bluuebunny/crossref_metadata_2025_split huggingface dataset:
Equity in access to non-communicable disease medicines: a cross-sectional study in Kenya
Authors: Rockers Peter C , Laing Richard O , Wirtz Veronika J 
Published: June 2018

IntroductionWealth-based inequity in access to medicines is an impediment to achieving universal health coverage in many low-income and middle-income countries. We explored the relationship between household wealth and access to medicines for non-communicable diseases (NCDs) in Kenya.MethodsWe administered a cross-sectional survey to a sample of patients prescribed medicines for hypertension, diabetes or asthma. Data were collected on medicines available in the home, including the location and cost of purchase. Household asset information was used to construct an indicator of wealth. We analysed the relationship between household wealth and various aspects of access, including the probability of having NCD medicines at home and price paid.ResultsAmong 639 patients interviewed, hypertension was the most prevalent NCD (69.6%), followed by diabetes (22.2%) and asthma (20.2%). There was a positive and statistically significant association between wealth and having medicines for patients with hypertension (p=0.020) and asthma (p=0.016), but not for diabetes (p=0.160). Poorer patients lived farther from their nearest health facility (p=0.050). There was no relationship between household wealth and the probability that the nearest public or non-profit health facility had key NCD medicines in stock, though less poor patients were significantly more likely to purchase medicines at better stocked private outlets. The relationship between wealth and median price paid for metformin by patients with diabetes was strongly u-shaped, with the middle quintile paying the lowest prices and the poorest and least poor paying higher prices. Patients with asthma in the poorest wealth quintile paid more for salbutamol than those in all other quintiles.ConclusionThe poorest in Kenya appear to face increased barriers to accessing NCD medicines as compared with the less poor. To achieve universal health coverage, the country will need to consider pro-poor policies for improving equity in access.
Quantifying intervals to diagnosis in myeloma: a systematic review and meta-analysis
Authors: Koshiaris Constantinos , Oke Jason , Abel Lucy , Nicholson Brian D , Ramasamy Karthik , Van den Bruel Ann 
Published: June 2018

ObjectivesTo quantify the duration of each step of the diagnostic pathway for patients with multiple myeloma from symptom onset to confirmation of diagnosis.DesignSystematic review and meta-analysis.Data sources and selection criteriaThe MEDLINE and Embase databases were searched up until January 2018 to identify articles that reported time intervals from onset of symptoms to diagnosis. Articles focusing on children or adolescents and on the asymptomatic form of the disease (monoclonal gammopathies and smouldering myeloma) were excluded.Data collection and data analysisData were extracted independently by two reviewers. Weighted estimates of the median and IQR were calculated. Risk of bias was assessed using the Aarhus checklist.Main resultsNine studies were included. The patient interval (first symptom to first presentation) had a median of 26.3 days (IQR: 1–98, n=465, two studies). Subsequently, the primary care interval (first presentation to first referral) was 21.6 days (IQR: 4.6–55.8, n=326, two studies), the diagnostic interval (first presentation to diagnosis) was 108.6 days (IQR: 33.3–241.7, n=5395, seven studies) and the time to diagnosis (first symptom to diagnosis) interval was 163 days (IQR: 84–306, n=341, one study). No studies reported data for the referral to diagnosis interval.ConclusionThe review demonstrates that there is scope for significant reductions in the time to myeloma diagnosis. At present, many patients experience a diagnostic interval longer than 3 months until diagnosis is confirmed.Review registrationNot available. Protocol available in the appendix.
Young man presenting with out-of-hospital cardiac arrest
Authors: Huang Hans David , Lombardi William L , Steinberg Zachary Louis 
Published: June 2018

Clinical introductionA man in his early 30s with remote history of a febrile rash as a toddler presented to the emergency room following an out-of-hospital cardiac arrest while riding his bicycle. He received bystander cardiopulmonary resuscitation and one shock from an automatic external defibrillator, successfully restoring sinus rhythm. On arrival, he was haemodynamically stable without ECG evidence of ST segment changes to suggest active ischaemia, and an initial troponin I was mildly elevated at 0.10 ng/mL (normal <0.04 ng/mL). A CT angiogram (CTA) was obtained showing a normal-appearing aorta and no abnormal extracardiac findings. Urgent coronary angiography was performed; images are shown in figure 1A–C. Echocardiogram revealed a mildly reduced left ventricular ejection fraction (45%) with a hypokinetic inferior wall.Figure 1(A) Right coronary artery angiogram in the left anterior oblique cranial projection. (B) Left coronary artery angiogram in the right anterior oblique caudal projection. (C) Left coronary artery angiogram in the right anterior oblique cranial projection. CAUD, caudal; CRAN, cranial; LAO, left anterior oblique; RAO, right anterior oblique.QuestionWhat is the next best step in the management of this patient at this time?Complete revascularisation via percutaneous coronary intervention (PCI).Referral for coronary artery bypass surgery (CABG).Initiation of high-dose steroids.Initiation of dual-antiplatelet therapy without planned revascularisation.
Factors associated with anal cancer screening follow-up by high-resolution anoscopy
Authors: Apaydin Kaan Z , Nguyen Andy , Borba Christina P C , Shtasel Derri L , Ulery Sharon , Mayer Kenneth H , Keuroghlian Alex S 
Published: June 2018

ObjectivesHigh-resolution anoscopy (HRA) is a potential screening method for detection of anal cancer precursors. We evaluated factors associated with adherence to recommended HRA follow-up time intervals among men who have sex with men (MSM).MethodsWe employed a retrospective, observational cohort study with 155 MSM screened by HRA between 1 April 2011 and 31 March 2016 at a Federally Qualified Health Centre in Boston, Massachusetts.ResultsThe sample was 80% white, with a median age of 48 (non-normal distribution, IQR 15). All patients were assigned male sex at birth and none identified as transgender. Fifty patients (32%) followed up with a HRA appointment within 6 months of previous HRA detection of anal high-grade squamous intraepithelial lesion (HSIL). Among patients, 112 (72%) were HIV infected, 56 (36%) had a syphilis diagnosis during the study period, 89 (57.4%) had initiated Hepatitis A or B vaccination series, 70 (45.2%) accessed case management services and 19 (12.3%) utilised pre-exposure prophylaxis (PrEP). In bivariate analysis, patients who underwent recommended follow-up HRA within 6 months of HSIL diagnosis were less likely to report: case management utilisation (p=0.023), initiation of Hepatitis A or B vaccination (p=0.047), HIV diagnosis (p<0.001) and syphilis diagnosis (p=0.001), but were more likely to use HIV PrEP (p<0.001). In binomial logistic regression modelling after adjusting for age and race/ethnicity, patients who had follow-up with HRA within a recommended period of 6 months after HSIL diagnosis were less likely to have initiated Hepatitis A or B vaccination (adjusted OR 0.43, 95% CI 0.20 to 0.94), more likely to use PrEP (adjusted OR 4.47, 95% CI 1.30 to 15.49) and less likely to have a syphilis diagnosis (adjusted OR 0.34, 95% CI 0.14 to 0.86).ConclusionsThree-quarters of patients with HSIL did not have follow-up HRA within the clinic’s recommended follow-up period of 6 months following HSIL diagnosis by HRA. Future studies ought to explore whether addressing anal health during other STI-related care helps improve adherence to recommended time intervals for follow-up HRA. Given the high prevalence of STI and PrEP use, studies might also evaluate whether integrating HRA follow-up with other sexual health screenings helps improve adherence to recommended HRA follow-up.
Metamorphic processes preserved in early Archean supracrustal rocks of the Barberton Greenstone Belt, South Africa
Authors: Grosch Eugene G. 
Published: June 2018

Abstract

The Palaeoarchean supracrustal rocks of the Barberton Greenstone Belt (BGB) consist of hydrothermally altered volcanic and silicified sedimentary rocks that form the dramatic topography in the Barberton Mountain Land of Mphumalanga Province in South Africa and Swaziland. Previous metamorphic studies are limited and used mainly empirical chlorite geothermometry in the BGB sequence regionally, or Raman thermometry, both proposing a narrow range in metamorphic conditions of around 320°C regional for the BGB. This study demonstrates that a range of petrological and thermodynamic modelling techniques are required in an integrated approach to unravel the very low- to medium-grade metamorphic conditions preserved in the oldest part of the BGB. The study investigates low-temperature metamorphic processes in the Komati, Hooggenoeg, Kromberg and Mendon formations of the
c.
3530–3298 Ma Onverwacht Group. Chlorite thermodynamic modelling indicates metamorphic conditions of between 250 and 445°C, in the
c.
3482 Ma Komati Formation, but uncertainties on these conditions are large (
c.
80 and 100°C) due to the protoliths being mostly ultramafic in composition with uncertainty in XFe
3+
estimates. Raman thermometry on carbonaceous material in the
c.
3472 Ma volcano-sedimentary Middle Marker chert (HC1) at the base of the Hooggenoeg Formation indicates metamorphic conditions of between 281 and 301°C, lower than in previous studies. Raman thermometry on a carbonaceous chert (HC5) in the 3472–3432 Ma Hooggenoeg Formation in conjunction with δ
18
O oxygen isotope values on underlying metabasalts, indicate metamorphic temperature conditions of less than 340°C, preserved in the Hooggenoeg Formation. Application and critical evaluation of chlorite thermodynamic modelling results confirm the presence of an inverted metamorphic field gradient beneath a fuchsite–chlorite–quartz shear zone in the
c.
3334 Ma Kromberg Formation. Thermodynamic modelling using a di-octahedral mica model indicates that retrograde metamorphism in the Kromberg ultramafic shear zone occurred along a kyanite-type geothermal gradient, providing evidence in support of tectonic thrusting at
c.
3227–3223 Ma. In the
c.
3298 Ma Mendon Formation seawater alteration involving metasomatism occurred at conditions of
T
= 150°C with log
a
CO
2
(aq) of −2.74. This study sheds new light on the metamorphic history of the BGB supracrustal sequence and early Earth metamorphic processes. It also demonstrates that combining different petrological and thermodynamic methods across the BGB supracrustal stratigraphy allows a robust critical assessment of metamorphic conditions for the first time, with implications for the early Archean geodynamic evolution of the BGB.
Loss of E-cadherin Enhances IGF1–IGF1R Pathway Activation and Sensitizes Breast Cancers to Anti-IGF1R/InsR Inhibitors
Authors: Nagle Alison M. , Levine Kevin M. , Tasdemir Nilgun , Scott Julie A. , Burlbaugh Kara , Kehm Justin , Katz Tiffany A. , Boone David N. , Jacobsen Britta M. , Atkinson Jennifer M. , Oesterreich Steffi , Lee Adrian V. 
Published: June 2018

Abstract
Purpose: Insulin-like growth factor 1 (IGF1) signaling regulates breast cancer initiation and progression and associated cancer phenotypes. We previously identified E-cadherin (CDH1) as a repressor of IGF1 signaling and in this study examined how loss of E-cadherin affects IGF1R signaling and response to anti-IGF1R/insulin receptor (InsR) therapies in breast cancer.
Experimental Design: Breast cancer cell lines were used to assess how altered E-cadherin levels regulate IGF1R signaling and response to two anti-IGF1R/InsR therapies. In situ proximity ligation assay (PLA) was used to define interaction between IGF1R and E-cadherin. TCGA RNA-seq and RPPA data were used to compare IGF1R/InsR activation in estrogen receptor-positive (ER+) invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC) tumors. ER+ ILC cell lines and xenograft tumor explant cultures were used to evaluate efficacy to IGF1R pathway inhibition in combination with endocrine therapy.
Results: Diminished functional E-cadherin increased both activation of IGF1R signaling and efficacy to anti-IGF1R/InsR therapies. PLA demonstrated a direct endogenous interaction between IGF1R and E-cadherin at points of cell–cell contact. Increased expression of IGF1 ligand and levels of IGF1R/InsR phosphorylation were observed in E-cadherin–deficient ER+ ILC compared with IDC tumors. IGF1R pathway inhibitors were effective in inhibiting growth in ER+ ILC cell lines and synergized with endocrine therapy and similarly IGF1R/InsR inhibition reduced proliferation in ILC tumor explant culture.
Conclusions: We provide evidence that loss of E-cadherin hyperactivates the IGF1R pathway and increases sensitivity to IGF1R/InsR targeted therapy, thus identifying the IGF1R pathway as a potential novel target in E-cadherin–deficient breast cancers. Clin Cancer Res; 24(20); 5165–77. ©2018 AACR.
Lupine Becomings—Tracking and Assembling Romanian Wolves through Multi-Sensory Fieldwork
Authors: O’Mahony Kieran , Corradini Andrea , Gazzola Andrea 
Published: June 2018

AbstractThis paper outlines the fieldwork methods utilized by ecologists in (re)presenting wolves in Romania. By revealing the processes and performances of this aspect of wildlife conservation, the paper highlights the complex more-than-human assemblages that make up wolf ecology. It briefly discusses the waysHAS(Human-Animal Studies) and the social sciences have addressed conservation and unpacked the oft obscured hinterland of bodies and technologies. It then blends field stories and ethnographic narrative to emphasize the multi-sensory techniques employed in non-invasive wolf research. By using this novel case, the paper contextualizes the significance of concepts such as becoming, affect, and attunement in creating partial affinities between researchers and wildlife. It argues that these contribute to an emplaced knowledge that allows practices to adapt to contingencies in field. This is important when modern, remote technologies aimed at minimizing effort in the field are seen to be a panacea for monitoring elusive wildlife.
Learning a Craft from Books
Authors: Hagendijk Thijs 
Published: June 2018

Abstract
The early modern period witnessed a great increase in the production and dissemination of artisanal handbooks, manuals and recipes. A central question is what role these texts played in the transmission of artisanal knowledge. This study explores the case of Dutch silversmith Willem van Laer (1674–1722) who published a Guidebook for upcoming gold- and silversmiths (1721), a comprehensive and well-received manual of the craft. To assess the role of the Guidebook in the acquisition of practical skills in the eighteenth century, this study employs traditional historical methods combined with historical re-enactment. I argue that effective use of the Guidebook depended on complementary hands-on education of master craftsmen, which suggests that the Guidebook was far from a DIY crash course and illustrates that the textual transmission of craft knowledge depended upon, rather than threatened, established routes to craft learning, such as apprenticeships.
Copystree
Authors: Pompei Simone , Loreto Vittorio , Tria Francesca 
Published: June 2018

AbstractThe reconstruction of phylogenies of cultural artefacts represents an open problem that mixes theoretical and computational challenges. Existing benchmarks rely on simulated phylogenies, where hypotheses on the underlying evolutionary mechanisms are unavoidable, or on real data phylogenies, for which no true evolutionary history is known. Here we introduce a web-based game, Copystree, where users create phylogenies of manuscripts through successive copying actions in a fully monitored setup. While players enjoy the experience, Copystree allows to build artificial phylogenies whose evolutionary processes do not obey any predefined theoretical mechanisms, being generated instead with the unpredictability of human creativity. We present the analysis of the data gathered during the first set of experiments and use the artificial phylogenies gathered for a first test of existing phylogenetic algorithms.
Armenian prosody in typology and diachrony
Authors: DeLisi Jessica 
Published: June 2018

AbstractThis paper examines the relationship between typology and historical linguistics through a case study from the history of Armenian, where two different stress systems are found in the modern language. The first is a penult system with no associated secondary stress ([… σ́σ]ω). The other, the so-called hammock pattern, has primary stress on the final syllable and secondary stress on the initial syllable of the prosodic word ([σ̀ … σ́]ω). Although penult stress patterns are by far more typologically common than the hammock pattern in the world’s languages, I will argue that the hammock pattern must be reconstructed for the period of shared innovation, the Proto-Armenian period.
Coherent Turbulence in the Boundary Layer of Hurricane Rita (2005) during an Eyewall Replacement Cycle
Authors: Guimond Stephen R. , Zhang Jun A. , Sapp Joseph W. , Frasier Stephen J. 
Published: June 2018

Abstract
The structure of coherent turbulence in an eyewall replacement cycle in Hurricane Rita (2005) is presented from novel airborne Doppler radar observations using the Imaging Wind and Rain Airborne Profiler (IWRAP). The IWRAP measurements and three-dimensional (3D) wind vector calculations at a grid spacing of 250 m in the horizontal and 30 m in the vertical reveal the ubiquitous presence of organized turbulent eddies in the lower levels of the storm. The data presented here, and the larger collection of IWRAP measurements, currently are the highest-resolution Doppler radar 3D wind vectors ever obtained in a hurricane over the open ocean. Coincident data from NOAA airborne radars, the Stepped Frequency Microwave Radiometer, and flight-level data help to place the IWRAP observations into context and provide independent validation. The typical characteristics of the turbulent eddies are the following: radial wavelengths of ~1–3 km (mean value is ~2 km), depths from the ocean surface up to flight level (~1.5 km), aspect ratio of ~1.3, and horizontal wind speed perturbations of 10–20 m s−1. The most intense eddy activity is located on the inner edge of the outer eyewall during the concentric eyewall stage with a shift to the inner eyewall during the merging stage. The evolving structure of the vertical wind shear is connected to this shift and together these characteristics have several similarities to boundary layer roll vortices. However, eddy momentum flux analysis reveals that high-momentum air is being transported upward, in contrast with roll vortices, with large positive values (~150 m2 s−2) found in the turbulent filaments. In the decaying inner eyewall, elevated tangential momentum is also being transported radially outward to the intensifying outer eyewall. These results indicate that the eddies may have connections to potential vorticity waves with possible modifications due to boundary layer shear instabilities.
The Impact of Spatial Resolution, Land Use, and Spinup Time on Resolving Spatial Precipitation Patterns in the Himalayas
Authors: Bonekamp P. N. J. , Collier E. , Immerzeel W. W. 
Published: June 2018

Abstract
Frequently used gridded meteorological datasets poorly represent precipitation in the Himalayas because of their relatively low spatial resolution and the associated representation of the complex topography. Dynamical downscaling using high-resolution atmospheric models may improve the accuracy and quality of the precipitation fields. However, most physical parameterization schemes are designed for a spatial resolution coarser than 1 km. In this study the Weather Research and Forecasting (WRF) Model is used to determine which resolution is required to most accurately simulate monsoon and winter precipitation, 2-m temperature, and wind fields in the Nepalese Himalayas. Four model nests are set up with spatial resolutions of 25, 5, 1, and 0.5 km, respectively, and a typical 10-day period in summer and winter in 2014 are simulated. The model output is compared with observational data obtained from automatic weather stations, pluviometers, and tipping buckets in the Langtang catchment. Results show that, despite issues with the quality of the observational data due to undercatch of snowfall, the highest resolution of 500 m does provide the best match with the observations and gives the most plausible spatial distribution of precipitation. The quality of the wind and temperature fields is also improved, whereby the cold temperature bias is decreased. Our results further elucidate the performance of WRF at high resolution and demonstrate the importance of accurate surface boundary conditions and spinup time for simulating precipitation. Furthermore, they suggest that future modeling studies of High Mountain Asia should consider a subkilometer grid for accurately estimating local meteorological variability.
The Arctic Ocean Seasonal Cycles of Heat and Freshwater Fluxes: Observation-Based Inverse Estimates
Authors: Tsubouchi Takamasa , Bacon Sheldon , Aksenov Yevgeny , Naveira Garabato Alberto C. , Beszczynska-Möller Agnieszka , Hansen Edmond , de Steur Laura , Curry Beth , Lee Craig M. 
Published: June 2018

AbstractThis paper presents the first estimate of the seasonal cycle of ocean and sea ice heat and freshwater (FW) fluxes around the Arctic Ocean boundary. The ocean transports are estimated primarily using 138 moored instruments deployed in September 2005–August 2006 across the four main Arctic gateways: Davis, Fram, and Bering Straits, and the Barents Sea Opening (BSO). Sea ice transports are estimated from a sea ice assimilation product. Monthly velocity fields are calculated with a box inverse model that enforces mass and salt conservation. The volume transports in the four gateways in the period (annual mean ± 1 standard deviation) are −2.1 ± 0.7 Sv in Davis Strait, −1.1 ± 1.2 Sv in Fram Strait, 2.3 ± 1.2 Sv in the BSO, and 0.7 ± 0.7 Sv in Bering Strait (1 Sv ≡ 106 m3 s−1). The resulting ocean and sea ice heat and FW fluxes are 175 ± 48 TW and 204 ± 85 mSv, respectively. These boundary fluxes accurately represent the annual means of the relevant surface fluxes. The ocean heat transport variability derives from velocity variability in the Atlantic Water layer and temperature variability in the upper part of the water column. The ocean FW transport variability is dominated by Bering Strait velocity variability. The net water mass transformation in the Arctic entails a freshening and cooling of inflowing waters by 0.62 ± 0.23 in salinity and 3.74° ± 0.76°C in temperature, respectively, and a reduction in density by 0.23 ± 0.20 kg m−3. The boundary heat and FW fluxes provide a benchmark dataset for the validation of numerical models and atmospheric reanalysis products.