bluuebunny/crossref_metadata_2025_split huggingface dataset:
Type I Diabetes is the Main Cost Driver in Autoimmune Polyendocrinopathy
Authors: Radermacher Lena-Katharina , Ponto Katharina , Merkesdal Sonja , Pomart Vanessa , Frommer Lara , Pfeiffer Norbert , König J , Kahaly George J 
Published: September 2019

Abstract

Context
Autoimmune polyendocrinopathy (AP), a chronic complex orphan disease, encompasses at least two autoimmune-induced endocrine diseases.

Objective
To estimate for the first time total, indirect and direct costs for patients with AP, as well as cost drivers.

Design
Cross-sectional cost of illness study.

Setting
Academic tertiary referral center for AP.

Patients
146 consecutive, unselected AP patients.

Intervention
Interviews pertaining to patients’ socioeconomic situation covered a recall period of 12 months. Both the human capital (HCA) and the friction cost approaches (FCAs) were applied as estimation methods.

Main outcome measures
Direct and indirect annual costs, and sick leave and medication costs.

Results
AP markedly impacts healthcare expenses. Mean overall costs of AP in Germany ranged from €5 971 090 to €29 848 187 per year (HCA). Mean indirect costs ranged from €3 388 284 to €16 937 298 per year (HCA) while mean direct costs ranged from €2 582 247 to €12 908 095/year. Mean direct costs per year were €1851 in AP patients with type 1 diabetes (T1D, 76%) and €671 without T1D, which amounts to additional direct costs of €1209 for T1D when adjusting for concomitant autoimmune disease (95% CI = €1026–1393, P &lt; 0.0001). Sick leave cost estimates for AP patients with T1D exceeded those without T1D by 70% (FCA) and 43% (HCA), respectively. In multiple regression analyses, T1D predicted total and direct costs, medication costs and costs for diabetic devices (all P &lt; 0.001). Overall, AP patients with T1D were 54% (FCA) more expensive than those without T1D.

Conclusions
Public health socioeconomic relevance of AP was demonstrated, with T1D as main cost driver.
Preeclampsia Is Associated With Increased Preclinical Carotid Atherosclerosis in Women With Type 1 Diabetes
Authors: Amor Antonio J , Vinagre Irene , Valverde Maite , Pané Adriana , Urquizu Xavier , Meler Eva , López Eva , Quirós Carmen , Giménez Marga , Codina Laura , Conget Ignacio , Barahona Maria J , Perea Verónica 
Published: September 2019

Abstract

Purpose
Although preeclampsia (PE) is a well-established cardiovascular risk factor (CVRF) in the general population, its role in type 1 diabetes (T1D) has been scarcely studied. We assessed the association between PE and preclinical atherosclerosis in T1D.

Methods
We recruited 112 women without cardiovascular disease and last pregnancy ≥5 years before: (1) T1D and previous PE (T1D+/PE+; n = 28); (2) T1D without preeclampsia (T1D+/PE–; n = 28); (3) previous PE without T1D (T1D–/PE+; n = 28); and (4) controls (without T1D or PE; T1D–/PE–; n = 28). Groups were matched by age, several CVRFs, and diabetes duration and retinopathy (in T1D participants). Carotid intima-media thickness (IMT) and the presence of plaque (IMT ≥ 1.5 mm) were assessed by standardized ultrasonography protocol.

Results
Mean age of the participants was 44.9 ± 7.8 years (14.3% hypertension and 21.4% active smokers). Groups including T1D (T1D+/PE+ and T1D+/PE–) more frequently presented hypertension and statin treatment (23.2% vs 5.4% and 37.5% vs 8.9%; respectively; P &lt; 0.01), without differences in other CVRFs. Carotid plaques were observed in 20.5%. In multivariate models adjusted for age, CVRF, and statins, both T1D and PE showed a similar impact on the presence of plaque, with odds ratios (95% confidence interval), 5.45 (1.36–21.9) and 4.24 (1.04–17.3), respectively. Both entities showed an additive effect when combined, both in common carotid-IMT (T1D+/PE– or T1D–/PE+, β = 0.198; T1D+/PE+, β = 0.297) and in the presence of plaque (8.53 [1.07–68.2] and 28.1 [2.67–296.4], respectively).

Conclusions
Previous PE was independently associated with preclinical atherosclerosis in T1D. Further studies are needed to ascertain its usefulness for stratifying risk in T1D women.
The Flighty Coquette Sings on Easter Sunday
Authors: Pesic Andrei 
Published: September 2019

AbstractFrench colonists in Saint-Domingue brought a variety of entertainments from the metropole to the island's theaters during the later eighteenth century. This included the Parisian Concert Spirituel, which replaced theatrical entertainments with performances of religious and instrumental music during religious holidays. Yet these concerts never caught on in earnest and began to diverge significantly from the metropolitan institution: the Easter concert in Port-au-Prince entirely composed of opera arias would have been unthinkable in the metropole. Linking developments in the colony's entertainments with the understudied subject of religious practices among France's Caribbean colonists, this article argues that strong market pressures overrode weaker religious constraints in Saint-Domingue, making opera arias acceptable for Eastertide. It presents a new fine-grained approach for studying how cultural practices are transformed when traveling within an empire, with implications beyond the history of the arts.Les colons français ont importé une grande variété de divertissements de la métropole à Saint-Domingue durant la deuxième moitié du dix-huitième siècle. Le Concert spirituel de Paris, qui remplaçait les spectacles profanes pendant les fêtes religieuses, a été l'une de ces institutions. Néanmoins ces concerts n'ont jamais entièrement pris dans le contexte colonial et ont peu à peu divergé de leurs homologues métropolitains : un concert de Pâques à Port-au-Prince entièrement constitué d'airs d'opéra aurait été inimaginable dans l'Hexagone à cette époque. Liant l'histoire des divertissements coloniaux et le sujet peu étudié des pratiques religieuses des colons, cet article développe l'idée que de fortes pressions commerciales ont primé sur de faibles contraintes religieuses à Saint-Domingue, rendant des airs d'opéra acceptables au moment des fêtes de Pâques. L'analyse souligne la façon dont les pratiques culturelles évoluent lorsqu'elles voyagent au sein d'un empire colonial, tirant des implications qui vont au-delà de l'histoire des arts.
Effect of Cuff Pressure on Blood Flow during Blood Flow–restricted Rest and Exercise
Authors: CROSSLEY KENT W. , PORTER DORAN A. , ELLSWORTH JOSHUA , CALDWELL TABITHA , FELAND J. BRENT , MITCHELL ULRIKE , JOHNSON A. WAYNE , EGGET DENNIS , GIFFORD JAYSON R. 
Published: September 2019

ABSTRACT

Purpose
This study investigated the relationship between blood flow restriction (BFR) cuff pressure and blood flow at rest and during exercise, with the aim of determining if lower cuff pressures will provide an ischemic stimulus comparable to higher pressures.

Methods
The relationship between blood flow and cuff pressure at rest was determined by measuring blood flow (Doppler Ultrasound) through the superficial femoral artery (SFA) in 23 adults across a range of pressures (0%–100% Arterial Occlusion Pressure at rest [rAOP]). The interplay between cuff pressure, blood flow and exercise was assessed by determining AOP at rest and during plantar flexion exercise (eAOP) and subsequently measuring the blood flow response to plantar flexion exercise with BFR cuff pressure set to either 40% rAOP or 40% eAOP.

Results
At rest, a nonlinear relationship between cuff pressure and blood flow through the SFA exhibited a plateau at moderate pressures, with nonsignificant differences in blood flow (~9%, P = 1.0) appearing between pressures ranging from 40% to 80% rAOP. While eAOP was greater than rAOP (229 ± 1.5 mm Hg vs 202 ± 1.5 mm Hg, P < 0.01), blood flow during plantar flexion exercise did not significantly differ (P = 0.49) when applying 40% rAOP or 40% eAOP.

Conclusions
Blood flow through the SFA exhibits a nonlinear relationship with cuff pressure, such that cuff pressures in the range of 40% to 80% rAOP reduce blood flow to approximately the same degree. The BFR interventions opting for lower (e.g., 40% AOP), more comfortable pressures will likely provide an ischemic stimulus comparable to that of higher (80% AOP), less-comfortable pressures.
Implementing Pediatric Asthma Pathways in Community Hospitals: A National Qualitative Study
Authors: McDaniel Corrie E , Jeske Melanie , Sampayo Esther M , Liu Peony , Walls Theresa A , Kaiser Sunitha V 
Published: September 2019

BACKGROUNDPathways can improve the quality of care and outcomes for children with asthma; however, we know little about how to successfully implement pathways across diverse hospital settings. Prior studies of pathways have focused on determining clinical effectiveness and the majority were conducted in children's hospitals. These approaches have left crucial gaps in our understanding of how to successfully implement pathways in community hospitals, where most of the children with asthma are treated nationally.OBJECTIVEThe aim of this study was to identify the key determinants of successful pediatric asthma pathway implementation in community hospitals.METHODSWe conducted a qualitative study of healthcare providers that served as project leaders in a national collaborative to improve pediatric asthma care. Data were collected by recording semi‐structured discussions between project leaders and external facilitators (EF) from December 2017 to April 2018. Using inductive thematic analysis, we identified the themes that describe the key determinants of pathway implementation.RESULTSProject leaders (n = 32) from 18 hospitals participated in this study. The key determinants of pathway implementation in community hospitals included (1) building an implementation infrastructure (eg, forming a team of local champions, modifying clinical workflows, delivering education/skills training), (2) engaging and motivating providers (eg, obtaining project buy‐in, facilitating multidisciplinary collaboration, handling conflict), (3) addressing organizational and resource limitations (eg, support for electronic medical record integration), and (4) devising implementation solutions with EFs (eg, potential workflow modifications).CONCLUSIONSOur identification of the key determinants of pathway implementation may help guide pediatric quality improvement efforts in community hospitals. EFs may play an important role in successfully implementing pathways in community settings.
Universidade pública e contrarrevolução: da “travessia de uma ponte” ao “caminho da prosperidade”
Authors: Lima Kátia 
Published: September 2019

O texto tem como objetivo apresentar um conjunto de reflexões teóricas sobre o fim do governo de coalizão de classes e a ascensão da extrema direita no Brasil, problematizando como as alterações na configuração histórica e espacial da luta de classes incidem na política de educação superior. Recuperando o profícuo instrumental analítico de Florestan Fernandes, consideramos que está em curso uma nova fase da contrarrevolução burguesa preventiva, que, marcada pela natureza antissocial e violenta da burguesia brasileira articulada ao imperialismo, conduz o aprofundamento da mercantilização da universidade pública e da ofensiva reacionária na educação. Tal aprofundamento indica a tarefa urgente e necessária de defesa da educação pública, lócus privilegiado da produção crítica e criativa do conhecimento. Palavras-Chave: contrarrevolução burguesa; formação social brasileira; educação superior pública.
Família, conservadorismo e políticas sociais no Brasil: questões para reflexão
Authors: Souza Ilka De Lima , De Lima Rita De Lourdes 
Published: September 2019

Neste artigo visamos discutir o familismo nas políticas sociais brasileiras na cena contemporânea. A partir de uma revisão bibliográfica, apresentamos, inicialmente, aspectos da formação sócio-histórica brasileira e suas implicações na configuração da família. Para isso, discutimos as principais características de nossa formação: conservadora, patriarcal, paternalista e patrimonialista. Em seguida, analisamos como o familismo, presente no campo das políticas sociais no Brasil, ao mesmo tempo em que, de um lado, se respalda em um discurso de acesso aos direitos, de outro, reforça a sobrecarga das famílias, sobretudo das mulheres, que são responsabilizadas socialmente pelas tarefas domésticas e pelo cuidado com os membros da família. Concluimos ressaltando a necessidade de a sociedade humana avançar na defesa e na busca de valores emancipatórios, por meio da construção de uma nova sociedade. Nesse sentido, precisamos problematizar o familismo nas políticas sociais, desmistificando os limites intrínsecos de uma análise que a desconecta da genericidade humana. Palavras-Chave: família; políticas sociais; formação sócio-histórica brasileira; conservadorismo.
Craniofacial polyostotic fibrous dysplasia: A case report
Authors: Forbes-Haley Claire , Najran Anna , Nandra Sukbir , Bhola Surina 
Published: September 2019

Fibrous dysplasia is a bone disorder whereby normal medullary bone is replaced by fibrous tissue. Many sites may be affected, including the craniofacial skeleton. A 33-year-old female presented at the Bristol Dental Hospital in 2007 complaining of a prominent and expanding lower jaw as well as poor aesthetics. She was diagnosed with craniofacial polyostotic fibrous dysplasia. In order to manage her concerns and the ongoing growth of the polyostotic lesions, a combined maxillofacial and restorative approach was utilized. After ten years of ongoing management and care, including surgery and dental rehabilitation, her primary concerns have been addressed. CPD/Clinical Relevance: The clinician should be able to understand the clinical and radiographic appearance of craniofacial fibrous dysplasia, how the condition can impact a patient and the complex management that may be involved.
Prescribing practices of antimicrobial prophylaxis in older patients in the surgical wards
Authors: Khan Zakir , Ahmed Naveed , ur Rehman Asim , Khan Faiz Ullah , Hamid Syed Muhammad 
Published: September 2019

Background: appropriate prescribing of antimicrobial prophylaxis (AP) is a main strategy of the antimicrobial stewardship programme. Aim: to investigate the prescribing practices of antimicrobial prophylaxis and adherence to recommended protocols in older patients in the surgical wards at a 600-bed teaching hospital in Islamabad, Pakistan. Method: researchers selected 240 surgical procedures retrospectively for patients aged 65 years and older admitted to four surgical specialties (abdominal, orthopaedic, urological and neurosurgery) during 1 year. The different parameters of antimicrobial prescription were compared with international clinical practice guidelines. Findings: There were more ‘clean’ surgical wound procedures (n=104; 43.3%) than ‘clean contaminated’ (n=97; 40.4%) and most of these were elective surgical procedures (n=226; 94%). The indication, selection, route, dose, and timing of antimicrobial were found to have adhered with the standard guidelines in 89.6%, 32.5%, 100%, 100% and 55.3% of cases, respectively (optimal value 100%). A statistically significant difference was observed between antimicrobial practices and surgical procedures (P< 0.001). The commonly prescribed antimicrobials were ceftriaxone followed by cefazolin. Conclusion: about 89% of participants who underwent surgical procedures received antimicrobials. The selection of therapeutic agent, the timing and use of broad-spectrum antimicrobial were the common problems in our setting.
IMMUNOINFLAMMATORY RHEUMATIC DISEASES ASSOCIATED WITH TYPE I INTERFERON: NEW EVIDENCE
Authors: Nasonov E. L. , Avdeeva A. S. 
Published: September 2019

Immunoinflammatory rheumatic diseases (IIRDs) are a large group of pathological conditions with impaired immunological tolerance to autogenous tissues, leading to inflammation and irreversible organ damage. The review discusses current ideas on the role of type I interferons in the immunopathogenesis of IIRDs, primarily systemic lupus erythematosus, and new possibilities for personalized therapy.
Victorian Mages: Robert Browning’s “Pietro of Abano” as a Critical Corollary to Alfred Tennyson’s Merlin
Authors: Manor Gal 
Published: September 2019

Abstract
Against the backdrop of Victorian celebrity culture, Robert Browning and Alfred Tennyson conjure the literary trope of the magician in order to convey their poetic choices and to examine the relationship between the poet and his audience. Whereas Browning’s magician, “Pietro of Abano” of Dramatic Idyls (1880), is subversive, odd and persecuted, the Poet Laureate’s Merlin of the Idylls of the King (1859–1875) is acknowledged and well admired. This essay will explore Browning’s Pietro as a critical response to Tennyson’s Merlin, reflecting the complex personal relationship between the two poets, their stylistic differences and their dissimilar reception by their contemporaries.
A left ventricular phantom for 3D echocardiographic twist measurements
Authors: Hjertaas Johannes Just , Matre Knut 
Published: September 2019

AbstractTraditional two-dimensional (2D) ultrasound speckle tracking echocardiography (STE) studies have shown a wide range of twist values, also for normal hearts, which is due to the limitations of short-axis 2D ultrasound. The same limitations do not apply to three-dimensional (3D) ultrasound, and several studies have shown 3D ultrasound to be superior to 2D ultrasound, which is unreliable for measuring twist. The aim of this study was to develop a left ventricular twisting phantom and to evaluate the accuracy of 3D STE twist measurements using different acquisition methods and volume rates (VR). This phantom was not intended to simulate a heart, but to function as a medium for ultrasound deformation measurement. The phantom was made of polyvinyl alcohol (PVA) and casted using 3D printed molds. Twist was obtained by making the phantom consist of two PVA layers with different elastic properties in a spiral pattern. This gave increased apical rotation with increased stroke volume in a mock circulation. To test the accuracy of 3D STE twist, both single-beat, as well as two, four and six multi-beat acquisitions, were recorded and compared against twist from implanted sonomicrometry crystals. A custom-made software was developed to calculate twist from sonomicrometry. The phantom gave sonomicrometer twist values from 2.0° to 13.8° depending on the stroke volume. STE software tracked the phantom wall well at several combinations of temporal and spatial resolution. Agreement between the two twist methods was best for multi-beat acquisitions in the range of 14.4–30.4 volumes per second (VPS), while poorer for single-beat and higher multi-beat VRs. Smallest offset was obtained at six-beat multi-beat at 17.1 VPS and 30.4 VPS. The phantom proved to be a useful tool for simulating cardiac twist and gave different twist at different stroke volumes. Best agreement with the sonomicrometer reference method was obtained at good spatial resolution (high beam density) and a relatively low VR. 3D STE twist values showed better agreement with sonomicrometry for most multi-beat recordings compared with single-beat recordings.
Retrieving the Law and Gospel Distinction for the Task of Dogmatics
Authors: Wisse Maarten 
Published: September 2019

Summary
In this paper, I argue that contemporary dogmatics shares a common interest in the representation of God and God’s acts in human language, be this in a more narrowly propositional way or a more broadly defined doxological or dramaturgical way. I argue for an alternative way of looking at the task of dogmatics in terms of the classical distinction between Law and Gospel. I argue that this view of the task of dogmatics makes us understand premodern dogmatics better than from the perspective of dogmatics as oriented towards representation. Finally, I argue that this alternative can be a way of doing dogmatics nowadays in a fresh way. I illustrate these three points by reference to the doctrine of the Trinity, Christology and atonement.
The Voice of the People in Homer
Authors: Nikias Kyriaco 
Published: September 2019

Abstract
The informality of the Homeric assembly is often emphasised to distinguish it from the democratic bodies of the classical polis, and to show that the people in the Homeric society had no means to qualify the power of their aristocratic leaders. This article argues, to the contrary, that the lack of a formal system of command and control in the Homeric society conditioned the dependence of the leaders on a political model of persuasion. Since this was necessarily directed at the mass population of the society, they people were integrated in the system of government. This was maintained through three general mechanisms: first, the voice of the people was institutionalised, in the form of a popular assembly, the agorē; second, the people had a standardised, effective means by which to express consent and a limited amount of dissent to their leaders in the assembly; third, the people participated in a juridical function which was communal in purpose and form. This model seeks to show that, in these ways, the voice of the people held an important position in the structure of power, one which depended on the informality of that structure rather than being reduced by it.
Sprachliche Akkommodation in onkologischen Therapieplanungsgesprächen
Authors: Imo Wolfgang 
Published: September 2019

Abstract
Accommdation is ubiquitous in interaction. Depending on the situation, accommodation can be successful or it can fail, either intentionally or unintentionally, leading to under-accommodation, over-accommodation or contra-accommodation. Accommodation plays a vital role in interactional settings, especially in doctor-patient-communication, because accommodation is closely linked to the management of understanding, establishment of shared knowledge and building of trust. It is this interactional work of mutual adaption that this article is about. Using examples from a corpus of oncology consultations between doctors and patients in various oncology departments of a hospital, it is shown how doctors and patients accommodate both in a sequentially and temporally structured way or – only rarely – counter-, over- or underaccommodate.
„... und wenn etwas unglaubwürdig klingt, was man ihnen nachsagt, so könnt ihr versichert sein, daß es noch um die Hälfte hinter der Wahrheit zurückbleibt“. Wahr-Sagen als sprachliche Strategie des Widerstehens in Thomas Manns BBC-Reden
Authors: Markewitz Friedrich 
Published: September 2019

Abstract
Linguistics predominantly concentrate on the language use of the National Socialist regime. Resistance and oppostional discourses and their linguistic actions of resisting were only rudimentary taken into account and still represents a research desideratum. Based on a central actor of the exiled resistance – Thomas Mann – an important linguistic strategy of resisting – true saying – is to be made an issue in this context and worked on exemplarily in the BBC speeches held between 1940 and 1945. Based on the uses of the lexeme Wahrheit, wahr and wahrhaftig, their use in the individual speeches should be reflected against the background that it was Mann’s stated goal to discredit the constructions of reality of the NS propaganda and to convey alternative perspectives to the german listeners. The processing of his strategies are the subject of this essay.