bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of extremum value theorems for function spaces in optimal control under numerical uncertainty
Authors: Osinenko P , Streif S 
Published: May 2018

Abstract
The extremum value theorem for function spaces plays the central role in optimal control. It is known that computation of optimal control actions and policies is often prone to numerical errors which may be related to computability issues. The current work addresses a version of the extremum value theorem for function spaces under explicit consideration of numerical uncertainties. It is shown that certain function spaces are bounded in a suitable sense, i.e., they admit finite approximations up to an arbitrary precision. The proof of this fact is constructive in the sense that it explicitly builds the approximating functions. Consequently, existence of approximate extremal functions is shown. Applicability of the theorem is investigated for finite-horizon optimal control, dynamic programming and adaptive dynamic programming. Some possible computability issues of the extremum value theorem in optimal control are shown on counterexamples.
Using mobile location data in biomedical research while preserving privacy
Authors: Goldenholz Daniel M , Goldenholz Shira R , Krishnamurthy Kaarkuzhali B , Halamka John , Karp Barbara , Tyburski Matthew , Wendler David , Moss Robert , Preston Kenzie L , Theodore William 
Published: May 2018

AbstractLocation data are becoming easier to obtain and are now bundled with other metadata in a variety of biomedical research applications. At the same time, the level of sophistication required to protect patient privacy is also increasing. In this article, we provide guidance for institutional review boards (IRBs) to make informed decisions about privacy protections in protocols involving location data. We provide an overview of some of the major categories of technical algorithms and medical–legal tools at the disposal of investigators, as well as the shortcomings of each. Although there is no “one size fits all” approach to privacy protection, this article attempts to describe a set of practical considerations that can be used by investigators, journal editors, and IRBs.
Frequency and Abundance of Selected Early-Season Insect Pests of Cotton
Authors: Allen K Clint , Luttrell Randall G , Sappington Thomas W , Hesler Louis S , Papiernik Sharon K 
Published: May 2018

Abstract
The use of insecticides at planting has been a common crop management practice in cotton for several decades. Historically, U.S. cotton growers relied on in-furrow applications of insecticides, such as aldicarb, to control early-season insect pests. In-furrow applications have largely been replaced with insecticide-treated seed. Since 2012, more than 60% of the U.S. cotton crop is planted with seed treated with insecticide, primarily the neonicotinoids imidacloprid or thiamethoxam. Several insects or insect groups are included on the labels of these neonicotinoids for use as seed treatments. An increased understanding of the risks associated with economically injurious populations of insect pests is needed to optimize use of early-season insecticides and reduce over-reliance on them in cotton, especially when initial decisions for insect control before planting have subsequent influence on future pest abundance. Existing literature pertaining to these early-season cotton insect pests was examined to identify factors favoring their distribution and abundance and the importance of insect control tactics used at planting. The relative importance of some of these pests is dependent on the cotton-growing region and impacted by local production practices. Thrips (predominantly Frankliniella spp.) (Thysanoptera: Thripidae) are the most prevalent early-season insect group in cotton across the United States and the primary target of initial insect control. Other targeted insects include the black cutworm, Agrotis ipsilon (Hufnagel) (Lepidoptera: Noctuidae), aphids (predominantly Aphis gossypii Glover) (Hemiptera: Aphididae), plant bugs (Hemiptera: Miridae), and wireworms (Coleoptera: Elateridae).
Myopericytoma at the Craniocervical Junction: Clinicopathological Report and Review of a Rare Perivascular Neoplasm
Authors: Yang Jimmy C , Venteicher Andrew S , Koch Matthew J , Stapleton Christopher J , Friedman Gabriel N , Venteicher Emma M , Shin John H 
Published: May 2018

Abstract

BACKGROUND AND IMPORTANCE
Myopericytoma is an emerging class of neoplasm originating from the perivascular myoid cellular environment, previously classified as a variant of hemangiopericytoma. Most reported myopericytomas are found in soft tissues of the extremities; however, infrequent cases are described involving the central nervous system. Intracranial myopericytoma remains rare. Here, we describe the first report of myopericytoma occurring at the cervicomedullary junction in close proximity to the vertebral artery, mimicking a vascular lesion.

CLINICAL PRESENTATION
A 64-yr-old woman presented with radiating neck pain. Magnetic resonance imaging revealed a well-circumscribed enhancing lesion adjacent to the vertebral artery-accessory nerve complex. She underwent a far lateral craniotomy and cervical laminectomy to obtain proximal vertebral artery control and adequate exposure of the lesion, which appeared most consistent with neoplasm at surgery. Histopathology revealed a grade I myopericytoma. A gross total resection was achieved, and the patient has no evidence of recurrence 3 yr after surgery.

CONCLUSION
Tumors of perivascular origin include hemangiopericytoma, glomus tumor, myofibroma, and myopericytoma and are uncommon lesions intracranially. Consideration of and distinction among these perivascular tumors is critically important, as they each have distinct clinical behaviors and management. Myopericytoma can mimic other neoplastic and cerebrovascular pathologies, but it most commonly has a benign course and can be surgically cured if a gross total resection can be achieved. Rarer myopericytoma variants that adopt a more malignant course have been described, and ongoing molecular studies may identify mutations or activated signaling pathways that can be targeted to offer chemotherapeutic options in the future.
Normative Data for the BTrackS Balance Test of Postural Sway: Results from 16,357 Community-Dwelling Individuals Who Were 5 to 100 Years Old
Authors: Goble Daniel J , Baweja Harsimran S 
Published: May 2018

AbstractBackgroundPostural sway is routinely assessed because increased postural sway is associated with poorer performance of activities of daily living, higher rates of residential care, and increased risk of falling. Force plate technology is one of the most sensitive and objective means of assessing postural sway in the clinic.ObjectiveThe aim of this study was to provide the first set of normative data for the BTrackS Balance Test (BBT) of postural sway.DesignThe design was descriptive and population based.MethodsBBT results from 16,357 community-dwelling individuals who were 5 to 100 years old were accumulated and assessed for effects of age, sex, height, and weight. Percentile rankings were calculated for significant groupings.ResultsBBT results were dependent on age and sex but not height or weight. Therefore, percentile rankings were determined for male and female individuals in each age category, with no consideration of participant height or weight.LimitationsData were collected by third-party practitioners with various backgrounds in more than 50 locations across the United States and Canada. There was an imbalance in the sample sizes for age and sex groupings.ConclusionsThe findings of this study represent the largest normative dataset ever published for postural sway results. Normative data on the BBT can assist in determining abnormalities in postural sway, which have been linked to negative clinical outcomes.
Respiratory Muscle Effort during Expiration in Successful and Failed Weaning from Mechanical Ventilation
Authors: Doorduin Jonne , Roesthuis Lisanne H. , Jansen Diana , van der Hoeven Johannes G. , van Hees Hieronymus W. H. , Heunks Leo M. A. 
Published: May 2018

Abstract

What We Already Know about This Topic

What This Article Tells Us That Is New

Background
Respiratory muscle weakness in critically ill patients is associated with difficulty in weaning from mechanical ventilation. Previous studies have mainly focused on inspiratory muscle activity during weaning; expiratory muscle activity is less well understood. The current study describes expiratory muscle activity during weaning, including tonic diaphragm activity. The authors hypothesized that expiratory muscle effort is greater in patients who fail to wean compared to those who wean successfully.

Methods
Twenty adult patients receiving mechanical ventilation (more than 72 h) performed a spontaneous breathing trial. Tidal volume, transdiaphragmatic pressure, diaphragm electrical activity, and diaphragm neuromechanical efficiency were calculated on a breath-by-breath basis. Inspiratory (and expiratory) muscle efforts were calculated as the inspiratory esophageal (and expiratory gastric) pressure–time products, respectively.

Results
Nine patients failed weaning. The contribution of the expiratory muscles to total respiratory muscle effort increased in the “failure” group from 13 ± 9% at onset to 24 ± 10% at the end of the breathing trial (P = 0.047); there was no increase in the “success” group. Diaphragm electrical activity (expressed as the percentage of inspiratory peak) was low at end expiration (failure, 3 ± 2%; success, 4 ± 6%) and equal between groups during the entire expiratory phase (P = 0.407). Diaphragm neuromechanical efficiency was lower in the failure versus success groups (0.38 ± 0.16 vs. 0.71 ± 0.36 cm H2O/μV; P = 0.054).

Conclusions
Weaning failure (vs. success) is associated with increased effort of the expiratory muscles and impaired neuromechanical efficiency of the diaphragm but no difference in tonic activity of the diaphragm.
Monocyte Chemoattractant Protein-1 as a Predictor of Coronary Atherosclerosis in Patients Receiving Coronary Angiography
Authors: Mahler Simon A. , Register Thomas C. , Riley Robert F. , D’Agostino Ralph B. , Stopyra Jason P. , Miller Chadwick D. 
Published: May 2018

Background:
Animal studies suggest that monocyte chemoattractant protein-1 (MCP-1) is a promising biomarker for coronary artery atherosclerosis (CAA), but human studies have been inconclusive.

Objective:
To determine potential relationships between plasma MCP-1 and CAA in patients with acute chest pain.

Methods:
A secondary analysis of 150 patients enrolled in emergency department chest pain risk stratification clinical investigations was conducted. Participants with stored blood and known coronary phenotypes (determined by coronary angiography) were selected using stratified randomization such that 50 patients were included into 3 groups: (1) no angiographic evidence of CAA, (2) nonobstructive CAA, and (3) obstructive CAA (stenosis ≥ 70%). Plasma MCP-1 levels were determined by enzyme-linked immunosorbent assay. The association between MCP-1 and obstructive CAA or any CAA was modeled using logistic regression. Variables in the unreduced model included age, sex, race, prior diagnosis of CAA or acute coronary syndrome, hyperlipidemia, hypertension, diabetes, smoking, and cardiac troponin I measurement.

Results:
Among the 150 participants, 65.3% (98/150) had invasive coronary angiography and 34.7% (52/150) had coronary computed tomographic angiography. Myocardial infarction occurred in 27.3% (41/150) and coronary revascularization occurred in 26% (39/150) of the participants. Each 10 pg/mL increase in MCP-1 measurement was associated with an odds ratio of 1.12 (95% confidence interval, 1.06–1.19) for obstructive CAA. MCP-1 remained a significant predictor of obstructive CAA and any CAA after adjustment for age, sex, race, traditional cardiac risk factors, and cardiac troponin I.

Conclusions:
MCP-1 is independently associated with CAA among emergency department patients with chest pain.
Angiography-guided Multivessel Percutaneous Coronary Intervention Versus Ischemia-guided Percutaneous Coronary Intervention Versus Medical Therapy in the Management of Significant Disease in Non–Infarct-related Arteries in ST-Elevation Myocardial Infarction Patients With Multivessel Coronary Disease
Authors: Perera Dhanuka , Crake Tom , Lee Victor 
Published: May 2018

Background:
In ST-elevation myocardial infarction (STEMI) patients with multivessel (MV) disease, after primary percutaneous coronary intervention (PCI), emerging evidence suggests that significant disease in non–infarct-related coronary arteries (IRAs) should be routinely stented. Whether this procedure should be guided by angiography alone or ischemia testing is unclear.

Methods:
All STEMI patients treated with primary PCI between January 1, 2005, and December 31, 2012, at a tertiary cardiology center were reviewed retrospectively. Inclusion criterion is patients with at least 70% stenosis in non-IRAs. There were 3 treatment groups: (1) angiography-guided MV-PCI, (2) ischemia-guided PCI, and (3) medical therapy. Primary endpoint is all-cause mortality, and secondary end point is major adverse cardiovascular events (MACE), including death, acute coronary syndrome, revascularization, or stent thrombosis. Event-free survivals were compared using multivariate Cox proportional-hazards analysis. A propensity score–adjusted analysis was performed.

Results:
Four hundred forty-seven STEMI patients had >70% stenosis in non-IRAs. For all-cause mortality, the 3 strategies did not differ. For MACE, ischemia-guided PCI was associated with the lowest MACE rate, followed by angiography-guided PCI and medical therapy, which was associated with the highest MACE rate, driven by death and myocardial infarction. Hazard ratios (HRs) for MACE: angiography-guided MV-PCI versus ischemia-guided MV-PCI: HR = 2.23 [95% confidence interval (CI), 1.11–4.48; P = 0.023]; medical therapy versus angiography-guided MV-PCI: HR = 1.58 (95% CI, 0.99–2.63; P = 0.062); medical therapy versus ischemia-guided MV-PCI: HR = 1.72 (95% CI, 1.08–2.74; P = 0.022). Propensity score–adjusted analysis yielded similar results.

Conclusions:
After primary PCI, complete revascularization in STEMI multivessel disease is associated with lower MACE rates than medical therapy. However, ischemia-testing–guided rather than angiography-guided revascularization was associated with the lowest MACE. This study provides preliminary data and hypotheses for future randomized controlled studies.
The Impact of a Change in the Price of VA Health Care on Utilization of VA and Medicare Services
Authors: Nelson Richard E. , Hicken Bret , Vanneman Megan , Liu Chuan-Fen , Rupper Randall 
Published: May 2018

Introduction:
The passage of the Veterans Access, Choice, and Accountability Act of 2014 has expanded the non-Veteran Affairs (VA) care options for eligible US Veterans. In order for these new arrangements to provide the best care possible for Veterans, it is important to understand the relationship between VA and non-VA care options. The purpose of this study was to use another recent VA policy change, one that increased the reimbursement rate that eligible Veterans receive for travel for health care to VA, to understand the use of VA and Medicare services among Medicare-enrolled Veterans.

Methods:
We used a difference-in-difference technique to compare inpatient and outpatient utilization and cost in VA and Medicare between Veterans who were eligible for travel reimbursement and those who were not eligible following 2 increases in the travel reimbursement rate. We used generalized estimating equation models and 2-part models when cost outcomes were rare.

Results:
Our cohort consisted of 110,007 Medicare-enrolled Veterans, including 25,076 under 65 and 84,931 over 65 years old. Following the travel reimbursement rate increases, the number of VA outpatient encounters increased for Veterans in our cohort regardless of age group or whether living in an urban or rural area. The number of non-VA outpatient encounters decreased significantly for Veterans in both age groups living in rural areas following these policy changes.

Conclusions:
Our estimates suggest that VA outpatient care may be a substitute for Medicare outpatient care for Medicare-enrolled Veterans living in rural areas. These results are important because they indicate how Veteran health care utilization might be affected by future policy changes designed to increase access to VA services. They also indicate the ripple effects that may occur in other health systems due to changes in the VA system.
Examining Women Veteran’s Experiences, Perceptions, and Challenges With the Veterans Choice Program
Authors: Mattocks Kristin M. , Yano Elizabeth M. , Brown Amber , Casares Jose , Bastian Lori 
Published: May 2018

Background:
The Veterans Choice Program (VCP) was launched in 2014 to address the growing concerns about the timeliness and quality of Veterans Health Administration (VHA) care. Given that many sex-specific health services, such as mammography and maternity care, are not routinely provided in all VHA facilities, women Veterans may disproportionately rely on VCP care. Understanding the provision and coordination of VCP care is crucial in order to ensure that care is not fragmented across the 2 health care systems.

Objectives:
The main objective of this study was to understand women Veterans’ experiences, perceptions, and challenges with VCP care.

Design:
This study was a semistructured interview with 148 women at 13 VHA facilities nationwide.

Results:
Four major themes emerged: (1) eligibility information for the VCP was limited and confusing; (2) women experienced difficulty scheduling VCP appointments; (3) VCP care results were not shared with women Veterans or their VHA providers in a timely manner; and (4) concerns with unpaid VCP bills were common.

Conclusions:
Our study highlights challenges women experienced with VCP care, and the need for improved care coordination. An ideal care coordination system would be the one in which all Veterans’ non-Veteran Affairs care, including scheduling, follow-up, communication with community providers, coordination of services, and transition back to Veteran Affairs care is ensured.
Teaching mental health first aid in the school setting: a novel approach to improving outcomes for common adolescent mental disorders
Authors: Hart Laura M. , Cox Georgina R. , Lees Lucy 
Published: May 2018

Purpose of review
Common adolescent mental disorders, such as depression, often go untreated and severely impact health and educational outcomes. The purpose of this review is to describe what is currently known about school-based mental health interventions and to describe a new intervention, Mental Health First Aid training.

Recent findings
Universal and selective prevention and treatment programmes have been widely evaluated, though population-level dissemination remains elusive. A novel approach is to train adolescents in how to recognise early signs of mental disorder onset, decrease stigmatising beliefs and barriers to help-seeking, and to use appropriate first aid strategies for assisting peers in mental health crisis, such as those with depression and suicidal ideation.

Summary
Teaching adolescents the skills necessary to recognise and respond to mental health problems and mental health crises may provide life-long skills that prompt lower stigmatising beliefs, greater support of peers and appropriate, timely help-seeking.
Genetics of pubertal timing
Authors: Zhu Jia , Kusa Temitope O. , Chan Yee-Ming 
Published: May 2018

Purpose of review
To summarize advances in the genetics underlying variation in normal pubertal timing, precocious puberty, and delayed puberty, and to discuss mechanisms by which genes may regulate pubertal timing.

Recent findings
Genome-wide association studies have identified hundreds of loci that affect pubertal timing in the general population in both sexes and across ethnic groups. Single genes have been implicated in both precocious and delayed puberty. Potential mechanisms for how these genetic loci influence pubertal timing may include effects on the development and function of the GnRH neuronal network and the responsiveness of end-organs.

Summary
There has been significant progress in identifying genetic loci that affect normal pubertal timing, and the first single-gene causes of precocious and delayed puberty are being described. How these genes influence pubertal timing remains to be determined.
A Pilot Study to Reduce Computed Tomography Utilization for Pediatric Mild Head Injury in the Emergency Department Using a Clinical Decision Support Tool and a Structured Parent Discussion Tool
Authors: Engineer Rakesh S. , Podolsky Seth R. , Fertel Baruch S. , Grover Purva , Jimenez Heather , Simon Erin L. , Smalley Courtney M. 
Published: May 2018

Introduction
The American College of Emergency Physicians embarked on the “Choosing Wisely” campaign to avoid computed tomographic (CT) scans in patients with minor head injury who are at low risk based on validated decision rules. We hypothesized that a Pediatric Mild Head Injury Care Path could be developed and implemented to reduce inappropriate CT utilization with support of a clinical decision support tool (CDST) and a structured parent discussion tool.

Methods
A quality improvement project was initiated for 9 weeks to reduce inappropriate CT utilization through 5 interventions: (1) engagement of leadership, (2) provider education, (3) incorporation of a parent discussion tool to guide discussion during the emergency department (ED) visit between the parent and the provider, (4) CDST embedded in the electronic medical record, and (5) importation of data into the note to drive compliance. Patients prospectively were enrolled when providers at a pediatric and a freestanding ED entered data into the CDST for decision making. Rate of care path utilization and head CT reduction was determined for all patients with minor head injury based on International Classification of Diseases, Ninth Revision codes. Targets for care path utilization and head CT reduction were established a priori. Results were compared with baseline data collected from 2013.

Results
The CDST was used in 176 (77.5%) of 227 eligible patients. Twelve patients were excluded based on a priori criteria. Adherence to recommendations occurred in 162 (99%) of 164 patients. Head CT utilization was reduced from 62.7% to 22% (odds ratio, 0.17; 95% confidence interval, 0.12–0.24) where CDST was used by the provider. There were no missed traumatic brain injuries in our study group.

Conclusion
A Pediatric Mild Head Injury Care Path can be implemented in a pediatric and freestanding ED, resulting in reduced head CT utilization and high levels of adherence to CDST recommendations.