bluuebunny/crossref_metadata_2025_split huggingface dataset:
One-pot simultaneous production and sustainable purification of fibrinolytic protease from Bacillus cereus using natural deep eutectic solvents
Authors: Rathnasamy Senthil Kumar , Durai Aadhavan , Vigneshkumar A. A. , Purushothaman C. , Rajendran Devi Sri , Chandramouliswaran K. 
Published: August 2020

AbstractThe present study report for the first time on the one-pot production and purification of fibrinolytic protease from Bacillus cereus by extractive fermentation using natural deep eutectic solvents (NADES). Cheese whey was chosen as a sustainable low-cost production alternative yielding a significantly high amount of protease (185.7 U/mg). Five natural deep eutectic solvents with menthol as hydrogen bond donor and sugar molecules as corresponding hydrogen bond acceptors were synthesized and their association was confirmed with H1 NMR. Thermophysical investigation of the synthetic NADES was accomplished as a function of temperature to define their extraction ability. Response surface methodology based optimization of concentration of NADES (77.5% w/w), Na2SO4 (14% w/v) and cheese whey (1% w/w) were accomplished for extractive fermentation. Further, preparative purification using size exclusion chromatography was used to quantify the amount of enzyme obtained in the extraction phase (190 U/ml). On subsequent purification with an anion exchange column, the maximum purity fold (21.2) with enzyme activity (2,607.8 U/ml) was attained. The optimal pH (8.0), temperature (50 °C) were determined and the in-vitro fibrinolytic activity has been confirmed using a fibrin plate assay.
Accuracy of Trained Physicians is Inferior to Deep Learning-Based Algorithm for Determining Angles in Ultrasound of the Newborn Hip
Authors: Oelen David , Kaiser Pascal , Baumann Thomas , Schmid Raoul , Bühler Christof , Munkhuu Bayalag , Essig Stefan 
Published: August 2020

Abstract
Purpose Sonographic diagnosis of developmental dysplasia of the hip allows treatment with a flexion-abduction orthosis preventing hip luxation. Accurate determination of alpha and beta angles according to Graf is crucial for correct diagnosis. It is unclear if algorithms could predict the angles. We aimed to compare the accuracy for users and automation reporting root mean squared errors (RMSE).
Materials and Methods We used 303 306 ultrasound images of newborn hips collected between 2009 and 2016 in screening consultations. Trained physicians labelled every second image with alpha and beta angles during the consultations. A random subset of images was labeled with time and precision under lab conditions as ground truth. Automation predicted the two angles using a convolutional neural network (CNN). The analysis was focused on the alpha angle.
Results Three methods were implemented, each with a different abstraction of the problem: (1) CNNs that directly learn the angles without any post-processing steps; (2) CNNs that return the relevant landmarks in the image to identify the angles; (3) CNNs that return the base line, bony roof line, and the cartilage roof line which are necessary to calculate the angles. The RMSE between physicians and ground truth were found to be 7.1° for alpha. The best CNN architecture was (2) landmark detection. The RMSE between landmark detection and ground truth was 3.9° for alpha.
Conclusion The accuracy of physicians in their daily routine is inferior to deep learning-based algorithms for determining angles in ultrasound of the newborn hip. Similar methods could be used to support physicians.
Glucagon and Liver Fat are Downregulated in Response to Very
Low-calorie Diet in Patients with Obesity and Type-2 Diabetes
Authors: Haas Stephan L. , Löfgren Patrik , Stål Per , Hoffstedt Johan 
Published: August 2020

Abstract
Background and Study Aims In patients with obesity and type-2
diabetes, short-time very low-calorie diet may ameliorate hyperglycemia and
hepatic steatosis. Whether this also implies the glucose-regulating hormone
glucagon remains to be elucidated. This study investigated the effects of a
very low-calorie diet on plasma levels of glucagon and liver fat in obese
patients with type-2 diabetes.
Patients and Methods Ten obese patients with type-2 diabetes, 6 men
and 4 women, were included. At baseline, fasting plasma glucagon, insulin
and glucose were determined, and liver fat and stiffness evaluated by
transient elastography. The subjects were then prescribed a very low-calorie
diet of maximum 800 kcal/day for 7 weeks and reexamined
after 7 weeks and 12 months.
Results At baseline, BMI was
42±4 kg/m2 and fasting glucose
10.6±3.4 mmol/l. All patients had hepatic steatosis.
Plasma glucagon was strongly related to liver fat
(r2=0.52, p=0.018). After 7 weeks of very
low-calorie diet, plasma glucagon was significantly decreased by nearly
30% (p=0.004) along with reductions of BMI
(p<0.0001), glucose (p=0.02), insulin (p=0.03),
liver fat (p=0.007) and liver stiffness (p=0.05). At 12
months follow-up, both glucagon and liver fat increased and were not
different to basal levels, despite persistent reductions of BMI
(p<0.002) and glucose (p=0.008).
Conclusion In obese type-2 diabetic subjects, plasma glucagon and
liver fat are correlated and similarly affected by a very low-calorie diet,
supporting a role of hepatic steatosis in glucagon metabolism.
Narrative review of non-pharmaceutical behavioural measures for the prevention of COVID-19 (SARS-CoV-2) based on the Health-EDRM framework
Authors: Yang Chan Emily Ying , Shahzada Tayyab Salim , Sham Tiffany Sze Tung , Dubois Caroline , Huang Zhe , Liu Sida , Ho Janice Ying-en , Hung Kevin K C , Kwok Kin On , Shaw Rajib 
Published: August 2020

Abstract

Introduction
Non-pharmaceutical measures to facilitate a response to the COVID-19 pandemic, a disease caused by novel coronavirus SARS-CoV-2, are urgently needed. Using the World Health Organization (WHO) health emergency and disaster risk management (health-EDRM) framework, behavioural measures for droplet-borne communicable diseases and their enabling and limiting factors at various implementation levels were evaluated.

Sources of data
Keyword search was conducted in PubMed, Google Scholar, Embase, Medline, Science Direct, WHO and CDC online publication databases. Using the Oxford Centre for Evidence-Based Medicine review criteria, 10 bottom-up, non-pharmaceutical prevention measures from 104 English-language articles, which published between January 2000 and May 2020, were identified and examined.

Areas of agreement
Evidence-guided behavioural measures against transmission of COVID-19 in global at-risk communities were identified, including regular handwashing, wearing face masks and avoiding crowds and gatherings.

Areas of concern
Strong evidence-based systematic behavioural studies for COVID-19 prevention are lacking.

Growing points
Very limited research publications are available for non-pharmaceutical measures to facilitate pandemic response.

Areas timely for research
Research with strong implementation feasibility that targets resource-poor settings with low baseline health-EDRM capacity is urgently needed.
Political fragmentation, rural-to-urban migration and urban growth patterns in western Eurasia, 800–1800
Authors: Cox Gary W , Figueroa Valentin 
Published: August 2020

Abstract
Prominent scholars argue that Europe’s political fragmentation improved the security of property rights, thereby promoting growth. We explore a complementary mechanism: urban fragmentation—the proliferation of self-governing cities—helped emancipate labor, and freer labor promoted both faster and more correlated town growth. To test these hypotheses, we first show that polities with more self-governing cities offered more protection to runaway serfs against lordly recapture. We then show that more fragmented areas exhibited both faster and more correlated urban growth. While both the property rights and labor freedom mechanisms predict faster growth, only the latter predicts more highly correlated growth.
The diminishing status of international law in the decisions of the Israeli Supreme Court concerning the Occupied Territories
Authors: Hostovsky Brandes Tamar 
Published: August 2020

Abstract
This article examines the attitude of the Supreme Court of Israel towards international law in the past decade, focusing on cases concerning the Occupied Territories. It compares the decisions of the past decade to those of the preceding decade, which were characterized as developing a “jurisprudence inspired by international law.” The article argues that the status of international law in decisions that regard the Occupied Territories has, overall, declined. While the international law of occupation still operates, officially, as the governing law in the Occupied Territories, the emphasis on compliance with the norms of international law in the Court’s decisions has decreased. Instead of relying on international law, the Court has increased its reliance on Israeli administrative law, and, in recent years, on Israeli constitutional law. As a result, the distinction between the Occupied Territories and Israel is blurred. The article argues that this shift is consistent with a deliberate eradication of the distinction between Israel and the Occupied Territories by the legislator and the government. While the article does not argue that the Court intentionally supports this eradication, it does argue that it facilitates it.
The Missing Link: Monetary Policy and The Labor Share
Authors: Cantore Cristiano , Ferroni Filippo , León-Ledesma Miguel 
Published: August 2020

AbstractThe textbook New Keynesian (NK) model implies that the labor share is procyclical conditional on a monetary policy shock. We present evidence that a monetary policy tightening robustly increased the labor share and decreased real wages during the Great Moderation period in the United States, the Euro Area, the United Kingdom, Australia, and Canada. We show that this is inconsistent not only with the basic NK model, but also with medium-scale NK models commonly used for monetary policy analysis and where it is possible to break the direct link between the labor share and the inverse markup. Our results imply that either NK models are unable to separate the dynamics of the labor share from the markup or markups do not respond in the way NK models predict.
Dietary Supplements: Knowledge and Adverse Event Reporting Practices of Department of Defense Health Care Providers
Authors: Rittenhouse Melissa , Scott Jonathan , Deuster Patricia 
Published: August 2020

Abstract

Introduction
The purpose of the study was to assess the knowledge of dietary supplements (DS) and adverse event (AE) reporting practices of the Department of Defense health care providers. AEs related to use of DS are not uncommon. However, it is estimated that less than 2% of AEs are reported. This is problematic given the Food and Drug Administration relies on AE reports to identify and ultimately remove unsafe products from the market. Inadequate reporting of AE puts all DS users at risk.

Materials and Methods
Cross-sectional design was used. Electronic surveys were sent to the Department of Defense health care professionals (HCPs) and Emergency Medicine (EM) physicians asking questions about practices regarding DS and AE knowledge and reporting behaviors. The surveys were open for 5 months. During this period of time, HCPs received three email reminders following the initial email to enhance participation. The computer package IBM SPSS version 25 software (IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 21.0, Armonk, New York) was used for statistical analysis. Frequency distributions of the responses were analyzed.

Results
Of the 1,700 surveyed, 270 HCPs and 68 EM physicians completed the surveys. At least 39% of HCPs reported never receiving formal DS training. Seventy-two percent of HCPs reported asking their patients about the use of DS. However, when asked if they knew where to report an AE, only 40% of HCPs knew where to report an AE and only 38% knew how to report an AE. Of the EM physicians, only 38% asked their patients about DS. However, a majority (78%) reported that they had encountered an AE. EM physicians also reported they lacked knowledge regarding where (87%) and how (87%) to report AE.

Conclusions
It is clear that physician and nonphysician HCPs would benefit from additional training about DS and how and where to report suspected AE. Providing regular training on risks, common AE, and how and where to report an AE would help fill the knowledge gap in the ever-changing DS industry. Addressing these issues and coming up with a solution to integrating AE reporting into clinical care could improve health care practices and increase AE reporting to the Food and Drug Administration, which would have a beneficial impact on patient care, public safety, and mission readiness.
A novel continuum-based framework for translating behavioral health integration to primary care settings
Authors: Goldman Matthew L , Smali Ekaterina , Richkin Talia , Pincus Harold A , Chung Henry 
Published: August 2020

Abstract
Although evidence-based behavioral health integration models have been demonstrated to work well when implemented properly, primary care practices need practical guidance on the steps they can take to build behavioral health integration capacities. This is especially true for practice settings with fewer resources. This study is a pilot field test of a framework continuum composed of core components of behavioral health integration that can be used to translate the implementation of behavioral health into diverse clinical settings guided by a practice's priorities and available resources. This framework, in combination with technical assistance by the study team, was piloted in 11 small primary care sites (defined as ≤5 primary care providers) throughout New York State. Surveys were collected at baseline, 6 months, and 12 months. Informal check-in calls and site visits using qualitative semistructured individual and group interviews were conducted with 10 of the 11 sites. A mixed-methods approach was used to incorporate the survey data and qualitative thematic analysis. All practices advanced at least one level of behavioral health integration along various components of the framework. These advances included implementing depression screening, standardizing workflows for positive screens, integrating patient tracking tools for follow-up behavioral health visits, incorporating warm hand-offs to on-site or off-site behavioral health providers, and formalized external referrals using collaborative agreements. Practices reported they had overall positive experiences using the framework and offered feedback for how to improve future iterations. The framework continuum, in combination with technical assistance, was shown to be useful for primary care practices to advance integrated behavioral health care based on their priorities and resource availability. The results combined with feedback from the practices have yielded a revised “Framework 2.0” that includes a new organization as well as the addition of a “Sustainability” domain.
Defining and measuring core processes and structures in integrated behavioral health in primary care: a cross-model framework
Authors: Stephens Kari A , van Eeghen Constance , Mollis Brenda , Au Margaret , Brennhofer Stephanie A , Martin Matthew , Clifton Jessica , Witwer Elizabeth , Hansen Audrey , Monkman Jeyn , Buchanan Gretchen , Kessler Rodger 
Published: August 2020

AbstractA movement towards integrated behavioral health (IBH) in primary care continues to grow, among an accumulating evidence base for its effectiveness for improving care. However, healthcare organizations struggle to navigate where to target their limited resources for improving integration. We evaluated a cross-model framework of IBH core processes and structures. We used a mixed-methods approach for evaluation of the framework, which included (a) an evaluation survey of national experts and stakeholders, (b) crosswalks with common IBH measures, and (c) a real-world usability test. Five core IBH principles, mapping to 25 processes, and nine clinic structures were defined. Survey responses from 29 IBH domain and policy experts and stakeholders resulted in uniformly high ratings of importance and variable levels of feasibility for measurement, particularly with respect to electronic health record (EHR) systems. A real-world usability test resulted in good uptake and use of the framework across a state-wide effort. An IBH Cross-Model Framework of core principles, processes, and structures generated good acceptability and showed good real-world utility in a state-wide effort to improve IBH across disparate levels of integration in diverse primary care settings. Findings identify feasible areas of measurement, particularly with EHR systems. Next steps include testing the relationship between the individual framework components and patient outcomes to help guide clinics towards prioritizing efforts focused on improving integration.
Congenital Unilesional Cutaneous Langerhans Cell Histiocytosis: A Case Report
Authors: Ungari Marco , Caresana Gioachino , Tanzi Giulia , Drera Bruno , Frittoli Marta Claudia , Gusolfino Marino Daniel , Ferrero Giuseppina , Varotti Elena , Manotti Laura , Trombatore Monica , Bertoni Ramona 
Published: August 2020

Abstract:
Langerhans cell histiocytosis (LCH) is a clonal proliferation of bone-marrow-derived cells, which normally reside as epidermal and mucosal dendritic cells involved in antigen presentation. It is a rare disease more common in children than adults, that is believed to be neoplastic in most cases. The diagnosis is based on clinical and radiological findings in combination with histopathologic, immunophenotypic, or ultrastructural analyses. LCH have a broad spectrum of clinical manifestations, ranging from benign cutaneous lesions to malignant multisystem disease. Based on the extent of involvement at diagnosis, LCH can be divided in single-system LCH when only one organ or system is involved, usually with multiple lesions, and multisystem LCH, when 2 or more organs or systems are involved at diagnosis. One variant of LCH is characterized by congenital isolated cutaneous involvement. It typically manifests at birth or in the postnatal period with a widespread eruption of red-to-brown papulo-nodules or, more uncommonly, a solitary lesion. The overall prognosis for single lesion skin limited LCH is excellent and most lesions spontaneously resolve within 4–18 weeks. Systemic involvement is rare. Skin findings cannot predict systemic disease and obtaining an oncology consultation is recommended for further evaluation. Herein, we present an additional case in a full-term, well-appearing, female infant with an isolated, asymptomatic, ulcerated, papule of the left arm, that was noted at birth.
The Use of Dermal Substitutes for Donor Site Closure After Radial Forearm Free Flap Harvesting
Authors: Abbate Vincenzo , Iaconetta Giorgio , Sani Lorenzo , Bonavolontà Paola , Di Lauro Alessandro E. , Masone Stefania , Califano Luigi , Orabona Giovanni D.A. 
Published: August 2020

Objective:
The aim of our study was to analyze the aesthetic and functional outcome in the radial forearm free flap donor site using a simple split thickness skin grafting (STSG) closure compared with the use of dermal scaffold supporting the STSG closure.

Methods:
The study analyzed 18 patients, divided in 2 groups based on the donor site closure modality. In STSG group, a simple STSG was used to cover the defect. In the DS + STSG group, the defect was covered by the use of dermal substitute (MatriDerm) supporting the STSG. Groups were compared on the following outcome variable: scar status; hand function; circumferences at most proximal and most distal point of the graft. All patients were followed up 1, 6, and 12 months post-operative.

Results:
Nine patients from STSG group showed a difference in circumference between the operated and contralateral limbs respectively of 2.9 mm proximal and 1.2 mm distal; in the 9 patients of DS + STGS group the difference was respectively of 1.2 mm proximal and 1.3 mm distal. Welch unequal variances t-test demonstrated statistical significance of the values with P < 0.004 (P < 0.5). The average VSS was 1.82 ± 0.2 for STSG group and 1.75 ± 0.2 for DS + STGS group. The DASH score was 21.8% in STSG group and 19.4% in DS + STGS group.

Conclusion:
Our study shows that patients treated with Matriderm + STSG obtained a better result both in esthetic and functional outcomes.
Endoscopic Lateral Osteotomy in Rhinoplasty
Authors: Altunay Zeynep Onerci , Onerci Metin 
Published: August 2020

Objectives:
The purpose of this study was to investigate the advantages of endoscopic lateral osteotomy, to evaluate the effects of the periosteal elevation on ecchymosis and to search the reasons for the ecchymosis and the intranasal mucosal tears.

Methods:
On a randomly chosen side a subperiosteal tunnel was elevated, on the other side a subperiosteal tunnel was not elevated. Bilateral lateral osteotomies were performed. Internal nasal packing was not used. The post-operative care was similar for all patients. The patients were evaluated on the third post-operative day. The intranasal mucosal tears, the lateral osteotomy cut on the periosteal elevation side were examined using endoscopes. The degree of ecchymosis was determined by 2 other surgeons, who were unaware of the elevated side, using the grading system adapted from Hoffman et al.

Results:
The intranasal mucosal injury was seen in 16 of non-elevated side whereas it was 14 on the periosteal elevated side. Endoscopy showed the perforating arteries and elevation of the periosteum caused rupture and oozing from these arteries which might be a cause for ecchymosis. Ecchymosis was more severe on the side with subperiosteal tunnel in 6 patients; whereas only in 2 patients it was more severe on the side with no subperiosteal tunnel elevation while in 12 patients the degree of ecchymosis was the same on both sides.

Conclusion:
Endoscopy gives a great opportunity to visualize the lateral osteotomy site. Besides the lateral osteotomy cut, the arteries and the intranasal mucosal injury can be visualized. Periost elevation increases the severity of ecchymosis due to the rupture of the perforating arteries, not due to the trauma of the angular artery. Intramucosal tears do not increase the severity of the ecchymosis.