bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extent of Exclusions for Chronic Conditions in Breast Cancer Trials
Authors: Kronish Ian M , Fenn Kathleen , Cohen Laura , Hershman Dawn L , Green Paige , Jenny Lee Sung A , Suls Jerry 
Published: October 2018

Abstract
Experts have expressed concerns that patients with chronic conditions are being excessively excluded from cancer randomized clinical trials (RCTs), limiting generalizability. Accordingly, we queried clinicaltrials.gov to determine the extent to which patients with chronic conditions were excluded from phase III cancer trials, using National Cancer Institute-sponsored breast cancer RCTs as a test case. Two physicians independently coded for the presence of 19 prevalent chronic conditions within eligibility criteria. They also coded for exclusions based on performance status and vague criteria that could have broadly excluded patients with chronic conditions. The search identified 58 RCTs, initiated from 1993 to 2012. Overall, 88% of trials had at least one exclusion for a chronic condition, performance status, or vague criterion. The three most commonly excluded conditions were chronic kidney disease, heart failure, and ischemic heart disease. Our study demonstrated that patients with prevalent chronic conditions were commonly excluded from National Cancer Institute-sponsored RCTs.
Histopathologic Correlates of Familial Hemophagocytic Lymphohistiocytosis Isolated to the Central Nervous System
Authors: Solomon Isaac H , Li Hojun , Benson Leslie A , Henderson Lauren A , Degar Barbara A , Gorman Mark P , Duncan Christine N , Lidov Hart G , Alexandrescu Sanda 
Published: October 2018

AbstractFamilial hemophagocytic lymphohistiocytosis (HLH) is an immune hyperactivation syndrome caused by mutations in genes associated with cytotoxic T-cell and NK-cell function. While neurological manifestations frequently accompany systemic inflammation at initial presentation, isolated central nervous system (CNS) involvement is rare, and the histological correlates are not well described. We present 3 patients (ages 5, 6, and 7 years) with CNS-isolated familial HLH, who presented with a variety of neurological symptoms and underwent brain biopsies for multifocal enhancing supratentorial and infratentorial lesions. Biopsy slides from all 3 patients revealed similar findings: perivascular lymphocytes, predominantly CD3+ T-cells (CD4>CD8) with occasional intramural infiltration of small vessels; scattered histiocytes without hemophagocytosis; parenchymal and leptomeningeal inflammation varying from mild and focal to severe and sheet-like with associated destructive lesions. There was no evidence of demyelination, neoplasia, or infection. Genetic testing identified compound heterozygous mutations in PRF1 (Patients 1 and 2) and UNC13D (Patient 3), with no evidence of systemic disease except decreased NK-cell function. All 3 patients were treated with hematopoietic stem cell transplantation with marked improvement of symptoms. These findings combined with the poor outcomes associated with delayed diagnosis and lack of aggressive treatment highlight the need to consider HLH in the differential diagnosis of inflammatory brain lesions.
Metalogic and the Overgeneration Argument
Authors: Florio Salvatore , Incurvati Luca 
Published: October 2018

AbstractA prominent objection against the logicality of second-order logic is the so-called Overgeneration Argument. However, it is far from clear how this argument is to be understood. In the first part of the article, we examine the argument and locate its main source, namely, the alleged entanglement of second-order logic and mathematics. We then identify various reasons why the entanglement may be thought to be problematic. In the second part of the article, we take a metatheoretic perspective on the matter. We prove a number of results establishing that the entanglement is sensitive to the kind of semantics used for second-order logic. These results provide evidence that by moving from the standard set-theoretic semantics for second-order logic to a semantics which makes use of higher-order resources, the entanglement either disappears or may no longer be in conflict with the logicality of second-order logic.
Evidence for diurnal periodicity of earthquakes from midnight to daybreak
Authors: Hao Jinlai , Zhang Jinhai , Yao Zhenxing 
Published: October 2018

Abstract
Previously, inadequate earthquake catalogs and the lack of method made it challenging, if not impossible, to determine the dominant period of earthquake occurrence. With the advent of densely distributed seismic stations in Japan since 2002, 410 642 M1.0+ earthquakes have been cataloged under the mainland within 30-km depth, which provide a superb dataset to identify the periodicity of earthquakes. We processed this catalog using time-frequency analyses and daily stacking, which are powerful in extracting weak periodical signal from strong random noises. We concentrated on the time sector from 0:00 to 6:00 (i.e. from midnight to daybreak), which is a reliable time window for much higher detectability of weak earthquakes, since it has the lowest affects from cultural noises. We successfully observed two apparent periodicities of 12- and 24-hour, which are much smaller than the fortnightly periodicity presented previously in the literature. Synthetic earth tides, after intentionally ignoring the contribution from the Moon, present similar dominant periods as the earthquakes. This may indicate that the dominant period of earthquakes is statistically associated with the Sun rather than the Moon. The daily stacking number of earthquakes using a 15-minute or 1-hour interval shows a peak around 1:30, rather than usually expected 3:00 to 4:00. In addition, bigger earthquakes show more evident variations in the stacking results, and the trend is very consistent for various lower limits of earthquake magnitude from M1.0 to M4.0. These discoveries settled the disputes on the existence of the periodicity of earthquakes since 1886 and may open a window to unravel the mystery of earthquakes.
Embedding Learning and Assessment Within Police Practice: The Opportunities and Challenges Arising from the Introduction of the PEQF in England and Wales
Authors: Wood Dominic A 
Published: October 2018

Abstract
This article reflects upon the development of the Policing Education Qualifications Framework (PEQF) in England and Wales and considers the implications it will have for policing degrees. Given the topic, the article is primarily forward-looking, but it draws upon the experiences of having worked closely with police for over 20 years in designing bespoke policing degree programmes. It is offered as an opinion piece. The PEQF represents a significant step change in the development of police training and education. In particular, it places tertiary education at the centre of all aspects of learning within the police organization. The article welcomes the PEQF as a significant opportunity to develop our understanding of police practice. In particular, it provides an impetus to explore ways of embedding learning and assessment within operational police practice. However, this will require both investment and a substantial change programme to ensure that police services have the appropriate infrastructure to support tertiary levels of learning and assessment. It will also require a cultural shift within both universities and police organizations. Most importantly, if the PEQF is to fulfil its potential, police services will need to embrace, promote, and enable reflective practitioners and become reflective practices in the fullest sense. If this is achieved, I argue, the policing degrees of tomorrow will be radically transformed for the better.
Distance to treatment as a factor for loss to follow up of hepatitis C patients in North East England
Authors: Simpson H , Manley P , Lawler J , Morey S , Buchanan E , Hewett M , Knowles J , Miller C , McCarron B , Valappil M , McPherson S 
Published: October 2018

Abstract

Background
A large proportion of the 200 000 HCV-infected individuals in the UK are undiagnosed or lost to follow-up. Engaging known infected individuals in treatment is essential for elimination.

Methods
Using PHE surveillance data and HCV treatment registers from North East of England (NE) treatment centres for 1997–2016, we estimated the number of HCV cases not linked to treatment and the proportion with active infection. We compared distances of treated and untreated cases to treatment services, and assessed the effect of expanding HCV treatment into existing drug and alcohol treatment centres in the NEE on treatment accessibility.

Results
The odds of being treated was associated with distance to treatment services. Confirmatory results for ~50% were not reported to PHE NE. Overall, 3385 patients reported to PHE NE had no record of treatment; we estimated 1621 of these may have been lost to follow-up after confirmation of active infection.

Conclusions
Poor access to healthcare services may contribute to under-diagnosis or loss to follow-up. Expanding HCV treatment delivery into NEE drug and alcohol treatment centres would improve the accessibility of treatment services to people infected with/at risk of HCV. This may increase the proportion receiving treatment and support progress towards elimination.
Borrowing for Growth: Big Pushes and Debt Sustainability in Low-Income Countries
Authors: Zanna Luis-Felipe , Buffie Edward F , Portillo Rafael , Berg Andrew , Pattillo Catherine 
Published: October 2018

AbstractThe paper evaluates big push borrowing-and-investment programs in a new model-based framework of debt sustainability that is explicitly designed for policy analysis. The new framework is grounded in a fully-articulated, dynamic macroeconomic model. It allows for financing schemes that mix concessional, external commercial, and domestic debt, while taking into account the impact of public investment on growth and constraints on the speed and magnitude of fiscal adjustment. Supplementing concessional loans with nonconcessional borrowing in world capital markets is generally a high-risk, high-return strategy. It may greatly enhance the prospects for debt sustainability or lead to spectacular failure; much depends on the fine details governing debt contracts, the dynamics of growth, and the speed of fiscal adjustment.
Vesicular hand dermatitis
Authors: Sobering Geraldine , Dika Cheryl 
Published: October 2018

Abstract:
Vesicular hand dermatitis is a type of eczema involving the fingers, hands, and sometimes the feet. It is common in primary care, requiring prompt treatment to prevent chronicity. The cause is often unknown, making the condition challenging to treat. Management consists of avoiding irritants and using emollients and topical corticosteroids.
Clinical Overview and Considerations for the Management of Opioid-induced Constipation in Patients With Chronic Noncancer Pain
Authors: Viscusi Eugene R. 
Published: October 2018

Objectives:
Opioid analgesics may be associated with chronic adverse effects, such as opioid-induced constipation (OIC). Available and emerging prescription medications for OIC in patients with chronic noncancer pain are described, including concerns and challenges associated with OIC management.

Methods:
Narrative review.

Results:
OIC is characterized by a change in bowel habits and defecation patterns that occurs when initiating opioid therapy and is associated with reduced bowel frequency, straining, sensation of incomplete evacuation, and/or patient distress related to bowel habits. Prescription medications are indicated when OIC persists despite conservative approaches (eg, increased fiber and fluid intake, exercise, over-the-counter laxatives and stool softeners). Phase 3 studies have demonstrated the efficacy of peripherally acting µ-opioid receptor antagonists (PAMORA; methylnaltrexone, naloxegol, naldemedine), and a chloride channel activator (lubiprostone) for improving OIC in patients with chronic noncancer pain. Although head-to-head studies are lacking, a meta-analysis demonstrated that μ-opioid receptor antagonists were more effective than placebo for the treatment of OIC. The most common adverse effects associated with prescription medications for OIC are gastrointestinal related (eg, nausea, diarrhea, abdominal pain, or distention), with most being mild or moderate in severity. Therapy currently in development for OIC includes the PAMORA axelopran.

Discussion:
Health care providers should be aware of this complication in patients receiving opioids and should monitor and address constipation-related symptoms to optimize pain management and improve patient quality of life.
Pharmacovigilance Program of India: history, evolution and current status
Authors: Thatte Urmila M. , Chaudhari Nayan L. , Gogtay Nithya J. 
Published: October 2018

SummaryUnlike developed nations most of whom put into place systems of pharmacovigilance in the early 1960s following the thalidomide disaster, India's Pharmacovigilance Program formally began only in the mid-1980s. After several unsuccessful attempts, a robust program was put in place by the Central Drugs Standard Control Organization in 2010 called the Pharmacovigilance Program of India. Today, this is a stable system with the Indian regulator at the helm, a formal legislation in place to support the program and a National Coordinating Center located at the Indian Pharmacopoeia Commission. In the 8 years since its resurrection, the activities have expanded by leaps and bounds. There are 250 adverse reactions monitoring centers throughout the country and India contributes 1.7% of Individual Case Safety Reports to the Uppsala Monitoring Center's database. The WHO, recognizing India's concerted efforts in the area of pharmacovigilance, established its first WHO Collaborating Centre for Pharmacovigilance in Public Health Programs and Regulatory Services at the National Coordinating Center. The proposed expansion of the program in the coming years will further strengthen the cause of medicines safety in the country in line with the WHO's Third Global Patient Safety Challenge of Medication without Harm.
Sexual Counseling Provided by Cardiovascular Nurses
Authors: Gök Fadime , Demir Korkmaz Fatma 
Published: October 2018

Background:
Although sex lives of patients with cardiovascular disease (CVD) are affected in various ways and degrees, nurses working with these patients refrain from talking about sexual matters with their patients or encounter barriers trying to do so.

Objective:
The purpose of this descriptive study was to identify attitudes and beliefs of cardiovascular nurses regarding talking to their patients about sexual problems, perceived barriers, and proposed solutions.

Methods:
The sample included 170 nurses working for the cardiology and cardiac surgery departments of 1 university hospital, 2 ministry of health hospitals, and 2 private hospitals in Turkey. Data were collected between April and August 2015 through a 4-section questionnaire including the Sexual Attitude and Beliefs Scale. Descriptive, parametric, and nonparametric statistics were used to analyze the data.

Results:
Most (73.5%) reported not talking to their patients about sexual issues, and only 35.9% stated that they had been educated on how to do so. The major reason for nurses avoiding discussions about sex with their patients was not considering sexuality as a patient care priority (86.4%). Establishing privacy for the patient (91.2%) was the solution proposed by most nurses. The average score of the nurses on the Sexual Attitude and Beliefs Scale was only medium.

Conclusion:
Most of the nurses were untrained about how to talk about sexual problems with their patients and therefore were unable to talk about it freely.
Persistent Postural-Perceptual Dizziness—A Systematic Review of the Literature for the Balance Specialist
Authors: Trinidade Aaron , Goebel Joel A. 
Published: October 2018

Objective:
To present a systematic review of the current data on persistent postural-perceptual dizziness (PPPD), a useful and relatively new diagnosis for a disorder that has previously been known by many different names. In addition, to discuss diagnostic criteria and management strategies for this condition with the otologist in mind.

Data Sources:
CINAHL, Embase, PubMed, Medline, PsycINFO, PubMed, Google Scholar.

Review Method:
The phrase “persistent postural-perceptual dizziness” and its acronym “PPPD” were used.

Results:
From 318 articles, 15 were selected for full analysis with respect to PPPD. Most were case-control studies, with one consensus paper from the Bárány Society available. Overall, the pathophysiology of PPPD remains relatively poorly understood, but is likely to be a maladaptive state to a variety of insults, including vestibular dysfunction and not a structural or psychiatric one. Cognitive behavioral therapy, vestibular rehabilitation, selective serotonin uptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs) all seem to have a role in its management.

Conclusions:
PPPD is useful as a diagnosis for those treating dizziness as it helps to define a conglomeration of symptoms that can seem otherwise vague and allows for more structured management plans in those suffering from it.
Can Preoperative High Resolution Computed Tomography Be Rationalized in Adult Cochlear Implant Candidates?
Authors: Gaskell Peter , Muzaffar Jameel , Colley Steve , Coulson Chris 
Published: October 2018

Objective:
To establish whether criteria can be used to identify patients who do not need high resolution computed tomography (HRCT) scans before cochlear implant operations, by retrospectively applying a preoperative selection pathway, the Cambridge Cochlear Implant Protocol (CCIP).

Study Design:
Retrospective case series.

Setting:
Tertiary referral center, Queen Elizabeth Hospital, Birmingham, UK (QEHB).

Patients:
One hundred adult patients receiving primary cochlear implantation (CI) operations from April 2015 to July 2016 performed at the QEHB who received preoperative HRCTs.

Main Outcome Measures:
Etiology of hearing loss and anatomical abnormalities were collected by reanalyzing HRCT scans. Patients were retrospectively grouped according to criteria to restrict HRCT use derived from the Cambridge Cochlear Implant Programme (CCIP). The two main outcomes, recorded management change and significant abnormalities, were compared between the two CCIP groups, scanned and not scanned.

Results:
Twenty-six patients had significant abnormalities detected on imaging, 16 in the scanned group and 10 in the not scanned group (p = 0.152). Five patients had a recorded management change as a result of HRCT scan, four scanned group, one not scanned group (p = 0.107). Significant abnormalities and recorded management change were seen across all etiological subgroups of hearing loss.

Conclusion:
The anatomy within the temporal bone is variable amongst CI recipients. Recorded management change and significant abnormalities occurred in both CCIP groups and across many etiologies of hearing loss patients. No specific group, based on the etiology of their hearing loss could be identified that do not require preoperative HRCT. Therefore, it is recommended that all CI patients should continue to receive preoperative HRCT imaging.
Prior History of Pancreatitis Accelerates the Development of Pancreatic Adenocarcinoma
Authors: Phillips Anna Evans , Shah Nilesh , Borhani Amir A. , Yadav Dhiraj , Brand Randall E. 
Published: October 2018

Objectives
Presentation of pancreatic adenocarcinoma (PC) as acute pancreatitis (AP), association of chronic pancreatitis (CP) with PC, and role of inflammation in PC carcinogenesis are well recognized. We hypothesized that inflammatory changes associated with remote history of AP (≥2 years before PC diagnosis) would result in earlier age of PC diagnosis.

Methods
We evaluated PC patients prospectively enrolled in the Pancreatic Adenocarcinoma Gene Environment Risk (PAGER) study at the University of Pittsburgh for history of pancreatitis and reviewed relevant medical records and imaging studies. Univariate and multivariable linear regression analyses evaluated the relationship between PC and remote history of AP.

Results
Among 790 patients with histologically confirmed PC, 114 (14.4%) had a history of pancreatitis (AP within 2 years of PC diagnosis in 69 [8.7%], remote history of AP in 28 [3.5%], CP in 4 [0.5%], and unknown duration of pancreatitis in 13 [1.6%]). After controlling for age, sex, body mass index, smoking, alcohol history, and diabetic status at diagnosis, patients with a remote history of AP were diagnosed on average 4.7 years earlier with PC when compared with PC patients without history of AP (P < 0.035).

Conclusions
Remote history of AP may accelerate carcinogenesis in PC.
Concordance of the Balthazar Grade and the Revised Atlanta Classification
Authors: Li Weiran , Luo Shuanghong , Zhu Yu , Shu Min , Wen Yang , Wang Zhiling , Wan Chaomin 
Published: October 2018

Objectives
The aim of this study was to compare the concordance of the Balthazar grade and the revised Atlanta classification and then establish a modified radiological scoring system that would predict 3 degrees of severity of acute pancreatitis (AP) based on the latest Atlanta classification.

Methods
A retrospective study enrolling pediatric inpatients with AP who had completed computed tomography was conducted between January 2006 and March 2018. The concordance of the 2 radiological scoring systems was assessed with κ statistic.

Results
The Balthazar grade was unable to accurately predict the severity of AP compared with the revised Atlanta classification. However, a modified Balthazar grading system defining patents with Balthazar grades A to C as mild, grade D as moderately, and grade E as severe presented perfect agreement with the revised Atlanta classification across the enrolled population (κ, 0.85; 95% confidence interval, 0.73–0.97). The concordance of the modified Balthazar score and the revised Atlanta classification remained a perfect degree of agreement across repeated tests in 90 random samples (κ, 0.85; 95% confidence interval, 0.85–0.85).

Conclusions
The modified Balthazar grade demonstrated perfect agreement with the latest Atlanta classification for AP severity scoring. As such, the modified Balthazar grade can be used to predict 3 degrees of severity of AP.
Predictive Factors for Autoimmune Pancreatitis Relapse After 3 Years of Maintenance Therapy
Authors: Nakamura Akira , Ozawa Makiko , Watanabe Takayuki , Ito Tetsuya , Muraki Takashi , Hamano Hideaki , Koinuma Masayoshi , Kawa Shigeyuki 
Published: October 2018

Objectives
Oral corticosteroid treatment is the standard therapy for autoimmune pancreatitis (AIP) and is highly effective. However, relapse may occur during maintenance therapy (MT). We aimed to clarify the predictive factors for relapse after 3 years of MT for use in deciding on the continuation of long-term MT.

Methods
Among 56 retrospectively recruited AIP patients who received corticosteroid remission induction therapy followed by MT for a minimum of 5 years, 38 subjects were enrolled after exclusion criteria and divided into the relapse group of patients who experienced relapse after 3 years of MT and the nonrelapse group of patients who did not.

Results
According to multivariate analysis, at least 4 other organ involvement numbers at diagnosis (hazard ratio, 5.82; 95% confidence interval, 1.203–28.192) and IgG of 1400 mg/dL or greater at 3 years of MT (hazard ratio, 4.41; 95% confidence interval, 1.096–17.790) were predictive factors for relapse after MT for 3 years, with patients exhibiting both predictive factors having a higher cumulative relapse rate than those with 1 or fewer predictive factor.

Conclusions
We uncovered 2 predictive factors for AIP relapse after 3 years of MT. These findings will assist in deciding corticosteroid therapy regimens at 3 years of MT to minimize AIP relapse risk and adverse corticosteroid effects.