bluuebunny/crossref_metadata_2025_split huggingface dataset:
A ‘Rich Crop of Nervousness’: Childhood, Expertise, and the State in the mid-1880s British Over-Pressure Controversy
Authors: Bischof Christopher 
Published: January 2017

Abstract
This article explores the debates surrounding the 1884 over-pressure controversy in Britain about how to know children, the nature of professional expertise and the duty of the state. The idea of ‘over-pressure’ captured the public’s imagination in the wake of a partly social-scientific, partly sensationalist report on the state of elementary education by the crusading social reformer Dr James Crichton-Browne. This alleged that the high-stakes annual examination of elementary-school children led teachers to ‘over-pressure’ children to such an extent that it interfered with children’s growth, led them to sleepwalk, and even caused some to commit suicide. However, Crichton-Browne soon found himself in the centre of a vigorous debate as teachers, policy-makers and politicians sought to undercut his claims that a medical background allowed him to understand the condition of the nation’s children. The question of how to know children sparked a proliferation of claims to professional authority and expertise. Teachers asserted that their everyday intimacy with children uniquely positioned them to know children’s abilities and vulnerabilities and thus entitled them to more discretionary power to adapt education policies. Different parts of the state launched their own investigations into over-pressure and the condition of Britain’s children as they attempted to mobilise a bureaucratic mode of knowing. By galvanising new inquiries into the state of Britain’s children and debates about the very way by which to know them, the over-pressure controversy shaped the development not only of elementary education, but also ideas about childhood, professional expertise and the liberal state more broadly.
Anticoagulation for pregnant women with mechanical heart valves: a systematic review and meta-analysis
Authors: D’Souza Rohan , Ostro Jackie , Shah Prakesh S. , Silversides Candice K. , Malinowski Ann , Murphy Kellie E. , Sermer Mathew , Shehata Nadine 
Published: January 2017

Aims
To review maternal and foetal outcomes in women with mechanical heart valves (MHVs) treated with vitamin-K antagonists (VKAs), first-trimester heparin followed by VKAs (sequential treatment), low molecular weight heparin (LMWH) and unfractionated heparin (UFH) during pregnancy, in order to inform practice.

Methods and results
Medline, Embase and Central were searched from inception until February 2016. Two reviewers independently screened 1786 titles, reviewed 110 full-texts and extracted data and assessed risk-of-bias from 46 articles. Pooled incidence (95% confidence intervals) was calculated for maternal and foetal outcomes. Included studies had a moderate or high risk-of-bias. With VKAs, sequential treatment and LMWH, maternal mortality occurred in 0.9% (0.4–1.4), 2.0% (0.8–3.1) and 2.9% (0.2–5.7), thromboembolic complications in 2.7% (1.4–4.0), 5.8% (3.8–7.7) and 8.7% (3.9–13.4), livebirths in 64.5% (48.8–80.2), 79.9% (74.3–85.6) and 92.0% (86.1–98.0) and anticoagulant-related foetal/neonatal adverse events (embryopathy or foetopathy) in 2.0% (0.3–3.7), 1.4% (0.3–2.5) and 0%, respectively. When UFH is used throughout pregnancy, 11.2% (2.8–19.6) suffered thromboembolic complications. Foetal loss and adverse events occurred with first-trimester warfarin doses ≤ 5 mg/day, although there were more livebirths [83.6% (75.8–91.4) vs. 43.9% (32.8–55.0)] and fewer foetal anomalies [2.3% (0.7–4.0) vs. 12.4% (3.3–21.6)] with lower doses than with warfarin &gt; 5 mg/day.

Conclusions
VKAs are associated with fewest maternal complications but also with fewest livebirths. Sequential treatment does not eliminate anticoagulant-related foetal/neonatal adverse events. LMWH is associated with the highest number of livebirths. The safety of UFH throughout pregnancy and first-trimester warfarin  ≤ 5 mg/day remains unconfirmed.
Pulmonary arterial hypertension in congenital heart disease: translational opportunities to study the reversibility of pulmonary vascular disease
Authors: van der Feen Diederik E. , Bartelds B. , de Boer Rudolf A. , Berger Rolf M.F. 
Published: January 2017

Abstract
Pulmonary arterial hypertension (PAH) is a progressive and lethal pulmonary vascular disease (PVD). Although in recent years outcome has improved by new treatments that delay disease progression, a cure has not yet been achieved. In PAH associated with congenital heart disease (CHD), remodeling of the pulmonary vasculature reaches an irreversible phenotype similar to all forms of end-stage PAH. In PAH-CHD, however, also an early stage is recognised, which can be completely reversible. This reversible phase has never been recognised in other forms of PAH, most likely because these patients are only diagnosed once advanced disease has developed. We propose that the clinical model of PAH-CHD, with an early reversible and advanced irreversible stage, offers unique opportunities to study pathophysiological and molecular mechanisms that orchestrate the transition from reversible medial hypertrophy into irreversible plexiform lesions. Comprehension of these mechanisms is not only pivotal in clinical assessment of disease progression and operability of patients with PAH-CHD; specific targeting of these mechanisms may also lead to pharmacological interventions that transform ‘irreversible’ plexiform lesions into a reversible PVD: one that is amenable for a cure. In recent years, significant steps have been made in the strive to ‘reverse the irreversible’. This review provides an overview of current clinical and experimental knowledge on the reversibility of PAH, focussing on flow-associated mechanisms, and the near-future potential to advance this field.
Clinical characteristics of wild-type transthyretin cardiac amyloidosis: disproving myths
Authors: González-López Esther , Gagliardi Christian , Dominguez Fernando , Quarta Cristina Candida , de Haro-del Moral F. Javier , Milandri Agnese , Salas Clara , Cinelli Mario , Cobo-Marcos Marta , Lorenzini Massimiliano , Lara-Pezzi Enrique , Foffi Serena , Alonso-Pulpon Luis , Rapezzi Claudio , Garcia-Pavia Pablo 
Published: January 2017

Abstract

Aims
Wild-type transthyretin amyloidosis (ATTRwt) is mostly considered a disease predominantly of elderly male, characterized by concentric LV hypertrophy, preserved LVEF, and low QRS voltages. We sought to describe the characteristics of a large cohort of ATTRwt patients to better define the disease.

Methods and results
Clinical findings of consecutive ATTRwt patients diagnosed at 2 centres were reviewed. ATTRwt was diagnosed histologically or non-invasively (LV hypertrophy ≥12 mm, intense cardiac uptake at 99mTc-DPD scintigraphy and AL exclusion). Mutations in TTR were excluded in all cases. The study cohort comprised 108 patients (78.6 ± 8 years); 67 (62%) diagnosed invasively and 41 (38%) non-invasively. Twenty patients (19%) were females. An asymmetric hypertrophy pattern was observed in 25 (23%) patients. Mean LVEF was 52 ± 14%, with 39 patients (37%) showing a LVEF &lt; 50%. Atrial fibrillation (56%) and a pseudo-infarct pattern (63%) were the commonest ECG findings. Only 22 patients fulfilled QRS low-voltage criteria while 10 showed LV hypertrophy on ECG. Although heart failure was the most frequent profile leading to diagnosis (68%), 7% of individuals presented with atrioventricular block and 11% were diagnosed incidentally. Almost one third (35; 32%) were previously misdiagnosed.

Conclusion
The clinical spectrum of ATTRwt is heterogeneous and differs from the classic phenotype: women are affected in a significant proportion; asymmetric LV hypertrophy and impaired LVEF are not rare and only a minority have low QRS voltages. Clinicians should be aware of the broad clinical spectrum of ATTRwt to correctly identify an entity for which a number of disease-modifying treatments are under investigation.
Radial versus femoral access in patients with acute coronary syndromes with or without ST-segment elevation
Authors: Vranckx Pascal , Frigoli Enrico , Rothenbühler Martina , Tomassini Francesco , Garducci Stefano , Andò Giuseppe , Picchi Andrea , Sganzerla Paolo , Paggi Anita , Ugo Fabrizio , Ausiello Arturo , Sardella Gennaro , Franco Nicoletta , Nazzaro Marco , de Cesare Nicoletta , Tosi Paolo , Falcone Camillo , Vigna Carlo , Mazzarotto Pietro , Di Lorenzo Emilio , Moretti Claudio , Campo Gianluca , Penzo Carlo , Pasquetto Giampaolo , Heg Dik , Jüni Peter , Windecker Stephan , Valgimigli Marco ,   for the MATRIX Investigators
Published: January 2017

Aims
To assess whether radial compared with femoral access is associated with consistent outcomes in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS).

Methods and results
In the Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX (MATRIX) programme patients were randomized to radial or femoral access, stratified by STEMI (2001 radial, 2009 femoral) and NSTE-ACS (2196 radial, 2198 femoral). The 30-day co-primary outcomes were major adverse cardiovascular events (MACE), defined as death, myocardial infarction, or stroke, and net adverse clinical events (NACE), defined as MACE or major bleeding In the overall study population, radial access reduced the NACE but not MACE endpoint at the prespecified 0.025 alpha. MACE occurred in 121 (6.1%) STEMI patients with radial access vs. 126 (6.3%) patients with femoral access [rate ratio (RR) = 0.96, 95% CI = 0.75–1.24; P = 0.76] and in 248 (11.3%) NSTE-ACS patients with radial access vs. 303 (13.9%) with femoral access (RR = 0.80, 95% CI = 0.67–0.96; P = 0.016) (Pint = 0.25). NACE occurred in 142 (7.2%) STEMI patients with radial access and in 165 (8.3%) patients with femoral access (RR = 0.86, 95% CI = 0.68–1.08; P = 0.18) and in 268 (12.2%) NSTE-ACS patients with radial access compared with 321 (14.7%) with femoral access (RR = 0.82, 95% CI = 0.69–0.97; P = 0.023) (Pint = 0.76). All-cause mortality and access site-actionable bleeding favoured radial access irrespective of ACS type (Pint = 0.11 and Pint = 0.36, respectively).

Conclusion
Radial as compared with femoral access provided consistent benefit across the whole spectrum of patients with ACS, without evidence that type of presenting syndrome affected the results of the random access allocation.
Daily Memory Lapses in Adults: Characterization and Influence on Affect
Authors: Mogle Jacqueline , Muñoz Elizabeth , Hill Nikki L , Smyth Joshua M , Sliwinski Martin J 
Published: January 2017

Abstract

Objective
The current analyses examined the impact of daily memory lapses on daily affect and whether this impact varied across age.

Method
One hundred sixty-six adults (ages 20–79) completed assessments of memory lapses and affect each day for 7 consecutive days. Assessments included retrospective and prospective memory lapses as well as the impact of these lapses (how irritating, interfering, and consequential). Affect was assessed using ratings of daily positive and negative affect.

Results
Participants reported memory lapses on 33.3% of days. Prospective lapses were consistently rated as more consequential. Regardless of age, participants had significantly lower in positive affect and significantly higher in negative affect on days with a prospective lapse. Effects of retrospective lapses depended on age: compared to older adults, younger adults reported lower positive affect on days with a retrospective lapse.

Discussion
Previous work on daily memory lapses has focused on prospective lapses. Although retrospective lapses occurred more frequently in this sample, prospective lapses appeared to have a greater impact on daily experiences regardless of age. By measuring daily memory lapses and affect over consecutive days, we can begin to understand how the experience of forgetting impacts individuals at a micro-level.
Interacting convection modes in a saturated porous medium of nearly square planform: four modes
Authors: Florio Brendan J. , Bassom Andrew P. , Sakellariou Konstantinos , Stemler Thomas 
Published: January 2017

Abstract
Convection can occur in a confined saturated porous box when the associated Rayleigh number exceeds a threshold critical value: the identity of the preferred onset convection mode depends sensitively on the geometry of the box. Here we discuss examples for which the box dimensions are such that four modes share a common critical Rayleigh number. Perturbation theory is used to derive a system of coupled ordinary differential equations that governs the nonlinear interaction of the four modes and an analysis of this set is undertaken. In particular, it is demonstrated that as the Rayleigh number is increased beyond critical so a series of pitchfork bifurcations occur and multiple stable states are identified that correspond to the survival of just one of the four modes. The basins of attraction for each mode in the 4D phase space are described by a reduction to a suitable 3D counterpart.
Refugee Youth in Sweden Who Arrived as Unaccompanied Minors and Separated Children
Authors: Çelikaksoy Aycan , Wadensjö Eskil 
Published: January 2017

Abstract
The number of children fleeing and/or seeking asylum alone without parents or guardians has been increasing during the last decade worldwide, where Sweden has been receiving the largest number of asylum claims by unaccompanied minors in Europe. Despite the growing interest in the situation of this group in destination countries, there is a lack of research articles that address this group with nationwide comprehensive data. This study examines the labour-market situation of the whole population of the refugee youth who entered Sweden as unaccompanied minors or separated children and were registered during the years 2003–12. We investigate whether this group is in a disadvantageous situation regarding labour-market incorporation compared to their counterparts who arrived with their families due to their specific marginalized and vulnerable position within society. The results show that this group exhibits capacity and resilience in terms of finding employment and willingness to work. The results are discussed with a structural incorporation framework from a reception and integration policy perspective as well as from an immigrant wellbeing and a ‘whole-child’ approach.
Spine Oncology—Metastatic Spine Tumors
Authors: Choi David , Bilsky Mark , Fehlings Michael , Fisher Charles , Gokaslan Ziya 
Published: January 2017

Abstract
Surgery for spinal metastases remains the mainstay treatment for pain, instability, and neurological deterioration due to tumor infiltration of the spine. However, several new therapies are emerging which may improve outcomes further, and in some cases even replace the need for surgery. We now have a better understanding of which factors influence survival and quality of life after surgery, and this underpins the development and application of new treatments, and assessment of outcome.
Depending on genetic subtyping of tumors, novel immunotherapies and chemotherapies may be very effective in prolonging quality of life. New surgical techniques allow smaller, quicker, and safer operations with less blood loss, pain, and quicker recovery after surgery. Radiation treatments have also leapt forward with the greater accuracy and higher doses possible from intensity-modulated photon radiation, stereotactic body radiation treatment, proton beam therapy, or carbon ion treatment. Combined with more advanced materials for vertebral body stabilization, computer navigation systems, and robotics, more can be done at earlier or later stages of the spinal disease than was previously possible, resulting in more options and improved outcomes for patients.
Incidence and Management of Late Adverse Radiation Effects After Arteriovenous Malformation Radiosurgery
Authors: Pollock Bruce E , Link Michael J , Branda Megan E , Storlie Curtis B 
Published: January 2017

Abstract

BACKGROUND
Late adverse radiation effects (ARE) typically occur many years after stereotactic radiosurgery (SRS) of intracranial arteriovenous malformations (AVM). They are characterized by perilesional edema or cyst formation and are distinct from radiation-induced changes (RIC) noted in the first 1 to 2 years after AVM SRS and radiation necrosis.

OBJECTIVE
To determine the incidence of late ARE after AVM SRS.

METHODS
Retrospective review of 233 AVM patients having SRS from 1990 to 2009. Patients had sporadic AVM, no prior radiation, and a minimum of 5 years of magnetic resonance imaging (MRI) follow-up. The median MRI follow-up after SRS was 9.8 years (range, 5-24.2).

RESULTS
Late ARE were observed in 16 patients (6.9%) at a median of 8.7 years after SRS (range, 2.0-16.1). The 5-, 10-, and 15-year incidence of late ARE was 0.4%, 7.7%, and 12.5%, respectively. Eight patients (3.4%) were symptomatic at the time of ARE detection. Three of 8 patients who were initially asymptomatic had documented cyst progression (at 11, 40, and 42 months), for an overall symptomatic rate of 4.7%. Five patients with asymptomatic ARE have been observed for a median of 9.3 years (range, 2.0-14.1) without progression. Patients having early RIC (hazard ratio [HR] = 2.11, P < .001), patients having obliteration (HR = 1.24, P = .02), and patients having SRS before April 1997 (HR = 1.12, P = .02) were more likely to develop late ARE.

CONCLUSION
Late ARE are common in AVM patients who develop early RIC after SRS. Resection of the thrombosed AVM and the adjacent damaged tissue is effective at eliminating the mass effect and improving patients’ neurological condition.
Of Bubbles and Layers: Which Cerebral Cavernous Malformations are Most Difficult to Dissect From Surrounding Eloquent Brain Tissue?
Authors: Dammann Philipp , Wrede Karsten , Jabbarli Ramazan , Müller Oliver , Mönninghoff Christoph , Forsting Michael , Sure Ulrich 
Published: January 2017

Abstract

BACKGROUND: Cerebral cavernous malformations (CCM) may lead to repetitive intracerebral hemorrhage. In selected cases, a surgical resection is indicated.

OBJECTIVE: To identify magnetic resonance imaging (MRI) features of CCM that correlate with the difficulty of dissection and postoperative outcome.

METHODS: This study prospectively analyzed pre- and postoperative MRI features, intraoperative findings (surgical questionnaire), and postoperative outcome of 41 patients with eloquent CCM. Based on the results of the surgeon's questionnaire and postoperative MRI findings, all surgical procedures were dichotomized in a “difficult” (group A) or “not difficult” (group B) lesion dissection. Based on the correlation of preoperative MRI features with groups A and B, a 3-tiered classification was established and tested for sensitivity and specificity.

RESULTS: In 22 patients, dissection of the lesion was rated difficult. This was significantly correlated with amount of postoperative diffusion restriction on MRI (P = .001) and postoperative outcome (P = .05). Various preoperative MRI features were tested for correlation and combined in a 3-tiered classification. Receiver operating characteristics revealed excellent and good results for predicting difficulty of dissection for the different classification types.

CONCLUSION: We provide a meticulous analysis and new classification of preoperative MRI features that seem to be involved in the microsurgical resection of CCM.
The Health Impact of Adult Cervical Deformity in Patients Presenting for Surgical Treatment: Comparison to United States Population Norms and Chronic Disease States Based on the EuroQuol-5 Dimensions Questionnaire
Authors: Smith Justin S. , Line Breton , Bess Shay , Shaffrey Christopher I. , Kim Han Jo , Mundis Gregory , Scheer Justin K. , Klineberg Eric , O’Brien Michael , Hostin Richard , Gupta Munish , Daniels Alan , Kelly Michael , Gum Jeffrey L , Schwab Frank J. , Lafage Virginie , Lafage Renaud , Ailon Tamir , Passias Peter , Protopsaltis Themistocles , Albert Todd J. , Riew K. Daniel , Hart Robert , Burton Doug , Deviren Vedat , Ames Christopher P. , Group International Spine Study 
Published: January 2017

Abstract

BACKGROUND: Although adult cervical spine deformity (ACSD) is associated with pain and disability, its health impact has not been quantified in comparison to other chronic diseases.

OBJECTIVE: To perform a comparative analysis of the health impact of symptomatic ACSD to US normative and chronic disease values using EQ-5D (EuroQuol-5 Dimensions questionnaire) scores.

METHODS: ACSD patients presenting for surgical treatment were identified from a prospectively collected multicenter database. Baseline demographics and EQ-5D scores were collected and compared with US normative and disease state values.

RESULTS: Of 121 ACSD patients, 115 (95%) completed the EQ-5D (60% women, mean age 61 years, previous spine surgery in 44%). Diagnoses included kyphosis with mid-cervical (63.4%), cervico-thoracic (23.5%), or thoracic (8.7%) apex and primary coronal deformity (4.3%). The mean ACSD EQ-5D index was 0.511 (standard definition = 0.224), which is 34% below the bottom 25th percentile (0.780) for similar age- and gender-matched US normative populations. Mean ACSD EQ-5D index values were worse than the bottom 25th percentile for several other disease states, including chronic ischemic heart disease (0.708), malignant breast cancer (0.708), and malignant prostate cancer (0.708). ACSD mean index values were comparable to the bottom 25th percentile values for blindness/low vision (0.543), emphysema (0.508), renal failure (0.506), and stroke (0.463). EQ-5D scores did not significantly differ based on cervical deformity type (P = .66).

CONCLUSION: The health impact of symptomatic ACSD is substantial, with negative impact across all EQ-5D domains. The mean ACSD EQ-5D index was comparable to the bottom 25th percentile values for blindness/low vision, emphysema, renal failure, and stroke.
Understanding United States Investigational Device Exemption Studies—Clinical Relevance and Importance for Healthcare Economics
Authors: Ament Jared D. , Mollan Scott , Greenan Krista , Binyamin Tamar , Kim Kee D. 
Published: January 2017

Abstract

INTRODUCTION: The US Food and Drug Administration allows a previously unapproved device to be used clinically to collect safety and effectiveness data under their Investigational Device Exemption (IDE) category. The process usually falls under 3 different trial categories: noninferiority, equivalency, and superiority. To confidently inform our patients, understanding the basic concepts of these trials is paramount. The purpose of this manuscript was to provide a comprehensive review of these topics using recently published IDE trials and economic analyses of cervical total disc replacement as illustrative examples.

CASE STUDY: MOBI-C ARTIFICIAL CERVICAL DISC: In 2006, an IDE was initiated to study the safety and effectiveness of total disc replacement controlled against the standard of care, anterior cervical discectomy, and fusion. Under the IDE, randomized controlled trials comparing both 1 and 2 level cervical disease were completed. The sponsor designed the initial trial as noninferiority; however, using adaptive methodology, superiority could be claimed in the 2-level investigation.

REVIEWING HEALTHCARE ECONOMICS: Healthcare economics are critical in medical decision making and reimbursement practices. Once both cost- and quality-adjusted life-year (QALY) are known for each patient, the incremental cost-effectiveness ratio is calculated. Willingness-to-pay is controversial, but a commonly cited guideline considers interventions costing below 20 000 $/QALY strongly cost effective and more than 100 000 $/QALY as not cost effective.

CONCLUSION: While large Food and Drug Administration IDE studies are often besieged by complex statistical considerations and calculations, it is fundamentally important that clinicians understand at least the terminology and basic concepts on a practical level.