bluuebunny/crossref_metadata_2025_split huggingface dataset:
Historicizing Mobility Trajectories of Highskilled Migrants from Coastal Andhra to the United States
Authors: Roohi Sanam 
Published: May 2018

Guntur-Krishna districts in the state of Andhra Pradesh has seen intense mobility of professionals to the USA from among the ‘dominant’ castes of the region, particularly the Kammas. Kammas were a rural agrarian caste who have successfully transnationalized themselves, but continue to have strong connections with their region of origin. Rather than making sense of this duality only through anthropological literature on transnationalism, in this account, taking a longue durée approach, I show how certain historical moments in the region created possibilities for the Kammas to first become urbanized, and later, cater to the demand of flexible high skilled labour in the west. Using a meso and micro level schema, the article argues that transnational migration was preceded by changes in the political economy of the region due to the region’s encounter with the colonial state. Moreover, the response of the community to these changes to achieve social and economic mobility further facilitated their rural to urban migration and, later, transnational migration. Finally, this article argues that rather than understanding transnational migration patterns through a statist lens, a more dissgaregated historical analysis is vital to bring out region and community inflected constitutive elements of such migration. JEL: O15, J61, N35
Long-term prognostic value of coronary computed tomography angiography in chest pain patients
Authors: Sandstedt Mårten , De Geer Jakob , Henriksson Lilian , Engvall Jan , Janzon Magnus , Persson Anders , Alfredsson Joakim 
Published: May 2018

Background Coronary computed tomography angiography (CCTA) is increasingly used to detect coronary artery disease (CAD), but long-term follow-up studies are still scarce. Purpose To evaluate the prognostic value of CCTA in patients with suspected CAD. Material and Methods A total of 1205 consecutive CCTA patients with chest pain were classified as normal coronary arteries, non-obstructive CAD, or obstructive CAD. The primary outcome was major adverse cardiac event (MACE), defined as a composite outcome including cardiac death, myocardial infarction, unstable angina pectoris, or late revascularization (after >90 days). Results Over 7.5 years follow-up (median = 3.1 years), Kaplan–Meier estimates demonstrated a MACE in 1.0%, 4.6%, and 20.7% in normal coronary arteries, non-obstructive CAD, and obstructive CAD, respectively. Log rank test for pairwise comparisons showed significant differences between non-obstructive CAD and normal coronary arteries ( P = 0.023) and between obstructive CAD and normal coronary arteries ( P < 0.001). In a multivariable analysis, adjusting for classical risk factors, non-obstructive CAD and obstructive CAD were independent predictors of MACE, with hazard ratios (HR) of 3.22 ( P = 0.041) and 25.18 ( P < 0.001), respectively. Conclusion Patients with normal coronary arteries have excellent long-term prognosis, but the risk for MACE increases with non-obstructive and obstructive CAD. Both non-obstructive and obstructive CAD are independently associated with future ischemic events.
Dependence of intravoxel incoherent motion diffusion MR threshold b-value selection for separating perfusion and diffusion compartments and liver fibrosis diagnostic performance
Authors: Wáng Yì Xiáng J , Li Yáo T , Chevallier Olivier , Huang Hua , Leung Jason Chi Shun , Chen Weitian , Lu Pu-Xuan 
Published: May 2018

Background Intravoxel incoherent motion (IVIM) tissue parameters depend on the threshold b-value. Purpose To explore how threshold b-value impacts PF ( f), Dslow ( D), and Dfast ( D*) values and their performance for liver fibrosis detection. Material and Methods Fifteen healthy volunteers and 33 hepatitis B patients were included. With a 1.5-T magnetic resonance (MR) scanner and respiration gating, IVIM data were acquired with ten b-values of 10, 20, 40, 60, 80, 100, 150, 200, 400, and 800 s/mm2. Signal measurement was performed on the right liver. Segmented-unconstrained analysis was used to compute IVIM parameters and six threshold b-values in the range of 40–200 s/mm2 were compared. PF, Dslow, and Dfast values were placed along the x-axis, y-axis, and z-axis, and a plane was defined to separate volunteers from patients. Results Higher threshold b-values were associated with higher PF measurement; while lower threshold b-values led to higher Dslow and Dfast measurements. The dependence of PF, Dslow, and Dfast on threshold b-value differed between healthy livers and fibrotic livers; with the healthy livers showing a higher dependence. Threshold b-value = 60 s/mm2 showed the largest mean distance between healthy liver datapoints vs. fibrotic liver datapoints, and a classification and regression tree showed that a combination of PF (PF < 9.5%), Dslow (Dslow < 1.239 × 10–3 mm2/s), and Dfast (Dfast < 20.85 × 10–3 mm2/s) differentiated healthy individuals and all individual fibrotic livers with an area under the curve of logistic regression (AUC) of 1. Conclusion For segmented-unconstrained analysis, the selection of threshold b-value = 60 s/mm2 improves IVIM differentiation between healthy livers and fibrotic livers.
Effects of Allogenic Dermal Fibroblasts on Rotator Cuff Healing in a Rabbit Model of Chronic Tear
Authors: Kwon Jieun , Kim Yun Hee , Rhee Sung-Min , Kim Tae In , Lee Jimin , Jeon Saewha , Oh Joo Han 
Published: May 2018

Background: The failure of rotator cuffs to heal after repair is an unresolved surgical issue. There have been substantial efforts, including the use of biological supplements, to enhance tendon healing. Dermal fibroblasts are a good candidate for tendon tissue engineering because they are similar to the tenocytes used for collagen synthesis. In addition, they are easily accessible because autologous dermal fibroblasts can be obtained from individual skin without major skin defects and allogenic dermal fibroblasts (ADFs) have already been commercialized in the field of skin engineering. Purpose: To determine the effects of dermal fibroblasts on tendon-to-bone healing in a rabbit model of a chronic rotator cuff tear. Study Design: Controlled laboratory study. Methods: A total of 33 rabbits were randomly allocated into 3 groups (n = 11 each). Supraspinatus tendons were detached and left for 6 weeks to establish a chronic rotator tear model. Torn tendons were repaired in a transosseous manner with the injection of 5 × 106 ADFs with fibrin in group A, fibrin only in group B, and saline only in group C. At 12 weeks after repair, the mechanical test and histological evaluation were performed. Results: Seven rabbits died before the evaluation (1 in group A, 2 in group B, 4 in group C). In the final evaluation, the mean ± SD load to failure was 48.1 ± 13.3 N/kg for group A, 34.5 ± 8.9 N/kg for group B, and 31.1 ± 8.3 N/kg for group C, and group A showed significantly higher load-to-failure values than the other groups ( P = .011). The midsubstance tear rate, which presented stronger tendon-to-bone healing than insertional tear, was 50.0% in group A, 22.2% in group B, 28.6% in group C, but the differences were not statistically significant ( P = .413). In the histological evaluation, group A showed greater collagen fiber continuity and better orientation than the other groups. Conclusion: This controlled laboratory study verified, on the basis of biomechanics and histology, the potential for the use of ADFs in rotator cuff healing. The current results suggest a new biological supplement to increase the rate of rotator cuff healing. Clinical Relevance: The most important finding of this study was the potential for a new biological supplement to enhance rotator cuff healing—a continuing challenge.
Predictors of Elbow Torque Among Youth and Adolescent Baseball Pitchers
Authors: Okoroha Kelechi R. , Lizzio Vincent A. , Meta Fabien , Ahmad Christopher S. , Moutzouros Vasilios , Makhni Eric C. 
Published: May 2018

Background: There has been an increasing incidence of overuse elbow injuries among youth and adolescent pitchers. Pitch type has been implicated as a risk factor for excess torque at the medial elbow; however, this has not been definitively demonstrated. Purpose: To assess predictors of torque across the medial elbow in youth and adolescent pitchers with a mobile sensor. In addition, the authors aimed to determine the differences in elbow torque produced according to pitch type (fastball, curveball, changeup) and pitcher demographics. Study Design: Descriptive laboratory study. Methods: Twenty youth and adolescent pitchers were instructed to throw 8 fastballs, 8 curveballs, and 8 changeups in a standardized but randomized sequence over a 25-minute period. Five pitchers were evaluated each day. A sensor placed at the medial elbow reported elbow torque, arm speed, arm slot, and shoulder rotation for each pitch, while a radar gun measured peak ball velocity. The primary outcome was a determination of thrower and pitch characteristics associated with elevated torque across the medial elbow. Secondary outcomes included the evaluation of differences in throwing biomechanics among different pitch types. Outcomes were assessed via a multivariable model, which controlled for possible covariates. Results: In total, 20 youth baseball pitchers with a mean age of 14.1 years (range, 12-17 years) were included in the study. On average, fastballs caused the greatest torque across the medial elbow (least squares mean ± SE, 47.3 ± 0.5 N·m) as compared with changeups (44.2 ± 0.5 N·m; P < .001) and curveballs (45.0 ± 0.5 N·m; P = .002). However, curveballs produced the greatest arm speed (917.8 rpm). Pitchers who started throwing curveballs at an older age experienced less elbow torque ( P < .001). A multivariable model demonstrated that increased ball velocity and body mass index and decreased arm slot were independent predictors of increased elbow torque. Conversely, increasing age, longer arm length, and greater elbow circumference were independent protectors against elbow torque. Conclusion: This study found that among youth and adolescent pitchers, fastballs generate the highest elbow torque while curveballs generated the greatest arm speed. Increased ball velocity and body mass index and decreased arm slot were predictors of elbow torque; however, increasing age and size of a pitcher’s arm were protectors against elbow torque. These findings are important to better understand risk factors for overuse injury in this at-risk athletic population. Clinical Relevance: These findings may inform future pitching recommendations with intentions of curtailing medial elbow injuries experienced by young pitchers, such as ulnar collateral ligament injuries.
Le temps des consommateurs : état des recherches et perspectives
Authors: Lallement Jeanne , Gourmelen Andrea 
Published: May 2018

Résumé Cet article propose une synthèse des recherches sur le temps des consommateurs. Mobilisant une étude systématique des travaux depuis 25 ans, il offre une grille de lecture originale en regroupant le temps des consommateurs en deux catégories. Dans la première, les travaux sur le « temps ressource » soulignent que celui-ci est apprécié différemment selon des antécédents situationnels et individuels. Dans la seconde, les recherches sur le « temps-trait de personnalité » présentent celui-ci dans une perspective globale (où le temps est apprécié comme un tout), comparative (comparant plusieurs zones temporelles) ou encore sélective (positionnée dans une zone temporelle précise), approche elle-même caractérisée selon l’ancrage plus ou moins profond de la variable temporelle dans la personnalité de l’individu. Si le temps des consommateurs s’éclaire à lumière de ces catégorisations, on ne peut que constater l’impossibilité d’avoir un ancrage théorique unifié. Cette recherche plaide pour un décloisonnement des différentes approches et méthodologies.
Categorical state sequence analysis and regression tree to identify determinants of care trajectory in chronic disease: Example of end-stage renal disease
Authors: Le Meur Nolwenn , Vigneau Cécile , Lefort Mathilde , Lebbah Saïd , Jais Jean-Philippe , Daugas Eric , Bayat Sahar 
Published: May 2018

Background Patients with chronic diseases, like patients with end-stage renal disease (ESRD), have long history of care driven by multiple determinants (medical, social, economic, etc.). Although in most epidemiological studies, analyses of health care determinants are computed on single health care events using classical multivariate statistical regression methods. Only few studies have integrated the concept of treatment trajectories as a whole and studied their determinants. Methods All 18- to 80-year-old incident ESRD patients who started dialysis in Ile-de-France or Bretagne between 2006 and 2009 and could be followed for a period of 48 months after initiation of a renal replacement therapy were included ( n = 5568). Their care trajectories were defined as categorical state sequences. Associations between patients’ characteristics and care trajectories were assessed using a regression tree model together with a discrepancy analysis. Results On average, each patient experienced 1.56 different renal replacement therapies (min = 1; max = 5) during the 48 months of follow-up. About 55% of patients never changed treatment and only 1% tried three or more renal replacement therapy modalities. Twelve homogeneous care trajectory groups were identified. Covariates explained 12% of the discrepancy between groups, particularly age, regions and initiation of hemodialysis with a catheter. Conclusions Regression tree analysis of categorical state sequence highlighted geographical disparities in the care trajectory of French patients with ESRD that cannot be observed when focusing on a single outcome, such as survival. This method is an original tool to visualize and characterize care trajectories, notably in the context of chronic condition like ESRD.
Investigation of risk factors of geriatric patients with significant brain injury from ground‐level fall: A retrospective cohort study in a local Accident and Emergency Department setting
Authors: So Wing Hong , Chan Ho Fai , Li Mei Kwan 
Published: May 2018

Background:Trauma was the fifth leading cause of death in Hong Kong in 2013.4 Injuries caused by falls ranked first in traumatic brain injury (TBI) cases among older adults (51%).5 Elderly trauma patients face an increased risk of adverse consequences6 from trauma compared with their younger counterparts, as advanced age itself is already a well‐recognized risk factor for less favorable outcomes following trauma. Therefore, identifying factors associated with significant brain injury in geriatric patients in A&E triage is crucial in providing timely care to these patients.Objectives:To identify the risk factors for geriatric patients with significant brain injury from ground‐level falls and to formulate their association of risk factors with significant brain injury as a consequence from ground‐level falls.Methods:This was a retrospective study with data collected from the Clinical Data Analysis and Reporting System of Queen Mary Hospital from 1 January 2013 to 31 December 2015. A total of 1101 cases were identified.Results:There were 76% of the recruited patients with a normal computed tomography scan. However, the remaining 24% had computed tomography scans indicative of brain injury. Severe head injuries were scored 3 ‐8 on the Glasgow Coma Scale and moderate head injuries were scored 9 ‐12. Respectively, these were 20 times (p = 0.005) and 5 times (p = 0.002) more likely to have positive computed tomography findings than patients with a Glasgow Coma Scale score from 13 to 15. Patients with loss of consciousness were two times more likely to have a positive computed tomography result than those without loss of consciousness (p = 0.001). Although warfarin use is a well‐established risk factor for intracranial hemorrhage after head injury, in our dataset, the result was not statistically significant. However, the use of new oral anti‐coagulants was associated with positive computed tomography findings with patients taking new oral anti‐coagulants 2.3 times more likely to have positive computed tomography findings compared with those with no anticoagulant use (p = 0.033).Conclusions:Early detection of patients with significant brain injury and aggressive management may prevent secondary injury from the complications of brain injury, hence improving patient mortality and morbidity, and reducing hospital stay and health care costs.
The significance of National Early Warning Score for predicting prognosis and evaluating conditions of patients in resuscitation room
Authors: Yuan Wang Chang , Tao Cao , Dan Zhu Dan , Yi Sun Chang , Jing Wang , Jian Qin 
Published: May 2018

Background:For critical patients in resuscitation room, the early prediction of potential risk and rapid evaluation of disease progression would help physicians with timely treatment, leading to improved outcome. In this study, it focused on the application of National Early Warning Score on predicting prognosis and conditions of patients in resuscitation room. The National Early Warning Score was compared with the Modified Early Warning Score) and the Acute Physiology and Chronic Health Evaluation II.Objectives:To assess the significance of NEWS for predicting prognosis and evaluating conditions of patients in resuscitation rooms.Methods:A total of 621 consecutive cases from resuscitation room of Xuanwu Hospital, Capital Medical University were included during June 2015 to January 2016. All cases were prospectively evaluated with Modified Early Warning Score, National Early Warning Score, and Acute Physiology and Chronic Health Evaluation II and then followed up for 28 days. For the prognosis prediction, the cases were divided into death group and survival group. The Modified Early Warning Score, National Early Warning Score, and Acute Physiology and Chronic Health Evaluation II results of the two groups were compared. In addition, receiver operating characteristic curves were plotted. The areas under the receiver operating characteristic curves were calculated for assessing and predicting intensive care unit admission and 28‐day mortality.Results:For the prognosis prediction, in death group, the National Early Warning Score (9.50 ± 3.08), Modified Early Warning Score (4.87 ± 2.49), and Acute Physiology and Chronic Health Evaluation II score (23.29 ± 5.31) were significantly higher than National Early Warning Score (5.29 ± 3.13), Modified Early Warning Score (3.02 ± 1.93), and Acute Physiology and Chronic Health Evaluation II score (13.22 ± 6.39) in survival group (p < 0.01). For the disease progression evaluation, the areas under the receiver operating characteristic curves of National Early Warning Score, Modified Early Warning Score, and Acute Physiology and Chronic Health Evaluation II were 0.760, 0.729, and 0.817 (p < 0.05), respectively, for predicting intensive care unit admission; they were 0.827, 0.723, and 0.883, respectively, for predicting 28‐day mortality. The comparison of the three systems was significant (p < 0.05).Conclusion:The performance of National Early Warning Score for predicting intensive care unit admission and 28‐day mortality was inferior than Acute Physiology and Chronic Health Evaluation II but superior than Modified Early Warning Score. It was able to rapidly predict prognosis and evaluate disease progression of critical patients in resuscitation room.
Presurgical Nasal Molding With a Nasal Spring in Patients With Mild-to-Moderate Nasal Deformity With Incomplete Unilateral Cleft Lip With or Without Cleft Palate
Authors: Peanchitlertkajorn Supakit 
Published: May 2018

Objective: Traditional nasoalveolar molding (NAM) requires steep learning curve for clinicians and significant compliance from parents. Nasal springs have been developed by the author to simplify presurgical nasal molding. This article presents the design, construction, and application of the spring. The treatment goal is to improve nasal deformity prior to primary repair in infants born with incomplete unilateral cleft lip with or without cleft palate. Method: The design, fabrication, and utility of the nasal spring are described. The spring has a simpler design and construction compared to a traditional NAM appliance. Participants: Two patients with incomplete unilateral cleft lip with and without cleft palate are presented. Interventions: The spring is constructed and delivered. The active arm of the spring can be 3-dimensionally (3-D) adjusted to mold the alar cartilage of the affected nostril. The spring does not require an oral plate for adherence as a traditional NAM appliance does, hence an oral impression is not needed. The spring is easy for clinicians to adjust. It also requires less compliance by parents. Main Outcome Measures/Results: The presurgical molding achieved by the use of a nasal spring improved surgical nasolabial aesthetic outcomes. Conclusion: The nasal springs are effective in reducing the initial cleft nasal deformity. This facilitates primary surgical cleft lip and nose correction and improves surgical outcomes in patients with incomplete unilateral cleft lip with or without cleft palate.
Abnormalities of vascular histology and collagen fiber configuration in patients with advanced chronic kidney disease
Authors: Allon Michael , Litovsky Silvio H , Tey Jason Chieh Sheng , Sundberg Chad A , Zhang Yingying , Chen Zhen , Fang Yun , Cheung Alfred K , Shiu Yan-Ting 
Published: May 2018

Introduction: Several histologic features have been identified in the upper-extremity arteries and veins of patients with advanced chronic kidney disease, which may affect arteriovenous fistula maturation. However, it is unclear whether these chronic kidney disease vascular features are abnormal. Methods: We obtained upper-extremity arterial and venous specimens from 125 advanced chronic kidney disease patients undergoing arteriovenous fistula creation and from 15 control subjects. We quantified medial fibrosis, micro-calcification, and intimal hyperplasia with appropriate histology stains. We characterized medial collagen fiber configuration in second-harmonic-generation microscopy images for the fiber anisotropy index and the dominant fiber direction. Results: The advanced chronic kidney disease patients were significantly younger than control subjects (53 ± 14 years vs 76 ± 11 years, p < 0.001). After controlling for age, the chronic kidney disease patients had greater arterial medial fibrosis (69% ± 14% vs 51% ± 10%, p < 0.001) and greater arterial micro-calcification (3.03% ± 5.17% vs 0.01% ± 0.03%, p = 0.02), but less arterial intimal thickness (30 ± 25 µm vs 63 ± 25 µm, p < 0.001), as compared to control subjects. The anisotropy index of medial collagen fibers was lower in both arteries (0.24 ± 0.10 vs 0.44 ± 0.04, p < 0.001) and veins (0.28 ± 0.09 vs 0.53 ± 0.10, p < 0.001) in chronic kidney disease patients, indicating that orientation of the fibers was more disordered. The dominant direction of medial collagen fibers in chronic kidney disease patients was greater in the arteries (49.3° ± 23.6° vs 4.0° ± 2.0°, p < 0.001) and the veins (30.0° ± 19.6° vs 3.9° ± 2.1°, p < 0.001), indicating that the fibers in general were aligned more perpendicular to the lumen. Conclusion: Advanced chronic kidney disease is associated with several abnormalities in vascular histology and collagen fiber configuration. Future research is needed to investigate whether these abnormalities affect the maturation outcomes of arteriovenous fistulas.