bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evolving Climate Services into Knowledge–Action Systems
Authors: Weichselgartner Juergen , Arheimer Berit 
Published: March 2019

AbstractThe current landscape of climate services represents a highly diverse and still growing range of programs, projects, and portals involved in developing and/or providing climate services at different administrative levels and spatial–temporal scales. The diversity of service producers, users, and policy arenas has created a highly heterogeneous data- and information-oriented service landscape, and the authors contend that the domain of climate services requires efforts toward agreed structures and forms of conceptualization, operationalization, and evaluation. It is proposed here that qualitative classification be applied into climate change adaptation products, services, and systems to better guide research, policy, and practice with a clear terminology and analysis framework. This differentiation allows the pinpointing of critical challenges associated with the production and application of climate-relevant information, as well as the identification of suitable metrics to assess the impact of climate services. The article concludes with recommendations to advance climate services into knowledge–action systems and increase their sustainability.
Cardiac Measures of Cognitive Workload: A Meta-Analysis
Authors: Hughes Ashley M. , Hancock Gabriella M. , Marlow Shannon L. , Stowers Kimberly , Salas Eduardo 
Published: March 2019

Objective: We aimed to provide an assessment of the impact of workload manipulations on various cardiac measurements. We further sought to determine the most effective measurement approaches of cognitive workload as well as quantify the conditions under which these measures are most effective for interpretation. Background: Cognitive workload affects human performance, particularly when load is relatively high (overload) or low (underload). Despite ongoing interest in assessing cognitive workload through cardiac measures, it is currently unclear which cardiac-based assessments best indicate cognitive workload. Although several quantitative studies and qualitative reviews have sought to provide guidance, no meta-analytic integration of cardiac assessment(s) of cognitive workload exists to date. Method: We used Morris and DeShon’s meta-analytic procedures to quantify the changes in cardiac measures due to task load conditions. Results: Sample-weighted Cohen’s d values suggest that several metrics of cardiac activity demonstrate sensitivity in response to cognitive workload manipulations. Heart rate variability measures show sensitivity to task load, conditions of event rate, and task duration. Authors of future work should seek to quantify the utility of leveraging multiple metrics to understand workload. Conclusion: Results suggest that assessment of cognitive workload can be done using various cardiac activity indicators. Further, given the number of valid and reliable measures available, researchers and practitioners should base their selection of a psychophysiological measure on the experimental and practical concerns inherent to their task/protocol. Applications: Findings bear implications for future assessment of cognitive workload within basic and applied settings. Future research should seek to validate conditions under which measurements are best interpreted, including but not limited to individual differences.
Tumor heterogeneity in oral and oropharyngeal squamous cell carcinoma assessed by texture analysis of CT and conventional MRI: a potential marker of overall survival
Authors: Ren Jiliang , Yuan Ying , Shi Yiqian , Tao Xiaofeng 
Published: March 2019

Background The combined prognostic value of texture analysis on computed tomography (CT) and conventional magnetic resonance imaging (MRI) in oral and oropharyngeal squamous cell carcinoma (OOSCC) has rarely been reported. Purpose To evaluate the ability of texture-based heterogeneity indices extracted from CT and conventional MRI to predict the overall survival (OS) of OOSCC patients. Material and Methods Eighty-eight patients with OOSCC underwent contrast-enhanced CT, and T2-weighted (T2W) and contrast-enhanced T1-weighted (T1W) imaging. For each imaging protocol, four histogram (HISTO) and six gray-level co-occurrence matrix (GLCM) parameters were extracted. Intraclass correlation coefficients (ICCs) were used to evaluate variation in inter-observer delineation. The association of clinicopathologic factors and texture parameters with OS was analyzed using log-rank testing and Cox regression. The Harrell Concordance Index (C-index) was used to evaluate the prognostic performance of the predictors and Cox model. Results Higher inter-observer delineation agreement of texture analysis on contrast-enhanced T1W imaging was observed relative to that on CT and T2W imaging. T stage ( P = 0.026, hazard ratio [HR] = 2.35), GLCM_Entropy on CT ( P = 0.003, HR = 3.15), and HISTO_Energy ( P = 0.036, HR = 0.27) and HISTO_Skewness ( P = 0.026, HR = 0.41) on contrast-enhanced T1W imaging were independent predictors for the OS of OOSCC patients. The multivariate Cox model performed strongly in predicting OS, with a significantly higher C-index than the independent predictors separately (C-index: 0.751 vs. 0.600–0.627, P < 0.005 for all). Conclusion Texture analysis using CT and conventional MRI could provide a valuable method for survival stratification of OOSCC patients.
Computerized texture analysis predicts histological invasiveness within lung adenocarcinoma manifesting as pure ground-glass nodules
Authors: Yang Yang , Wang Wei-Wei , Ren Yan , Jin Xian-Qiao , Zhu Quan-Dong , Peng Cheng-Tao , Liu Han-Qiu , Zhang Jun-Hai 
Published: March 2019

Background Differentiating histological invasiveness of lung adenocarcinoma that manifest as pure ground-glass nodules (pGGNs) is challenging. Purpose To investigate the value of computerized texture analysis for predicting histological invasiveness of pulmonary adenocarcinoma that manifest as pGGNs. Material and Methods The study consisted of 138 patients with 142 pathologically confirmed lung adenocarcinomas who had undergone computed tomography (CT) imaging. Each nodule was manually segmented and 96 texture features were extracted automatically. Hierarchical cluster analysis, the ReliefF method, and a logistic regression model were used for dimension reduction and feature selection. Performance of the texture features was evaluated by receiver operating characteristic (ROC) curve analysis. Results Pathologic analysis confirmed 26 adenocarcinomas in situ (AISs), 71 minimally invasive adenocarcinomas (MIAs), and 45 invasive adenocarcinomas (IACs). Seven best features (10 percentile, maximum 3D diameter, surface volume ratio, elongation, maximum probability, large area low gray level emphasis, and zone entropy) were chosen by using hierarchical cluster analysis and the ReliefF method. Multivariate logistic regression analysis revealed larger maximum 3D diameter, lower surface volume ratio, and higher zone entropy as independent differentiators of IACs (adjusted odds ratio [OR] = 1.59, P = 0.011; OR = 0.47, P = 0.002; OR = 6.78, P = 0.001, respectively). The accuracy based on the logistic regression model using these features for differentiating IAC from AIS/MIA reached 78.7% with ROC analysis (AUC = 0.861; sensitivity = 78.0%; specificity = 80.0%). Conclusion In patients with pGGN, computerized texture analysis has the potential to differentiate histological invasiveness; maximum 3D diameter, surface volume ratio, and zone entropy in particular are independent differentiators of IACs from AISs and MIAs.
Mollicutes antibiotic resistance profile and presence of genital abnormalities in couples attending an infertility clinic
Authors: Maldonado-Arriaga Brenda , Escobar-Escamilla Noé , Pérez-Razo Juan Carlos , Alcaráz-Estrada Sofia Lizeth , Flores-Sánchez Ignacio , Moreno-García Daniel , Pérez-Cabeza de Vaca Rebeca , Mondragón-Terán Paul , Shaw Jonathan , Hernandez-Cortez Cecilia , Castro-Escarpulli Graciela , Suárez-Cuenca Juan Antonio 
Published: March 2019

Objective The present study aimed to identify Mollicutes infection in the reproductive system. We also examined the microbiological, biochemical, and antimicrobial profiles of Mollicutes infection, which are potentially associated with clinical reproductive abnormalities causing infertility in couples. Methods Thirty-seven couples who were attending an infertility clinic were enrolled. Detection of genital mycoplasmas was performed in cervicovaginal samples or male urethral swabs. Microbiological culture and biochemical and antimicrobial profiles were characterized using a Mycoplasma kit. The results were associated with reproductive abnormalities, as assessed by medical specialists from the infertility clinic. Results Up to 28.3% of all biological samples (n = 74) showed positive cultures. Bacterial isolates were Ureaplasma urealyticum (71.4%), Mycoplasma hominis (9.5%), or coinfections (19%). Most Mollicutes showed significant resistance to fluoroquinolones, macrolides, and tetracycline; and showed susceptibility to doxycycline, josamycin, and pristinamycin. The presence of resistant strains to any antibiotic was significantly associated with genital abnormalities (χ2 test, relative risk = 11.38 [95% confidence interval: 5.8–22.9]), particularly in women. The highest statistical association was found for macrolide-resistant strains. Conclusion The microbiological antibiotic resistance profile is epidemiologically associated with abnormalities of the reproductive system in couples attending an infertility clinic.
The relationship and threshold of serum phosphate with regard to the 28-day mortality risk in sepsis patients undergoing continuous renal replacement therapy
Authors: Wang Hai , Bai Zheng-Hai , Lv Jun-Hua , Sun Jiang-Li , Shi Yu , Zhang Zheng-Liang , Pei Hong-Hong 
Published: March 2019

Objective To investigate the association between serum phosphate levels and the risk of 28-day mortality in critically-ill patients with septic acute kidney injury (AKI) undergoing continuous renal replacement therapy (CRRT). Methods This retrospective cohort study analysed data from critically-ill patients with septic AKI who underwent CRRT between January 2009 and September 2016. Demographic, clinical and routine biochemical data were retrieved from a database and analysed to identify risk factors for 28-day mortality. Results A total of 796 patients were included in the analyses. Multivariate regression analyses showed that phosphate (0 h), phosphate (24 h) and delta phosphate were associated with the 28-day mortality in patients with septic AKI undergoing CRRT. The adjusted odds ratios (95% confidence interval) were 1.12 (1.03, 1.22), 1.22 (1.14, 1.30) and 1.12 (1.04, 1.20) for phosphate (0 h), phosphate (24 h) and delta phosphate, respectively. Curve fitting and threshold analyses showed that when phosphate (0 h) was between 5.6 mg/dl and 8.7 mg/dl, phosphate (24 h) was >3.8 mg/dl and delta phosphate was >–1, the 28-day mortality risk increased significantly. Conclusion In patients with septic AKI undergoing CRRT, serum phosphate level was associated with the prognosis of patients in terms of 28-day mortality.
Predictors of Persistent Postoperative Pain at Minimum 2 Years After Arthroscopic Treatment of Femoroacetabular Impingement
Authors: Stone Austin V. , Malloy Philip , Beck Edward C. , Neal William H. , Waterman Brian R. , Bush-Joseph Charles A. , Nho Shane J. 
Published: March 2019

Background: Hip arthroscopy for femoroacetabular impingement syndrome (FAIS) is a rapidly expanding field, and preoperative factors predictive of persistent postoperative pain are currently unknown. Purpose: To identify predictors for persistent postoperative pain at the site of surgery after hip arthroscopy for FAIS. Study Design: Case-control study; Level of evidence, 3. Methods: Patients who underwent hip arthroscopy for FAIS and had a minimum 2-year follow-up with patient-reported outcomes (PROs) were included in this study. Patients with previous open hip surgery and diagnoses other than FAIS were excluded. Patients were grouped by visual analog scale scores for pain as limited (<30) and persistent (≥30). Patient factors and outcomes were analyzed with univariate and correlation analyses to build a logistic regression model to identify predictors of persistent postoperative pain. Results: The limited pain (n = 514) and persistent pain (n = 174) groups totaled 688 patients (449 females). There was a statistically significant difference in age between groups, with the persistent pain group being older than the low pain group (35.9 ± 12.2 vs 32.4 ± 12.6, respectively; P = .002). Patients with persistent postoperative pain demonstrated significantly lower preoperative PRO scores in the Hip Outcome Score–Activities of Daily Living (57.6 ± 21.2 vs 67.7 ± 16.8), Hip Outcome Score–Sport Specific (35.9 ± 23.9 vs 44.1 ± 22.7), modified Harris Hip Score (51.6 ± 16.2 vs 59.6 ± 12.9), and International Hip Outcome Tool (32.0 ± 16.8 vs 40.0 ± 17.82) but no significant differences in preoperative visual analog scale scores for pain (7.3 ± 1.8 vs 7.2 ± 1.7). Mean postoperative PRO differences between pain groups were all statistically significant. Bivariate logistic regression analysis demonstrated that history of anxiety or depression (odds ratio, 1.8; 95% CI, 1.02-3.32; P = .042), revision hip arthroscopy (odds ratio, 8.6; 95% CI, 1.79-40.88; P = .007), and a low preoperative modified Harris Hip Score (odds ratio, 0.97; 95% CI, 0.95-0.99; P = .30) were predictors of persistent postoperative pain. Conclusion: Independent predictors for persistent postoperative pain include revision hip arthroscopy and mental health history positive for anxiety and depression. Our analysis demonstrated significant improvements in pain and functional PROs in the limited pain and persistent pain groups; however, those with persistent pain demonstrated significantly lower PRO scores.
Acute Anterior Cruciate Ligament Rupture: Repair or Reconstruction? Two-Year Results of a Randomized Controlled Clinical Trial
Authors: Hoogeslag Roy A. G. , Brouwer Reinoud W. , Boer Barbara C. , de Vries Astrid J. , Huis in ‘t Veld Rianne 
Published: March 2019

Background: Contemporary anterior cruciate ligament (ACL) suture repair techniques have been subject to renewed interest in recent years. Although several clinical studies have yielded good short-term results, high-quality evidence is lacking in regard to the effectiveness of this treatment compared with ACL reconstruction. Hypothesis: Dynamic augmented ACL suture repair is at least as effective as anatomic single-bundle ACL reconstruction for the treatment of acute ACL rupture in terms of patient self-reported outcomes at 2 years postoperatively. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: After stratification and randomization, 48 patients underwent either dynamic augmented ACL suture repair or ACL reconstruction with a single-bundle, all-inside, semitendinosus technique. The International Knee Documentation Committee (IKDC) subjective score at 2 years postoperatively was the primary outcome measure. Patient-reported outcomes (IKDC subjective score, Knee injury and Osteoarthritis Outcome Score, Tegner score, visual analog scale for satisfaction), clinical outcomes (IKDC physical examination score, leg symmetry index for the quadriceps, hamstrings strength, and jump test battery), and radiological outcomes as well as adverse events including reruptures were recorded. Analyses were based on an intention-to-treat principle. Results: The lower limit for the median IKDC subjective score of the repair group (86.2) fell within the prespecified noninferiority margin, confirming noninferiority of dynamic augmented ACL suture repair compared with ACL reconstruction. No statistical difference was found between groups for median IKDC subjective score (repair, 95.4; reconstruction, 94.3). Overall, 2 reruptures (8.7%) occurred in the dynamic ACL suture repair group and 4 reruptures (19.0%) in the ACL reconstruction group; further, 5 repeat surgeries—other than for revision ACL surgery—took place in 4 patients from the dynamic ACL suture repair group (20.8%) and in 3 patients from the ACL reconstruction group (14.3%). Conclusion: Dynamic augmented ACL suture repair is not inferior to ACL reconstruction in terms of subjective patient-reported outcomes as measured with the IKDC subjective score 2 years postoperatively. However, for reasons other than revision ACL surgery due to rerupture, a higher number of related adverse events leading to repeat surgery were seen in the dynamic augmented ACL suture repair group within 2 years postoperatively. Clinical Relevance: Dynamic augmented ACL suture repair might be a viable treatment option for patients with an acute ACL rupture. Registration: NCT02310854 ( ClinicalTrials.gov identifier).
Functional Neurologic Symptom Disorder in Children: Clinical Features, Diagnostic Investigations, and Outcomes at a Tertiary Care Children’s Hospital
Authors: Watson Carla , Sivaswamy Lalitha , Agarwal Roshani , Du Wei , Agarwal Rajkumar 
Published: March 2019

Objective: To describe the presenting symptoms and short-term outcomes of children diagnosed with functional neurologic symptom disorder and to compare the demographic and clinical characteristics of children who received neurodiagnostic testing to those who did not. Study Design: Single center, retrospective review of 222 children who presented to the emergency department of a children’s hospital, and diagnosed with functional neurologic symptom disorder, between 2010 and 2015. Results: Out of 222 visits (females = 156, African Americans = 130, mean age = 13.9 years), neurodiagnostic tests were performed in 102/222 (46%) visits. The most commonly performed investigations were magnetic resonance imaging (MRI) of brain (n = 37) and electroencephalogram (EEG) (n = 56) and were noted to be unremarkable in all instances. Neurodiagnostic tests were more likely to be performed in patients who (1) were non–African American (54% vs 40%; P = .03), (2) presented with new-onset symptoms (55% vs 31%; P < .01), (3) underwent hospitalization (61% vs 17%; P < .01), and (4) were evaluated by a neurologist (59% vs 9%; P < .01) or a psychiatrist (58% vs 28%; P < .01). Common clinical presentations included seizurelike or strokelike symptoms. Short-term follow-up was possible in 20%, with an alternate diagnosis of syncope, noted in only 1 child. Conclusions: Most children who presented with a functional neurologic symptom disorder in our study were noted to have seizurelike or strokelike presentations and were adolescent females. Caucasians were more likely to undergo neurodiagnostic investigations. Radiologic and neurophysiological tests were more commonly performed when neurology and psychiatry consultations were sought. Such investigations had low diagnostic utility.
A Case Study of Biological Nurturing
Authors: Rosin Stefanie Inge 
Published: February 2019

Introduction: This case of a mother and her two children, born 20 years apart, highlights how Biological Nurturing (BN) supported a woman in meeting her personal breastfeeding goals. We know lack of breastfeeding support contributes to early weaning. Applying the principles of BN (unrestricted and laid-back breastfeeding) enabled this mother to return to breastfeeding without supplements. Main Issue: After giving birth to her first son prematurely in 1997, the dyad was separated, and formula introduced. These interventions, combined with inadequate breastfeeding support, resulted in low milk supply and unplanned weaning by week six. In 2017, a full term sibling baby girl was born, with breastfeeding again beginning with concerns of low milk supply. Management Consultation with an International Board Certified Lactation Consultant successfully addressed common breastfeeding problems, including vasospasm and insufficient milk supply. Continuous emotional support helped this mother overcome perceived insufficient milk supply. Introducing BN led to breastfeeding without supplementation, by enabling the dyad to experience enjoyment, comfort and feeding autonomy. Conclusion: While the repeated experience of insufficient milk supply two decades apart constituted a psychological barrier to exclusive breastfeeding, BN enabled reaching this mother’s breastfeeding goals. BN appears to be a powerful tool for both breastfeeding initiation and overcoming breastfeeding difficulties, potentially setting new best practice standards.
Application of job security laws, workers’ bargaining power and employment outcomes in India
Authors: Roychowdhury Anamitra 
Published: February 2019

This article empirically investigates two propositions normally advanced to explain employment stagnation in the organised sector of the Indian labour market namely, rigid labour laws regulating the ‘hiring and firing’ of workers (along with factory closures) and militant trade union activity boosting workers’ bargaining power. It is claimed that labour laws arrest employment creation by making the labour adjustment process difficult. Additionally, it is claimed that workers’ increased bargaining power raises the effective cost of labour, hindering employment creation. This article critically examines both these claims. First, it questions whether labour laws can be held responsible as an explanation for employment stagnation in the organised sector as a whole, since a close reading of the Indian legislation reveals that labour laws apply in less than 35% of aggregate employment in the organised sector in India. Next, it investigates whether employment stagnation in those industry segments where labour laws apply – namely, organised manufacturing – is due to restrictions on ‘hiring and firing’. We find no evidence to support this hypothesis. Finally, it analyses the trend in workers’ bargaining power through various indicators, and finds such power to be unambiguously declining. Thus, the study finds no empirical support for the two conventional arguments put forward to explain employment stagnation in the organised sector of the Indian labour market. JEL codes: J31, J63, J88