bluuebunny/crossref_metadata_2025_split huggingface dataset:
Limitation of treatment in prehospital care – the experiences of helicopter emergency medical service physicians in a nationwide multicentre survey
Authors: Kangasniemi Heidi , Setälä Piritta , Huhtala Heini , Kämäräinen Antti , Virkkunen Ilkka , Tirkkonen Joonas , Yli-Hankala Arvi , Hoppu Sanna 
Published: October 2019

Abstract

Background
Making ethically sound treatment limitations in prehospital care is a complex topic. Helicopter Emergency Medical Service (HEMS) physicians were surveyed on their experiences with limitations of care orders in the prehospital setting, including situations where they are dispatched to healthcare facilities or nursing homes.

Methods
A nationwide multicentre study was conducted among all HEMS physicians in Finland in 2017 using a questionnaire with closed five-point Likert-scale questions and open questions. The Ethics Committee of the Tampere University Hospital approved the study protocol (R15048).

Results
Fifty-nine (88%) physicians responded. Their median age was 43 (IQR 38–47) and median medical working experience was 15 (IQR 10–20) years. All respondents made limitation of care orders and 39% made them often. Three fourths (75%) of the physicians were often dispatched to healthcare facilities and nursing homes and the majority (93%) regularly met patients who should have already had a valid limitation of care order. Every other physician (49%) had sometimes decided not to implement a medically justifiable limitation of care order because they wanted to avoid conflicts with the patient and/or the next of kin and/or other healthcare staff. Limitation of care order practices varied between the respondents, but neither age nor working experience explained these differences in answers. Most physicians (85%) stated that limitations of care orders are part of their work and 81% did not find them especially burdensome. The most challenging patient groups for treatment limitations were the under-aged patients, the severely disabled patients and the patients in healthcare facilities or residing in nursing homes.

Conclusion
Making limitation of care orders is an important but often invisible part of a HEMS physician’s work. HEMS physicians expressed that patients in long-term care were often without limitations of care orders in situations where an order would have been ethically in accordance with the patient’s best interests.
Persistence of global well-posedness for the 2D Boussinesq equations with fractional dissipation
Authors: Su Xing , Wang Gangwei , Wang Yue 
Published: October 2019

AbstractIn this paper, we study the IBVP for the 2D Boussinesq equations with fractional dissipation in the subcritical case, and prove the persistence of global well-posedness of strong solutions. Moreover, we also prove the long time decay of the solutions, and investigate the existence of the solutions in Sobolev spaces$W^{2,p}({R}^{2})\times W^{1,p}({R}^{2})$W2,p(R2)×W1,p(R2)for some$p>2$p>2.
Associations of PGK1 promoter hypomethylation and PGK1‐mediated PDHK1 phosphorylation with cancer stage and prognosis: a TCGA pan‐cancer analysis
Authors: Shao Fei , Yang Xueying , Wang Wei , Wang Juhong , Guo Wei , Feng Xiaoli , Shi Susheng , Xue Qi , Gao Shugeng , Gao Yibo , Lu Zhimin , He Jie 
Published: October 2019

AbstractBackgroundCancer cells reprogram metabolism for proliferation. Phosphoglycerate kinase 1 (PGK1), as a glycolytic enzyme and newly identified protein kinase, coordinates glycolysis and mitochondrial metabolism. However, the clinical significance of PGK1 expression and function in cancer progression is unclear. Here, we investigated the relationship between the progression and prognosis of multiple cancer types and PGK1 expression and its function in the mitochondrial metabolism regulation.MethodsWe performed pan‐cancer analyses of PGK1 mRNA level and DNA methylation in 11,908 tumor tissues and 1582 paired normal tissues across 34 cancer types in The Cancer Genome Atlas datasets. Using specific antibodies against PGK1 S203 and PDHK1 T338 phosphorylation, we performed immunohistochemistry with tissue microarray assay in additional 818 cancer cases with 619 paired normal tissues from five cancer types.ResultsThe PGK1 mRNA level was significantly elevated with hypomethylation in promotor regions and associated with advanced TNM stage in 15 and four cancer types, respectively. In breast carcinoma, elevated PGK1 mRNA level and promoter hypomethylation were associated with poor prognosis. Positively correlated PGK1 S203 and PDHK1 T338 phosphorylation levels were significantly associated with short overall survival (OS) in cancers of the breast, liver, lung, stomach, and esophagus and with advanced TNM stage in breast and esophageal cancers. PGK1 pS203 and PDHK1 pT338 were also independent predictors of short OS in liver, lung, and stomach cancer.ConclusionsThe elevated expression, promoter hypomethylation, and phosphorylation of PGK1 and PDHK1 were related with disease progression and short OS in diverse types of cancer. PGK1 and PDHK1 phosphorylation may be potential prognostic biomarkers.
Looking like the locals - gut microbiome changes post-release in an endangered species
Authors: Chong Rowena , Grueber Catherine E. , Fox Samantha , Wise Phil , Barrs Vanessa R. , Hogg Carolyn J. , Belov Katherine 
Published: October 2019

Abstract

Background
Captivity presents extreme lifestyle changes relative to the wild, and evidence of microbiome dysbiosis in captive animals is growing. The gut microbiome plays a crucial role in host health. Whilst captive breeding and subsequent reintroduction to the wild is important for conservation, such efforts often have limited success. Post-release monitoring is essential for assessing translocation success, but changes to the microbiome of released individuals are poorly understood. The Tasmanian devil was previously shown to exhibit loss of microbiome diversity as a result of intense captive management. This current study examines changes in the devil gut microbiome in response to translocation and aims to determine if perturbations from captivity are permanent or reversible.

Methods
Using 16S rRNA amplicon sequencing, we conducted temporal monitoring of the gut microbiome of released devils during two translocation events, captive-to-wild and wild-to-wild. To investigate whether the microbiome of the released devils changed following translocation, we characterized their microbiome at multiple time points during the translocation process over the course of 6–12 months and compared them to the microbiome of wild incumbent devils (resident wild-born devils at the respective release sites).

Results
We showed that the pre-release microbiome was significantly different to the microbiome of wild incumbent animals, but that the microbiomes of animals post-release (as early as 3 to 4 weeks post-release) were similar to wild incumbents. The gut microbiome of released animals showed significant compositional shifts toward the wild incumbent microbiome of both translocation events.

Conclusion
Our results suggest that the devil gut microbiome is dynamic and that loss of microbiome diversity in captivity can be restored following release to the wild. We recommend the broader application of microbiome monitoring in wildlife translocation programs to assess the impacts of translocation on animal microbiomes.
Primary hip arthroplasty for the treatment of alkaptonuric hip arthritis: 3- to 24-year follow-ups
Authors: Pachore Javahir A. , Shah Vikram Indrajit , Upadhyay Sachin , Shah Kalpesh , Sheth Ashish , Kshatriya Amish 
Published: October 2019

Abstract

Background
The objective of this study is to share our experience in total hip replacement for the treatment of ochronotic hip arthritis, in particular to report how to establish the diagnosis and some tips to limit complications.

Method
A cohort comprised of 10 patients (12 hips) with alkaptonuric hip arthritis. There were six men and four women with the mean age of 62.80 ± 7.57 years. All patients had a stiff spine, grossly restricted movements of hip joints, and severely limited daily routine activities. Total hip replacement was performed in all patients. The patients were evaluated at 6, 12, and 24 months after surgery, as well as every 4 years thereafter. Harris hip score was used to assess the functional outcome. The level of significance was set at p < 0.05.

Results
The mean follow-up lasted 16.70 ± 6.82 years (3 to 24 years). At the final available follow-up, nine patients returned to work, ambulate without an orthosis, and achieve complete pain relief. Harris hip score was improved from poor to excellent. One patient died 16 years after surgery due to breast cancer. No complication relating to prosthetic failures was detected.

Conclusion
Total hip replacement gives long-term satisfactory results in patients with alkaptonuric hip arthritis, resulting in comparable function of the hips in patients who undergo primary osteoarthrosis.
Lean management in a liaison psychiatry department: implementation, benefits and pitfalls
Authors: Alexander Lauren , Moore Susan , Salter Nigel , Douglas Leonard 
Published: October 2019

Aims and methodTo apply process mapping, a component of lean management, to a liaison psychiatry service of an emergency department. Lean management is a strategy that has been adapted to healthcare from business and production industries and aims to improve efficiency of a process. The process consisted of four stages: individual interviews with stakeholders, generation of process maps, allocation of goals and assessment of outcomes.ResultsThere was a significant reduction in length of stay of psychiatric patients in the emergency department (median difference: 1 h; P = 0.015). Five of the six goals were met successfully.Clinical implicationsThis article demonstrates a management intervention that successfully reduced length of stay in an emergency department. Further to the improvements in tangible (quantitative) outcomes, process mapping improved interpersonal relations between different disciplines. This paper may be used to guide similar quality improvement exercises in other areas of healthcare.
Global Oncology Research and Training Collaborations Led by the National Cancer Institute (NCI)–Designated Cancer Centers: Results From the 2018 NCI/ASCO Global Oncology Survey of NCI-Designated Cancer Centers
Authors: Duncan Kalina , Abudu Rachel , Cira Mishka K. , Pyle Doug H.M. 
Published: October 2019

PURPOSE The National Cancer Institute (NCI)–Designated Cancer Centers (NDCCs) are active in global oncology research and training, leading collaborations that contribute to the evidence to support global cancer control. To better understand global oncology activities led by NDCCs, the National Cancer Institute Center for Global Health (NCI-CGH) collaborated with ASCO to conduct the 2018 NCI/ASCO Global Oncology Survey of NDCCs. METHODS The 70 NDCCs received a two-part survey that focused on global oncology programs at NDCCs and non–National Institutes of Health (NIH)–funded global oncology projects with an international collaborator led by the NDCCs. Sixty-five NDCCs responded to the survey, and 57 reported non–NIH-funded global oncology projects. Data were cleaned, coded, and analyzed by NCI-CGH staff. RESULTS Thirty NDCCs (43%) report having a global oncology program, and 538 non–NIH-funded global oncology projects were reported. Of the NDCCs with global oncology programs, 17 report that trainees complete rotations outside the United States, and the same number enroll trainees from low- and middle-income countries (LMICs). In addition, 147 (28%) of the non–NIH-funded projects focused on capacity building or training, the second highest category after research. Of the 30 top project collaborator countries, 17 were LMICs. Compared with the NCI-funded international grant portfolio, non–NIH-funded global oncology projects were more likely to focus on prevention (12% NCI-funded v 20% non–NIH-funded); early detection, diagnosis, and prognosis (23% v 30%); and cancer control, survivorship, and outcomes research (13% v 22%). CONCLUSION This survey shows that there is a substantial amount of global oncology research and training supported by NDCCs, and much of this is happening in LMICs. Results of the 2018 Global Oncology Survey can be used to foster opportunities for NDCCs to work collaboratively on activities and to share their findings with relevant stakeholders in their LMIC collaborator countries.
No Association of Antenatal Synthetic Glucocorticoid Exposure and Hair Steroid Levels in Children and Adolescents
Authors: Ilg Liesa , Kirschbaum Clemens , Li Shu-Chen , Wimberger Pauline , Nitzsche Katharina , Rosenlöcher Franziska , Alexander Nina 
Published: October 2019

Abstract

Context
Antenatal synthetic glucocorticoid (sGC) treatment constitutes a potent programming factor of the hypothalamic–pituitary–adrenal (HPA) axis. Previous findings from our group revealed long-term changes in cortisol stress reactivity following antenatal sGC therapy. However, the few prior studies exclusively relied on spot measurements of phasic HPA axis activity, which may not adequately capture cortisol output over prolonged periods of time.

Objective
To address this gap, the current study utilized hair steroid concentrations, a valid marker of integrated long-term HPA-axis activity, to investigate endocrine changes in individuals treated with antenatal sGC.

Design, Setting, and Participants
This cross-sectional study comprised 76 term-born children (7–12 years) and 58 adolescents (14–18 years). Cumulated hormonal secretion in scalp hair over a 3-month period was determined for different biomarkers of tonic HPA axis activity by liquid chromatography coupled with tandem mass spectrometry. Hair steroid levels were compared between participants with antenatal sGC therapy (dexamethasone or betamethasone) and different control groups.

Results
Findings from this study provide no evidence for a significant effect of antenatal sGCs on long-term hair steroid concentrations. Participants treated with antenatal sGC exhibited comparable levels of hair cortisol, cortisone, dehydroepiandrosterone, and cortisol/dehydroepiandrosterone ratios compared to those of mothers who had been admitted to hospital for pregnancy complications but had never received sGC therapy and controls from physiological pregnancies.

Conclusion
In conjunction with data from previous studies, it is thus tempting to speculate that sGC may affect the capacity of dynamic changes and flexible adaption of an individual’s HPA axis rather than changes in tonic steroid output.
Ischemic Optic Neuropathy
Authors: Morrow Mark J. 
Published: October 2019

ABSTRACTPURPOSE OF REVIEWVision is often threatened or lost by acute ischemic damage to the optic nerves. Such pathology most often affects the anterior portion of the nerve and is visible on funduscopic examination. Ischemic optic neuropathy is associated with typical vascular risk factors and with one systemic disease in particular: giant cell arteritis (GCA). This article provides an overview of the three major classes of ischemic optic neuropathy, including information on risk factors, differential diagnosis, evaluation, and management.RECENT FINDINGSOptical coherence tomography provides precise anatomic imaging in ischemic optic neuropathy, showing neural loss weeks before it is visible on examination. Refinements of optical coherence tomography reveal optic nerve microvasculature and may assist in understanding pathogenesis and verifying diagnosis. New diagnostic algorithms and cranial vascular imaging techniques help define the likelihood of GCA in patients with ischemic optic neuropathy. Finally, intraocular drug and biological agent delivery holds promise for nonarteritic ischemic optic neuropathy, whereas newer immunologic agents may provide effective steroid-sparing treatment for GCA.SUMMARYIt is essential to recognize ischemic optic neuropathy upon presentation, especially to determine the likelihood of GCA and the need for immediate steroid therapy. A broad differential diagnosis should be considered so as not to miss alternative treatable pathology, especially in cases with retrobulbar optic nerve involvement.
Optic Neuritis
Authors: Bennett Jeffrey L. 
Published: October 2019

ABSTRACTPURPOSE OF REVIEWThis article discusses the clinical presentation, evaluation, and management of the patient with optic neuritis. Initial emphasis is placed on clinical history, examination, diagnostic testing, and medical decision making, while subsequent focus is placed on examining specific inflammatory optic neuropathies. Clinical clues, examination findings, neuroimaging, and laboratory testing that differentiate autoimmune, granulomatous, demyelinating, infectious, and paraneoplastic causes of optic neuritis are assessed, and current treatments are evaluated.RECENT FINDINGSAdvances in technology and immunology have enhanced our understanding of the pathologies driving inflammatory optic nerve injury. Clinicians are now able to interrogate optic nerve structure and function during inflammatory injury, rapidly identify disease-relevant autoimmune targets, and deliver timely therapeutics to improve visual outcomes.SUMMARYOptic neuritis is a common clinical manifestation of central nervous system inflammation. Depending on the etiology, visual prognosis and the risk for recurrent injury may vary. Rapid and accurate diagnosis of optic neuritis may be critical for limiting vision loss, future neurologic disability, and organ damage. This article will aid neurologists in formulating a systematic approach to patients with optic neuritis.
Higher Cortical Visual Disorders
Authors: Prasad Sashank , Dinkin Marc 
Published: October 2019

ABSTRACT

PURPOSE OF REVIEW
This article reviews the disorders that result from disruption of extrastriate regions of the cerebral cortex responsible for higher visual processing. For each disorder, a historical perspective is offered and relevant neuroscientific studies are reviewed.

RECENT FINDINGS
Careful analysis of the consequences of lesions that disrupt visual functions such as facial recognition and written language processing has improved understanding of the role of key regions in these networks. In addition, modern imaging techniques have built upon prior lesion studies to further elucidate the functions of these cortical areas. For example, functional MRI (fMRI) has identified and characterized the response properties of ventral regions that contribute to object recognition and dorsal regions that subserve motion perception and visuospatial attention. Newer network-based functional imaging studies have shed light on the mechanisms behind various causes of spontaneous visual hallucinations.

SUMMARY
Understanding the regions and neural networks responsible for higher-order visual function helps the practicing neurologist to diagnose and manage associated disorders of visual processing and to identify and treat responsible underlying disease.
How to Make Dense and Flat Perovskite Layers for &gt;20% Efficient Solar Cells: Oriented, Crystalline Perovskite Intermediates and Their Thermal Conversion
Authors: Ozaki Masashi , Nakaike Yumi , Shimazaki Ai , Jung Mina , Maruyama Naoki , Yakumaru Shinya , Rafieh Alwani Imanah , Ekanayake Piyasiri , Saito Takashi , Shimakawa Yuichi , Sasamori Takahiro , Murata Yasujiro , Murdey Richard , Wakamiya Atsushi 
Published: October 2019

Abstract
CH3NH3PbI3 (MAPbI3) perovskite layers can be obtained by thermal annealing thin films of the intermediate dimethyl sulfoxide (DMSO) intercalated complex, MA2Pb3I8·2DMSO. In the present work, the formation, structure, and thermal transformation of the intermediate complex in both bulk and thin film form is examined in detail. The grain size and orientation of the intermediate crystallites in the solvent-intercalated thin film material is shown to directly influence the flatness of the annealed perovskite layer. Flat-lying orientation of the small needle-like intermediate crystallites is found to yield dense and flat perovskite layers. Optimized spin coating and annealing processes are developed for the formation and thermal conversion, respectively, of the intermediate film. Based on these methods, MAPbI3 perovskite solar cells with high power conversion efficiency (maximum ∼20.3%) were obtained with high reproducibility.
Geração de Cenários de Estresse para Curva de Juros
Authors: Dario Alan De Genaro , Fernández Mariela 
Published: October 2019

Este trabalho descreve uma aplicação da classe de
modelos Heath-Jarrow-Morton na geração de cenários de estresse para a estrutura a termo da taxa de juros. Por meio da análise de componentes principais consegue-se reduzir a dimensão do problema e criar uma ponte entre a informação que um especialista possui para definir cenários, informação geralmente de dimensão baixa, e a robustez do modelo Heath-Jarrow-Morton. A metodologia é aplicada ao mercado brasileiro no auge da crise em 2008 e em outras oportunidades.
Reservas de Óleo e Gás em Modelos de Avaliação para Empresas Petrolíferas
Authors: Ribeiro Eduardo Pontual , Menezes Neto Luiz Teles , Bröker Bone Rosemarie 
Published: October 2019

O objetivo deste artigo é avaliar o efeito da acumulação de reservas de petróleo e gás sobre o valor de mercado de empresas integradas do setor petrolífero. A análise baseia-se no modelo de Ohlson, que possui como casos especiais os múltiplos P/L (preço/lucro), P/E (preç patrimônio líquido) e, para o caso da indústria petrolífera, o múltiplo P/R (preço- reservas).	Reservas	são	importantes	para	petrolíferas,	mas	não	aparecem	no	patrimônio líquido (PL), nas práticas contábeis geralmente aceitas. Baseado em dados de empresas listadas na NYMEX, os resultados mostram que as reservas correlacionam-se positivamente com o preço de mercado das empresas. Todavia, o mercado parece penalizar uma estratégia de aumento de reservas sem contrapartida de aumento de lucros ou PL, com redução esperada no preço das ações. Por fim, o uso de múltiplos pode ser considerado ineficiente para a avaliação deste tipo de empresa, pois a relação entre lucros ou PL e preço da ação não parece proporcional.
One Step at a Time: Does Gradualism Build Coordination?
Authors: Ye Maoliang , Zheng Jie , Nikolov Plamen , Asher Sam 
Published: October 2019

This study investigates a potential mechanism to promote coordination. With theoretical guidance using a belief-based learning model, we conduct a multiperiod, binary-choice, and weakest-link laboratory coordination experiment to study the effect of gradualism—increasing the required levels (stakes) of contributions slowly over time rather than requiring a high level of contribution immediately—on group coordination performance. We randomly assign subjects to three treatments: starting and continuing at a high stake, starting at a low stake but jumping to a high stake after a few periods, and starting at a low stake while gradually increasing the stakes over time (the Gradualism treatment). We find that relative to the other two treatments, groups coordinate most successfully at high stakes in the Gradualism treatment. We also find evidence that supports the belief-based learning model. These findings point to a simple mechanism for promoting successful voluntary coordination. This paper was accepted by Axel Ockenfels, behavioral analysis.