bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Spirit Moves: Mobility and Saintliness in the Old French
Vie de Saint Alexis
Authors: Brown Katherine A 
Published: October 2017

Abstract

In the oldest versions of the Old French
Vie de Saint Alexis
, the saint’s renunciation of the profane takes the form of movement. Alexis’s flight from Rome and his return after seventeen years are the defining moments of this version of the Life in Old French, yet scholars have tended to focus on place as it reveals the holy identity of Alexis. This article contends that movement, defined as the absence of fixed place, indicates holiness throughout the text and that Alexis’s flight and return are the true markers of his progression towards perfection. Ultimately, this article posits that Alexis’s holiness in the oldest redactions is always an absence for the audience and movement is one metaphor by which this absence is expressed in the text. Similarly, the narrative movement in the text and the transmission of the tradition of the Life both undermine the centrality of place and reinforce the relationship between movement and holy revelation. In contrast to later, more popular redactions, the oldest witnesses of the Life in Old French present a more universalizing view of the saint and ultimately contribute to the formation of the hagiographic paradigm.
Newton–Okounkov Bodies over Discrete Valuation Rings and Linear Systems on Graphs
Authors: Katz Eric , Urbinati Stefano 
Published: October 2017

AbstractThe theory of Newton–Okounkov bodies attaches a convex body to a line bundle on a variety equipped with a flag of subvarieties. This convex body encodes the asymptotic properties of sections of powers of the line bundle. In this article, we study Newton–Okounkov bodies for schemes defined over discrete valuation rings. We give the basic properties and then focus on the case of toric schemes and semistable curves. We provide a description of the Newton–Okounkov bodies for semistable curves in terms of the Baker–Norine theory of linear systems on graphs, finding a connection with tropical geometry. We do this by introducing an intermediate object, the Newton–Okounkov linear system of a divisor on a curve. We prove that it is equal to the set of effective elements of the real Baker–Norine linear system of the specialization of that divisor on the dual graph of the curve. As a bonus, we obtain an asymptotic algebraic geometric description of the Baker–Norine linear system.
Evaluation of a prognostic scoring system based on the systemic inflammatory and nutritional status of patients with locally advanced non-small-cell lung cancer treated with chemoradiotherapy
Authors: Mitsuyoshi Takamasa , Matsuo Yukinori , Itou Hitoshi , Shintani Takashi , Iizuka Yusuke , Kim Young Hak , Mizowaki Takashi 
Published: October 2017

Abstract
Systemic inflammation and poor nutritional status have a negative effect on the outcomes of cancer. Here, we analyzed the effects of the pretreatment inflammatory and nutritional status on clinical outcomes of locally advanced non-small-cell lung cancer (NSCLC) patients treated with chemoradiotherapy. We retrospectively reviewed 89 patients with locally advanced NSCLC treated with chemoradiotherapy between July 2006 and June 2013. Serum C-reactive protein (CRP) was assessed as an inflammatory marker, and serum albumin, body mass index (BMI) and skeletal mass index were assessed as nutritional status markers. The relationships between these markers and overall survival (OS) were assessed. The median OS was 24.6 months [95% confidence interval (CI): 19.4–39.3 months]. During follow-up, 58 patients (65%) had disease recurrence and 52 patients (58%) died. In multivariate Cox hazard analysis, CRP levels and BMI approached but did not achieve a significant association with OS (P = 0.062 and 0.094, respectively). Recursive partitioning analysis identified three prognostic groups based on hazard similarity (CRP-BMI scores): 0 = CRP &lt; 0.3 mg/dl, 1 = CRP ≥ 0.3 mg/dl and BMI ≥ 18.5 kg/m2, and 2 = CRP ≥ 0.3 mg/dl and BMI &lt; 18.5 kg/m2. The CRP-BMI score was significantly associated with OS (P = 0.023). Patients with scores of 0, 1 and 2 had median OS of 39.3, 24.5 and 14.5 months, respectively, and the scores also predicted the probability of receiving salvage treatment after recurrence. The CRP-BMI score is thus a simple and useful prognostic marker of clinical outcome for patients with locally advanced NSCLC treated with chemoradiotherapy.
The impact of the Hall effect during cloud core collapse: Implications for circumstellar disk evolution
Authors: Tsukamoto Yusuke , Okuzumi Satoshi , Iwasaki Kazunari , Machida Masahiro N. , Inutsuka Shu-ichiro 
Published: October 2017

Abstract
We perform three-dimensional radiation non-ideal magnetohydrodynamics simulations and investigate the impact of the Hall effect on the angular momentum evolution in collapsing cloud cores in which the magnetic field B and angular momentum Jang are misaligned with each other. We find that the Hall effect noticeably changes the magnetic torques in the pseudo-disk, and strengthens and weakens the magnetic braking in cores with acute and obtuse relative angles between B and Jang, respectively. This suggests that the bimodal evolution of the disk size may occur in the early disk evolutionary phase even if B and Jang are randomly distributed. We show that a counter-rotating envelope forms in the upper envelope of the pseudo-disk in cloud cores with obtuse relative angles. We also find that a counter-rotating region forms at the midplane of the pseudo-disk in cloud cores with acute relative angles. The former and latter types of counter-rotating envelopes may be associated with young stellar objects with large (r ∼ 100 au) and small (r ≲ 10 au) disks, respectively.
Analgesia Nociception Index Monitoring During Supratentorial Craniotomy
Authors: Kommula Lakshman K. , Bansal Sonia , Umamaheswara Rao Ganne S. 
Published: October 2017

Background:
Objective monitoring of pain during and after surgery has been elusive. Recently, Analgesia Nociception Index (ANI) monitor based on the high frequency component of heart rate variability has been launched into clinical practice. We monitored analgesia during craniotomy using ANI monitor and compared it with cardiovascular parameters and response entropy (RE) of entropy monitor.

Materials and Methods:
In 21 patients undergoing a craniotomy for a supratentorial lesion, we monitored ANI, heart rate (HR), mean arterial pressure (MAP), state entropy, and RE throughout the surgery. Also, ANI, hemodynamic variables and spectral entropy values were noted at the times of maximal stimulation, such as induction, intubation, head pin fixation, skin incision, craniotomy, durotomy, and skin closure. We also compared ANI with RE during administration of bolus doses of fentanyl.

Results:
There was an inverse correlation between ANI values and the hemodynamic changes. When the HR and MAP increased, ANI decreased suggesting a good correlation between hemodynamics and ANI values during the times of maximal stimulation. State entropy and RE did not change significantly in response to bolus doses of fentanyl administered during the course of surgery, while ANI increased significantly.

Conclusion:
In neurosurgical patients undergoing elective supratentorial craniotomy, ANI measures response to noxious stimuli with at least as much reliability as hemodynamic variables and changes in ANI parallel the changes in HR and MAP. ANI is superior to RE for measurement of response to noxious stimuli.
Transition to College and Adherence to Prescribed Attention Deficit Hyperactivity Disorder Medication
Authors: Gray Wendy N. , Kavookjian Jan , Shapiro Steven K. , Wagoner Scott T. , Schaefer Megan R. , Resmini Rawlinson Alana , Hinnant James B. 
Published: October 2017

ABSTRACT:

Objective:
As youth with attention deficit hyperactivity disorder (ADHD) transition to adulthood, they must learn how to manage their ADHD treatment independently. This may be challenging because many of the skills necessary to adhere to treatment (e.g., organization, planning) are impaired in those with ADHD. Using electronic monitoring, we examine trajectories of adherence to medication in a cohort of college students with ADHD. Further, we examine the effect of transitioning to college and executive functioning on adherence.

Methods:
Electronic monitors tracked adherence for 51 undergraduate students with ADHD across an academic semester. Multilevel modeling examined individual trajectories in monthly adherence and the role of transition status and self-reported executive functioning on these trajectories.

Results:
Overall, participants adhered to 53.53% of prescribed doses. Transition status predicted the linear slope in adherence (β = −8.95, standard error [SE] = 3.61, p < .05), with lower initial adherence among undergraduates transitioning to independence (34.17%) compared with post-transition undergraduates (67.63%; β = 33.46, SE = 8.00, p < .001). Adherence demonstrated a curvilinear change (β = −7.23, SE = 1.25, p < .001). It increased from the beginning of the semester to midterms before subsequently declining through the rest of the semester, including during final exams. Executive functioning did not predict adherence (β = −.10, SE = .02, p = .54).

Conclusion:
Only half of all doses were taken as prescribed. Adolescents transitioning to independence demonstrated the lowest levels of adherence, suggesting that the transition to independence is a high-risk period for poor self-management of ADHD.
Prediction of N0 Irradiated Rectal Cancer Comparing MRI Before and After Preoperative Chemoradiotherapy
Authors: Pomerri Fabio , Crimì Filippo , Veronese Nicola , Perin Alessandro , Lacognata Carmelo , Bergamo Francesca , Boso Caterina , Maretto Isacco 
Published: October 2017

BACKGROUND:
The prediction of lymph node status using MRI has an impact on the management of rectal cancer, both before and after preoperative chemoradiotherapy.

OBJECTIVE:
The purpose of this study was to maximize the negative predictive value and sensitivity of mesorectal lymph node imaging after chemoradiotherapy because postchemoradiation node-negative patients may be treated with rectum-sparing approaches.

DESIGN:
This was a retrospective study.

SETTINGS:
The study was conducted at a tertiary care hospital.

PATIENTS:
Sixty-four patients with locally advanced rectal cancer who underwent preoperative chemoradiotherapy and MRI for staging and the assessment of response were evaluated.

MAIN OUTCOME MEASURES:
The sums of the sizes of all mesorectal lymph nodes in each patient on both prechemoradiotherapy and postchemoradiotherapy imaging data sets were calculated to determine the lymph node global size reduction rates, taking these to be the outcomes of the histopathologic findings. Other included measures were interobserver agreement regarding the prediction of node status based on morphologic criteria and the diagnostic performance of contrast-enhanced images.

RESULTS:
Using a cutoff value of a 70% lymph node global size reduction rate with only 15 node-positive patients on histopathology, the sensitivity in the prediction of nodal status and negative predictive value were 93% (95% CI, 70.2%–98.8%) and 97% (95% CI, 82.9%–99.8%) for observer 1 and 100% (95% CI, 79.6%–100%) and 100% (95% CI, 62.9%–100%) for observer 2. The areas under the receiver operating characteristic curves for the 2 observers were 0.90 (95% CI, 0.82–0.98; p < 0.0001) for observer 1 and 0.65 (95% CI, 0.50–0.79; p = 0.08) for observer 2. The efficacy of the morphologic criteria and contrast-enhanced images in predicting node status was limited after chemoradiotherapy.

LIMITATIONS:
This study is limited by its small sample size and retrospective nature.

CONCLUSIONS:
Assessing the lymph node global size reduction rate value reduces the risk of undetected nodal metastases and may be helpful in better identifying suitable candidates for the local excision of early stage rectal cancer. See Video Abstract at http://links.lww.com/DCR/A412.
A Distal Resection Margin of ≤1 mm and Rectal Cancer Recurrence After Sphincter-Preserving Surgery: The Role of a Positive Distal Margin in Rectal Cancer Surgery
Authors: Zeng Wei-gen , Liu Meng-jia , Zhou Zhi-xiang , Wang Zhen-jun 
Published: October 2017

BACKGROUND:
There is little information about the prognostic value of a microscopically positive distal margin in patients who have rectal cancer.

OBJECTIVE:
We aimed to investigate the influence of a distal margin of ≤1 mm on oncologic outcomes after sphincter-preserving resection for rectal cancer.

DESIGN:
This is a retrospective cohort study.

SETTINGS:
The study was conducted at 2 hospitals.

PATIENTS:
A total of 6574 patients underwent anterior resection for rectal cancer from January 1999 to December 2014; 97 (1.5%) patients with a distal margin of ≤1 mm were included in this study. For comparative analyses, patients were matched with 194 patients with a negative distal margin (>1 mm) according to sex, age, BMI, ASA score, neoadjuvant treatment, tumor location, and stage.

MAIN OUTCOME MEASURES:
The oncologic outcomes of the 2 groups were compared.

RESULTS:
Perineural and lymphovascular invasion rates were significantly higher in patients with a positive distal margin (54.6% vs 28.9%; 67.0% vs 42.8%; both p < 0.001) compared with to patients with negative distal margin. Comparison between microscopically positive and negative distal margin showed worse oncologic outcomes in patients with a microscopically positive distal margin, including 5-year local recurrence rate (24.1% vs 12.0%, p = 0.005); 5-year distant recurrence rate (35.5% vs 20.2%, p = 0.011); 5-year disease-free survival (45.5% vs 69.5%, p < 0.001); and 5-year OS (69.2% vs 79.7%, p = 0.004). Among the 97 patients with a microscopically positive distal margin, the 5-year disease-free survival rate was higher in patients who received adjuvant therapy (52.0% vs 30.7%, p = 0.089).

LIMITATIONS:
This is a retrospective study; bias may exist.

CONCLUSIONS:
A distal margin of 1 mm is associated with worse oncologic results. Our data indicate the importance of achieving a clear distal margin in the surgical treatment of rectal cancer. Adjuvant therapy should be used in these patients to reduce recurrence. See Video Abstract at http://links.lww.com/DCR/A408.
Ultrafast Track Robotic-Assisted Minimally Invasive Coronary Artery Surgical Revascularization
Authors: Tarola Christopher L. , Al-Amodi Hussein A. , Balasubramanian Sankar , Fox Stephanie A. , Harle Christopher C. , Iglesias Ivan , Sridhar Kumar , Teefy Patrick J. , Chu Michael W.A. , Kiaii Bob B. 
Published: October 2017

Objective Contemporary anesthetic techniques have enabled shorter sedation and early extubation in off-pump and minimally invasive coronary artery bypass (CABG) surgery. Robotic-assisted CABG represents the optimal surgical approach for ultrafast track anesthesia, with patients able to bypass the cardiac surgical intensive care unit with recovery in the postanesthesia care unit (PACU) and inpatient ward. Methods In-hospital postoperative outcomes from ninety patients who underwent either elective or urgent robotically-assisted CABG at our institution were reviewed. These patients were carefully selected by a multidisciplinary team to undergo fast-track anesthesia: extubation in the operating room, 4-hour recovery in the postanesthesia care unit and transfer to the inpatient ward. Intrathecal, paravertebral local, and patient-controlled anesthesia techniques were used to facilitate transition to oral analgesics. Results Average patient age was 61 ± 9 years. Sixty-six patients (73%) were male. Seventy cases were elective, and 20 patients required urgent revascularization. All patients underwent intraoperative angiography after graft construction, which revealed Fitzgibbon class A grafts. There were no in-hospital mortalities. One patient required re-exploration for bleeding, through the same minimally invasive incision, did not require conversion to sternotomy for bleeding, and was transferred to the intensive care unit postexploration for bleeding for standard postoperative care. Postoperative complications were limited to one superficial wound infection. The mean hospital length of stay was 3.5 ± 1.17 days. Conclusions In patients undergoing robotic-assisted CABG, ultrafasttrack cardiac surgery with immediate postprocedure extubation and transfer to the inpatient ward has been demonstrated to be safe with no increase in perioperative morbidity or mortality. It requires a dedicated heart team with a carefully selected group of patients. Avoiding cardiac surgical intensive care unit expedites recovery, with possible avoidance of infection and early discharge from hospital.
Minimally Invasive Mitral Valve Annuloplasty with Realignment of Both Papillary Muscles for Correction of Type IIIb Functional Mitral Regurgitation
Authors: Girdauskas Evaldas , Conradi Lenard , Karolina Harmel Eva , Reichenspurner Hermann 
Published: October 2017

Objective Pathophysiological background of type IIIb functional mitral regurgitation (FMR) is a progressively increasing distance between papillary muscle tips and mitral annular plane. Standard surgical treatment of such FMR by means of undersized mitral annuloplasty is associated with a high recurrence rate. Methods We propose a modified subannular maneuver to correct type IIIb FMR while combining undersized annuloplasty with a controlled realignment of both papillary muscles, thereby fixing the distance between mitral annular plane and papillary muscle tips. The differences of this subannular maneuver as compared with the previously published techniques are the following: (1) controlled realignment of both papillary muscles, (2) fixation of the papillary muscles to mitral annulus distance on an annuloplasty ring, and (3) application in a three-dimensional endoscopic minithoracotomy setting. Results We describe a surgical technique of minimally invasive mitral valve repair performed due to severe type IIIb FMR, which includes a modified subannular maneuver to realign both papillary muscles. Preliminary results of the first 10 patients who underwent this procedure at our institution are presented. There was no in-hospital mortality and follow-up echocardiography (mean ± SD echocardiographic follow-up = 10 ± 6 months) demonstrated stable functional results. Conclusions Our initial experience indicates that adding of this subannular maneuver to the standard annuloplasty and thereby fixing the distance between papillary muscles and mitral annular plane have a potential to improve results of surgical FMR treatment.
Nocardia nova Tenosynovitis and Abscess After a Remote Gunshot Wound
Authors: Linder Kathleen A. , Herc Erica S. , Kauffman Carol A. 
Published: October 2017

Abstract

Nocardia nova is a less commonly isolated Nocardia species that was formerly classified as belonging to the Nocardia asteroides complex. This organism is a rare cause of primary cutaneous nocardiosis. We report a case of N. nova flexor tenosynovitis and abscess involving the right forearm after a remote inoculation injury.
Pneumocystis Pneumonia and Acute Pulmonary Embolism in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome
Authors: Olanipekun Titilope , Effoe Valery S. , Medhane Kimberly A. , Fransua Mesfin 
Published: October 2017

Abstract
Severe immunosuppression and the presence of opportunistic infections in human immunodeficiency virus/acquired immunodeficiency syndrome are strongly associated with incidence of venous thromboembolism especially deep venous thrombosis and pulmonary embolism (PE). The co-occurrence of 2 diseases with similar clinical presentation can pose diagnostic and treatment challenges. We describe the case of a 54-year-old male, with no significant past medical history who presented with complaints of a 6-week history of shortness of breath. He was diagnosed with human immunodeficiency virus 1 infection with a CD4 count of 121 cells/μL and severe Pneumocystis jirovecii pneumonia. After 5 days of treatment without significant improvement, we obtained a computed tomography pulmonary angiogram, which showed concurrent acute PE. His clinical condition improved with anticoagulation therapy. Clinicians need to have a high index of suspicion and consider PE in the differential diagnosis of dyspnea and hypoxemia, particularly when P. jirovecii pneumonia infection or other acquired immunodeficiency syndrome defining illnesses are suspected.
Enhancing Care of Aged and Dying Prisoners: Is e-Learning a Feasible Approach?
Authors: Loeb Susan J. , Penrod Janice , Myers Valerie H. , Baney Brenda L. , Strickfaden Sophia M. , Kitt-Lewis Erin , Wion Rachel K. 
Published: October 2017

ABSTRACT

Background
Prisons and jails are facing sharply increased demands in caring for aged and dying inmates. Our Toolkit for Enhancing End-of-life Care in Prisons effectively addressed end-of-life (EOL) care; however, geriatric content was limited, and the product was not formatted for broad dissemination. Prior research adapted best practices in EOL care and aging; but, delivery methods lacked emerging technology-focused learning and interactivity.

Purposes
Our purposes were to uncover current training approaches and preferences and to ascertain the technological capacity of correctional settings to deliver computer-based and other e-learning training.

Methods
An environmental scan was conducted with 11 participants from U.S. prisons and jails to ensure proper fit, in terms of content and technology capacity, between an envisioned computer-based training product and correctional settings.

Results
Environmental scan findings focused on content of training, desirable qualities of training, prominence of “homegrown” products, and feasibility of commercial e-learning.

Conclusions/Implications
This study identified qualities of training programs to adopt and pitfalls to avoid and revealed technology-related issues to be mindful of when designing computer-based training for correctional settings, and participants spontaneously expressed an interest in geriatrics and EOL training using this learning modality as long as training allowed for tailoring of materials.
STRC Deletion is a Frequent Cause of Slight to Moderate Congenital Hearing Impairment in the Czech Republic
Authors: Plevova Pavlina , Paprskarova Martina , Tvrda Petra , Turska Petra , Slavkovsky Rastislav , Mrazkova Eva 
Published: October 2017

Objective:
This study aimed to clarify the molecular epidemiology of hearing loss by identifying the responsible genes in patients without GJB2 mutations.

Study Design:
Prospective genetic study.

Setting:
Tertiary referral hospital.

Patients:
Fifty one patients with bilateral sensorineural hearing loss, 20 men, and 31 women, mean age 24.9 years, range 3 to 64 years, from 49 families. GJB2 and deltaGJB6-D13S1830 mutations were excluded previously.

Intervention:
Diagnostic. Sixty-nine genes reported to be causative of hearing loss were analyzed. Sequence capture technology, next-generation sequencing, and multiplex ligation-dependent probe amplification (MLPA) were used. Coverage of STRC was screened in Integrative Genomics Viewer software.

Main Outcome Measure:
Identification of causal pathogenic mutations in genes related to deafness.

Results:
Five families (10%) had recessive STRC deletions or mutations. Five unrelated patients (10%) had recessive mutations in TMPRSS3, USH2A, PCDH15, LOXHD1, and MYO15A. Three families (6%) had autosomal dominant mutations in MYO6A, KCNQ4, and SIX1. One family (2%) had an X-linked POU3F4 mutation. Thus, we identified the cause of hearing loss in 28% of the families studied.

Conclusions:
Following GJB2, STRC was the second most frequently mutated gene in patients from the Czech Republic with hearing loss. To decrease the cost of testing, we recommend STRC deletion screening with MLPA before next-generation sequencing. The existence of a pseudogene and polymorphic STRC regions can lead to false-positive or false-negative results when copy number variation analysis is based on next-generation sequencing data.