bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the Clinical Performance of the HPV-Risk Assay Using the VALGENT-3 Panel
Authors: Polman N. J. , Oštrbenk A. , Xu L. , Snijders P. J. F. , Meijer C. J. L. M. , Poljak M. , Heideman D. A. M. , Arbyn M. 
Published: October 2017

ABSTRACT

Human papillomavirus (HPV) testing is increasingly being incorporated into cervical cancer screening. The Validation of HPV Genotyping Tests (VALGENT) is a framework designed to evaluate the clinical performance of various HPV tests relative to that of the validated and accepted comparator test in a formalized and uniform manner. The aim of this study was to evaluate the clinical performance of the HPV-Risk assay with samples from the VALGENT-3 panel and to compare its performance to that of the clinically validated Hybrid Capture 2 assay (HC2). The VALGENT-3 panel comprises 1,300 consecutive samples from women participating in routine cervical cancer screening and is enriched with 300 samples from women with abnormal cytology. DNA was extracted from original ThinPrep PreservCyt medium aliquots, and HPV testing was performed using the HPV-Risk assay by investigators blind to the clinical data. HPV prevalence was analyzed, and the clinical performance of the HPV-Risk assay for the detection of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) and CIN2 or worse (CIN2+) relative to the performance of HC2 was assessed. The sensitivity of the HPV-Risk assay for the detection of CIN3+ was similar to that of HC2 (relative sensitivity, 1.00; 95% confidence interval [CI], 0.95 to 1.05;
P
= 1.000), but the specificity of the HPV-Risk assay was significantly higher than that of HC2 (relative specificity, 1.02; 95% CI, 1.01 to 1.04;
P
< 0.001). For the detection of CIN2+, similar results were obtained, with the relative sensitivity being 0.98 (95% CI, 0.93 to 1.02;
P
= 0.257) and the relative specificity being 1.02 (95% CI, 1.01 to 1.03;
P
< 0.001). The performance of the HPV-Risk assay for the detection of CIN3+ and CIN2+ was noninferior to that of HC2, with all
P
values being ≤0.006. In conclusion, the HPV-Risk assay demonstrated noninferiority to the clinically validated HC2 by the use of samples from the VALGENT-3 panel for test validation and comparison.
Patient characteristics of the Accident and Emergency Department of Kenyatta National Hospital, Nairobi, Kenya: a cross-sectional, prospective analysis
Authors: Myers Justin Guy , Hunold Katherine M , Ekernas Karen , Wangara Ali , Maingi Alice , Mutiso Vincent , Dunlop Stephen , Martin Ian B K 
Published: October 2017

BackgroundResource-limited settings are increasingly experiencing a ‘triple burden’ of disease, composed of trauma, non-communicable diseases (NCDs) and known communicable disease patterns. However, the epidemiology of acute and emergency care is not well characterised and this limits efforts to further develop emergency care capacity.ObjectiveTo define the burden of disease by describing the patient population presenting to the Accident and Emergency Department (A&E) at Kenyatta National Hospital (KNH) in Kenya.MethodsWe completed a prospective descriptive assessment of patients in KNH’s A&E obtained via systematic sampling over 3 months. Research assistants collected data directly from patients and their charts. Chief complaint and diagnosis codes were grouped for analysis. Patient demographic characteristics were described using the mean and SD for age and n and percentages for categorical variables. International Classification of Disease 10 codes were categorised by 2013 Global Burden of Disease Study methods.ResultsData were collected prospectively on 402 patients with an average age of 36 years (SD 19), and of whom, 50% were female. Patients were most likely to arrive by taxi or bus (39%), walking (28%) or ambulance (17%). Thirty-five per cent of patients were diagnosed with NCDs, 24% with injuries and 16% with communicable diseases, maternal and neonatal conditions. Overall, head injury was the single most common final diagnosis and occurred in 32 (8%) patients. The most common patient-reported mechanism for head injury was road traffic accident (39%).ConclusionThis study estimates the characteristics of the A&E population at a tertiary centre in Kenya and highlights the triple burden of disease. Our findings emphasise the need for further development of emergency care resources and training to better address patient needs in resource-limited settings, such as KNH.
Sex differences in the significance of isolated reactive treponemal chemiluminescence immunoassay results
Authors: Bopage Rohan I , Vollmer-Conna Ute , Shand Antonia W , Post Jeffrey John 
Published: October 2017

ObjectivesThe significance of sera with isolated reactive treponemal chemiluminescence immunoassay (IRTCIA) results is unclear. Women have this phenotype more commonly than men. Most cohorts examining this phenotype have included predominantly men and have demonstrated evidence of past or subsequently confirmed syphilis infection in a significant proportion of cases. We hypothesised that a proportion of sera with IRTCIA results would be positive on immunoblot testing and that sera from women with IRTCIA would have different results in immunoblot testing than men.MethodsIRTCIA sera from a tertiary referral serology laboratory serving multiple clinical sites were analysed with a syphilis line immunoblot assay (LIA) and analysed by sex. Logistic regression was undertaken to assess factors associated with LIA status. Medical record review and descriptive analysis of a separate cohort of women with the IRTCIA phenotype from a single campus was also undertaken.ResultsOverall, 19/63 (30.1%) subjects with the IRTCIA phenotype were positive in the LIA, including 13 men and 6 women. Women were significantly less likely to have definitive results (positive or negative) than men (p=0.015). Pregnant women were less likely than non-pregnant women to have a negative LIA result (OR 0.57; p=0.03). Record review of 22 different women with IRTCIA reactivity showed that 2/22 (9.1%) had HIV and previous syphilis infection, 15/22 (68.2%) were pregnant and 3 (13.6%) had autoimmune disease.ConclusionsA significant proportion of sera with IRTCIA results on serological tests are reactive on LIA testing and some may not be false positive results. The interpretation of IRTCIA results should be undertaken in conjunction with an assessment of factors such as sex, pregnancy, a history of syphilis and other STIs and syphilis risk.
Design of Low Voltage Low Power DC–DC Converters Using Adiabatic Technique
Authors: Kordetoodeshki Elham , Hassanzadeh Alireza 
Published: October 2017

In this paper two low voltage, low power DC–DC converter circuits have been designed with input voltages as low as 290[Formula: see text]mV to 500[Formula: see text]mV. Adiabatic technique has been used to reduce power consumption and increase the efficiency of the charge pump of the converters. Boost converter circuits are simulated and the efficiency and power consumption are improved using adiabatic technique. Optimum capacitor bank and rise time–fall time values have been obtained for the adiabatic circuits. Power consumption for the doubler circuit with 310[Formula: see text]mV input decreases by 67% using adiabatic technique and 0.18[Formula: see text][Formula: see text]m CMOS technology parameters.
A novel single-beat approach to assess right ventricular systolic function
Authors: Bellofiore Alessandro , Vanderpool Rebecca , Brewis Melanie J. , Peacock Andrew J. , Chesler Naomi C. 
Published: October 2017

Clinical assessment of right ventricular (RV) contractility in diseases such as pulmonary arterial hypertension (PAH) has been hindered by the lack of a robust methodology. Here, a novel, clinically viable, single-beat method was developed to assess end-systolic elastance (Ees), a measure of right ventricular (RV) contractility. We hypothesized that this novel approach reduces uncertainty and interobserver variability in the estimation of the maximum isovolumic pressure (Piso), the key step in single-beat methods. The new method was designed to include a larger portion of the RV pressure data and minimize subjective adjustments by the operator. Data were obtained from right heart catheterization of PAH patients in a multicenter prospective study ( data set 1) and a single-center retrospective study ( data set 2). To obtain Piso, three independent observers used an established single-beat method (based on the first derivative of the pressure waveform) and the novel method (based on the second derivative). Interobserver variability analysis included paired t-test, one-way ANOVA, interclass correlation (ICC) analysis, and a modified Bland-Altman analysis. The Piso values obtained from the two methods were linearly correlated for both data set 1 ( R2 = 0.74) and data set 2 ( R2 = 0.91). Compared with the established method, the novel method resulted in smaller interobserver variability ( P < 0.001), nonsignificant differences between observers, and a narrower confidence interval. By reducing uncertainty and interobserved variability, this novel approach may pave the way for more effective clinical management of PAH. NEW & NOTEWORTHY A novel methodology to assess right ventricular contractility from clinical data is demonstrated. This approach significantly reduces interobserver variability in the analysis of ventricular pressure data, as demonstrated in a relatively large population of subjects with pulmonary hypertension. This study may enable more accurate clinical monitoring of systolic function in subjects with pulmonary hypertension.
Impact of Patient–Provider Race, Ethnicity, and Gender Concordance on Cancer Screening: Findings from Medical Expenditure Panel Survey
Authors: Malhotra Jyoti , Rotter David , Tsui Jennifer , Llanos Adana A.M. , Balasubramanian Bijal A. , Demissie Kitaw 
Published: October 2017

Abstract
Background: Racial and ethnic minorities experience lower rates of cancer screening compared with non-Hispanic whites (NHWs). Previous studies evaluating the role of patient–provider race, ethnicity, or gender concordance in cancer screening have been inconclusive.
Methods: In a cross-sectional analysis using the Medical Expenditure Panel Survey (MEPS), data from 2003 to 2010 were assessed for associations between patient–provider race, ethnicity, and/or gender concordance and, screening (American Cancer Society guidelines) for breast, cervical, and colorectal cancer. Multivariable logistic analyses were conducted to examine associations of interest.
Results: Of the 32,041 patient–provider pairs in our analysis, more than 60% of the patients were NHW, 15% were non-Hispanic black (NHB), and 15% were Hispanic. Overall, patients adherent to cancer screening were more likely to be non-Hispanic, better educated, married, wealthier, and privately insured. Patient–provider gender discordance was associated with lower rates of breast [OR, 0.83; 95% confidence interval (CI), 0.76–0.90], cervical (OR, 0.83; 95% CI, 0.76–0.91), and colorectal cancer (OR, 0.84; 95% CI, 0.79–0.90) screening in all patients. This association was also significant after adjusting for racial and/or ethnic concordance. Conversely, among NHWs and NHBs, patient–provider racial and/or ethnic concordance was not associated with screening. Among Hispanics, patient–provider ethnic discordant pairs had higher breast (58% vs. 52%) and colorectal cancer (45% vs. 39%) screening rates compared with concordant pairs.
Conclusions: Patient–provider gender concordance positively affected cancer screening. Patient–provider ethnic concordance was inversely associated with receipt of cancer screening among Hispanics. This counter-intuitive finding requires further study.
Impact: Our findings highlight the importance of gender concordance in improving cancer screening rates. Cancer Epidemiol Biomarkers Prev; 26(12); 1804–11. ©2017 AACR.
This Kind of Collective Is Not That Kind of Collective—In Search of a Path of Communitarian and Integrated Cooperatives (此集体非彼集体——为社区性、综合性乡村合作组织探路)
Authors: Yang (杨团) Tuan 
Published: October 2017

This paper combs through more than 30 years of the rural collective economic system reforms and distinguishes the conceptual differences among the People's Communes collective, the joint stock cooperative collective, and the community cooperative collective, and among the cooperative economy, the collective economy, the shareholding economy, and the community economy. This paper argues that it is not suitable to simply and rashly push forward the practice of China’s most developed areas’ rural collective economy property rights system to the whole country.Taking the Puhan model and Jindian model as examples, this paper shows that by absorbing the experiences of the East Asian farmers’ integrated cooperatives, their experiences in local community development, and also the comprehensive rural cooperative organizations in mainland China, there exists a third possible way to bring forth the vitality of village communities and generate healthy and sustainable rural development, in preference to the old rural collective Commune system and the corporate or joint stock co-op models.本文梳理了围绕农村集体经济制度改革的30余年历史，分辨了人民公社集体、股份合作制集体和社区合作集体；合作经济、集体经济、股份经济与社区（社群）经济的不同，提出不宜将适合发达地区的农村集体经济产权制度改革推向全国。本文以蒲韩和金店两地的农民组织为例说明，借鉴东亚综合农协经验和本土经验的社区性、综合性乡村合作组织，是在公社集体制和公司制或股份合作制之外，能激发村庄活力和形成经济社会良性循环的第三条路。 (This article is in Chinese.)
Submesoscale Coherent Structures on the Continental Shelf
Authors: Dauhajre Daniel P. , McWilliams James C. , Uchiyama Yusuke 
Published: October 2017

AbstractDiscovery and analysis of submesoscale variability O(0.3–30) km on the continental shelf is made possible by a high-resolution (Δx = 75 m) Regional Oceanic Modeling System (ROMS) simulation of the Southern California Bight (SCB). This variability is manifest in ubiquitous yet ephemeral coherent structures: fronts, filaments, and vortices. Similar to their open-ocean counterparts, fronts and filaments on the shelf are identified by their strong vertical velocity, surface convergence, cyclonic vorticity, and horizontal density gradient. Life cycles of these features typically last 3–5 days, with the formation dominated by a horizontal advective tendency that increases density and velocity gradients (i.e., frontogenesis). The shape of the coastline and depth of the water column both influence the abundance and spatial orientation of shallow-water fronts and filaments. Closer to shore, fronts and filaments often align themselves parallel to isobaths, and headlands often act as sites of intense vorticity generation through bottom stress. A quasi-steady, approximate momentum balance among rotation, pressure gradient, and vertical mixing—known as turbulent thermal wind (TTW)—often is valid in the strong secondary circulations local to fronts and filaments. However, front and filament circulations subject to strong diurnal variation in surface heating and vertical mixing are inconsistent with steady-state TTW balance. The secondary circulations can induce ephemeral material trapping and substantial vertical heat fluxes on the shelf.
Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psychological functioning and in trait measures of prosocial attitudes and behaviors
Authors: Griffiths Roland R , Johnson Matthew W , Richards William A , Richards Brian D , Jesse Robert , MacLean Katherine A , Barrett Frederick S , Cosimano Mary P , Klinedinst Maggie A 
Published: October 2017

Psilocybin can occasion mystical-type experiences with participant-attributed increases in well-being. However, little research has examined enduring changes in traits. This study administered psilocybin to participants who undertook a program of meditation/spiritual practices. Healthy participants were randomized to three groups (25 each): (1) very low-dose (1 mg/70 kg on sessions 1 and 2) with moderate-level (“standard”) support for spiritual-practice (LD-SS); (2) high-dose (20 and 30 mg/70 kg on sessions 1 and 2, respectively) with standard support (HD-SS); and (3) high-dose (20 and 30 mg/70kg on sessions 1 and 2, respectively) with high support for spiritual practice (HD-HS). Psilocybin was administered double-blind and instructions to participants/staff minimized expectancy confounds. Psilocybin was administered 1 and 2 months after spiritual-practice initiation. Outcomes at 6 months included rates of spiritual practice and persisting effects of psilocybin. Compared with low-dose, high-dose psilocybin produced greater acute and persisting effects. At 6 months, compared with LD-SS, both high-dose groups showed large significant positive changes on longitudinal measures of interpersonal closeness, gratitude, life meaning/purpose, forgiveness, death transcendence, daily spiritual experiences, religious faith and coping, and community observer ratings. Determinants of enduring effects were psilocybin-occasioned mystical-type experience and rates of meditation/spiritual practices. Psilocybin can occasion enduring trait-level increases in prosocial attitudes/behaviors and in healthy psychological functioning. Trial Registration ClinicalTrials.gov Identifier NCT00802282
Significant Chondrocyte Viability Is Present in Acetabular Chondral Flaps Associated With Femoroacetabular Impingement
Authors: Wright Vonda J. , McCrum Christopher Laurence , Li Hongshuai , Tranovich Michael J. , Huard Johnny 
Published: October 2017

Background: Patients presenting with cam deformity of the femoral head and neck sustain repeated trauma to the articular cartilage of the superior acetabulum, with chondral delamination injuries found during hip arthroscopy. Two previous studies reveal conflicting chondrocyte viability data in these traumatic cartilage injuries. The full-thickness nature of flaps may suggest that chondrocytes residing in the cartilage flap matrix in the joint environment would remain viable despite shear trauma. Hypothesis/Purpose: The purpose of this study is to determine the in vivo tissue viability of acetabular chondral flaps in patients with femoroacetabular impingement (FAI) when samples are analyzed immediately after biopsy. We hypothesize that the majority of the tissue in acetabular chondral flaps is viable in the joint microenvironment. Study Design: Descriptive laboratory study. Methods: Partially detached cartilage flaps from 10 patients undergoing arthroscopic hip surgery for FAI were biopsied in a minimally traumatic manner before chondroplasty and microfracture. Samples were placed in cold Hank’s Balanced Salt Solution without phenol red solution and immediately transported on ice to our laboratory. The edge of the samples was trimmed and further cut into 3 separate, 1-mm-thick sections. Sections were stained using a live/dead staining kit. Images were obtained with confocal microscopy, and the percentage of live cells was quantified. Results: Patients averaged 36 ± 11 years (range, 18-48 years), and 2 patients were female. The mean body mass index was 28.9 ± 5.6 kg/m2. The total proportion of live cells from all sections analyzed was 85.8%. The proportion of live cells per patient was 87% ± 10%. Conclusion: We determined that acetabular chondral flaps are approximately 87% live cells when analyzed immediately after biopsy, with 6 of 10 patients having greater than 90% live cells. These data point to the importance of laboratory techniques in making viability judgments in biologic systems. Clinical Relevance: Full-thickness cartilage loss is a difficult problem for all active people but particularly in the young population in whom joint preservation is key. We describe the viability of chondrocytes present in full-thickness acetabular-based chondral flaps encountered during hip arthroscopy. Identification of greater than 85% chondrocyte viability supports a foundation for evaluation and creation of novel clinical innovations for repair and replacement techniques using the flap as donor tissue, as alternatives to chondroplasty and microfracture.
A Biomechanical Analysis of the Association Between Forearm Mechanics and the Elbow Varus Moment in Collegiate Baseball Pitchers
Authors: Solomito Matthew J. , Garibay Erin J. , Nissen Carl W. 
Published: October 2017

Background: The incidence of upper extremity injury in baseball pitchers has increased over the past decade. This has resulted in a large body of research mainly focused on the kinematic and kinetic patterns of the elbow and shoulder to elucidate the cause of these injuries, with little attention on studying the associations of forearm rotation and upper arm joint moments. Hypothesis: There will be significant differences in forearm kinematics and kinetics when comparing the fastball pitch with the curveball pitch. There will be a positive association between forearm kinetics, specifically supination and pronation moments, and the elbow varus moment. Study Design: Descriptive laboratory study. Methods: A total of 78 pitchers were recruited for this study, and they underwent a pitching analysis using motion analysis techniques. A random-intercept, mixed-effects regression model was used to determine differences in forearm kinematics and kinetics when pitching a fastball compared with a curveball, as well as to determine if associations existed between forearm supination and pronation moments and the elbow varus moment. Results: There were a number of significant differences in forearm position when pitching a fastball compared with a curveball, with the curveball producing a more supinated forearm position. Significant associations were found between increasing forearm supination moments and an increase in elbow varus moment for both the fastball and the curveball ( P = .002 and P < .001, respectively). For every 1-N·m increase in the supination moment, there was a 1-N·m and 1.1-N·m increase in the elbow varus moment for the fastball and curveball, respectively. Conclusion: The results demonstrated that the forearm position was not associated with the elbow varus moment. However, the supination moment was associated with the elbow varus moment. Clinical Relevance: On the basis of these findings, pitching coaches and trainers can understand the implications of proper lower arm pitching mechanics in the later portion of the pitch cycle as a potential risk of injury and, therefore, can develop coaching strategies to reduce incorrect positioning, especially when players are pitching the curveball.
A Note on the Law and Economics of Stolen Valor
Authors: Weisman Dennis L. 
Published: October 2017

The issue of stolen valor concerns the act of trading on false claims of being awarded valorous military service medals. The Supreme Court overturned the 2005 Stolen Valor Act, largely on First Amendment grounds, ruling that even false speech deserves some protection. Misrepresentation that devalues the reputation of medals for valor may not violate the revised statute despite reducing the expected wage premium associated with being awarded the medal for valor and discouraging investment in military effort. Hence, the law and economics of stolen valor are in some conflict. JEL Classifications: D82, H1, K23