bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reduced Elective Operation Rates and High Patient Satisfaction After the Implementation of Decision Aids in Patients with Gallstones or an Inguinal Hernia
Authors: Latenstein Carmen S. S. , van Wely Bob J. , Klerkx Mieke , Meinders Marjan J. , Thomeer Bastiaan , de Reuver Philip R. 
Published: April 2019

AbstractBackgroundFor both gallbladder removal and inguinal hernia repair, it is important to include patients’ perspective in the decision‐making process, as watchful waiting is an accepted alternative in selected patients. The aim of this study was to evaluate operation rates before and after implementation of decision aids (DAs) and to assess patient compliance with the use of DAs.MethodsA single‐centered retrospective study was performed, including all patients ≥18 years referred to the surgical outpatient clinic with symptomatic gallstones or an inguinal hernia between January 2014 and December 2017. Operation rates before and after implementation of DAs (December 2015) were compared. In addition, patient compliance with the use of DAs and satisfaction with final treatment were assessed.ResultsOverall, 1625 patients with gallstones and 1798 patients with an inguinal hernia were included. After implementation, DAs were provided to 512 patients (63.1%) with gallstones of whom 80.7% (413/512) used the DA and to 528 patients (58.8%) with an inguinal hernia, which was used by 80.7% (426/528). Before implementation, the operation rate in patients with gallstones was 72.0% (586/814) and after implementation 56.7% (460/811) (− 15.3%, p < 0.001). The operation rate in patients with an inguinal hernia decreased from 77.8% (700/900) to 64.6% (580/898) (− 13.2%, p < 0.001). Patient satisfaction with final treatment was high (9/10).ConclusionImplementation of DAs in the surgical outpatient clinic for patients with gallstones or an inguinal hernia is associated with reduced elective operation rates and is associated with high DA compliance.
Analysis of Surgical Adverse Events at a Major University Hospital in South Africa
Authors: Wain Howard , Kong Victor , Bruce John , Laing Grant , Clarke Damian 
Published: April 2019

AbstractBackgroundSurgical ‘never events’ have serious adverse outcomes for patients. A never event can be defined as a serious, avoidable patient safety incident that would not occur if necessary preventative measures are implemented. The literature from South Africa on this topic is limited. This study aims to understand these never events in our setting and to develop a taxonomy to classify these events which facilitates the development of strategies to prevent and reduce the incidence and impact of surgical never events.Materials and methodsA retrospective review was undertaken over a 5‐year period (December 2012–December 2017) at the Pietermaritzburg Metropolitan Surgical Service, South Africa. All morbidities and surgical never events recorded on the Hybrid Electronic Medical Registry (HEMR) were retrieved and analyzed.ResultsA total of 20,432 patient admissions were captured on HEMR, and total of 7187 morbidities were recorded. Of these morbidities, 61.6% were in males and 38.3% in females. Patients admitted to general surgery accounted for 62.7% of the total, and trauma surgery and pediatric surgery accounted for 33.6% and 3.8%, respectively, of the total number of morbidities. Of these 7187 morbidities, a total of 79 never events were identified: 53 (67.1%) in males and 26 (32.9%) in females. Of all morbidities reported, 1.1% (79/7187) constituted a never event. The rate of never events for all admissions was (79 never events/20,432 admissions) or 0.39%. Among the 79 never events, general surgery patients experienced 47 (59.5%), trauma surgery 25 (31.6%), and pediatric surgery 7 (8.9%). In addition to these 79 never events, a total of 126 near misses were identified, of which 80 (63.5%) occurred in males.ConclusionSurgical morbidity is common and has a substantial impact of both the individual patient and society as a whole. Robust reporting mechanisms are needed to capture data, and these data must feed into evidence‐based strategies to reduce the incidence and impact of this morbidity. Our systems ensure that our incidence of surgical never events is relatively low, but ongoing efforts must be made to ensure that we drive this level down even further.
Doxastic Deontology and Cognitive Competence
Authors: Forrai Gábor 
Published: April 2019

AbstractThe paper challenges William Alston’s argument against doxastic deontology, the view that we have epistemic duties concerning our beliefs. The core of the argument is that doxastic deontology requires voluntary control over our beliefs, which we do not have. The idea that doxastic deontology requires voluntary control is supposed to follow from the principle that ought implies can (OIC). The paper argues that this is wrong: in the OIC principle which regulates our doxastic duties the “can” does not stand for the ability to shape our beliefs voluntarily. As an examination of everyday examples shows, it stands for cognitive competence, the reliable ability to acquire beliefs in compliance with the epistemic norms. The doxastic OIC principle asserts, in brief, that one is only obliged to believe something if one’s cognitive capacities are sufficiently strong. It is also explained why the doxastic duties do not require voluntary control as opposed to moral duties. This understanding of doxastic duties saves our everyday doxastic deontic judgments from Alston’s argument, but does not help the deontological conception of justification, which understands justification as not violating one’s epistemic duties. It actually provides another argument against the deontological conception: if the OIC regulating our doxastic duties is construed as suggested, the deontological conception of justification implies that one’s doxastic duties and, consequently, whether one’s belief is justified depend on one’s cognitive competence. Since cognitive competence varies from person to person, justification will not matter to truth and knowledge in the way epistemic justification is supposed to do.
Impact of travel time uncertainties on the solution cost of a two-echelon vehicle routing problem with synchronization
Authors: Anderluh Alexandra , Larsen Rune , Hemmelmayr Vera C. , Nolz Pamela C. 
Published: April 2019

AbstractTwo-echelon vehicle routing problems which contain synchronization between vehicles can be deeply impacted by time uncertainty, because one vehicle’s delay can propagate to other vehicles. In this paper, we evaluate the deterministic solution of such a problem based on simulated travel time scenarios. The information obtained by simulation is incorporated in the optimization procedure iteratively. Computational results show that the degree of synchronization in an instance is directly correlated with the potential improvements by reoptimization. We present findings on the number of travel time scenarios required to obtain a representative picture of the stochastic solutions. In addition, we demonstrate that time dependent travel times can be aggregated on a city-wide level and linearized as a function of free flow times without major loss of reliability.
Increasing the take-up of the housing allowance among Swedish pensioners: a field experiment
Authors: Engström Per , Forsell Eskil , Hagen Johannes , Stefánsson Arnaldur 
Published: April 2019

AbstractUsing a randomized field experiment in the Swedish pension system, we investigate whether receiving an information letter affects the take-up rate of the housing allowance for pensioners. We also investigate whether the framing of the information letter affects take-up. The results show that simple information letters had a significant effect on the application rate and subsequent take-up rate: The baseline application rate in the targeted control population was only 1.4%, while the corresponding rates in the different treatment groups were between 9.9 and 12.1%. However, while the applications in the control group were accepted in almost 3 out of 4 cases, up to 50% of the applications in the treatment group were declined. The lower conditional acceptance rate in the treatment group seems to be largely driven by wealth, which the Pensions Agency cannot observe prior to submission. Information campaigns aimed at increasing benefit take-up therefore need careful design in situations with imperfect targeting.
Pilot randomised controlled trial of a brief mindfulness-based intervention for those with persistent pain
Authors: Howarth Ana , Riaz Muhammad , Perkins-Porras Linda , Smith Jared G. , Subramaniam Jeevakan , Copland Claire , Hurley Mike , Beith Iain , Ussher Michael 
Published: April 2019

AbstractA pilot-randomised controlled trial (RCT) examined the effects of a brief mindfulness-based intervention (MBI) on persistent pain patients and assessed the feasibility of conducting a definitive RCT. A brief (15 min) mindfulness body-scan audio was compared with an active control administered in a clinic and then used independently over 1 month. Immediate effects of the intervention were assessed with brief measures of pain severity, distraction and distress. Assessments at baseline, 1 week and 1 month included pain severity and interference, mood, pain-catastrophizing, mindfulness, self-efficacy, quality of life and intervention acceptability. Of 220 referred patients, 147 were randomised and 71 completed all assessments. There were no significant immediate intervention effects. There were significant positive effects for ratings of intervention ‘usefulness’ at 1 week (p = 0.044), and pain self-efficacy at 1 month (p = 0.039) for the MBI group compared with control. Evidently, it is feasible to recruit persistent pain patients to a brief MBI study. Strategies are needed to maximise retention of participants.Trial registration Current controlled trials ISRCTN61538090. Registered 20 April 2015.
Radiographic Humerus Union Measurement (RHUM) Demonstrates High Inter- and Intraobserver Reliability in Assessing Humeral Shaft Fracture Healing
Authors: Christiano Anthony V. , Goch Abraham M. , Burke Christopher J. , Leucht Philipp , Konda Sanjit R. , Egol Kenneth A. 
Published: April 2019

Background Orthopedic surgeons use radiographs to determine degrees of fracture healing, guide progression of clinical care, and assist in determining weight bearing and removal of immobilization. However, no gold standard exists to determine the progression of healing of humeral shaft fractures treated non-operatively. Purpose The purpose of this study was to determine whether a scale comparable to the modified Radiographic Union Score for Tibial (RUST) fractures applied to non-operatively treated humeral shaft fractures can increase interobserver reliability in determining fracture healing. Methods A retrospective review was undertaken by three orthopedic traumatologists and one musculoskeletal radiologist, who evaluated 50 sets of anteroposterior and lateral radiographs, presented at random, of non-operatively treated humeral shaft fractures at various stages of healing from 17 patients. The radiographs were scored using a modified RUST scale called the Radiographic Humerus Union Measurement (RHUM). Observers were blinded to the time from injury. After a 4-week washout period, observers again scored the same radiographs. Observers classified each fracture as either healed or not healed based on the combination of radiographs. Inter- and intraobserver reliability of the RHUM were determined using an intraclass correlation coefficient (ICC). Interobserver reliability of determining a healed fracture was calculated using Cohen's kappa (κ) statistics. A receiver operator characteristic curve was conducted to determine the RHUM score predictive of a fracture being considered healed. Results ICC demonstrated almost perfect interobserver reliability (ICC, 0.838; ICC 95% CI, 0.765 to 0.896) and intraobserver reliability (ICC range, 0.822 to 0.948) of the RHUM. κ demonstrated substantial agreement between observers in considering a fracture healed (κ = 0.647). Receiver operating characteristic (ROC) curve demonstrated that a RHUM of 10 or higher is an excellent predictor of the observer considering the fracture healed (area under the ROC curve = 0.946, specificity = 0.957, 95% CI specificity, 0.916 to 0.979). Conclusions This cortical scoring system has excellent interobserver reliability in humeral shaft fractures treated non-operatively. Consistent with previous cortical scoring systems, a RHUM score of 10 or above can be considered radiographically healed.
Distribution of Ni, Co, Precious, and Platinum Group Metals in Copper Making Process
Authors: Sukhomlinov Dmitry , Klemettinen Lassi , Avarmaa Katri , O’Brien Hugh , Taskinen Pekka , Jokilaakso Ari 
Published: April 2019

Abstract
The distribution coefficients of Ni, Co, Ag, Au, Pt, and Pd between molten copper and silica-saturated iron silicate slags (

$$ {\text{L}}_{\text{Me}}^{{{\text{Cu}}/{\text{s}}}} $$

L

Me

Cu
/
s

) were measured experimentally. The distribution behaviors were studied under typical conditions of copper converting and fire refining, i.e., from 1250 °C to 1350 °C, and from 10−8 to 10−4 atm oxygen partial pressure. The coefficients were determined as the ratios of the trace element weight concentrations measured in situ, directly from the equilibrated metal and slag phases. For the quantitative elemental analysis of the phases, state-of-the-art analytic techniques, including electron probe microanalysis and laser ablation-inductively coupled plasma-mass spectrometry, were employed. The distribution coefficients

$$ {\text{L}}_{\text{Me}}^{{{\text{Cu}}/{\text{s}}}} $$

L

Me

Cu
/
s

determined can be arranged in the following order: Pt > Au > Pd >> Ag > (Cu) > Ni > Co > (Fe).
Disinformation in international politics
Authors: Lanoszka Alexander 
Published: April 2019

AbstractConcerns over disinformation have intensified in recent years. Policymakers, pundits, and observers worry that countries like Russia are spreading false narratives and disseminating rumours in order to shape international opinion and, by extension, government policies to their liking. Despite the importance of this topic, mainstream theories in International Relations offer contradictory guidance on how to think about disinformation. I argue that disinformation is ineffective in terms of changing the policies of a target as regards to its foreign policy alignments and armaments – that is, the balance of power. To be strategically effective, disinformation must somehow overcome three powerful obstacles: first, the fundamental uncertainty that international anarchy generates over any information broadcasted by adversaries; second, the pre-existing prejudices of foreign policy elites and ordinary citizens; and third, the countermeasures that are available even amid political polarisation. I examine the most likely case of there seemingly being a conscious and effective strategy that emphasises disinformation: the Russian campaign that has targeted the Baltic states, especially since the 2014 annexation of Crimea. The available evidence strongly suggests that the strategic effects of disinformation are exaggerated.
Test stewardship, frequency and fidelity: Impact on reported hospital-onset Clostridioides difficile
Authors: Fleming Michele S. , Hess Olivia , Albert Heather L. , Styslinger Emily , Doll Michelle , Nguyen Huong Jane , McAulay-Kidd Susan , Hemphill Robin R. , Srivastava Tara , Cooper Kaila D. , Stevens Michael P. , Bearman Gonzalo 
Published: April 2019

AbstractWe assessed the impact of an embedded electronic medical record decision-support matrix (Cerner software system) for the reduction of hospital-onset Clostridioides difficile. A critical review of 3,124 patients highlighted excessive testing frequency in an academic medical center and demonstrated the impact of decision support following a testing fidelity algorithm.
Life cycle of a star: Carl Sagan and the circulation of reputation
Authors: MARSH OLIVER 
Published: April 2019

AbstractIt is a commonplace in the history of science that reputations of scientists play important roles in the stories of scientific knowledge. I argue that to fully understand these roles we should see reputations as produced by communicative acts, consider how reputations become known about, and study the factors influencing such processes. I reapply James Secord's ‘knowledge-in-transit’ approach; in addition to scientific knowledge, I also examine how ‘biographical knowledge’ of individuals is constructed through communications and shaped by communicative contexts. My case study is Carl Sagan, widely discussed – amongst scientists, media professionals and publics – for his skill as a charismatic popularizer, his perceived arrogance, his political activism, and his debated merit as a researcher. By examining how aspects of Sagan's reputation circulated alongside his scientific work – rather than existing as a static context for his scientific work – I show how different forms of knowledge (biographical and scientific) influence each other as they circulate.
Intake of α-linolenic acid is not consistently associated with a lower risk of peripheral artery disease: results from a Danish cohort study
Authors: Bork Christian S. , Lasota Anne N. , Lundbye-Christensen Søren , Jakobsen Marianne U. , Tjønneland Anne , Calder Philip C. , Schmidt Erik B. , Overvad Kim 
Published: April 2019

AbstractIntake of the plant-derivedn-3 fatty acid α-linolenic acid (ALA) has been associated with anti-atherosclerotic properties. However, information on the association between ALA intake and development of peripheral artery disease (PAD) is lacking. In this follow-up study, we investigated the association between dietary intake of ALA and the rate of PAD among middle-aged Danish men and women enrolled into the Danish Diet, Cancer and Health cohort between 1993 and 1997. Incident PAD cases were identified through the Danish National Patient Register. Intake of ALA was assessed using a validated FFQ. Statistical analyses were performed using Cox proportional hazard regression allowing for separate baseline hazards among sexes and adjusted for established risk factors for PAD. During a median of 13·6 years of follow-up, we identified 950 valid cases of PAD with complete information on covariates. The median energy-adjusted ALA intake within the cohort was 1·76 g/d (95 % central range: 0·94–3·28). In multivariable analyses, we found no statistically significant association between intake of ALA and the rate of PAD (P= 0·339). Also, no statistically significant associations were observed in analyses including additional adjustment for co-morbidities and in sex-specific analyses. In supplemental analyses with additional adjustment for potential dietary risk factors, we found a weak inverse association of PAD with ALA intake above the median, but the association was not statistically significant (P= 0·314). In conclusion, dietary intake of ALA was not consistently associated with decreased risk of PAD.
Estimating sodium intake from spot urine samples at population level: a validation and application study in French adults
Authors: Emeville Elise , Lassale Camille , Castetbon Katia , Deschamps Valérie , Salanave Benoît , Vernay Michel , Guergour Dorra , Faure Patrice , Hercberg Serge , Galan Pilar , Kesse-Guyot Emmanuelle , Verdot Charlotte 
Published: April 2019

AbstractThe aim of this study was to assess the validity of the predictive INTERSALT equation using spot urine samples to estimate 24-h urinary Na (24-hUNa) excretion and daily Na intake among the French adult population. Among 193 French adults (‘validation sample’), we assessed the validity by comparing predicted 24-hUNa excretion from spot urine and measured 24-hUNa excretion from 24-h urine collections. Spearman correlation coefficients and Bland–Altman plots were used and we calculated calibration coefficients. In a nationally representative sample of 1720 French adults (‘application sample’), the calibrated predictive equation was then applied to the spot urine Na values to estimate 24-hUNa excretion and daily Na intake. In that sample, predicted Na intake was compared with that estimated from 24-h dietary recalls. Results were adjusted and corrected using calibration coefficients. In the validation sample, the measured 24-hUNa excretion was on average 14 % higher than the predicted 24-hUNa (+13 % for men and +16 % for women). Correlation between measured and predicted 24-hUNa excretion was moderate (Spearmanr0·42), and the Bland–Altman plots showed underestimation at lower excretion level and overestimation at higher level. In the application study, estimated daily salt intake was 8·0 g/d using dietary recalls, 8·1 g/d using predicted INTERSALT equation and 9·3 g/d after applying calibration coefficients calculated in the validation study. Despite overall underestimation of 24-hUNa excretion by spot urinary Na, the use of predictive INTERSALT equation remains an acceptable alternative in monitoring global Na intake/excreted in the French population but its use is not advised at the individual level.
Oxylipin concentration, but not fatty acid composition, is altered in human donor milk pasteurised using both thermal and non-thermal techniques
Authors: Pitino Michael A. , Alashmali Shoug M. , Hopperton Kathryn E. , Unger Sharon , Pouliot Yves , Doyen Alain , O’Connor Deborah L. , Bazinet Richard P. 
Published: April 2019

AbstractHuman donor milk (DM) is Holder pasteurised (62·5°C, 30 min) to ensure its microbiological safety for infant consumption. In low-resource settings, flash heating is used to pasteurise milk. Although there is considerable interest in non-thermal alternatives (high hydrostatic pressure processing (HHP) and UVC irradiation) for pasteurisation, their effect on the fatty acid composition is not well understood. Of particular interest is the effect of pasteurisation on the generation of oxylipins. DM from eight mothers containing bacteria >5 × 107colony-forming units/l was used. In a paired design, each pool of milk underwent four pasteurisation techniques: Holder; flash heating; UVC (250 nm, 25 min) and HHP (500 MPa, 8 min). Fatty acids were quantified by GC-flame ionisation detection and oxylipins derived from arachidonic acid; 18-carbon PUFA (α-linolenic acid, linoleic acid and γ-linolenic acid) and EPA/DHA were measured by liquid chromatography-tandem MS in aliquots of raw and processed milk. There were no significant changes to the composition of fatty acids following all pasteurisation techniques compared with raw milk. Then-6:n-3 ratio remained constant ranging from 6·4 to 6·6. Several arachidonic acid-derived oxylipins were highest post-UVC and elevated post-HHP compared with raw milk. Several oxylipins derived from 18-carbon PUFA (linoleic and α-linolenic acids) were elevated in UVC-treated milk. EPA/DHA-derived oxylipins were on average, unaffected by pasteurisation. Although some PUFA-derived oxylipins were increased following UVC and HHP, no method affected the fatty acid composition of human DM. Further research is needed to determine if varying levels of oxylipins in human DM as a result of processing can potentially mediate cellular signalling; proliferation and apoptosis, especially important for preterm infant development.
PLAUTIANUS' ZEBRAS: A ROMAN EXPEDITION TO EAST AFRICA IN THE EARLY THIRD CENTURY
Authors: Mallan C.T. 
Published: April 2019

The kleptocratic supremacy of the praetorian prefect C. Fulvius Plautianus (PIR2F 554) was felt throughout the city of Rome, the Empire and (according to one author) even beyond the imperial frontiers. Indeed, for the senatorial historian Dio Cassius, there was no more picturesque demonstration of Plautianus' acquisitiveness than his seizure of strange striped horse-like creatures from ‘islands in the Erythraean Sea’. The passage, as preserved in the text of Xiphilinus'Epitome, reads as follows (Dio Cass. 76[75].14.3):καὶ τέλος ἵππους Ἡλίῳ <ἱεροὺς> τιγροειδεῖς ἐκ τῶν ἐν τῇ Ἐρυθρᾷ θαλάσσῃ νήσων, πέμψας ἑκατοντάρχους, ἐξέκλεψεν·In the end he even stole tiger-like horses <sacred> to Helios from the islands in the Erythraean Sea, having sent some centurions to carry out the task.