bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are banks using leverage to target return on equity? Evidence from the US and the EU
Authors: Pagratis Spyros , Karakatsani Eleni , Louri Helen 
Published: July 2019

Abstract
We find evidence that banks actively use leverage to attain RoE targets and that leverage adjustments are primarily driven by capital distributions to shareholders. Using a large group of publicly-traded commercial banks from the US and the EU for the period 2001–2013, we demonstrate that this effect particularly holds for large banks before the crisis. Such behaviour may have led banks to enter the crisis with insufficient capital buffers to absorb losses, requiring unprecedented support by the public sector to maintain their solvency. Therefore, recent policies restricting the use of RoE as a metric in remuneration schemes and introducing constraints to capital distributions unless banks maintain certain buffers above the regulatory minimum, are in the right direction.
A rare case of an isolated aneurysmal supravalvar mitral ring in a young Nigerian adult: a cor-triatriatum mimic
Authors: Kushimo Oyewole A , Sokunbi Ogochukwu , Akinkunmi Michael , Akinbolagbe Yeside O 
Published: July 2019

Abstract
Supravalvar mitral ring is a rare congenital abnormality characterized by a ridge of connective tissue located above the mitral valve. It is a cause of congenital mitral stenosis typically presenting in childhood and usually associated with other cardiac abnormalities. We report the rare case of a 24-year-old male presenting with an isolated aneurysmal supravalvar mitral ring. He presented at the emergency room with a 2-week history of worsening heart failure symptoms and antecedent effort intolerance of 4 years duration. He was referred from a primary care facility with an echo diagnosis of cor-triatriatum. Echocardiography done at our centre revealed an isolated aneurysmal supravalvar mitral ring of the intramitral variant. This report highlights the unusual isolated presentation of a supravalvar mitral ring in a young adult and the need to carefully differentiate it from cor-triatriatum, a possible close mimic.
Metachronous pleuropulmonary blastoma in an adult patient with endometrial cancer: a case report
Authors: Bhalerao Sagar , Adhav Aditya , Gandhe Sucheta , Nagarkar Rajnish 
Published: July 2019

Abstract
Pulmonary blastoma is a rare form of lung cancer with a reported incidence of 0.25–0.55 of primary pulmonary cancers. Pleuropulmonary blastoma (PPB) is a common finding in children while it is rarely found in adults. In the past few years, the incidence of a second primary tumour has increased to 3.5% followed by third primary tumour at 0.5% and fourth tumour at 0.3%. The clinical significance of diagnosing and distinguishing a secondary primary tumour is often challenging. As per our knowledge, this is the first case of metachronous PPB in an adult patient previously diagnosed with endometrial cancer.
Iron oxide nanoparticles promote vascular endothelial cells survival from oxidative stress by enhancement of autophagy
Authors: Duan Jimei , Du Jiuju , Jin Rongrong , Zhu Wencheng , Liu Li , Yang Li , Li Mengye , Gong Qiyong , Song Bin , Anderson James M , Ai Hua 
Published: July 2019

Abstract
Dextran-coated superparamagnetic iron oxide nanoparticles (Dex-SPIONs) are excellent magnetic resonance imaging contrast agents for disease diagnosis and therapy. They can be delivered to target tissues mainly though vascular endothelium cells, which are major targets of oxidative stress. In cardiovascular cells, autophagy serves primarily on a pro-survival approach that protects the cells from oxidative stress even some autophagy inducers have been developed for adjuvant therapy of cardiovascular disorders. Our study demonstrated that the nanoparticles could be taken up by human umbilical vein endothelial cells (HUVECs) without causing obvious cytotoxicity but triggering autophagy. Furthermore, our results revealed that Dex-SPIONs could enhance HUVECs survival and reverse the reduction of nitric oxide secretion under the condition of H2O2 damage. However, these effects could be diminished by the autophagy inhibitor. In particular, we discovered that Dex-SPIONs evoked autophagy in HUVECs by reducing the phosphorylation of PRAS40, an upstream regulator of autophagy initiation. These results suggested that Dex-SPIONs functions as an autophagic-related antioxidant in HUVECs which may be utilized as an adjuvant therapy to cardiovascular disease associated with oxidative stress.
Anterior Hippocampal–Cortical Functional Connectivity Distinguishes Antipsychotic Naïve First-Episode Psychosis Patients From Controls and May Predict Response to Second-Generation Antipsychotic Treatment
Authors: Blessing Esther M , Murty Vishnu P , Zeng Botao , Wang Jijun , Davachi Lila , Goff Donald C 
Published: July 2019

Abstract

Background
Converging evidence implicates the anterior hippocampus in the proximal pathophysiology of schizophrenia. Although resting state functional connectivity (FC) holds promise for characterizing anterior hippocampal circuit abnormalities and their relationship to treatment response, this technique has not yet been used in first-episode psychosis (FEP) patients in a manner that distinguishes the anterior from posterior hippocampus.

Methods
We used masked-hippocampal-group-independent component analysis with dual regression to contrast subregional hippocampal–whole brain FC between healthy controls (HCs) and antipsychotic naïve FEP patients (N = 61, 36 female). In a subsample of FEP patients (N = 27, 15 female), we repeated this analysis following 8 weeks of second-generation antipsychotic treatment and explored whether baseline FC predicted treatment response using random forest.

Results
Relative to HC, untreated FEP subjects displayed reproducibly lower FC between the left anteromedial hippocampus and cortical regions including the anterior cingulate and insular cortex (P &lt; .05, corrected). Anteromedial hippocampal FC increased in FEP patients following treatment (P &lt; .005), and no longer differed from HC. Random forest analysis showed baseline anteromedial hippocampal FC with four brain regions, namely the insular–opercular cortex, superior frontal gyrus, precentral gyrus, and postcentral gyrus predicted treatment response (area under the curve = 0.95).

Conclusions
Antipsychotic naïve FEP is associated with lower FC between the anterior hippocampus and cortical regions previously implicated in schizophrenia. Preliminary analysis suggests that random forest models based on hippocampal FC may predict treatment response in FEP patients, and hence could be a useful biomarker for treatment development.
Teaching mathematical modelling: a framework to support teachers’ choice of resources
Authors: Dunn Peter K , Marshman Margaret F 
Published: July 2019

AbstractMathematics teachers are often keen to find ways of connecting mathematics with the real world. One way to do so is to teach mathematical modelling using real data. Mathematical models have two components: a model structure and parameters within that structure. Real data can be used in one of two ways for each component: (a) to validate what theory or context suggests or (b) to estimate from the data. It is crucial to understand the following: the implications of using data in these different ways, the differences between them, the implications for teaching and how this can influence students’ perceptions of the real-world relevance of mathematics. Inappropriately validating or estimating with data may unintentionally promote poor practice and (paradoxically) reinforce in students the incorrect idea that mathematics has no relevance to the real world. We recommend that teachers approach mathematical modelling through mathematizing the context. We suggest a framework to support teachers’ choice of modelling activities and demonstrate these using examples.
Morphological evolution of the skull roof in temnospondyl amphibians mirrors conservative ontogenetic patterns
Authors: Pérez-Ben Celeste M , Báez Ana M , Schoch Rainer R 
Published: July 2019

AbstractAddressing the patterns of ontogenetic allometry is relevant to understand morphological diversification because allometry might constrain evolution to specific directions of change in shape but also facilitate phenotypic differentiation along lines of least evolutionary resistance. Temnospondyl amphibians are a suitable group to address these issues from a deep-time perspective because different growth stages are known for numerous Palaeozoic and Mesozoic species. Herein we examine the patterns of ontogenetic allometry in the skull roof of 15 temponspondyl species and their relationship with adult morphological evolution. Using geometric morphometrics, we assessed ontogenetic and evolutionary allometries of this cranial part and the distribution of adult shapes in the morphospace to investigate whether these patterns relate to each other and/or to lifestyle and phylogeny. We found conspicuous stereotyped ontogenetic changes of the skull roof which are mirrored at the evolutionary level and consistency of the adult shape with phylogeny rather than lifestyle. These results suggest that the evolution of adult cranial shape was significantly biased by development towards pathways patterned by ontogenetic change in shape. The retrieved conserved patterns agree with a widespread evolutionary craniofacial trend found in amniotes, suggesting that they might have originated early in tetrapod evolutionary history or even earlier.
Management of Difficult Tracheal Intubation
Authors: Joffe Aaron M. , Aziz Michael F. , Posner Karen L. , Duggan Laura V. , Mincer Shawn L. , Domino Karen B. 
Published: July 2019

Abstract

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background
Difficult or failed intubation is a major contributor to morbidity for patients and liability for anesthesiologists. Updated difficult airway management guidelines and incorporation of new airway devices into practice may have affected patient outcomes. The authors therefore compared recent malpractice claims related to difficult tracheal intubation to older claims using the Anesthesia Closed Claims Project database.

Methods
Claims with difficult tracheal intubation as the primary damaging event occurring in the years 2000 to 2012 (n = 102) were compared to difficult tracheal intubation claims from 1993 to 1999 (n = 93). Difficult intubation claims from 2000 to 2012 were evaluated for preoperative predictors and appropriateness of airway management.

Results
Patients in 2000 to 2012 difficult intubation claims were sicker (78% American Society of Anesthesiologists [ASA] Physical Status III to V; n = 78 of 102) and had more emergency procedures (37%; n = 37 of 102) compared to patients in 1993 to 1999 claims (47% ASA Physical Status III to V; n = 36 of 93; P < 0.001 and 22% emergency; n = 19 of 93; P = 0.025). More difficult tracheal intubation events occurred in nonperioperative locations in 2000 to 2012 than 1993 to 1999 (23%; n = 23 of 102 vs. 10%; n = 10 of 93; P = 0.035). Outcomes differed between time periods (P < 0.001), with a higher proportion of death in 2000 to 2012 claims (73%; n = 74 of 102 vs. 42%; n = 39 of 93 in 1993 to 1999 claims; P < 0.001 adjusted for multiple testing). In 2000 to 2012 claims, preoperative predictors of difficult tracheal intubation were present in 76% (78 of 102). In the 97 claims with sufficient information for assessment, inappropriate airway management occurred in 73% (71 of 97; κ = 0.44 to 0.66). A “can’t intubate, can’t oxygenate” emergency occurred in 80 claims with delayed surgical airway in more than one third (39%; n = 31 of 80).

Conclusions
Outcomes remained poor in recent malpractice claims related to difficult tracheal intubation. Inadequate airway planning and judgment errors were contributors to patient harm. Our results emphasize the need to improve both practitioner skills and systems response when difficult or failed tracheal intubation is encountered.
Prediction Model for Audiological Outcomes in Patients With GJB2 Mutations
Authors: Chen Pey-Yu , Lin Yin-Hung , Liu Tien-Chen , Lin Yi-Hsin , Tseng Li-Hui , Yang Ting-Hua , Chen Pei-Lung , Wu Chen-Chi , Hsu Chuan-Jen 
Published: July 2019

Objectives:
Recessive mutations in GJB2 are the most common genetic cause of sensorineural hearing impairment (SNHI) in humans. SNHI related to GJB2 mutations demonstrates a wide variation in audiological features, and there has been no reliable prediction model for hearing outcomes until now. The objectives of this study were to clarify the predominant factors determining hearing outcome and to establish a predictive model for SNHI in patients with GJB2 mutations.

Design:
A total of 434 patients confirmed to have biallelic GJB2 mutations were enrolled and divided into three groups according to their GJB2 genotypes. Audiological data, including hearing levels and audiogram configurations, were compared between patients with different genotypes. Univariate and multivariate generalized estimating equation (GEE) analyses were performed to analyze longitudinal data of patients with multiple audiological records.

Results:
Of the 434 patients, 346 (79.7%) were homozygous for the GJB2 p.V37I mutation, 55 (12.7%) were compound heterozygous for p.V37I and another GJB2 mutation, and 33 (7.6%) had biallelic GJB2 mutations other than p.V37I. There was a significant difference in hearing level and the distribution of audiogram configurations between the three groups. Multivariate GEE analyses on 707 audiological records of 227 patients revealed that the baseline hearing level and the duration of follow-up were the predominant predictors of hearing outcome, and that hearing levels in patients with GJB2 mutations could be estimated based on these two parameters: (Predicted Hearing Level [dBHL]) = 3.78 + 0.96 × (Baseline Hearing Level [dBHL]) + 0.55 × (Duration of Follow-Up [y]).

Conclusion:
The baseline hearing level and the duration of follow-up are the main prognostic factors for outcome of GJB2-related SNHI. These findings may have important clinical implications in guiding follow-up protocols and designing treatment plans in patients with GJB2 mutations.
Electro-Tactile Stimulation Enhances Cochlear-Implant Melody Recognition: Effects of Rhythm and Musical Training
Authors: Huang Juan , Lu Thomas , Sheffield Benjamin , Zeng Fan-Gang 
Published: July 2019

Objectives:
Electro-acoustic stimulation (EAS) enhances speech and music perception in cochlear-implant (CI) users who have residual low-frequency acoustic hearing. For CI users who do not have low-frequency acoustic hearing, tactile stimulation may be used in a similar fashion as residual low-frequency acoustic hearing to enhance CI performance. Previous studies showed that electro-tactile stimulation (ETS) enhanced speech recognition in noise and tonal language perception for CI listeners. Here, we examined the effect of ETS on melody recognition in both musician and nonmusician CI users.

Design:
Nine musician and eight nonmusician CI users were tested in a melody recognition task with or without rhythmic cues in three testing conditions: CI only (E), tactile only (T), and combined CI and tactile stimulation (ETS).

Results:
Overall, the combined electrical and tactile stimulation enhanced the melody recognition performance in CI users by 9% points. Two additional findings were observed. First, musician CI users outperformed nonmusicians CI users in melody recognition, but the size of the enhancement effect was similar between the two groups. Second, the ETS enhancement was significantly higher with nonrhythmic melodies than rhythmic melodies in both groups.

Conclusions:
These findings suggest that, independent of musical experience, the size of the ETS enhancement depends on integration efficiency between tactile and auditory stimulation, and that the mechanism of the ETS enhancement is improved electric pitch perception. The present study supports the hypothesis that tactile stimulation can be used to improve pitch perception in CI users.
The Effect of Musical Training and Working Memory in Adverse Listening Situations
Authors: Escobar Jillian , Mussoi Bruna S. , Silberer Amanda B. 
Published: July 2019

Objectives:
Speech-in-noise (SIN) perception is essential for everyday communication. In most communication situations, the listener requires the ability to process simultaneous complex auditory signals to understand the target speech or target sound. As the listening situation becomes more difficult, the ability to distinguish between speech and noise becomes dependent on recruiting additional cognitive resources, such as working memory (WM). Previous studies have explored correlations between WM and SIN perception in musicians and nonmusicians, with mixed findings. However, no study to date has examined the speech perception abilities of musicians and nonmusicians with similar WM capacity. The objectives of this study were to investigate (1) whether musical experience results in improved listening in adverse listening situations, and (2) whether the benefit of musical experience can be separated from the effect of greater WM capacity.

Design:
Forty-nine young musicians and nonmusicians were assigned to subgroups of high versus low WM, based on the performance on the backward digit span test. To investigate the effects of music training and WM on SIN perception, performance was assessed on clinical tests of speech perception in background noise. Listening effort (LE) was assessed in a dual-task paradigm and via self-report. We hypothesized that musicians would have an advantage when listening to SIN, at least in terms of reduced LE.

Results:
There was no statistically significant difference between musicians and nonmusicians, and no significant interaction between music training and WM on any of the outcome measures used in this study. However, a significant effect of WM on SIN ability was found on both the Quick Speech-In-Noise test (QuickSIN) and the Hearing in Noise Test (HINT) tests.

Conclusion:
The results of this experiment suggest that music training does not provide an advantage in adverse listening situations either in terms of improved speech understanding or reduced LE. While musicians have been shown to have heightened basic auditory abilities, the effect on SIN performance may be more subtle. Our results also show that regardless of prior music training, listeners with high WM capacity are able to perform significantly better on speech-in-noise tasks.
Long-term Impacts of Brace Treatment for Adolescent Idiopathic Scoliosis on Body Composition, Paraspinal Muscle Morphology, and Bone Mineral Density
Authors: Ohashi Masayuki , Watanabe Kei , Hirano Toru , Hasegawa Kazuhiro , Katsumi Keiichi , Shoji Hirokazu , Mizouchi Tatsuki , Endo Naoto 
Published: July 2019

Study Design.
A retrospective, long-term follow-up study.

Objective.
We aimed to investigate the long-term impacts of brace treatment for adolescent idiopathic scoliosis (AIS) on the musculoskeletal system.

Summary of Background Data.
Although full-time brace treatment is the mainstay of conservative treatment for AIS, the restrictive nature of brace treatment for lumbosacral motion might negatively affect the musculoskeletal system.

Methods.
Of 319 patients treated nonoperatively for AIS, 80 patients completed clinical and imaging examinations. Body composition, including body fat mass, lean mass, fat percent, and muscle mass, was estimated via bioelectrical impedance analysis. Bone mineral density (BMD) was measured at the lumbar spine and left hip. In 73 patients, the measurement of cross-sectional area and fatty degeneration of paraspinal muscles at the superior endplate of L4 were performed using axial T2-weighted magnetic resonance imaging. Patients were divided into the full-time brace (FB; >13 hours per day) and nonfull-time brace (NFB; observation, part-time bracing, or drop out from FB within a year) groups.

Results.
There were 44 patients in the FB group and 36 in the NFB group. Patients in the FB group were significantly younger at the initial visit (12.7 ± 1.3 years) and older at the final follow-up (41.5 ± 5.6 years) than those in the NFB group (14.2 ± 3.2 and 37.4 ± 7.1 years, respectively; P < 0.01). The rate of patients engaging in mild or moderate sports activity in adulthood tended to be higher in the FB group (47.7%) than in the NFB group (25%) (P = 0.11). However, there were no significant differences in body composition, paraspinal muscle morphology, and BMD between the two groups both before and after adjusting for age.

Conclusion.
Full-time brace wearing during adolescence did not have any negative impacts on the musculoskeletal system in adulthood. This information will be helpful for improving the compliance of full-time bracing.

Level of Evidence: 4
Respiratory Complications After Posterior Spinal Fusion for Neuromuscular Scoliosis
Authors: Cohen Jacob L. , Klyce Walter , Kudchadkar Sapna R. , Kotian Ronak N. , Sponseller Paul D. 
Published: July 2019

Study Design.
Retrospective cohort.

Objective.
To determine how respiratory failure rates and duration of intensive care unit (ICU) stay after posterior spinal fusion (PSF) for neuromuscular scoliosis compare between children with Rett syndrome (RS) versus cerebral palsy (CP).

Summary of Background Data.
Rett syndrome and CP are associated with high incidence of neuromuscular scoliosis and respiratory dysfunction.

Methods.
We included 21 patients with RS (mean age, 13 ± 3.1 yrs) and 124 with CP (mean age, 14 ± 3.2 yrs) who underwent PSF by one surgeon from 2004 to 2017. Preoperative motor function was assessed using the Gross Motor Function Classification System (GMFCS). Primary outcomes were respiratory failure and duration of ICU stay. Secondary outcomes were pneumonia and prolonged use of positive pressure ventilation (PPV). Using multivariate regression, we identified associations of age, intraoperative vital signs, duration of hospital stay, number of vertebral levels fused, anesthesia and surgery durations, and estimated blood loss with longer ICU stay and respiratory failure.

Results.
A greater proportion of CP patients (96%) than RS patients (66%) were in GMFCS IV or V (P < 0.01). Respiratory failure was more common in RS patients (43% vs. 19%; P = 0.02), as was PPV (67% vs. 31%; P < 0.01). RS patients had shorter median durations of anesthesia and surgery (P < 0.01). RS patients had a longer median (interquartile range) ICU stay (4 days [1–5] vs. 2 days [2–19]; P = 0.01). Incidence of pneumonia did not differ between groups (P = 0.69). Only RS diagnosis (P = 0.02) and prolonged PPV (P < 0.01) were associated with longer ICU stay.

Conclusion.
Despite better preoperative motor function and shorter anesthesia and surgery durations, patients with RS experienced more respiratory failure, prolonged PPV use, and longer ICU stays after PSF than did children with CP.

Level of Evidence: 4