bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Undoing of the Leitmotif Technique
Authors: Baumgartner Michael 
Published: September 2022

Abstract
This chapter examines the last step of Godard’s systematic dismantling of the leitmotif technique. Meaning to demythologize cinematic illusion, Godard revokes all narrative agency from Georges Delerue’s memorable Camille theme in Le mépris, which is repeated verbatim several times during the apartment sequence with Paul and Camille quarreling. The Camille theme acts as a leitmotif but is emptied of any identifiable narrative significance and only attracts attention to itself as metafilm music. In Made in U.S.A., Godard treats several fragments from a Beethoven piano sonata and a Schumann symphony in an even more radical fashion. They become objets trouvés in the sense of surrealist art. By arbitrarily repeating these concise quotations several times throughout the film, Godard does not treat them as memorable leitmotifs but uses them instead as building blocks for a sound collage. Without preparing the spectator for their entrances, these musical quotations have no dramaturgical function and are thus relegated to the level of mere sound effects. Godard erases the last hints of the leitmotif technique in Deux ou trois choses que je sais d’elle. Due to the extreme ephemerality of several extremely short fragments from Beethoven’s late String Quartet, Op. 135, the music completely loses its function as film music and, therefore, also as metafilm music. These musical micro-shards no longer express anything discernible; evaporate amid the dense soundscape, dialogue, and voice-overs; and ultimately cease supporting the film’s narrative.
Referencing Film Music as a Genre
Authors: Baumgartner Michael 
Published: September 2022

Abstract
Based on the assumption that film music is responsible for conjuring up the audience’s emotions, this chapter explores Antoine Duhamel’s score for Pierrot le fou and Georges Delerue’s score for Le mépris as archetypical, self-conscious music referencing specific film genres. With his critical approach to film music as metafilm music in his 1960s films, Godard frequently alludes to overused paradigms of film music that are modeled after the prerogatives of Hollywood cinema. Such genre-typical music in Godard’s films is reminiscent of scores used in romantic comedies, suspense thrillers, and melodramas. The clichéd use of genre-specific music draws attention to itself and questions the efficacy of music as an integral part of the cinematic narrative influencing the viewing experience. Godard reduces Duhamel’s Pierrot score to the four most basic film musical articulations which are intended to evoke appropriate emotions in the spectator. This reduction to one function raises the question of whether film music can be defined as its own musical genre, similar to opera or symphony. A closer look at Delerue’s Le mépris score demonstrates that such a reduction to genre-specific musical denominators suggests Claudia Gorbman’s experiment of commutation. One score that expresses a specific mood can be easily exchanged with another one conceived in a similar mood without substantially altering the filmic message. Le mépris’s main-title theme, resembling a 1950s Hollywood melodrama score, assumes the role of a placeholder for generic melodramatic music and can thus be effortlessly replaced by any similar score written in an inherently melodramatic idiom.
Music Making as Metaphor for Filmmaking I
Authors: Baumgartner Michael 
Published: September 2022

Abstract
This and the following chapter are concerned with Godard’s objective of adding a philosophical underpinning to his innovative and singular film music aesthetics in the 1980s. Based on his observation that music making acts as a guide to understanding the creative process of filmmaking, Godard establishes an aesthetical concept of film music that corresponds to his complex cinematic language of the 1980s. As part of a profound investigation involving both the image and the soundtrack, he approached film music as metafilm music in Prénom: Carmen and Soigne ta droite (Une place sur la terre) as an equally important component of these films to storytelling itself. He thus established an aesthetical concept of film music that corresponds to his intricate cinematic language of the 1980s. Similar explorations had begun already in the late 1960s, when he captured the Rolling Stones on film in One Plus One during the recording of their song “Sympathy for the Devil.” As in Prénom: Carmen, in which he depicts the Quatuor Prat rehearsing Beethoven’s string quartets, Godard intertwines the rehearsal footage with fictional and quasi-documentary material. The objective of this chapter is thus to investigate how Godard self-reflexively emulates the process of music making for the sphere of cinema by utilizing the rehearsal sequences in the two discussed films as a metaphor for the act of filmmaking itself.
Music Making as Metaphor for Filmmaking II
Authors: Baumgartner Michael 
Published: September 2022

Abstract
This chapter continues the discussion of Godard’s self-reflexive understanding of music making as a model for filmmaking. After One Plus One and Prénom: Carmen, Godard returned once more to the metaphor of rehearsing music as viable guidance for filmmaking. In Soigne ta droite (Une place sur la terre), the sequences with the eclectic French techno-pop duo Les Rita Mitsouko rehearsing in their home studio displays an intimate and productive relationship between the two musicians. The rehearsal sequences are frequently interrupted by non-congruent sketches with comedian Jacques Villeret and a second side story with Godard as “the Idiot” finishing a film within twenty-four hours. With an intricate montage of the three disparate storylines supported by frequent text quotations from evocative Austrian author Hermann Broch, André Malraux, and Samuel Beckett, Godard investigates the crisis of the (post)modernist artist and the notion of the ever-unfinished artwork which itself is based on a never-ending string of quotations. Music, as metafilm music assuming a transcendental role, is involved—with the other filmic devices—in searching for the truth of artistic creation. In this thought-provoking yet underrated film, Godard’s intertwined, multilayered use of music and sound as part of a complex audiovisual web confirms the increasingly more complex function of music in his films from the late 1980s up to the late 2010s.
Emergency and essential surgical capacity assessment in Gimbichu district: cross-sectional study
Authors: Gebregzi Amare H. , Meshesha Berhane R. , Chekol Tadesse S. , Bereded Eyobed K. , Adem Getachew Y. , Beshir Hassen M. , Taye Desalegn B. , Negash Fitsum T. , Andarie Netsanet B. 
Published: September 2022

Introduction:
Effectively integrating surgical and anesthesia care through bottom-up approach to fulfill universal health coverage is a crucial step to avail essential surgical and emergency service in low and middle-income countries.

Objective:
The study aims to assess the surgical and anesthesia service delivery capacity of Gimbichu district, East Shao Zone of Oromia Regional State, Ethiopia, using WHO’s emergency and essential surgical care situational analysis assessment tool.

Methods:
A cross-sectional survey design is conducted in Gimbichu district health facilities and linked referral hospitals to assess the surgical capacity. Direct observation and interview using WHO surgical capacity assessment, is used to collect data. All surgical patients managed from January to December 2021 are included in the study. Descriptive statistics were used to describe and present the finding.

Result:
The total amount of surgical procedures performed in a year in the health centers and nearby referral hospitals is 2838 procedures. Two health facilities that receive referrals from the district have a combined surgical workforce of 23 people serving a population of >1.5 million people in the catchment area. Gimbichu district health institutions execute 18.32% of the interventions/procedures recommended by the WHO emergency and essential surgical list. Nearby health facilities affiliated to Gimbichu district health institutions refer surgical patients for 56% of procedures classified as an emergency and necessary surgical services. Referred patients travel 5.6 km on average to access essential and emergency surgical services.

Conclusion and recommendation:
Building the capacity of health extension professionals on utilization of health facility service directory, community-level surgical condition assessment, referral, and linkage need to be priority activity to cement responsive primary health system to community surgical demand. Further improvement areas includes surgical workforce deployment and expanding the surgical capacity of health facilities in the Gimbichu district and nearby referral hospitals.
Preoperative Evaluation of Otosclerosis: A National Survey of Otologists
Authors: Doerfer Karl W. , Tu Nathan C. , Sioshansi Pedrom C. , Luryi Alex L. , Schutt Christopher A. , Babu Seilesh C. 
Published: September 2022

Objective
Describe practice patterns in preoperative assessment for stapedectomy.

Study Design
Survey.

Setting
Tertiary referral center.

Subjects
Active members of the American Neurotologic Society and American Otologic Society.

Intervention
Survey.

Main Outcome Measures
Percent of respondents performing preoperative testing with acoustic reflexes (ARs), electrocochleography, vestibular evoked myogenic potentials, and computed tomography (CT). Further analysis of those not ordering routine CT to determine whether imaging would be ordered for previous ear surgery, vestibular complaints, childhood hearing loss, AR inconsistent with otosclerosis, possible advanced otosclerosis, or atypical complaints, including autophony. Further subgroup analysis based on years in practice and practice setting (private versus academic).

Results
Most respondents (56.5%) had practiced more than 15 years and worked in academic settings (69.4%). Rates of routine use of preoperative AR, vestibular evoked myogenic potential, and electrocochleography were 80, 4.7, and 0%, respectively. There were no significant differences based on time in practice or practice settings. For CT, 35.3% reported routine use with a statistically significant difference between academic and private practice respondents (42.4% versus 19.2%, p = 0.040). For CT contingent on specific clinical factors, only AR inconsistent with otosclerosis showed a statistically significant difference between academic and private practice providers (85.3% versus 57.1%, p = 0.020).

Conclusion
Most otologists routinely obtain AR before stapedectomy. Academic providers more commonly order CT routinely and for AR inconsistent with otosclerosis. Most respondents not ordering routine CT ordered imaging in specific clinical scenarios. Overall, there is a high level of consistency in preoperative testing regardless of practice setting or time in practice.
Hearing Aid Usage and Reported Hearing Difficulty in Americans With Subclinical Hearing Loss
Authors: Dragon Jacqueline M. , Grewal Maeher R. , Irace Alexandria L. , Golub Justin S. 
Published: September 2022

Objective
Subclinical hearing loss (SCHL) (previously defined by our group as a four-frequency pure tone average [PTA4] >0 to ≤25 dB) has recently been associated with depressive symptoms and cognitive decline. This suggests that the common 25 dB adult cutpoint in the United States for normal hearing may not be sensitive enough. We aim to characterize real-world hearing difficulties, as measured by hearing aid use and self-reported hearing difficulty, among individuals with SCHL.

Study Design
Analysis of biennial cross-sectional epidemiologic survey (National Health and Nutrition Examination Survey, 1999–2012, 2015–2016).

Setting
Community, multicentered, national.

Subjects
Noninstitutionalized US citizens ≥12 years old, n = 19,246.

Measures
PTA4 (500, 1,000, 2,000, 4,000 Hz), high-frequency pure tone average (PTAhf) (6,000, 8,000 Hz), reported hearing aid use, subjective difficulty hearing.

Results
There were 806,705 Americans with SCHL who wore hearing aids (or 0.35% of the 227,324,096 Americans with SCHL; 95% confidence interval = 0.23%–0.54%). Among those with SCHL, 14.6% (33.1 million Americans) perceived a little trouble hearing and 2.29% (5.21 million Americans) perceived moderate/a lot of trouble hearing. When restricted to the borderline subcategory (>20 to ≤25 dB), 42.43% (6.64 million Americans) had at least a little trouble hearing. Among those with SCHL who wore hearing aids, 81% had a PTAhf >25 dB.

Conclusion
Despite hearing loss traditionally being defined by PTA4 ≤ 25 dB in the United States, nearly 1 million adults and adolescents with SCHL wore hearing aids, and nearly half with borderline HL had subjective difficulty hearing. To better reflect real-world difficulties, stricter definitions of hearing loss should be explored, including a lower cutpoint for the PTA4 or by using the more sensitive PTAhf.
Optimized Infliximab Induction Predicts Better Long‐Term Clinical and Biomarker Outcomes Compared to Standard Induction Dosing
Authors: Lawrence Sally , Faytrouni Farah , Harris Rachel E. , Irvine Mike , Carrion Estefania , Scott Gregor , Clarke Benjamin , Garrick Vikki , Curtis Lee , Gervais Lisa , Tayler Rachel , Riou Marliss , Hansen Richard , Jacobson Kevan , Russell Richard K. 
Published: September 2022

Objectives:To evaluate the efficacy of standard and optimized infliximab induction dosing in attaining corticosteroid (CS) free clinical remission at week 52 and the effect that post‐induction trough levels have on long‐term outcome.Methods:Inflammatory bowel disease (IBD) patients ≤18 years commenced on infliximab between August 1, 2016, and August 1, 2018, from Vancouver, Canada, and Glasgow, Scotland, were included. The Glasgow cohort followed standard induction while the Vancouver cohort undertook induction optimization based on clinical, biomarker, and proactive infliximab trough levels. Baseline characteristics and laboratory values were documented.Results:In total, 140 children were included [median age 14.1 years (interquartile range (IQR) 12.0–16.0)]; 54% male. CS‐free clinical remission at week 52 was higher in the optimized group compared to the standard cohort [65/78 (83%) vs. 32/62 (52%), P < 0.001]. Combined CS‐free clinical and biomarker remission (CRP < 5 mg/L) was also higher in the optimized compared to the standard cohort [65/78 (83%) vs 25/62 (40%), P < 0.001]. The median post‐induction trough level was higher in children who were in CS‐free clinical remission at week 52 [3.6 mg/L (1.5‐7.1)] vs. those who were not [2.0 mg/L (0.8–4.1), P = 0.04]. The odds of attaining a therapeutic post‐induction trough level were almost 4‐fold higher in the optimized group than the standard cohort (OR 3.97, 95% CI: 1.89–8.68, P < 0.001).Conclusions:Standard infliximab induction resulted in less favorable long‐term outcomes for pediatric IBD patients. Optimizing induction using clinical, biomarker, and proactive trough levels resulted in higher post‐induction trough levels and a greater odds of attaining long‐term clinical remission.
Addressing What Matters Aligning care with the priorities of older adults and their caregivers.
Authors: Carbonell Ellen , Zonsius Mary C. , Rodriguez-Morales Grisel , Newman Michelle , Emery-Tiburcio Erin E. 
Published: September 2022

This article is the second in a series, Supporting Family Caregivers in the 4Ms of an Age-Friendly Health System, published in collaboration with the AARP Public Policy Institute and originally appearing in the American Journal of Nursing, Volume 122, issue 1, as part of the ongoing Supporting Family Caregivers: No Longer Home Alone series. The 4Ms of an Age-Friendly Health System (What Matters, Medication, Mentation, and Mobility) is an evidence-based framework for assessing and acting on critical issues in the care of older adults across settings and transitions of care. Engaging the health care team, including older adults and their family caregivers, with the 4Ms framework can help to ensure that every older adult gets the best care possible, is not harmed by health care, and is satisfied with the care they receive.
The articles in this series present considerations for implementing the 4Ms framework in the inpatient hospital setting and incorporating family caregivers in doing so. Resources for both nurses and family caregivers, including a series of accompanying videos developed by AARP and the Rush Center for Excellence in Aging and funded by The John A. Hartford Foundation, are also provided. Nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet—Information for Family Caregivers—and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses. Cite this article as: Carbonell, E., et al. Addressing What Matters. Am J Nurs 2022; 122(1): 54-58.
Predicting the response to Neoadjuvant Chemotherapy. Can the addition of tomosynthesis improve the accuracy of CESM? A comparison with breast MRI
Authors: Savaridas Sarah L , Vinnicombe Sarah , Warwick Violet , Evans Andrew J 
Published: September 2022

AbstractBackgroundNeoadjuvant chemotherapy (NACT) is used to downstage breast cancer prior to surgery. Image monitoring is essential to guide treatment and to assess in vivo chemosensitivity. Breast MRI is considered the gold-standard imaging technique; however, it is contraindicated or poorly tolerated in some patients and may be hard to access. Evidence suggests contrast enhanced spectral mammography (CESM) may approach the accuracy of MRI. This novel pilot study investigates whether the addition of digital breast tomosynthesis (DBT) to CESM increases the accuracy of response prediction.ResultsSixteen cancers in fourteen patients were imaged with CESM+DBT and MRI following completion of NACT. Ten cancers demonstrated pathological complete response (pCR) defined as absence of residual invasive disease. Greatest accuracy for predicting pCR was with CESM contrast-enhancement only (accuracy 81.3%, sensitivity 100%, specificity 57.1%), followed by MRI (accuracy 62.5%, sensitivity 44.4%, specificity 85.7%). Concordance with invasive tumour size was greater for CESM than MRI, concordance-coefficients 0.70 vs 0.66 respectively. MRI demonstrated greatest concordance with whole tumour size followed by CESM contrast-enhancement plus microcalcification, concordance-coefficients 0.86 vs 0.69. The addition of DBT did not improve accuracy for prediction of pCR or residual disease size. Whereas CESM+DBT tended to underestimate size of residual disease, MRI tended to overestimate but no significant differences were seen (p>0.05).ConclusionsCESM contrast-enhancement plus microcalcification is similar to MRI for predicting residual disease post-NACT. Size of enhancement alone demonstrates best concordance with invasive disease. Inclusion of residual microcalcification improves concordance with DCIS. The addition of DBT to CESM does not improve accuracy.HighlightsNo benefit of adding DBT to CESM for NACT response predictionCESM appears similar to MRI for predicting response to NACTCESM has greatest accuracy for residual invasive tumour size.CESM+calcification has greater accuracy for predicting residual in situ disease.
Evaluating the frequency and the impact of pharmacogenetic alleles in an ancestrally diverse Biobank population
Authors: Verma Shefali S. , Keat Karl , Li Binglan , Hoffecker Glenda , Risman Marjorie ,   Regeneron Genetics Center, Sangkuhl Katrin , Whirl-Carrillo Michelle , Dudek Scott , Verma Anurag , Klein Teri E. , Ritchie Marylyn D. , Tuteja Sony 
Published: September 2022

AbstractBackgroundPharmacogenomics (PGx) aims to utilize a patient’s genetic data to enable safer and more effective prescribing of medications. The Clinical Pharmacogenetics Implementation Consortium (CPIC) provides guidelines with strong evidence for 24 genes that affect 72 medications. Despite strong evidence linking PGx alleles to drug response, there is a large gap in the implementation and return of actionable pharmacogenetic findings to patients in standard clinical practice. In this study, we evaluated opportunities for genetically guided medication prescribing in a diverse health system and determined the frequencies of actionable PGx alleles in an ancestrally diverse biobank population.MethodsA retrospective analysis of the Penn Medicine electronic health records (EHRs), which includes ∼3.3 million patients between 2012-2020, provides a snapshot of the trends in prescriptions for drugs with genotype-based prescribing guidelines (‘CPIC level A or B’) in the Penn Medicine health system. The Penn Medicine BioBank (PMBB) consists of a diverse group of 43,359 participants whose EHRs are linked to genome-wide SNP array and whole exome sequencing (WES) data. We used the Pharmacogenomics Clinical Annotation Tool (PharmCAT), to annotate PGx alleles from PMBB variant call format (VCF) files and identify samples with actionable PGx alleles.ResultsWe identified ∼316,000 unique patients that were prescribed at least 2 drugs with CPIC Level A or B guidelines. Genetic analysis in PMBB identified that 98.9% of participants carry one or more PGx actionable alleles where treatment modification would be recommended. After linking the genetic data with prescription data from the EHR, 14.2% of participants (n=6157) were prescribed medications that could be impacted by their genotype (as indicated by their PharmCAT report). For example, 856 participants received clopidogrel who carriedCYP2C19reduced function alleles, placing them at increased risk for major adverse cardiovascular events. When we stratified by genetic ancestry, we found disparities in PGx allele frequencies and clinical burden. Clopidogrel users of Asian ancestry in PMBB had significantly higher rates ofCYP2C19actionable alleles than European ancestry users of clopidrogrel (p<0.0001, OR=3.68).ConclusionsClinically actionable PGx alleles are highly prevalent in our health system and many patients were prescribed medications that could be affected by PGx alleles. These results illustrate the potential utility of preemptive genotyping for tailoring of medications and implementation of PGx into routine clinical care.