bluuebunny/crossref_metadata_2025_split huggingface dataset:
Web-Based Tool to Facilitate Shared Decision Making With Regard to Neoadjuvant Chemotherapy Use in Muscle-Invasive Bladder Cancer
Authors: Galsky Matthew D. , Diefenbach Michael , Mohamed Nihal , Baker Charles , Pokhriya Sumit , Rogers Jason , Atreja Ashish , Hu Liangyuan , Tsao Che-Kai , Sfakianos John , Mehrazin Reza , Waingankar Nikhil , Oh William K. , Mazumdar Madhu , Ferket Bart S. 
Published: December 2017

Purpose Level 1 evidence supports the use of neoadjuvant chemotherapy (NAC) for the treatment of muscle-invasive bladder cancer (MIBC), but observational data demonstrate that this approach is underused. A barrier to shared decision making is difficulty in predicting and communicating survival estimates after cystectomy with or without NAC. Methods We included patients with MIBC from the National Cancer Database treated with cystectomy. A state-transition model was constructed for calculating 5-year death risk using baseline patient-, tumor-, and facility-level variables. Internal-external cross-validation by geographic region was performed. The effect of NAC was integrated using a literature-derived hazard ratio. Bladder cancer–specific and other-cause mortality was estimated from all-cause mortality rates from US life tables. From the state-transition model, a Web-based tool was developed and pilot usability testing performed. Results A total of 9,824 patients with MIBC who underwent cystectomy were eligible for inclusion. Median overall survival was 39.6 months (95% CI, 37.4 to 42.4 months). Increasing age, higher clinical T stage, higher comorbidity index, and black race were associated with shorter survival. Private insurance, higher income, and cystectomy at a high-volume facility were associated with longer survival. The prediction model was well calibrated across geographic regions, with observed-to-predicted 5-year death risks ranging from 0.85 to 1.17. Absolute risk reductions with NAC varied from 8.6% to 10.1%. The Web-based tool allowed input of the predictor variables and a user-defined hazard ratio associated with the effect of NAC to generate individualized survival estimates. The tool demonstrated good usability with clinicians. Conclusion A Web-based tool was developed to individualize outcome prediction and communication in patients with MIBC treated with cystectomy with or without NAC to facilitate shared decision making.
Effect of Age on Response to Therapy and Mortality in Patients With Thyroid Cancer at High Risk of Recurrence
Authors: Shah Sona , Boucai Laura 
Published: December 2017

Abstract

Context
Age at diagnosis has been identified as a major determinant of thyroid cancer–specific survival, with older patients being at higher risk for mortality, but the association of age with risk of recurrence has not been studied to date.

Objective
To examine the effect of a patient’s age on response to therapy and disease-specific mortality in a cohort of thyroid cancer patients at high risk of recurrence, as defined by the American Thyroid Association (ATA) risk stratification system.

Design
Retrospective cohort study of 320 patients, median age 49.3 years, with follicular cell-derived thyroid carcinoma classified at ATA high risk and followed for a median of 7 years.

Main Outcome Measures
Association of age with response to therapy, overall mortality, disease-specific mortality, and timing of metastases.

Results
Age was a major determinant of response to therapy. There was a significantly larger percentage of excellent responders among young patients (age &lt;55) than among old patients (age ≥55), 40.3% vs 27.5%, P = 0.002, respectively, whereas the proportion of structural incomplete responders was higher in the old group compared with the young group, 53% vs 33%, P = 0.002, respectively. ATA high-risk young patients with a structural incomplete response to therapy had a significantly better disease-specific survival than old patients (74% vs 12%, P &lt; 0.001, respectively).

Conclusions
Age was a key predictor of response to therapy and disease-specific survival in ATA high-risk thyroid cancer patients. Its incorporation as a variable in the ATA risk stratification system would improve its power to predict response to therapy as well as mortality.
Quality of life assessment and use of patient-reported outcomes in practice
Authors: Sommer R. , Augustin M. , Blome C. 
Published: December 2017

SummaryBackground: Patient-reported outcomes (PROs) are essential components of wound and vascular diagnostics and management. Aim: To provide an overview of PROs as diagnostic tools in the management of chronic wounds.Methods: Review of different concepts on inclusion of PROs in wound practice from literature.Results: PROs are indispensable sources of information for the understanding of the biopsycho- social context of wound diseases. Essential dimensions to be recorded are pain, health-related quality of life and patient benefit. Psychological parameters, adherence, treatment goals and treatment benefits are often needed. Further fields of interest include cumulative life course impairment, coping with disease, stigmatisation specifically applied according to clinical questions.Conclusion: Patient-reported outcomes are mandatory for the diagnostic work-up of chronic wounds. They also provide essential information in the course of a disease, can be diagnostic clues for non-adherence and treatment failures. Measurement of many PRO parameters in wound disease, such as health-related quality of life and pain, is facilitated by validated instruments, which are recommended for practice.
Purpura pigmentosa progressiva
Authors: Mitschang C. , Görge T. 
Published: December 2017

ZusammenfassungDie Purpura pigmentosa progressiva (PPP) ist eine benigne, häufig chronisch rezidivierende Dermatose, die sich vor allem symmetrisch an den unteren Extremitäten, in ausgeprägten Fällen auch am Rumpf und den oberen Extremitäten, manifestiert. Auch einmalige Krankheitsverläufe sind beschrieben. Klinisch äußert sich die Purpura pigmentosa progressiva in der Akutphase in Form von meist asymptomatischen petechialen Einblutungen, in ihrem Verlauf mit bräunlich-orangenen Maculae. In einigen Fällen wird von einem geringen Juckreiz berichtet. Meist führt der ästhetische Aspekt zum Arztbesuch. Es werden in der Literatur verschiedene Ursachen diskutiert, der genaue Pathomechanismus ist jedoch unklar. Eine zugrundeliegende Systemerkrankung liegt nicht vor. Histologisch zeigen sich Erythrozytenextravasate, perivaskuläre Lymphozyteninfiltrate und Hämosiderinablagerungen ohne Zeichen einer Vaskulitis. Differenzialdiagnostisch kommen vor allem eine leukozytoklastische Vaskulitis oder Gerinnungsstörungen in Betracht. Therapeutisch empfiehlt sich die Gabe von Vitamin C in Kombination mit Rutosid.
Detecting Markov Chain Instability: A Monte Carlo Approach
Authors: Mandjes M. , Patch B. , Walton N. S. 
Published: December 2017

We devise a Monte Carlo based method for detecting whether a non-negative Markov chain is stable for a given set of parameter values. More precisely, for a given subset of the parameter space, we develop an algorithm that is capable of deciding whether the set has a subset of positive Lebesgue measure for which the Markov chain is unstable. The approach is based on a variant of simulated annealing, and consequently only mild assumptions are needed to obtain performance guarantees. The theoretical underpinnings of our algorithm are based on a result stating that the stability of a set of parameters can be phrased in terms of the stability of a single Markov chain that searches the set for unstable parameters. Our framework leads to a procedure that is capable of performing statistically rigorous tests for instability, which has been extensively tested using several examples of standard and non-standard queueing networks.
Large Composite Neighborhoods for the Capacitated Location-Routing Problem
Authors: Schneider Michael , Löffler Maximilian 
Published: December 2017

The capacitated LRP (CLRP) jointly takes decisions on the location of capacitated depots and the routing of capacitated vehicles to serve a set of customers with known demands from the opened depots. In city logistics, the CLRP is used for the planning of single-echelon distribution networks. In this application context, large-scale CLRP instances with a high number of potential depot locations (representing concrete candidates for running urban depots) and a high number of customers (as a result of densely populated urban areas) are particularly relevant. We introduce a tree-based search algorithm (TBSA) that explores the space of depot configurations in a tree-like fashion using a customized first improvement strategy. In the routing phase, the multi-depot vehicle-routing problem defined by the depot configuration is solved with a granular tabu search that uses a large composite neighborhood described by 14 operators.In numerical studies, we find that using the large composite neighborhood has a positive impact on the effectivity, efficiency, and robustness of TBSA. We show that the trade-off between run time and solution quality of TBSA can be controlled by the number of total iterations and the strength of the sparsification in the granular search, and we investigate a fast, a basic, and a quality-oriented variant of TBSA. On the commonly used small-to-medium–sized CLRP benchmark sets from the literature, the fast version is able to dominate all previously published heuristic solution methods, that is, it achieves better solution quality within shorter run times. The basic and quality-oriented variants provide outstanding solution quality within reasonable run times; on average, both variants achieve negative gaps to the previous best known solutions. Thus, on the considered benchmark sets, the three variants together form the Pareto frontier of heuristic solution methods for the CLRP. Moreover, TBSA matches or improves the large majority of previous best known solutions in these instances. Finally, TBSA is able to solve newly generated, large-scale instances with up to 600 customers and 30 depots with reasonable run times and convincing scaling behavior and robustness. Additional experiments on open LRP benchmarks confirm the performance of TBSA.Data are available at https://doi.org/10.1287/trsc.2017.0770 .
As relações de paz e guerra entre Peru e Equador no contexto do complexo de segurança regional / The relations of peace and war between Peru and Ecuador in the context of regional security complex
Authors: Duarte Samuel Correa 
Published: December 2017

O presente estudo procura analisar os acontecimentos centrais relativos à Guerra do Cenepa ocorrida em 1995 na fronteira entre Peru e Equador, situando a mesma no contexto da segurança regional do complexo americano. Argumentamos que a Guerra do Cenepa produziu três resultados básicos: apontou para a existência de uma balança de poder entre os dois países; não gerou nenhuma alteração substancial no conteúdo do tratado firmado anteriormente sobre a fronteira na base do Rio Cenepa; nem tampouco implicou em transferência de território. Então, como podemos explicar a dinâmica do conflito entre Peru e Equador? A tese central da análise que será aqui empreendida é que, em primeiro lugar, um padrão recorrente de hostilidades favorece um comportamento ofensivo e, em segundo lugar, a certeza sobre a balança de poder favorece as negociações. Como tese subjacente defendemos que a prevalência da hegemonia norte-americana contribuiu para o desenlace do conflito.ABSTRACTThe present study aims to analyze the central events related to the Cenepa War that occurred in 1995 on the border between Peru and Ecuador, into regional security of the American complex. We argue that the Cenepa War produced three basic results: pointed to the existence of a balance of power between the two countries; did not generate any substantial change in the content of the previously signed treaty on the border at the base of the Rio Cenepa; nor did it entail transfer of territory. How can we explain the dynamics of the conflict between Peru and Ecuador? Central thesis of the analysis that will be undertaken here is that, first, a recurrent pattern of hostility favors offensive behavior, and secondly, certainty about the balance of power favors negotiations. As an underlying thesis, we argue that the prevalence of US hegemony contributed to the outcome of the conflict.Palavras-chave: segurança regional; fronteira; conflito. Keywords: regional security; border; conflict.Recebido em 26 de Julho de 2016 | Aceito em 07 de Agosto de 2017Received on July 26, 2016 | Accepted on August 7, 2017DOI: 10.12957/rmi.2016.24824
A Política Externa Brasileira como Política Pública: a proposta de um Conselho Nacional e a experiência do Comitê Brasileiro de Direitos Humanos e Política Externa | Brazilian foreign policy as public policy: the proposal of a National Council and the exp
Authors: Da Silva Danielle Costa , Klein Magno 
Published: December 2017

Refletimos sobre a atual política externa brasileira a partir da constatação da sua diversificação em termos deagendas e atores. A pluralização de atores ocorre tanto no âmbito burocrático (fragilizando a tradicionalprimazia do Itamaraty) como com atores da sociedade civil (mídia, ONGs, empresários, etc.). Com ainternacionalização da vida cotidiana, surgem novas demandas a respeito da agenda internacional,pressionando por novas dinâmicas nas práticas da política externa. Defendeseque a política externa é umapolítica pública que, guardando sua especificidade, deve ser analisada como as demais políticas públicasbrasileiras. A proposta de um Conselho Nacional de Política Externa e a recente experiência do ComitêBrasileiro de Direitos Humanos e Política Externa são demonstrações da importância de se levar emconsideração as dinâmicas domésticas para uma compreensão adequada da política externa brasileiracontemporânea.ABSTRACTThis paper delves into the current Brazilian foreign policy based on the assumption of its diversification in terms both of its agenda and actors. The pluralization of actors occurs not only in the bureaucratic scope (weakening the traditional Itamaraty’s primacy), but also with other players from civil society (such as the media, NGOs, the business sector, and others). With the internationalization of everyday life, new demands regarding the international agenda emerge, pressing for new dynamics on the practices of foreign policy. We defend that foreign policy is a public policy that, considering its specificity, should be analyzed such as others Brazilians public policies. The proposal of a National Council on Foreign Affairs and the recent experience of the Human Rights and Foreign Affairs Brazilian Committee are examples of the importance of reflecting upon domestic dynamics as a path to a better understanding of Brazilian contemporary foreign policy.Palavras-chave: política externa brasileira; análise de política externa; política públicaKeywords: Brazilian foreign policy; foreign policy analysis; public policyRecebido em 29 de Novembro de 2016 | Aceito em 29 de Setembro de 2017Received on November 29, 2016 | Accepted September 29, 2017DOI: 10.12957/rmi.2016.26899
Observations on John Garstang’s Excavations at Kazanlı Höyük (Cilicia) in 1937
Authors: Ahrens Alexander , Manuelli Federico 
Published: December 2017

AbstractIn 1937, British archaeologist John Garstang (1876–1956) excavated several trenches at the site of Kazanlı Höyük as part of the Neilson Expedition in Cilicia. The site is located in Plain Cilicia, approximately 2 km from the modern coastline (ca. 11 km east of modern-day Mersin, and 17 km west of Tarsus, roughly located by the ancient/modern road connecting these two cities). After these short trial excavations, however, Garstang’s interest shifted to the site of Mersin/Yumuktepe, where he then excavated for a number of years. Apart from two very brief preliminary reports on his excavations at Kazanlı Höyük, which were published in the journal “Annals of Archaeology and Anthropology of the University of Liverpool,” not much is known about his work at the site. Unpublished photographs kept in the Special Collections of the University College London (UCL) shed new light on Garstang’s work at the site.
In Defense of Nebuchadnezzar II the Warrior
Authors: Fantalkin Alexander 
Published: December 2017

AbstractRecent scholarly trends diminish Nabû-kudurrī-uṣur’s II (Nebuchadnezzar’s II) military achievements in general while, at the same time, amplifying hypothetical martial accomplishments of Psammetichus II in the Levant. This paper argues that Nabû-kudurrī-uṣur’s military reputation should be maintained and that during his reign Egyptian advances in the Levant were decidedly modest.
Siedlungskammer Kilikien
Authors: Rutishauser Susanne 
Published: December 2017

AbstractAn essential aspect of understanding past human activity is knowledge about the natural environment. Like almost no other landscape in Asia Minor, the Cilician Plain is defined by strong topographic contrasts: a large fertile plain surrounded by the sea and steep mountain ranges. The Cilician Plain is separated by a natural border into a western (Çukurova) and an eastern (Yukarıova) settlement cluster. All central places in the Çukurova have been located over the millennia at the foothills of the mountains. By contrast, the central places in the Yukarıova were less constant. The avulsion of the rivers can be seen as a reason for this development. However, there also exists for the construction of main Late Bronze and Iron Age monuments in the Cilician Plain a correlation with rivers and channels.
The Account of Nabû-šuma-iškun Revisited
Authors: Zadok Ran 
Published: December 2017

AbstractNabû-šuma-iškun is described as the emblematic malevolent king in the polemical pamphlet, authored in all probability by an anonymous member of the Urukean priestly establishment. However, certain measures taken by him are within the norms of ancient Near Eastern politics. In addition, accusations made against him by the author of the polemical pamphlet may be relativized. Nabû-šuma-iškun’s actions in the international sphere prove that he was a far-sighted statesman. It is demonstrated that important religious and political objectives of this king were not fundamentally different from those of later Babylonian rulers, including kings of the Neo-Babylonian Empire.
Association of adrenal hormone metabolites and mortality over a 6-year follow-up in COPD patients with acute exacerbation
Authors: Zurfluh Seline , Nickler Manuela , Ottiger Manuel , Steuer Christian , Kutz Alexander , Christ-Crain Mirjam , Zimmerli Werner , Thomann Robert , Hoess Claus , Henzen Christoph , Bernasconi Luca , Huber Andreas , Mueller Beat , Schuetz Philipp 
Published: December 2017

Abstract

Background:
The release of hormones from the adrenal gland is vital in acute and chronic illnesses such as chronic obstructive pulmonary disease (COPD) involving recurrent exacerbations. Using a metabolomic approach, we aim to investigate associations of different adrenal hormone metabolites with short- and long-term mortality in COPD patients.

Methods:
We prospectively followed 172 COPD patients (median age 75 years, 62% male) from a previous Swiss multicenter trial. At baseline, we measured levels of a comprehensive spectrum of adrenal hormone metabolites, including glucocorticoid, mineralocorticoid and androgen hormones by liquid chromatography coupled with tandem mass spectrometry (MS). We calculated Cox regression models adjusted for gender, age, comorbidities and previous corticosteroid therapy.

Results:
Mortality was 6.4% after 30 days and increased to 61.6% after 6 years. Higher initial androgen hormones predicted lower long-term mortality with significant results for dehydroepiandrosterone (DHEA) [adjusted hazard ratio (HR), 0.82; 95% confidence interval (CI), 0.70–0.98; p=0.026] and dehydroepiandrosterone sulfate (DHEA-S) (adjusted HR, 0.68; 95% CI, 0.50–0.91; p=0.009). An activation of stress hormones (particularly cortisol and cortisone) showed a time-dependent effect with higher levels pointing towards higher mortality at short term, but lower mortality at long term. Activation of the mineralocorticoid axis tended to be associated with increased short-term mortality (adjusted HR of aldosterone, 2.76; 95% CI, 0.79–9.65; p=0.111).

Conclusions:
Independent of age, gender, corticosteroid exposure and exacerbation type, adrenal hormones are associated with mortality at short and long term in patients with COPD exacerbation with different time-dependent effects of glucocorticoids, androgens and mineralocorticoids. A better physiopathological understanding of the causality of these effects may have therapeutic implications.
Miguel de Cervantes’s Don Quixote and John Barth’s The Sot-Weed Factor: A Deconstructive Reading
Authors: Martín-Párraga Javier 
Published: December 2017

Abstract
Miguel de Cervantes’s Don Quixote is one of the earliest and most influential novels in the history of Western literature. John Barth’s The Sot-Weed Factor, published almost three centuries later, can be considered as one of the most seminal postmodern novels ever written in the English language. The goal of this paper is to examine Cervantes’s influence on John Barth in particular and in American postmodernism from a more general point of view. For the Spanish genius’ footsteps on American postmodernism, a deconstructive reading will be employed. Consequently, concepts such as deconstruction of binary opposites, the role of the subaltern or how the distinction between history and story are paramount to both Cervantes and Barth will be used.
Czesław Miłosz’s Migrant Perspective in Rodzinna Europa [Native Realm]
Authors: Kołodziejczyk Ewa 
Published: December 2017

Abstract
The article traces the impact of Czesław Miłosz’s first American stay on his image of Central Europe in Rodzinna Europa [Native Realm]. In the United States, the post-war immigrant from Vilnius learned to perceive, understand and evaluate American culture; he also gained a new perspective on his region of Europe and Slavic immigrants. This experience enabled him to adopt an American point of view in his autobiographical essay. Following William Faulkner, Miłosz carries on an analysis of Eastern and Central Europe’s history and identities. The uses Western historical and sociological glossary to describe processes that formed his “native realm.” Analogically, the poet from pre-war Vilnius reflects on American multi-ethnicity and religious diversity from a Central European perspective. In Rodzinna Europa, Miłosz takes the position of a migrant translator and a two-way mediator between East and West.
Game Logic in the TV Series The Walking Dead: On Transmedial Plot Structures and Character Layouts
Authors: Lickhardt Maren 
Published: December 2017

Abstract
This paper discusses plot structures and characters of the The Walking Dead TV series which can be traced back to the influence of computer games and gameplay. It shall prove that the series’ narration as a transmedial phenomenon is characterised by ludic logic, although interactive aspects are omitted due to the intermedial change from games to a TV series. The characters’ twin layout as both civilised and archaic, the permanent necessity to make live-or-death decisions, as well as the struggle for survival, simulate aspects of adventure games in particular. The long duration of the series and its repetitive structure rely on PC gamers’ habits.