bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cosmopolitanism, Pluralism and Self-Orientalisation in the Modern Mystical World of Java
Authors: Schlehe Judith 
Published: August 2019

Abstract
At present, a great deal of the scholarly research on Indonesia focuses on the processes of Islamisation. This paper will discuss a phenomenon that seems to point in a different direction, namely the contemporary reconfiguration of dukun/spiritual experts called paranormal. These mystics indicate a peculiar form of pluralism. They are an assemblage of tradition and modernity, locality and translocality, religion and mysticism, spirituality and business, and global esotericism and popular psychology. Most of them belong to the urban middle class, are highly professional, and make extensive use of modern mass media to advertise their supernatural skills. Yet, how do they position themselves in Indonesian and global cultural contexts? This paper identifies the ongoing ambivalence between cosmopolitan ideas and their rupture in polarising, orientalist, and occidentalist imaginaries. Finally, a new understanding of cosmopolitanism is suggested that expands the reference beyond the world of humans by also including a plurality of supernatural powers.
Epistolary Pilgrimage and Eldership in G.E.H. Palmer’s Correspondence with Fr. Nikon Strandtman
Authors: Johnson Christopher D.L. 
Published: August 2019

Abstract
Between the years 1948 and 1963, British spiritual seeker Gerald Palmer, who edited the English Philokalia, carried on a written correspondence with the Russian hieromonk and Athonite elder Fr. Nikon Strandtman. Through a regular exchange of letters, these men were able to build a bridge between their disparate worlds and establish a close lifelong relationship. Their letters functioned devotionally to extended the practices of pilgrimage and spiritual direction and supplement their face-to-face encounters with virtual interactions, which allowed Palmer to maintain a continuous link to the place of Athos and the person of Fr. Nikon.
Lower-Tropospheric Influences on the Timing and Intensity of Afternoon Severe Convection over Modest Terrain in a Convection-Allowing Ensemble
Authors: Trier Stanley B. , Romine Glen S. , Ahijevych David A. , Sobash Ryan A. 
Published: August 2019

AbstractA 50-member convection-allowing ensemble is used to examine effects of daytime PBL evolution and ambient flow interacting with modest terrain features on convection initiation (CI) in the lee of the Rocky Mountains. The examined case (4 June 2015) has isolated supercell storms that initiate during mid- to late afternoon along the northern portion of the Palmer Lake Divide, which is a ~0.5-km-deep zonally oriented terrain feature in east-central Colorado that extends eastward from the Rocky Mountains. To diagnose factors most crucial to storm development, two 10-member subensembles are constructed from the full 50-member ensemble. One subensemble (STRONG) has storm locations with mature storm intensities, and average timing of CI similar to that observed. The other subensemble (WEAK) has fewer storms, with generally weaker intensity, and delayed CI. Environmental composites constructed from these subensembles reveal a stronger surface horizontal convergence zone and moisture gradient in STRONG, resulting from 2–3.5 m s−1 stronger southerly winds on the south flank of the convergence zone. The stronger southerlies result from accelerated PBL growth and momentum mixing in the presence of strong low-to-midtropospheric vertical shear, which is facilitated by reduced above-PBL static stability in the composite STRONG initial condition. Stronger time-averaged low-to-midtropospheric upward motion coincides with the surface convergence zone in STRONG, and individual CI locations occur at the northeastern edge of the composite vertical motion maximum. Trajectory analysis with STRONG members confirms that the CI locations are consistent with large vertical displacements, and corresponding relative humidity increases leading to decreases in convective inhibition, as the southerly airstream ascends across the convergence zone.
Long-term sustainability of a quality improvement program on cancer pain management: a complex intervention in an inpatient setting
Authors: Tanzi Silvia , Leo Silvia Di , Mazzini Elisa , Castagnetti Mattia , Turrà Caterina , Peruselli Carlo , Costantini Massimo 
Published: August 2019

Background: Several approaches towards pain control for admitted cancer patients have been suggested by the literature without achieving satisfactory results. In this quality improvement project, we proposed a multicomponent intervention. Measures: A set of indicators was established for each component of the project. The feasibility of both the intervention and its evaluation system was measured. According to the literature review and the analysis of the local context, 5 active components were identified, piloted, and assessed: training of ward professionals, education of patients and nonprofessional caregivers, regular pain assessment, specialist-level pain consultation procedures, and involvement of hospital management. Results: Multiprofessional training programs with daily discussions, daily pain assessment, and a readily available specialized palliative care service seem to be the active components of this complex intervention. The quality improvement project achieved 2 years sustainability. Conclusion: Consolidated educational and organizational methodologies support the feasibility of this complex intervention.
Treatment strategy for brain metastases from esophageal cancer
Authors: Domeki Yasushi , Nakajima Masanobu , Takahashi Masakazu , Kikuchi Maiko , Yokoyama Haruka , Ogata Hideo , Okamoto Kentaro , Yamaguchi Satoru , Sasaki Kinro , Tsuchioka Takashi , Kato Hiroyuki 
Published: August 2019

Background: This study aimed to examine the treatment outcomes of patients with brain metastases from esophageal cancer. Brain metastases from esophageal cancer are rare and have a poorer prognosis than brain metastases from lung and breast cancer. Methods: This study included patients who were diagnosed with and treated for esophageal cancer in our department and subsequently developed brain metastases between April 2010 and December 2014. We examined the differences in survival in patients based on receiving chemotherapy. Results: In total, 8 patients (7 men and 1 woman) with a mean age of 65 years (range 51–73) were included. Seven presented with neurologic symptoms. Two were diagnosed via computed tomography (CT), 5 via magnetic resonance imaging, and 1 via positron emission tomography/CT. They were treated using whole-brain irradiation or with a gamma knife. In 5 patients, chemotherapy was administered after treatment of the brain metastases. The mean survival from the start of treatment was 358 days (range 31–1196). Conclusion: The relatively successful local control of brain metastases in these patients indicates that long-term survival may be attainable via concomitant chemotherapy.
Professional Athletes Are at Higher Risk of Septic Arthritis After Anterior Cruciate Ligament Reconstruction: An Analysis of 4421 Consecutive Patients Including 265 Elite Athletes From the SANTI Study Group
Authors: Sonnery-Cottet Bertrand , Saithna Adnan , Abreu Felipe Galvão , Franck Florent , de Abreu Guilherme Venturi , Vieira Thais D. , Daggett Matthew , Pioger Charles 
Published: August 2019

Background: Professional athletes are reported to be at greater risk of septic arthritis (SA) after anterior cruciate ligament reconstruction (ACLR) than the nonprofessional population. However, this finding has been controversial, and confusion has arisen in the literature owing to the underpowering of previous studies. Purpose/Hypothesis: The purpose was to report the differences in the rate of SA after ACLR in a large series of patients and to perform pooled data analysis including previously published studies. The hypothesis was that professional athletes have a significantly higher risk of SA than nonprofessional athletes. Study Design: Case-control study; Level of evidence, 3. Methods: A retrospective analysis of prospectively collected data was performed. Patients who underwent ACLR between January 2009 and July 2017 (with a minimum follow-up of 12 months) were considered for study eligibility. The rate of SA was determined, and multivariate analysis was used to evaluate potentially important risk factors, including participation in professional sport. Furthermore, a literature search was performed, and data were extracted from all identified relevant studies. A pooled data analysis was performed to determine differences in the risk of SA between professional and nonprofessional populations. Results: The current series comprised 4421 anterior cruciate ligament surgical procedures with 265 professional athletes. There were 15 cases of SA diagnosed over the study period (0.34%; 95% CI, 0.19%-0.56%). Ten cases occurred in professional athletes (3.8%; 95% CI, 1.82%-6.83%). The percentage of SA was 0.12% (95% CI, 0.04%-0.28%) in the nonprofessional population. Being a professional athlete was associated with a significantly increased risk of SA after ACLR (odds ratio, 21.038; 95% CI, 6.585-75.789; P < .0001). This finding was confirmed in the pooled data analysis comprising 11,416 patients including 1118 professional athletes (odds ratio, 5.03; 95% CI, 1.17-21.61). Conclusion: Professional athletes are at greater risk of SA after ACLR than nonprofessional athletes. The results of previous studies may have been conflicting owing to underpowering. The current study confirms the elevated risk by using a large clinical series and pooled data analysis to avoid the limitations of previous studies.
Simulation as a Tool to Promote Professional Identity Formation and Patient Ownership in Medical Students
Authors: Tien Lillie , Wyatt Tasha R. , Tews Matthew , Kleinheksel A. J. 
Published: August 2019

Background. Simulation has become a valuable tool in medical education, providing standardized clinical experiences without jeopardizing patient safety. Simulation may also help promote students’ professional identity formation (PIF) and patient ownership. Methods. A mixed-methods study was performed to explore the relationship between simulation, PIF, and patient ownership among third-year medical students in between their clerkship rotation blocks. Data were collected from 76 students after a simulated emergent case. A priori codes were developed and categorized into individual and contextual elements, and latent content analysis was conducted on the responses. Quantitative analysis identified how clerkship rotations and prior clinical experience affected students’ PIF and feelings of patient ownership. Results. Students exhibited both PIF and feelings of patient ownership as a result of the simulation. Students who completed an in-patient clerkship block described individual elements more frequently than students who completed the out-patient clerkship block (p = 0.017). Students who had no clinical experience prior to medical school remarked on individual elements more frequently than students who did have prior clinical experience (p = 0.017). Conclusions. When medical students felt like a physician, they took ownership of their patients. When they took ownership of their patients, they felt like a physician. Simulation has long been recognized as a valuable tool for developing clinical skills and teamwork behaviors, but it also fosters PIF and a sense of patient ownership. By introducing simulation activities earlier in medical education, students will have opportunities to develop patient ownership and professional identity earlier, allowing for a fuller, more mature development process.
How can the spatial equity of health services be defined and measured? A systematic review of spatial equity definitions and methods
Authors: Whitehead Jesse , L. Pearson Amber , Lawrenson Ross , Atatoa-Carr Polly 
Published: August 2019

Background Spatial equity analysis has been carried out in a variety of contexts and on a range of health services. However, there is no clear consensus on spatial equity definitions or measures. This review seeks to summarize spatial equity definitions and methods of analysis. Methods We systematically searched two electronic databases and six journals for papers providing a definition of spatial equity or performing a spatial equity analysis on health services. Studies were classified according to four definition themes: (1) distributional fairness; (2) needs-based distribution; (3) focus on outcomes or causes and (4) none provided. Results Seventy-five studies met our inclusion criteria. Sixty-one papers provided a definition of spatial equity, while a further 14 papers analysed the spatial equity of health services without providing a definition. Most authors used a needs-based definition of spatial equity, while the Gini coefficient was the most commonly used equity measure. However, analysis approaches varied according to the definition provided by each paper. Among the needs-based definitions, spatial autocorrelation was the most common spatial equity measure. Conclusions To our knowledge, this is the first systematic review summarizing spatial equity definitions and analysis methods. A lack of consensus on definitions and measures persists. The classification of measures according to definition themes makes this review a useful tool for planning and interpreting spatial equity investigations. Future research should examine the impact different measures of accessibility and need have on the results of spatial equity research.
Study on the Patency of the Contralateral Iliac Vein After Stenting Across the Iliocaval Confluence With an Experimental In Vivo Model
Authors: Zhang Xicheng , Huang Wennuo , Yu Huiming , Chen Yong , Liu Jiaxin , Gao Qihang , Zhao Dengqiu 
Published: August 2019

Objective: Stenting is the preferred treatment for iliac vein lesions. For the treatment of occlusions in the junction of the iliac vein and the inferior vena cava (IVC), the stent needs to be positioned in the IVC to cover the lesion. However, the pathological changes in the contralateral iliac vein due to stent coverage on its ostium remain unclear. We observed the patency of the contralateral iliac vein via animal experiments. Methods: The stents were placed in the left iliac vein and extended into the IVC in 8 beagle dogs. Doppler ultrasonography, angiography, and histopathological examination were used to assess the patency and histopathological changes in the contralateral iliac vein. Results: Angiography showed patency of the contralateral iliac vein and no sign of thrombosis or stenosis. Twelve months after stenting, Doppler ultrasonography showed a stenotic change in the ostium of the contralateral iliac vein. The histopathological examination showed that the stent strut at the ostium of the contralateral iliac vein was mostly covered by the intima, and the cross-sectional stenosis rate was greater than 60%. Conclusions: The coverage of the iliac vein stent on the ostium of the contralateral iliac vein does not cause complete occlusion of the contralateral vein but can cause significant stenosis at the ostium of the contralateral iliac vein, which is considered to be a potential risk factor for thrombosis.
Child and parent perceptions of participating in multimethod research in the acute aftermath of pediatric injury
Authors: Kindler Christine , Kassam-Adams Nancy , Borger Tia , Marsac Meghan L. 
Published: August 2019

Background: Despite growing evidence that participation in psychological trauma research is well tolerated by children and parents, ethics boards may voice concerns regarding research with families with recent acute trauma exposure. Factors impacting child and parent experiences of research participation are not well documented, particularly for methodologies including observational components. Objectives: This study describes child and parent perceptions of research participation involving an observational task following an acute traumatic event and explores potential relationships between research experience and selected demographic factors (race/ethnicity, sex, age, prior trauma exposure), and post-traumatic stress symptoms. Methods: As part of a larger study on the role of biopsychosocial factors in post-traumatic stress symptoms, 96 child–parent dyads (ages 8–12 years, M = 10.6) participated in a three–time point study following hospitalization for pediatric injury. At baseline, children and parents completed measures of reactions to research participation, post-traumatic stress symptoms, and trauma history. Measures of post-traumatic stress symptoms were repeated at 6- and 12-week follow-up assessments. Results: The majority of families reported they were glad they participated in the research study (61% children; 72% parents) and felt good about helping others (74% children; 93% parents). Negative feelings were uncommon (<10% of families). Perceptions of participation were not related to race, sex, or trauma history, but child age significantly factored into trust of the research team and informed consent (Spearman’s ρ = .289, p < .01). Reactions to research were not significantly related to child or parent post-traumatic stress symptoms at any time point. Conclusion: Current results extend past research to suggest that most children’s and parents’ research experience is positive, even when completing an observational task during hospitalization for an injury. Children under the age of 10 years may perceive their participation as less voluntary, supporting prior findings that additional steps be taken to ensure their understanding of their choice in participation.
Maintenance and Acceleration of Pericellular Matrix Formation within 3D Cartilage Cell Culture Models
Authors: Owida Hamza A. , Kuiper Nicola L. , Yang Ying 
Published: August 2019

Objective In native articular cartilage, chondrocytes are surrounded by a thin pericellular matrix (PCM) forming chondrons. The PCM is exclusively rich in type VI collagen. The retention of the PCM has a significant influence on the metabolic activity of the chondrocytes. Design This study investigated the influence of 2 hydrogels (hyaluronic acid [HA] and agarose) and 2 media compositions (basal and chondrogenic) on the preservation/maintenance and acceleration of PCM formation over a 21-day time course. Different combinations of chondrocytes, chondrons, and mesenchymal stem cells (MSCs) were studied. Results Both hydrogels preserved chondrons PCM from day 1 up to 21-day culture regardless of media composition. Type VI collagen immunostaining of the cultured chondrons appeared both dense and homogenous. The presence of MSCs did not influence this outcome. At day 1, type VI collagen was not present around chondrocytes alone or their co-culture with MSCs. In the HA hydrogel, type VI collagen was located within the PCM after 7 days in both mono- and co-cultures. In the agarose hydrogel, collagen VI was located within the PCM at 7 days (co-cultures) and 14 days (monocultures). In both hydrogel systems, chondrogenic media enhanced the production of key extracellular matrix components in both mono- and co-cultures in comparison to basal media (11.5% and 14% more in glycosaminoglycans and type II collagen for chondrocytes samples at day 21 culture samples, respectively). However, the media types did not enhance type VI collagen synthesis. Conclusion Altogether, a 3D chondrogenic hydrogel environment is the primary condition for maintenance and acceleration of PCM formation.
A New Method for Cartilage Evaluation in Femoroacetabular Impingement Using Quantitative T2 Magnetic Resonance Imaging: Preliminary Validation against Arthroscopic Findings
Authors: Ben-Eliezer Noam , Raya José G. , Babb James S. , Youm Thomas , Sodickson Daniel K. , Lattanzi Riccardo 
Published: August 2019

Objective The outcome of arthroscopic treatment for femoroacetabular impingement (FAI) depends on the preoperative status of the hip cartilage. Quantitative T2 can detect early biochemical cartilage changes, but its routine implementation is challenging. Furthermore, intrinsic T2 variability between patients makes it difficult to define a threshold to identify cartilage lesions. To address this, we propose a normalized T2-index as a new method to evaluate cartilage in FAI. Design We retrospectively analyzed magnetic resonance imaging (MRI) data of 18 FAI patients with arthroscopically confirmed cartilage defects. Cartilage T2 maps were reconstructed from multi-spin-echo 3-T data using the echo-modulation-curve (EMC) model-based technique. The central femoral cartilage, assumed healthy in early-stage FAI, was used as the normalization reference to define a T2-index. We investigated the ability of the T2-index to detect surgically confirmed cartilage lesions. Results The average T2-index was 1.14 ± 0.1 and 1.13 ± 0.1 for 2 separated segmentations. Using T2-index >1 as the threshold for damaged cartilage, accuracy was 88% and 100% for the 2 segmentations. We found moderate intraobserver repeatability, although separate segmentations yielded comparable accuracy. Damaged cartilage could not be identified using nonnormalized average T2 values. Conclusions This preliminary study confirms the importance of normalizing T2 values to account for interpatient variability and suggests that the T2-index is a promising biomarker for the detection of cartilage lesions in FAI. Future work is needed to confirm that combining T2-index with morphologic MRI and other quantitative biomarkers could improve cartilage assessment in FAI.
Dual-release hydrocortisone improves hepatic steatosis in patients with secondary adrenal insufficiency: a real-life study
Authors: Guarnotta Valentina , Mineo Mariagrazia Irene , Radellini Stefano , Pizzolanti Giuseppe , Giordano Carla 
Published: August 2019

Background: Conventional glucocorticoid treatment has a significant impact on liver in patients with adrenal insufficiency. Dual-release hydrocortisone (DR-HC) provides physiological cortisol exposure, leading to an improvement in anthropometric and metabolic parameters. We aimed to evaluate the effects of 12-month DR-HC treatment on the hepatic steatosis index (HSI), a validated surrogate index of hepatic steatosis, in patients with secondary adrenal insufficiency (SAI). Methods: A total of 45 patients with hypopituitarism, 22 with hypogonadism, hypothyroidism, ACTH, and GH deficiencies, and 23 with hypogonadism, hypothyroidism, and ACTH deficiency, on replacement therapy for all the pituitary deficiencies, were switched from conventional hydrocortisone to DR-HC. At baseline and after 12 months, glucose and insulin levels, surrogate estimates of insulin sensitivity, and hepatic steatosis were evaluated through ultrasonography and HSI. Results: At diagnosis, ultrasonography documented steatosis in 31 patients (68.8%) while 33 (73.3%) showed high HSI. Hydrocortisone (HC) dose (β = 1.231, p  = 0.010), insulin resistance index (HOMA-IR) (β = 1.431, p = 0.002), and insulin sensitivity index (ISI)-Matsuda (β = −1.389, p = 0.034) were predictors of HSI at baseline. After 12 months of DR-HC, a significant decrease in body mass index (BMI) ( p = 0.008), waist circumference (WC) ( p = 0.010), fasting insulin ( p  = 0.041), HOMA-IR ( p = 0.047), HSI ( p < 0.001) and number of patients with HSI ⩾36 ( p = 0.003), and a significant increase in sodium ( p < 0.001) and ISI-Matsuda ( p = 0.031) were observed. HOMA-IR (β = 1.431, p  = 0.002) and ISI-Matsuda (β = −9.489, p < 0.001) were identified as independent predictors of HSI at 12 months. Conclusions: In adults with SAI, DR-HC is associated with an improvement in HSI, regardless of the dose used, mainly related to an improvement in insulin sensitivity.