bluuebunny/crossref_metadata_2025_split huggingface dataset:
Double D Technique: An Innovative Modified Bifurcated Stent Graft Deployment Strategy for an Isolated Common Iliac Artery Aneurysm With a Challenging Renal Artery Anatomy
Authors: Date Yusuke , Takano Tamaki , Fujii Taishi , Terasaki Takamitsu , Sakaguchi Masayuk 
Published: July 2019

Purpose: Endovascular aneurysm repair (EVAR) for an isolated common iliac artery aneurysm (iCIAA) sometimes requires a bifurcated stent graft (SG). In EVAR, it is essential to preserve the renal artery (RA). However, this is challenging in cases of anatomical variation. The double D technique (DDT) can be used in anatomically inadequate cases with a commercially approved bifurcated SG. Here, we report the repair of iCIAA in the presence of a challenging RA anatomy, through EVAR using the DDT. Case Report: An 84-year-old woman was diagnosed with a maximal 35-mm diameter left iCIAA and a nonaneurysmal aorta by computed tomography (CT), which also showed that the right RA arose 50-mm above the aortic bifurcation. The DDT was chosen because commercially approved bifurcated SGs typically require a distance of >70 mm from the proximal position to the aortic bifurcation. Postoperative CT showed excellent results with no endoleaks or SG kinking and occlusion, as well as preservation of robust blood flow to the right RA. Conclusion: Endovascular aneurysm repair using the DDT can be an alternative option for treatment of iCIAA with a challenging RA anatomy.
The Association Between Cardiac Biomarker NT-proBNP and 30-Day Readmission or Mortality After Pediatric Congenital Heart Surgery
Authors: Parker Devin M. , Everett Allen D. , Stabler Meagan E. , Leyenaar JoAnna , Vricella Luca , Jacobs Jeffrey P. , Thiessen-Philbrook Heather , Parikh Chirag , Greenberg Jason , PhD Jeremiah R. Brown 
Published: July 2019

Background: Very little is known about clinical and biomarker predictors of readmissions following pediatric congenital heart surgery. The cardiac biomarker N-terminal pro-brain natriuretic peptide (NT-proBNP) can help predict readmission in adult populations, but the estimated utility in predicting risk of readmission or mortality after pediatric congenital heart surgery has not previously been studied. Our objective was to evaluate the association between pre- and postoperative serum biomarker levels and 30-day readmission or mortality for pediatric patients undergoing congenital heart surgery. Methods: We measured pre- and postoperative NT-proBNP levels in two prospective cohorts of 522 pediatric patients <18 years of age who underwent at least one congenital heart operation from 2010 to 2014. Blood samples were collected before and after surgery. We evaluated the association between pre- and postoperative NT-proBNP with readmission or mortality within 30 days of discharge, using multivariate logistic regression, adjusting for covariates based on the Society of Thoracic Surgeons (STS) Congenital Heart Surgery Mortality Risk Model. Results: The Johns Hopkins Children's Center cohort and the Translational Research Investigating Biomarker Endpoints in Acute Kidney Injury (TRIBE-AKI) cohort demonstrate event rates of 12.9% and 9.4%, respectively, for the composite end point. After adjustment for covariates in the STS congenital risk model, we did not find an association between elevated levels of NT-proBNP and increased risk of readmission or mortality following congenital heart surgery for either cohort. Conclusions: In our two cohorts, preoperative and postoperative values of NT-proBNP were not significantly associated with readmission or mortality following pediatric congenital heart surgery. These findings will inform future studies evaluating multimarker risk assessment models in the pediatric population.
Aortic or Pulmonary Valved Homograft Right Ventricle to Pulmonary Artery Conduit in the Norwood Procedure
Authors: Nasirov Teimour , Maeda Katsuhide , Reinhartz Olaf 
Published: July 2019

Background: Several modifications of the Norwood procedure utilizing valved right ventricle to pulmonary artery conduits have recently been reported. Our group has been using aortic or pulmonary valved homografts combined with PTFE tube grafts for now 16 years. Methods: In this report, we review our technique in detail and describe any changes that have occurred over the years. We provide detailed illustrations of our preferred surgical technique, report outcome data, and compare it to the other conduit options available. Results: Between 2006 and 2015, 130 stage I Norwood procedures were performed at our institution, 100 of them using valved conduits. Our technique is described and illustrated in detail. Early mortality was 15%. Postoperative percutaneous intervention on the conduit was required in 29% of cases. Conclusions: While a randomized trial comparing different valved conduits is lacking, we believe a composite conduit made from homograft aortic or pulmonary valves and PTFE tube grafts is an excellent choice in stage I Norwood procedure.
Staged Biventricular Repair After Hybrid Procedure in High-Risk Neonates and Infants
Authors: Erek Ersin , Suzan Dilek , Aydin Selim , Temur Bahar , Demir Ibrahim Halil , Odemis Ender 
Published: July 2019

Background: Single-stage biventricular repair remains a challenging and difficult decision in high-risk newborns and early infants with the presence of left ventricular outflow tract obstruction (LVOTO) or borderline hypoplasia of the left ventricle (LV). Methods: Six high-risk patients underwent the initial hybrid procedure (bilateral pulmonary banding + ductal stenting) for staged biventricular repair. Their median age was 17 days (range: 7-55 days). The diagnosis was interrupted aortic arch (IAA), ventricular septal defect (VSD), and LVOTO (n = 3); IAA and VSD (n = 1); and aortic annular hypoplasia, aortic arch hypoplasia, VSD, and LVOTO (n = 1). The last patient had borderline LV with large atrial septal defect (ASD) and aortic arch hypoplasia. The patient with borderline LV had also ASD closure with small fenestration. Results: One patient died of sepsis after the hybrid procedure. Other patients underwent biventricular repair 8 to 13 months later. Three patients had conventional repair with conal septum resection. The other patient with IAA, in whom LVOTO was considered nonresectable, underwent Yasui operation. The last patient with borderline LV had enough development of left heart structures during follow-up and underwent aortic arch repair. One patient who had conal septum resection died after biventricular repair. One patient needed a tracheostomy; four patients were discharged uneventfully and their clinical conditions were good on postoperative year 1. Conclusion: Staged biventricular repair with the initial hybrid procedure may be a feasible and safe alternative in high-risk neonates and early infants. Hybrid intervention may provide the development of cardiac structures in time and a better evaluation for the possibility of biventricular repair in borderline patients.
Development of an Innovative Career Development Program for Early-Career Women Faculty
Authors: Danhauer Suzanne C , Tooze Janet A , Barrett Natalie AM , Blalock Jamie S , Shively Carol A , Voytko Mary Lou , Crandall Sonia J 
Published: July 2019

Objective Our institutional Women in Medicine & Science Program (formerly the Office of Women in Medicine and Science) developed the Early Career Development Program for Women to promote the careers of women faculty. At 6 monthly sessions, participants learn relevant content (imposter syndrome, strengths, change style, career management, assertive communication, feedback, personal influence, conflict management, negotiation, importance of mentors, resilience, and self-care); exchange ideas; and expand their professional networks. Here, we report changes in participants’ career skills/knowledge, confidence, and perceptions of the current environment after attending the program. Method Between 2014 and 2017, participants (N = 65) completed pre- and post-program surveys that assessed career knowledge and skills, confidence, and perceptions of the current environment and provided program feedback. Results Most skills showed pre–post significant improvement. The greatest increases occurred in knowing paths to promotion, tailoring communication style, ability to manage conflict, and ability to handle personal–professional role balance. Women reported a significant increase for all items measuring confidence. Among these items, establishing networks, understanding institutional culture, providing feedback, motivating others, strategic planning, delegating, and conflict management had the largest increases. Overall, 89.3% of respondents rated the program impact as very strong/profound, 98.5% rated the concepts as essential, 95.2% rated the skills as essential, and 90.8% rated the sense of community with women in their class as very/extremely close. Conclusions Work-related skills/knowledge, confidence, and perceptions of the current environment increased significantly among program participants. These early-career women faculty indicated that the program augmented the skills needed to develop their careers in an academic medical center.
Assessing spontaneous passage of prophylactic pancreatic duct stents by X-ray: is a radiology report adequate?
Authors: Loloi Justin , Lipkin Jacob S. , Gagliardi Eileen M. , Levenick John M. 
Published: July 2019

Background: Pancreatic duct stents are frequently placed for prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis. Because of concern for possible secondary ductal changes from a retained stent, these stents need to be monitored and removed if retained. Usually an abdominal X-ray is performed to assess retained stent, and if present, an esophagogastroduodenoscopy is performed to remove the stent. Limited data is published on false-negative radiology reports for spontaneous passage of stents. Methods: Using an Institutional Review Board–approved stent log, a retrospective chart review of all pancreatic duct stents placed at our institution from 2008 to 2014 was performed. Results: A total of 856 pancreatic duct stents were placed during the study period. Of these, 435 (50.8%) were prophylactic stents and 421 (49.2%) were therapeutic. Complete follow-up data were available in 426 (97.9%) patients with prophylactic stents. Six patients (1.4%) were lost to follow up and three (0.7%) expired prior to removal. In all, 283 (66%) had follow-up imaging, with 167 (39.2%) having the official radiology read with no retained pancreatic duct stent in place. Eight of these cases were “false-negative” radiology interpretation (4.8% of cases read as “no stent,” NNH = 20). The stent was found either by review of image by an endoscopist or incidental stent discovery during a follow-up procedure. Conclusion: Radiologist interpretation of abdominal X-rays to assess spontaneous passage of prophylactic pancreatic ducts stents resulted in a false-negative interpretation in approximately 5% of cases. Independent review of the images by the endoscopist may be beneficial given unfamiliarity of these stents by radiologists.
Genetic defects in hematopoietic transcription factors and predisposition to acute lymphoblastic leukemia
Authors: Gocho Yoshihiro , Yang Jun J. 
Published: July 2019

Abstract
Recent genome-wide studies have revealed a plethora of germline variants that significantly influence the susceptibility to acute lymphoblastic leukemia (ALL), thus providing compelling evidence for genetic inheritance of this blood cancer. In particular, hematopoietic transcription factors (eg, ETV6, PAX5, IKZF1) are most frequently implicated in familial ALL, and germline variants in these genes confer strong predisposition (albeit with incomplete penetrance). Studies of germline risk factors for ALL provide unique insights into the molecular etiology of this leukemia.
Jan Steen’s ground layers analysed with Principal Component Analysis
Authors: Albrecht Marya , de Noord Onno , Meloni Sabrina , van Loon Annelies , Haswell Ralph 
Published: July 2019

Abstract
In-depth technical and art historical research into Jan Steen’s (ca. 1626–1679) oeuvre has been a focus at the Mauritshuis since 2012, as part of the Partners in Science collaboration with Shell. The aim of this project is to shed light on the chronology of Steen’s oeuvre based on the materials he used, since only 10% of his circa 450 works are dated. Steen worked in different cities within the Netherlands (Haarlem, The Hague, Delft, Leiden and Warmond), each with a distinct artistic community. So far 39 paintings from the Mauritshuis and many other collections in and outside the Netherlands have been analysed. This paper focuses on the ground layers in Steen’s paintings. Cross sections were taken of each painting and analysed using SEM-EDX. Principal Component Analysis (PCA) on the resulting dataset was used to find correlations between variables and clustering of samples. Special versions of PCA were explored to analyse pigment identifications and to allow data fusion of this binary data with the quantitative elemental analyses, which is not trivial with normal PCA. The statistical analyses allowed us to group paintings linking them to the different cities where Steen worked and to see outliers in terms of the ground layer composition. Interestingly, the present survey also revealed that apart from commercially prepared grounds, Steen also used grounds prepared in his own studio.
A Cohort Analysis of Clinical and Ultrasound Variables Predicting Cancer Risk in 20,001 Consecutive Thyroid Nodules
Authors: Angell Trevor E , Maurer Rie , Wang Zhihong , Kim Matthew I , Alexander Caroline A , Barletta Justine A , Benson Carol B , Cibas Edmund S , Cho Nancy L , Doherty Gerard M , Doubilet Peter M , Frates Mary C , Gawande Atul A , Krane Jeff F , Marqusee Ellen , Moore Francis D , Nehs Matthew A , Larsen P Reed , Alexander Erik K 
Published: July 2019

AbstractContextAssessing thyroid nodules for malignancy is complex. The impact of patient and nodule factors on cancer evaluation is uncertain.ObjectivesTo determine precise estimates of cancer risk associated with clinical and sonographic variables obtained during thyroid nodule assessment.DesignAnalysis of consecutive adult patients evaluated with ultrasound-guided fine-needle aspiration for a thyroid nodule ≥1 cm between 1995 and 2017. Demographics, nodule sonographic appearance, and pathologic findings were collected.Main Outcome MeasuresEstimated risk for thyroid nodule malignancy for patient and sonographic variables using mixed-effect logistic regression.ResultsIn 9967 patients [84% women, median age 53 years (range 18 to 95)], thyroid cancer was confirmed in 1974 of 20,001 thyroid nodules (9.9%). Significant ORs for malignancy were demonstrated for patient age <52 years [OR: 1.82, 95% CI (1.63 to 2.05), P < 0.0001], male sex [OR: 1.68 (1.45 to 1.93), P < 0.0001], nodule size [OR: 1.30 (1.14 to 1.49) for 20 to 19 mm, OR: 1.59 (1.34 to 1.88) for 30 to 39 mm, and OR: 1.71 (1.43 to 2.04) for ≥40 mm compared with 10 to 19 mm, P < 0.0001 for all], cystic content [OR: 0.43 (0.37 to 0.50) for 25% to 75% cystic and OR: 0.21 (0.15 to 0.28) for >75% compared with predominantly solid, P < 0.0001 for both], and the presence of additional nodules ≥1 cm [OR: 0.69 (0.60 to 0.79) for two nodules, OR: 0.41 (0.34 to 0.49) for three nodules, and OR: 0.19 (0.16 to 0.22) for greater than or equal to four nodules compared with one nodule, P < 0.0001 for all]. A free online calculator was constructed to provide malignancy-risk estimates based on these variables.ConclusionsPatient and nodule characteristics enable more precise thyroid nodule risk assessment. These variables are obtained during routine initial thyroid nodule evaluation and provide new insights into individualized thyroid nodule care.
Indigenous Technologies in the 1577 Relaciones geográficas of New Spain: Collective Land Memory, Natural Resources, and Herbal Medicine
Authors: McDonough Kelly S. 
Published: July 2019

Abstract
This essay applies the analytic category of technologies proposed by historian Marcy Norton as complex systems of knowledges, practices, and products generated in specific social contexts to a study of the sixteenth-century bureaucratic surveys known as the Relaciones geográficas (RG) manuscripts. As a methodological intervention, the principal aim is to draw out the relatively understudied Indigenous knowledges and practices found throughout the corpus. The first section of the essay outlines the conceptual framework of technologies and contextualizes the RG survey and response processes. The remainder of the essay discusses Indigenous technologies including collective land memory, natural resources, and herbal medicines recorded in the Archdiocese of Mexico corpus of RGs (appendix), thirty-one manuscripts in total.
Information Aggregation and P-Hacking
Authors: Rytchkov Oleg , Zhong Xun 
Published: July 2019

This paper studies the interplay between information aggregation and p-hacking in the context of predicting stock returns. The standard information-aggregation techniques exacerbate p-hacking by increasing the probability of the type I error. We propose an aggregation technique that is a simple modification of three-pass regression filter/partial least squares regression with an opposite property: the predictability tests applied to the combined predictor become more conservative in the presence of p-hacking. Using simulations, we quantify the advantages of our approach relative to the standard information-aggregation techniques. We also apply our aggregation technique to three sets of return predictors proposed in the literature and find that the forecasting ability of combined predictors in two cases cannot be explained by p-hacking.This paper was accepted by Karl Diether, finance.
Dialectical Methods and the Stoicheia Paradigm in Plato’s Trilogy and Philebus
Authors: Smith Colin C. 
Published: July 2019

Plato’s Theaetetus, Sophist, and Statesman exhibit several related dialectical methods relevant to Platonic education: maieutic in Theaetetus, bifurcatory division in Sophist and Statesman, and non-bifurcatory division in Statesman, related to the ‘god-given’ method in Philebus. I consider the nature of each method through the letter or element (στοιχεῖον) paradigm, used to reflect on each method. At issue are the element’s appearances in given contexts, its fitness for communing with other elements like it in kind, and its own nature defined through its relations to others. These represent stages of inquiry for the Platonic student inquiring into the sources of knowledge.
Plato’s Socrates, Sophistic Antithesis and Scepticism
Authors: Blyth Dougal 
Published: July 2019

In some Platonic dialogues Socrates apparently shares significant characteristics with contemporary sophists, especially a technique of antithetical argumentation. Since sophists anticipated later Academic philosophers in arguing antithetically and a resultant form of, then, with Socrates’ repeated claims to ignorance, Plato’s depiction of him arguing antithetically suggests later Academics could plausibly appeal to Plato for evidence that Socrates and he were, as it seems they actually did.
PERLINDUNGAN HUKUM NASABAH PERBANKAN DALAM TRANSAKSI ELEKTRONIK
Authors: Syaifuddin Luthfi , Prananingtyas Paramita 
Published: July 2019

Electronics is now a necessity for modern society to use it as a means of payment. In the trade business for example, technological advances have given rise to the method of transactions known as E-Commerce (Electronic Commerce). The use of internet facilities is a technological advancement that can be said to support the overall spectrum of commercial activities. The method of approach used in this study is empirical juridical, which uses the primary data of BNI leadership Kcp Ngaliyan through interviews and secondary data through library research. All data collected was analyzed using a qualitative method then presented descriptively so that a conclusion was obtained. Based on the results of the study Legal protection for customers of E-Banking users has not run properly. Legal safeguards against customers of E-Banking users can only be realized with the participation of various parties. The customer must be more proactive in knowing his rights and obligations and also the Bank should be more open and improve its performance. Also Electronic Information and Transactions require a more representative formulation that can reach all forms of crime using E Banking Keywords: Customer Legal Protection, Electronic Transactions AbstrakElektronik saat ini merupakan suatu kebutuhan masyarakat modern untuk menggunakannya sebagai sarana pembayaran. Dalam bisnis perdagangan misalnya, kemajuan teknologi telah melahirkan metode bertransaksi yang dikenal dengan istilah E-Commerce ( Electronic Commerce ). Penggunaan sarana internet merupakan suau kemajuan teknologi yang dapat dikatakan menunjang secara keseluruhan spectrum kegiatan komersial.Metode pendekatan yang digunakan dalam penelitian ini adalah yuridis empiris, yang menggunakan data primer pimpinan BNI Kcp Ngaliyan melalui wawancara dan data sekunder melalui studi kepustakaan. Seluruh data yang tekumpul dianalisis menggunakan metode kualitatif kemudian dipaparkan secara deskriptif sehingga diperoleh suatu kesimpulan. Berdasarkan pada hasil penelitian Perlindungan hukum terhadap nasabah pengguna E-Banking belum berjalan sebagaimana mestinya. Upaya Perlindungan hukum terhadap nasabah pengguna E-Banking hanya dapat terwujud dengan adanya partisipasi dari berbagai pihak. Pihak nasabah harus bersikap lebih proaktif untuk mengetahui hak dan kewajibannya dan juga pihak Bank hendaknya lebih bersikap terbuka dan memperbaiki kinerjanya. Juga Informasi dan Transaksi Elekronik diperlukan perumusan yang lebih representatif yang dapat menjangkau semua bentuk kejahatan dengan menggunakan E Banking. Kata kunci : Perlindungan Hukum Nasabah, Transaksi Elektronik
Využití pojmových map s následným rozhovorem jako výzkumného nástroje při hledání žákovských miskoncepcí
Authors: Pavlátová Věra 
Published: July 2019

Článek ilustruje tvorbu a reflexi pojmových map (= PM) ve výzkumu publikovaném v tomto čísle Envigogiky („Dětská pojetí vybraných environmentálních fenoménů u žáků 1. a 2. stupně základní školy“). Zde byly pojmové mapy a následný doplňující rozhovor využity k analýze porozumění významu vybraných fenoménů. Každý žák měl nejprve pochopit, co je pojmová mapa, a mohl si vyzkoušet, jak se vytváří. Pro účely výzkumu pak zpracoval vlastní pojmovou mapu, vždy kolem vybraného centrálního fenoménu (celkem jich bylo 8). V rámci následujícího rozhovoru s výzkumníkem tento žák vysvětloval své myšlenkové operace v PM, případně pomocí návodných otázek ještě dále pokračoval v rozboru. O použité metodě více vypovídá související článek; zde přinášíme příklad tvorby pojmových map a průběhu rozhovoru s jedním ze žáků a zobecnění všech provedených rozhovorů.