bluuebunny/crossref_metadata_2025_split huggingface dataset:
Geriatric Research Policy: Japan Clinical Oncology Group (JCOG) policy
Authors: Mizutani Tomonori , Nakamura Kenichi , Fukuda Haruhiko , Ogawa Asao , Hamaguchi Tetsuya , Nagashima Fumio ,   Geriatric Study Committee/Japan Clinical Oncology Group
Published: June 2019

AbstractDue to the rapid aging of Japan’s population, clinical research focusing on older patients with cancer is urgently needed. The Japan Clinical Oncology Group (JCOG) has conducted several such clinical trials, but there has been no formal policy for geriatric research. We have therefore established a JCOG policy for geriatric cancer research.We defined the patient selection policy based on treatment tolerance and chronological age. Older patients are categorized into three conceptual groups: ‘fit patients’ who can undergo the same standard treatment given to younger patients, ‘frail patients’ for whom best supportive or palliative care is indicated and ‘vulnerable patients’ who fall between the fit and frail categories. Unmet needs often exist for vulnerable patients.The policy recommends that study endpoints include not only survival but also other endpoints such as physical and cognitive function because the objective of therapy in older patients is not only extended life expectancy but also maintenance of the patient’s general condition. In this viewpoint, co-primary or composite endpoints that incorporate geriatric assessment in the study design are often applicable.Study design will differ depending on the study population, clinical question, and treatment. Even for older patients, a randomized clinical trial is still the gold standard when the clinical question asks which treatment is better. An observational study of a broader population is applicable for investigating actual conditions of older patients.This JCOG Geriatric Research Policy includes several practical solutions for various issues in geriatric research. We plan to revise this policy periodically to guide future geriatric research.
Towards a radially resolved semi-analytic model for the evolution of disc galaxies tuned with machine learning
Authors: Forbes John C , Krumholz Mark R , Speagle Joshua S 
Published: June 2019

ABSTRACT
We present a flexible, detailed model for the evolution of galactic discs in a cosmological context since z ≈ 4, including a physically motivated model for radial transport of gas and stars within galactic discs. This expansion beyond traditional semi-analytic models that do not include radial structure, or include only a prescribed radial structure, enables us to study the internal structure of disc galaxies and the processes that drive it. In order to efficiently explore the large parameter space allowed by this model, we construct a neural-network-based emulator that can quickly return a reasonable approximation for many observables we can extract from the model, e.g. the star formation rate or the half-mass stellar radius, at different redshifts. We employ the emulator to constrain the model parameters with Bayesian inference by comparing its predictions to 11 observed galaxy scaling relations at a variety of redshifts. The constrained models agree well with observations, both those used to fit the data and those not included in the fitting procedure. These models will be useful theoretical tools for understanding the increasingly detailed observational data sets from Integral Field Units (IFUs).
A critical assessment of turbulence models for 1D core-collapse supernova simulations
Authors: Müller Bernhard 
Published: June 2019

Abstract
It has recently been proposed that global or local turbulence models can be used to simulate core-collapse supernova explosions in spherical symmetry (1D) more consistently than with traditional approaches for parametrized 1D models. However, a closer analysis of the proposed schemes reveals important consistency problems. Most notably, they systematically violate energy conservation as they do not balance buoyant energy generation with terms that reduce potential energy, thus failing to account for the physical source of energy that buoyant convection feeds on. We also point out other non-trivial consistency requirements for viable turbulence models. The Kuhfuss model from the 1980s proves more consistent than the newly proposed approaches for supernovae, but still cannot account naturally for all the relevant physics for predicting explosion properties. We perform numerical simulations for a $20 \, \mathrm{M}_\odot$ progenitor to further illustrate problems of 1D turbulence models. If the buoyant driving term is formulated in a conservative manner, the explosion energy of ${\sim }2\times 10^{51}\, \mathrm{erg}$ for the corresponding non-conservative turbulence model is reduced to $\lt 10^{48} \, \mathrm{erg}$ even though the shock expands continuously. This demonstrates that the conservation problem cannot be ignored. Although plausible energies can be reached using an energy-conserving model when turbulent viscosity is included, it is doubtful whether the energy budget of the explosion is regulated by the same mechanism as in multidimensional models. We conclude that 1D turbulence models based on a spherical Reynolds decomposition cannot provide a more consistent approach to supernova explosion and remnant properties than other phenomenological approaches before some fundamental problems are addressed.
Galaxies in X-ray selected clusters and groups in Dark Energy Survey data – II. Hierarchical Bayesian modelling of the red-sequence galaxy luminosity function
Authors: Zhang Y , Miller C J , Rooney P , Bermeo A , Romer A K , Vergara Cervantes C , Rykoff E S , Hennig C , Das R , McKay T , Song J , Wilcox H , Bacon D , Bridle S L , Collins C , Conselice C , Hilton M , Hoyle B , Kay S , Liddle A R , Mann R G , Mehrtens N , Mayers J , Nichol R C , Sahlén M , Stott J , Viana P T P , Wechsler R H , Abbott T , Abdalla F B , Allam S , Benoit-Lévy A , Brooks D , Buckley-Geer E , Burke D L , Carnero Rosell A , Carrasco Kind M , Carretero J , Castander F J , Crocce M , Cunha C E , D’Andrea C B , da Costa L N , Diehl H T , Dietrich J P , Eifler T F , Flaugher B , Fosalba P , García-Bellido J , Gaztanaga E , Gerdes D W , Gruen D , Gruendl R A , Gschwend J , Gutierrez G , Honscheid K , James D J , Jeltema T , Kuehn K , Kuropatkin N , Lima M , Lin H , Maia M A G , March M , Marshall J L , Melchior P , Menanteau F , Miquel R , Ogando R L C , Plazas A A , Sanchez E , Schubnell M , Sevilla-Noarbe I , Smith M , Soares-Santos M , Sobreira F , Suchyta E , Swanson M E C , Tarle G , Walker A R ,   (DES Collaboration)
Published: June 2019

Abstract
Using ∼100 X-ray selected clusters in the Dark Energy Survey Science Verification data, we constrain the luminosity function (LF) of cluster red-sequence galaxies as a function of redshift. This is the first homogeneous optical/X-ray sample large enough to constrain the evolution of the LF simultaneously in redshift (0.1 &lt; z &lt; 1.05) and cluster mass ($13.5 \le \rm {log_{10}}(M_{200crit}) \sim \lt 15.0$). We pay particular attention to completeness issues and the detection limit of the galaxy sample. We then apply a hierarchical Bayesian model to fit the cluster galaxy LFs via a Schechter function, including its characteristic break (m*) to a faint end power-law slope (α). Our method enables us to avoid known issues in similar analyses based on stacking or binning the clusters. We find weak and statistically insignificant (∼1.9σ) evolution in the faint end slope α versus redshift. We also find no dependence in α or m* with the X-ray inferred cluster masses. However, the amplitude of the LF as a function of cluster mass is constrained to ${\sim } 20{{\ \rm per\ cent}}$ precision. As a by-product of our algorithm, we utilize the correlation between the LF and cluster mass to provide an improved estimate of the individual cluster masses as well as the scatter in true mass given the X-ray inferred masses. This technique can be applied to a larger sample of X-ray or optically selected clusters from the Dark Energy Survey, significantly improving the sensitivity of the analysis.
A Network Autonomy Framework: Reconceptualizing Special District Autonomy in Polycentric Systems
Authors: Greer Robert A , Scott Tyler A 
Published: June 2019

AbstractThe widespread proliferation of special districts and their role in producing and delivering public goods and services has been well documented. Each new entity further fragments government authority, and thus their autonomy is a critical determinant of how local governance systems function. Existing theories of special district autonomy emphasize formal institutional attributes such as election structure and state restrictions. We argue that this approach does not fully incorporate how relational dynamics such as functional interdependence, interest alignment, and social capital affect how special districts fit within regional polycentric governance systems. We propose a Network Autonomy Framework for local governments that focuses on relational dynamics between co-located1 governments and demonstrate an example of how this framework can be applied to a metropolitan region. By understanding how co-located governments relate to one another, we can gain a deeper understanding of special districts’ role in local governance systems and advance propositions as to how they will affect a variety of local policy outcomes.
Efficacy and safety of apremilast for Behçet’s syndrome: a real-life single-centre Italian experience
Authors: De Luca Giacomo , Cariddi Adriana , Campochiaro Corrado , Vanni Daniele , Boffini Nicola , Tomelleri Alessandro , Cavalli Giulio , Dagna Lorenzo 
Published: June 2019

Abstract

Objectives
To evaluate the efficacy and safety of apremilast in treating oral ulcers (OUs), the cardinal and high-disabling feature of Behçet’s disease (BD).

Methods
Twelve consecutive patients affected by BD with recurrent/relapsing OUs resistant and/or intolerant to conventional therapy were enrolled and prospectively followed. The primary endpoint was the number of OUs at week 12. Secondary endpoints were modification from baseline to week 12 in Behçet’s Syndrome Activity Score (BSAS), Behçet’s Disease Current Activity Form (BDCAF) score, Behçet’s Disease Quality of Life (BDQOL) scale and pain of OUs, as measured by a visual analogue scale (VAS). All adverse events (AEs) were recorded during follow-up. Non-parametric tests (Wilcoxon rank test) were used and a P-value &lt;0.05 was considered statistically significant.

Results
After 12 weeks of apremilast, there was a significant reduction in the number of OUs [0.58 (s.d. 0.67) vs 3.33 (s.d. 1.45) at baseline, P = 0.02] that was paralleled by improvement in disease activity: BSAS was 16.8 (s.d. 9.1) [from 45.9 (s.d. 19.6) at baseline] (P = 0.02), BDCAF score was 0.72 (s.d. 0.65) [vs 2.45 (s.d. 1.0) at baseline] (P = 0.04) and the VAS score for pain decreased to 23.3 (s.d. 13.7) [vs 67.9 (s.d. 17.2) at baseline] (P = 0.02). Consistently, an improvement of BDQOL was assessed (P = 0.02). Clinical improvement led to complete steroid discontinuation in six patients and a tapering of the prednisone dose in two patients (P = 0.016). Colchicine was discontinued in six of nine patients (P = 0.031). AEs related to apremilast occurred in four patients (mainly due to gastrointestinal AEs), leading to drug discontinuation in all of them.

Conclusion
Our preliminary real-world data support the use of apremilast as an effective therapeutic strategy against BD-related recurrent OUs resistant or intolerant to first-line therapy.
Vagabond Microbes, Leaky Laboratories and Epidemic Mapping: Alexandre Yersin and the 1898 Plague Epidemic in Nha Trang
Authors: Lynteris Christos 
Published: June 2019

Summary
This article examines the epidemic mapping produced by the Pasteurian doctor Alexandre Yersin in the course of the outbreak of bubonic plague in the town of Nha Trang (French Indochina, 1898). Examining how Yersin responded to and reasoned about the outbreak as this unfolded around his laboratory, the article argues for a situated, processual approach of epidemic mapping. Considering four maps produced by Yersin during the outbreak, it is argued that these should not be simply seen as visual objects aimed at establishing and systematising epidemiological knowledge. Instead the changes evinced in and between these maps were driven by Yersin’s desire to distance plague from his laboratory, which stood accused as the origin of the epidemic. It is thus argued that, in this case, epidemic mapping acquires a distancing function, with its aim being to symbolically banish the source of the outbreak back to China.
Oscillatory patterns in the electroencephalogram at sleep onset
Authors: Achermann Peter , Rusterholz Thomas , Stucky Benjamin , Olbrich Eckehard 
Published: June 2019

AbstractFalling asleep is a gradually unfolding process. We investigated the role of various oscillatory activities including sleep spindles and alpha and delta oscillations at sleep onset (SO) by automatically detecting oscillatory events. We used two datasets of healthy young males, eight with four baseline recordings, and eight with a baseline and recovery sleep after 40 h of sustained wakefulness. We analyzed the 2-min interval before SO (stage 2) and the five consecutive 2-min intervals after SO. The incidence of delta/theta events reached its maximum in the first 2-min episode after SO, while the frequency of them was continuously decreasing from stage 1 onwards, continuing over SO and further into deeper sleep. Interestingly, this decrease of the frequencies of the oscillations were not affected by increased sleep pressure, in contrast to the incidence which increased. We observed an increasing number of alpha events after SO, predominantly frontally, with their prevalence varying strongly across individuals. Sleep spindles started to occur after SO, with first an increasing then a decreasing incidence and a continuous decrease in their frequency. Again, the frequency of the spindles was not altered after sleep deprivation. Oscillatory events revealed derivation dependent aspects. However, these regional aspects were not specific of the process of SO but rather reflect a general sleep related phenomenon. No individual traits of SO features (incidence and frequency of oscillations) and their dynamics were observed. Delta/theta events are important features for the analysis of SO in addition to slow waves.
Adolescent SBIRT Practices Among Pediatricians in Massachusetts
Authors: Levy Sharon , Wiseblatt Aria , Straus John H. , Strother Heather , Fluet Christina , Harris Sion K. 
Published: June 2019

Objectives:
Adolescent Screening, Brief Intervention, and Referral to Treatment (SBIRT) in primary care is a key strategy to prevent, identify, and respond to substance use problems and disorders, including opioid and other drug addictions. Despite substantial investment in recent years to increase its implementation, few studies have reported on recent levels of SBIRT implementation among pediatricians. We aimed to assess self-reported use of the SBIRT framework with adolescent patients among Massachusetts pediatricians, and describe trends since an earlier survey.

Methods:
We analyzed responses to a cross-sectional survey mailed in 2017 to a representative sample of pediatricians in Massachusetts. We computed response frequencies for all SBIRT practice questions. We used the chi-square test to compare current data to data collected in 2014, as we found no demographic differences between the 2 samples.

Results:
Nearly all pediatricians in the 2017 sample (n = 160) reported annual screening of their adolescent patients (99%). The majority reported giving positive reinforcement (87%), brief advice (92%), counseling (90%), and referral to treatment (66%) in response to screen results. Compared with 2014, a significantly higher proportion of pediatricians in 2017 referred patients who screened positively for problematic alcohol use, but perceived barriers to screening and follow-up remain, such as insufficient time to screen and patient refusal to return.

Conclusions:
Among respondents to a Massachusetts pediatrician survey, we found high rates of delivering SBIRT in accordance with published guidelines, though barriers remain. Whether the content of the counseling adheres to guidelines is unknown.
Diminishing Clinical Returns of Multilevel Minimally Invasive Lumbar Interbody Fusion
Authors: Passias Peter G. , Bortz Cole , Horn Samantha R. , Segreto Frank A. , Stekas Nicholas , Ge David H. , Alas Haddy , Varlotta Christopher G. , Frangella Nicholas J. , Lafage Renaud , Lafage Virginie , Steinmetz Leah , Vasquez-Montes Dennis , Diebo Bassel , Janjua Muhammad B. , Moawad Mohamed A. , Deflorimonte Chloe , Protopsaltis Themistocles S. , Buckland Aaron J. , Gerling Michael C. 
Published: June 2019

Study Design.
Single institution retrospective clinical review.

Objective.
To investigate the relationship between levels fused and clinical outcomes in patients undergoing open and minimally invasive surgical (MIS) lumbar fusion.

Summary of Background Data.
Minimally invasive spinal fusion aims to reduce the morbidity associated with conventional open surgery. As multilevel arthrodesis procedures are increasingly performed using MIS techniques, it is necessary to weigh the risks and benefits of multilevel MIS lumbar fusion as a function of fusion length.

Methods.
Patients undergoing <4 level lumbar interbody fusion were stratified by surgical technique (MIS or open), and grouped by fusion length: 1-level, 2-levels, 3+ levels. Demographics, Charlson Comorbidity Index (CCI), surgical factors, and perioperative complication rates were compared between technique groups at different fusion lengths using means comparison tests.

Results.
Included: 361 patients undergoing lumbar interbody fusion (88% transforaminal, 14% lateral; 41% MIS). Breakdown by fusion length: 63% 1-level, 22% 2-level, 15% 3+ level. Op-time did not differ between groups at 1-level (MIS: 233 min vs. Open: 227, P = 0.554), though MIS at 2-levels (332 min vs. 281) and 3+ levels (373 min vs. 323) were longer (P = 0.033 and P = 0.231, respectively). While complication rates were lower for MIS at 1-level (15% vs. 30%, P = 0.006) and 2-levels (13% vs. 27%, P = 0.147), at 3+ levels, complication rates were comparable (38% vs. 35%, P = 0.870). 3+ level MIS fusions had higher rates of ileus (13% vs. 0%, P = 0.008) and a trend of increased adverse pulmonary events (25% vs. 7%, P = 0.110). MIS was associated with less EBL at all lengths (all P < 0.01) and lower rates of anemia at 1-level (5% vs. 18%, P < 0.001) and 2-levels (7% vs. 16%, P = 0.193). At 3+ levels, however, anemia rates were similar between groups (13% vs. 15%, P = 0.877).

Conclusion.
MIS lumbar interbody fusions provided diminishing clinical returns for multilevel procedures. While MIS patients had lower rates of perioperative complications for 1- and 2-level fusions, 3+ level MIS fusions had comparable complication rates to open cases, and higher rates of adverse pulmonary and ileus events.

Level of Evidence: 3
Assessment of Inequality Alongside Policy-oriented Trials
Authors: Søgaard Rikke , Lindholt Jes S. 
Published: June 2019

Background:
Despite the dual objectives of many health care systems of improving total health and reducing health inequality, trial designs seem to ignore the assessment of inequality effects. Our study aimed to illustrate an empirical framework for the assessment of inequality effects alongside policy-oriented trials to inform a possible efficiency versus equality trade-off.

Methods:
We measured inequality in the concentrations of all-cause and disease-related mortality and hospital admissions across ranks of socioeconomic status in a randomized controlled trial that tested the efficacy of general population screening of men for vascular disease. We used alternative definitions of inequality (relative/absolute, in attainment/shortfall, ranked by education/income), and supplemented the classical “frequentist” approach to statistical inference with Bayesian posterior probabilities. Equality contours for health improvement that leave inequality unaffected are illustrated graphically. We used bootstrapping for interpretation.

Results:
We estimated the posterior probability of screening increasing inequality to be between 0.21 and 0.93 depending on the inequality definition. Income-ranked inequality appeared to be generally higher than education-ranked inequality but less affected by screening. For the shortfall-relative index based on education-rank, the mean health improvement of a 7% relative reduction in all-cause mortality generated by screening incurred a mean relative increase in inequality of 28%. For the income-based indices, there was no evidence of a trade-off.

Discussion:
We illustrated how decision uncertainty can be reduced by explicit assessment of inequality alongside trials and found some evidence of a possible equity–efficiency trade-off in the context of screening, although this depended on the definition of equality.
Higher Anxiety and Will to Live Are Associated With Poorer Adherence to Cardiac Rehabilitation
Authors: Harris Kristie M. , Anderson Derek R. , Landers Jacob D. , Emery Charles F. 
Published: June 2019

Purpose:
Cardiac rehabilitation (CR) session attendance and rates of completion remain suboptimal. Greater distress (ie, depression and anxiety) has been associated with both better and poorer adherence. Will to live (ie, desire, determination and effort to survive) has been associated with survival among cardiac patients and thus may be relevant for CR adherence. It was hypothesized that depression and anxiety would be negatively associated with adherence, and that will to live would moderate these relationships.

Methods:
Sixty patients (mean age = 56.9 ± 10.8 yr; 38 males) entering outpatient CR completed self-report measures of will to live (Wish to Prolong Life Questionnaire) and distress (Hospital Anxiety and Depression Scale). Hierarchical regression analyses were performed to predict CR session attendance (%) and program completion (yes/no) from depression and anxiety, as well as the interaction of those variables with will to live.

Results:
Neither depression nor anxiety was associated with CR adherence (Ps > .33). However, there was a significant interaction of will to live with anxiety in predicting attendance (β= −0.31, P = .03, Model R
2 = .19, P = .01), reflecting that anxiety predicted lower attendance only among patients reporting greater will to live.

Conclusions:
These data help clarify the complex relationship between distress and CR adherence. Findings suggest that higher anxiety is associated with poorer adherence, but only in combination with greater motivation for living. Patients higher in anxiety and will to live may benefit from additional strategies to make actionable behavioral change in the context of CR.