bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autopsy of a reservoir: Facies architecture in a multidam system, Elwha River, Washington, USA
Authors: Stratton Laurel E. , Grant Gordon E. 
Published: April 2019

AbstractThe 2011–2014 removal of two large dams on the Elwha River, Washington State, the largest dam removal yet completed globally, created extensive cutbank exposures of reservoir sediments, allowing the first characterization of the facies architecture of sediments through direct observation in reservoirs worldwide and providing an unparalleled opportunity to assess the relationship between environmental influences, such as changes in sediment supply, and their expression in the stratigraphic record. Using a combination of facies description from observation of 49 measured sections and >100 exposures and analysis of digital elevation models and historic aerial photographs, we delineated the characteristic depositional zones of each reservoir and mapped the evolution of the subaerial delta over the life span of the reservoir. Former Lake Mills, the younger, upstream reservoir, was characterized by a tripartite, subaerial Gilbert-style delta that prograded >1 km into the main reservoir from 1927 to 2011. Sediments were composed of coarse-grained topset beds, steeply dipping foreset beds, and a fine-grained, gently dipping prodelta. While individual event horizons were discernible in fine-grained sediments of former Lake Mills, their number and spacing did not correspond to known drawdown or flood events. Former Lake Aldwell, impounded from 1913 to 2011, was initially defined by the rapid progradation of a Gilbert-style, subaerial delta prior to the upstream completion of Glines Canyon Dam. However, the 1927 closure of Glines Canyon Dam upstream caused the delta to evolve to a fine-grained, mouth-bar–type delta indicative of low, finer-grained sediment. This evolution, combined with a previously unrecognized landslide deposit into the upper delta plain, suggests that understanding the exogenic influences on reservoir sedimentation is critical to interpretation and prediction of the sedimentation within individual systems.
Topographic correlation between macular superficial microvessel density and ganglion cell-inner plexiform layer thickness in glaucoma-suspect and early normal-tension glaucoma
Authors: Kim Jin-Soo , Kim Young Kook , Baek Sung Uk , Ha Ahnul , Kim Yong Woo , Jeoung Jin Wook , Park Ki Ho 
Published: April 2019

Background/AimsTo investigate the topographic relationship between macular superficial microvessel density (SMD) and macular ganglion cell-inner plexiform layer (GCIPL) thickness in eyes with glaucoma-suspect (GS) and early normal-tension glaucoma (NTG).MethodsA total of 86 eyes of 86 patients with early NTG (standard automated perimetry mean deviation >−5.5 decibels) and a total of 25 eyes of 25 patients with GS were retrospectively reviewed. All of the subjects underwent optical coherence tomography (OCT) and OCT angiography (OCTA) scan. On the OCTA scan images, macular SMD was analysed by customised software.ResultsIn GS and patients with early NTG, macular GCIPL thickness showed significant correlations with macular SMD in the superotemporal (ST), inferotemporal (IT) and inferoinferior (II) sectors (r=0.191, 0.373 and 0.346 for ST, IT and II sector, respectively). Additionally, circumpapillary retinal nerve fibre layer (RNFL) thickness and macular SMD showed significant correlations between the ST sector of the macula and the 1, 9 clock-hour peripapillary regions and between the IT and II sectors of the macula and the 6, 7, 8 clock-hour peripapillary regions. The IT sector macular SMD showed fair diagnostic power (area under the receiver operating characteristic curve [AUROC] = 0.758) and showed high diagnostic power when combined with IT sector macular GCIPL thickness (AUROC=0.954).ConclusionsSectoral macular SMD showed topographic correlations with macular GCIPL thickness and circumpapillary RNFL thickness in patients with GS and early-stage NTG. Macular SMD analysis is potentially useful in the clinical evaluation of early glaucoma.
Self-administration of injectable contraception: a systematic review and meta-analysis
Authors: Kennedy Caitlin E , Yeh Ping Teresa , Gaffield Mary Lyn , Brady Martha , Narasimhan Manjulaa 
Published: April 2019

IntroductionDepot medroxyprogesterone acetate subcutaneous injectable contraception (DMPA-SC) may facilitate self-administration and expand contraceptive access. To inform WHO guidelines on self-care interventions, we conducted a systematic review and meta-analysis comparing self-administration versus provider administration of injectable contraception on outcomes of pregnancy, side effects/adverse events, contraceptive uptake, contraceptive continuation, self-efficacy/empowerment and social harms.MethodsWe searched PubMed, Cumulative Index to Nursing and Allied Health Literature, LILACS and EMBASE in September 2018 for peer-reviewed studies comparing women who received injectable contraception with the option of self-administration with women who received provider-administered injectable contraception on at least one outcome of interest. Risk of bias was assessed using the Cochrane tool for randomised controlled trials (RCTs) and the Evidence Project tool for non-randomised studies. Meta-analysis was conducted using random-effects models to generate pooled estimates of relative risk (RR).ResultsSix studies with 3851 total participants met the inclusion criteria: three RCTs and three controlled cohort studies. All studies examined self-injection of DMPA-SC; comparison groups were either provider-administered DMPA-SC or provider-administered intramuscular DMPA. All studies followed women through 12 months of contraceptive coverage and measured (dis)continuation of injectable contraception. Meta-analysis found higher rates of continuation with self-administration compared with provider administration in three RCTs (RR: 1.27, 95% CI 1.16 to 1.39) and three controlled cohort studies (RR: 1.18, 95% CI 1.10 to 1.26). Four studies reported pregnancies; all showed no difference across study arms. Four studies reported side effects/adverse events; while two controlled cohort studies showed increased injection site reactions with self-administration, no other side effects increased with self-administration. One study found no difference in social harms. No studies reported measuring uptake or self-efficacy/empowerment.ConclusionA growing evidence base suggests that self-administration of DMPA-SC can equal or improve contraceptive continuation rates compared with provider administration. This benefit comes without notable increases in pregnancy or safety concerns. Self-injection of DMPA-SC is a promising approach to increasing contraceptive use.
Clinical characteristics and lipid lowering treatment of patients initiated on proprotein convertase subtilisin-kexin type 9 inhibitors: a nationwide cohort study
Authors: Jensen Jakob Solgaard , Weeke Peter Ejvin , Bang Lia Evi , Høfsten Dan Eik , Ripa Maria Sejersten , Schjerning Anne-Marie , Theilade Juliane Elizabeth , Køber Lars Valeur , Gislason Gunnar Hilmar , Pallisgaard Jannik 
Published: April 2019

ObjectivesGiven the novelty of proprotein convertase subtilisin-kexin type 9 inhibitors (PCSK9i), little is known regarding overall implementation or clinical characteristics among patients who initiate treatment. We aimed to assess the total number of patients initiated on PCSK9i along with a description of the clinical characteristics and lipid lowering treatment (LLT) of such patients.SettingA register-based descriptive cohort study of patients receiving a PCSK9i in the time period from 01 January 2016 to 31 March 2017 using a cross linkage between three nationwide Danish registers. Information regarding PCSK9i prescriptions, patient demographics, concurrent pharmacotherapy, comorbidities and previous coronary procedures was identified.ResultsOverall, 137 patients initiated treatment with PCSK9i in the study period from 11 in the first quarter of 2016 to 40 in the first quarter of 2017. The majority had a history of ischaemic heart disease (IHD) (67.9%) with ischaemic stroke and diabetes mellitus being present in 7.3% and 16.8% of patients, respectively. All patients initiated on PCSK9i had been previously prescribed statin treatment with atorvastatin and simvastatin being most frequently prescribed in 53% and 36% of patients, respectively. The majority of patients had received both statins and ezetimibe (94.9%) and approximately half of these patients had also received bile acid sequestrant (45.3%). Clinical characteristics mainly differed in patients receiving triple LLT compared with patients not receiving triple LLT in the regards of heart failure.ConclusionPatients treated with PCSK9i were rare, characterised by having IHD and had received various and intensive conventional LLT prior to PCSK9i initiation in agreement with current international guidelines.
Female genital cutting in Malaysia: a mixed-methods study
Authors: Rashid Abdul , Iguchi Yufu 
Published: April 2019

ObjectiveThis study aimed to understand the reasons for the practice by the Muslim community, traditional practitioners and the views of religious scholars as well as the medicalisation trend of the practice of female genital cutting (FGC).DesignThis is a mixed-method (qualitative and quantitative) study. A questionnaire was created and used by three trained research assistants for the quantitative component of the study. The qualitative component of the study included in-depth interviews and focus group interviews.SettingThis study was conducted in rural areas of two states in the Northern Peninsular Malaysia.ParticipantsDue to the sensitive nature of the study, the study sample was chosen using a snowball sampling method. Two of the three Northern states Mufti’s approached consented to participate in the study.ResultsQuantitative: There were 605 participants, most had undergone FGC (99.3%), were in the opinion FGC is compulsory in Islam (87.6%) and wanted FGC to continue (99.3%). Older respondents had FGC conducted by traditional midwives (X2=59.13, p<0.001) and younger age groups preferred medical doctors (X2=32.96, p<0.001) and would permit doctors (X2=29.17, p<0.001) to conduct FGC on their children. These findings suggest a medicalisation trend. Regression analysis showed the odds of FGC conducted by traditional midwives and nurses and trained midwives compared with medical doctors was 1.07 (1.05; 1.09) and 1.04 (1.01; 1.06), respectively. For every 1-year decrease in age, the odds of participants deciding medical doctors should perform FGC as compared with traditional midwives increase by 1.61.Qualitative: Focus group discussions showed most believed that FGC is compulsory in Islam but most traditional practitioners and the Mufti’s stated that FGC is not compulsory in Islam.ConclusionAlmost everyone in the community believed FGC is compulsory in Islam and wanted the practice to continue, whereas the traditional practitioners and more importantly the Mufti’s, who are responsible in issuing religious edicts, say it is not a religious requirement.
Management of multiple sclerosis symptoms through reductions in sedentary behaviour: protocol for a feasibility study
Authors: Aminian Saeideh , Motl Robert W , Rowley Jacqueline , Manns Patricia, J 
Published: April 2019

IntroductionPeople with multiple sclerosis (MS) are less physically active, and more sedentary than their peers despite evidence that activity helps to manage MS-related symptoms. Traditional approaches to increasing physical activity, such as exercise programmes, can be challenging for people with MS, especially those with walking disability. Focusing on decreasing prolonged sitting, and increasing light-intensity activities may be more feasible and result in more sustainable behaviour change in persons with MS. This paper describes the rationale and development of a sedentary behaviour intervention targeting persons with MS.Methods and analysisThe feasibility and preliminary efficacy of a sedentary behaviour intervention will be tested using a prepost intervention design in 40 adults with MS. The 22-week programme includes a 15-week intervention and a 7-week follow-up. The intervention itself is divided into two stages: Sit-Less and Move-More. The Sit-Less stage is designed to encourage participants to break up prolonged sitting bouts, while the Move-More stage promotes increasing steps per day, in addition to interrupting sitting. The intervention is delivered through individual coaching sessions between an interventionist and a participant, and an accompanying newsletter based on social cognitive theory. A Fitbit is used to monitor activity throughout the programme. Process, resource and management metrics will be recorded (eg, retention, time required for communication during the trial). Sedentary and physical activities and MS-related symptoms are measured before and after the intervention and again during follow-up. Experiences with the programme are explored through an online survey and one-on-one interviews.Ethics and disseminationThe Health Research Ethics Board at the University of Alberta granted permission to conduct this study. Results will be disseminated in scientific journals and conferences, and the MS Society of Alberta. Physical therapists and kinesiologists are important stakeholders and will be targeted during dissemination.Trial registration numberNCT03136744.
Achieving integrated care through commissioning of primary care services in the English NHS: a qualitative analysis
Authors: McDermott Imelda , Checkland Kath , Moran Valerie , Warwick-Giles Lynsey 
Published: April 2019

ObjectivesSince April 2015, Clinical Commissioning Groups (CCGs) have taken on the responsibility to commission primary care services. The aim of this paper is to analyse how CCGs have responded to this new responsibility and to identify challenges and factors that facilitated or inhibited achievement of integrated care systems.DesignWe undertook an exploratory approach, combining data from interviews and national telephone surveys, with analysis of policy documents and case studies in four CCGs. Data were analysed using thematic content analysis.Setting/participantsWe reviewed 147 CCG application documents and conducted two national telephone surveys with CCGs (n=49 and n=21). We interviewed 6 senior policymakers and 42 CCG staff who were involved in primary care co-commissioning (general practitioners and managers). We observed 74 primary care commissioning committee meetings and their subgroups (approx. 111 hours).ResultsCCGs in our case studies focused their primary care commissioning activities on developing strategic plans, ‘new’ primary care initiatives, and dealing with legacy work. Many plans focused on incentivising and supporting practices to work together and provide a broad range of services. There was a clear focus on ensuring the sustainability of general practice. Our respondents expressed mixed views as to what new collaborative service models, such as the new models of care and sustainability and transformation partnerships (STPs), would mean for the future of primary care and the impact they could have on CCGs and their members.ConclusionsThere is a disconnect between locally based primary care and the wider system. One of the major challenges we identified is the lack of knowledge and expertise in the field of primary care at STP level. While primary care commissioning by CCGs seems to be supporting local collaborations between practices, there is some way to go before this is translated into broader integration initiatives across wider footprints.
Comparison of the Kane formula with existing formulas for intraocular lens power selection
Authors: Connell Benjamin J , Kane Jack X 
Published: April 2019

ObjectiveTo compare the accuracy of a new intraocular lens (IOL) power formula (Kane formula) with existing formulas using IOLMaster, predominantly model 3, biometry (measures variables axial length, keratometry and anterior chamber depth) and optimised lens constants. To compare the accuracy of three new or updated IOL power formulas (Kane, Hill-RBF V.2.0 and Holladay 2 with new axial length adjustment) compared with existing formulas (Olsen, Barrett Universal 2, Haigis, Holladay 1, Hoffer Q, SRK/T).Methods and analysisA single surgeon retrospective case review was performed from patients having uneventful cataract surgery with Acrysof IQ SN60WF IOL implantation over 11 years in a Melbourne private practice. Using optimised lens constants, the predicted refractive outcome for each formula was calculated for each patient. This was compared with the actual refractive outcome to give the prediction error. Eyes were separated into subgroups based on axial length as follows: short (≤22.0 mm), medium (>22.0 to <26.0 mm) and long (≥26.0 mm).ResultsThe study included 846 patients. Over the entire axial length range, the Kane formula had the lowest mean absolute prediction error (p<0.001, all formulas). The mean postoperative difference from intended outcome for the Kane formula was −0.14+0.27×1 (95% LCL −1.52+0.93×43; 95% UCL +0.54+1.03×149). The formula demonstrated the lowest absolute error in the medium axial length range (p<0.001). In the short and long axial length groups, no formula demonstrated a significantly lower absolute mean prediction error.ConclusionUsing three variables (AL, K, ACD), the Kane formula was a more accurate predictor of actual postoperative refraction than the other formulae under investigation. There were not enough eyes of short or long axial length to adequately power statistical comparisons within axial length subgroups.
Ageing population has changed the nature of major thoracic injury
Authors: Ferrah Noha , Cameron Peter , Gabbe Belinda , Fitzgerald Mark , Judson Rodney , Marasco Silvana , Kowalski Tanya , Beck Ben 
Published: April 2019

IntroductionAn increasing proportion of the major trauma population are older persons. The pattern of injury is different in this age group and serious chest injuries represent a significant subgroup, with implications for trauma system design. The aim of this study was to examine trends in thoracic injuries among major trauma patients in an inclusive trauma system.MethodsThis was a retrospective review of all adult cases of major trauma with thoracic injuries of Abbreviated Injury Scale score of 3 or more, using data from the Victorian State Trauma Registry from 2007 to 2016. Prevalence and pattern of thoracic injury was compared between patients with multitrauma and patients with isolated thoracic injury. Poisson regression was used to determine whether population-based incidence had changed over the study period.ResultsThere were 8805 cases of hospitalised major trauma with serious thoracic injuries. Over a 10-year period, the population-adjusted incidence of thoracic injury increased by 8% per year (incidence rate ratio [IRR] 1.08, 95% CI 1.07 to 1.09). This trend was observed across all age groups and mechanisms of injury. The greatest increase in incidence of thoracic injuries, 14% per year, was observed in people aged 85 years and older (IRR 1.14, 95% CI 1.09 to 1.18).ConclusionsAdmissions for thoracic injuries in the major trauma population are increasing. Older patients are contributing to an increase in major thoracic trauma. This is likely to have important implications for trauma system design, as well as morbidity, mortality and use of healthcare resources.
BIOMECHANICAL PERFORMANCE OF A MODIFIED DESIGN OF DYNAMIC CERVICAL IMPLANT COMPARED TO CONVENTIONAL BALL AND SOCKET DESIGN OF AN ARTIFICIAL INTERVERTEBRAL DISC IMPLANT: A FINITE ELEMENT STUDY
Authors: BHATTACHARYA SHAMBO , ROY SANDIPAN , RANA MASUD , BANERJEE SREERUP , KARMAKAR SANTANU KUMAR , BISWAS JAYANTA KUMAR 
Published: April 2019

Most of the implants used for total disc replacement (TDR) surgery are designed as a ball and socket pair aimed at providing a three-dimensional unconstrained motion. However, one of the major concerns with ball and socket design is the wear of the implant which limits its life. In this study the biomechanical performance of two types of implant designs is compared — a conventional ball and socket type (Prodisc-C) and a modified design of dynamic cervical implant (DCI) using FE analysis. A 3-dimensional geometrical model of cervical spine (C1–T1) was developed using CT scan data of a middle-aged healthy male. Subsequently, using FE analysis, the ROM values were validated with the existing literature using a compressive load in combination with different physiological motions of the neck. Furthermore, FE analysis on the two implants, fitted at C5–C6 segment, showed a significant increase in the ROM of implanted segment using Prodisc and decrease in the ROM of inferior segment, but modified-DCI restored the motion of the implanted and adjacent segments. Analysis of average bone strains adjacent to the implant showed a possibility of stress shielding for Prodisc. However, higher stress distribution on the modified-DCI limited its clinical use.
Towards a Diffraction-based Sensing Approach on Human Activity Recognition
Authors: Zhang Fusang , Niu Kai , Xiong Jie , Jin Beihong , Gu Tao , Jiang Yuhang , Zhang Daqing 
Published: April 2019

In recent years, wireless sensing has been exploited as a promising research direction for contactless human activity recognition. However, one major issue hindering the real deployment of these systems is that the signal variation patterns induced by the human activities with different devices and environmental settings are neither stable nor consistent, resulting in unstable system performance. The existing machine learning based methods usually take the "black box" approach and fails to achieve consistent performance. In this paper, we argue that a deep understanding of radio signal propagation in wireless sensing is needed, and it may be possible to develop a deterministic sensing model to make the signal variation patterns predictable.
With this intuition, in this paper we investigate: 1) how wireless signals are affected by human activities taking transceiver location and environment settings into consideration; 2) a new deterministic sensing approach to model the received signal variation patterns for different human activities; 3) a proof-of-concept prototype to demonstrate our approach and a case study to detect diverse activities. In particular, we propose a diffraction-based sensing model to quantitatively determine the signal change with respect to a target's motions, which eventually links signal variation patterns with motions, and hence can be used to recognize human activities. Through our case study, we demonstrate that the diffraction-based sensing model is effective and robust in recognizing exercises and daily activities. In addition, we demonstrate that the proposed model improves the recognition accuracy of existing machine learning systems by above 10%.