bluuebunny/crossref_metadata_2025_split huggingface dataset:
On Talking Together about Ordinary Abortion
Authors: Buchbinder Mara 
Published: August 2018

AbstractThe scarlet “A” that the protagonist of Nathaniel Hawthorne's seventeenth‐century novel is forced to pin to her dress symbolizes the shame and social disgrace that she endures for conceiving a child out of adultery. In Scarlet A: The Ethics, Law, & Politics of Ordinary Abortion, Katie Watson argues that abortion is our era's scarlet letter: a mark of stigma that is invisible yet no less shameful, causing unnecessary cultural silences around what is a remarkably common practice. In this brilliant new book, Watson draws on legal proceedings, bioethics literature, and personal experience; offers cultural and literary analysis; and uses her unique vantage point as a lawyer, bioethicist, and medical educator to develop a thought‐provoking and thoroughly fresh perspective on one of the most divisive moral issues of our time.
Are Obese Children Abused Children?
Authors: Priest Maura 
Published: August 2018

AbstractIn 2010, a South Carolina mother was taken to court when her fourteen‐year‐old son reached 555 pounds. An article on the story reported, “His mother, Jerri Gray, lost custody of her son and is being charged with criminal neglect. Gray is facing 15 years on two felony counts, the first U.S. felony case involving childhood obesity.” If the caretakers of obese children are negligent, then they are also morally and legally blameworthy. I want to suggest, however, that important ethical differences exist between negligent or abusive caretakers and the caretakers of obese children and that these differences ought to make a moral and legal difference. The distinctions are nuanced, and the ethical pictures in cases of abuse, neglect, and obesity are far from black and white. However, the various types of harm that children face from their caretakers should be placed in neither the same ethical nor the same legal category.When children are beaten or sexually molested, the justification for taking them out of the home is clear: the caretakers are violating the rights of their children. Similarly, with neglect, caretakers are failing to provide their children the necessities to which they are entitled. The central question that I want to address in this article is whether the actions (or inaction) of caretakers that allow a child to become obese are morally or practically analogous to physical abuse or neglect. Ultimately, I will argue that parenting that allows a child to become obese is so morally different from both abuse and neglect that it is best understood as falling outside these categories altogether. This conclusion has important moral, practical, and legal implications.
The Next Wave in Health Care Priority Setting
Authors: Rid Annette 
Published: August 2018

AbstractA new problem in health care priority‐setting is currently emerging for wealthy countries: what should be done when a new drug is considered cost effective but implementing it would still be unaffordable? The standard approach to setting priorities in health care rests on cost effectiveness. This approach is now being tested by new drugs that are highly effective but very costly. Because they are so effective, these drugs deliver “value for money” despite their high cost. However, when the targeted condition affects a sizeable number of patients, implementing the drugs becomes unaffordable. There are no easy alternatives. A key virtue of setting health care priorities with a presumptive cost‐effectiveness threshold is that it provides all patients a prima facie equal claim on the available resources, and alternative approaches to addressing affordability face their own challenges.
Advance Directives and Dementia
Authors: Kaebnick Gregory E. 
Published: August 2018

AbstractA competent person can avoid the onset of dementia by refusing life‐sustaining medical care and by voluntarily stopping eating and drinking, bringing life to an end well before any health crisis. A competent person can also try to limit the duration of dementia by drafting an advance directive that sets bounds on the life‐sustaining care, including artificial nutrition and hydration, that medical caregivers can provide when the person no longer has the capacity to make her own medical decisions. But between these two strategies there can lie a significant gap. A person could live with moderate to severe dementia for a considerable time, no longer able to voluntarily stop eating and drinking yet also not yet requiring the life‐sustaining care forbidden by advance directive.This gap has been much discussed in recent years in the Hastings Center Report. Several years ago (in the May‐June 2014 issue), Paul Menzel and M. Colette Chandler‐Cramer argued for what they described as a moderate correction to the dominant view that food and water should always be offered to a patient with dementia if the patient expresses a desire to eat and drink. The problem is taken up again by the legal scholar Norman L. Cantor in this issue (July‐August 2018), and Cantor, too, tries to find a moderate alternative.
Development and evaluation of a multimodal marker of major depressive disorder
Authors: Yang Jie , Zhang Mengru , Ahn Hongshik , Zhang Qing , Jin Tony B. , Li Ien , Nemesure Matthew , Joshi Nandita , Jiang Haoran , Miller Jeffrey M. , Ogden Robert Todd , Petkova Eva , Milak Matthew S. , Sublette Mary Elizabeth , Sullivan Gregory M. , Trivedi Madhukar H. , Weissman Myrna , McGrath Patrick J. , Fava Maurizio , Kurian Benji T. , Pizzagalli Diego A. , Cooper Crystal M. , McInnis Melvin , Oquendo Maria A. , Mann Joseph John , Parsey Ramin V. , DeLorenzo Christine 
Published: August 2018

AbstractThis study aimed to identify biomarkers of major depressive disorder (MDD), by relating neuroimage‐derived measures to binary (MDD/control), ordinal (severe MDD/mild MDD/control), or continuous (depression severity) outcomes. To address MDD heterogeneity, factors (severity of psychic depression, motivation, anxiety, psychosis, and sleep disturbance) were also used as outcomes. A multisite, multimodal imaging (diffusion MRI [dMRI] and structural MRI [sMRI]) cohort (52 controls and 147 MDD patients) and several modeling techniques—penalized logistic regression, random forest, and support vector machine (SVM)—were used. An additional cohort (25 controls and 83 MDD patients) was used for validation. The optimally performing classifier (SVM) had a 26.0% misclassification rate (binary), 52.2 ± 1.69% accuracy (ordinal) and r = .36 correlation coefficient (p < .001, continuous). Using SVM, R2 values for prediction of any MDD factors were <10%. Binary classification in the external data set resulted in 87.95% sensitivity and 32.00% specificity. Though observed classification rates are too low for clinical utility, four image‐based features contributed to accuracy across all models and analyses—two dMRI‐based measures (average fractional anisotropy in the right cuneus and left insula) and two sMRI‐based measures (asymmetry in the volume of the pars triangularis and the cerebellum) and may serve as a priori regions for future analyses. The poor accuracy of classification and predictive results found here reflects current equivocal findings and sheds light on challenges of using these modalities for MDD biomarker identification. Further, this study suggests a paradigm (e.g., multiple classifier evaluation with external validation) for future studies to avoid nongeneralizable results.
Administrative databases and clinical governance: The case of COPD
Authors: Pacileo Guglielmo , Tozzi Valeria D. , Sotgiu Giovanni , Aliberti Stefano , Morando Verdiana , Blasi Francesco 
Published: August 2018

SummaryBackgroundChronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. However, COPD is still underdiagnosed, undertreated, and not sufficiently prevented. Health administrative databases provide a powerful way of studying COPD in the population.MethodsThis retrospective study used administrative data, collected during 2011 and 2012, retrieved from 3 Italian local health authorities (LHAs).ResultsThe analysis through administrative databases allowed firstly to identify patients with COPD receiving services by the 3 LHAs: The estimated average is ~3% of the population aged ≥40 years. Furthermore, it was also possible to stratify patients by investigating the health consumption in hospitalization for COPD and use of respiratory drugs. In all 3 LHA patients with moderate COPD were the majority of the population with COPD. Finally, it was possible to distinguish patients who made an appropriate use of SABA (76% of the total), patients who had a potentially inappropriate use (20%), and those with an overuse of SABA (4%).ConclusionThe use of SABA consumption patterns can be a reliable proxy variable to detect subgroups who may necessitate therapy revision. Health administrative databases seem beneficial for planning health care interventions, including the COPD field. They are robust information systems subjected to regular data quality controls remaining the prevalent data source, reliable because of the amount of data and the population coverage, especially in countries with a National Health Service System.
The positive predictive value of low‐density lipoprotein for recurrence‐free survival in ovarian cancer
Authors: Zhu Fangfang , Xu Xinxin , Shi Beibei , Zeng Linchai , Wang Luhui , Wu Xueqing , Zhu Haiyan 
Published: August 2018

AbstractObjectiveTo evaluate the prognostic impact of preoperative plasma lipid profile, glucose, and body mass index in patients with ovarian cancer.MethodsA retrospective study was performed among women with ovarian cancer who underwent surgical resection between January 1, 2001, and December 1, 2015, at the First Affiliated Hospital of Wenzhou Medical University, China. Data were evaluated using Cox regression analyses, Kaplan–Meier survival analysis and landmark survival analysis.ResultsThere were 267 women included in the study. Multivariate Cox regression analysis showed that increased levels of low‐density lipoprotein cholesterol (LDL) were associated with a favorable recurrence‐free survival (RFS) of ovarian cancer (hazard ratio [HR] 0.18, 95% confidence interval [CI] 0.07–0.51). Further Kaplan–Meier survival analysis demonstrated that the patients with high levels of LDL (≥3.07 mmol/L) had better RFS compared with the patients with low levels of LDL. Moreover, landmark survival analysis indicated that a higher LDL level predicted improved 5‐year RFS (P=0.026) but not 0.5‐year RFS (P=0.913) of ovarian cancer.ConclusionElevated preoperative LDL was independently associated with an improved 5‐year RFS in women with ovarian cancer, thus the utility of LDL could help to predict the recurrence risk for patients with ovarian cancer.
Safety, Pharmacokinetics, and Pharmacodynamics of Multiple Rising Doses of BI 655064, an Antagonistic Anti‐CD40 Antibody, in Healthy Subjects: A Potential Novel Treatment for Autoimmune Diseases
Authors: Schwabe Christian , Rosenstock Bernd , Doan Thi , Hamilton Paul , Dunbar P. Rod , Eleftheraki Anastasia G. , Joseph David , Hilbert James , Schoelch Corinna , Padula Steven J. , Steffgen Jürgen 
Published: August 2018

AbstractBI 655064 is a humanized antagonistic anti‐cluster of differentiation (CD) 40 monoclonal antibody that selectively blocks the CD40‐CD40L interaction. The CD40‐CD40L pathway is a promising treatment target for autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, and lupus nephritis. The safety, tolerability, pharmacokinetics, and pharmacodynamics of repeated once‐weekly BI 655064 subcutaneous dosing over 4 weeks were evaluated in a multiple‐dose study in healthy subjects. Subjects (N = 40) were randomized 4:1 to four sequential BI 655064 dose groups (80, 120, 180, 240 mg) or to placebo. Safety and tolerability, plasma exposure, CD40 receptor occupancy, and CD40L‐induced CD54 upregulation were assessed over 64 and 78 days for the 80‐ to 180‐mg and 240‐mg dose groups, respectively. BI 655064 exposure increased in a supraproportional manner, due to target‐mediated drug clearance, for doses between 80 mg and 120 mg, but was near proportional for doses greater than 120 mg. Terminal half‐life ranged between 6 and 8 days. Dose‐dependent accumulation of BI 655064 supports the use of a loading dose in future clinical studies. Following 4 weeks of dosing, >90% CD40 receptor occupancy and inhibition of CD54 upregulation were observed at all dose levels, lasting for 17 days after the last dose. BI 655064 was generally well tolerated. There were no serious adverse events and the frequency and intensity of adverse events were similar for BI 655064 and placebo; no dose relationship or relevant signs of an acute immune reaction were observed. These findings support further investigation of BI 655064 as a potential treatment for autoimmune diseases.
Risk of endometrial cancer and endometrial hyperplasia with atypia in asymptomatic postmenopausal women with endometrial thickness ≥11 mm: A systematic review and meta‐analysis
Authors: Alcázar Juan Luis , Bonilla Laura , Marucco Julia , Padilla Ana Isabel , Chacón Enrique , Manzour Nabil , Salas Aina 
Published: August 2018

AbstractPurposeTo evaluate the risk of endometrial cancer and/or endometrial hyperplasia with atypia in asymptomatic postmenopausal women with endometrial thickness ≥ 11 mm.MethodsSystematic review of literature using database search (PubMed and Web of Science) of articles published between January 1990 and December 2016 evaluating the correlation between endometrial thickness as measured by transvaginal ultrasound (double layer) and histopathological findings in asymptomatic postmenopausal women, using the following terms: “endometrial thickness,” “postmenopausal,” “postmenopause,” and “asymptomatic.” Inclusion criteria were prospective or retrospective studies of more than 150 cases that provided information on endometrial thickness and its correlation with histopathological data. Studies that included patients with hormone replacement therapy, tamoxifen, or aromatase inhibitors were excluded. The overall relative risk (RR) for EC/EHA was calculated, stratifying the patients into two groups according to endometrial thickness (<11 mm and ≥11 mm). Heterogeneity was assessed by calculating I2.ResultsThe search identified 289 studies. After exclusions, nine articles that met all the inclusion criteria were included, comprising data from 4751 women. The prevalence of endometrial cancer and/or endometrial hyperplasia with atypia was 2.4%. The relative risk of endometrial cancer and/or endometrial hyperplasia with atypia in the ≥11 mm group was 2.59 (95% CI: 1.66‐4.05). High heterogeneity was observed between studies (I2: 57.3%, P = .016).ConclusionsOverall the risk for EC/EHA was 2.6 times greater in women with ET ≥11 mm vs women with ET 5‐10 mm, although there was significant heterogeneity in estimates across studies.
Boundary Spanning and Engineering: A Qualitative Systematic Review
Authors: Jesiek Brent K. , Mazzurco Andrea , Buswell Natascha T. , Thompson Julia D. 
Published: August 2018

AbstractBackgroundEngineers are often expected to span organizational, cultural, stakeholder, geographic, temporal, and other boundaries. Yet, few studies on boundary spanning have appeared in the engineering education literature, suggesting the need for improved theoretical and conceptual foundations to guide empirical studies of boundary spanning in engineering.PurposeTo develop a more comprehensive understanding of boundary spanning, this study addresses five research questions: (a) What types of boundaries have been identified as topics of interest? (b) How are boundary spanners and boundary spanning defined? (c) What types of activities and behaviors comprise or have been linked to boundary spanning? (d) What individual competencies and characteristics have been proposed or studied as important for boundary spanning? and (e) What boundary spanning themes are most prominent in studies of engineers and other technical professionals?Scope/MethodUsing a qualitative systematic review process, we identified and analyzed 72 scholarly papers from multiple disciplines. Multiple reviewers coded each paper using a hybrid deductive‐inductive content analysis process to identify key themes related to boundary spanning.ConclusionsThe analysis resulted in a framework consisting of six boundary types, three types of roles and definitions, and five types of activities. Discussion of boundary spanning competencies was limited in the collected works, and only seven papers exclusively focused on engineers. We conclude by proposing boundary spanning as an important meta‐attribute for engineers and a promising lens for investigating engineering practice. We also relate our findings to the engineering education literature and suggest directions for future research.
Quality of life and sexual well‐being after nipple sparing mastectomy: A matched comparison of patients using the breast Q
Authors: Yoon‐Flannery Kahyun , DeStefano Lauren M. , De La Cruz Lucy M. , Fisher Carla S. , Lin Lisa Y. , Coffua Lauren S. , Mustafa Rose E. , Sataloff Dahlia M. , Tchou Julia C. , Brooks Ari D. 
Published: August 2018

BackgroundNipple sparing mastectomy (NSM) is considered safe for select patients. Our objective was to examine quality of life (QOL) and satisfaction for NSM compared with skin sparing mastectomy (SSM). We aimed to evaluate these using the BREAST‐Q.MethodsAfter IRB approval, we analyzed patients who underwent NSM and reconstruction between July 2010‐June 2015. NSM patients were matched with those after SSM based on age, race, and body mass index. Telephone interviews were prospectively conducted using the BREAST‐Q Mastectomy Postoperative Module. Bivariate analysis and a paired samples t‐test were performed.ResultsWe identified 43 patients meeting our inclusion criteria with a response rate 60% (N = 26). NSM and SSM patients were matched well in age (P = 1.00), race (P = 1.00), and Body Mass Index (P = 0.99). There were no significant differences in stage, estrogen and progesterone status, HER2 expression, reconstruction type and radiation. Mean BREAST‐Q scores did not vary between NSM and SSM in regards to satisfaction with breasts (P = 0.604), psychosocial well‐being (P = 0.146), physical well‐being (P = 0.121), and satisfaction with surgeon (P = 0.170). Sexual well‐being was significantly higher in NSM patients (P = 0.011).ConclusionNSM provides patients with favorable results in psychosocial, sexual, and physical well‐being and overall satisfaction. Sexual well‐being showed significant improvement for NSM.
Measurement of circulating transcript levels (NETest) to detect disease recurrence and improve follow‐up after curative surgical resection of well‐differentiated pancreatic neuroendocrine tumors
Authors: Genç Cansu G. , Jilesen Anneke P.J. , Nieveen van Dijkum Els J.M. , Klümpen Heinz‐Josef , van Eijck Casper H.J. , Drozdov Ignat , Malczewska Anna , Kidd Mark , Modlin Irvin 
Published: August 2018

BackgroundRecurrence of pancreatic neuroendocrine tumors (pNET) after surgery is common. Strategies to detect recurrence have limitations. We investigated the role of clinical criteria and the multigene polymerase chain reaction–based NETest during post‐operative follow‐up of pNET.MethodsWe studied 3 groups of resections: R0 with no recurrence (n = 11), R0 with recurrence (n = 12), and R1 with no recurrence (n = 12). NETest levels (>40%) were compared with chromogranin A (CgA) and clinicopathological criteria (CC; grade, lymph node metastases, size). Nonparametric, receiver operating characteristics, logistic regression, and predictive feature importance analyses were performed.ResultsNETest was higher in R0 with recurrence (56 ± 8%) compared with R1 with no recurrence (39 ± 6%) and R0 with no recurrence (28 ± 6%, P < .005). NETest positively correlated with recurrence (area under the curve: 0.82), CgA was not (area under the curve: 0.51 ± 0.09). Multiple regression analysis defined factor impact as highest for NETest (P < .005) versus CC (P < .03) and CgA (P = .23). NETest gave false positive or negative recurrence in 18% using a 40% cutoff. Logistic regression modeling of CC was 83% accurate; it was 91% when the NETest was included. Combining CC and NETest was approximately 2× more effective than individual CC alone (increase in R
2 value from 43% to 80%).ConclusionsA multigene blood test facilitates effective identification of pNET recurrence, prediction of disease relapse, and outperforms CgA.
PROMIS® scores in operative metastatic bone disease patients: A multicenter, prospective study
Authors: Blank Alan T. , Lerman Daniel M. , Shaw Sara , Dadrass Farnaz , Zhang Yue , Liu Wei , Hung Man , Jones Kevin B. , Randall R. Lor 
Published: August 2018

BackgroundThe prevalence of metastatic bone disease (MBD) grows each year as treatments improve. Little has been published about functional and pain outcomes in this group after surgery. Patient‐Reported Outcomes Measurement Information System (PROMIS®) can collect information, in just minutes, about patient's physical, mental, and social health. This study evaluated PROMIS® pain and functional scores in surgically treated patients with MBD.MethodsBasic demographics and PROMIS® scores were recorded from a total of 13 patients at 9 periods of time over 6 months.ResultsThe average change in physical function at week 1 was −2.5 (standard deviation [SD] = 5.4), at 2 weeks 1.7 (SD = 7.6), after 4 weeks 6.9 (SD = 10), after 6 weeks 6.4 (SD = 10.9), after 10 weeks 15.3 (SD = 3.1), and after 3 months 8.6 (SD = 7.6). The average change in pain inference at week 1 was −1.2 (SD = 7.3), at 2 weeks −2.1 (SD = 9.5), after 4 weeks −12.6 (SD = 4.5), after 6 weeks −8.3 (SD = 10.2), after 10 weeks −16.6 (SD = 4.3), and after 3 months −11.4 (SD = 8.2).ConclusionsPROMIS® provides a feasible means to collect data in this population. Trends of improved function and decreased pain were seen after surgery. Continuing this study will hopefully elucidate more insight into the surgical treatment of MBD.
Ergonomics in microsurgery
Authors: Lakhiani Chrisovalantis , Fisher Sean M. , Janhofer David E. , Song David H. 
Published: August 2018

AbstractThere is a growing body of evidence to suggest that surgeon posture while operating contributes to cervical musculoskeletal strain, discomfort, and chronic pain. Microsurgeons may be particularly susceptible to this risk due to persistent neck flexion, long periods of static posture, and the use of heavy, high‐power loupe magnification. Several techniques are thus presented that may help in obviating the cervicospinal repercussions of performing microsurgery.