bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Epidemiology and Burden of Influenza B/Victoria and B/Yamagata Lineages in Kenya, 2012–2016
Authors: Emukule Gideon O , Otiato Fredrick , Nyawanda Bryan O , Otieno Nancy A , Ochieng Caroline A , Ndegwa Linus K , Muturi Peter , Bigogo Godfrey , Verani Jennifer R , Muthoka Philip M , Hunsperger Elizabeth , Chaves Sandra S 
Published: October 2019

Abstract

Background
The impact of influenza B virus circulation in Sub-Saharan Africa is not well described.

Methods
We analyzed data from acute respiratory illness (ARI) in Kenya. We assessed clinical features and age-specific hospitalization and outpatient visit rates by person-years for influenza B/Victoria and B/Yamagata and the extent to which circulating influenza B lineages in Kenya matched the vaccine strain component of the corresponding season (based on Northern Hemisphere [October–March] and Southern Hemisphere [April–September] vaccine availability).

Results
From 2012 to 2016, influenza B represented 31% of all influenza-associated ARIs detected (annual range, 13–61%). Rates of influenza B hospitalization and outpatient visits were higher for &lt;5 vs ≥5 years. Among &lt;5 years, B/Victoria was associated with pneumonia hospitalization (64% vs 44%; P = .010) and in-hospital mortality (6% vs 0%; P = .042) compared with B/Yamagata, although the mean annual hospitalization rate for B/Victoria was comparable to that estimated for B/Yamagata. The 2 lineages co-circulated, and there were mismatches with available trivalent influenza vaccines in 2/9 seasons assessed.

Conclusions
Influenza B causes substantial burden in Kenya, particularly among children aged &lt;5 years, in whom B/Victoria may be associated with increased severity. Our findings suggest a benefit from including both lineages when considering influenza vaccination in Kenya.
Improvement in Overground Walking After Treadmill-Based Gait Training in a Child With Agenesis of the Corpus Callosum
Authors: Henderson Gena , Beerse Matthew , Liang Huaqing , Ferreira Diego , Wu Jianhua 
Published: October 2019

Abstract

Background
Agenesis of the corpus callosum (ACC) is a rare congenital brain defect that produces a wide variety of cognitive and motor impairments. Literature regarding the response of pediatric populations with ACC to physical rehabilitation is scarce. Treadmill-based gait training (TT) has been shown to improve walking ability in some pediatric populations but has not been investigated in children with ACC.

Objective
The purpose of this study was to investigate the effect of a novel treadmill intervention paradigm on the gait parameters of a child with ACC.

Design
A single-participant design with 2 phases was used.

Methods
The settings were the participant’s home and the laboratory. The participant was a 13-year-old girl who had ACC and cortical visual impairment and who ambulated independently using a reverse walker for household and short community distances. A home-based TT intervention (2 phases of 3 months of training over 6 months) was implemented, and a laboratory-based gait analysis was conducted at 4 time points: baseline, after each of the 2 training phases, and 3 months after the cessation of training. The intervention consisted of weekly bouts of TT. Phase I incorporated forward, backward, and incline walking for 15 minutes each; in phase II, this protocol was continued, but short-burst interval training for 10 minutes was added. Data collected at each laboratory visit included spatiotemporal parameters and kinematics (joint angles) during overground and treadmill walking.

Results
After both phases of training, increased step length, decreased step width, and foot progression angle and decreased variability of most spatiotemporal parameters were observed for the participant. Further, after phase II, increased peak extension at the hip, knee, and ankle, decreased crouched gait, and improved minimum foot clearance during overground walking were observed. Most gait improvements were retained for 3 months after the cessation of the intervention.

Limitations
The small sample size of this study and wide variety of presentations within individuals with ACC limit the generalizability of our findings.

Conclusions
TT may be a safe and effective treatment paradigm for children with ACC. Future research should investigate the effect of intervention dosage on gait improvements and generalization in individuals with ACC.
Politics, State Ownership, and Corporate Investments
Authors: Alok Shashwat , Ayyagari Meghana 
Published: October 2019

Abstract
We document a political cycle in the investment decisions of state-owned enterprises (SOEs) by using the constitutionally mandated election schedule in India as a source of exogenous variation in politicians’ incentive to cater to voters. Using a project-level investment database, we find that SOEs announce more capital expenditure projects in election years, especially in infrastructure, and in districts with close elections, high-ranking politicians, and left-wing incumbents. SOE projects in election years have negative announcement returns, suggesting a loss in shareholder value. These patterns are not seen in nongovernment firms or in off-election years. (JEL G31, G38, D72, D73, P16)
Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
P33 Adolescent and young adult health training needs of healthcare professionals including rheumatology
Authors: Smith Elizabeth , Willis Emily , McDonagh Janet 
Published: October 2019

Abstract

Background
The need for training in adolescent and young adult (AYA) health is highlighted in paediatrics, adult medical trainees and the EULAR transition guidance. We aim to identify the current training needs of healthcare professionals regarding AYA health in a UK region including paediatric and adult rheumatology professionals.

Methods
An online survey designed using SelectSurvey.NET for healthcare professionals was distributed by email using a snowballing technique after piloting (1 nurse, 3 doctors). A control question was included on safeguarding, which is mandatory training for all healthcare professionals irrespective of setting.

Results
The overall response rate was 20% (166/820) and included 56% (n = 88/158 doctors -39% of whom were trainees), and 29% (n = 46/158) nurses. 8 identified themselves as rheumatology professionals (8/293, 3% rheumatology-specific response rate). 51% (n = 85/166) of healthcare professionals (including 2 rheumatology professionals) reported having received no formal training in AYA health (43% were doctors, 67% nurses). Of those who had previous training, the main training method was lecture based, with only 7% having accessed the UK Adolescent Health e-learning project. In comparison to 85% and 78% reporting adequate knowledge and skill respectively in safeguarding, less than 40% reported adequate knowledge and/or skills in key areas of AYA health (see Table 1). Respondents who had received training perceived themselves to have better knowledge and skills across many areas of AYA than those who had not received such training. Finally, in some areas of AYA health, there was a large discrepancy between perceived knowledge and skill level.
P33 Table 1 Area of AYA Health % of Healthcare Professionals with Adequate Knowledge % of Healthcare Professionals with Adequate Skill Rheumatology (n = 8) Rest (n = 137) Rheumatology (n = 8) Rest (n = 126) Safeguarding 87.5% 85% 75% 78% Confidentiality & consent 75% 75% 75% 70% Home/family 37.5% 61% 50% 48% Health management 37.5% 56% 37.5% 52% Transitional care 62.5% 54% 75% 47% Eating 12.5% 54% 12.5% 40% Exercise 25% 53% 25% 44% Sleep 50% 43% 37.5% 40% Peer relations 25% 43% 25% 34% Safety 37.5% 40% 37.5% 29% Mental health 12.5% 39% 25% 36% Education/vocation 37.5% 34% 37.5% 27% Sexual health 25% 35% 12.5% 28% Social media 12.5% 33% 25% 30% Substance use 0% 31% 0% 20%

Conclusion
There is still a need to both raise awareness of and improve training opportunities for all healthcare professionals who interact with adolescents and young adults, including rheumatology. This training should be both practical and knowledge based to overcome the discrepancy between knowledge and skill levels.

Conflicts of Interest
The authors declare no conflicts of interest.
INTRAOPERATIVE CHOLANGIOGRAPHY DURING CHOLECYSTECTOMY RESULTS IN LOW EXPOSURE TO RADIATION: A RETROSPECTIVE COHORT STUDY
Authors: Mattila Anne , Larjava Heli , Helminen Olli , Kairaluoma Matti 
Published: October 2019

Abstract
This study aimed to determine the exposure to radiation delivered to the patient during routine intraoperative cholangiography (IOC) in cholecystectomy and examine the factors affecting radiation dose and fluoroscopy time (FT). From January 2016 to December 2017, 598 IOC examinations were performed. This study included 324 intraoperative cholangiographies performed with c-arm equipment not exceeding 10 years of age. When residents performed the procedures, the mean kerma area product (KAP) was 0.36 (standard deviation [SD] 0.70) Gycm 2 and in specialist surgeons group 0.36 (SD 0.47) Gycm2, P = 0.47. In residents group, the mean FT was 11.4 (SD 10.1) seconds and in specialist surgeons group, 9.2 (SD 11.9) seconds, P &lt; 0.01. Linear regression analysis showed association between increased KAP-values and the presence of common bile duct (CBD) stones and body mass index (BMI). Age, BMI, laparoscopic surgery, acute cholecystitis, presence of CBD stones, resident surgeon performing IOC and ASA III–IV were associated with higher FT. National diagnostic reference level for IOC has not been introduced in Finland so far. Our mean KAP values (0.36 Gycm2) were 3–4 times lower and FT (10.1 seconds) were 3–5 times lower than the few reported in the literature. Routine use of IOC during cholecystectomy results in relatively low-radiation dose performed either by residents or specialist surgeons, irrespective of whether CBD stones were visualized or not.
Between promise and performance: Science and technology policy implementation through network governance
Authors: Whetsell Travis A , Leiblein Michael J , Wagner Caroline S 
Published: October 2019

AbstractThis research analyzes the effects of US science and technology policy on the technological performance of organizations in a global strategic alliance network. During the mid-1980s, the US semiconductor industry appeared to be collapsing. Industry leaders and policymakers moved to support and protect US firms by creating a program called Sematech. While many scholars regard Sematech as a success, how the program succeeded remains unclear. This study re-contextualizes Sematech as a network administrative organization which lowered cooperation costs and enhanced resource combination for innovation at the cutting edge. This study combines network analysis and longitudinal regression techniques to test the effects of public policy on organizational network position and technological performance in an unbalanced panel of semiconductor firms between 1986 and 2001. This research suggests that governments might achieve policy through inter-organizational innovations aimed at the development and administration of robust governance networks.
A clinical rule for the prediction of meningitis in HIV patients in the era of combination antiretroviral therapy
Authors: Abd El-Wahab Ekram W , Farrag Talaat , Metwally Mohammed 
Published: October 2019

AbstractBackgroundThe diagnosis of meningitis in HIV patients is challenging due to altered immune responses. Diagnostic scoring systems were recently proposed for use in research settings to help prompt and easy differential diagnosis. The objective of this study was to create a clinical prediction rule (CPR) for meningitis in HIV-infected patients and to address the enigma of differentiating bacterial (BM), TB (TBM) and cryptococcal (CCM) meningitis based on clinical features alone, which may be enhanced by easy-to-obtain laboratory testing.MethodsWe retrospectively enrolled 352 HIV patients presenting with neurological manifestations suggesting meningitis over the last 18 y (2000–2018). Relevant clinical and laboratory information were retrieved from inpatient records. The features independently predicting meningitis or its different types in microbiologically proven meningitis cases were modelled by multivariate logistic regression to create a CPR in an exploratory data set. The performance of the meningitis diagnostic score was assessed and validated in a subset of retrospective data.ResultsAIDS clinical stage, injecting drug use, jaundice and cryptococcal antigen seropositivity were equally important as classic meningitic symptoms in predicting meningitis. Arthralgia and elevated cerebrospinal fluid Lactate dehydrogenase (LDH) were strong predictors of BM. Patients with cryptococcal antigenemia had 25 times the probability of having CCM, whereas neurological deficits were highly suggestive of TBM.ConclusionThe proposed CPRs have good diagnostic potential and would support decision-making in resource-poor settings.
Antifibrinolytic Drugs and Allogeneic Transfusion in Pediatric Multilevel Spine Surgery
Authors: McNeil John , Raphael Jacob , Chow Jonathan H. , Tanaka Kenichi , Mazzeffi Michael A. 
Published: October 2019

Study Design.
Observational cohort study with propensity score matching.

Objective.
Determine whether antifibrinolytic drug use is associated with decreased allogeneic blood transfusion in multilevel pediatric spine surgery.

Summary of Background Data.
Antifibrinolytic drugs are commonly used in adult multilevel spine surgery to reduce blood loss and allogeneic transfusion; however, only small studies have examined their efficacy in pediatric patients having multilevel spine surgery.

Methods.
Pediatric patients who had posterior multilevel spine surgery between 2016 and 2017 were identified in the national surgery quality improvement program participant use file. Propensity score matching was used to reduce bias from confounding and the rate of intraoperative allogeneic transfusion was compared between patients who received antifibrinolytic drugs and those who did not. Secondary outcomes included intraoperative cell saver volume, postoperative allogeneic transfusion, massive intraoperative transfusion, and adverse events including venous thromboembolism and seizure.

Results.
A total of 6904 patients underwent posterior multilevel spine surgery during the study period and 83% received antifibrinolytics. The matched cohort included 604 patients. Antifibrinolytic use had no association with reduced intraoperative allogeneic transfusion: odds ratio (OR) = 0.71 (99% confidence interval [CI] = 0.40–1.26, P = 0.12) or cell saver volume, median volume = 114 mL (0, 250 mL) in antifibrinolytic group versus 100 mL (0, 246 mL) in control group, P = 0.04. There was also no association with reduced postoperative allogeneic transfusion OR = 1.23 (99% CI = 0.54–2.81, P = 0.52) or massive transfusion OR = 1.0 (99% CI = 0.34–2.92, P = 1.0). No patient in the matched cohort had a venous thromboembolism or seizure.

Conclusion.
Antifibrinolytic drugs are commonly used in pediatric multilevel spine surgery in the United States, but no efficacy was demonstrated in our study. There were no venous thromboembolisms or seizures implying an excellent safety profile in pediatric patients.

Level of Evidence: 3
Electrosclerotherapy as a Novel Treatment Option for Hypertrophic Capillary Malformations: A Randomized Controlled Pilot Trial
Authors: Horbach Sophie E.R. , Wolkerstorfer Albert , Jolink Folkert , Bloemen Paul R. , van der Horst Chantal M.A.M. 
Published: October 2019

BACKGROUND
Bleomycin sclerotherapy is ineffective for treating capillary malformations (CMs) because bleomycin cannot adequately be injected into the small-diameter capillary lumina. Electrosclerotherapy (EST) might be a new treatment modality for CMs, as it combines bleomycin sclerotherapy and “electroporation”—an electric field applied to the tissue. Electroporation disrupts the transmembrane potential, facilitating bleomycin transportation across the vessel wall, hypothetically leading to targeted drug delivery and increased effectiveness of bleomycin in CMs.

OBJECTIVE
To explore the efficacy, safety, and feasibility of EST for CMs in a randomized within-patient controlled pilot study.

MATERIALS AND METHODS
Fifteen regions of interest (ROI) within the hypertrophic CMs of 5 patients were randomly allocated to EST, bleomycin injection, or no treatment. Outcome was assessed after 7 weeks by the patient and a blinded outcome assessor using the patient-observer scar assessment score (POSAS), global assessment of change (GAC), colorimetry, and laser speckle contrast imaging.

RESULTS
Color and hypertrophy of all ROIs treated with EST significantly improved, based on the POSAS (medians patient −11; observer −13), GAC, and colorimetry (ΔE 3.4–16.5) scores.

CONCLUSION
This pilot study demonstrates the first proof of concept for electrosclerotherapy as a new treatment modality for CMs. Further research is warranted.
A case–control study of breast cancer risk and ambient exposure to pesticides
Authors: Tayour Carrie , Ritz Beate , Langholz Bryan , Mills Paul K. , Wu Anna , Wilson John P. , Shahabi Kaveh , Cockburn Myles 
Published: October 2019

Background:
While the estrogenic properties of certain pesticides have been established, associations between pesticide exposure and risk of breast cancer have been inconsistently observed. We investigated the relation between pesticide exposure and breast cancer risk using methods capable of objectively assessing exposure to specific pesticides occurring decades before diagnosis.

Methods:
A case–control study was conducted to evaluate the risk of postmenopausal breast cancer associated with historic pesticide exposure in California’s Central Valley, the most agriculturally productive region in the United States where pesticide drift poses a major source of nonoccupational exposure. Residential and occupational histories were linked to commercial pesticide reports and land use data to determine exposure to specific chemicals. Cases (N = 155) were recruited from a population-based cancer registry, and controls (N = 150) were obtained from tax assessor and Medicare list mailings.

Results:
There was no association between breast cancer and exposure to a selected group of organochlorine pesticides thought to have synergistic endocrine-disrupting potential; however, breast cancer was three times as likely to occur among women exposed to chlorpyrifos compared with those not exposed, after adjusting for exposure to other pesticides including organochlorines (OR = 3.22; 95% CI = 1.38, 7.53).

Conclusions:
Organophosphate pesticides, such as chlorpyrifos, have rarely been evaluated in studies of breast cancer risk. Additional research is needed to confirm these findings and to better understand the underlying mechanisms given that chlorpyrifos has been detected in local air monitoring at levels of concern for residents living in the agricultural regions where it is used.
Junctional zone endometrium alterations in gynecological and obstetrical disorders and impact on diagnosis, prognosis and treatment
Authors: Tanos Vasilios , Balami Safinez , Lingwood Lee 
Published: October 2019

Purpose of reviewTo investigate the JZE alterations in gynecological and obstetrical disorders and impact on diagnosis, prognosis and treatment.Recent findingsJZE was found to be significantly extended in patients with endometriosis, leading to the conclusion that endometriosis is a primary disease of the uterus, much like adenomyosis. Statistical correlation was then demonstrated between the severity of endometriosis and the depth of the adenomyosis infiltrates, hence the thickening of the JZE. Stem cells, predominantly found in the JZE were also found in histological sections of leiomyoma, suggested to be the origin of leiomyoma. This reservoir of JZE stem cells is influenced by different stressors leading to their differentiation into leiomyoma, endometriosis, adenomyosis or endometrial cancer, according to the stressor. The variability in presentation was hypothesized to be connected to genetic and epigenetic factors. JZE was also suggested to act as a barrier, stopping endometrial carcinoma cells invasion and metastasis. In addition, JZE plays a major role in conception, pregnancy and postpartum.SummaryJZE is an important anatomical landmark of the uterus contributing to normal uterine function under the influence of ovarian hormones. Alterations of the JZE thickness and contractility can be used as pathognomonic clinical markers in infertility and chronic pelvic pain, for subendometrial and myometrial disorders, for example, adenomyosis and fibroids. Prospective randomized control trials will clarify the diagnostic steps, imaging modalities to follow and probably triage the patients between medical and surgical treatments.
Volumetric Effect of Pregnancy on a Unilateral Facial Fat Graft
Authors: Tuin A. Jorien , Schepers Rutger H. , Spijkervet Frederik K. L. , Vissink Arjan , Jansma Johan 
Published: October 2019

Summary:
Weight gain can affect the volume of a facial fat graft, resulting in unfavorable asymmetries. Weight gain during pregnancy is more complex and does not just entail an increase in adipose tissue. This case report objectifies whether pregnancy results in volume changes of a facial fat graft. A 24-year-old woman received a fat graft (7 ml) in the mandibular area to mask a volume deficiency. This deficiency occurred after a fibula reconstruction of a mandibular defect resulting from the removal of an ameloblastoma. The patient became pregnant 3 weeks after the fat graft procedure. Standardized 3-dimensional photographs (3dMD) were available preoperatively and at 7 weeks (first trimester), 6 months (second trimester), 9 months (third trimester), and 14 months (4 months after delivery) postoperatively. Three-dimensional analysis revealed that no substantial volume changes of the fat graft occurred during pregnancy other than the overall proportional gain in facial volume. Pregnancy apparently does not affect the volume of a small unilateral fat graft applied in the facial region.