bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurosurgical Resident Exposure to Pediatric Neurosurgery: An Analysis of Resident Case Logs
Authors: White Michael D. , Zollman Joshua , McDowell Michael M. , Agarwal Nitin , Abel Taylor J. , Hamilton David K. 
Published: May 2019

<b><i>Introduction:</i></b> The purpose of this study is to identify the national trends of exposure to pediatric procedures during neurosurgical residency and to subsequently evaluate how neurosurgery residents’ experiences correlate with the minimum requirements set forth by the American College of Graduate Medical Education (ACGME). <b><i>Methods:</i></b> ACGME resident case logs from residents graduating between 2013 and 2017 were retrospectively reviewed. These reports were analyzed to determine trends in resident operative experience in pediatric procedures. The number of cases performed by residents was compared to the required minimums set by the ACGME within each pediatric surgical category. A linear regression analysis and <i>t</i> tests were utilized to analyze the change in cases performed over the study period. <b><i>Results:</i></b> A mean of 98.8 procedures were performed for each of the 877 residents graduating between 2013 and 2017. The total number of pediatric procedures declined at a rate of 1.7 cases/year (<i>r</i><sup>2</sup> = 0.77, <i>p</i> = 0.05). Spine and cerebrospinal fluid diversion procedures showed decreasing trends at rates of 1.9 (<i>r</i><sup>2</sup> = 0.70, <i>p</i> = 0.08) and 1.2 (<i>r</i><sup>2</sup> = 0.70, <i>p</i> = 0.08) cases/year, respectively. The number of trauma and brain tumor cases were shown to have increasing rates at 1.0 (<i>r</i><sup>2</sup> = 0.86, <i>p</i> = 0.02) and 0.3 (<i>r</i><sup>2</sup> = 0.69, <i>p</i> = 0.08) cases/year, respectively, with trauma cases showing significant increases. There was also a trend of increasing cases logged as the lead resident surgeon by 12.9 cases/year (<i>r</i><sup>2</sup> = 0.99, <i>p</i> &#x3c; 0.001). The number of cases performed by the average graduating resident was also significantly higher than the minimums required by the ACGME; residents, on average, performed 3 times the required minimum number of pediatric cases. <b><i>Conclusion:</i></b> Neurosurgical residents graduating from 2013 to 2017 reported significantly higher volumes of pediatric neurosurgery cases than the standards set for by the ACGME. During this time, there was also a significant trend of increasing cases logged as the lead resident surgeon, suggesting more involvement in the critical portions of pediatric cases. There was also a significant, but not clinically impactful, decrease in pediatric case volumes during this time. However, the overall data indicate that residents are continuing to gain valuable pediatric experience during residency training.
Integrating Data From Randomized Controlled Trials and Observational Studies to Assess Survival in Rare Diseases
Authors: Torbicki Adam , Bacchi Marisa , Delcroix Marion , Farber Harrison W. , Ghofrani Hossein-Ardeschir , Hennessy Brian , Jansa Pavel , Mehta Sanjay , Perchenet Loïc , Pulido Tomas , Rosenberg Daniel , Rubin Lewis J. , Sastry B.K.S. , Simonneau Gérald , Sitbon Olivier , Souza Rogério , Wei Lee-Jen , Channick Richard , Benza Raymond 
Published: May 2019

Background:
Conducting randomized controlled trials to investigate survival in a rare disease like pulmonary arterial hypertension has considerable ethical and logistical constraints. In many studies, such as the Study with an Endothelin Receptor Antagonist in Pulmonary Arterial Hypertension to Improve Clinical Outcome (SERAPHIN) randomized controlled trial, evaluating survival is further complicated by bias introduced by allowing active therapy among placebo-treated patients who clinically deteriorate.

Methods and Results:

SERAPHIN enrolled and followed patients in the same time frame as the US Registry to Evaluate Early And Long-term PAH Disease Management, providing an opportunity to compare observed survival for SERAPHIN patients with predicted survival had they received real-world treatment as in the Registry to Evaluate Early And Long-term PAH Disease Management. From the Registry to Evaluate Early And Long-term PAH Disease Management (N=3515), 734 patients who met SERAPHIN eligibility criteria were selected and their data used to build a prediction model for time to death up to 3 years based on 10 baseline prognostic variables. The model was used to predict a survival curve for each of the 742 SERAPHIN patients via their baseline variables. The average of these predicted survival curves was compared with observed survival of the placebo (n=250) and macitentan 10 mg (n=242) groups using a log-rank test and Cox proportional hazard model. Observed mortality risk for patients randomized to placebo, 62% of whom were taking background pulmonary arterial hypertension therapy, tended to be lower than that predicted for all SERAPHIN patients (16% lower;
P
=0.259). The observed placebo survival curve closely approximated the predicted survival curve for the first 15 months. Beyond that time, observed risk of mortality decreased compared with predicted mortality, potentially reflecting the impact of crossover of patients in the placebo group to active therapy. Over 3 years, risk of mortality observed with macitentan 10 mg was 35% lower than predicted mortality (
P
=0.010).

Conclusions:
These analyses show that, in a rare disease, real-world observational data can complement randomized controlled trial data to overcome some challenges associated with assessing survival in the setting of a randomized controlled trial.

Clinical Trial Registration:

https://www.clinicaltrials.gov
. Unique identifiers: NCT00660179 and NCT00370214.
Natural History, Quality of Life, and Outcome in Cardiac Transthyretin Amyloidosis
Authors: Lane Thirusha , Fontana Marianna , Martinez-Naharro Ana , Quarta Candida Cristina , Whelan Carol J. , Petrie Aviva , Rowczenio Dorota M. , Gilbertson Janet A. , Hutt David F. , Rezk Tamer , Strehina Svetla G. , Caringal-Galima Joan , Manwani Richa , Sharpley Faye A. , Wechalekar Ashutosh D. , Lachmann Helen J. , Mahmood Shameem , Sachchithanantham Sajitha , Drage Edmund P.S. , Jenner Harvey D. , McDonald Rosie , Bertolli Ottavia , Calleja Alan , Hawkins Philip N. , Gillmore Julian D. 
Published: May 2019

Background:
Transthyretin amyloidosis cardiomyopathy (ATTR-CM) is an increasingly recognized cause of heart failure in older individuals. We sought to characterize the natural history of ATTR-CM and compare outcomes and quality of life among patients with acquired and hereditary forms of the disease.

Methods:
We studied 711 patients with wild-type ATTR-CM, 205 with hereditary ATTR-CM associated with the V122I variant (V122I-hATTR-CM), and 118 with non-V122I-hATTR-CM at the UK National Amyloidosis Center between 2000 and 2017. Patients underwent prospective protocolized evaluations comprising assessment of cardiac parameters, functional status by 6-minute walk test, quality of life according to the Kansas City Cardiomyopathy Questionnaire, and survival. Hospital service usage pre- and postdiagnosis was established using English central health records in a subset of patients.

Results:

There was substantial diagnostic delay, with patients using hospital services a median (interquartile range) of 17 (9–27) times during the 3 years before diagnosis, by which time quality of life was poor; diagnosis of wild-type ATTR-CM was delayed >4 years after presentation with cardiac symptoms in 42% of cases. Patients with V122I-hATTR-CM were more impaired functionally (
P
<0.001) and had worse measures of cardiac disease (
P
<0.001) at the time of diagnosis, a greater decline in quality of life, and poorer survival (
P
<0.001) in comparison with the other subgroups.

Conclusions:
ATTR-CM is an inexorably progressive and eventually fatal cardiomyopathy associated with poor quality of life. Diagnosis is often delayed for many years after symptoms develop. Improved awareness and wider use of recently validated diagnostic imaging methods are urgently required for patients to benefit from recent therapeutic developments.
Myocardial Strain and Cardiac Output are Preferable Measurements for Cardiac Dysfunction and Can Predict Mortality in Septic Mice
Authors: Hoffman Matthew , Kyriazis Ioannis D. , Lucchese Anna M. , de Lucia Claudio , Piedepalumbo Michela , Bauer Michael , Schulze P. Christian , Bonios Michael J. , Koch Walter J. , Drosatos Konstantinos 
Published: May 2019

Background
Sepsis is the overwhelming host response to infection leading to shock and multiple organ dysfunction. Cardiovascular complications greatly increase sepsis‐associated mortality. Although murine models are routinely used for preclinical studies, the benefit of using genetically engineered mice in sepsis is countered by discrepancies between human and mouse sepsis pathophysiology. Therefore, recent guidelines have called for standardization of preclinical methods to document organ dysfunction. We investigated the course of cardiac dysfunction and myocardial load in different mouse models of sepsis to identify the optimal measurements for early systolic and diastolic dysfunction.

Methods and Results

We performed speckle‐tracking echocardiography and assessed blood pressure, plasma inflammatory cytokines, lactate, B‐type natriuretic peptide, and survival in mouse models of endotoxemia or polymicrobial infection (cecal ligation and puncture, [
CLP
]) of moderate and high severity. We observed that myocardial strain and cardiac output were consistently impaired early in both sepsis models. Suppression of cardiac output was associated with systolic dysfunction in endotoxemia or combined systolic dysfunction and reduced preload in the
CLP
model. We found that cardiac output at 2 hours post‐
CLP
is a negative prognostic indicator with high sensitivity and specificity that predicts mortality at 48 hours. Using a known antibiotic (ertapenem) treatment, we confirmed that this approach can document recovery.

Conclusions

We propose a non‐invasive approach for assessment of cardiac function in sepsis and myocardial strain and strain rate as preferable measures for monitoring cardiovascular function in sepsis mouse models. We further show that the magnitude of cardiac output suppression 2 hours post‐
CLP
can be used to predict mortality.
What War Narratives Tell About the Psychology and Coalitional Dynamics of Ethnic Violence
Authors: Moncrieff Michael , Lienard Pierre 
Published: May 2019

AbstractModels of ethnic violence have primarily been descriptive in nature, advancing broad or particular social and political reasons as explanations, and neglecting the contributions of individuals as decision-makers. Game theoretic and rational choice models recognize the role of individual decision-making in ethnic violence. However, such models embrace a classical economic theory view of unbounded rationality as utility-maximization, with its exacting assumption of full informational access, rather than a model of bounded rationality, modeling individuals as satisficing agents endowed with evolved domain-specific competences. A newer theoretical framework hypothesizing the existence of a human coalitional psychology, an evolved domain of competence, allows us to make sense of core features of memorial narratives about ethnic violence. Qualitative data from the interviews of fifty-seven participants who were impacted by the Croatian Homeland War support expectations entailed by a coalitional psychology model of ethnic strife.
Indian Medical Traditions Between State and Village
Authors: Bode Maarten 
Published: May 2019

AbstractApart from an introduction to the eight essays that make up this special issue of Asian Medicine this opening piece discusses India’s hierarchical medical landscape and the politics of value involved. Inspired by recent scholarship, I argue on the one hand that state-sanctioned medicine—formal biomedicine and formal Indian medicine—and, on the other hand, subaltern medicine practiced by informal practitioners—both folk and biomedical—typify the Indian medical landscape. Forms of Indian medicine are not bounded by themselves. Their demarcation is a political act. These politics of signification beg to be deconstructed when we want policies concerning Indian medicine to be realistic and successful. After all, the assumption of this introduction and the special issue as a whole is that Indian medicine deserves a place next to biomedicine.
Medicine and the Cultural Politics of National Belongings in Contemporary India
Authors: Khalikova Venera R. 
Published: May 2019

AbstractThe Government of India claims to promote plural medical traditions, currently institutionalized under the acronym AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy). Yet, one medical system—Ayurveda—receives most social and ideological support: Ayurveda is routinely constructed as the only truly Indian, homegrown, and national medicine, while the national belonging of other AYUSH traditions is challenged. This essay explores discourses surrounding the promotion of AYUSH and the privileged position of Ayurveda, situating them within two competing nationalist ideologies: the ideology of inclusive secularism anchored in the principle of India’s cultural diversity and the ideology of Hindu nationalism, which promotes a distinctive image of India as a country with a culturally monolithic foundation. By doing so, I show how a nation can be differently imagined through one medical tradition or through medical plurality. Furthermore, by analyzing media reports, official statements, and the narratives of AYUSH practitioners, I outline factors that contribute to Ayurvedic hegemony. In particular, I argue that the exceptionalism of Ayurveda rests on the fact that, unlike other alternative medical systems in India, it has been promoted as both cultural (“Indian”) and universal medicine—that is, medicine with global appeal.
Structuring Chinese Energy Investments Under the Russian Law on Strategic Investments
Authors: Seliverstov Sergey S. , Krivonosov Vsevolod D. 
Published: May 2019

Abstract
As one of the world’s leading oil- and gas-exporting countries, Russia has many of the prerequisites for playing a significant role in achieving some of the energy policy objectives of China’s Belt and Road Initiative (BRI). In fact a number of multi-billion Chinese investments in the Russian energy sector have been made during the past few years. Taking the existing experience of Chinese energy investors into account, this article critically analyzes the legal and regulatory framework governing the production of natural resources and the making of energy investments in Russia. The Russian authorities consider energy as a sector of high strategic importance, necessitating increased attention by its legislator and supervising bodies. The article argues that the restrictions imposed on investors by Russia’s rigid legislation predetermine the participation of state-controlled companies and ensure that all major foreign investments in Russia’s oil and gas sector are assessed primarily for their political significance.
Chinese Foreign Investments in the European Union Energy Sector: The Regulation of Security Concerns
Authors: Bungenberg Marc , Hazarika Angshuman 
Published: May 2019

Abstract
Energy investments from China have been flowing into the European Union (EU) over the last decade at an increasing rate. Part of these investments are made under China’s Belt and Road Initiative (BRI) and involve Chinese State-owned Enterprises (SOEs). This flow of investments into critical sectors such as energy infrastructure and generation has raised considerable concern over their potential national security implications and prompted the European Commission to prepare new legislation to screen foreign investments in critical sectors, including energy. The new EU regulations complement existing investment screening mechanisms in a number of EU member states, and the application of EU merger control law. This article looks at the different screening and clearance mechanisms which Chinese investments in the energy sector may have to pass in the EU and aims to show how these screening mechanisms are used in practice.
Local-Scale Urban Energy Balance Observation under Various Sky Conditions in a Humid Subtropical Region
Authors: Shi Yurong , Zhang Yufeng , Li Riyi 
Published: May 2019

AbstractThe present study presents local-scale urban energy balance observations under various sky conditions in a humid subtropical region. The study site is a typical urban residential area in Guangzhou in which building density is 38%, vegetation coverage is 36%, and mean building height is 21 m. The observation was conducted at a 110-m-high tower using the eddy covariance technique from September to November 2016. The median diurnal pattern and daily maxima were achieved for all radiation components and turbulent fluxes. The Bowen ratio (β) results indicated a predominant role for sensible heat flux (QH) in the daytime and latent heat flux (QE) at night. The sky conditions played a significant part in the urban surface energy exchanges, showing that the median daily maxima of net radiation (Q*),QH, storage heat flux (ΔQS), surface albedo, andβall present a consistent order from large to small for clear, cloudy, and rainy days and a different order of rainy, clear, and cloudy days forQE. The mean daytimeQH/Q*,QE/Q*, ΔQS/Q*, andβchanged with urban density, whileQE/Q* andβalso varied with vegetation fraction. Furthermore, the adaptability of net all-wave radiation parameterization (NARP), objective hysteresis model (OHM), and local-scale urban meteorological parameterization scheme (LUMPS) were validated, given the index of agreements of 0.998 and 0.951 forQ* and ΔQSand the reasonable RMSEs forQHandQE. The present study helps to verify and improve the parameterizations of energy exchange over an urban surface in the humid subtropical region.
Response of Southern Ocean Ventilation to Changes in Midlatitude Westerly Winds
Authors: Waugh Darryn W. , McC. Hogg Andrew , Spence Paul , England Matthew H. , Haine Thomas W. N. 
Published: May 2019

ABSTRACTChanges in ventilation of the Southern Hemisphere oceans in response to changes in midlatitude westerly winds are examined by analyzing the ideal age tracer from global eddy-permitting ocean–ice model simulations in which there is an abrupt increase and/or a meridional shift in the winds. The age response in mode and intermediate waters is found to be close to linear; the response of a combined increase and shift of peak winds is similar to the sum of the individual responses to an increase and a shift. Further, a barotropic response, following Sverdrup balance, can explain much of the age response to the changes in wind stress. There are similar peak decreases (of around 50 years) in the ideal age for a 40% increase or 2.5° poleward shift in the wind stress. However, while the age decreases throughout the thermocline for an increase in the winds, for a poleward shift in the winds the age increases in the north part of the thermocline and there are decreases in age only south of 35°S. As a consequence, the change in the volume of young water differs, with a 15% increase in the volume of water with ages younger than 50 years for a 40% increase in the winds but essentially no change in this volume for a 2.5° shift. As ventilation plays a critical role in the uptake of carbon and heat, these results suggest that the storage of anthropogenic carbon and heat in mode and intermediate waters will likely increase with a strengthening of the winds, but will be much less sensitive to a meridional shift in the peak wind stress.
A Vortex-Based Doppler Velocity Dealiasing Algorithm for Tropical Cyclones
Authors: Chang Pao-Liang , Fang Wei-Ting , Lin Pin-Fang , Yang Ming-Jen 
Published: May 2019

AbstractIn this study, a vortex-based Doppler velocity dealiasing (VDVD) algorithm for tropical cyclones (TCs) is proposed. The algorithm uses a Rankine combined vortex model as a reference field for dealiasing based on an inner–outer iterative procedure. The structure of the reference vortex is adjusted in an inner iterative procedure of VDVD that applies the ground-based velocity track display (GBVTD) technique. The outer loop of the VDVD based on the GBVTD-simplex algorithm is used for center correction. The VDVD is able to recover not only the aliased Doppler velocities from a simulated symmetric vortex but also those superimposed with wavenumber-1 asymmetry, radial wind, or mean flow. For real cases, the VDVD provides dealiased Doppler velocity with 99.4% accuracy for all pixels, based on 472 elevation sweeps from a typhoon without landfall. It is suggested that the VDVD algorithm can improve the quality of downstream applications such as Doppler wind retrievals and radar data assimilations of TCs and other storms, such as tornadoes and mesocyclones, with vortex signatures.
Compliance of a Baby-Friendly Designated Hospital in Ghana With the WHO/UNICEF Baby and Mother-Friendly Care Practices
Authors: Agbozo Faith , Ocansey Doris , Atitto Prosper , Jahn Albrecht 
Published: May 2019

Background: Although the Baby-Friendly Hospital Initiative has improved breastfeeding rates globally, weak monitoring still affects hospital-level implementation. Research aim: To reassess compliance of a Baby-Friendly Hospital with the Ten Steps to Successful Breastfeeding, International Code of Marketing of Breast-milk Substitutes, HIV and Infant Feeding, and Mother-Friendly Care following the WHO/UNICEF global criteria. Methods: In this cross-sectional, prospective, mixed-methods study ( N = 180), clinical staff ( n = 60), pregnant women ( n = 40), postpartum mothers ( n = 60), and mothers of babies in intensive care ( n = 20) were randomly selected from one urban secondary-level public hospital in Ghana designated as Baby-Friendly in 2004 but never reassessed. Data were collected through interviews, document reviews, and observations using the revised WHO/UNICEF external reassessment tool and analyzed quantitatively using the Baby-Friendly Hospital Initiative computer tool. Scores higher than 80% signified a pass (high compliance). Scores rated as low (< 50%) and moderate (50–80%) signified noncompliance. Results: The facility passed the criteria for full compliance with the International Code (86%) but failed other components. Compliance with the Ten Steps was moderate (55%). Step 7 about rooming-in (84%) and Step 9 about human milk substitutes (100%) were passed, whereas Step 1 about written breastfeeding policies (0%), Step 2 about staff training (7%), and Step 4 about early breastfeeding initiation (31%) were met the least. Compliance with Mother-Friendly Care (34%) and HIV and Infant Feeding (47%) were low. Main implementation gaps were unavailability of policies and staff’s inadequate knowledge about Baby-Friendly practices. Conclusions: Improving staff training and maternal counseling, routinely reassessing designated facilities, and providing technical support in problematic areas might sustain implementation.