bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tetralogy of Fallot: morphological variations and implications for surgical repair
Authors: Khan Saad M , Drury Nigel E , Stickley John , Barron David J , Brawn William J , Jones Timothy J , Anderson Robert H , Crucean Adrian 
Published: December 2018

AbstractOBJECTIVESTetralogy of Fallot is characterized by anterocephalad deviation of the outlet septum, along with abnormal septoparietal trabeculations, which lead to subpulmonary infundibular stenosis. Archives of retained hearts are an important resource for improving our understanding of congenital heart defects and their morphological variability. This study aims to define variations in aortic override, coronary arterial patterns and ventricular septal defects in tetralogy of Fallot as observed in a morphological archive, highlighting implications for surgical management.METHODSThe Birmingham Children’s Hospital archive contains 211 hearts with tetralogy of Fallot, of which 164 were analysed [69 (42.1%) unrepaired and 95 (57.9%) operated specimens]. A detailed morphological and geometric analysis was performed using a rigorous 5-layer review process.RESULTSAnomalies were observed in the orifices, origins and course of the coronary arteries: 20 hearts (13.0%) had more than 2 orifices and 3 hearts (1.9%) had a single orifice. In 7 hearts (4.3%), a coronary artery crossed the right ventricular outflow tract. The extent of aortic override ranged from 31.0% to 100% (median of 59.5%). The ventricular septal defect was most often perimembranous (139, 84.8%), but we also found muscular (14, 8.5%), atrioventricular (7, 4.3%) and doubly committed juxta-arterial (2, 1.2%) variants.CONCLUSIONSAnatomical variations are common and can impact surgical management. Anomalous coronary arteries may require a conduit rather than a transannular patch. Variability in aortic override determines the size of patch used to baffle blood to the aorta. The type of ventricular septal defect affects patch closure and the risk of postoperative conduction defects.
Glycated haemoglobin (HbA1c) as a reliable option for detecting diabetes among the urban poor population in Bangladesh
Authors: Chiang Chifa , Aoyama Atsuko , Khalequzzaman Md , Choudhury Sohel R. , Paul Debatosh , Rayna Shahrin E. , Khan Fahmida A. , Hirakawa Yoshihisa , Iso Hiroyasu , Yatsuya Hiroshi 
Published: December 2018

Abstract
Our previous epidemiological survey targeting urban slum dwellers in Bangladesh showed that the prevalence of diabetes defined by glycated haemoglobin (HbA1c) was higher than the national estimation, and higher in women than men. Subsequently, we conducted the oral glucose tolerance test (OGTT) and found that HbA1c values were consistent with the OGTT findings for detecting diabetes. Our findings indicated that HbA1c ≥6.5% was a rational cut-off, but the optimal HbA1c cut-off for this population might be lower than the internationally recommended threshold. Measuring HbA1c would be a reliable and feasible option for detecting diabetes among underprivileged population in developing countries.
Barriers to GPs identifying patients at the end-of-life and discussions about their care: a qualitative study
Authors: Pocock Lucy V , Wye Lesley , French Lydia R M , Purdy Sarah 
Published: December 2018

Abstract

Background
Identification of patients at the end-of-life is the first step in care planning and many general practices have Palliative Care Registers. There is evidence that these largely comprise patients with cancer diagnoses, but little is known about the identification process.

Objective
To explore the barriers that hinder GPs from identifying and registering patients on Palliative Care Registers.

Methods
An exploratory qualitative approach was undertaken using semi-structured interviews with GPs in South West England. GPs were asked about their experiences of identifying, registering and discussing end-of-life care with patients. Interviews were audio recorded, transcribed and analysed thematically.

Results
Most practices had a Palliative Care Register, which were mainly composed of patients with cancer. They reported identifying non-malignant patients at the end-of-life as challenging and were reluctant to include frail or elderly patients due to resource implications. GPs described rarely using prognostication tools to identify patients and conveyed that poor communication between secondary and primary care made prognostication difficult. GPs also detailed challenges around talking to patients about end-of-life care.

Conclusions
Palliative Care Registers are widely used by GPs for patients with malignant diagnoses, but seldom for other patients. The findings from our study suggest that this arises because GPs find prognosticating for patients with non-malignant disease more challenging. GPs would value better communication from secondary care, tools for prognostication and training in speaking with patients at the end-of-life enabling them to better identify non-malignant patients at the end-of-life.
Determining the extent and drivers of attrition losses from wind using long-term datasets and machine learning techniques
Authors: Moore John , Lin Yue 
Published: December 2018

Abstract
In addition to causing large-scale catastrophic damage to forests, wind can also cause damage to individual trees or small groups of trees. Over time, the cumulative effect of this wind-induced attrition can result in a significant reduction in yield in managed forests. Better understanding of the extent of these losses and the factors associated with them can aid better forest management. Information on wind damage attrition is often captured in long-term growth monitoring plots but analysing these large datasets to identify factors associated with the damage can be problematic. Machine learning techniques offer the potential to overcome some of the challenges with analysing these datasets. In this study, we applied two commonly-available machine learning algorithms (Random Forests and Gradient Boosting Trees) to a large, long-term dataset of tree growth for radiata pine (Pinus radiata D. Don) in New Zealand containing more than 157 000 observations. Both algorithms identified stand density and height-to-diameter ratio as being the two most important variables associated with the proportion of basal area lost to wind. The algorithms differed in their ease of parameterization and processing time as well as their overall ability to predict wind damage loss. The Random Forest model was able to predict ~43 per cent of the variation in the proportion of basal area lost to wind damage in the training dataset (a random sample of 80 per cent of the original data) and 45 per cent of the validation dataset (the remaining 20 per cent of the data). Conversely, the Gradient Boosting Tree model was able to predict more than 99 per cent of the variation in wind damage loss in the training dataset, but only ~49 per cent of the variation in the validation dataset, which highlights the potential for overfitting models to specific datasets. When applying these techniques to long-term datasets, it is also important to be aware of potential issues with the underlying data such as missing observations resulting from plots being abandoned without measurement when damage levels have been very high.
Impact of Sarcopenia on Adverse Outcomes After Allogeneic Hematopoietic Cell Transplantation
Authors: Armenian Saro H , Xiao Meisi , Berano Teh Jennifer , Lee Brandyn , Chang Howard A , Mascarenhas Kristen , Lee Sean , Iukuridze Alex , Xie Jack J , Scott Jessica M , Jones Lee W , Lennie Wong F , Forman Stephen J , Nakamura Ryotaro 
Published: December 2018

Abstract

Background
High intensity treatments such as hematopoietic cell transplantation (HCT) can be curative for patients with hematologic malignancies, but this needs to be balanced by the high risk of nonrelapse mortality (NRM) during the first 2 years after HCT. Sarcopenia (low muscle mass) is associated with physical disability and premature mortality in individuals with nonmalignant diseases and may be a predictor of NRM and poor overall survival in patients undergoing HCT.

Methods
This was a retrospective cohort study of 859 patients with acute leukemia or myelodysplastic syndrome who underwent a first HCT as adults (≥18 years) between 2007 and 2014. Sarcopenia was assessed from pre-HCT abdominal computed tomography scans. Two-year cumulative incidence of NRM was calculated, with relapse/progression considered as a competing risk event. Fine-Gray subdistribution hazard ratio estimates and 95% confidence intervals (CI) were obtained and adjusted for relevant covariates. Kaplan-Meier method was used to examine overall survival. All statistical tests were two-sided.

Results
Median age at HCT was 51 years (range = 18–74 years); 52.5% had a high [≥3] HCT-comorbidity index; 33.7% had sarcopenia pre-HCT. Sarcopenia was an independent predictor of higher NRM risk (hazard ratio = 1.58, 95% CI = 1.16 to 2.16) compared with patients who were not. The 2-year incidence of NRM approached 30% in patients with sarcopenia and high (≥3) HCT-comorbidity index. Patients with sarcopenia had on average a longer hospitalization (37.2 days vs 31.5 days, P < .001) and inferior overall survival at 2 years (55.2%, 95% CI = 49.5% to 61.0% vs 66.9%, 95% CI = 63.0% to 70.8%, P < .001).

Conclusions
Sarcopenia is an important and independent predictor of survival after HCT, with potential additional downstream impacts on health-economic outcomes. This information can be used to facilitate treatment decisions prior to HCT and guide interventions to decrease the risk of treatment-related complications after HCT.
Molecular types of Cryptococcus neoformans and Cryptococcus gattii in Western Australia and correlation with antifungal susceptibility
Authors: Lee Gar-hing Andrew , Arthur Ian , Merritt Adam , Leung Michael 
Published: December 2018

AbstractCryptococcus neoformans and Cryptococcus gattii species complexes have a worldwide distribution; however, there is geographical variation in the prevalence of different molecular types. Additionally, antifungal susceptibility differences between molecular types have been demonstrated. This study investigates the distribution of cryptococcal molecular types among human clinical isolates over a 10-year period from a Western Australian population. Molecular type was determined based on polymorphisms in the phospholipase gene locus identified through amplification and sequencing. Minimum inhibitory concentrations (MICs) were identified for fluconazole, 5-fluorocytosine, posaconazole, itraconazole, voriconazole, and amphotericin B. Most isolates were C. neoformans complex (42) of which over half were molecular type VNI (22) followed by VNII (20). Among the remaining C. gattii complex (13) the majority were VGI (11) with VGII (2) uncommonly found. All isolates demonstrated low MICs to antifungal agents including fluconazole. Geometric mean MIC values against 5-fluorocytosine for VNI (1.741 mg/l) were significantly higher than those for VGI (0.47 mg/l, P = .002). Similarly fluconazole geometric mean MICs against fluconazole for VNI (2.3 mg/l) were significantly higher than VNII (0.87 mg/l, P = .036). These data reveal the presence of four molecular types (VNI, VNII, VGI and VGII) within clinical Western Australian cryptococcal isolates and, while elevated antifungal MICs were not encountered, significant molecular type dependent differences in susceptibility were found.
Effect of denosumab on trabecular bone score in de novo kidney transplant recipients
Authors: Bonani Marco , Frey Diana , Graf Nicole , Wüthrich Rudolf P 
Published: December 2018

AbstractBackgroundKidney transplant recipients (KTR) are at risk to lose bone mass. The trabecular bone score (TBS) represents a recently developed parameter of lumbar spine trabecular bone texture that correlates with the occurrence of fractures.MethodsWe analysed the 1-year changes in TBS in 44 de novo KTR that were randomized 1:1 to denosumab or no treatment. TBS was derived from dual energy X-ray absorptiometry and was correlated with 1-year areal bone mineral density (aBMD) changes at the lumbar spine and total hip. Correlations were also performed with parameters of peripheral bone microarchitecture and bone strength at the distal tibia and distal radius, as assessed by high-resolution peripheral quantitative computed tomography (HRpQCT) and micro-finite element analysis.ResultsThe baseline TBS in KTR amounted to 1.312 ± 0.101, which is lower than the TBS of an age-matched normal control population (range 1.364–1.471). The TBS correlated positively with aBMD at the lumbar spine (Spearman’s ρ = 0.56; P < 0.001) and total hip (ρ = 0.33; P < 0.05). The baseline TBS also correlated with HRpQCT-derived total (ρ = 0.49; P < 0.05) and trabecular volumetric BMD (ρ = 0.57; P < 0.01) and trabecular separation (ρ = −0.46; P < 0.05) at the tibia. Denosumab treatment led to an increase in TBS, paralleling the BMD changes at the lumbar spine.ConclusionsThe TBS is a useful additional score of bone health, which may help to better define fracture risk. Treatment with denosumab led to improved trabecular bone texture in de novo KTR in addition to its beneficial effect on BMD.
Pilot randomized, controlled trial of a dyadic yoga program for glioma patients undergoing radiotherapy and their family caregivers
Authors: Milbury Kathrin , Li Jing , Weathers Shiao-Pei , Mallaiah Smitha , Armstrong Terri , Li Yisheng , Bruera Eduardo , Cohen Lorenzo 
Published: December 2018

Abstract

Background
While the use of behavioral medicine in managing glioma patients’ symptoms is not well studied, the high symptom burden in patients and their family caregivers is well established. We conducted a pilot randomized, controlled trial to examine the feasibility and preliminary efficacy of a dyadic yoga (DY) intervention as a supportive care strategy.

Methods
Glioma patients undergoing radiotherapy and their caregivers were randomized to a 12-session DY or waitlist control (WLC) group. Prior to radiotherapy and randomization, both groups completed measures of cancer-related symptoms (MD Anderson Symptom Inventory-Brain Tumor module), depressive symptoms (Center for Epidemiological Studies-Depression measure), fatigue (Brief Fatigue Inventory), and overall quality of life (QOL; Medical Outcomes Study 36-item short-form survey). Dyads were reassessed at the last day of radiotherapy.

Results
Twenty patients (mean age: 46 years, 50% female, 80% WHO grade IV and caregivers (mean age: 50 years, 70% female, 50% spouses) participated in the trial. A priori feasibility criteria were met regarding consent (70%), adherence (88%), and retention (95%) rates. Controlling for relevant covariates, change score analyses revealed clinically significant improvements for patients in the DY compared with the WLC group for overall cancer symptom severity (d = 0.96) and symptom interference (d = 0.74), depressive symptoms (d = 0.71), and mental QOL (d = 0.69). Caregivers in the DY group reported clinically significant improvements in depressive symptoms (d = 1.12), fatigue (d = 0.89), and mental QOL (d = 0.49) relative to those in the WLC group.

Conclusion
A DY intervention appears to be a feasible and beneficial symptom and QOL management strategy for glioma patients undergoing radiotherapy and their caregivers. An efficacy trial with a more stringent control group is warranted.

Clinical Trial Number
NCT02481349
Glioma surgery under awake condition can lead to good independence and functional outcome excluding deep sensation and visuospatial cognition
Authors: Nakajima Riho , Kinoshita Masashi , Okita Hirokazu , Yahata Tetsutaro , Nakada Mitsutoshi 
Published: December 2018

Abstract

Background
Awake surgery for the eloquent cortex is a common strategy for glioma surgery. Although a recent emphasis has been placed on awake surgery both for dominant and nondominant cerebral hemispheres to preserve neurological/neuropsychological functions, those functional outcomes are not well investigated because few studies have focused on the longitudinal recovery process. This study explored the outcome of neurological/neuropsychological functions following awake surgery until the chronic phase.

Methods
A total of 87 patients with glioma who underwent awake surgery were included, and of these 66 patients matched our inclusion criteria. Each patient was assessed for neurological/neuropsychological functions before surgery, as well as acute and chronic phase. Additionally, scores for the KPS were collected.

Results
Almost all functions recovered within 3 months postoperatively, even when transient deficits were observed in the acute phase; however, deep sensory perception deficits and visuospatial cognitive disorders persisted into the chronic phase (15.4% of patients with parietal lesions, 14.3% of patients with right cerebral hemispheric lesion, respectively). KPS score ≥90 was achieved in 86.0% of patients with lower-grade glioma, whereas only 52.2% of glioblastoma patients scored ≥90. Primary causes of declined KPS were disorder of visuospatial cognition, sensorimotor function including deep sensation, aphasia, and emotional function.

Conclusions
Awake surgery leads to good functional outcome at the chronic phase of neurological/neuropsychological functions, except for deep sensory and visuospatial cognition. Because sensation and visuospatial cognitive disorder have major impacts on patients’ independence level, further importance should be placed on preserving these functions during surgery.
Evaluating Structural Interventions
Authors: Hensen B , Dringus S , Eakle R , Remme M , Hargreaves J 
Published: December 2018

Abstract
Evaluating structural interventions to understand whether they are effective, for whom, and in what context is critical to determining whether, where, and how to deliver structural interventions at scale. This chapter provides a comprehensive evaluation framework comprising three main components: impact of the intervention, process evaluation, and an economic evaluation. Featured within this chapter is the point that structural-level interventions are amenable to evaluation using adaptation of the gold-standard randomized controlled trial design. Where randomization is not feasible, however, the chapter provides alternative designs to evaluate effectiveness, including those that use the stepped-wedge cluster randomized trial, interrupted time series, and nonequivalent comparison group. Four types of economic evaluation techniques are also described.
Employment and Poverty Dynamics Before, During, and After the Crisis
Authors: Gábos András , Branyiczki Réka , Binder Barbara , Tóth István György 
Published: December 2018

Abstract
This chapter investigates how changes in employment and poverty relate to each other across the European Union’s Member States. Large employment volatility was accompanied by sizable changes in poverty rates between 2005 and 2012. Based on panel regression results, the poverty to employment elasticity was estimated to be around 25% on average. The role of changes in the poverty rates of individuals in jobless and non-jobless households and of changes in the share of those in jobless households differs greatly across countries. The success of poverty reduction depends to a large extent on three factors: the dynamics of overall employment growth, the fair distribution of employment growth across households with different levels of work intensity, and properly designed social welfare systems to smooth out income losses for families in need.
Financing Affordability
Authors: Coffin Sarah L. 
Published: December 2018

Abstract
Reinvestment in declining or poor areas is necessary to attract new middle-class residents, reduce concentrated poverty, and improve housing conditions for the poor. Private-sector housing and commercial real estate developers consistently argue that, without assistance from the public sector, projects are not economically feasible. However, fiscal and political constraints make local governments hesitant to provide direct subsidies to developers. Tax increment financing (TIF) is often offered as a politically attractive solution to this complicated development scenario. The expedited nature of TIF allows communities to fund projects and generate development investment through a highly decentralized process, potentially avoiding public involvement. This fiscalization of the development process raises key questions. Are the communities most in need of redevelopment benefiting from TIF, or do they compete for development? How does TIF’s “creative” financing strategy influence political fragmentation? This chapter illustrates these challenges and explores ways the tool can be used to promote inclusionary development practices and support creative affordable-housing strategies.
Beyond Education Triage
Authors: Tate William F. 
Published: December 2018

Abstract
Social policies seeking to ameliorate racial and economic segregation stem in part from the adverse disparities associated with the alternatives—limited income mobility, intractable concentrated poverty, negative health outcomes, constrained access to quality housing, and poor social services—which generate a cycle of economic inequalities and more segregation. Many social scientists have argued that high-quality educational opportunities for students experiencing segregation are linked to better life-course outcomes. Education could thus be viewed as a potential intervention to address segregation. This chapter argues that the predominant approach to educational reform is analogous to triage in medicine. The effects of triage policy have been anemic. Its failure is reinforcing segregation. Instead, we need to develop a different approach to education and youth development, an approach that takes an intergenerational perspective on education achievement, attainment, and youth development in our nation’s most segregated communities. Examples are provided.
Ontological History
Authors: Nail Thomas 
Published: December 2018

Abstract
This chapter lays out an original method for the study of the history of ontology. It also critiques two major problems in the study of ontology: stasis and reductionism. Ontological practice is a historical and kinetic activity, and it therefore makes an important intervention into the study of ontology more broadly. What is at stake, therefore, in the development of an ontology of motion is a solution to these two problems. In addition, the chapter develops a theory of ontology as a practice of graphism. Finally, it provides an outline of the plan of the book and the major theses that will be argued herein.
Grammaticalization in Africa
Authors: Heine Bernd 
Published: December 2018

AbstractSub-Saharan Africa is an area for which hardly any earlier written documents are available. The student of African languages is therefore at a disadvantage when it comes to reconstructing processes of grammaticalization. That this is nevertheless possible has been demonstrated in a number of studies, using a conjunction of internal reconstruction and diachronic typological generalizations as a tool. After presenting an overview of the state of the art in grammaticalization studies in African languages, the present chapter is concerned with a more theoretical issue, namely the question of how grammaticalization processes arise. To this end, two contrasting hypotheses are discussed, namely the ‘parallel reduction’ and the ‘meaning-first’ hypotheses. Evidence from African languages suggests that it is the second hypothesis that is correct, but that both hypotheses nevertheless have their place in a framework of grammaticalization.