bluuebunny/crossref_metadata_2025_split huggingface dataset:
All That’s Lost: The Hollowing of Summit Diplomacy in a Socially Distanced World
Authors: Naylor Tristen 
Published: October 2020

Summary
This essay considers the implications of virtual summits replacing in-person multilateral gatherings of political leaders. Focusing on the loss of physicality, it argues that two critical dimensions of summitry are eliminated in this shift: sublime governance and inter-moments. Drawing on illustrative examples from the Group of 20, it demonstrates that while moving online maintains the formal, procedural interactions around which summits are built, doing so loses these critical elements of summitry which render it a valuable and unique practice in within the overall institution of diplomacy. This move also undercuts the effects of these elements, in the immediate context of a particular summit and more broadly within the international system itself. The elimination of summitry’s performative and interpersonal dimensions fundamentally renders online meetings unable to achieve what in-person summits can. This has acute consequences in the immediate wake of the COVID-19 pandemic, and also more generally as diplomacy moves online.
Co-evolution of Diplomacy after the Corona Crisis: An Agenda for Practitioners
Authors: Salinas Pérez Dalya , Canchola Gutiérrez Ulises , López-Portillo José-Juan 
Published: October 2020

Summary
The ‘corona crisis’ has transformed a generalized and long-standing concern for foreign service reform into an urgent necessity. The reform of the Mexican Foreign Service Law in 2018 offers a valuable example of a recent, comprehensive attempt to prepare a diplomatic apparatus for a context of accelerated change and uncertainty. The authors of this essay, who directly participated in this reform, explain how some of its main features provided them with useful tools to respond effectively to the COVID-19 pandemic from their new posting in Norway. After discussing the lessons from their experiences, they propose an agenda for discussion among practitioners and academics on subjects that must be addressed if diplomacy is to fulfil its urgent role in the construction of a new, post-pandemic world order.
A Silent Quest for New Shīʿa Religious Leaders in Italy
Authors: Mirshahvalad Minoo 
Published: October 2020

Abstract
The special tie between Shīʿas and their religious authority ignites curiosity about the probable evolution of this relationship in a non-Islamic milieu. This paper aims to analyse why the conventional forms of the Shīʿa authority does not suit the life condition in Italy and why there is an implicit demand for new Shīʿa leaders. The answer is given through a two-year empirical research on the Shīʿas’ life in the peninsula. Two factors are deemed responsible of this inadequacy: first, the definition and expectations of the Italian society of the Islamic authority, and second, the Shīʿas’ exigencies that are not met in their relations with the traditional authority.
The Equatorial Current System West of the Galápagos Islands during the 2014–16 El Niño as Observed by Underwater Gliders
Authors: Rudnick Daniel L. , Owens W. Brechner , Johnston T. M. Shaun , Karnauskas Kristopher B. , Jakoboski Julie , Todd Robert E. 
Published: October 2020

AbstractThe strong El Niño of 2014–16 was observed west of the Galápagos Islands through sustained deployment of underwater gliders. Three years of observations began in October 2013 and ended in October 2016, with observations at longitudes 93° and 95°W between latitudes 2°N and 2°S. In total, there were over 3000 glider-days of data, covering over 50 000 km with over 12 000 profiles. Coverage was superior closer to the Galápagos on 93°W, where gliders were equipped with sensors to measure velocity as well as temperature, salinity, and pressure. The repeated glider transects are analyzed to produce highly resolved mean sections and maps of observed variables as functions of time, latitude, and depth. The mean sections reveal the structure of the Equatorial Undercurrent (EUC), the South Equatorial Current, and the equatorial front. The mean fields are used to calculate potential vorticity Q and Richardson number Ri. Gradients in the mean are strong enough to make the sign of Q opposite to that of planetary vorticity and to have Ri near unity, suggestive of mixing. Temporal variability is dominated by the 2014–16 El Niño, with the arrival of depressed isopycnals documented in 2014 and 2015. Increases in eastward velocity advect anomalously salty water and are uncorrelated with warm temperatures and deep isopycnals. Thus, vertical advection is important to changes in heat, and horizontal advection is relevant to changes in salt. Implications of this work include possibilities for future research, model assessment and improvement, and sustained observations across the equatorial Pacific.
Do family meetings for hospitalised palliative care patients improve outcomes and reduce health care costs? A cluster randomised trial
Authors: Hudson Peter , Girgis Afaf , Thomas Kristina , Philip Jennifer , Currow David C , Mitchell Geoffrey , Parker Deborah , Liew Danny , Brand Caroline , Le Brian , Moran Juli 
Published: October 2020

Background: Family meetings facilitate the exploration of issues and goals of care however, there has been minimal research to determine the benefits and cost implications. Aims: To determine: (1) if family caregivers of hospitalised patients referred to palliative care who receive a structured family meeting report lower psychological distress (primary outcome), fewer unmet needs, improved quality of life; feel more prepared for the caregiving role; and receive better quality of end-of-life care; (2) if outcomes vary dependant upon site of care and; (3) the cost-benefit of implementing meetings into routine practice. Design: Pragmatic cluster randomised trial involving palliative care patients and their primary family caregivers at three Australian hospitals. Participants completed measures upon admission (Time 1); 10 days later (Time 2) and two months after the patient died (Time 3). Regression analyses, health utilisation and process evaluation were conducted. Results: 297 dyads recruited; control ( n = 153) and intervention ( n = 144). The intervention group demonstrated significantly lower psychological distress (Diff: –1.68, p < 0.01) and higher preparedness (Diff: 3.48, p = 0.001) at Time 2. No differences were identified based on quality of end of life care or health utilisation measures. Conclusions: Family meetings may be helpful in reducing family caregiver distress and enhancing their preparedness for the caregiving role and it appears they may be conducted without increased hospital health utilisation impacts; although opportunity costs need to be considered in order to routinely offer these as a standardised intervention. Additional health economic examination is also advocated to comprehensively understand the cost-benefit implications. Trial Registration: Australian and New Zealand Clinical Trials Registry ACTRN12615000200583
Could Solutions Low in Glucose Degradation Products Preserve Residual Renal Function in Incident Peritoneal Dialysis Patients? A 1-Year Multicenter Prospective Randomized Controlled Trial (Balnet Study)
Authors: Kim Sung Gyun , Kim Sejoong , Hwang Young-Hwan , Kim Kiwon , Oh Ji Eun , Chung Wookyung , Oh Kook-Hwan , Kim Hyung Jik ,   Curie Ahn for the Korean Balnet Study Group
Published: October 2020

⋄ Objectives In vitro studies of peritoneal dialysis (PD) solutions demonstrated that a lactate-buffered fluid with neutral pH and low glucose degradation products (LF) has better biocompatibility than a conventional acidic lactate-buffered fluid (CF). However, few clinical trials have evaluated the long-term benefit of the biocompatible solution on residual renal function (RRF). To compare LF with CF, we performed a prospective, randomized study with patients starting PD. ⋄ Patients and Methods After 1-month run-in period, 91 new PD patients were randomized for 12 months of treatment with either LF (Balance: Fresenius Medical Care, Bad Homburg, Germany; n = 48) or CF (Stay•Safe: Fresenius; n = 43). We measured RRF, acid–base balance, peritoneal equilibration test, and adequacy of dialysis every 6 months after the run-in period. ⋄ Results After 12 months of treatment, the residual glomerular filtration rate (GFR) in patients using LF tended to be higher than that of patients on CF ( p = 0.057 by repeated-measures analysis of variance). We observed a significant difference in the changes of residual GFR between the two groups ( p = 0.009), a difference that was especially marked in the subgroup whose baseline residual GFR was more than 2 mL/min/1.73 m2. In addition, serum total CO2 levels were higher ( p = 0.001) and serum anion gap was lower ( p = 0.019) in the LF group. We observed no differences between groups for Kt/V, C-reactive protein, or normalized protein equivalent of nitrogen appearance. ⋄ Conclusions In incident PD patients with significant residual GFR, LF may better preserve RRF over a 12-month treatment period. Additionally, pH-neutral PD fluid may improve acid–base balance as compared with CF.
Comparison of Midterm Outcomes Between Open and Robotic Emergent Ventral Hernia Repair
Authors: Kudsi Omar Y. , Gokcal Fahri , Bou-Ayash Naseem , Chang Karen 
Published: October 2020

Background. There are no studies on the role of robotics in emergency ventral hernia repair (EVHR). We aimed to compare outcomes of robotic EVHR (REVHR) and open (OEVHR). Methods. We performed a retrospective study of EVHRs performed between 2013 and 2019. Patients who underwent ventral hernia repair in an elective setting and patients who had concomitant non-abdominal wall procedures were excluded. Pre-, intra-, and postoperative variables were compared. Univariate and multivariate analyses were performed. Results. In all, 43 patients underwent OEVHR as compared to 35 patients who underwent REVHR. The patients in both groups were similar in terms of hernia etiology as well as Acute Physiology and Chronic Health Evaluation (APACHE-II) and the Sequential Organ Failure Assessment (SOFA) scores. Mean operative times for the robotic group were almost 2-fold compared with those of the open group (139 minutes vs 70 minutes, respectively; P < .001). Median length of stay (LOS) did not differ between the groups (3 days for both groups; P = .488). Major complications ( P = .001), morbidity scores ( P = .006), surgical site events (SSEs) ( P = .045), and procedural interventions ( P = .020) were found higher in the open group. No differences in freedom of recurrence were found ( P = .662). Multivariate logistic regression analysis showed that open repair was associated with a 4-fold risk for the development of complications as compared to robotic repair ( P = .025; odds ratio (OR) = 4, 95% confidence interval (CI) = 1.193-13.444). Conclusion. Compared to OEVHR, REVHR resulted in longer operative times and lower morbidity, including SSEs and related interventions. However, neither LOS nor recurrence differed between the groups.
Upper cervical range of rotation during the flexion-rotation test is age dependent: an observational study
Authors: Schäfer Axel Georg Meender , Schöttker-Königer Thomas , Hall Toby Maxwell , Mavroidis Ilias , Roeben Christoph , Schneider Martina , Wild Yorick , Lüdtke Kerstin 
Published: October 2020

Background: The flexion-rotation test (FRT) is widely used to detect movement dysfunction in the spinal segment C1/C2, especially in patients with cervicogenic headache. The current published literature indicates that range recorded during the FRT is not age dependent. This is questionable, considering the well documented relationship between aging and degeneration in the cervical spine and loss of cervical movement in older people. The present study therefore aims to examine the influence of age on FRT mobility, and to provide normative values for different age groups. An additional aim is to examine the influence of age on the ratio between lower and upper cervical rotation mobility. Methods: For this cross-sectional, observational study, healthy subjects aged from 18 to 90 years were recruited. The upper cervical range of rotation during the FRT was measured using a digital goniometer. Personal data including age, weight, height, and lifestyle factors were also assessed. Results: A total of 230 (124 male) healthy, asymptomatic subjects, aged between 18 and 87 years were included. Regression analysis showed that 27.91% ( p < 0.0001) of the variance in FRT mobility can be explained by age alone, while 41.28% ( p < 0.0001) of the variance in FRT mobility can be explained by age and total cervical range of motion (ROM). Normative values for different age decades were calculated using regression analysis. No significant influence of age on the ratio between ROM of lower and upper cervical rotation was found. There was no relevant impact of personal (gender, height, and weight) and lifestyle (smartphone and PC use) factors on ROM during the FRT. Conclusion: Upper cervical rotation mobility determined by the FRT correlates strongly with age; hence, the results of the FRT have to be interpreted taking into account the individual age of the tested subject. The ratio between lower and upper cervical rotation mobility is maintained in all age groups.
Tolvaptan-induced hypernatremia related to low serum potassium level accompanying high blood pressure in patients with acute decompensated heart failure
Authors: Fukuoka Hidetada , Tachibana Koichi , Shinoda Yukinori , Minamisaka Tomoko , Inui Hirooki , Ueno Keisuke , Inoue Soki , Mine Kentaro , Ueda Kumpei , Hoshida Shiro 
Published: October 2020

Abstract

Backgrounds
Tolvaptan significantly increases urine volume in acute decompensated heart failure (ADHF); serum sodium level increases due to aquaresis in almost all cases. We aimed to elucidate clinical factors associated with hypernatremia in ADHF patients treated with tolvaptan.

Methods
We enrolled 117 ADHF patients treated with tolvaptan in addition to standard therapy. We examined differences in clinical factors at baseline between patients with and without hypernatremia in the initial three days of hospitalization.

Results
Systolic (p = 0.045) and diastolic (p = 0.004) blood pressure, serum sodium level (p = 0.002), and negative water balance (p = 0.036) were significantly higher and serum potassium level (p = 0.026) was significantly lower on admission day in patients with hypernatremia (n = 22). In multivariate regression analysis, hypernatremia was associated with low serum potassium level (p = 0.034). Among patients with serum potassium level ≤ 3.8 mEq/L, the cutoff value obtained using receiver operating characteristic curve analysis, those with hypernatremia related to tolvaptan treatment showed significantly higher diastolic blood pressure on admission day (p = 0.004).

Conclusion
In tolvaptan treatment combined with standard therapy in ADHF patients, serum potassium level ≤ 3.8 mEq/L may be a determinant factor for hypernatremia development. Among hypokalemic patients, those with higher diastolic blood pressure on admission may be carefully managed to prevent hypernatremia.
Chronic disorders of consciousness: a case report with longitudinal evaluation of disease progression using 7 T magnetic resonance imaging
Authors: Li Xiaoxia , Tan Xufei , Wang Pinyi , Hu Xiaohua , Dong Yan , Zhang Xiaotong , Luo Benyan 
Published: October 2020

Abstract

Background
Outcome prediction for patients with disorders of consciousness (DOC) is essential yet challenging. Evidence showed that patients with DOC lasting 1 year or longer after a brain injury were less likely to recover. However, the reasons why outcomes of DOC patients differ greatly remain unclear. With a variety of analytical methods and through quantitative behavioral assessments, we aimed to track the progression of a patient with severe brain injury, in order to advance our understanding of the underlying mechanisms of DOC.

Case presentation
We performed a longitudinal study for a 52-year-old male DOC patient who has remained in the state for 1.5 years with comprehensive rehabilitative therapies. The patient underwent 3 times of assessments of Coma Recovery Scale-Revised (CRS-R) and ultra-high-field 7 T magnetic resonance imaging (MRI). Both topologic properties and brain microstructure were analyzed to track disease progression. We observed dynamic increases of fiber densities with measurements at three time points (t1:1.5 M, t2:7.5 M t3:17.5 M). Specifically, fiber densities of the superior longitudinal fasciculus and arcuate fasciculus nerve fiber bundles improved mostly in the visual, verbal, and auditory subscales, which was consistent with the CRS-R scores. Moreover, the graph-theory analyses demonstrated that network topologic properties showed an improvement although the disease duration exceeded 1 year.

Conclusions
DOC patients with a course longer than 1 year remain possible to improve, and including evaluation methods such as WM connectome analysis and graph theory could be potentially valuable for a more precise assessment of patients with a longer course of DOC.
Effectiveness and safety of high dose clopidogrel plus aspirin in ischemic stroke patients with the single CYP2C19 loss-of-function allele: a randomized trial
Authors: Wu Hongliang , Song Huiqun , Dou Lianwei , Gao Bo , Pan Yan , Dong Mei , Chen Qi , Li Jiazhen , Song Lixiang , Liu Chuanyu , Li Bing , Chu Wenzheng 
Published: October 2020

Abstract

Background
Dual antiplatelet aggregation therapy leads to better outcomes in patients with carotid artery stenosis, intracranial artery stenosis, minor strokes, or transient ischaemic attacks. However, carriers of the CYP2C19 loss-of-function allele may not experience the desired effects. We attempted to increase the clopidogrel dose to determine whether it would improve the outcomes of stroke patients who carry a single loss-of-function allele.

Methods
We recruited 131 patients with minor ischaemic stroke, within less than 7 days of stroke onset and a CYP2C19 loss-of-function allele, who had moderate-to-severe cerebral artery stenosis. Patients were divided into the high dose group (clopidogrel 150 mg per day + aspirin 100 mg per day over 21 days.) and a normal dose group (clopidogrel 75 mg per day + aspirin 100 mg per day over 21 days). The reported outcomes included any vascular or major bleeding events as the primary and safety endpoints, respectively.

Results
One and six vascular events occurred in the high dose and normal dose groups during the 3-months follow-up period, respectively. However, no significant difference was found between the two groups when adjusted for history of diabetes (hazard ratio, 5482; 95% confidence interval, 0.660 to 45.543; P = 0.115). No major bleeding events occurred.

Conclusions
In patients with ischaemic stroke who had a single CYP2C19 loss-of-function allele and moderate to severe cerebral stenosis, fewer vascular events occurred within 3 months with high dose of clopidogrel and aspirin than with normal dose of clopidogrel and aspirin. However, the difference between the two groups was not significant.

Trial registration
Clinical study of clopidogrel in the treatment of patients with symptomatic moderate to severe cerebral artery stenosis with intermediate metabolites of CYP2C19, URL: http://www.chictr.org.cn/. Unique identifier: ChiCTR1800017411, 07/28/2018;
Live birth rate and neonatal outcomes of different quantities and qualities of frozen transferred blastocyst in patients requiring whole embryo freezing stratified by age
Authors: Chen Shiping , Du Hongzi , Liu Jianqiao , Liu Haiying , Li Lei , He Yuxia 
Published: October 2020

Abstract

Background
Multiple pregnancies are associated with significant complications and health risks for both mothers and infants. Single blastocyst transfer (SBT) is a logical and effective measure to reduce the incidence of multiple pregnancy with assisted reproductive technology (ART). Whether it is suitable for everyone undergoing SBT was inconclusive, in view of the consideration of embryo quality and patients’ age. Therefore, this study aimed to explore live birth rate (LBR) and neonatal outcomes of different quantities and qualities of blastocysts in patients stratified by age, using a cutoff of 35 years, who required whole embryo freezing and underwent a subsequent frozen thawed transfer (FET) cycle.

Methods
Atotal of 3,362 patients were divided into five groups: group A (n=1569) received a single good-quality blastocyst, group B (n=1113) received two good-quality blastocysts, group C (n=313) received one good-and one average-quality blastocyst, group D (n=222) received two average-quality blastocysts, and group E (n=145) received one average-quality blastocyst.

Results
For patients who received good-quality blastocysts, irrespective of age, the LBR of double blastocyst transfer (DBT) was about 50–65% and the multiple pregnancy rate (MPR) was 40–60%; however, the LBR of SBT was 40–55%, and the MPR was 3.5–6.3%. For patients who only had average-quality blastocysts, the MPR of double average-quality blastocyst transfer was as high as 30–50%. Moreover, about 70–90% of preterm births resulted from multiple pregnancies, and about 85–95% of low birth weight babies come from multiple pregnancies. The neonatal outcomes (gestational age, birth weight, and birth height) of DBT were significantly lower than those of SBT regardless of age, and this statistical difference disappeared if the patients were subgrouped by singleton or twin. There is no significant difference in neonatal outcomes between single good-quality blastocyst and single average-quality blastocyst transfer.

Conclusions
SBT is a preferable option for patients regardless of age when good-quality blastocysts are available. For patients who only had average-quality blastocysts, they should be informed that DBT was associated with higher multiple pregnancy and adverse neonatal outcomes when compared with SBT regardless of age, suggesting that the practice of SBT is also feasible for these patients.
Verteporfin inhibits cell proliferation and induces apoptosis in different subtypes of breast cancer cell lines without light activation
Authors: Wei Changran , Li Xiangqi 
Published: October 2020

AbstractBackgroundBreast cancer (BC) can be divided into five subtypes: Lumina1A, Lumina1B, HER-2 overexpression, Basal-like and Normal breast-like subtype, based on the differently expressed genes in breast cancer tissue. The Hippo signaling pathway plays an indispensable role in BC. The YAP gene is a terminal effector of Hippo pathway, and hyperactivation of YAP mediates tumorigenesis. As an inhibitor of YAP, non-photoactivated verteporfin (VP) can inhibit YAP-mediated tumor proliferation and angiogenesis by eliminating its interaction with TEAD. This study aimed to determine the effect and molecular mechanisms of VP-mediated inhibition of YAP in different subtypes of BC.MethodsLuminal A, Luminal B and Basal-like BC cells were cultivated in vitro to study effects of VP on proliferation and apoptosis of these three molecular BC subtypes.ResultsOur experimental results showed that VP inhibited cell proliferation, YAP-TEAD interaction and expression of its downstream targets. VP also induced tumor cell apoptosis, and promoted the cleavage of Caspase-9 and PARP in the cells of various molecular subtypes of BC.ConclusionThese findings provide a basis for the use of VP as a potential anti-tumor therapeutic for BC by targeting the Hippo pathway effector YAP.