bluuebunny/crossref_metadata_2025_split huggingface dataset:
Involving Minors in Medical Decision Making: Understanding Ethical Issues in Assent and Refusal of Care by Minors
Authors: Lang Abigail , Paquette Erin 
Published: October 2018

AbstractWhen caring for minors, the clinician–patient relationship becomes more ethically complex by the inclusion of parents in the clinician–parent–patient triad. As they age, children become more capable of participating in the decision-making process. This involvement may lead them to either accept or refuse proposed care, both of which are ethically acceptable positions when the minor's capacity to participate in decision making is carefully considered in the context of their age, development, and overall health. Certain conditions may be more likely to impact their capacity for participation, but it is important for clinicians to avoid categorical presumption that minors of a certain age or with certain conditions are incapable of participating in decisions regarding their care. Understanding the ethical bases for decision making in pediatric patients and considerations for the involvement of minors who both assent to and refuse proposed treatment will equip clinicians to respect the growing autonomy of minor patients.
Successful Management of Giant Placental Chorangioma by Microcoil Embolization
Authors: Emery Stephen , Orons Philip , Bonadio Jeffrey 
Published: October 2018

AbstractOptimal prenatal management of giant placental chorangioma (also known as chorioangioma, angiomyxoma, fibroangiomyxoma, or fibroma) has yet to be determined. Interventions intended to devascularize the tumor such as interstitial laser, bipolar coagulation, fetoscopic laser photocoagulation, and chemical embolization have met mixed results. We report a minimally invasive, extra-amniotic approach, technically similar to cordocentesis, of microcoil embolization of the feeding vessel. These percutaneously placed microcoils initiate clot formation at the site of insertion and are unable to migrate through the tumor, thereby minimizing fetal harm by downstream embolic phenomena. Intervention at 26 and 22 weeks resulted in intraoperative fetal loss in the former and vaginal delivery at term of a healthy neonate in the latter. Preoperative, intraoperative, and placental findings are highlighted. The ease and safety of this procedure may alter the risk–benefit equation toward earlier intervention with potentially better clinical outcomes.
Sildenafil Use in the Treatment of Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension: A Case Series
Authors: Qasim Amna , Dasgupta Soham , Aly Ashraf , Jain Sunil 
Published: October 2018

Objective This article studies the role of sildenafil in reducing myocardial stress (measured by serial N-terminal pro b-type natriuretic peptide [NTproBNP] levels) secondary to bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH).
Study Design This is a case series of three extremely low birth weight infants with severe BPD at 36 weeks' postmenstrual age. All infants had very elevated NTproBNP (> 2,000 ng/dL) levels and echocardiographic evidence of BPD-PH. Sildenafil was started and infants were followed up every 2 weeks clinically along with NTproBNP levels and echocardiograms.
Results After 4 weeks of sildenafil treatment, NTproBNP levels decreased significantly in all infants, echocardiograms showed significant improvement in one infant, and respiratory severity score improved significantly in one infant. All infants tolerated sildenafil.
Conclusion Sildenafil reduced NTproBNP levels in all infants with BPD-PH but the echocardiographic findings and respiratory scores did not improve consistently. We speculate that this may be due to a delay in diagnosis and initiation of therapy after irreversible pulmonary changes have set in.
Effectiveness of Laboratory Markers in Determining Serious Bacterial Infection in Children with Fever without Source
Authors: Gunduz Ahmet , Konca Capan , Turgut Mehmet , Tekin Mehmet 
Published: October 2018

AbstractWe assessed the effectiveness of laboratory markers in determining the presence of serious bacterial infection (SBI) in well-appearing children aged 3 months to 17 years with fever without source (FWS). One hundred eighteen patients aged between 3 months and 17 years presenting to the pediatric department due to fever and with no focus of fever determined through history and physical examination were included in this prospective study. SBI was determined in 14 (11.9%) of the 118 patients. No significant difference was determined between the two groups in terms of age, sex, degree of fever, duration of fever, and mean platelet volume. The neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), and procalcitonin (PCT) were identified as independent predictive markers in a multivariate logistic regression analysis. PCT above 0.58 ng/mL emerged as the most sensitive and specific test at receiver operating curve analysis (sensitivity: 92.8%, specificity: 90.3%, area under the curve: 0.908, and p < 0.001). The method with the highest positive predictive value, 69.2, was a laboratory score consisting of CRP, PCT, and complete urine analysis ≥3 (95% confidence interval [CI]: 38.6–90.7), while the marker with the highest negative predictive value, 98.9, was PCT > 0.58 ng/mL (95% CI:94.3–99.8). The NLR, CRP, and PCT were independent predictive markers in determining the presence of SBI in well-appearing children with FWS. PCT was the marker with the highest sensitivity and specificity in determining presence of SBI. The method with the highest positive predictive value was laboratory score, while PCT was the marker with the best negative predictive value.
Retrosigmoid Approach for Trapping and Removal of a Distal Dissecting Superior Cerebellar Artery Aneurysm in a Child
Authors: Ros de San Pedro Javier 
Published: October 2018

Objectives To demonstrate the feasibility of the retrosigmoid craniotomy for surgical management of vascular lesions located in the cerebellopontine angle (CPA).
Method A previously healthy 2-year-old boy presented a sudden episode of torticollis to the left while sleeping. This episode was selflimited but it occurred two more times in a 6-day span. Torticollis worsened in the upright position, caused unsteady gait and refusal to walk from the child. The preoperative magnetic resonance imaging (MRI) showed the presence of a round, heterogenous vascular lesion in the left CPA. The lesion clearly enhanced after contrast administration. The preoperative angiography demonstrated the absence of left anterior inferior cerebellar artery anterior inferior cerebellar artery (AICA), being the left superior cerebellar artery (SCA) the supplier of the left lateral cerebellum. A blurred blush on the distal left SCA was compatible with a fusiform aneurysm. A standard retrosigmoid approach was planned for trapping and removal of the aneurysm.
Results Through a left retrosigmoid craniotomy the aneurysm was approached, along with the different neurovascular structures of the CPA. The aneurysm leaned on the VII, VIII nerves complex and the superior petrosal vein, while tightly attached to the lateral cerebellum. Both proximal and distal SCA segments to the aneurysm were dissected, clipped, and divided for a complete trapping. Finally, the aneurysm was completely detached and removed in a whole piece. The patient fully recovered after surgery with no relapse of his symptoms.
Conclusion The retrosigmoid craniotomy is a versatile approach that permits wide exposure of all CPA structures and adequate removal of distal aneurysms located in those cerebellar arteries supplying the lateral cerebellum.The link to the video can be found at: https://youtu.be/oEVfy4goFYM.
Comparing continual task learning in minds and machines
Authors: Flesch Timo , Balaguer Jan , Dekker Ronald , Nili Hamed , Summerfield Christopher 
Published: October 2018

Significance
Humans learn to perform many different tasks over the lifespan, such as speaking both French and Spanish. The brain has to represent task information without mutual interference. In machine learning, this “continual learning” is a major unsolved challenge. Here, we studied the patterns of errors made by humans and state-of-the-art neural networks while they learned new tasks from scratch and without instruction. Humans, but not machines, seem to benefit from training regimes that blocked one task at a time, especially when they had a prior bias to represent stimuli in a way that encouraged task separation. Machines trained to exhibit the same prior bias suffered less interference between tasks, suggesting new avenues for solving continual learning in artificial systems.
UNC Perceived Message Effectiveness: Validation of a Brief Scale
Authors: Baig Sabeeh A , Noar Seth M , Gottfredson Nisha C , Boynton Marcella H , Ribisl Kurt M , Brewer Noel T 
Published: October 2018

AbstractBackgroundInterventionists commonly identify promising messages for health communication efforts based on audience members’ ratings of perceived message effectiveness (PME).PurposeWe sought to validate a new PME measure that improved on existing scales by focusing on the behavior and respondent, being brief, and having strong psychometric properties.MethodsParticipants were a national convenience sample of 999 adults and national probability samples of 1,692 adults and 869 adolescents recruited in 2015. Smokers and nonsmokers rated up to six brief messages about the chemicals in cigarette smoke on two PME scales. The first was the new three-item University of North Carolina (UNC) PME Scale that assessed effects perceptions. The second was an established six-item PME scale that assessed message perceptions. We examined the UNC PME Scale’s psychometric properties and compared both scales using item factor analysis.ResultsThe UNC PME Scale measured the same construct across multiple chemical messages (all factor loadings ≥ 0.86). It exhibited high reliability (>0.85) over very low to moderate levels of PME (z = −2.5 to 0.2), a range that is useful for identifying more promising messages. Samples of adults and adolescents showed a similar pattern of results. As expected, the UNC PME Scale was strongly positively correlated with message perceptions (r = .84). It also exhibited strong psychometric properties among participants regardless of education, reactance, sex, and smoking status.DiscussionThe UNC PME Scale reliably and validly measured PME among adults and adolescents from diverse groups. This brief scale may be used to efficiently evaluate candidate antismoking messages and may be suitable for adaptation to other health risk behaviors.
Subdistribution hazard models for competing risks in discrete time
Authors: Berger Moritz , Schmid Matthias , Welchowski Thomas , Schmitz-Valckenberg Steffen , Beyersmann Jan 
Published: October 2018

Summary
A popular modeling approach for competing risks analysis in longitudinal studies is the proportional subdistribution hazards model by Fine and Gray (1999. A proportional hazards model for the subdistribution of a competing risk. Journal of the American Statistical Association94, 496–509). This model is widely used for the analysis of continuous event times in clinical and epidemiological studies. However, it does not apply when event times are measured on a discrete time scale, which is a likely scenario when events occur between pairs of consecutive points in time (e.g., between two follow-up visits of an epidemiological study) and when the exact lengths of the continuous time spans are not known. To adapt the Fine and Gray approach to this situation, we propose a technique for modeling subdistribution hazards in discrete time. Our method, which results in consistent and asymptotically normal estimators of the model parameters, is based on a weighted ML estimation scheme for binary regression. We illustrate the modeling approach by an analysis of nosocomial pneumonia in patients treated in hospitals.
Continuity and Discontinuity in Human Cortical Development and Change From Embryonic Stages to Old Age
Authors: Fjell Anders M , Chen Chi-Hua , Sederevicius Donatas , Sneve Markus H , Grydeland Håkon , Krogsrud Stine K , Amlien Inge , Ferschmann Lia , Ness Hedda , Folvik Line , Beck Dani , Mowinckel Athanasia M , Tamnes Christian K , Westerhausen René , Håberg Asta K , Dale Anders M , Walhovd Kristine B 
Published: October 2018

AbstractThe human cerebral cortex is highly regionalized, and this feature emerges from morphometric gradients in the cerebral vesicles during embryonic development. We tested if this principle of regionalization could be traced from the embryonic development to the human life span. Data-driven fuzzy clustering was used to identify regions of coordinated longitudinal development of cortical surface area (SA) and thickness (CT) (n = 301, 4–12 years). The principal divide for the developmental SA clusters extended from the inferior–posterior to the superior–anterior cortex, corresponding to the major embryonic morphometric anterior–posterior (AP) gradient. Embryonic factors showing a clear AP gradient were identified, and we found significant differences in gene expression of these factors between the anterior and posterior clusters. Further, each identified developmental SA and CT clusters showed distinguishable life span trajectories in a larger longitudinal dataset (4–88 years, 1633 observations), and the SA and CT clusters showed differential relationships to cognitive functions. This means that regions that developed together in childhood also changed together throughout life, demonstrating continuity in regionalization of cortical changes. The AP divide in SA development also characterized genetic patterning obtained in an adult twin sample. In conclusion, the development of cortical regionalization is a continuous process from the embryonic stage throughout life.
Who Gets Lost, and What Difference Does It Make? Mixed Modes, Nonresponse Follow-up Surveys and the Estimation of Turnout
Authors: Goldberg Andreas C , Sciarini Pascal 
Published: October 2018

AbstractThis article assesses whether—and to what extent—turnout bias in postelection surveys is reduced by adding a short nonresponse follow-up (NRFU) survey to a mixed-mode survey. Specifically, we examine how the NRFU survey influences response propensities across demographic groups and political factors and whether this affects data quality. We use a rich dataset on validated voter turnout data, collected across two different ballots. In addition to the main survey that comprises computer-assisted telephone interviews (CATI) and web respondents, both studies include a short follow-up mail survey for nonrespondents. The results demonstrate that collecting extra information from additional respondents on so-called “central” questions is worth the effort. In both studies, the NRFU survey substantially increases representativeness with respect to sociodemographic and participation variables. In particular, voters and politically active citizens are more accurately represented in the NRFU survey. This tends to result in better estimates of turnout determinants in the final (combined) sample than is seen from CATI/web respondents only. Moreover, the increase in response rate and the decrease in nonresponse bias comes at almost no price in terms of measurement errors. Vote overreporting is only slightly higher in the mail follow-up survey than in the main CATI/web survey.
Probabilistic Tractography to Predict the Position of Cranial Nerves Displaced by Skull Base Tumors: Value for Surgical Strategy Through a Case Series of 62 Patients
Authors: Jacquesson Timothée , Cotton Francois , Attyé Arnaud , Zaouche Sandra , Tringali Stéphane , Bosc Justine , Robinson Philip , Jouanneau Emmanuel , Frindel Carole 
Published: October 2018

Abstract

BACKGROUND
Predicting the displacement of cranial nerves by tumors could make surgery safer and the outcome better. Recent advances in imaging and processing have overcome some of the limits associated with cranial nerve tractography, such as spatial resolution and fiber crossing. Among others, probabilistic algorithms yield to a more accurate depiction of cranial nerve trajectories.

OBJECTIVE
To report how cranial nerve probabilistic tractography can help the surgical strategy in a series of various skull base tumors.

METHODS
After distortion correction and region of interest seeding, a probabilistic tractography algorithm used the constrained spherical deconvolution model and attempted the reconstruction of cranial nerve trajectories in both healthy and displaced conditions.

RESULTS
Sixty-two patients were included and presented: vestibular schwannomas (n = 33); cerebellopontine angle meningiomas (n = 15); arachnoid or epidermoid cysts (n = 6); cavernous sinus and lower nerves schwannomas (n = 4); and other tumors (n = 4). For each patient, at least one ‘displaced’ cranial nerve was not clearly identified on classical anatomical MRI images. All 372 cranial nerves were successfully tracked on each healthy side; among the 175 cranial nerves considered ‘displaced’ by tumors, 152 (87%) were successfully tracked. Among the 127 displaced nerves of operated patients (n = 51), their position was confirmed intraoperatively for 118 (93%) of them. Conditions that led to tractography failure were detailed. On the basis of tractography, the surgical strategy was adjusted for 44 patients (71%).

CONCLUSION
This study reports a cranial nerve probabilistic tractography pipeline that can: predict the position of most cranial nerves displaced by skull base tumors, help the surgical strategy, and thus be a pertinent tool for future routine clinical application.
Volatility and growth: a not so straightforward relationship
Authors: Bakas Dimitrios , Chortareas Georgios , Magkonis Georgios 
Published: October 2018

AbstractConflicting theoretical models and diverse empirical evidence characterize research analysing the relationship between business cycle volatility and economic growth. While the average reported effect of volatility on growth is negative, the empirical estimates vary substantially across studies. We identify the factors that explain this heterogeneity in estimates by conducting a meta-analysis. Our evidence suggests that researchers’ choices regarding the measure of volatility, the control set of the estimated equation, the estimation methods, and the data characteristics can all explain the differences in the reported estimates. Finally, the literature is found to be free of publication bias.
High entropy and evidence for a merger in the low surface brightness cluster Abell 2399
Authors: Mitsuishi Ikuyuki , Babazaki Yasunori , Ota Naomi , Sasaki Shin , Böhringer Hans , Chon Gayoung , Pratt Gabriel W 
Published: October 2018

AbstractWe present results of the X-ray analyses of the nearby cluster of galaxies Abell 2399 ($z$ = 0.058) using the XMM–Newton and Suzaku satellites. This cluster is classified as a low surface brightness (LSB) cluster. It has a bimodal structure in X-rays, and the X-ray-emission peaks are significantly offset from the peaks in gas temperature. By de-projecting the annular spectra, the temperature and electron density in the central r &lt; 0.1 r200 region are measured to be 3.6 keV and 1.4 × 10−3 cm−3, respectively. This yields a very high gas entropy, ∼300 keV cm2, in the central region, comparable to the values observed in other LSB clusters. The scaled entropy of Abell 2399 is the highest among the REXCESS cluster sample. The spatial distribution of the member galaxies exhibits multiple substructures, the locations of which are significantly different from those in the X-ray image. We discovered a clear discontinuity in the X-ray brightness and temperature distributions in the western gas clump, which provides evidence of the presence of a cold front. Therefore, our results strongly suggest that A2399 has experienced a merger and that the high central entropy originates from the merger activity.
Head Impact Burden and Change in Neurocognitive Function During a Season of Youth Football
Authors: Rose Sean C. , Yeates Keith O. , Fuerst Darren R. , Ercole Patrick M. , Nguyen Joseph T. , Pizzimenti Natalie M. 
Published: October 2018

Objective:
To determine the association of repetitive subconcussive head impacts with functional outcomes in primary and high school tackle football players.

Setting:
Youth football fields and an outpatient sports neurology clinic.

Participants:
A total of 112 primary school (n = 55, age 9-12 years) and high school (n = 57, age 15-18 years) football players.

Design:
A prospective cohort study.

Main Measures:
Helmet-based sensors were used to record head impacts during practices and games during the 2016 football season. Impact g-forces were summed to yield a measure of cumulative impact. History of self-reported premorbid medical diagnoses was obtained preseason. Players completed assessments of a variety of outcomes both pre- and postseason: neuropsychological test performance, symptoms, vestibular and ocular-motor screening, balance, parent-completed attention-deficit hyperactivity disorder (ADHD) symptoms, and self-reported behavioral adjustment.

Results:
Average cumulative impact was 3700 (standard deviation = 2700) g-forces for the season and did not differ between age groups (P = .594). Cumulative impact did not predict pre- to postseason change scores on any outcome measures (all P > .05). Instead, younger age group and reported history of premorbid ADHD predicted change scores on several cognitive testing measures and parent-reported ADHD symptoms, while reported history of premorbid anxiety and depression predicted change scores on symptom reporting.

Conclusions:
In youth tackle football, subconcussive head impacts sustained over the course of a single season may not be associated with neurocognitive functional outcomes. The absence of a significant association may reflect the relatively short follow-up interval, and signals the need for studies across multiple seasons.
Emergency nurse practitioner practice analysis: Report and implications of the findings
Authors: Tyler Diane O. , Hoyt Karen Sue , Evans Dian Dowling , Schumann Lorna , Ramirez Elda , Wilbeck Jennifer , Agan Donna 
Published: October 2018

ABSTRACT

Background and purpose:
A practice analysis of nurse practitioners (NPs) working in emergency care was undertaken to define their job tasks and develop a specialty certification by examination.

Method:
In phase I, clinical experts created a qualitative description of domains of practice, tasks performed, knowledge required, and procedures performed by NPs in emergency care. Phase II involved validating the qualitative description through a national survey (N = 474) of emergency nurse practitioners (ENPs). Evidence from the validation survey was used to create a test content outline for the ENP examination.

Findings and Conclusions:
The delineation of ENP practice validated by the survey (Cronbach alpha = 0.86–0.94 across rating scales) included 5 ENP practice domains: medical screening, medical decision-making/differential diagnoses, patient management, patient disposition and professional, legal and ethical practices. There were 22 job tasks across domains, 10 types of patient conditions/emergency types, 42 knowledge areas, and 68 procedures performed by ENPs. These resulted in a test blueprint providing the foundation for the ENP certification examination content validity.

Implications for practice:
Beyond certification, the practice analysis has the potential to further inform the scientific basis of emergency specialty practice. Additional uses include refining professional scope and standards of practice, job descriptions, performance appraisals, research, and policy development.