bluuebunny/crossref_metadata_2025_split huggingface dataset:
Type 3 neovascularisation (retinal angiomatous proliferation) treated with antivascular endothelial growth factor: real-world outcomes at 24 months
Authors: Invernizzi Alessandro , Teo Kelvin , Nguyen Vuong , Daniell Mark , Squirrell David , Barthelmes Daniel , Gillies Mark C 
Published: December 2018

AimsTo compare 24 months outcomes of eyes with retinal angiomatous proliferations (RAPs) treated with antivascular endothelial growth factor (anti-VEGF) with a group of controls diagnosed with other neovascular age-related macular degeneration (nAMD) subtypes in a real-world setting.MethodsTreatment-naïve nAMD eyes that commenced anti-VEGF between January 2006 and November 2015 were identified from a registry of nAMD treatment outcomes. Cases were defined as eyes diagnosed with RAP. Three controls per case were selected among nAMD eyes with non-RAP lesions and matched on baseline visual acuity (VA), year of treatment initiation, anti-VEGF agent first injected and follow-up. Baseline VA was compared with 12 and 24 months VA. Change in VA, number of injections received, proportion of visits with active nAMD and time to first inactivation were compared between RAPs and controls.Results157 RAPs and 469 controls were included. Baseline VA (mean (SD)) increased at 12 months (61.4 (15.5) vs 68.7 (14.7) letters, p<0.001) and remained higher (66.6 (17.3) letters) at 24 months (p<0.001) in RAPs. The change from baseline VA (mean(95% CI)) was significantly higher in RAPs than in controls at 12 months (7.3 (5.4 to 9.1) vs 4.1 (2.8 to 5.4) letters, p=0.01) and at 24 months (5.1 (2.8 to 7.3) vs 2.5 (1 to 4) letters, p=0.056). Both groups received a median of 13 injections. RAPs inactivated earlier and were less active than controls (both p<0.001).ConclusionsRAPs responded well to anti-VEGF, with a significant improvement in VA persisting at 24 months. RAPs had better visual outcomes than controls at 12 and 24 months, tended to inactivate earlier and were less active throughout 2 years follow-up.
Core temperature up to 41.5ºC during the UCI Road Cycling World Championships in the heat
Authors: Racinais Sebastien , Moussay Sebastien , Nichols David , Travers Gavin , Belfekih Taoufik , Schumacher Yorck Olaf , Periard Julien D 
Published: December 2018

ObjectiveTo characterise the core temperature response and power output profile of elite male and female cyclists during the 2016 UCI Road World Championships. This may contribute to formulating environmental heat stress policies.MethodsCore temperature was recorded via an ingestible capsule in 10, 15 and 15 cyclists during the team time trial (TTT), individual time trial (ITT) and road race (RR), respectively. Power output and heart rate were extracted from individual cycling computers. Ambient conditions in direct sunlight were hot (37°C±3°C) but dry (25%±16% relative humidity), corresponding to a wet-bulb globe temperature of 27°C±2°C.ResultsCore temperature increased during all races (p<0.001), reaching higher peak values in TTT (39.8°C±0.9°C) and ITT (39.8°C±0.4°C), relative to RR (39.2°C±0.4°C, p<0.001). The highest temperature recorded was 41.5°C (TTT). Power output was significantly higher during TTT (4.7±0.3 W/kg) and ITT (4.9±0.5 W/kg) than RR (2.7±0.4 W/kg, p<0.001). Heart rate increased during the TTs (p<0.001) while power output decreased (p<0.001).Conclusion85% of the cyclists participating in the study (ie, 34 of 40) reached a core temperature of at least 39°C with 25% (ie, 10 of 40) exceeding 40°C. Higher core temperatures were reached during the time trials than the RR.
The impact of reducing dietary aflatoxin exposure on child linear growth: a cluster randomised controlled trial in Kenya
Authors: Hoffmann Vivian , Jones Kelly , Leroy Jef L 
Published: December 2018

IntroductionObservational studies have documented an association between aflatoxin (AF) exposure and reduced linear growth in infants and young children. Our objective was to assess the effectiveness of reducing AF exposure on child linear growth and serum AF levels in rural areas in Eastern Kenya.MethodsA cluster randomised controlled design was used (28 intervention and 28 control clusters). The intervention arm received a swapping (contaminated maize was replaced with safe maize) and a stockist intervention (households were encouraged to purchase from a stockist supplied with clean maize). Women in the fifth to final month of pregnancy were invited to enrol in the study. Outcomes were child length-for-age Z-score (LAZ), the prevalence of stunting and child serum AFB1-lysine adduct level 24 (endline, primary outcomes) and 11 to 19 months (midline, secondary outcomes) after trial commencement, respectively. The trial was registered with socialscienceregistry.org.ResultsOf the 1230 unborn children enrolled in the study, 881 (72%) were included in the LAZ and 798 (65%) in the serum AFB1analysis. The intervention significantly reduced endline ln serum AFB1-lysine adduct levels (intervention effect—0.273, 95% CI −0.547 to 0.001; one-sided p=0.025), but had no effect on endline LAZ or stunting (mean LAZ at endline was −1.64). At midline, the intervention increased LAZ by 0.16 (95% CI −0.009 to 0.33; one-sided p=0.032) and reduced stunting by seven percentage points (95% CI −0.125 to −0.007; one-sided p=0.015), but had no impact on serum AFB1levels.ConclusionImproving access to AF-free maize substantially reduced endline serum AF, but had no effect on child linear growth. The midline analysis suggests that AF may affect linear growth at younger ages.Trial registration numberAEARCTR-0000105.
What is the minimum number of specialist anaesthetists needed in low-income and middle-income countries?
Authors: Davies Justine I , Vreede Eric , Onajin-Obembe Bisola , Morriss Wayne W 
Published: December 2018

IntroductionThe number of specialist anaesthetists in most low-income and middle-income countries is below what is needed to provide a safe quality anaesthesia service. There are no estimates of the optimal number; therefore, we estimated the minimum density of specialist anaesthetists to achieve a reasonable standard of healthcare as indicated by the maternal mortality ratio (MMR).MethodsUtilising existing country-level data of the number of physician anaesthesia providers (PAPs), MMR and Human Development Index (HDI), we developed best-fit curves to describe the relationship between MMR and PAPs, controlling for HDI. The aim was to use this relationship to estimate the number of PAPs associated with achieving the median MMR.ResultsWe estimated that, in order to achieve a reasonable standard of healthcare, as indicated by the global median MMR, countries should aim to have at least four PAPs per 100 000 population. Existing data show that currently 80 countries have fewer than this number.ConclusionFour PAPs per 100 000 population is a modest target, but there is a need to increase training of doctors in many countries in order to train more specialist anaesthetists. It is important that this target is considered during the development of national workforce plans, even if a stepwise approach to workforce planning is chosen.
Long-term impact of community-based participatory women’s groups on child and maternal mortality and child disability: follow-up of a cluster randomised trial in rural Nepal
Authors: Heys Michelle , Gram Lu , Wade Angie , Haworth Edward James Norman , Osrin David , Sagar Khadkha , Shrestha Dej Krishna , Neupane Rishi Prasad , Adhikari Dhruba , Adhikari Ramesh Kant , Budhathoki Bharat , Manandhar Dharma , Costello Anthony 
Published: December 2018

BackgroundCommunity-based women’s groups practising participatory learning and action (PLA) can reduce maternal and neonatal mortality in low-income countries. However, it is not clear whether these reductions are associated with subsequent increased or decreased rates of childhood death and disability. We assessed the impact on child deaths and disability beyond the perinatal period among participants in the earliest trial in Nepal 2001–2003.MethodsHousehold interviews were conducted with mothers or household heads. At cluster and individual levels, we analysed disability using pairwise log relative risks and survival using multilevel logistic models.FindingsFrom 6075 children and 6117 mothers alive at 4 weeks post partum, 44 419 children (73%) were available for interview a mean 11.5 years later. Rates of child deaths beyond the perinatal period were 36.6 and 52.0 per 1000 children in the intervention and control arms respectively. Rates of disability were 62.7 and 85.5 per 1000 children in the intervention and control arms respectively. Individual-level analysis, including random effects for cluster pairing and adjusted for baseline maternal literacy, socioeconomic status and maternal age, showed lower, statistically non-significant, odds of child deaths (OR 0.70 (95% CI 0.43 to 1.18) and disability (0.64 (0.39 to 1.06)) in the intervention arm.ConclusionCommunity-level exposure to women’s groups practising PLA did not significantly impact childhood death or disability or death beyond the perinatal period. Follow-up of other trials with larger sample sizes is warranted in order to explore the possibility of potential long-term survival and disability benefits with greater precision.
Educational intervention to reduce treatment of asymptomatic bacteriuria in long-term care
Authors: Lee Christine , Phillips Casey , Vanstone Jason Robert 
Published: December 2018

ObjectiveTo determine if an educational intervention can decrease the inappropriate antibiotic treatment of long-term care (LTC) residents with asymptomatic bacteriuria (ASB).DesignProspective chart audit between May and July 2017.SettingSeven LTC facilities in Regina, Saskatchewan, Canada.ParticipantsChart audits were performed on all LTC residents over 18 years of age with a positive urine culture. Educational sessions and tools were available to all clinical staff at participating LTC facilities.InterventionFifteen-minute educational sessions were provided to LTC facility staff outlining the harms of unnecessary antibiotic use, antibiotic resistance and the diagnostic criteria of a urinary tract infection (UTI). Educational sessions were complimented with posters and pocket cards that summarised UTI diagnostic criteria.Main outcome measureThe primary outcome measure was the number of residents who received inappropriate antibiotic treatment for ASB. Secondary outcome measures included the appropriateness of urine culture tests, number of tests and cost associated with inappropriate treatments.ResultsIn the preintervention period, 172 urine culture and sensitivity (UC&S) tests were performed, 62 (36.0%) were positive and 50/62 (80.6%) residents had ASB based on chart review. In the postintervention period, 151 UC&S tests were performed, 50 (33.1%) were positive and 35/50 (70.0%) residents had ASB. There was a statistically significant decrease in the number of residents treated with antibiotics for ASB, from 45/50 (90%) preintervention to 22/35 (62.9%) postintervention (χ2=9.087, p=0.003).ConclusionsAn educational intervention was associated with a statistically significant decrease in inappropriate antibiotic treatment of LTC residents with ASB.
IFNγ-Induced IFIT5 Promotes Epithelial-to-Mesenchymal Transition in Prostate Cancer via miRNA Processing
Authors: Lo U-Ging , Pong Rey-Chen , Yang Diane , Gandee Leah , Hernandez Elizabeth , Dang Andrew , Lin Chung-Jung , Santoyo John , Ma Shihong , Sonavane Rajni , Huang Jun , Tseng Shu-Fen , Moro Loredana , Arbini Arnaldo A. , Kapur Payal , Raj Ganesh V. , He Dalin , Lai Chih-Ho , Lin Ho , Hsieh Jer-Tsong 
Published: December 2018

AbstractIFNγ, a potent cytokine known to modulate tumor immunity and tumoricidal effects, is highly elevated in patients with prostate cancer after radiation. In this study, we demonstrate that IFNγ can induce epithelial-to-mesenchymal transition (EMT) in prostate cancer cells via the JAK–STAT signaling pathway, leading to the transcription of IFN-stimulated genes (ISG) such as IFN-induced tetratricopeptide repeat 5 (IFIT5). We unveil a new function of IFIT5 complex in degrading precursor miRNAs (pre-miRNA) that includes pre-miR-363 from the miR-106a-363 cluster as well as pre-miR-101 and pre-miR-128, who share a similar 5′-end structure with pre-miR-363. These suppressive miRNAs exerted a similar function by targeting EMT transcription factors in prostate cancer cells. Depletion of IFIT5 decreased IFNγ-induced cell invasiveness in vitro and lung metastasis in vivo. IFIT5 was highly elevated in high-grade prostate cancer and its expression inversely correlated with these suppressive miRNAs. Altogether, this study unveils a prometastatic role of the IFNγ pathway via a new mechanism of action, which raises concerns about its clinical application.Significance: A unique IFIT5–XRN1 complex involved in the turnover of specific tumor suppressive microRNAs is the underlying mechanism of IFNγ-induced epithelial-to-mesenchymal transition in prostate cancer.See related commentary by Liu and Gao, p. 1032
Leveraging the Electronic Health Record to Create an Automated Real‐Time Prognostic Tool for Peripheral Arterial Disease
Authors: Arruda‐Olson Adelaide M. , Afzal Naveed , Priya Mallipeddi Vishnu , Said Ahmad , Moussa Pacha Homam , Moon Sungrim , Chaudhry Alisha P. , Scott Christopher G. , Bailey Kent R. , Rooke Thom W. , Wennberg Paul W. , Kaggal Vinod C. , Oderich Gustavo S. , Kullo Iftikhar J. , Nishimura Rick A. , Chaudhry Rajeev , Liu Hongfang 
Published: December 2018

Background

Automated individualized risk prediction tools linked to electronic health records (
EHR
s) are not available for management of patients with peripheral arterial disease. The goal of this study was to create a prognostic tool for
patients with peripheral arterial disease
using data elements automatically extracted from an
EHR
to enable real‐time and individualized risk prediction at the point of care.

Methods and Results

A previously validated phenotyping algorithm was deployed to an
EHR
linked to the Rochester Epidemiology Project to identify
peripheral arterial disease
cases from Olmsted County,
MN,
for the years 1998 to 2011. The study cohort was composed of 1676 patients: 593 patients died over 5‐year follow‐up. The c‐statistic for survival in the overall data set was 0.76 (95% confidence interval [CI], 0.74–0.78), and the c‐statistic across 10 cross‐validation data sets was 0.75 (95% CI, 0.73–0.77). Stratification of cases demonstrated increasing mortality risk by subgroup (low: hazard ratio, 0.35 [95% CI, 0.21–0.58]; intermediate‐high:
hazard ratio,
2.98 [95% CI, 2.37–3.74]; high:
hazard ratio,
8.44 [95% CI, 6.66–10.70], all
P
<0.0001 versus the reference subgroup). An equation for risk calculation was derived from Cox model parameters and β estimates. Big data infrastructure enabled deployment of the real‐time risk calculator to the point of care via the
EHR
.

Conclusions

This study demonstrates that electronic tools can be deployed to
EHR
s to create automated real‐time risk calculators to predict survival of patients with peripheral arterial disease. Moreover, the prognostic model developed may be translated to patient care as an automated and individualized real‐time risk calculator deployed at the point of care.
The Many Facets of National Culture: A Critical Appraisal
Authors: AlMutairi Shihanah , Yen Dorothy , Heller Michael 
Published: December 2018

Abstract
Due to its wide usage in vast fields of study, there is a lack of studies synthesizing the many aspects of national culture theory. The authors argue that given the proliferation of national culture theories in various disciplines, the need to integrate and provide an analytical review is fundamental for further research. As such, they have reviewed 110 empirical and conceptual studies on the concept of national culture and recounted the different national culture theories within. They have also assimilated the varied criticism towards each respective national culture theory and synthesized them under six discernable shortcomings: the ecological fallacy, the concept of nations as units, the complexity of culture, the construct’s conceptualization, the research approach, and the dangers of stereotyping.
Developing Resilient K-12 STEM Teachers
Authors: Wright Diane S. , Balgopal Meena M. , Sample McMeeking Laura B. , Weinberg Andrea E. 
Published: December 2018

The Problem The US is currently experiencing a shortage of K-12 science, technology, engineering, and mathematics (STEM) teachers, especially in high-poverty communities. The shortage can be explained by both low teacher recruitment and high teacher turnover; however, the reasons why teachers leave the profession are complex. The Solution We argue that teacher professional development programs are often focused on how teachers can meet the needs of their students but ignore how teachers can build their own professional resilience. We draw from research in both teacher self-efficacy and ecological adaptive capacity to propose a revised Teacher-Centered Systemic Reform Model that identifies adaptive capacity as an outcome goal for individuals and school systems. School environments are dynamic (e.g., new policies, student needs, and changing administrators), and as a result, teachers need skills to adapt, enabling them to be resilient while still meeting students’ needs. The Stakeholders Professional development, teacher educators, human resource development (HRD) practitioners, K-12 STEM teachers.
ADVANCING Women Academic Faculty in STEM Careers: The Role of Critical HRD in Supporting Diversity and Inclusion
Authors: Hutchins Holly M. , Kovach Jamison V. 
Published: December 2018

The Problem The low representation of women and women of color (WoC) faculty in science, technology, engineering, and mathematics (STEM) academic disciplines represents a critical talent development issue by constraining universities from being truly diverse and inclusive therefore limiting the development and advancement of women scientists. The Solution We describe the National Science Foundation’s (NSF) ADVANCE program as a mechanism for increasing STEM women and WoC faculty career development, inclusion, and advancement. We situate this program as a critical human resource development (CHRD) project and analyze the interventions of ADVANCE Centers at five institutions using a coding scheme based on Acker’s theory of organizational gendering. We identify how key interventions address gendered processes and how these efforts align with human resource development (HRD) disciplinary expertise. The Stakeholders This article will benefit HRD scholars and professionals by identifying how HRD disciplinary expertise can be used to support institutional change efforts focused on faculty diversity and inclusion.
Updated diagnostic criteria for neuromyelitis optica spectrum disorder: Similar outcomes of previously separate cohorts
Authors: McCreary M , Mealy MA , Wingerchuk DM , Levy M , DeSena A , Greenberg BM 
Published: December 2018

Background The specificity of the aquaporin-4 antibody to predict recurrent inflammatory central nervous system disease has led to the design of the 2015 neuromyelitis optica spectrum disorder criteria which capture all aquaporin-4 antibody seropositive patients. Objective The purpose of this study was to compare treatment outcomes in aquaporin-4 antibody seropositive patients who met the previous 2006 clinical criteria for neuromyelitis optica with patients who meet the 2015 neuromyelitis optica spectrum disorder criteria. Methods The study involved a three-center retrospective chart review of clinical outcomes among aquaporin-4 patients diagnosed with neuromyelitis optica and neuromyelitis optica spectrum disorder. Results Hazard ratios of relapse during immunosuppressive therapy, relative to pre-therapy, were not significantly different for patients who met the 2006 criteria of neuromyelitis optica versus the 2015 neuromyelitis optica spectrum disorder criteria among those treated with azathioprine (  p = 0.24), mycophenolate mofetil (  p = 0.63), or rituximab (  p = 0.97). Conclusion Reductions in the hazard of relapse during treatment with immunosuppressive therapies, relative to average pre-treatment, were not different for aquaporin-4 antibody seropositive patients categorized using the 2006 criteria of neuromyelitis optica and the 2015 neuromyelitis optica spectrum disorder criteria. These therapeutic findings support the design of the 2015 neuromyelitis optica spectrum disorder criteria which capture all aquaporin-4 antibody seropositive patients.
Controversies and emerging topics in lung transplantation
Authors: Abelson David , Glanville Allan R. 
Published: December 2018

Lung transplantation provides a realistic hope of improved survival and enhanced quality of life. However, outcomes can be disappointing, meaning many decisions are highly controversial. Practice is largely based on expert opinion and there is a dearth of high-level evidence. Not surprisingly, this leads to centre-specific practices that may vary considerably in controversial areas. The aim of this review, therefore, is to explore some of those domains and present the available evidence. As the science of lung transplantation approaches its fifth decade, we are only now reaching a critical mass of clinicians and scientific researchers to enable adequately powered studies to assist in informing our approach to some of these controversies.Key pointsLung transplantation remains an art, combining experience with evidence.Clinicians need evidence to guide them on a myriad of questions, from candidate selection and listing, to organ donor acceptance, immunosuppression and chronic allograft dysfunction.Chronic lung allograft dysfunction pathogenesis deserves further detailed study.Educational aimsTo illustrate the spectrum of controversial areas in lung transplantation including whom to list, which organs can be used and for whom, immune suppression and infection prophylaxis, and causes and phenotypes of chronic lung allograft dysfunction.To inspire clinicians to always ask questions and help collect the evidence we need to inform decision making.