bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative biliary drainage adversely affects surgical outcomes in periampullary cancer: a retrospective and propensity score‐matched analysis
Authors: Lee Hongeun , Han Youngmin , Kim Jae Ri , Kwon Wooil , Kim Sun‐Whe , Jang Jin‐Young 
Published: December 2017

AbstractBackgroundThe use of preoperative biliary drainage (PBD) for managing patients with periampullary cancer awaiting surgery remains controversial. The impact of PBD status and type on surgical outcomes has not been established, leading to a lack of consensus. We aimed to evaluate the impact of PBD on short‐term surgical outcomes in curatively resected periampullary cancer.MethodsWe retrospectively reviewed data from patients undergoing curative periampullary cancer resection. A propensity score‐matched analysis was performed to adjust for clinical differences. Univariate and multivariate analyses were performed to determine independent risk factors for complications.ResultsThe overall complication rate was significantly higher in patients who underwent PBD (P = 0.027). Additionally, complication rates were significantly higher in the endoscopic biliary drainage (EBD) group than in the percutaneous transhepatic biliary drainage (PTBD) group (P < 0.001). After propensity score matching, overall complication rates in patients receiving EBD (P < 0.001) were significantly higher. PBD type and diagnosis were independent risk factors for complications (hazard ratios: 1.927 for EBD; 1.921 for biliary tract cancer).ConclusionsPreoperative biliary drainage, especially EBD, should not be routinely performed in patients awaiting surgery for periampullary cancer, as it increases the risk of complications.
HIV prevention where it is needed most: comparison of strategies for the geographical allocation of interventions
Authors: Anderson Sarah‐Jane , Ghys Peter D , Ombam Regina , Hallett Timothy B 
Published: December 2017

AbstractIntroductionA strategic approach to the application of HIV prevention interventions is a core component of the UNAIDS Fast Track strategy to end the HIV epidemic by 2030. Central to these plans is a focus on high‐prevalence geographies, in a bid to target resources to those in greatest need and maximize the reduction in new infections. Whilst this idea of geographical prioritization has the potential to improve efficiency, it is unclear how it should be implemented in practice. There are a range of prevention interventions which can be applied differentially across risk groups and locations, making allocation decisions complex. Here, we use mathematical modelling to compare the impact (infections averted) of a number of different approaches to the implementation of geographical prioritization of prevention interventions, similar to those emerging in policy and practice, across a range of prevention budgets.MethodsWe use geographically specific mathematical models of the epidemic and response in 48 counties and major cities of Kenya to project the impact of the different geographical prioritization approaches. We compare the geographical allocation strategies with a nationally uniform approach under which the same interventions must be applied across all modelled locations.ResultsWe find that the most extreme geographical prioritization strategy, which focuses resources exclusively to high‐prevalence locations, may substantially restrict impact (41% fewer infections averted) compared to a nationally uniform approach, as opportunities for highly effective interventions for high‐risk populations in lower‐prevalence areas are missed. Other geographical allocation approaches, which intensify efforts in higher‐prevalence areas whilst maintaining a minimum package of cost‐effective interventions everywhere, consistently improve impact at all budget levels. Such strategies balance the need for greater investment in locations with the largest epidemics whilst ensuring higher‐risk groups in lower‐priority locations are provided with cost‐effective interventions.ConclusionsOur findings serve as a warning to not be too selective in the application of prevention strategies. Further research is needed to understand how decision‐makers can find the right balance between the choice of interventions, focus on high‐risk populations, and geographical targeting to ensure the greatest impact of HIV prevention.
Redemption of the “spoiled identity:” the role of HIV‐positive individuals in HIV care cascade interventions
Authors: Camlin Carol S , Charlebois Edwin D , Geng Elvin , Semitala Fred , Wallenta Jeanna , Getahun Monica , Kampiire Leatitia , Bukusi Elizabeth A , Sang Norton , Kwarisiima Dalsone , Clark Tamara D , Petersen Maya L , Kamya Moses R , Havlir Diane V 
Published: December 2017

AbstractIntroductionThe concept of “therapeutic citizenship” has drawn attention to ways in which public testimony, the “story‐telling in the public sphere” undertaken by people living with HIV (PLHIV), has shaped the global response to the epidemic. This paper presents qualitative findings from two large studies in eastern Africa that reveal how the advent of population‐based HIV testing campaigns and efforts to accelerate antiretroviral “treatment for all” has precipitated a rapidly expanding therapeutic citizenship “project,” or social movement. The title of this paper refers to Goffman's original conceptualization of stigma as a social process through which a person's identity is rendered “spoiled.”MethodsData were derived from qualitative studies embedded within two clinical trials, Sustainable East African Research in Community Health (SEARCH) (NCT# 01864603) in Kenya and Uganda, and START‐ART (NCT# 01810289) in Uganda, which aimed to offer insights into the pathways through which outcomes across the HIV care continuum can be achieved by interventions deployed in the studies, any unanticipated consequences, and factors that influenced implementation. Qualitative in‐depth semi‐structured interviews were conducted among cohorts of adults in 2014 through 2015; across both studies and time periods, 217 interviews were conducted with 166 individuals. Theoretically informed, team‐based analytic approaches were used for the analyses.ResultsNarratives from PLHIV, who have not always been conceptualized as actors but rather usually as targets of HIV interventions, revealed strongly emergent themes related to these individuals' use of HIV biomedical resources and discourses to fashion a new, empowered subjecthood. Experiencing the benefits of antiretroviral therapy (ART) emboldens many individuals to transform their “spoiled” identities to attain new, valorized identities as “advocates for ART” in their communities. We propose that the personal revelation of what some refer to as the “gospel of ARVs,” the telling of personal stories about HIV in the public sphere and actions to accompany other PLHIV on their journey into care, is driven by its power to redeem the “spoiled identity:” it permits PLHIV to overcome self‐stigma and regain full personhood within their communities.ConclusionsPLHIV are playing an unanticipated but vital role in the successful implementation of HIV care cascade interventions.
Understanding uptake of an intervention to accelerate antiretroviral therapy initiation in Uganda via qualitative inquiry
Authors: Semitala Fred C , Camlin Carol S , Wallenta Jeanna , Kampiire Leatitia , Katuramu Richard , Amanyire Gideon , Namusobya Jennifer , Chang Wei , Kahn James G , Charlebois Edwin D , Havlir Diane V , Kamya Moses R , Geng Elvin H 
Published: December 2017

AbstractIntroductionThe Streamlined Antiretroviral Therapy Initiation Strategy (START‐ART) study found that a theory‐based intervention using opinion leaders to inform and coach health care providers about the risks of treatment delay, provision of point of care (POC) CD4 testing machines (PIMA) and reputational incentives, led to rapid rise in ART initiation. We used qualitative research methods to explore mechanisms of provider behaviour change.MethodsWe conducted in‐depth interviews (IDIs) with 24 health care providers and nine study staff to understand perceptions, attitudes and the context of changes in ART initiation practices. Analyses were informed by the Theoretical Domains Framework.ResultsRapid dissemination of new practices was enabled in the environmental context of an existing relationship based on communication, implementation and accountability between Makerere University Joint AIDS Program (MJAP), a Ugandan University‐affiliated organization that provided technical oversight for HIV service delivery at the health facilities where the intervention was implemented, and a network of health facilities operated by the Uganda Ministry of Health. Coaching carried out by field coordinators from MJAP strengthened influence and informal accountability for carrying out the intervention. Frontline health workers held a pre‐existing strong sense of professional identity. They were proud of attainment of new knowledge and skills and gratified by providing what they perceived to be higher quality care. Peer counsellors, who were not explicitly targeted in the intervention design, effectively substituted some functions of health care providers; as role models for successful ART uptake, they played a crucial role in creating demand for rapid ART initiation through interactions with patients. Point of care (POC) CD4 testing enabled immediate action and relieved providers from frustrations of lost or delayed laboratory results, and led to higher patient satisfaction (due to reduced costs because of ability to initiate ART right away, requiring fewer return trips to clinic).ConclusionsQualitative data revealed that a multicomponent intervention to change provider behaviour succeeded in the context of strong institutional and individual relationships between a University‐affiliated organization, government facilities, and peer health workers (who acted as a crucial link between stakeholders) and the community. Fostering stable institutional relationships between institutional actors (non‐governmental organization (NGOs) and ministry‐operated facilities) as well as between facilities and the community (through peer health workers) can enhance uptake of innovations targeting the HIV cascade in similar clinical settings.
“My mother told me that I should not”: a qualitative study exploring the restrictions placed on adolescent girls living with HIV in Zambia
Authors: Mackworth‐Young Constance RS , Bond Virginia , Wringe Alison , Konayuma Katongo , Clay Sue , Chiiya Chipo , Chonta Mutale , Sievwright Kirsty , Stangl Anne L 
Published: December 2017

AbstractIntroductionAdolescent girls in sub‐Saharan Africa are disproportionately affected by HIV due to a range of social and structural factors. As they transition to adulthood, they are recipients of increasing blame for HIV infection and ‘improper’ sex, as well as increasing scrutiny, restrictions and surveillance. This study used a qualitative and participatory approach to explore the messaging and restrictions imposed on adolescent girls living with HIV in Zambia.MethodsThirty‐four in‐depth interviews and four participatory workshops were carried out with 24 adolescent girls aged 15 to 19 years old living with HIV in Lusaka, Zambia. Key themes explored included experiences living with HIV, finding out about HIV status, disclosure, experiences with antiretroviral treatment, and support needs. Data were organized, coded and analysed using a grounded theory approach to thematic analysis. This analysis uses data on participants’ experiences of living with HIV and their interactions with their parents, guardians and healthcare providers.ResultsFamily and healthcare providers, partly in a quest to protect both the health of adolescent girls living with HIV and also to protect them from blaming discourse, imposed restrictions on their behaviour around three main topics: don't disclose your HIV status, don't have sex, and don't miss your medicines. These restrictions were often delivered using tactics of fear, and usually disconnected from other options. Participants responded to these messages in several ways, including internalizing the messages, changing their behaviour either to comply with or resist the restrictions, by remaining silent and anxious when restrictions were broken, and developing concerns around their own health and sexual and reproductive aspirations. Participants also sometimes experiencing stigma when restrictions could not be maintained.ConclusionsRestrictive messages were delivered to adolescent girls living with HIV through the broader social discourses of stigma, religion, and global and local narratives about HIV. Programmes aiming to support adolescent girls living with HIV need to work together with parents and healthcare providers to reflect on the impact of sanctioning messages, and to encourage more enabling and empowering messaging for adolescent girls living with HIV.
Starch–metal complexes and metal compounds
Authors: Staroszczyk Hanna , Ciesielski Wojciech , Tomasik Piotr 
Published: December 2017

AbstractRecently, metal derivatives of starch evoked considerable interest. Such metal derivatives can take a form of starch compounds bearing metal atoms and metal carrying moieties either covalently bound or complexed. Starch metal complexes may have a character of either Werner, inclusion, sorption or capillary complexes. In this publication, preparation, structure, properties and numerous current and potential applications of those compounds as well as benefits resulting from the application and formation of the complexes are presented. © 2017 Society of Chemical Industry
A homochiral porous organic cage with large cavity and pore windows for the efficient gas chromatography separation of enantiomers and positional isomers
Authors: Zhang Jun‐Hui , Xie Sheng‐Ming , Wang Bang‐Jin , He Pin‐Gang , Yuan Li‐Ming 
Published: December 2017

AbstractPorous organic cages composed of discrete cage molecules have attracted considerable recent attention as gas adsorption materials and separation media. In this study, we report a homochiral porous organic cage CC5 with a large cavity and pore windows as a novel stationary phase for high‐resolution gas chromatographic separations. The capillary column was prepared by a static coating method. A large number of racemic compounds have been resolved on the coated capillary column, including derivatized amino acids, alcohols, alcohol amines, esters, ethers, ketones, and epoxides. It is interesting that the CC5‐coated capillary column exhibits significant chiral recognition complementarity to a commercial β‐DEX 120 column and a previously reported homochiral porous organic cage CC3‐R‐coated column, which could expand the range of the analytes amenable to separation on porous organic cage‐based capillary columns. Moreover, the fabricated column also shows excellent selectivity for the separation of positional isomers, including the challenging ethylbenzene and xylene isomers. Experimental results demonstrate an excellent separation performance and stability of the CC5‐coated column, making it promising for gas chromatography applications.
Multiscale Modeling Scheme for Simulating Polymeric Melts: Application to Poly(Ethylene Oxide)
Authors: Wu C. 
Published: December 2017

AbstractThe poly(ethylene oxide) (PEO) is employed as one typical example to demonstrate a new multiscale modeling scheme for simulating high‐molecular‐weight polymeric melts. In this scheme, the structural distributions and the densities at five elevated temperatures at 1 atm, which are obtained from molecular dynamics (MD) simulations of all‐atomistic oligomeric melt, are employed as the target functions to parameterize the coarse‐grained (CG) potentials. The extensive CG MD simulations reproduce the densities at a wide temperature range, from which the glass transition temperatures (Tg) and the volumetric expansion coefficients can be determined for the PEO bulks. These results confirm that the so‐developed CG potentials exhibit excellent chain‐length and temperature transferability. Furthermore, some essential structural properties and dynamics speedup features are captured, and the latter qualitatively dictates the agreement in Tg. Such a scheme can play an important role in predicting thermomechanical properties of specific complex polymers.
Evaluation of motion artifact metrics for coronary CT angiography
Authors: Ma Hongfeng , Gros Eric , Szabo Aniko , Baginski Scott G. , Laste Zachary R. , Kulkarni Naveen M. , Okerlund Darin , Schmidt Taly G. 
Published: December 2017

PurposeThis study quantified the performance of coronary artery motion artifact metrics relative to human observer ratings. Motion artifact metrics have been used as part of motion correction and best‐phase selection algorithms for Coronary Computed Tomography Angiography (CCTA). However, the lack of ground truth makes it difficult to validate how well the metrics quantify the level of motion artifact. This study investigated five motion artifact metrics, including two novel metrics, using a dynamic phantom, clinical CCTA images, and an observer study that provided ground‐truth motion artifact scores from a series of pairwise comparisons.MethodFive motion artifact metrics were calculated for the coronary artery regions on both phantom and clinical CCTA images: positivity, entropy, normalized circularity, Fold Overlap Ratio (FOR), and Low‐Intensity Region Score (LIRS). CT images were acquired of a dynamic cardiac phantom that simulated cardiac motion and contained six iodine‐filled vessels of varying diameter and with regions of soft plaque and calcifications. Scans were repeated with different gantry start angles. Images were reconstructed at five phases of the motion cycle. Clinical images were acquired from 14 CCTA exams with patient heart rates ranging from 52 to 82 bpm. The vessel and shading artifacts were manually segmented by three readers and combined to create ground‐truth artifact regions. Motion artifact levels were also assessed by readers using a pairwise comparison method to establish a ground‐truth reader score. The Kendall's Tau coefficients were calculated to evaluate the statistical agreement in ranking between the motion artifacts metrics and reader scores. Linear regression between the reader scores and the metrics was also performed.ResultsOn phantom images, the Kendall's Tau coefficients of the five motion artifact metrics were 0.50 (normalized circularity), 0.35 (entropy), 0.82 (positivity), 0.77 (FOR), 0.77(LIRS), where higher Kendall's Tau signifies higher agreement. The FOR, LIRS, and transformed positivity (the fourth root of the positivity) were further evaluated in the study of clinical images. The Kendall's Tau coefficients of the selected metrics were 0.59 (FOR), 0.53 (LIRS), and 0.21 (Transformed positivity). In the study of clinical data, a Motion Artifact Score, defined as the product of FOR and LIRS metrics, further improved agreement with reader scores, with a Kendall's Tau coefficient of 0.65.ConclusionThe metrics of FOR, LIRS, and the product of the two metrics provided the highest agreement in motion artifact ranking when compared to the readers, and the highest linear correlation to the reader scores. The validated motion artifact metrics may be useful for developing and evaluating methods to reduce motion in Coronary Computed Tomography Angiography (CCTA) images.
Free‐breathing whole‐heart 3D cine magnetic resonance imaging with prospective respiratory motion compensation
Authors: Moghari Mehdi H. , Barthur Ashita , Amaral Maria E. , Geva Tal , Powell Andrew J. 
Published: December 2017

PurposeTo develop and validate a new prospective respiratory motion compensation algorithm for free‐breathing whole‐heart 3D cine steady‐state free precession (SSFP) imaging.MethodsIn a 3D cine SSFP sequence, 4 excitations per cardiac cycle are re‐purposed to prospectively track heart position. Specifically, their 1D image is reconstructed and routed into the scanner's standard diaphragmatic navigator processing system. If all 4 signals are in end‐expiration, cine image data from the entire cardiac cycle is accepted for image reconstruction. Prospective validation was carried out in patients (N = 17) by comparing in each a conventional breath‐hold 2D cine ventricular short‐axis stack and a free‐breathing whole‐heart 3D cine data set.ResultsAll 3D cine SSFP acquisitions were successful and the mean scan time was 5.9 ± 2.7 min. Left and right ventricular end‐diastolic, end‐systolic, and stroke volumes by 3D cine SSFP were all larger than those from 2D cine SSFP. This bias was < 6% except for right ventricular end‐systolic volume that was 12%. The 3D cine images had a lower ventricular blood‐to‐myocardium contrast ratio, contrast‐to‐noise ratio, mass, and subjective quality score.ConclusionThe novel prospective respiratory motion compensation method for 3D cine SSFP imaging was robust and efficient and yielded slightly larger ventricular volumes and lower mass compared to breath‐hold 2D cine imaging. Magn Reson Med 80:181–189, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
Evolution of pore structure and hydraulic conductivity of randomly distributed soluble particle mixture
Authors: Shin Hosung , Hung Truong Q. , Lee Jong‐Sub , Choo Hyunwook , Lee Changho 
Published: December 2017

SummaryThe plane strain behavior of particulate mixtures containing soluble particles was investigated by conducting both laboratory tests and numerical analysis. To perform the laboratory experiments, soluble mixtures were prepared using photoelastic disks and ice disks with diameters in the ratios (Dice disk/Dphotoelastic disk) of 0.5 and 0.7, and the evolution of the force chain and pore structure was monitored during the dissolution of the ice disks. Subsequently, numerical analysis was conducted by using the 2‐dimensional discrete element method for the soluble mixtures, and it was compared with the experimental results. Additionally, parametric studies were implemented by varying the particle size ratios between the soluble and non‐soluble particles and the volumetric fraction of the soluble particles. The results of the laboratory experiments and numerical analysis demonstrate that (1) after the dissolution of the soluble particles, the pore fabric of the specimens changed, resulting in a force chain changes, local void increases, and coordination number decreases; (2) the effects of soluble particles on the macro‐behaviors of the mixtures could be divided into 3 zones based on the particle size ratios between the soluble and non‐soluble particles and volumetric fraction of soluble particles. These zones were as follows: (Zone 1)—with a small total soluble volume, slight decrease in the in situ lateral pressure (K0), and minor increase in the hydraulic conductivity (k); (Zone 2)—with a moderate soluble particle; the dissolution generated a honey‐comb particle structure; (Zone 3)—the total soluble volume was very large, and the high volumetric fraction of the dissolving particle collapsed the pore structure, decreasing in the in situ lateral pressure (K0) but increasing the hydraulic conductivity (k). The horizontal stress returned to almost the original level, and the internal arching formation increased significantly with the hydraulic conductivity (k).