bluuebunny/crossref_metadata_2025_split huggingface dataset:
Digit ratio and autism spectrum disorders in the Avon Longitudinal Study of Parents and Children: a birth cohort study
Authors: Guyatt Anna Louise , Heron Jon , Knight Bernice Le Cornu , Golding Jean , Rai Dheeraj 
Published: August 2015

ObjectivesTo investigate whether second-to-fourth digit ratio (2D:4D), a measure commonly used as a proxy for fetal testosterone exposure, is associated with autism spectrum disorders (ASDs), as predicted by the extreme male brain theory of autism.DesignA birth cohort study.SettingThe Avon Longitudinal Study of Parents and Children (ALSPAC).Participants6015 ALSPAC children with data on digit ratio, at least 1 outcome measure and information on potential confounding variables (parental occupational class, maternal education and age at digit ratio measurement). Digit ratio was measured by the photocopy and calliper method.OutcomesASD diagnosis (cases were identified previously by record linkage or maternal report) and 4 measures that combine optimally within ALSPAC to predict ASD: the Children's Communication Checklist (coherence subscale), the Social and Communication Disorders Checklist, a repetitive behaviour measure, and the Emotionality, Activity and Sociability scale (sociability subscale). These measures were dichotomised, with approximately 10% defined as the ‘risk’ group.ResultsUsing logistic regression, we examined the association of 2D:4D with ASDs and 4 dichotomised ASD traits. Covariates were occupational class, maternal education and age at 2D:4D measurement. 2D:4D was not associated with ASDs in males (adjusted OR per 1 SD increase in mean 2D:4D, 0.88 (95% CI 0.65 to 1.21), p=0.435) or females (adjusted OR=1.36 (95% CI 0.81 to 2.28), p=0.245). Similar results were observed after adjustment for IQ. There was 1 weak association between reduced coherence and increased left 2D:4D in males, in the opposite direction to that predicted by the extreme male brain theory (adjusted OR=1.15 (95% CI 1.02 to 1.29), p=0.023). Given multiple comparisons, this is consistent with chance.ConclusionsIn this population-based study, there was no strong evidence of an association between 2D:4D and ASD diagnosis or traits, although the CIs were wide. These results are not consistent with the extreme male brain theory.
Risk factors for maternal morbidity in Victoria, Australia: a population-based study
Authors: Lindquist Anthea C , Kurinczuk Jennifer J , Wallace Euan M , Oats Jeremy , Knight Marian 
Published: August 2015

ObjectivesThe aim of this analysis was to quantify the risk factors associated with maternal morbidity among women in Victoria, Australia, focusing particularly on sociodemographic factors.DesignCase–control analysis.ParticipantsData on all maternities in Victoria from 1 January 2006 to 31 December 2008.MethodsA case–control analysis was conducted using unconditional logistic regression to calculate adjusted ORs (aORs). Cases were defined as all women noted to have had a severe complication during the index pregnancy. Severe maternal morbidity was defined by the validated, composite Australian Maternal Morbidity Outcome Indicator. Socioeconomic position was defined by Socio-Economic Indices for Areas (SEIFA), specifically the Index of Relative Socioeconomic Disadvantage (IRSD), and other variables analysed were age, parity, Indigenous background, multiple pregnancy, country of birth, coexisting medical condition, previous caesarean section, spontaneous abortion or ectopic pregnancy.ResultsThe study population comprised 211 060 women, including 1119 cases of severe maternal morbidity (0.53%). Compared with the highest IRSD quintile, the aOR for the 2nd quintile was 1.23 (95% CI 1.03 to 1.49), 0.98 (95% CI 0.79 to 1.21) for the 3rd quintile, 1.55 (95% CI 1.28 to 1.87) for the 4th and 1.21 (95% CI 1.00 to 1.47) for the lowest (most deprived) quintile. Indigenous status was associated with twice (aOR 2.02; 95% CI 1.32 to 3.09) the odds of being a case. Other risk factors for severe maternal morbidity were age ≥35 years (aOR 1.22; 95% CI 1.04 to 1.44), coexisting medical condition (aOR 1.39; 95% CI 1.16 to 1.65), multiple pregnancy (aOR 2.30; 95% CI 1.71 to 3.10), primiparity (aOR 1.36; 95% CI 1.18 to 1.57), previous caesarean section (aOR 1.79; 95% CI 1.53 to 2.10) and previous spontaneous miscarriage (aOR 1.25; 95% CI 1.08 to 1.44).ConclusionsThe findings from Victoria strongly suggest that social disadvantage needs to be acknowledged and further investigated as an independent risk factor for adverse maternal outcomes in Australia and incorporated into appropriate policy planning and healthcare programmes.
The evaluation of an interactive web-based Pulmonary Rehabilitation programme: protocol for the WEB SPACE for COPD feasibility study
Authors: Chaplin Emma , Hewitt Stacey , Apps Lindsay , Edwards Kelly , Brough Chris , Glab Aga , Bankart John , Jacobs Ruth , Boyce Sally , Williams Johanna , Singh Sally 
Published: August 2015

IntroductionPulmonary Rehabilitation (PR) is an evidence-based intervention that has been recommended in guidelines to be available to those who may benefit. However, not all patients with chronic obstructive pulmonary disease (COPD) have access to this service. Healthcare services have shown the need for the provision of PR in other forms to enable patient choice and service capacity. There is an increase in evidence for the use of the internet in the management of long-term conditions to provide education and promote self-management. The aim of this study is to see if an interactive web-based PR programme is a feasible alternative compared with conventional PR.Methods and analysisThis is a feasibility study designed to evaluate the efficacy of providing a web-based PR programme to improve patients exercise capacity, quality of life and promote self-management in patients with moderate to severe COPD compared with conventional PR programmes. Eligible patients will be randomly allocated to receive either the web-based programme or conventional rehabilitation programme for 7 weeks using an internet-based randomisation system. Participants will be recruited from PR assessments, primary care and community rehabilitation programmes. Those randomised to the web-based programme work through the website which contains all the information that the patients receive in the PR classes. They receive weekly phone calls by a professional to help progress through the course on line. The outcome measures will be recruitment rates and eligibility as well as that standard for a PR assessment including measures of exercise capacity, quality of life questionnaires and physical activity.Ethics and disseminationThe research ethics committee for Northampton has provided ethical approval for the conduct of the study. The results of the study will be disseminated through appropriate conference presentations and peer reviewed journals.Trial registration numberISRCTN03142263.
Time-driven activity-based costing of multivessel coronary artery bypass grafting across national boundaries to identify improvement opportunities: study protocol
Authors: Erhun F , Mistry B , Platchek T , Milstein A , Narayanan V G , Kaplan R S 
Published: August 2015

IntroductionCoronary artery bypass graft (CABG) surgery is a well-established, commonly performed treatment for coronary artery disease—a disease that affects over 10% of US adults and is a major cause of morbidity and mortality. In 2005, the mean cost for a CABG procedure among Medicare beneficiaries in the USA was $32 201±$23 059. The same operation reportedly costs less than $2000 to produce in India. The goals of the proposed study are to (1) identify the difference in the costs incurred to perform CABG surgery by three Joint Commission accredited hospitals with reputations for high quality and efficiency and (2) characterise the opportunity to reduce the cost of performing CABG surgery.Methods and analysisWe use time-driven activity-based costing (TDABC) to quantify the hospitals’ costs of producing elective, multivessel CABG. TDABC estimates the costs of a given clinical service by combining information about the process of patient care delivery (specifically, the time and quantity of labour and non-labour resources utilised to perform each activity) with the unit cost of each resource used to provide the care. Resource utilisation was estimated by constructing CABG process maps for each site based on observation of care and staff interviews. Unit costs were calculated as a capacity cost rate, measured as a $/min, for each resource consumed in CABG production. Multiplying together the unit costs and resource quantities and summing across all resources used will produce the average cost of CABG production at each site. We will conclude by conducting a variance analysis of labour costs to reveal opportunities to bend the cost curve for CABG production in the USA.Ethics and disseminationAll our methods were exempted from review by the Stanford Institutional Review Board. Results will be published in peer-reviewed journals and presented at scientific meetings.
‘We might as well be speaking different languages’: an innovative interprofessional education tool to teach and assess communication skills critical to patient safety
Authors: Gillespie Colleen , Adams Jennifer , Hanley Kathleen , Wagner Ellen , Shaker-Brown Amara , Naidu Mrudula , Kalet Adina , Zabar Sondra 
Published: August 2015

IntroductionAll practicing health professionals must be able to communicate effectively with their colleagues around the care of patients. Better communication between health professionals not only improves patient outcomes, but also cuts down on costly and unnecessary tests or healthcare services. At New York University (NYU), we have addressed the need for interprofessional education (IPE) by incorporating a set of interprofessional objective structured clinical examinations (OSCEs) cases into our performance-based assessment programme to expand the educational tools for interprofessional collaborative (IPC) practice, assessment and feedback.MethodsWe identified and operationalised IPC competencies to create an assessment tool for use in IPC clinical cases, delineating core domains and then identifying observable behaviours that represented the broader competencies. IPC cases (for use in OSCEs) were designed in a way that required medical students and residents to collaborate effectively with a health professional from another discipline (standardised registered nurse (RN)) in order to provide quality care to a (standardised) patient. Feedback from the standardised RN and the participants was content analysed and our own experience in implementing was described.ResultsThis method demonstrates that IPC practice can effectively be incorporated into medical education training and assessment, at the undergraduate and graduate level. We found high internal consistency among items within each of the core IPC competency domains (Cronbach's α 0.80–0.85). Based on both standardised RN and faculty feedback, the cases were effective in discriminating among learners within and across undergraduate medical education (UME) and graduate medical education (GME) levels, and within learners, in identifying individual strengths and weaknesses. Learners found these cases to be realistic, challenging and stimulating.ConclusionsOSCE-based IPC training is a feasible and useful methodology. Ultimately, IPC OSCE cases are training tools that provide learners with a safe environment to practice, receive feedback and develop the critical skills needed for our evolving healthcare system. The next steps are to expand the scope of IPE cases to include more team members, and team work to also incorporate faculty development to ensure that our teachers and role models are effective in providing feedback on IPC practice.
Role of immunohistochemistry in the era of genetic testing inMYC-positive aggressive B-cell lymphomas: a study of 209 cases
Authors: Agarwal Rishu , Lade Stephen , Liew Danny , Rogers Toni-Maree , Byrne David , Feleppa Frank , Juneja Surender , Westerman David A 
Published: August 2015

AimsMYCrearrangements with or withoutBCL2rearrangements have been shown to be associated with poor prognosis and inferior survival in diffuse large B-cell lymphomas (DLBCL). Most of these cases are still diagnosed by fluorescent in situ hybridisation (FISH) testing, which is expensive, requires expertise and is not routinely available in all laboratories. Immunohistochemistry (IHC) is widely available and has the potential to be used as a screening test to identify cases with increased protein expression and select cases that require confirmatory testing. We correlated the expression ofMYCandBCL2by IHC with FISH studies in an attempt to define a cut-off value, which can be used by laboratories to select cases requiring confirmatory FISH testing. The prevalence ofMYC-positive DLBCL and double-hit lymphoma (DHL) has also been studied.Methods209 cases comprising of 15 cases of Burkitt lymphoma (BL), 13 cases of intermediate BL/DLBCL and 181 cases of DLBCL were included. IHC and FISH forMYCandBCL2were performed and the results were correlated.ResultsThe prevalence ofMYC-positive DLBCL andMYC/BCL2DHL was 13.4% and 7.4%, respectively, in our study. Germinal-centre subtype was more common inMYC-positive DLBCL and DHL.MYC-positive DLBCL also showed higher median Ki-67 (>90%) and CD10 positivity as compared withMYC-negative cases.ConclusionsIHC can be used for screening cases, which require further confirmatory FISH testing. We recommend a cut-off value of ≥30% forMYCby IHC; however, international standardisation of these values is necessary to provide uniformity among laboratories.
Efficacy and follow-up of transcatheter aortic valve implantation in patients with radiation-induced aortic stenosis
Authors: Dijos Marina , Reynaud Amélie , Leroux Lionel , Réant Patricia , Cornolle Claire , Roudaut Raymond , Dos Santos Pierre , Lafitte Stéphane 
Published: August 2015

ObjectiveTo investigate transcatheter aortic valve implantation (TAVI) feasibility, effectiveness and safety in radiation-induced aortic valve stenosis cases.Methods198 consecutive patients referred for TAVI were prospectively enrolled. They were divided into two groups: patients with a history of chest radiation therapy with suspected radiation-induced valvular disease (RXT) and others with suspected degenerative aortic valve stenosis (NRXT). Procedural, early and mid-term clinical outcomes were compared.ResultsOf the 198 patients enrolled in our study, 9.6% qualified for inclusion in the RXT group. A comparison of baseline characteristics revealed that patients with RXT were younger than patients with NRXT (68.3 vs 82.5 years; p<0.05) and exhibited a lower surgical risk score (Euroscore: 7.1% vs 21.8%; p<0.05) and a higher frequency of hostile thorax and porcelain aorta (52.6% vs 28.5%; p<0.05; 63.2% vs 10.6%; p<0.05, respectively). In both groups, the implantation success rate was high and the 30-day safety end point acceptable (RXT: 94.7% and 83.3%; NRXT: 93.9% and 75.6%, respectively). At 6 months, overall mortality was significantly lower in the RXT group (0% vs 18%; p=0.048).ConclusionsIn patients suffering from radiation-induced aortic valve stenosis and contraindicated for surgery, TAVI is a promising approach, with high feasibility, acceptable risk, low mortality and high clinical effectiveness at mid-term follow-up.
Dielectric relaxation in pure and Co-doped Bi12GeO20 single crystals
Authors: Filipič C. , Klos A. , Gajc M. , Pawlak D. A. , Dolinšek J. , Levstik A. 
Published: August 2015

We report the results of investigation of dielectric spectroscopy study of single crystals of [Formula: see text] and [Formula: see text] doped with Co nanoparticles. The complex dielectric constant was measured in the temperature interval from 5 to 450 K and frequencies from 1 Hz to 1 MHz. The electrical conductivity of both samples was thermally activated with potential barriers of 0.55 eV and 0.59 eV, respectively. Doped samples had bigger complex dielectric constants and [Formula: see text] exhibited slightly steeper temperature dependence than in the pure sample. The dielectric relaxation was observed in pure and doped single crystals and relaxation frequencies showed similar activation energies as electrical conductivities.
A Comprehensive Implementation and Evaluation of Direct Interrupt Delivery
Authors: Tu Cheng-Chun , Ferdman Michael , Lee Chao-tung , Chiueh Tzi-cker 
Published: August 2015

As the performance overhead associated with CPU and memory virtualization becomes largely negligible, research efforts are directed toward reducing the I/O virtualization overhead, which mainly comes from two sources: DMA set-up and payload copy, and interrupt delivery. The advent of SRIOV and MRIOV effectively reduces the DMA-related virtualization overhead to a minimum. Therefore, the last battleground for minimizing virtualization overhead is how to directly deliver every interrupt to its target VM without involving the hypervisor.
This paper describes the design, implementation, and evaluation of a KVM-based direct interrupt delivery system called DID. DID delivers interrupts from SRIOV devices, virtual devices, and timers to their target VMs directly, completely avoiding VM exits. Moreover, DID does not require any modifications to the VM's operating system and preserves the correct priority among interrupts in all cases. We demonstrate that DID reduces the number of VM exits by a factor of 100 for I/O-intensive workloads, decreases the interrupt invocation latency by 80%, and improves the throughput of a VM running Memcached by a factor of 3.
PARS
Authors: Cui Lei , Wo Tianyu , Li Bo , Li Jianxin , Shi Bin , Huai Jinpeng 
Published: August 2015

Virtual machine (VM) snapshot enhances the system availability by saving the running state into stable storage during failure-free execution and rolling back to the snapshot point upon failures. Unfortunately, the snapshot state may be lost due to disk failures, so that the VM fails to be recovered. The popular distributed file systems employ replication technique to tolerate disk failures by placing redundant copies across disperse disks. However, unless user-specific personalization is provided, these systems consider the data in the file as of same importance and create identical copies of the entire file, leading to non-trivial additional storage overhead.
This paper proposes a page-aware replication system (PARS) to store VM snapshots efficiently. PARS employs VM introspection technique to explore how a page is used by guest, and classifies the pages by their importance to system execution. If a page is critical, PARS replicates it multiple copies to ensure high availability and long-term durability. Otherwise, the loss of this page causes no harm for system to work properly, PARS therefore saves only one copy of the page. Consequently, PARS improves storage efficiency without compromising availability. We have implemented PARS to justify its practicality. The experimental results demonstrate that PARS achieves 53.9% space saving compared to the native replication approach in HDFS which replicates the whole snapshot file fully and identically.
AppSec
Authors: Ren Jianbao , Qi Yong , Dai Yuehua , Wang Xiaoguang , Shi Yi 
Published: August 2015

Malicious OS kernel can easily access user's private data in main memory and pries human-machine interaction data, even one that employs privacy enforcement based on application level or OS level. This paper introduces AppSec, a hypervisor-based safe execution environment, to protect both the memory data and human-machine interaction data of security sensitive applications from the untrusted OS transparently.
AppSec provides several security mechanisms on an untrusted OS. AppSec introduces a safe loader to check the code integrity of application and dynamic shared objects. During runtime, AppSec protects application and dynamic shared objects from being modified and verifies kernel memory accesses according to application's intention. AppSec provides a devices isolation mechanism to prevent the human-machine interaction devices being accessed by compromised kernel. On top of that, AppSec further provides a privileged-based window system to protect application's X resources. The major advantages of AppSec are threefold. First, AppSec verifies and protects all dynamic shared objects during runtime. Second, AppSec mediates kernel memory access according to application's intention but not encrypts all application's data roughly. Third, AppSec provides a trusted I/O path from end-user to application. A prototype of AppSec is implemented and shows that AppSec is efficient and practical.
Who Must We Target Now to Minimize Future Cardiovascular Events and Total Mortality?
Authors: Desai Jay R. , Vazquez-Benitez Gabriela , Xu Zhiyuan , Schroeder Emily B. , Karter Andrew J. , Steiner John F. , Nichols Gregory A. , Reynolds Kristi , Xu Stanley , Newton Katherine , Pathak Ram D. , Waitzfelder Beth , Elston Lafata Jennifer , Butler Melissa G. , Kirchner H. Lester , Thomas Abraham , O’Connor Patrick J. 
Published: August 2015

Background—
Examining trends in cardiovascular events and mortality in US health systems can guide the design of targeted clinical and public health strategies to reduce cardiovascular events and mortality rates.

Methods and Results—

We conducted an observational cohort study from 2005 to 2011 among 1.25 million diabetic subjects and 1.25 million nondiabetic subjects from 11 health systems that participate in the Surveillance, Prevention and Management of Diabetes Mellitus (SUPREME-DM) DataLink. Annual rates (per 1000 person-years) of myocardial infarction/acute coronary syndrome (
International Classification of Diseases-Ninth Revision
, 410.0–410.91, 411.1–411.8), stroke (
International Classification of Diseases-Ninth Revision
, 430–432.9, 433–434.9), heart failure (
International Classification of Diseases-Ninth Revision
, 428–428.9), and all-cause mortality were monitored by diabetes mellitus (DM) status, age, sex, race/ethnicity, and a prior cardiovascular history. We observed significant declines in cardiovascular events and mortality rates in subjects with and without DM. However, there was substantial variation by age, sex, race/ethnicity, and prior cardiovascular history. Mortality declined from 44.7 to 27.1 (
P
<0.0001) for those with DM and cardiovascular disease (CVD), from 11.2 to 10.9 (
P
=0.03) for those with DM only, and from 18.9 to 13.0 (
P
<0.0001) for those with CVD only. Yet, in the ≈85% of subjects with neither DM nor CVD, overall mortality (7.0 to 6.8;
P
=0.10) and stroke rates (1.6–1.6;
P
=0.77) did not decline and heart failure rates increased (0.9–1.15;
P
=0.0005).

Conclusions—
To sustain improvements in myocardial infarction, stroke, heart failure, and mortality, health systems that have successfully focused on care improvement in high-risk adults with DM or CVD must broaden their improvement strategies to target lower risk adults who have not yet developed DM or CVD.