bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evolution of a US County System for Acute Comprehensive Stroke Care
Authors: Raychev Radoslav I. , Stradling Dana , Patel Nirav , Gee Joey R. , Lombardi David A. , Moon Johnson L. , Brown David M. , Pathak Mayank , Yu Wengui , Stratton Samuel J. , Cramer Steven C. 
Published: April 2018

Background and Purpose—
In Orange County, California, patients with suspected acute stroke are taken to stroke neurology receiving centers that are designated by County Emergency Medical Services authorities as either hubs or spokes based on endovascular treatment capability. We examined relationships between stroke details, reperfusion therapies, hospital transfers, and their change over time.

Methods—
All patients from January 1, 2013, to December 31, 2015, for whom 911 was called within 7 hours of onset in whom Emergency Medical Services personnel suspected acute stroke were evaluated.

Results—

Among 6132 patients, 3924 (64%) had confirmed diagnosis of stroke (74% ischemic/26% hemorrhagic), yielding diagnostic precision of 64% in the field. Of the 2892 patients with acute ischemic stroke, acute reperfusion therapy was given to 29.2% (21.7% intravenous tPA [tissue-type plasminogen activator] only and 7.5% endovascular treatment). Rates of endovascular treatment of patients with ischemic stroke increased over time, more than doubling from 5.6% in 2013 to 12.5% (odds ratio per 3-month quarter=1.09; 95% confidence interval, 1.04–1.14;
P
<0.0001). Only 3.4% of patients with acute ischemic stroke were transferred from a spoke to a hub hospital; transfer rates were inversely related to age (
P
<0.0001), and reperfusion therapy rates did not vary according to transfer status.

Conclusions—
Favorable features of this acute stroke care system include reperfusion therapy in 29.2% of patients with ischemic stroke and substantial increases in endovascular treatment rates over time. Continued efforts to optimize acute stroke systems of care can be directed toward improving access to best acute stroke therapies.
Aseneth between Judaism and Christianity: Reframing the Debate
Authors: Hicks-Keeton Jill 
Published: April 2018

AbstractThe question of whether Joseph and Aseneth is “Jewish or Christian?” is the central frame in which the provenance of this tale has traditionally been sought. Yet, such a formulation assumes that “Judaism” and “Christianity” were distinct entities without overlap, when it is now widely acknowledged that they were not easily separable in antiquity for quite some time. I suggest that the question of whether Joseph and Aseneth is Jewish or gentile is more profitable for contextualizing Aseneth’s tale. This article offers fresh evidence for historicizing its origins in Judaism of Greco-Roman Egypt. Placing the narrative’s concerns for boundary-regulation alongside the discursive projects of other ancient writers (both Jewish and gentile Christian) who engaged the story of Joseph suggests that the author of Joseph and Aseneth was likely a participant in a Hellenistic Jewish interpretive tradition in Egypt that used Joseph’s tale as a platform for marking and maintaining boundaries.
The Culture of Catechesis and Lay Theology
Authors: Touber Jetze 
Published: April 2018

Abstract
In the seventeenth-century Dutch Republic, non-professional theologians articulated well-informed biblical interpretation, producing a lay theology that was unwelcome to representatives of the churches. Historians have long considered this lay theology as a manifestation of Early Enlightenment. It did not, however, necessarily result from the activities of rationalist philosophers usually associated with the Dutch Early Enlightenment, such as Benedictus de Spinoza (1632–1677). Equally important were the clergy’s efforts to educate laity in reading the Bible and contemplating divinity autonomously. This paper reconstructs the Dutch “culture of catechesis,” a collective effort to involve laity in reflection on religion and the Bible, dating back to at least the 1640s. Based on catechetical materials and their authors, this paper argues that the “culture of catechesis” had its roots in the Public Church itself, and that it contributed to lay theology, as much so as the outspoken programs of eccentric philosophers.
An Assessment of the FGGE Satellite Observing System during SOP-1
Authors: Halem M. , Kalnay E. , Baker W. E. , Atlas R. 
Published: April 2018

This study investigates the degree to which data from the space-borne FGGE observing systems are able to determine the complete state of the atmosphere when incorporated into a global objective analysis cycle. Three data assimilation experiments are performed with the Goddard Laboratory for Atmospheric Sciences (GLAS) analysis/forecast system, using different combinations of the FGGE level II–b data collected during the first Special Observing Period (SOP-1), 5 January through 5 March 1979. The control experiment is an assimilation cycle with the complete FGGE II–b data. The other two assimilation/forecast experiments consist of i) the conventional system without the satellite data and special FGGE data sets; and ii) the FGGE II–b surface and satellite temperature soundings and cloud-track winds, aircraft data, and special FGGE data sets, but without the conventional rawinsonde/pilot balloon network.
From these experiments, we attempt to assess the accuracy of the inferred mass and motion fields over data-sparse regions, by examining their influence on analyses and forecasts over data-rich regions. The sensitivity of the analysis to the FGGE satellite data is shown by comparisons of the 6 h forecast error of the 300 mb geopotential height fields for these three experiments. It is found that large 6 h forecast errors downstream of data-sparse regions are reduced when the satellite observations are incorporated in the analysis. Forecast impact results from the initial states of these assimilation cycles show the geographical influence of the FGGE satellite observing system on short- to medium-range (two to five days) weather forecasting. Over North America and Europe, there is a small improvement in forecast skill from the use of the FGGE II–b data. Over Australia, as expected, the positive impact of satellite data is much larger. The number of skillful four- and five-day forecasts over North America and Europe has been increased substantially by the addition of the FGGE II–b data. Examples of useful eight-day forecasts, which occurred in periods of atmospheric blocking situations also are presented.
Meso β-Scale Thunderstorm/Environment Interactions During AVE-SESAME V (20–21 May 1979)
Authors: Fuelberg Henry E. , Printy Matthew F. 
Published: April 2018

Meso β-scale rawinsonde data from the Atmospheric Variability Experiment-Severe Environmental Storms and Mesoscale Experiment (AVE-SESAME) V period (20–21 May 1979) are used to diagnose atmospheric variability in the environment of a convective area. As the storms developed, temperatures increased in the upper stratosphere; however, cooling was observed nearer to the surface and in the lower stratosphere. Height rises above 400 mb produced a mesohigh over the convective area that was most pronounced near 200 mb. Weaker height falls occurred in the lower troposphere.
Wind patterns underwent especially interesting fluctuations. North of the convective area, upper-level winds increased significantly during storm development. Southeast of the convection, however, winds near 200 mb decreased approximately 50% during a 3 h period coinciding with the most active storms. On the other hand, winds at 400 mb almost doubled during the same 3 h period. Strong low-level convergence, upper-level divergence, and ascending motion developed after storm initiation.
Much more detailed study is required to understand this fascinating case. However, many of the current findings about the meso β-scale storm environment are consistent with those previously attributed to feedback mechanisms from severe thunderstorms.
Marital Functioning in Couples Practicing Periodic Abstinence for Family Planning
Authors: Barroilhet Sergio , Señoret Camila , Mallea Ximena , Fritsch Rosemarie , Vöhringer Paul , Arraztoa José-Antonio 
Published: April 2018

Objective: To compare dyadic (marital) functioning between users of natural family planning (NFP) and users of artificial methods of contraception (AMC). Method: A cross-sectional study was conducted in healthy, over eighteen-year-old couples living in stable relationships recruited from primary and secondary health centers in Santiago, Chile. Participants were assessed using a structured interview on sociodemographic and sexual aspects. Primary outcome, marital functioning, was studied using the Dyadic Adjustment Scale (DAS). Results: One hundred and thirty-eight couples were studied, sixty-nine in each user group. Both groups had a similar average time living together (124.3 vs. 126.9 months). DAS results were consistent with functional couples in both groups, but on average, the NFP group had a significantly higher DAS score than AMC. After controlling for age, socioeconomic status, time in the relationship, and religious commitment in multivariable analysis, the NFP group had a 47 percent (odds ratio = 1.47) greater possibility of having a functional marital score above the cutoff (DAS > 114) when compared with the AMC group. The AMC group reported more frequency of sexual intercourse but similar sexual satisfaction. Most (>60 percent) of the NFP couples mentioned that their methods improved their relationship. Conclusion: There are sociodemographic differences between both groups, explained partly by unequal access to NFP centers. Both groups have DAS scores within functional range, but NFP users have a higher probability of being in that functional range. This study of mentally and emotionally healthy couples highlights the importance of family planning methods on intimate relationships. Summary Marital functioning is affected by family planning methods. A structured interview and a specific inventory to address conjugal functioning were applied to a group of healthy couples who live in stable relationships and are users of natural family planning (NFP) or artificial methods of contraception (AMC). The results were consistent with functional couples in both groups, but on average, the NFP group had a significantly higher score than the AMC group. The use of NFP explained this difference. This study of mentally and emotionally healthy couples highlights the importance of family planning methods on intimate relationships.
Osmangazi University score to reduce ionizing radiation in renal colic patients in emergency department
Authors: Baseskioglu Barbaros , Ozakin Engin , Dolgun Hakan , Arslan Ebubekir , Acar Nurdan , Bilgin Muzaffer , Colak Ertugrul 
Published: April 2018

Objective:Computerized tomography remains the gold standard imaging in renal colic patients. In this study, we develop a scoring system to select patients in emergency department for unnecessary computerized tomography imaging in order to decrease radiation exposure.Methods:Computerized tomography imaging of patients with renal colic in emergency department were retrospectively reviewed. Symptoms, laboratory results were recorded. Significant parameters were determined by univariate and multivariate analysis. Coefficients were found to obtain score points and receiver operating curve was used to find a cut-off value.Results:A total of 123 patients with a mean age of 42 years (18–75 years) were enrolled in the study. About, 20.3% of patients were stone-free in computerized tomography. Mean stone size was 6.1 ± 1.89 mm. According to analysis, four parameters were significant; nausea, stone history, creatinine, and hematuria with a total score 9 called as Osmangazi University STONE score. Cut-off value was found as >3, which computerized tomography imaging is recommended.Conclusion:Osmangazi University STONE score is useful and simple tool in emergency department to reduce unnecessary computerized tomography imaging in renal colic patients and also lowers cost and ionizing radiation exposure.
Facilitating Home Hospice Transitions of Care in Oncology: Evaluation of Clinical Pharmacists’ Interventions, Hospice Program Satisfaction, and Patient Representation Rates
Authors: Duffy Alison P. , Bemben Nina M. , Li Jueli , Trovato James 
Published: April 2018

Background: The importance of medication reconciliation and the pharmacist’s role within the interdisciplinary team at the point of transition to home hospice is understudied. A transitions of care pilot initiative was developed to streamline the transition for patients at end of life from inpatient cancer center care to home hospice. The initiative consisted of using a hospice discharge checklist, pharmacist-led discharge medication reconciliation in consultation with the primary team responsible for inpatient care, review of discharge prescriptions, and facilitation of bedside delivery of discharge medications. Methods: This was a single-center, prospective, pilot initiative. The objectives of this study were to characterize pharmacist interventions at the time of transition, to assess changes in hospice organizations’ perceptions of discharge readiness, and to evaluate differences in representation rates with the implementation of the pilot discharge process. Results: Fifteen patients in the preimplementation period and 12 patients in the postimplementation period were included. One hundred eleven pharmacist interventions were captured, an average of 9.3 interventions per patient, with an acceptance rate of 82.9% by providers. There was a statistically significant ( P = .035) improvement in hospice organizations’ perceptions of discharge readiness. There was no difference in 30-day representation rates postdischarge ( P = 1). Conclusion: This well-received pilot initiative demonstrated an improvement in local hospice’s perception of patient readiness for discharge and a high percentage of accepted pharmacist interventions during discharge medication reconciliation. A larger sample size of patients and longer follow-up period may be needed to demonstrate statistically significant improvements in representation rates postintervention.
Macular toxicity and blind spot enlargement during a treatment by voriconazole: A case report
Authors: Mounier Anaïs , Agard Emilie , Douma Ikrame , Chehab Hussam El , Vie Anne L , Dot Jean M , Dot Corinne 
Published: April 2018

Purpose: To report a case of macular toxicity and blind spot enlargement during voriconazole treatment. Methods: This is a case report. Results: We describe a 77-year-old man treated by voriconazole for pulmonary aspergillosis, who complained of visual disorders such as dyschromatopsia and visual hallucinations 3 days after voriconazole initiation. Initial ophthalmological examination found no loss of visual acuity. The anterior and posterior segments presented no anomalies. The chromatic vision evaluated with the Lanthony 15-Hue Desaturated Test demonstrated dyschromatopsia in the left eye along the tritan axis, and the Goldmann visual field examination found a blind spot enlargement in both eyes. The multifocal electroretinogram found a global decrease in the foveal peak in both eyes. Visual evoked potential showed asymmetric data and lower amplitudes of the P(100) wave on the left eye. No anomalies were observed on spectral domain macular optical coherence tomography. As a first step, based on presumed dose-dependent toxicity, voriconazole dose was reduced. No improvements were noted. The voriconazole treatment was then discontinued and replaced with itraconazole. After 1 month, visual field and multifocal electroretinogram had improved and visual hallucinations had disappeared. Conclusion: Voriconazole can cause potentially serious visual side effects. Adapting treatment based on plasma concentrations of voriconazole did not prevent the appearance of visual side effects in this case. Therapeutic drug switching within the same drug family seems to be an effective alternative to preserve ocular function.
New visual field indices of disharmony for early diagnosis of glaucoma, alone or associated with conventional parameters
Authors: Abreu-Gonzalez Rodrigo , Gonzalez-Hernandez Marta , Pena-Betancor Cristina , Rodriguez-Esteve Paloma , Gonzalez De La Rosa Manuel 
Published: April 2018

Purpose: To evaluate the specificity of new perimetric indices based on harmony, alone and in combination with structural data, for glaucoma detection. Methods: In this prospective observational cross-sectional study, one eye of 105 healthy subjects and 97 early and suspect glaucomas were sequentially included and examined with Cirrus optical coherence tomography, twice with OCULUS Smartfield perimeter (SPARK strategy) and twice with Humphrey Analyzer (24-2 SITA-Fast) at the Ophthalmology Department from the University Hospital La Candelaria. Disharmony in the visual field was evaluated including vertical threshold symmetry, threshold rank), and homogeneity (threshold standard deviation from its maximum) using the patient himself/herself as a reference. We also evaluated disharmony in combination with the mean deviation and the pattern standard deviation in a single index (mismatch) and various combinations of morphological and functional indices. Combinations used a new score based on values above certain critical cut-off levels of each index. Results: For 95% specificity, the highest sensitivities were as follows: vertical cup/disc ratio: 28.9%; SPARK threshold rank: 29.9%; and SITA-Fast threshold standard deviation: 28.9%. For the combined indices and 100% specificity, they were 5 SPARK indices mismatch: 10.3%; 5 SITA-Fast indices mismatch: 11.3%; 8 optical coherence tomography indices: 21.9%; 13 SPARK and optical coherence tomography indices: 27.8%; and 13 SITA-Fast and optical coherence tomography indices: 32.0%. Conclusion: Disharmony combined with normative value-based indices and/or optical coherence tomography indices is useful for very specific early diagnosis of glaucoma.
Neural Mechanisms of Qigong Sensory Training Massage for Children With Autism Spectrum Disorder: A Feasibility Study
Authors: Jerger Kristin K , Lundegard Laura , Piepmeier Aaron , Faurot Keturah , Ruffino Amanda , Jerger Margaret A , Belger Aysenil 
Published: April 2018

Objectives Despite the enormous prevalence of autism spectrum disorder (ASD), its global impact has yet to be realized. Millions of families worldwide need effective treatments to help them get through everyday challenges like eating, sleeping, digestion, and social interaction. Qigong Sensory Training (QST) is a nonverbal, parent-delivered intervention recently shown to be effective at reducing these everyday challenges in children with ASD. This study tested the feasibility of a protocol for investigating QST’s neural mechanism. Methods During a single visit, 20 children, 4- to 7-year-old, with ASD viewed images of emotional faces before and after receiving QST or watching a video (controls). Heart rate variability was recorded throughout the visit, and power in the high frequency band (0.15–0.4 Hz) was calculated to estimate parasympathetic tone in 5-s nonoverlapping windows. Cerebral oximetry of prefrontal cortex was recorded during rest and while viewing emotional faces. Results 95% completion rate and 7.6% missing data met a priori standards confirming protocol feasibility for future studies. Preliminary data suggest: (1) during the intervention, parasympathetic tone increased more in children receiving massage (M = 2.9, SD = 0.3) versus controls (M = 2.5, SD = 0.5); (2) while viewing emotional faces post-intervention, parasympathetic tone was more affected (reduced) in the massage group ( p = 0.036); and (3) prefrontal cortex response to emotional faces was greater after massage compared to controls. These results did not reach statistical significance in this small study powered to test feasibility. Discussion/Conclusion This study demonstrates solid protocol feasibility. If replicated in a larger sample, these findings would provide important clues to the neural mechanism of action underlying QST’s efficacy for improving sensory, social, and communication difficulties in children with autism.
Phase III Intergroup Trial of Adjuvant Androgen Deprivation With or Without Mitoxantrone Plus Prednisone in Patients With High-Risk Prostate Cancer After Radical Prostatectomy: SWOG S9921
Authors: Hussain Maha , Tangen Catherine M. , Thompson Ian M. , Swanson Gregory P. , Wood David P. , Sakr Wael , Dawson Nancy A. , Haas Naomi B. , Flaig Thomas W. , Dorff Tanya B. , Lin Daniel W. , Crawford E. David , Quinn David I. , Vogelzang Nicholas J. , Glode L. Michael 
Published: April 2018

Purpose Patients with high-risk prostate cancer after radical prostatectomy are at risk for death. Adjuvant androgen-deprivation therapy (ADT) may reduce this risk. We hypothesized that the addition of mitoxantrone and prednisone (MP) to adjuvant ADT could reduce mortality compared with adjuvant ADT alone. Methods Eligible patients had cT1-3N0 prostate cancer with one or more high-risk factors after radical prostatectomy (Gleason score [GS] ≥ 8; pT3b, pT4, or pN+ disease; GS 7 and positive margins; or preoperative prostate-specific antigen [PSA] > 15 ng/mL, biopsy GS score > 7, or PSA > 10 ng/mL plus biopsy GS > 6. Patients with PSA ≤ 0.2 ng/mL after radical prostatectomy were stratified by pT/N stage, GS, and adjuvant radiation plan and randomly assigned to ADT (bicalutamide and goserelin for 2 years) or ADT plus six cycles of MP. The primary end point was overall survival (OS). Median OS was projected to be 10 years in the ADT arm, requiring 680 patients per arm to detect a hazard ratio of 1.30 with 92% power and one-sided α = .05. Results Nine hundred sixty-one eligible intent-to-treat patients were randomly assigned to ADT or ADT + MP from October 1999 to January 2007, when the Data Safety Monitoring Committee recommended stopping accrual as a result of higher leukemia incidence with ADT + MP. Median follow-up was 11.2 years. The 10-year OS estimates were 87% with ADT (expected 50%) and 86% with ADT + MP (hazard ratio, 1.06; 95% CI, 0.79 to 1.43). The 10-year estimate for disease-free survival was 72% for both arms. Prostate cancer was the cause of death in 18% of patients in the ADT arm and 22% in the ADT + MP arm. More patients in the MP arm died of other cancers (36% v 18% in ADT alone arm). Conclusion MP did not improve OS and increased deaths from other malignancies. The DFS and 10-year OS in these patients treated with 2 years of ADT were encouraging compared with historical estimates, although a definitive conclusion regarding value of ADT may not be made without a nontreatment control arm.