bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Economic Geography of Kenyan Tobacco Farmers’ Livelihood Decisions
Authors: Li Qing , Magati Peter , Lencucha Raphael , Labonte Ronald , Makoka Donald , Drope Jeffrey 
Published: January 2019

Abstract

Introduction
The narrative of prosperous economic livelihood of tobacco farmers in Kenya as alleged by the tobacco industry deserves challenge as evidence increasingly suggests that smallholder tobacco farmers are making little or no profits. Article 17 of the World Health Organization Framework Convention on Tobacco Control encourages viable alternative livelihoods for tobacco farmers. There is little evidence, however, on how tobacco farmers make livelihood choice decisions.

Methods
A total of 527 purposefully selected smallholder tobacco farmers in Kenya from three main tobacco-growing regions participated in a 2017 economic livelihood survey. Geo-economic data were matched to surveyed farmers’ Global Positioning System coordinates to estimate each farmer’s access to nearby economic centers. Ownership of cell phones or radios was also used to estimate farmers’ virtual access to nearby economic activities to understand better the role of information. Multivariate logistic regressions were used to control socioeconomic status and self-reported activity in nearby economic centers.

Results
Tobacco farmers rarely live within 10 km of an economic center. Results suggest that the further away farmers live from economic centers, the less likely they are to grow tobacco, but more likely to grow tobacco under contract. Also, farmers owning a cell phone or radio are not only less likely to grow tobacco, but also to not engage in farming under contract if they do grow tobacco.

Conclusions
Physical and virtual access to nearby economic activities is significantly associated with tobacco farmers’ livelihood choice decision and should be taken into consideration by decision makers while developing interventions for FCTC Article 17.

Implications
Smallholder tobacco farmers in lower-income countries are making little or no profits, but few studies have been conducted to illuminate what perpetuates tobacco production, with such studies urgently needed to support governments to develop viable alternative livelihoods for tobacco farmers. This study suggests that geographic and technological factors that shape farmers’ economic decisions can help policy makers tailor alternative livelihood policies to different regional contexts and should be a focus of future research in this area.
Progression of Baseline Electrocardiogram Abnormalities in Chagas Patients Undergoing Antitrypanosomal Treatment
Authors: Soverow Jonathan , Hernandez Salvador , Sanchez Daniel , Forsyth Colin , Flores Carmen A , Viana Gracia , Meymandi Sheba 
Published: January 2019

Abstract

Background
The objective of the study was to better understand the impact of antitrypanosomal treatment on the evolution of Chagas-related, prognostically important electrocardiogram (ECG) abnormalities.

Methods
Initial and posttreatment ECGs were obtained in a prospective cohort of Chagas patients treated with nifurtimox or benznidazole and compared to an untreated cohort. Electrocardiogram disease progression was compared in those with and without baseline abnormalities pre- and posttherapy.

Results
Fifty-nine patients were recruited in the treatment arm and followed for an average of 3.9 years. There were no differences between ECG groups with regards to follow-up, age, baseline ejection fraction, or therapy. In the treated cohort, 0 of 30 patients with normal ECGs developed an abnormal ECG compared with 7 of 29 patients with baseline ECG abnormalities who developed new ECG abnormalities (P = .005). In an untreated cohort of 30 patients, 3 of 7 with normal ECGs developed an abnormality compared with 14 of 23 patients with baseline abnormalities (P = .67). Untreated patients had a higher likelihood of developing new EKG abnormalities (56.7% vs 11.9%, P &lt; .001) despite shorter follow-up, and in a multivariate analysis adjusting for baseline EKG status across both treated and untreated cohorts, treated patients were still less likely to have progression of their EKG disease (odds ratio = 0.13, P &lt; .001). The corrected QT (QTc) interval was not significantly affected by either study medication (415 vs 421 ms, initial vs posttreatment QTc; P = .06).

Conclusions
Over an average follow-up of 3.9 years, treated patients with normal baseline ECGs did not have significant changes during a course of treatment; however, those with baseline abnormal ECGs had significant progression of their conduction system disease despite treatment, and those without treatment also experienced a progression of ECG disease. These preliminary results suggest that Chagas patients with normal ejection fraction and normal ECG may benefit the most from antitrypanosomal treatment.
Substance Use, Demographic and Socioeconomic Factors Are Independently Associated With Postpartum HIV Care Engagement in the Southern United States, 1999–2016
Authors: Oliver Cassandra , Rebeiro Peter F , Hopkins Mary J , Byram Beverly , Carpenter Lavenia , Clouse Kate , Castilho Jessica L , Rogers William , Turner Megan , Bebawy Sally S , Pettit April C 
Published: January 2019

AbstractBackgroundRetention in care (RIC) and viral suppression (VS) are associated with reduced HIV transmission and mortality. Studies addressing postpartum engagement in HIV care have been limited by small sample size, short follow-up, and a lack of data from the Southeast United States.MethodsHIV-positive adult women with ≥1 prenatal visit at the Vanderbilt Obstetrics Comprehensive Care Clinic from 1999 to 2015 were included. Poor RIC was defined as not having ≥2 encounters per year, ≥90 days apart; poor VS was a viral load &gt;200 copies/mL. Modified Poisson regression was used to estimate adjusted relative risks (aRRs) of poor postpartum RIC and VS.ResultsAmong 248 women over 2070 person-years of follow-up, 37.6% person-years had poor RIC and 50.4% lacked VS. Prenatal substance use was independently associated with poor RIC (aRR, 1.40; 95% confidence interval [CI], 1.08–1.80) and poor VS (aRR, 1.20; 95% CI, 1.04–1.38), and lack of VS at enrollment was associated with poor RIC (aRR, 1.64; 95% CI, 1.15–2.35) and poor VS (aRR, 1.59; 95% CI, 1.30–1.94). Hispanic women were less likely and women with lower educational attainment were more likely to have poor RIC. Women &gt;30 years of age and married women were less likely to have poor VS.ConclusionsIn this population of women in prenatal care at an HIV primary medical home in Tennessee, women with prenatal substance use and a lack of VS at enrollment into prenatal care were at greater risk of poor RIC and lack of VS postpartum. Interventions aimed at improving postpartum engagement in HIV care among these high-risk groups are needed.
Image-Guided Biopsy of Intracranial Lesions with a Small Robotic Device (iSYS1): A Prospective, Exploratory Pilot Study
Authors: Legnani Federico G , Franzini Andrea , Mattei Luca , Saladino Andrea , Casali Cecilia , Prada Francesco , Perin Alessandro , Cojazzi Vittoria , Saini Marco , Kronreif Gernot , Wolfsberger Stefan , DiMeco Francesco 
Published: January 2019

Abstract

BACKGROUND
Robotic technologies have been used in the neurosurgical operating rooms for the last 30 yr. They have been adopted for several stereotactic applications and, particularly, image-guided biopsy of intracranial lesions which are not amenable for open surgical resection.

OBJECTIVE
To assess feasibility, safety, accuracy, and diagnostic yield of robot-assisted frameless stereotactic brain biopsy with a recently introduced miniaturized device (iSYS1; Interventional Systems Medizintechnik GmbH, Kitzbühel, Austria), fixed to the Mayfield headholder by a jointed arm.

METHODS
Clinical and surgical data of all patients undergoing frameless stereotactic biopsies using the iSYS1 robotized system from October 2016 to December 2017 have been prospectively collected and analyzed. Facial surface registration has been adopted for optical neuronavigation.

RESULTS
Thirty-nine patients were included in the study. Neither mortality nor morbidity related to the surgical procedure performed with the robot was recorded. Diagnostic tissue samples were obtained in 38 out of 39 procedures (diagnostic yield per procedure was 97.4%). All patients received a definitive histological diagnosis. Mean target error was 1.06 mm (median 1 mm, range 0.1-4 mm).

CONCLUSION
The frameless robotic iSYS1-assisted biopsy technique was determined to be feasible, safe, and accurate procedure; moreover, the diagnostic yield was high. The surface matching registration method with computed tomography as the reference image set did not negatively affect the accuracy of the procedure.
Tales of Broken Water Mains and ASDA Employees: Drafting Evolution or Drafting for Confusion?
Authors: Walsh Bernadette 
Published: January 2019

Abstract
Values and beliefs pertaining to the best approach to drafting legislation change over time. It is therefore inevitable that, when engaged in the replacement of older legislation, drafters will seek to change the style to better reflect current values and beliefs. But how easy is it for courts to distinguish between a change that simply represents an evolution of drafting style and a change of substance? This article explores that question through the lens of two recent cases and asks whether drafters, in their zeal to modernize and improve, may underestimate the risk that their changes will cause confusion.
Marginal Likelihoods in Phylogenetics: A Review of Methods and Applications
Authors: R Oaks Jamie , A Cobb Kerry , N Minin Vladimir , D Leaché Adam 
Published: January 2019

AbstractBy providing a framework of accounting for the shared ancestry inherent to all life, phylogenetics is becoming the statistical foundation of biology. The importance of model choice continues to grow as phylogenetic models continue to increase in complexity to better capture micro- and macroevolutionary processes. In a Bayesian framework, the marginal likelihood is how data update our prior beliefs about models, which gives us an intuitive measure of comparing model fit that is grounded in probability theory. Given the rapid increase in the number and complexity of phylogenetic models, methods for approximating marginal likelihoods are increasingly important. Here, we try to provide an intuitive description of marginal likelihoods and why they are important in Bayesian model testing. We also categorize and review methods for estimating marginal likelihoods of phylogenetic models, highlighting several recent methods that provide well-behaved estimates. Furthermore, we review some empirical studies that demonstrate how marginal likelihoods can be used to learn about models of evolution from biological data. We discuss promising alternatives that can complement marginal likelihoods for Bayesian model choice, including posterior-predictive methods. Using simulations, we find one alternative method based on approximate-Bayesian computation to be biased. We conclude by discussing the challenges of Bayesian model choice and future directions that promise to improve the approximation of marginal likelihoods and Bayesian phylogenetics as a whole.
Alpha2B-Adrenergic Receptor Overexpression in the Brain Potentiate Air Pollution-induced Behavior and Blood Pressure Changes
Authors: Rao Xiaoquan , Asico Laureano D , Zanos Panos , Mahabeleshwar Ganapati H , Singh Gangwar Roopesh , Xia Chang , Duan Lihua , Cisse Yasmine-Marie , Rengasamy Palanivel , Jose Pedro A , Gould Todd D , Nelson Randy , Biswal Shyam , Chen Lung-Chi , Zhong Jixin , Rajagopalan Sanjay 
Published: January 2019

AbstractFine ambient particulate matter (PM2.5) is able to induce sympathetic activation and inflammation in the brain. However, direct evidence demonstrating an essential role of sympathetic activation in PM2.5-associated disease progression is lacking. We assess the contribution of α2B-adrenergic receptor (Adra2b) in air pollution-associated hypertension and behavioral changes in this study. Wild-type mice and Adra2b-transgenic mice overexpressing Adra2b in the brain (Adra2bTg) were exposed to concentrated PM2.5 or filtered air for 3 months via a versatile aerosol concentrator exposure system. Mice were fed with a high salt diet (4.0% NaCl) for 1 week at week 11 of exposure to induce blood pressure elevation. Intra-arterial blood pressure was monitored by radio-telemetry and behavior changes were assessed by open field, light-dark, and prepulse inhibition tests. PM2.5 exposure increased Adra2b in the brain of wild-type mice. Adra2b overexpression enhanced the anxiety-like behavior and high salt diet-induced blood pressure elevation in response to air pollution but not filtered air exposure. Adra2b overexpression induced upregulation of inflammatory genes such as TLR2, TLR4, and IL-6 in the brain exposed to PM2.5. In addition, there were increased frequencies of activated effector T cells and increased expression of oxidative stress-related genes, such as SOD1, NQO1, Nrf2, and Gclm in Adra2bTg mice compared with wild-type mice. Our results provide new evidence of distinct behavioral changes consistent with anxiety and blood pressure elevation in response to high salt intake and air pollution exposure, highlighting the importance of centrally expressed Adra2b in the vulnerability to air pollution exposure.
Can You Escape Nursing School? Educational Escape Room in Nursing Education
Authors: Morrell Briyana L. M. , Ball Heather M. 
Published: January 2019

Abstract
Escape rooms, a form of collaborative live-action gaming requiring participants to solve clues to escape a locked room, have grown in popularity across the nation. Games bring together problem solving, critical thinking, and teamwork. This game method has not yet appeared in nursing education literature. The authors describe two versions of the innovative escape room pedagogical method used in undergraduate nursing education. Theoretical bases, learning activities, and types of game clues that could be used are detailed. Future research will address the ability of students to reach learning objectives before and after the game.
Adelante (Moving Forward): An Innovative Program for Nursing and Prenursing Students
Authors: Zamora Herlinda , Rogers Norma Martínez 
Published: January 2019

Abstract
The US population reflects a rich diversity of people that is not reflected in the health care workforce. This article describes the Adelante (Moving Forward) Program, an innovative model designed to increase nursing workforce diversity. Adelante was created to advance baccalaureate nursing students and prenursing students by using supportive developmental relationships and mentoring strategies. Graduates stated that they planned to advance their education. Further development of innovative programs for nursing students from diverse backgrounds is imperative to increase health care workforce diversity.
Intentional Application of Nursing Theory in Simulated Practice
Authors: Singleterry Lisa 
Published: January 2019

Abstract
A simulation focused on nursing theory was designed to replace one clinical day experience for 37 senior-level baccalaureate students. Pretest-posttest self-evaluations were used in the study to rate student confidence in using Locsin's technology competency as caring in nursing theory and in describing critical care equipment and monitoring technology. A dependent t-test showed improvements in confidence using theory in practice after the simulation and debriefing session. Using one-on-one debriefing sessions, students and faculty had an opportunity to discuss how nursing theory can guide nursing practice. Intentionally developed simulation and debriefing experiences can provide students experience using nursing theory.
Automated Titration of Vasopressor Infusion Using a Closed-loop Controller
Authors: Joosten Alexandre , Delaporte Amélie , Alexander Brenton , Su Fuhong , Creteur Jacques , Vincent Jean-Louis , Cannesson Maxime , Rinehart Joseph 
Published: January 2019

Abstract

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background
Multiple studies have reported associations between intraoperative hypotension and adverse postoperative complications. One of the most common interventions in the management of hypotension is vasopressor administration. This approach requires careful and frequent vasopressor boluses and/or multiple adjustments of an infusion. The authors recently developed a closed-loop controller that titrates vasopressors to maintain mean arterial pressure (MAP) within set limits. Here, the authors assessed the feasibility and overall performance of this system in a swine model. The authors hypothesized that the closed-loop controller would be able to maintain MAP at a steady, predefined target level of 80 mmHg for greater than 85% of the time.

Methods
The authors randomized 14 healthy anesthetized pigs either to a control group or a closed-loop group. Using infusions of sodium nitroprusside at doses between 65 and 130 µg/min, we induced four normovolemic hypotensive challenges of 30 min each. In the control group, nothing was done to correct hypotension. In the closed-loop group, the system automatically titrated norepinephrine doses to achieve a predetermined MAP of 80 mmHg. The primary objective was study time spent within ±5 mmHg of the MAP target. Secondary objectives were performance error, median performance error, median absolute performance error, wobble, and divergence.

Results
The controller maintained MAP within ±5 mmHg of the target for 98 ± 1% (mean ± SD) of the time. In the control group, the MAP was 80 ± 5 mmHg for 14.0 ± 2.8% of the time (P< 0.0001). The MAP in the closed-loop group was above the target range for 1.2 ± 1.2% and below it for 0.5 ± 0.9% of the time. Performance error, median performance error, median absolute performance error, wobble, and divergence were all optimal.

Conclusions
In this experimental model of induced normovolemic hypotensive episodes in pigs, the automated controller titrated norepinephrine infusion to correct hypotension and keep MAP within ±5 mmHg of target for 98% of management time.
Imaging the Injured Lung
Authors: Cereda Maurizio , Xin Yi , Goffi Alberto , Herrmann Jacob , Kaczka David W. , Kavanagh Brian P. , Perchiazzi Gaetano , Yoshida Takeshi , Rizi Rahim R. 
Published: January 2019

Abstract
Acute respiratory distress syndrome (ARDS) consists of acute hypoxemic respiratory failure characterized by massive and heterogeneously distributed loss of lung aeration caused by diffuse inflammation and edema present in interstitial and alveolar spaces. It is defined by consensus criteria, which include diffuse infiltrates on chest imaging—either plain radiography or computed tomography. This review will summarize how imaging sciences can inform modern respiratory management of ARDS and continue to increase the understanding of the acutely injured lung. This review also describes newer imaging methodologies that are likely to inform future clinical decision-making and potentially improve outcome. For each imaging modality, this review systematically describes the underlying principles, technology involved, measurements obtained, insights gained by the technique, emerging approaches, limitations, and future developments. Finally, integrated approaches are considered whereby multimodal imaging may impact management of ARDS.
Point-of-Care Intrapartum Group B Streptococcus Molecular Screening
Authors: El Helali Najoua , Habibi Fakher , Azria Elie , Giovangrandi Yves , Autret Fanny , Durand-Zaleski Isabelle , Le Monnier Alban 
Published: January 2019

OBJECTIVE:
To assess outcomes and costs associated with around-the-clock point-of-care intrapartum group B streptococcus (GBS) polymerase chain reaction (PCR) screening.

METHODS:
Intrapartum PCR screening was implemented in 2010. Intrapartum PCR was compared with antenatal culture screening in an uncontrolled, single institution, preintervention and postintervention study. The study periods included 4 years before and 6 years after the intervention, commencing in 2006 and concluding in 2015. The primary outcome measure was rate of early-onset neonatal GBS disease. Secondary outcomes included length of stay, days of antibiotics, and costs.

RESULTS:
During the 4 years of antenatal culture screening, 11,226 deliveries were recorded compared with 18,835 in the 6 years of intrapartum GBS PCR screening, corresponding to 11,818 and 18,980 live births, respectively. During the antenatal culture period, 3.8% of term deliveries did not undergo GBS testing compared with 0.1% during the intrapartum PCR period (P<.001). Between the two periods, the rate of proven early-onset GBS disease cases decreased from 1.01/1,000 to 0.21/1,000 (P=.026) and probable early-onset GBS disease cases from 2.8/1,000 to 0.73/1,000 (P<.001); the risk ratio for both was 0.25, 95% CI (0.14–0.43). Total days of hospital and antibiotic therapy for early-onset GBS disease declined by 64% and 60%, respectively, with no significant difference for average length of stay or antibiotic duration preintervention and postintervention. The yearly cost of delivery and treatment of newborns with GBS infection was reduced from $41,875±6,823 to $11,945±10,303 (P<.001). The estimated extra cost to avoid one early-onset GBS disease was $5,819.

CONCLUSION:
Point-of-care intrapartum GBS PCR screening was associated with a significant decrease in the rate of early-onset GBS disease and antibiotic use in newborns. The additional PCR costs were offset in part by the reduction in early-onset GBS disease treatment costs.
Nomogram for Predicting Individual Survival After Recurrence of Advanced-Stage, High-Grade Ovarian Carcinoma
Authors: Rose Peter G. , Java James J. , Salani Ritu , Geller Melissa A. , Secord Angeles Alvarez , Tewari Krishnansu S. , Bender David P. , Mutch David G. , Friedlander Michael L. , Van Le Linda , Method Michael W. , Hamilton Chad A. , Lee Roger B. , Wenham Robert M. , Guntupalli Saketh R. , Markman Maurie , Muggia Franco M. , Armstrong Deborah K. , Bookman Michael A. , Burger Robert A. , Copeland Larry J. 
Published: January 2019

OBJECTIVE:To analyze clinical prognostic factors for survival after recurrence of high-grade, advanced-stage ovarian–peritoneal–tubal carcinoma and to develop a nomogram to predict individual survival after recurrence.METHODS:We retrospectively analyzed patients treated in multicenter Gynecologic Oncology Group protocols for stage III and IV ovarian–peritoneal–tubal carcinoma who underwent primary debulking surgery, received chemotherapy with paclitaxel and a platinum compound, and subsequently developed recurrence. Prognostic factors affecting survival were identified and used to develop a nomogram, which was both internally and externally validated.RESULTS:There were 4,739 patients included in this analysis, of whom, 84% had stage III and 16% had stage IV ovarian carcinoma. At a median follow-up of 88.8 months (95% CI 86.2–92.0 months), the vast majority of patients (89.4%) had died. The median survival after recurrence was 21.4 months (95% CI 20.5–21.9 months). Time to recurrence after initial chemotherapy, clear cell or mucinous histology, performance status, stage IV disease, and age were significant variables used to develop a nomogram for survival after recurrence, which had a concordance index of 0.67. The time to recurrence alone accounted for 85% of the prognostic information. Similar results were found for patients who underwent second look laparotomy and had a complete pathologic response or received intraperitoneal chemotherapy.CONCLUSION:For individuals with advanced-stage ovarian carcinoma who recur after standard first-line therapy, estimated survivals after recurrence are closely related to the time to recurrence after chemotherapy and prognostic variables can be used to predict subsequent survival.CLINICAL TRIAL REGISTRATION:ClinialTrials.gov, NCT00002568, NCT00837993, NCT00002717, NCT01074398, and NCT00011986.