bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modeling optical and UV polarization of AGNs
Authors: Marin F. 
Published: June 2018

Context. One of the main challenges for polarimetric observations of active galactic nuclei (AGN) is to properly estimate the amount of parasitic light that contaminates the polarization signal. Removing this unpolarized flux is a complex task that has only been achieved in a couple of objects.Aims. In this fifth paper of the series, we present a new version of the Monte Carlo code STOKES that accounts for dilution by interstellar polarization and host starlight in radiative transfer modeling.Methods. We upgraded our code by including spectral energy distribution (SED) templates for a set of representative host galaxies. The unpolarized light emitted by those hosts alters the observer polarization while being coherently radiatively coupled to the AGN structure. We also included in our analysis tool a routine that may add, depending on the user’s objectives, an interstellar component.Results. Using a generic AGN model, we illustrate how interstellar polarization and starlight dilution impact the observed polarimetric signal of AGN. We applied our code to NGC 1068, an archetypal edge-on AGN and demonstrate that STOKES can reproduce its SED, the expected wavelength-dependent polarimetric signatures, and the observed high-angular resolution polarimetric maps. Using the flexibility of the code, we derived several intrinsic parameters such as the system inclination and the torus opening angle.Conclusions. The new version of our publicly available code now allows observers to better prepare their observations, interpret their data and simulate the three-dimensional geometry and physics of AGN in order to probe unresolved structures. Additionally, the radiative interaction between the host and the AGN can be used to probe the co-evolution of the system.
Untersuchung der Prävalenz kardiologischer Risikofaktoren in der Allgemeinbevölkerung: Ein Vergleich ambulanter ärztlicher Abrechnungsdaten mit Daten einer populationsbasierten Studie
Authors: Angelow Aniela , Reber Katrin Christiane , Schmidt Carsten Oliver , Baumeister Sebastian Edgar , Chenot Jean-Francois 
Published: June 2018

Zusammenfassung
Ziel der Studie Diese Studie untersucht die Validität ICD-kodierter Diagnosen für die kardiovaskulären Risikofaktoren arterielle Hypertonie, Diabetes mellitus, Dyslipidämie, Rauchen und Übergewicht aus kassenärztlichen Abrechnungsdaten in Bezug auf die Übereinstimmung mit klinischen Diagnosedaten einer populationsbasierten Kohortenstudie.
Methodik Hierzu wurden Abrechnungsdaten der Kassenärztlichen Vereinigung Mecklenburg-Vorpommern (Zeitraum 2008–2012) mit Daten der Study of Health in Pomerania (SHIP) gelinkt. Die Übereinstimmung der Abrechnungsdiagnosen (I10.- (arterielle Hypertonie), E10.- bis E14.- (Diabetes mellitus), E78.- (Dyslipidämie), F17.- (Zigarettenrauchen) und E65.- bis E68.- (Übergewicht oder Adipositas)) mit den erhobenen klinischen Goldstandarddaten von 1941 SHIP-Teilnehmern (46 % männlich, durchschnittliches Alter 58±SD 13 Jahre) wurde ermittelt.
Ergebnisse Von den untersuchten Abrechnungsdiagnosen lag für Diabetes mellitus (Sensitivität (Sens) 84%, Spezifität (Spez) 95%, Positiv Prädiktiver Wert (PPW) 80%) und arterielle Hypertonie (Sens 72%, Spez 93%, PPW 97%) eine höhere Übereinstimmung und für die Abrechnungsdiagnosen Zigarettenrauchen (Sens 18%, Spez 99%, PPW 89%), Übergewicht (Sens 22%, Spez 99%, PPW 99%) und Dyslipidämie (Sens 40%, Spez 60%, PPW 70%) eine geringe Übereinstimmung mit den klinischen Diagnosedaten vor. Bei vorliegendem Risikofaktor laut Goldstandard waren die Einnahme von Medikamenten, das Vorliegen weiterer dokumentierter kardiovaskulärer Risikofaktoren im Sinne von Komorbiditäten, Alter, Geschlecht und Erkrankungsschweregrad mit der Kodierung der Abrechnungsdiagnose assoziiert.
Schlussfolgerung Die Kodierqualität kardiovaskulärer Risikofaktoren im ambulanten Bereich variiert stark. Insgesamt besteht eine Unterkodierung, wobei abrechnungsrelevante Diagnosen besser kodiert werden. Basierend auf den Ergebnissen ist bevölkerungsbezogen eine Quantifizierung des Fehlers bei Prävalenzschätzungen auf Basis von Abrechnungsdaten für die untersuchten kardiovaskulären Risikofaktoren möglich.
Risikoberechnung mit Routinedaten? Entwicklung und Validierung multivariabler Modelle zur Prädiktion der 30- und 90-Tage-Mortalität nach chirurgischer Behandlung kolorektaler Karzinome
Authors: Crispin Alexander , Strahwald Brigitte , Cheney Catherine , Mansmann Ulrich 
Published: June 2018

Zusammenfassung
Ziele Qualitätssicherung, Benchmarking und Pay for Performance (P4P) erfordern aussagekräftige Indikatoren sowie die adäquate Berücksichtigung der Risikostruktur der Patientenpopulation der jeweiligen Institution anhand geeigneter statistischer Modelle. Der Ansatz, Abrechnungsdaten zur Qualitätsmessung und Risikomodellierung zu verwenden, wird häufig kritisch gesehen. Ziel unserer Analysen war die exemplarische Entwicklung von Prädiktionsmodellen für die 30- und 90-Tage-Mortalität nach chirurgischer Therapie kolorektaler Karzinome mit Routinedaten.
Studiendesign Vollerhebung der Patienten einer großen gesetzlichen Krankenkasse.
Setting Chirurgische Kliniken im gesamten Bundesgebiet.
Patienten 4283 bzw. 4124 Patienten mit Operationen kolorektaler Karzinome in den Jahren 2013 bzw. 2014.
Prädiktoren Alter, Geschlecht, Haupt- und Nebendiagnosen sowie Tumorlokalisation aus den von den Kliniken an die Krankenkasse übermittelten Abrechnungsdaten gemäß §301 Sozialgesetzbuch V.
Outcomes 30- und 90-Tage-Mortalität.
Statistische Analyse Ableitung von Elixhauser Comorbidities, Charlson Conditions sowie Charlson Scores aus den ICD-10-Diagnosen. Entwicklung von Prädiktionsmodellen anhand eines penalisierten Regressionverfahrens (logistische Ridge Regression) in einer Lernstichprobe (Patienten des Jahres 2013). Beurteilung von Kalibrierung und Diskriminationsfähigkeit der Modelle in einer internen Validierungsstichprobe (Patienten des Jahres 2014) mithilfe von Kalibrierungskurven, Brier Scores und Analysen von Receiver Operating Characteristic Curves (ROC-Kurven) und der Flächen unter denselben (Areas Under the Curves, AUC).
Ergebnisse Die 30- bzw. 90-Tage-Mortalität in der Lernstichprobe betrugen 5,7 bzw. 8,4%. Die entsprechenden Werte im Validierungssample waren 5,9% und gleichfalls 8,4%. Modelle auf der Basis der Elixhauser Comorbidities zeigten die beste Diskrimination mit AUC-Werten von 0,804 (95%-KI: 0,776–0,832) bzw. 0,805 (95%-KI: 0,782–0,828) für die 30- bzw. 90-Tage-Mortalität. Die zugehörigen Brier-Scores für die Elixhauser-Modelle betrugen 0,050 (95%-KI: 0,044–0,056) bzw. 0,067 (95%-KI: 0,060–0,074) und stimmten weitgehend mit denjenigen der konkurrierenden Modelle überein. Alle Modelle zeigten im Bereich niedriger prädizierter Wahrscheinlichkeiten eine gute Kalibrierung, bei höheren prädizierten Werten tendierten sie zur Überschätzung der Ereigniswahrscheinlichkeiten.
Schlussfolgerung Trotz der augenscheinlich befriedigenden Ergebnisse zur Diskriminierung und Kalibrierung der vorgestellten Prädiktionsmodelle auf der Basis von Abrechnungsdaten ist deren Anwendung im Kontext von P4P kritisch zu sehen. Als Alternative bietet sich die Modellierung auf der Basis klinischer Register an, die ein umfassenderes, valideres Bild vermitteln dürften.
4th International Consensus Conference on Advanced Breast Cancer (ABC4), Lisbon, November 4, 2017
Authors: Untch Michael , Würstlein Rachel , Marschner Norbert , Lüftner Diana , Augustin Doris , Briest Susanne , Ettl Johannes , Haidinger Renate , Müller Lothar , Müller Volkmar , Ruckhäberle Eugen , Harbeck Nadia , Thomssen Christoph 
Published: June 2018

AbstractThe fourth international advanced breast cancer consensus conference (ABC4) on the diagnosis and treatment of advanced breast cancer (ABC) headed by Professor Fatima Cardoso was once again held in Lisbon on November 2 – 4, 2017. To simplify matters, the abbreviation ABC will be used hereinafter in the text. In clinical practice, the abbreviation corresponds to metastatic breast cancer or locally far-advanced disease. This year the focus was on new developments in the treatment of ABC. Topics discussed included the importance of CDK4/6 inhibition in hormone receptor (HR)-positive ABC, the use of dual antibody blockade to treat HER2-positive ABC, PARP inhibition in triple-negative ABC and the potential therapeutic outcomes. Another major area discussed at the conference was BRCA-associated breast cancer, the treatment of cerebral metastasis, and individualized treatment decisions based on molecular testing (so-called precision medicine). As in previous years, close cooperation with representatives from patient organizations from around the world is an important aspect of the ABC conference. This cooperation was reinforced and expanded at the ABC4 conference. A global alliance was founded at the conclusion of the consensus conference, which aims to promote and coordinate the measures considered necessary by patient advocates worldwide. Because the panel of experts was composed of specialists from all over the world, it was inevitable that the ABC consensus also reflected country-specific features. As in previous years, a team of German breast cancer specialists who closely followed the consensus voting of the ABC panelists in Lisbon and intensively discussed the votes has therefore commented on the consensus in the context of the current German guidelines on the diagnosis and treatment of breast cancer 1, 2 used in clinical practice in Germany. The ABC consensus is based on the votes of the ABC panelists in Lisbon.
Mammography Screening 2.0 – How Can Risk-Adapted Screening be Implemented in Clinical Practice?
Authors: Fürst Nicole , Kiechle Marion , Strahwald Brigitte , Quante Anne 
Published: June 2018

Abstract
Introduction The mammography screening programme has been the subject of criticism for some time. Invitation to take part is currently based only on the risk factors of age and female sex, whereby women with an above-average risk are screened too seldom and women with a low risk are possibly screened too often. In future, an individualised risk assessment could make a risk-adapted procedure possible in breast cancer screening. In the RISIKOLOTSE.DE project, schemes are devised to calculate the individual breast cancer risk and evaluate the results. The aim is to assist doctors and screening participants in participatory decision-making. To gauge the baseline situation in the target groups, qualitative and quantitative surveys were conducted.
Method At the start of the project, a guideline-based focus group discussion was held with 15 doctors and representatives of the public health service. The transcript of this discussion was evaluated by means of a qualitative content analysis.
Results The participants assessed the concept of risk-adapted screening positively overall. At the same time, the majority of them were of the opinion that the results of individualised risk calculation can be understood and evaluated adequately only by doctors. The great communication requirement and lack of remuneration were given as practical obstacles to implementation.
Discussion The suggestions and new ideas from the focus group ranged from administrative and regulatory changes to new forms of counselling and adaptable practice aids. An important indicator for the RISIKOLOTSE.DE conception and for planning future surveys was that risk calculation for mammography screening 2.0 was regarded as a purely medical function and that the concept of participatory decision-making played hardly any part in the discussion.
Hypercoagulable States and Thrombophilias: Risks Relating to Recurrent Venous Thromboembolism
Authors: Rybstein Marissa , DeSancho Maria 
Published: June 2018

AbstractInherited and acquired thrombophilias and hypercoagulable states, such as active cancer, estrogen-induced, autoimmune disorders, major surgery, hospitalization, and trauma, are well-known risk factors for venous thromboembolism (VTE). The effect of these on recurrent VTE is different for each specific risk factor. The major risk factors affecting VTE recurrence include the presence of active cancer and an unprovoked first VTE. In addition, the use of combined female hormones in a woman with a previous history of estrogen-related VTE is a major risk factor for VTE recurrence. The extent of influence of inherited thrombophilia on the risk of recurrence is controversial. Conversely, the presence of antiphospholipid antibodies, specifically triple positive carriers, appears to increase the risk of VTE recurrence. Understanding the rates of recurrent VTE in a patient and the individual risk of bleeding is important in determining the duration of anticoagulation therapy.
Patient Assessment: Clinical Presentation, Imaging Diagnosis, Risk Stratification, and the Role of Pulmonary Embolism Response Team
Authors: Friedman Tamir , Quencer Keith , Madoff David , Winokur Ronald 
Published: June 2018

AbstractPulmonary embolism (PE) is currently the third leading cause of death and moreover is likely underdiagnosed. PE remains the most common preventable cause of hospital deaths in the United States, which may be attributable to its diagnostic challenges. Although difficult to diagnose, patient mortality rates are time-dependent, and thus, the suspicion and diagnosis of PE in a timely manner is imperative. Diagnosis based on several criteria which may dictate imaging workup as well as laboratory tests and clinical parameters are discussed. The evolution of treatment guidelines via various clinical trials and recommendations is outlined, setting the stage for the use of fibrinolytics, whether systemic or catheter directed. Treatment, including fibrinolytics, is predicated on patient triage into three large categories—massive, submassive, or low-risk PE. Additionally, a relatively new concept of a multidisciplinary team composed of several subspecialty experts known as the PE response team (PERT) is discussed. PERT's timely and unified recommendations have been shown to optimize care and decrease mortality while tailoring treatment to each individual afflicted by PE.
Novel Anticoagulant Treatment for Pulmonary Embolism with Direct Oral Anticoagulants Phase 3 Trials and Clinical Practice
Authors: van der Pol Liselotte , Mairuhu Albert , Leroyer Christophe , Couturaud Francis , Huisman Menno , Klok Frederikus , Tromeur Cécile 
Published: June 2018

AbstractAnticoagulant therapy is the cornerstone of therapeutic management in acute venous thromboembolism (VTE), consisting of pulmonary embolism and deep vein thrombosis. Direct oral anticoagulants (DOACs) have become the standard of care because of their good safety profile and ease of use in clinical practice. Indeed, phase 3 randomized trials (AMPLIFY, EINSTEIN, RECOVER, and HOKUSAI studies) showed that DOACs provided a similar efficacy and a better safety than conventional treatment with parenteral heparin with overlapping loading dose of vitamin K antagonists in acute VTE therapeutic management. The results of published data from real-world registries confirm the safety and efficacy of DOACs demonstrated in the phase 3 trials.
Peri-Procedural Platelet Reactivity in Percutaneous Coronary Intervention
Authors: Alexopoulos Dimitrios , Xenogiannis Iosif , Vlachakis Panagiotis , Tantry Udaya , Gurbel Paul 
Published: June 2018

AbstractPlatelet activation and aggregation play a pivotal role in thrombotic complications occurring during percutaneous coronary intervention (PCI), and peri-PCI anti-platelet therapy represents a standard of care. High platelet reactivity prior to PCI has been correlated with an increased incidence of peri-procedural myonecrosis. Pre-PCI platelet reactivity predicts post-PCI platelet reactivity and has a prognostic impact on subsequent ischaemic and bleeding events, so as the platelet inhibition measured post-PCI. Many anti-platelet treatment strategies, including aspirin, glycoprotein IIb/IIIa inhibitors, P2Y12 receptor blockers and vorapaxar, are being used in the routine clinical practice to modify platelet reactivity at each stage, e.g. pre-, during and post-PCI. Anti-platelet strategies with a ‘stronger and faster’ pharmacodynamic effect than clopidogrel have been mostly adopted in patients with acute coronary syndromes. However, several issues regarding the anti-platelet treatment such as benefits/risks of anti-platelet therapy pre-treatment and duration, and definite association between speed and potency of various anti-platelet agents and clinical outcomes remain controversial. We believe that a better understanding of peri-PCI platelet reactivity and its relations to outcomes may lead to the development of more effective and safe treatment strategies.
Can Sequential Coagulation Monitoring Predict Major Haemorrhage in Extremely Low Birth Weight Infants?
Authors: Thanhaeuser Margarita , Binder Christoph , Derhaschnig Ulla , Jilma Bernd , Kornsteiner-Krenn Margit , Huber-Dangl Mercedes , Repa Andreas , Kreissl Alexandra , Berger Angelika , Haiden Nadja 
Published: June 2018

Introduction Bleeds such as intra-ventricular (IVH) and pulmonary haemorrhage (PH) are life-threatening events in extremely low birth weight (ELBW) infants. Serial coagulation monitoring by measuring the international normalized ratio (INR) with small volume samples might facilitate early diagnosis and possibly prevent major bleeds.
Materials and Methods This was a prospective longitudinal study performed in ELBW infants, who received serial INR monitoring by point of care testing during their first 30 days of life. The primary objective was to explore whether INR monitoring could predict major bleeding events (IVH, PH). Secondary objectives were mortality and feasibility in this patient population.
Results A total of 127 ELBW infants were stratified into a bleeding and a non-bleeding group. Bleeding events occurred in 31% (39/127) of the infants, whereupon 24% developed IVH and 9% PH. Infants in the bleeding group were 4 days younger at birth (p = 0.05) and had a substantially higher mortality rate of 26% versus 5% in controls (p = 0.005). Median INR during the first 3 days before a bleeding event was 1.55 (95% confidence interval [CI]: 1.39–1.74) compared with the control group with 1.45 (95% CI: 1.44–1.58; p = 0.81). Platelet counts were significantly lower in the bleeding group on the 3rd day and during the 2nd to 4th week of life.
Discussion Serial coagulation monitoring by an INR point of care testing is feasible in ELBW infants but could not predict bleeding events. Further studies with daily monitoring of INR and platelet counts during the first days of life might be able to more precisely detect a risk of major haemorrhage in ELBW infants.
Genome-Wide Expression Analysis Suggests Hypoxia-Triggered Hyper-Coagulation Leading to Venous Thrombosis at High Altitude
Authors: Jha Prabhash , Sahu Anita , Prabhakar Amit , Tyagi Tarun , Chatterjee Tathagata , Arvind Prathima , Nair Jiny , Gupta Neha , Kumari Babita , Nair Velu , Bajaj Nitin , Shanker Jayashree , Sharma Manish , Kumar Bhuvnesh , Ashraf Mohammad 
Published: June 2018

AbstractVenous thromboembolism (VTE), a multi-factorial disease, is the third most common cardiovascular disease. Established genetic and acquired risk factors are responsible for the onset of VTE. High altitude (HA) also poses as an additional risk factor, predisposing individuals to VTE; however, its molecular mechanism remains elusive. This study aimed to identify genes/pathways associated with the pathophysiology of deep vein thrombosis (DVT) at HA. Gene expression profiling of DVT patients, who developed the disease, either at sea level or at HA-DVT locations, resulted in differential expression of 378 and 875 genes, respectively. Gene expression profiles were subjected to bioinformatic analysis, followed by technical and biological validation of selected genes using quantitative reverse transcription-polymerase chain reaction. Both gene ontology and pathway analysis showed enrichment of genes involved in haemostasis and platelet activation in HA-DVT patients with the most relevant pathway being ‘response to hypoxia’. Thus, given the environmental condition the differential expression of hypoxia-responsive genes (angiogenin, ribonuclease, RNase A family, 5; early growth response 1; lamin A; matrix metallopeptidase 14 [membrane-inserted]; neurofibromin 1; PDZ and LIM domain 1; procollagen-lysine 1, 2-oxoglutarate 5-dioxygenase 1; solute carrier family 6 [neurotransmitter transporter, serotonin], member 4; solute carrier family 9 [sodium/hydrogen exchanger], member 1; and TEK tyrosine kinase, endothelial) in HA-DVT could be a determining factor to understand the pathophysiology of DVT at HA.
Inherited Thrombophilia and Pregnancy Complications: Should We Test?
Authors: Makris Mike , Arachchillage Deepa 
Published: June 2018

AbstractRecurrent miscarriages and pregnancy-related complications cause significant stress to couples looking for successful pregnancy outcome as well as to health care professionals. There is conflicting evidence with respect to the presence and the strength of associations between inherited thrombophilia and these complications. A complete thrombophilia screen is expensive, and no proven effective treatment for women with recurrent miscarriage and inherited thrombophilia is currently available. Based on the concept of microvascular thrombosis of the placenta, women with recurrent miscarriage and placenta-related complications frequently get treated with antithrombotic therapy. In this narrative review, the authors explore the evolving understanding and evidence of inherited thrombophilia in recurrent miscarriages and other pregnancy complications, and whether antithrombotic treatment would modify pregnancy outcome in women with inherited thrombophilia. Finally, they provide some personal recommendations based on available evidence for clinical practice. In summary, inherited thrombophilia testing is not required outside a clinical trial for women with recurrent pregnancy losses or late pregnancy complications. The presence of thrombophilia markers does not generally indicate additional therapy during pregnancy, even if a heritable thrombophilic defect is found in women with recurrent miscarriages or late pregnancy complications.
The politics of the China―Pakistan economic corridor
Authors: Hameed Maham 
Published: June 2018

AbstractChina’s presence in the Global South has increased dramatically over the course of a decade. The discourse of mutual benefit and non-intervention has attracted much attention in the developing world, which is now facing the consequences of Western interventions. However, the extent to which Chinese engagement in the developing world stays true to these principles needs to be evaluated in terms of its effects on the political economic structures of the host nations. This study analyses how China and the China-Pakistan Economic Corridor (CPEC) is interacting with the political and economic realities of Pakistan. Firstly, the study traces the history of regionalism in Pakistan and shows that over the years, the developmental mission of the central state has created deep-seated regionalism in Pakistan. The study shows that CPEC is deepening such cleavages. The regionalist forces have opposed the project in two broad ways: through demanding a greater share in the project or through completely rejecting the interventions. Secondly, the study analyses the lop-sided civil-military relations in Pakistan and concludes that Chinese engagement in Pakistan is leading to the military’s tighter control of civilian and economic matters relating to CPEC.