
Tumors from patients with BRAF wild-type (WT), V600E (class I), and L597S (class II) metastatic melanoma were used to generate patient-derived xenografts (PDX). We assembled a panel of melanoma cell lines with class IIa (activation segment) or IIb (p-loop) mutations and compared these with WT or V600E/K BRAF mutant cells. Cell lines and PDXs were treated with BRAFi (vemurafenib, dabrafenib, encorafenib, and LY3009120), MEKi (cobimetinib, trametinib, and binimetinib), or the combination. We identified 2 patients with BRAF L597S metastatic melanoma who were treated with dMAPKi.

Results:
BRAFi impaired MAPK signaling and cell growth in class I and II BRAF mutant cells. dMAPKi was more effective than either single MAPKi at inhibiting cell growth in all class II BRAF mutant cells tested. dMAPKi caused tumor regression in two melanoma PDXs with class II BRAF mutations and prolonged survival of mice with class II BRAF mutant melanoma brain metastases. Two patients with BRAF L597S mutant melanoma clinically responded to dMAPKi.

Conclusions:
Class II BRAF mutant melanoma is growth inhibited by dMAPKi. Responses to dMAPKi have been observed in 2 patients with class II BRAF mutant melanoma. These data provide rationale for clinical investigation of dMAPKi in patients with class II BRAF mutant metastatic melanoma.
See related commentary by Johnson and Dahlman, p. 6107.
Is Cannabis Use Treatment Also Indicated for Patients with Low to Moderate Polysubstance Use
Authors: Neumann Maria , Bühringer Gerhard , Höfler Michael , Wittchen Hans-Ulrich , Hoch Eva 
Published: June 2018

<b><i>Background:</i></b> Polysubstance use (PSU) is common among patients with cannabis use (CU) and is related to more severe CU problems. However, it is unclear how PSU predicts CU treatment outcomes beyond CU patterns. We examined the frequency, amount, and class of additionally used substances as predictors for primary and secondary outcomes. <b><i>Methods:</i></b> We conducted crude and adjusted regression analyses for PSU variables as predictors of remission, abstinence, ­reduction, and secondary outcomes in 166 help-seeking ­patients from a randomized clinical trial of CANDIS, a ­cognitive behavioral treatment program. <b><i>Results:</i></b> Patients with recent illegal PSU experienced more difficulties in reducing their CU (B = –1.22, <i>p</i> &#x3c; 0.001). In contrast, remission rates were slightly higher in patients with a wide variety of ­last-year-PSU (RD = 0.04, <i>p</i> &#x3c; 0.001). Amphetamine use ­predicted poorer outcomes regarding CU-related problems (B = –4.22, <i>p</i> = 0.019), and the use of opiates, inhalants, and dissociative substances predicted poorer physical health outcomes (B = –0.62, <i>p</i> = 0.009; B = –0.96, <i>p</i> = 0.039; B = –1.18, <i>p</i> = 0.007). <b><i>Conclusions:</i></b> CU treatment is also effective for patients with moderate PSU. However, treatment effects may be enhanced by addressing specific PSU characteristics as part of a modularized program.
Intercollicular nucleus electric stimulation encoded “walk forward” commands in pigeons
Authors: Wang Hui , Yang Junqing , Lv Changzhi , Huai Ruituo , Li Yuxia 
Published: June 2018

Abstract
The bio-robot research field is growing. Robo-pigeons have been successfully programmed to turn left or right; however, a satisfactory method of commanding a robo-pigeon to walk forward is still lacking. This problem has become a roadblock to progress in bio-robot research and applications. In mammals, the midbrain periaqueductal gray region (PAG) plays a key role in mediating defensive reactions in response to fear and anxiety. The avian intercollicular nucleus (ICo) is thought to correspond to the PAG. In this study, we found that microstimulating the ICo could successfully induce a robo-pigeon to walk forward. Compared with stimulation of the previously used archistriatum, the response time was considerably shorter and the behavior accuracy significantly higher. This paper describes in detail the process of controlling a robo-pigeon such that it walks forward and backward along a prescribed straight line. From the results, we draw the conclusion that the ICo is suitable for prompting the “walk forward” order in robo-pigeons.
A Multi-Level Governance Approach to Residence Rights of Migrants and Irregular Residence in the EU
Authors: Hinterberger Kevin Fredy 
Published: June 2018

Abstract
This contribution analyses residence rights of migrants and irregular residence from a conceptual viewpoint. In the pertinent legal literature, it is argued that every Member State still decides autonomously if the residence of a migrant is permitted; in other words, if he or she is found to be irregular. I question this view, since it ignores the multi-layered character of decision-making in the EU. To do so, I differentiate between migrants who have privileged residence rights (e.g. Union citizens) and those who have not. In depicting the legal situation of migrants with privileged residence rights, I am able to identify three different levels among which the legislative decision-making power in the EU is distributed (international, EU and national level). Consequently, I challenge the ‘statist assumption’ in showing that legislative decisions with regard to residence rights of migrants have been partly taken out of the exclusive domain of Member States in the EU.
The Benefits of Global High Resolution for Climate Simulation: Process Understanding and the Enabling of Stakeholder Decisions at the Regional Scale
Authors: Roberts M. J. , Vidale P. L. , Senior C. , Hewitt H. T. , Bates C. , Berthou S. , Chang P. , Christensen H. M. , Danilov S. , Demory M.-E. , Griffies S. M. , Haarsma R. , Jung T. , Martin G. , Minobe S. , Ringler T. , Satoh M. , Schiemann R. , Scoccimarro E. , Stephens G. , Wehner M. F. 
Published: June 2018

AbstractThe time scales of the Paris Climate Agreement indicate urgent action is required on climate policies over the next few decades, in order to avoid the worst risks posed by climate change. On these relatively short time scales the combined effect of climate variability and change are both key drivers of extreme events, with decadal time scales also important for infrastructure planning. Hence, in order to assess climate risk on such time scales, we require climate models to be able to represent key aspects of both internally driven climate variability and the response to changing forcings. In this paper we argue that we now have the modeling capability to address these requirements—specifically with global models having horizontal resolutions considerably enhanced from those typically used in previous Intergovernmental Panel on Climate Change (IPCC) and Coupled Model Intercomparison Project (CMIP) exercises. The improved representation of weather and climate processes in such models underpins our enhanced confidence in predictions and projections, as well as providing improved forcing to regional models, which are better able to represent local-scale extremes (such as convective precipitation). We choose the global water cycle as an illustrative example because it is governed by a chain of processes for which there is growing evidence of the benefits of higher resolution. At the same time it comprises key processes involved in many of the expected future climate extremes (e.g., flooding, drought, tropical and midlatitude storms).
A Surveillance-Based Hepatitis C Care Cascade, New York City, 2017
Authors: Moore Miranda S. , Bocour Angelica , Laraque Fabienne , Winters Ann 
Published: June 2018

Objectives: The care cascade, a method for tracking population-level progression from diagnosis to cure, is an important tool in addressing and monitoring the hepatitis C virus (HCV) epidemic. However, little agreement exists on appropriate care cascade steps or how best to measure them. The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) sought to construct a care cascade by using laboratory surveillance data with clinically relevant categories that can be readily updated over time. Methods: We identified all NYC residents ever reported to the DOHMH surveillance registry with HCV through June 30, 2017 (n = 175 896). To account for outmigration, death, or treatment before negative RNA results became reportable to the health department, we limited the population to people with any test reported since July 1, 2014. Of these residents, we identified the proportion with a reported positive RNA test and estimated the proportion treated and cured since July 2014 by using DOHMH-developed surveillance-based algorithms. Results: Of 78 886 NYC residents ever receiving a diagnosis of HCV and tested since July 1, 2014, a total of 70 397 (89.2%) had ever been reported as RNA positive through June 30, 2017; 36 875 (46.7%) had initiated treatment since July 1, 2014, and 23 766 (30.1%) appeared cured during the same period. Conclusion: A substantial gap exists between confirming HCV infection and initiating treatment, even in the era of direct-acting antivirals. Using this cascade, we will monitor progress in improved treatment and cure of HCV in NYC.
CT colonography: implementation, indications, and technical performance – a follow-up national survey
Authors: Thorén Fredrik , Johnsson Åse A , Brandberg John , Hellström Mikael 
Published: June 2018

Background Computed tomography colonography (CTC) is an accepted complement or alternative to optical colonoscopy (OC) but its implementation is incompletely analyzed, and technical performance varies between centers. Purpose To evaluate implementation, indications, and technical performance of CTC in Sweden and to evaluate compliance to international guidelines. Material and Methods A structured, self-assessed questionnaire regarding implementation and technical performance of CTC was sent to all eligible radiology departments in Sweden. Eighty-six out of 89 departments replied. Comparisons were made with similar national surveys from 2004 and 2009. Results The number of centers performing CTC gradually increased from 23 in 2004 to 77 in 2016. In parallel, centers performing barium enema (BE) examinations have decreased from 89 in 2004 to 13 in 2016. Main reasons stated for still performing BE were lack of resources regarding CTC/OC. Main reasons for not performing CTC were lack of suitable software, lack of machine/reading time, and lack of experience. The majority of centers follow international CTC guidelines. An important exception is fecal tagging, which was implemented in only 63% of the centers. Incomplete OC remains a major indication for CTC, while preoperative CTC in colorectal cancer and follow-up after diverticulitis have emerged as new indications. Conclusion CTC today is well implemented in routine healthcare but still lacking in capacity. Indications have expanded over time, and most departments perform “state of the art” CTC, although fecal tagging is incompletely implemented.
The effectiveness of traditional Basic Life Support training and alternative technology‐enhanced methods in high schools
Authors: Onan Arif , Turan Sevgi , Elcin Melih , Erbil Bulent , Bulut Şule Çınar 
Published: June 2018

Background:Implementation of resuscitation training in school programs is a promising approach to improve rates of cardiopulmonary resuscitation use by trained bystanders. Unfortunately, theoretical cardiopulmonary resuscitation instruction alone is not sufficiently effective in developing practical skills.Objectives:This study aimed to investigate the effectiveness of traditional Basic Life Support training and alternative instructional methods to achieve learning objectives of Basic Life Support education.Methods:This quasi‐experimental study was conducted in a secondary school in Ankara, Turkey. Eighty‐three voluntary students were randomly allocated to theoretical (Group A), video‐based (Group B), and mobile‐assisted video‐based instructions (Group C). All groups were led by the course teacher. Assessments were conducted in training and again 1 week later. Assessments were based on Basic Life Support knowledge and confidence performance scores.Results:Statistically significant difference was found for the groups’ Confidence Scale scores (F(2, 73) = 3.513, p = 0.035, ηp2 = 0.088); Group C (6.76 ± 1.70) scored higher than Group A. The groups’ Basic Life Support checklist scores were statistically significant (F(2, 73) = 28.050, p = 0.000, ηp2 = 0.435); Group C (32.32 ± 3.84) scored higher than the other groups. Statistically significant difference was found for the groups’ measurable Basic Life Support scores (F(2, 73) = 13.527, p = 0.000, ηp2 = 0.270); and Group C (23.76 ± 3.98) scored higher than the other groups.Conclusion:Our findings showed that all instruction methods led to increased Basic Life Support knowledge scores. The mobile‐assisted program significantly increased knowledge scores. Same‐group high‐quality cardiopulmonary resuscitation parameters were more positive than the other instruction groups except for hand position. Group C students expressed higher confidence in their ability to act in an emergency when witnessing a victim collapse.
Outcomes of shoulder arthroplasty following axillary lymph node dissection
Authors: Padegimas Eric M , Merkow David , Nicholson Thema A , Lazarus Mark D , Ramsey Matthew L , Williams Gerald R , Namdari Surena 
Published: June 2018

Introduction Shoulder arthroplasty with previous axillary lymph node dissection historically has unsatisfactory outcomes. We analyzed outcomes of primary shoulder arthroplasty in patients with previous axillary lymph node dissection. Methods Thirty-two primary shoulder arthroplasties after prior axillary lymph node dissection were performed. These patients were analyzed for patient-reported outcomes, range of motion, complications, and reoperations. Results Average age was 70.8 ± 7.5 years old. There were 19 anatomic total shoulder arthroplasties, four hemiarthroplasties, and nine reverse total shoulder arthroplasties. Eight were performed by a superior approach while 24 were performed by a deltopectoral approach with cephalic vein preservation. There were three complications (one deltoid dehiscence, one axillary nerve palsy, and one postoperative pneumonia). There was one revision (hemiarthroplasty to reverse total shoulder arthroplasty for cuff failure at 91 weeks), two reoperations, and no infections. Patient-reported outcomes were available for 21/26 (80.1%) of the surviving shoulders at 4.8 ± 2.0 years. Average visual analog scale pain score was 7.1 ± 14.5, Simple Shoulder Test score 8.3 ± 2.6 “yes” responses, Single Assessment Numeric Evaluation score 80.2 ± 17.4, and American Shoulder and Elbow Surgeons score 83.6 ± 14.1. Conclusion Axillary lymph node dissection is not a contraindication to shoulder arthroplasty. A deltopectoral exposure can be utilized without substantial risk of worsening lymphedema or wound complications. While a superior approach avoids cephalic vein injury, important approach-related complications (deltoid dehiscence and axillary nerve palsy) were observed. Level of evidence: Level IV—case series.