bluuebunny/crossref_metadata_2025_split huggingface dataset:
P14.117 Cost efficient test algorithm for molecular subgrouping of medulloblastomas for day-to-day practice in resource limited countries
Authors: Kaur K , Jha P , Pathak P , Suri V , Sharma M C , Garg A , Suri A , Sarkar C 
Published: September 2019

Abstract

INTRODUCTION
Molecular classification of medulloblastomas(MB) is prognostically and therapeutically relevant and helps in better risk-stratification. Translation of this subgrouping to routine practice still remains a challenge. The most pathologist-accessible techniques for molecular subgrouping include immunohistochemistry(IHC), fluorescent in-situ hybridization(FISH) and Nanostring assay. Objectives:(1)Molecular subgrouping of MBs by IHC and FISH, and Nanostring Assay (2)To compare their efficacy against sequencing and DNA methylation, and cost for applicability in resource-constrained centers

METHODS
Ninety-five cases of MB with adequate tissue were included. Molecular subgrouping was performed by IHC for β-catenin, GAB1, YAP1, and p53; FISH for MYC amplification, and sequencing for CTNNB1, and by Nanostring Assay on the same set of MBs. Further, a subset of cases were subjected to 850k DNA methylation array.

RESULTS
IHC+FISH classified MBs into 15.8% WNT, 16.8% SHH, and 67.4% non-WNT/non-SHH subgroups; with MYC amplification identified in 20.3% cases of non-WNT/non-SHH. A single showed diffuse strong p53 positivity among the SHH subgroup. Nanostring successfully classified 91.5% MBs into 25.3% WNT, 17.2% SHH, 23% Group3 and 34.5% Group4. However, Nanostring assay failure was seen in eight cases, all of which were >8-years-old formalin-fixed paraffin-embedded tissue blocks. Concordant subgroup assignment was noted in 88.5% cases, while subgroup switching was seen in 11.5% cases. Both methods showed prognostic correlation. Among the 5 discrepant cases, which switched to WNT subgroup by Nanostring, only 2 were found to have CTNNB1 mutation. Methylation profiling performed on discordant cases revealed 1 out of 4 extra WNT identified by Nanostring to be WNT, others aligned with IHC subgroups; extra SHH by Nanostring turned out to be SHH by methylation.

CONCLUSIONS
Both IHC supplemented by FISH and Nanostring are robust methods for molecular subgrouping, albeit with few disadvantages. IHC cannot differentiate between Groups 3 and 4, while Nanostring cannot classify older-archived tumors, and is not available at most centres. WNT subgroup with the best prognosis is best detected by IHC or IHC followed by sequencing for confirmation. Nanostring Assay is better suitable to separate Group 3, the worst prognostic group from Group 4. Thus, both the methods complement each other and can be used in concert for high confidence allotment of molecular subgroups in clinical practice. The cost of IHC plus Nanostring will almost be the same as IHC plus FISH. We recommend a cost-efficient algorithmic approach using histopathological subtype and IHC as the first step followed by Nanostring or FISH, wherever suitable.
Predictors and early survival outcomes of maximal resection in WHO grade II 1p/19q-codeleted oligodendrogliomas
Authors: Harary Maya , Kavouridis Vasileios K , Torre Matthew , Zaidi Hasan A , Chukwueke Ugonma N , Reardon David A , Smith Timothy R , Iorgulescu J Bryan 
Published: September 2019

Abstract

Background
Although surgery plays a crucial diagnostic role in World Health Organization (WHO) grade II 1p/19q-codeleted oligodendrogliomas, the role of maximal tumor surgical resection remains unclear, with early retrospective series limited by lack of molecular classification or appropriate control groups.

Methods
The characteristics, management, and overall survival (OS) of patients ≥20 years old presenting with histology-proven WHO grade II 1p/19q-codeleted oligodendrogliomas during 2010–2016 were evaluated using the National Cancer Database and validated using multi-institutional data. Patients were stratified by watchful waiting (biopsy only) versus surgical resection. OS was analyzed using Kaplan–Meier methods and risk-adjusted proportional hazards.

Results
Five hundred ninety adults met inclusion criteria, of whom 79.0% (n = 466) underwent surgical resection. Of patient and tumor characteristics, younger patients were more likely to be resected. Achieving gross total resection (GTR; n = 320) was significantly associated with smaller tumors, management at integrated network cancer programs (vs community cancer programs), and Medicare insurance (as compared with no, private, or Medicaid/other government insurance) and independent of other patient or tumor characteristics. In risk-adjusted analyses, GTR, but not subtotal resection (STR), demonstrated improved OS (vs biopsy only: hazard ratio 0.28, 95% CI: 0.09–0.85, P = 0.02).

Conclusions
WHO grade II 1p/19q-codeleted oligodendrogliomas amenable to resection demonstrated improved OS with GTR, but not STR, compared with biopsy-only watchful waiting. The OS benefits of GTR were independent of age, tumor size, or tumor location. Medicare-insured and integrated network cancer program patients were significantly more likely to have GTR than other patients, suggesting that insurance status and care setting may play important roles in access to timely diagnosis or innovations that improve maximal resection.
A Retrospective Comparative Analysis of Titanium Mesh and Custom Implants for Cranioplasty
Authors: Rosinski Clayton L , Patel Saavan , Geever Brett , Chiu Ryan G , Chaker Anisse N , Zakrzewski Jack , Rosenberg David M , Parola Rown , Shah Koral , Behbahani Mandana , Mehta Ankit I 
Published: September 2019

Abstract

BACKGROUND
Autologous bone removed during craniectomy is often the material of choice in cranioplasty procedures. However, when the patient's own bone is not appropriate (infection and resorption), an alloplastic graft must be utilized. Common options include titanium mesh and polyetheretherketone (PEEK)-based custom flaps. Often, neurosurgeons must decide whether to use a titanium or custom implant, with limited direction from the literature.

OBJECTIVE
To compare surgical outcomes of synthetic cranioplasties performed with titanium or vs custom implants.

METHODS
Ten-year retrospective comparison of patients undergoing synthetic cranioplasty with titanium or custom implants.

RESULTS
A total of 82 patients were identified for review, 61 (74.4%) receiving titanium cranioplasty and 21 (25.6%) receiving custom implants. Baseline demographics and comorbidities of the 2 groups did not differ significantly, although multiple surgical characteristics did (size of defect, indication for craniotomy) and were controlled for via a 2:1 mesh-to-custom propensity matching scheme in which 36 titanium cranioplasty patients were compared to 18 custom implant patients. The cranioplasty infection rate of the custom group (27.8%) was significantly greater (P = .005) than that of the titanium group (0.0%). None of the other differences in measured complications reached significance. Discomfort, a common cause of reoperation in the titanium group, did not result in reoperation in any of the patients receiving custom implants.

CONCLUSION
Infection rates are higher among patients receiving custom implants compared to those receiving titanium meshes. The latter should be informed of potential postsurgical discomfort, which can be managed nonsurgically and is not associated with return to the operating room.
Inns And Elite Mobility In Late Georgian Britain*
Authors: Maudlin Daniel 
Published: September 2019

Abstract
This paper considers the significance of the spaces and material culture of the ‘principal inn’ as the centre of a distinct world of elite mobility in eighteenth-century Britain. Inns were central to the expansion and improvement of the travel network that brought the British Isles closer together through the long eighteenth century. The turnpike system introduced improved surfaces to old and new roads while new coach-building technology allowed faster movement on those roads. However, it was the national network of inns, regularly and reliably punctuating Britain's roads, that made fast and efficient travel a practical, everyday reality from London to York, Bristol to Holyhead, Edinburgh to Inverness. On arrival the inn provided food and accommodation for travellers, hay and stables for horses and grease for carriage axles. From cross-country travel to crossing the inn-yard, finding a table in the parlour or climbing the stairs to bed, the inn served the traveller across different scales of space and mobility. Moreover, for the elite traveller, inns were not simply blank containers for travel-related activities; they were material constructs that gave those activities form and meaning. Within the principal inn refined interior spaces and well-made, fashionable things placed the elite traveller in a reassuringly familiar cultural space, a bubble of comfort, luxury and good taste which they did not leave from one inn to the next.
The Long Parliament and the Law of Necessity in Seventeenth-Century England*
Authors: Collins John M 
Published: September 2019

Abstract
The ability to claim an eminent right over property was central to the parliamentary war effort. Relying on a narrative of necessity that jurists in both England and in western Europe had increasingly used since the end of the sixteenth century, MPs gave the English political public a narrative parallel to that of a beggar in extreme duress: in order for it to survive, the property rights of English subjects needed to give way. Scholars have noted the Long parliament's use of necessity in the past in order to disassociate the causes of the Civil War from a ‘rule of law’ ideology or to make a claim that Parliament made a novel political theory of emergency. Yet the Long parliament was not abandoning English law nor was it generating a novel theory of emergency. Instead, it was relying on legal concepts that jurists and Crown officials commonly used to advance the power of the state. This law of necessity was controversial, however, and the Long parliament's continued use of it generated conflict even as it also enabled MPs to seize control over England's armed forces.
Perioperative Gabapentin in Pediatric Thoracic Surgery Patients—Randomized, Placebo-Controlled, Phase 4 Trial
Authors: Tomaszek Lucyna , Fenikowski Dariusz , Maciejewski Piotr , Komotajtys Halina , Gawron Danuta 
Published: September 2019

Abstract

Objective
To determine whether the use of perioperative gabapentin reduces postoperative pain and anxiety, decreases ropivacaine consumption and side effects, and improves patient satisfaction.

Design
Randomized, placebo-controlled, phase 4 trial.

Blinding
Participants, care providers, investigators, data analysts.

Setting
Department of Thoracic Surgery of the Institute of Tuberculosis and Lung Disease, Rabka Zdrój Branch, Poland.

Subjects
Forty patients undergoing the Ravitch procedure.

Methods
Patients aged nine to 17 years were randomized into a gabapentin (preoperative 15 mg/kg, treatment) or placebo group. Postoperative analgesia included gabapentin (7.5 mg/kg) or placebo two times per day for three days, epidural ropivacaine + fentanyl, paracetamol, nonsteroidal anti-inflammatory drugs, and metamizol as a “rescue drug.” Pain, anxiety, analgesic consumption, side effects, and patient satisfaction were recorded.

Results
There was no statistically significant difference in median pain scores (numerical rating scale &lt; 1/10) or incidence of adverse side effects between the gabapentin group (N = 20) and the placebo group (N = 20). Postoperative anxiety scores were significantly lower than before surgery in the gabapentin group (6 [4–8] vs 7 [6–8.5], P &lt; 0.01) and remained unchanged in the placebo group (6 [5–6.5] vs 6 [5–7], P = 0.07). Gabapentin-treated patients received a lower number of doses of ondansetron when compared with the placebo group (6 [5–6] vs 7 [6–9], P = 0.02). A significant negative association was found between patient satisfaction and postoperative state anxiety in the gabapentin group (R = –0.51, P = 0.02).

Conclusions
Perioperative administration of gabapentin resulted in a decrease of postoperative anxiety in pediatric patients undergoing the Ravitch procedure.
The association between living conditions and health among Syrian refugee children in informal tented settlements in Lebanon
Authors: Habib Rima R , Ziadee Micheline , Abi Younes Elio , El Asmar Khalil , Jawad Mohammed 
Published: September 2019

Abstract

Background
This cross-sectional study explores the relationship between housing, social wellbeing, access to services and health among a population of Syrian refugee children in Lebanon.

Methods
We surveyed 1902 Syrian refugee households living in informal tented settlements in Lebanon in 2017. Logistic regressions assessed relationships between housing problems, socioeconomic deprivation, social environment and health.

Results
Of the 8284 children in the study, 33.0% had at least one health problem. A considerable number of households (43.1%) had &gt; 8 housing problems. Children in these households had higher odds to have three or more health problems compared to children in households with &lt; 6 housing problems (adjusted odds ratio [AOR], 2.39; confidence interval [CI], 1.50–3.81). Nearly three-quarters (74.3%) of households were severely food insecure. Children in these households had higher odds to have one health problem than those in food secure households (AOR, 1.75; CI, 1.11–2.76). There was a significant positive association between households that reported being unhappy with their neighbourhood and the number of children with health problems in those households.

Conclusions
This study highlights the association between the physical and social living conditions and refugee children’s health. Without multidimensional interventions that consider improvements to living conditions, the health of young Syrian refugees will continue to worsen.
Reflections on the meaning of ‘resilience’ in the Palestinian context
Authors: Giacaman Rita 
Published: September 2019

Abstract
This reflective piece offers an alternative perspective to understanding the components which support the Palestinian capacity to endure and resist 100 years of violation and injustice, in context. It traces the development of the author’s understanding over time as part of the Palestinian community living under Israeli military rule in chronic warlike conditions. It combines this lived experience with research results which raise question about what resilience means, the difficulties encountered in its measurement, and the utility of the concept in explaining the Palestinian reality. It emphasizes the need to include the contextual experiences of those who live in wars and conflicts in future research and for knowledge production. It ends by stressing that it is not sufficient to offer humanitarian aid to the victims of wars and conflicts without also advocating for justice not only for Palestinians but also in other contexts of injustice worldwide.
Empire and Modernism in Joseph Conrad’s ‘Karain: A Memory’
Authors: Purssell Andrew 
Published: September 2019

Abstract
Joseph Conrad’s ‘Karain: A Memory’ (1897) is not often cited as a landmark of literary modernism. Conrad’s Malay story appeared during the year in which The Nigger of the ‘Narcissus’ announced his arrival as an author with modernist ambitions. It also belongs to the same Blackwood’s period of his early career that produced arguably his most celebrated work, ‘Heart of Darkness’. Whereas these stories consensually exemplify Conrad’s modernism, ‘Karain’ tends to be construed as an early working-through of the contemporary popular influences that shaped his literary output. Yet, in a significant sense, it also dramatizes the colonial encounter that defined some of the conceptual contours of modernism. This essay explores the story’s composition, early transmission and reception, its self-conscious engagement with its popular cultural lineage, and Conrad’s parallel emergence as a writer of ‘challenging’ fiction. Its aim is not merely to recuperate ‘Karain’ as a work of early modernism, nor simply to re-evaluate Conrad’s story as a rehearsal, in terms of its interrogative relationship with imperialism, for some of his more overtly anti-colonialist fiction. Rather, its wider focus is on how Conrad’s story reflects upon the nature of empire and modernism as mutually sustaining enterprises, and, counter to the view of other modernist authors such as T. S. Eliot, how colonial fiction and modernist writing are not antithetical but rather interrelated literary practices.
Consumer Scores and Price Discrimination
Authors: Bonatti Alessandro , Cisternas Gonzalo 
Published: September 2019

Abstract
We study the implications of aggregating consumers’ purchase histories into scores that proxy for unobserved willingness to pay. A long-lived consumer interacts with a sequence of firms. Each firm relies on the consumer’s current score–a linear aggregate of noisy purchase signals—to learn about her preferences and to set prices. If the consumer is strategic, she reduces her demand to manipulate her score, which reduces the average equilibrium price. Firms in turn prefer scores that overweigh past signals relative to applying Bayes’ rule with disaggregated data, as this mitigates the ratchet effect and maximizes the firms’ ability to price discriminate. Consumers with high average willingness to pay benefit from data collection, because the gains from low average prices dominate the losses from price discrimination. Finally, hidden scores—those only observed by the firms—reduce demand sensitivity, increase average prices, and reduce consumer surplus, sometimes below the naive-consumer level.
Prudence in practice: Bartlett and beyond
Authors: Graham Toby , Tan Alicia 
Published: September 2019

Abstract
In Zhang Hong Li v DBS Bank (Hong Kong) Ltd and Ors the Court of Appeal in Hong Kong referred to trustee's ‘residual obligation’ to act in respect of an underlying company in circumstances where no reasonable trustee would refrain from doing so. This has attracted some criticism. We suggest that such criticism is narrowly drawn; if one looks more widely one can find support for the notion of a residual obligation. We suggest it is in keeping with developments in New Zealand's Trustee Act 2019 and question the hitherto narrow approach to the irreducible core. The balance between shareholder and directors that might have been thought appropriate 40 years ago, when Bartlett was decided, might be less appropriate today; we refer to increased activism amongst institutional investors. We touch on the private equity model as well. We conclude that trustees should, absent some good reason, seek board representation.
Eosinophilia and cystic echinococcosis: what is the relationship?
Authors: Collado-Aliaga Javier , Romero-Alegría Ángela , Alonso-Sardón Montserrat , López-Bernus Amparo , Galindo-Pérez Inmaculada , Muro Antonio , Velasco-Tirado Virginia , Muñoz Bellido Juan Luis , Belhassen-García Moncef , Pardo-Lledias Javier 
Published: September 2019

Abstract

Background
Cystic echinococcosis (CE) is a chronic, complex and neglected zoonotic disease caused by Echinococcus granulosus. Eosinophilia in CE is a classic analytic alteration, although its presentation and importance is very variable and not well established.

Methods
We performed a retrospective observational study of inpatients diagnosed with CE and eosinophilia from January 1998 to December 2017 in the Complejo Asistencial Universitario de Salamanca in western Spain.

Results
During the study period, 475 patients with a CE diagnosis underwent a haemogram and 118 (24.8%) patients had eosinophilia. Eighty-two (69.5%) were male and the mean age was 52.1±20.8 y, which was younger in the group with eosinophilia (p<0.001). The patients with eosinophilia had less comorbidity (33.1% vs 52.9%; p<0.001) and they were diagnosed with more complications (60.2% vs 39.8% asymptomatic; p<0.001). Clinical manifestations appeared in 71 cases (60.2%). The eosinophilia was related to the presence of pre-surgical fistulas (p=0.005). We observed significant differences when considering whether eosinophilia is a marker of the type of treatment (p<0.001).

Conclusions
Eosinophilia can be an indicator for an active search in CE because as much as 40% of cases are asymptomatic at diagnosis. In patients with eosinophilia, management is usually more aggressive and is usually a combined treatment. Our work shows the importance of eosinophilia in our patients with CE and raises unresolved questions.
Unravelling interspecific relationships among highland lizards: first phylogenetic hypothesis using total evidence of the Liolaemus montanus group (Iguania: Liolaemidae)
Authors: Abdala Cristian Simón , Quinteros Andrés Sebastián , Semhan Romina Valeria , Bulacios Arroyo Ana Lucia , Schulte James , Paz Marcos Maximiliano , Ruiz-Monachesi Mario Ricardo , Laspiur Alejandro , Aguilar-Kirigin Alvaro Juan , Gutiérrez Poblete Roberto , Valladares Faundez Pablo , Valdés Julián , Portelli Sabrina , Santa Cruz Roy , Aparicio James , Garcia Noelia , Langstroth Robert 
Published: September 2019

AbstractThe South American lizard genus Liolaemus comprises &gt; 260 species, of which &gt; 60 are recognized as members of the Liolaemus montanus group, distributed throughout the Andes in central Peru, Bolivia, Chile and central Argentina. Despite its great morphological diversity and complex taxonomic history, a robust phylogenetic estimate is still lacking for this group. Here, we study the morphological and molecular diversity of the L. montanus group and present the most complete quantitative phylogenetic hypothesis for the group to date. Our phylogeny includes 103 terminal taxa, of which 91 are members of the L. montanus group (58 are assigned to available species and 33 are of uncertain taxonomic status). Our matrix includes 306 morphological and ecological characters and 3057 molecular characters. Morphological characters include 48 continuous and 258 discrete characters, of which 70% (216) are new to the literature. The molecular characters represent five mitochondrial markers. We performed three analyses: a morphology-only matrix, a molecular-only matrix and a matrix including both morphological and molecular characters (total evidence hypothesis). Our total evidence hypothesis recovered the L. montanus group as monophyletic and included ≥ 12 major clades, revealing an unexpectedly complex phylogeny.