bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring Decision‐Making During Thyroidectomy: Validity Evidence for a Web‐Based Assessment Tool
Authors: Madani Amin , Gornitsky Jordan , Watanabe Yusuke , Benay Cassandre , Altieri Maria S. , Pucher Philip H. , Tabah Roger , Mitmaker Elliot J. 
Published: November 2017

AbstractBackgroundErrors in judgment during thyroidectomy can lead to recurrent laryngeal nerve injury and other complications. Despite the strong link between patient outcomes and intraoperative decision‐making, methods to evaluate these complex skills are lacking. The purpose of this study was to develop objective metrics to evaluate advanced cognitive skills during thyroidectomy and to obtain validity evidence for them.MethodsAn interactive online learning platform was developed (www.thinklikeasurgeon.com). Trainees and surgeons from four institutions completed a 33‐item assessment, developed based on a cognitive task analysis and expert Delphi consensus. Sixteen items required subjects to make annotations on still frames of thyroidectomy videos, and accuracy scores were calculated based on an algorithm derived from experts’ responses (“visual concordance test,” VCT). Seven items were short answer (SA), requiring users to type their answers, and scores were automatically calculated based on their similarity to a pre‐populated repertoire of correct responses. Test–retest reliability, internal consistency, and correlation of scores with self‐reported experience and training level (novice, intermediate, expert) were calculated.ResultsTwenty‐eight subjects (10 endocrine surgeons and otolaryngologists, 18 trainees) participated. There was high test–retest reliability (intraclass correlation coefficient = 0.96; n = 10) and internal consistency (Cronbach’s α = 0.93). The assessment demonstrated significant differences between novices, intermediates, and experts in total score (p < 0.01), VCT score (p < 0.01) and SA score (p < 0.01). There was high correlation between total case number and total score (ρ = 0.95, p < 0.01), between total case number and VCT score (ρ = 0.93, p < 0.01), and between total case number and SA score (ρ = 0.83, p < 0.01).ConclusionThis study describes the development of novel metrics and provides validity evidence for an interactive Web‐based platform to objectively assess decision‐making during thyroidectomy.
A double‐blind, placebo‐controlled trial of triheptanoin in adult polyglucosan body disease and open‐label, long‐term outcome
Authors: Schiffmann Raphael , Wallace Mary E. , Rinaldi Daisy , Ledoux Isabelle , Luton Marie‐Pierre , Coleman Scott , Akman H. Orhan , Martin Karine , Hogrel Jean‐Yves , Blankenship Derek , Turner Jacob , Mochel Fanny 
Published: November 2017

AbstractBackgroundAdult polyglucosan body disease (APBD) is a progressive neurometabolic disorder caused by a deficiency of glycogen branching enzyme. We tested the efficacy of triheptanoin as a therapy for patients with APBD based on the hypothesis that decreased glycogen degradation leads to brain energy deficit.Methods and resultsThis was a two‐site, randomized crossover trial of 23 patients (age 35–73 years; 63% men) who received triheptanoin or vegetable oil as placebo. The trial took place over 1 year and was followed by a 4‐year open‐label phase. Generalized linear mixed models were used to analyze this study. At baseline, using the 6‐min walk test, patients could walk a mean of 389 ± 164 m (range 95–672; n = 19), highlighting the great clinical heterogeneity of our cohort. The overall mean difference between patients on triheptanoin versus placebo was 6 m; 95% confidence interval (CI) −11 to 22; p = 0.50. Motion capture gait analysis, gait quality, and stair climbing showed no consistent direction of change. All secondary endpoints were statistically nonsignificant after false discovery rate adjustment. Triheptanoin was safe and generally well tolerated. During the open‐label phase of the study, the most affected patients at baseline kept deteriorating while mildly disabled patients remained notably stable up to 4 years.ConclusionsWe cannot conclude that triheptanoin was effective in the treatment of APBD over a 6‐month period, but we found it had a good safety profile. This study also emphasizes the difficulty of conducting trials in very rare diseases presenting with a wide clinical heterogeneity. ClinicalTrials.gov Identifier: NCT00947960.
Pregabalin Did Not Improve Pain Management after Spinal Fusions
Authors: Urban Michael K. , Labib Kristy M. , Reid Shane C. , Goon Amanda K. , Rotundo Valeria , Cammisa Frank P. , Girardi Federico P. 
Published: November 2017

Background The treatment of postoperative pain is a challenge after posterior spinal fusions. Pain management using predominantly opioids is often associated with multiple adverse effects, while multimodal postoperative analgesia may provide adequate pain relief with fewer opioid side effects. Questions/Purposes The purpose of this review is to determine whether addition of 150 mg pregabalin daily would reduce narcotic requirements and improve outcomes after posterior lumbar fusion (PLF). Methods The method used is a randomized, controlled trial of elective PLF patients who received pregabalin or placebo. With institutional review board (IRB) approval, 86 patients undergoing elective posterior lumbar fusion, ASA I–III, were randomized to receive either a placebo or pregabalin after obtaining written informed consent. Both arms, i.e., placebo and pregabalin, consisted of 43 patients each. The 86 patients for elective PLF were randomly assigned to receive 150 mg of pregabalin 1 h before surgery and then 150 mg daily, or a placebo tablet. All patients received a similar general anesthetic and in the post-anesthesia care unit (PACU), started on intravenous (IV) patient-controlled analgesia (PCA) of hydromorphone (0.2 mg/ml). Postoperative pain was assessed daily until discharge using a Numerical Rating Scale (NRS) at rest and with physical therapy (PT). Patients were also assessed twice daily for level of sedation and nausea and/or vomiting and expected PT milestones. All narcotics (IV, oral) were documented. Results Demographics and operative time between groups were similar. PCA hydromorphone administration and oral narcotic intake were not statistically different between the two groups. However, an increased incidence of nausea and vomiting in the placebo group reached statistical significance ( p < 0.05). In addition, there was no statistical difference between groups with respect to achieving PT milestones and hospital discharge day. Conclusion After PLF, patients receiving pregabalin 150 mg/day did not have reduced IV narcotic usage, improved PT milestones, or reduced length of hospital stay. We were unable to demonstrate an analgesic advantage to prescribing pregabalin to patients undergoing lumbar spinal fusions.
White matter signal abnormalities in former National Football League players
Authors: Alosco Michael L. , Koerte Inga K. , Tripodis Yorghos , Mariani Megan , Chua Alicia S. , Jarnagin Johnny , Rahimpour Yashar , Puzo Christian , Healy Rose C. , Martin Brett , Chaisson Christine E. , Cantu Robert C. , Au Rhoda , McClean Michael , McKee Ann C. , Lin Alexander P. , Shenton Martha E. , Killiany Ronald J. , Stern Robert A. 
Published: November 2017

AbstractIntroductionLater‐life brain alterations in former tackle football players are poorly understood, particularly regarding their relationship with repetitive head impacts (RHIs) and clinical function. We examined white matter signal abnormalities (WMSAs) and their association with RHIs and clinical function in former National Football League (NFL) players.MethodsEighty‐six clinically symptomatic former NFL players and 23 same‐age reportedly asymptomatic controls without head trauma exposure underwent magnetic resonance imaging and neuropsychological testing. FreeSurfer calculated WMSAs. A cumulative head impact index quantified RHIs.ResultsIn former NFL players, increased volume of WMSAs was associated with higher cumulative head impact index scores (P = .043) and worse psychomotor speed and executive function (P = .015). Although former NFL players had greater WMSA volume than controls (P = .046), these findings are inconclusive due to recruitment of controls based on lack of clinical symptoms and head trauma exposure.DiscussionIn former NFL players, WMSAs may reflect long‐term microvascular and nonmicrovascular pathologies from RHIs that negatively impact cognition.
Can visuospatial measures improve the diagnosis of Alzheimer's disease?
Authors: Salimi Shirin , Irish Muireann , Foxe David , Hodges John R. , Piguet Olivier , Burrell James R. 
Published: November 2017

AbstractIntroductionOverlapping and evolving symptoms lead to ambiguity in the diagnosis of dementia. Visuospatial function relies on parietal lobe function, which may be affected in the early stages of Alzheimer's disease (AD). This review evaluates visuospatial dysfunction in patients with AD, frontotemporal dementia, dementia with Lewy bodies, and vascular dementia to determine the diagnostic and prognostic potential of visuospatial tasks in AD.MethodsA systematic search of studies (1960–2016) investigating visuospatial dysfunction in dementia was conducted.ResultsTests measuring construction, specifically Block Design and Clock Drawing Test, and visual memory, specifically Rey‐Osterrieth Complex Figure recall and topographical tasks, show the greatest diagnostic potential in dementia. The Benton visual retention, Doors and People, and topographical memory tests show potential as prognostic markers.DiscussionTests of visuospatial function demonstrate significant diagnostic and prognostic potential in dementia. Further studies with larger samples of pathologically confirmed cases are required to verify clinical utility.
Retinal thickness correlates with parietal cortical atrophy in early‐onset Alzheimer's disease and controls
Authors: den Haan Jurre , Janssen Sarah F. , van de Kreeke Jacoba A. , Scheltens Philip , Verbraak Frank D. , Bouwman Femke H. 
Published: November 2017

AbstractIntroductionThe retina may reflect Alzheimer's disease (AD) neuropathological changes and is easily visualized with optical coherence tomography (OCT). Retinal thickness decrease has been correlated to AD, however, without information on amyloid status. We correlated retinal (layer) thickness to AD biomarkers in amyloid‐positive early‐onset AD (EOAD) patients and amyloid‐negative controls.MethodsWe measured macular thickness and peripapillary retinal nerve fiber layer thickness with OCT in 15 EOAD patients and 15 controls and correlated retinal thickness to visual rating scores for atrophy on magnetic resonance imaging.ResultsTotal macular thickness correlated to parietal cortical atrophy in both groups (Spearman ρ −0.603, P = .001). Macular and peripapillary retinal nerve fiber layer thicknesses were not significantly decreased in EOAD compared to controls.DiscussionRetinal thickness does not discriminate EOAD from controls but is correlated to parietal cortical atrophy in both groups. These findings may suggest reflection of cerebral cortical changes in the retina, independent of amyloid.
Changes in place of death among people with dementia in Finland between 1998 and 2013: A register study
Authors: Masuchi Yaeko , Jylhä Marja , Raitanen Jani , Aaltonen Mari 
Published: November 2017

AbstractIntroductionThe place of death is suggested as a quality indicator for end‐of‐life care. We investigated how the place of death changed between 1998 and 2013 among people with dementia.MethodsData from the Finnish national health and social care registers were extracted for all people with dementia, who had died at 70 years old during these years (N = 140,034). Descriptive analysis and logistic regression analysis were conducted.ResultsIn 2013, the most common place of death was the primary care hospital (39.8%), followed by nursing home and sheltered housing with 24‐hour assistance (20.5%). Dying at home was rare (8.1%). During the study years, dying in the hospital decreased while dying in sheltered housing with 24‐hour assistance increased.DiscussionThe place of death for people with dementia has changed from institutions to noninstitutional care facilities. Further research on noninstitutional care facilities' ability to provide high‐quality care at the end of life is needed.
An analysis of the risk factors of preeclampsia and prediction based on combined biochemical indexes
Authors: Quan Li‐Mei , Xu Qiu‐Lian , Zhang Gen‐Qin , Wu Lin‐Lin , Xu Heng 
Published: November 2017

AbstractThis study aims to investigate the risk factors and the joint biochemical indicators predictive value for preeclampsia. Related factors and biochemical indicators were investigated in 558 patients with preeclampsia and 435 normal pregnant women. Multiplicity analysis was performed by logistic regression. The predictive value of the biochemical index and joint biochemical indicators for predicting the incidence of pregnant women preeclampsia were analyzed by ROC curve. A progestation BMI of >24 kg/m2 (OR = 5.412, 95% CI: 1.169–9.447), hypertension history (OR = 7.487, 95% CI: 2.541–11.247) and advanced age (>35 years old, OR = 6.321, 95% CI: 3.142–20.342) are risk factors for preeclampsia. Tumor necrosis factor‐α and plasma protein‐A are valuable for preeclampsia prediction. The predictive success of preeclampsia could be improved by clinical risk factors associated with biochemical indicators detection.
The Advent of Lawyers in Japanese Government
Authors: FOOTE Daniel H. 
Published: November 2017

AbstractUntil 2003, Japanese lawyers were prohibited by law from entering full-time employment in governmental bodies. That year, in line with recommendations by the Justice System Reform Council, the Lawyers Act was amended to permit lawyers to undertake such employment. Incorporating information and insights from interviews with former government lawyers and other concerned parties, this article examines the rise in the hiring of government lawyers and its impact. The article considers factors that have contributed to the increase, examines the roles played by these lawyers, considers prospects for the future, and discusses implications for government, the legal profession, clients, and legal education and training. The article also seeks to identify a range of issues raised by these developments that warrant further in-depth research.
Brexit and Agriculture: Implementing a New Legal Framework for Agricultural Support
Authors: CARDWELL Michael 
Published: November 2017

AbstractBrexit has the capacity to impact heavily on the agricultural sector across the United Kingdom in that it is a sector which has been both in receipt of substantial expenditure under the Common Agricultural Policy and subject to a pattern of close regulation at European Union level. This article will explore the legal implications for post-Brexit agricultural support, proceeding in three stages. First, there will be an outline of the current structure of the industry, with particular reference to its diversity in terms of physical landscape, operational scale and legal foundations. Secondly, there will be discussion of emerging policy within both central UK government and the devolved administrations. In this context, specific attention will be directed to the likely extent of funding and the proposed drive towards higher standards in environmental protection and animal welfare. And, in each case, account will also be taken of specific implications which flow from overarching World Trade Organization rules. Thirdly, there will be consideration of the potentially difficult issues which arise as a result of agriculture being a devolved matter, different policy imperatives already becoming evident across the constituent parts of the UK. For the present, the prospect is that a bespoke support regime will survive Brexit and, in this sense, agricultural ‘exceptionalism’ will continue. However, the more precise form of such a regime remains as yet work-in-progress and its realisation will present considerable challenges not only in political terms, but also by reason of the complex legal geometry in which World Trade Organization rules and the constitutional rights of the devolved administrations are weighty factors.
Pituitary Adenoma Associated With Rathke’s Cleft Cyst: Report of 15 Cases
Authors: Wu Wenhao , Jia Guijun , Jia Wang , Li Guilin , Zhang Junting , Zhang Liwei 
Published: November 2017

AbstractObjective:The concomitant presence of pituitary adenoma (PA) with Rathke’s cleft cyst (RCC) is rare, and most of the literature published is case reports. RCC’s clinicopathological features have not been well described.Methods:We retrospectively reviewed the data of 15 patients with PA associated with RCC. We also provide a systematic review of the literature.Results:The patients included males and seven females. The transsphenoidal approach was adopted for all patients except one, who underwent right frontal craniotomy. Complete resection was achieved in nine cases, with grossly complete resection in five and partial removal in one. Of the PA subtypes available, five patients had nonfunctional pituitary adenomas, three had multiple-hormone secreting PAs, three had prolactin-producing adenomas, and one had a growth hormone-secreting adenoma. All of the patients’ symptoms and abnormal endocrine test results resolved or were relieved after surgery. The mean follow-up time was 27.6±16.6 months. All of the patients recovered well and had no signs of recurrence during their follow-up, except for one patient.Conclusions:A cyst-like signal indicated on images or cystic materials encountered during operation in a patient with PA suggest the possibility of PA associated with RCC. Transsphenoidal surgery is the preferred approach and can resolve or relieve patients’ symptoms to a great extent. Histologically, nonfunctional PA and prolactinoma are the most common types of PA coexisting with RCC; the mechanisms of PA associated with RCC need to be investigated further.
Changing prescribing patterns in an Irish community mental health service
Authors: Rowntree R. , McCarthy N. , Feeney L. 
Published: November 2017

ObjectivesMedication is an important component of the treatment of many mental illnesses. Very little information is available about the particular medications that are being prescribed by community mental health services and how this has changed over time. We set out to obtain details of psychiatric medications being prescribed by one Irish community mental health service.MethodAll prescribing by the Cluain Mhuire Community Mental Health Service became electronic during 2004. Using Business Intelligence software, we obtained details of all psychiatric medications prescribed from 2005 to 2016. We compared numbers of prescriptions written in the first 6 years (2005–2010) with the following 6 (2011–2016).ResultsOlanzapine was the most commonly prescribed medication throughout but its use declined by one-quarter over the study period. Clozapine, quetiapine, aripiprazole and haloperidol prescribing increased. Prescriptions for mood stabilisers and antidepressants fell by 25%. Sedative prescriptions declined by almost 50%. Absolute numbers of prescriptions written for methylphenidate and pregabalin were small but increased dramatically over the time period.ConclusionsThis community mental health service prescribed less of most psychiatric medications in 2016, than had been the case in 2005. This is despite an increase in the numbers of patients seen over the same period. It is not clear if this pattern is echoed in other services.
The grammar of engagement I: framework and initial exemplification
Authors: EVANS NICHOLAS , BERGQVIST HENRIK , SAN ROQUE LILA 
Published: November 2017

abstractHuman language offers rich ways to track, compare, and engage the attentional and epistemic states of interlocutors. While this task is central to everyday communication, our knowledge of the cross-linguistic grammatical means that target such intersubjective coordination has remained basic. In two serialised papers, we introduce the term ‘engagement’ to refer to grammaticalised means for encoding the relative mental directedness of speaker and addressee towards an entity or state of affairs, and describe examples of engagement systems from around the world. Engagement systems express the speaker’s assumptions about the degree to which their attention or knowledge is shared (or not shared) by the addressee. Engagement categories can operate at the level of entities in the here-and-now (deixis), in the unfolding discourse (definiteness vs indefiniteness), entire event-depicting propositions (through markers with clausal scope), and even metapropositions (potentially scoping over evidential values). In this first paper, we introduce engagement and situate it with respect to existing work on intersubjectivity in language. We then explore the key role of deixis in coordinating attention and expressing engagement, moving through increasingly intercognitive deictic systems from those that focus on the the location of the speaker, to those that encode the attentional state of the addressee.
The Diversity of Assembly Histories Leading to Disc Galaxy Formation in a ΛCDM Model
Authors: Font Andreea S. , McCarthy Ian G. , Le Brun Amandine M. C. , Crain Robert A. , Kelvin Lee S. 
Published: November 2017

AbstractDisc galaxies forming in a LambdaCDM cosmology often experience violent mergers. The fact that disc galaxies are ubiquitous suggests that quiescent histories are not necessary. Modern cosmological simulations can now obtain realistic populations of disc galaxies, but it is still unclear how discs manage to survive massive mergers. Here we use a suite of hydrodynamical cosmological simulations to elucidate the fate of discs encountering massive mergers. We follow the changes in the post-merger disc-to-total ratios (D/T) of simulated galaxies and examine the relations between their present-day morphology, assembly history and gas fractions. We find that approximately half of present-day disc galaxies underwent at least one merger with a satellite more massive the host's stellar component and a third had mergers with satellites three times as massive. These mergers lead to a sharp, but often temporary, decrease in the D/T of the hosts, implying that discs are usually disrupted but then quickly re-grow. To do so, high cold gas fractions are required post-merger, as well as a relatively quiescent recent history (over a few Gyrs before z = 0). Our results show that discs can form via diverse merger pathways and that quiescent histories are not the dominant mode of disc formation.