bluuebunny/crossref_metadata_2025_split huggingface dataset:
Demographic profile and pregnancy outcomes of adolescents and older mothers in Saudi Arabia: analysis from Riyadh Mother (RAHMA) and Baby cohort study
Authors: Fayed Amel A , Wahabi Hayfaa , Mamdouh Heba , Kotb Reham , Esmaeil Samia 
Published: November 2017

ObjectivesTo investigate the impact of maternal age on pregnancy outcomes with special emphasis on adolescents and older mothers and to investigate the differences in demographic profile between adolescents and older mothers.MethodsThis study is a secondary analysis of pregnancy outcomes of women in Riyadh Mother and Baby cohort study according to maternal age. The study population was grouped according to maternal age into five subgroups; <20, 20–29, 30–34, 35–39 and 40+years. The age group 20–29 years was considered as a reference group. Investigation of maternal age impact on maternal and neonatal outcomes was conducted with adjustment of confounders using regression models.ResultsAll mothers were married when conceived with the index pregnancy. Young mothers were less likely to be illiterate, more likely to achieve higher education and be employed compared with mothers ≥ 40 years. Compared with the reference group, adolescents were more likely to have vaginal delivery (and least likely to deliver by caesarean section (CS); OR=0.6, 95% CI 0.4 to 0.9, while women ≥40 years, were more likely to deliver by CS; OR 2.9, 95% CI 2.3 to 3.7. Maternal age was a risk factor for gestational diabetes in women ≥40 years; OR 1.7, 95% CI 1.3 to 2.1. Adolescents had increased risk of preterm delivery; OR 1.5, 95% CI 1.1 to 2.1 and women ≥40 years had similar risk; OR, 1.3, 95% CI 1.1 to 1.6.ConclusionAdverse pregnancy outcomes show a continuum with the advancement of maternal age. Adolescents mother are more likely to have vaginal delivery; however, they are at increased risk of preterm delivery. Advanced maternal age is associated with increased risk of preterm delivery, gestational diabetes and CS.
Differences in optimality index between planned place of birth in a birth centre and alternative planned places of birth, a nationwide prospective cohort study in The Netherlands: results of the Dutch Birth Centre Study
Authors: Hermus Marieke A A , Hitzert Marit , Boesveld Inge C , van den Akker-van Marle M Elske , Dommelen Paula van , Franx Arie , Graaf Johanna P de , Lith Jan M M van , Luurssen-Masurel Nathalie , Steegers Eric A P , Wiegers Therese A , Bruin Karin M van der Pal-de 
Published: November 2017

ObjectivesTo compare the Optimality Index of planned birth in a birth centre with planned birth in a hospital and planned home birth for low-risk term pregnant women who start labour under the responsibility of a community midwife.DesignProspective cohort study.SettingLow-risk pregnant women under care of a community midwife and living in a region with one of the 21 participating Dutch birth centres or in a region with the possibility for midwife-led hospital birth. Home birth was commonly available in all regions included in the study.Participants3455 low-risk term pregnant women (1686 nulliparous and 1769 multiparous) who gave birth between 1 July 2013 and 31 December 2013: 1668 planned birth centre births, 701 planned midwife-led hospital births and 1086 planned home births.Main outcome measurementsThe Optimality IndexNL-2015, a tool to measure ‘maximum outcome with minimal intervention’, was assessed by planned place of birth being a birth centre, a hospital setting or at home. Also, a composite maternal and perinatal adverse outcome score was calculated for the different planned places of birth.ResultsThere were no differences in Optimality Index NL-2015 for pregnant women who planned to give birth in a birth centre compared with women who planned to give birth in a hospital. Although effect sizes were small, women who planned to give birth at home had a higher Optimality Index NL-2015 than women who planned to give birth in a birth centre. The differences were larger for multiparous than for nulliparous women.ConclusionThe Optimality Index NL-2015 for women with planned birth centre births was comparable with planned midwife-led hospital births. Women with planned home births had a higher Optimality Index NL-2015, that is, a higher sum score of evidence-based items with an optimal value than women with planned birth centre births.
UpToDate adherence to GRADE criteria for strong recommendations: an analytical survey
Authors: Agoritsas Thomas , Merglen Arnaud , Heen Anja Fog , Kristiansen Annette , Neumann Ignacio , Brito Juan P , Brignardello-Petersen Romina , Alexander Paul E , Rind David M , Vandvik Per O , Guyatt Gordon H 
Published: November 2017

IntroductionUpToDate is widely used by clinicians worldwide and includes more than 9400 recommendations that apply the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. GRADE guidance warns against strong recommendations when certainty of the evidence is low or very low (discordant recommendations) but has identified five paradigmatic situations in which discordant recommendations may be justified.ObjectivesOur objective was to document the strength of recommendations in UpToDate and assess the frequency and appropriateness of discordant recommendations.DesignAnalytical survey of all recommendations in UpToDate.MethodsWe identified all GRADE recommendations in UpToDate and examined their strength (strong or weak) and certainty of the evidence (high, moderate or low certainty). We identified all discordant recommendations as of January 2015, and pairs of reviewers independently classified them either into one of the five appropriate paradigms or into one of three categories inconsistent with GRADE guidance, based on the evidence presented in UpToDate.ResultsUpToDate included 9451 GRADE recommendations, of which 6501 (68.8%) were formulated as weak recommendations and 2950 (31.2%) as strong. Among the strong, 844 (28.6%) were based on high certainty in effect estimates, 1740 (59.0%) on moderate certainty and 366 (12.4%) on low certainty. Of the 349 discordant recommendations 204 (58.5%) were judged appropriately (consistent with one of the five paradigms); we classified 47 (13.5%) as good practice statements; 38 (10.9%) misclassified the evidence as low certainty when it was at least moderate and 60 (17.2%) warranted a weak rather than a strong recommendation.ConclusionThe proportion of discordant recommendations in UpToDate is small (3.7% of all recommendations) and the proportion that is truly problematic (strong recommendations that would best have been weak) is very small (0.6%). Clinicians should nevertheless be cautious and look for clear explanations—in UpToDate and elsewhere—when guidelines offer strong recommendations based on low certainty evidence.
Inverse square law isothermal property in relativistic charged static distributions
Authors: Hansraj Sudan , Qwabe Nkululeko 
Published: November 2017

We analyze the impact of the inverse square law fall-off of the energy density in a charged isotropic spherically symmetric fluid. Initially, we impose a linear barotropic equation of state [Formula: see text] but this leads to an intractable differential equation. Next, we consider the neutral isothermal metric of Saslaw et al. [Phys. Rev. D 13, 471 (1996)] in an electric field and the usual inverse square law of energy density and pressure results thus preserving the equation of state. Additionally, we discard a linear equation of state and endeavor to find new classes of solutions with the inverse square law fall-off of density. Certain prescribed forms of the spatial and temporal gravitational forms result in new exact solutions. An interesting result that emerges is that while isothermal fluid spheres are unbounded in the neutral case, this is not so when charge is involved. Indeed it was found that barotropic equations of state exist and hypersurfaces of vanishing pressure exist establishing a boundary in practically all models. One model was studied in depth and found to satisfy other elementary requirements for physical admissibility such as a subluminal sound speed as well as gravitational surface redshifts smaller than 2. Buchdahl [Acta Phys. Pol. B 10, 673 (1965)], Böhmer and Harko [Gen. Relat. Gravit. 39, 757 (2007)] and Andréasson [Commum. Math. Phys. 198, 507 (2009)] mass-radius bounds were also found to be satisfied. Graphical plots utilizing constants selected from the boundary conditions established that the model displayed characteristics consistent with physically viable models.
Experience from Two Years of Visualizing Flash with SSDPlayer
Authors: Yadgar Gala , Shor Roman 
Published: November 2017

Data visualization is a thriving field of computer science, with widespread impact on diverse scientific disciplines, from medicine and meteorology to visual data mining. Advances in large-scale storage systems, as well as low-level storage technology, played a significant role in accelerating the applicability and adoption of modern visualization techniques. Ironically, “the cobbler’s children have no shoes”: Researchers who wish to analyze storage systems and devices are usually limited to a variety of static histograms and basic displays.The dynamic nature ofdata movementon flash has motivated the introduction of SSDPlayer, a graphical tool for visualizing the various processes that cause data movement on solid-state drives (SSDs). In 2015, we used the initial version of SSDPlayer to demonstrate how visualization can assist researchers and developers in their understanding of modern, complex flash-based systems. While we continued to use SSDPlayer for analysis purposes, we found it extremely useful for education and presentation purposes as well. In this article, we describe our experience from two years of using, sharing, and extending SSDPlayer and how similar techniques can further advance storage systems research and education.
Molecular Basis for Necitumumab Inhibition of EGFR Variants Associated with Acquired Cetuximab Resistance
Authors: Bagchi Atrish , Haidar Jaafar N. , Eastman Scott W. , Vieth Michal , Topper Michael , Iacolina Michelle D. , Walker Jason M. , Forest Amelie , Shen Yang , Novosiadly Ruslan D. , Ferguson Kathryn M. 
Published: November 2017

Abstract
Acquired resistance to cetuximab, an antibody that targets the EGFR, impacts clinical benefit in head and neck, and colorectal cancers. One of the mechanisms of resistance to cetuximab is the acquisition of mutations that map to the cetuximab epitope on EGFR and prevent drug binding. We find that necitumumab, another FDA-approved EGFR antibody, can bind to EGFR that harbors the most common cetuximab-resistant substitution, S468R (or S492R, depending on the amino acid numbering system). We determined an X-ray crystal structure to 2.8 Å resolution of the necitumumab Fab bound to an S468R variant of EGFR domain III. The arginine is accommodated in a large, preexisting cavity in the necitumumab paratope. We predict that this paratope shape will be permissive to other epitope substitutions, and show that necitumumab binds to most cetuximab- and panitumumab-resistant EGFR variants. We find that a simple computational approach can predict with high success which EGFR epitope substitutions abrogate antibody binding. This computational method will be valuable to determine whether necitumumab will bind to EGFR as new epitope resistance variants are identified. This method could also be useful for rapid evaluation of the effect on binding of alterations in other antibody/antigen interfaces. Together, these data suggest that necitumumab may be active in patients who are resistant to cetuximab or panitumumab through EGFR epitope mutation. Furthermore, our analysis leads us to speculate that antibodies with large paratope cavities may be less susceptible to resistance due to mutations mapping to the antigen epitope. Mol Cancer Ther; 17(2); 521–31. ©2017 AACR.
Interactive Effectiveness of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers or Their Combination on Survival of Hemodialysis Patients
Authors: Kido Ryo , Akizawa Tadao , Fukagawa Masafumi , Onishi Yoshihiro  , Yamaguchi Takuhiro , Fukuhara Shunichi 
Published: November 2017

<b><i>Background:</i></b> Does the use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers individually or as a combination confer a survival benefit in hemodialysis patients? The answer to this question is yet unclear. <b><i>Methods:</i></b> We performed a case-cohort study using data from the Mineral and Bone Disorder Outcomes Study for Japanese CKD stage 5D patients (MBD-5D), a 3-year multicenter prospective case-cohort study, including 8,229 hemodialysis patients registered from 86 facilities in Japan. All patients had secondary hyperparathyroidism, a condition defined as a parathyroid hormone level ≥180 pg/mL and/or receiving vitamin D receptor activators. We compared all-cause mortality rates between those receiving ACEI, ARB, and their combination and non-users with interaction testing. We used marginal structural Poisson regression (causal model) to estimate the causal effect and interaction adjusted for possible time-dependent confounding. Cardiovascular mortality was also evaluated. <b><i>Results:</i></b> Among 3,762 randomly sampled subcohort patients, those taking ACEI, ARB, and their combination at baseline accounted for 4.0, 31.6, and 3.8%, respectively. Over 3 years, 1,226 all-cause and 462 cardiovascular deaths occurred. Compared to non-users, ARB-alone users had a lower all-cause mortality rate (adjusted incident rate ratio [aIRR] 0.62, 95% CI 0.50–0.76), whereas ACEI-alone users showed a statistically similar rate (aIRR 1.01, 95% CI 0.57–1.77). On the contrary, combination users had a greater mortality rate (aIRR 2.56, 95% CI 1.22–5.37), showing significant interaction (<i>p</i> = 0.03). Analysis for cardiovascular mortality showed similar results. <b><i>Conclusion:</i></b> Among hemodialysis patients with secondary hyperparathyroidism, unlike ACEI use, ARB use was associated with greater survival than non-use. Conversely, combination use was associated with greater mortality. Controlled trials are warranted to verify the causality factors of these associations.
Cardiac Magnetic Resonance Imaging in Myocarditis Reveals Persistent Disease Activity Despite Normalization of Cardiac Enzymes and Inflammatory Parameters at 3-Month Follow-Up
Authors: Berg Jan , Kottwitz Jan , Baltensperger Nora , Kissel Christine K. , Lovrinovic Marina , Mehra Tarun , Scherff Frank , Schmied Christian , Templin Christian , Lüscher Thomas F. , Heidecker Bettina , Manka Robert 
Published: November 2017

Background:
There is a major unmet need to identify high-risk patients in myocarditis. Although decreasing cardiac and inflammatory markers are commonly interpreted as resolving myocarditis, this assumption has not been confirmed as of today. We sought to evaluate whether routine laboratory parameters at diagnosis predict dynamic of late gadolinium enhancement (LGE) as persistent LGE has been shown to be a risk marker in myocarditis.

Methods and Results:
Myocarditis was diagnosed based on clinical presentation, high-sensitivity troponin T, and cardiac magnetic resonance imaging, after exclusion of obstructive coronary artery disease by angiography. Cardiac magnetic resonance imaging was repeated at 3 months. LGE extent was analyzed with the software GT Volume. Change in LGE >20% was considered significant. Investigated cardiac and inflammatory markers included high-sensitivity troponin T, creatine kinase, myoglobin, N-terminal B-type natriuretic peptide, C-reactive protein, and leukocyte count. Twenty-four patients were enrolled. Absolute levels of cardiac enzymes and inflammatory markers at baseline did not predict change in LGE at 3 months. Cardiac and inflammatory markers had normalized in 21 patients (88%). LGE significantly improved in 16 patients (67%); however, it persisted to a lesser degree in 17 of them (71%) and increased in a small percentage (21%) despite normalization of cardiac enzymes.

Conclusions:
This is the first study reporting that cardiac enzymes and inflammatory parameters do not sufficiently reflect LGE in myocarditis. Although a majority of patients with normalizing laboratory markers experienced improved LGE, in a small percentage LGE worsened. These data suggest that cardiac magnetic resonance imaging might add value to currently existing diagnostic tools for risk assessment in myocarditis.
Relationships Between Baseline Q Waves, Time From Symptom Onset, and Clinical Outcomes in ST-Segment–Elevation Myocardial Infarction Patients
Authors: Zheng Yinggan , Bainey Kevin R. , Tyrrell Benjamin D. , Brass Neil , Armstrong Paul W. , Welsh Robert C. 
Published: November 2017

Background—
Using a comprehensive ST-segment–elevation myocardial infarction registry, we evaluated the relationships of baseline Q waves, time from symptom onset, and reperfusion strategy with in-hospital clinical outcomes.

Methods and Results—

Consecutive ST-segment–elevation myocardial infarction patients from a defined health region were classified by the presence of baseline Q waves and additionally into primary percutaneous coronary intervention, fibrinolysis, or no reperfusion. ECGs were collected at baseline, after reperfusion, and analyzed for the presence of Q waves using Selvester criteria. Among 2290 ST-segment–elevation myocardial infarction patients, 36.9% had Q waves on their baseline ECG. Patients with Q waves were older (median age, 59 versus 57), were more often male (82.0% versus 75.4%), had higher heart rate (80 versus 72), had higher Global Registry of Acute Coronary Events risk score (129 versus 127), and were with longer time to reperfusion (42 minutes longer). They had higher composite end points (16.3% versus 10.0%), consistent across times from symptom onset to presentation (15.4% versus 9.9% ≤3 hours; 18.5% versus 8.9% >3 to ≤6 hours; 15.9% versus 11.3% >6 hours; Q and no Q, respectively). Baseline Q waves, but not time to reperfusion, were associated with an increased odds of the in-hospital composite end point of death, congestive heart failure, cardiogenic shock, and reinfarction (adjusted odds ratio, 1.65; 95% confidence interval, 1.18–2.30;
P
=0.003). Type of reperfusion did not modify the association of baseline Q waves and in-hospital outcomes (
P
interaction=0.918).

Conclusions—
The presence of baseline Q waves, rather than time to treatment, was significantly associated with adverse in-hospital events in real-world patients, regardless of reperfusion strategy used.
Vertical distribution of calanoid copepods in a mature cyclonic eddy in the Gulf of California
Authors: Cruz-Hernández Javier , Sánchez-Velasco Laura , Godínez Victor M. , Beier Emilio , Palomares-García José R. , Barton Eric D. , Santamaría-Del-Ángel Eduardo 
Published: November 2017

The distribution of calanoid copepod habitats in a cyclonic eddy in the Gulf of California was examined. Direct velocity observations revealed that the eddy extended to approximately 550 m depth and 150 km diameter. The established thermocline suggested that active vertical pumping was not occurring because the eddy was in mature phase. A copepod habitat located in the surface mixed layer, showed high abundances, dominated bySubeucalanus subtenuis(Giesbrecht, 1888), whose abundances decrease towards the centre of the eddy. A second habitat, situated in thermocline, had the highest abundances dominated byNannocalanus minor(Claus, 1863) andTemora discaudataGiesbrecht, 1889. Another habitat, beneath the thermocline, was dominated by most of species recorded in thermocline, but with the lowest abundance. Results suggest that in the mature phase of a cyclonic eddy, the water column stratification induces layering of the calanoid copepod habitats, with the most propitious conditions for their feeding in thermocline.
The Sycophant in Episodic Scenes of Aristophanic Comedy
Authors: Pellegrino Matteo 
Published: November 2017

Abstract
The sycophant, a true ‘plague’ for Athenian society in the classical age, is dramatis persona in some episodic scenes of Aristophanic comedy. An analysis of the peculiarities of such scenes shows how the sycophant’s negative features were pushed to the extreme by the distorting lens of the greatest poet of Old Comedy, producing a surreal, monstrous comic mask apt to strike the imagination of an Attic audience, accustomed as it was to the sad reality of trials and tribunals, where those shady characters used to rage by accusing both Athenian and foreigners, offering testimonies for the prosecution, and demanding a sentence. Aristophanes’ plays, having sycophants mauled and expelled, thus expressed the common desire of Athenian citizens to punish such individuals and get rid – on the stage at least – of their ominous presence.
A Comparison of Daily Temperature-Averaging Methods: Spatial Variability and Recent Change for the CONUS
Authors: Bernhardt Jase , Carleton Andrew M. , LaMagna Chris 
Published: November 2017

Abstract
Traditionally, the daily average air temperature at a weather station is computed by taking the mean of two values, the maximum temperature (Tmax) and the minimum temperature (Tmin), over a 24-h period. These values form the basis for numerous studies of long-term climatologies (e.g., 30-yr normals) and recent temperature trends and changes. However, many first-order weather stations—such as those at airports—also record hourly temperature data. Using an average of the 24 hourly temperature readings to compute daily average temperature has been shown to provide a more precise and representative estimate of a given day’s temperature. This study assesses the spatial variability of the differences in these two methods of daily temperature averaging [i.e., (Tmax + Tmin)/2; average of 24 hourly temperature values] for 215 first-order weather stations across the conterminous United States (CONUS) over the 30-yr period 1981–2010. A statistically significant difference is shown between the two methods, as well as consistent overestimation of temperature by the traditional method [(Tmax + Tmin)/2], particularly in southern and coastal portions of the CONUS. The explanation for the long-term difference between the two methods is the underlying assumption for the twice-daily method that the diurnal curve of temperature is symmetrical. Moreover, this paper demonstrates a spatially coherent pattern in the difference compared to the most recent part of the temperature record (2001–15). The spatial and temporal differences shown have implications for assessments of the physical factors influencing the diurnal temperature curve, as well as the exact magnitude of contemporary climate change.
Two Consecutive Cases of Persistent Stapedial Artery Managed With a Carbon Dioxide Laser
Authors: Stevens Shawn M. , Walters Zoe A. , Tawfik Kareem , Samy Ravi N. 
Published: November 2017

Objective: (1) Discuss the presentation and management of persistent stapedial artery (PSA) discovered incidentally during cholesteatoma surgery. (2) Review use of carbon dioxide (CO2) laser for treatment of PSA in the setting of chronic ear disease. Patients: Two consecutive patients with PSA and primary acquired cholesteatoma. Intervention(s): Tympanomastoidectomy using a canal wall reconstruction technique. Main Outcome Measure(s): Surgical healing, collateral damage to surrounding anatomy, and postoperative hearing. Results: Persistent stapedial artery was detected incidentally in 2 patients, manifesting with heavy pulsatile bleeding arising during dissection of mesotympanic cholesteatoma. Preoperative computed tomography scans demonstrated absent foramen spinosum but no other aberrant vascular anatomy. Using CO2 laser, the PSAs were ablated and controlled, allowing complete resection of cholesteatoma and successful completion of the procedure. In both patients, surrounding anatomical structures suffered no iatrogenic injury. Postoperatively, no significant complications occurred. To date, neither patient has demonstrated evidence of recidivistic cholesteatoma. Conclusions: A CO2 laser can be useful for managing a PSA in the setting of chronic ear disease.