bluuebunny/crossref_metadata_2025_split huggingface dataset:
Madness, sex, and risk: A poststructural analysis
Authors: Evans Alicia M. , Holmes Dave , Quinn Chris 
Published: June 2020

AbstractThe body of the one deemed mad often remains a sexual body with sexual needs. Mental health services respond to these demands of the body in various ways, including constructing rules around physical movement. In this context, we were interested in how mental health clinicians problematized the sexual needs and practices of residents of a long‐stay mental health rehabilitation facility and how solutions were constructed in relation to the residents’ sexual desires. This paper reports findings from mental health clinicians, as part of a case study where we addressed this question. Mental health clinicians responded to residents’ sexuality from a discourse of risk. The notion of the engagement with each resident as a sexual subject was subordinated to the paternalistic notion of protecting the patient from risk. The resident became an object to be monitored and protected rather than a subject with sexual desire and agency. This paternalism also showed itself in relation to a ‘no‐sex on‐site’ rule that allowed for a shift of risk from the organization to the resident. Residents, rather than having a relatively safe place to have sexual relations, were required to find a place elsewhere, potentially unsafe, outside the facility.
Notch activation leads to loss of myoepithelial differentiation and poor outcome in solid adenoid cystic carcinoma
Authors: Zhang Ye , Liu Xiaoxiao , Zhou Chuan‐Xiang , Li Tie‐Jun 
Published: June 2020

ObjectiveWe aimed to investigate Notch pathway dysregulation in solid adenoid cystic carcinoma (AdCC) and to define the association of Notch activation with cell differentiation and prognosis in AdCCs.Materials and MethodsNotch1 mutations were detected from 125 AdCCs (62 cribriform‐tubular; 63 solid). RNA‐seq was performed in 16 AdCCs (6 Notch‐mutant; 10 wild type). Notch activation indicator NICD and myoepithelial marker p63 were detected using immunohistochemistry and double‐labelling immunofluorescence. The effect of exogenous NICD overexpression on p63 expression and cell proliferation was investigated using Western blotting and live‐cell imaging.ResultsWe identified 33 Notch1 activating mutations in 27 AdCCs including 26 solid and 1 cribriform‐tubular subtypes. Six tumours harboured more than one Notch1 mutation, and 18 Notch1 mutations were novel. Most (47/63, 74.6%) solid AdCCs showed NICD overexpression, whereas 61 of 62 (98.4%) cribriform‐tubular tumours were negative. NICD and p63 exhibited mutually exclusive expression, and exogenous NICD overexpression promoted cell proliferation and decreased p63 expression. NICD overexpression and Notch mutations were poor indicators for overall survival and metastasis, especially bone metastasis.ConclusionsDysregulated Notch signalling plays a critical role in AdCC severity. Notch activation may contribute to loss of myoepithelial differentiation as well as high proliferation and metastasis rates in solid AdCC.
One‐Stage Repair of Posterior Oblique Ligament Avulsion Fracture Combined with Medial Collateral Ligament Injury
Authors: Zhang Min , Ma Ji , Zhang Run‐Jie , Xi Gang , Wang Hao‐hao , Zhao Bin 
Published: June 2020

ObjectiveTo evaluate the clinical effect of the one‐stage repair of a posterior oblique ligament avulsion fracture combined with a medial collateral ligament injury.MethodsThis study was a retrospective trial. From February 2007 to May 2017, five patients with posterior oblique ligament avulsion fracture combined with medial collateral ligament injury were included in this study. The patients were aged 37–58 years old with a mean of 45.2 years. All patients underwent the primary repair of a posterior oblique ligament avulsion fracture and medial collateral ligament injury. The main observational index included Lysholm score, International Knee Documentation Committee (IKDC) score, Visual Analogue Scale (VAS) score, and range of motion (ROM).ResultsThe results showed that the average time of follow‐up was 53.6 months (range, 20–86 months). When compared to preoperative scores, the preoperative Lysholm score was significantly increased (47.8 ± 5.1 vs 95.0 ± 3.7, P < 0.05), the IKDC score was significantly increased (51.2 ± 5.6 vs 88.6 ± 4.2, P < 0.05), the VAS score was significantly decreased (7.0 ± 0.7 vs 0.4 ± 0.5, P < 0.05), and the ROM was significantly increased (91.6° ± 8.4° vs 129.9° ± 4.4°, P < 0.05).ConclusionOur study found that with the combination of the one‐stage repair of a posterior oblique ligament (POL) avulsion fracture and medial collateral ligament injury, the patient's postoperative function recovered well, their pain was relieved, and their knee joint stability was reliable.
CRT in a congenital heart disease patient with interventricular dyssynchrony due to an RV conduction delay
Authors: Miyazaki Aya , Matsutani Hayato , Nakano Yuta , Ikeda Tadashi , Uemura Hideki , Doi Hiraku 
Published: June 2020

AbstractWe encountered a unique pattern of cardiac dyssynchrony in a patient with complex congenital heart disease (heterotaxy syndrome) with a biventricular physiology and systemic left ventricle (LV). On speckle tracking echocardiography, dyssynchrony was not detected within the LV, but was noted in an interventricular fashion between the LV and right ventricle (RV). An electrophysiologic study revealed a conduction delay in the subpulmonary RV. Cardiac resynchronization therapy provided reverse cardiac remodeling and an excellent result in our patient by placing the pacing leads around the dyssynchronous lesion.
Pediatric allergic diseases in the Indian subcontinent—Epidemiology, risk factors and current challenges
Authors: Krishna Mamidipudi Thirumala , Mahesh Padukudru Anand , Vedanthan Pudupakkam K. , Mehta Vinay , Moitra Saibal , Christopher Devasahayam Jesudas 
Published: June 2020

AbstractIntroductionIndia is low‐middle‐income country (LMIC) with a population of 1.3bn, comprising about 20% of the global population. While the high‐income Western countries faced an “allergy epidemic” during the last three decades, there has been a gradual rise in prevalence of allergic diseases in India.MethodsNarrative review.Results and DiscussionAllergic diseases occur as a consequence of a complex interplay between genetic and environmental factors. There are multiple contrasting determinants that are important to consider in India including high levels of air pollution, in particular PM2.5 due to burning of fossil fuels and biomass fuels, diverse aero‐biology, tropical climate, cultural and social diversity, religious beliefs/myths, linguistic diversity, literacy level, breastfeeding and weaning, diet (large proportion vegetarian), and high incidence rates of TB, HIV, malaria, filariasis, parasitic infestations, and others, that not only shape the immune system early in life, but also impact on biomarkers relevant to allergic diseases.India has a relatively weak and heterogeneous healthcare framework, and allergology has not yet been recognized as an independent specialty. There are very few post‐graduate training programs, and allergic diseases are managed by primary care physicians, organ‐based specialists, and general pediatricians. Adrenaline auto‐injectors are not available, there is patient unaffordability for inhalers, nasal sprays, and biologics, and this is compounded by poor compliance leading to 40%‐50% of asthmatic children having uncontrolled disease and high rates of oral corticosteroid use. Standardized allergen extracts are not available for skin tests and desensitization.This article provides a critical analysis of pediatric allergic diseases in India.
“Bypass the UN”: Diplomatic Practices and Change in Multilateral Settings
Authors: Bélanger‐Vincent Ariane 
Published: June 2020

AbstractThis article highlights diplomatic practices that contributed to the wide approval of the polemical issue of humanitarian intervention, reframed into the term Responsibility to Protect (R2P). The expression was coined in 2001. It is now reported that R2P was unanimously agreed upon by 155 heads of states and governments during the 2005 World Summit held at the United Nations (UN) General Assembly. The conditions under which such an issue can reach a swift consensus are complex and manifold. Here, I focus on a diplomatic strategy employed by a handful of actors who carefully bypassed UN headquarters rather than promote the idea within the organization, as the official narratives on R2P suggest. I show that this strategy was inspired by a previous experience that led to another important change in global politics—the entry into force of the Anti‐Personnel Mine Ban Convention in 1999. The actors involved contributed to a normative change on humanitarian intervention by creating new forums of negotiations and using new kinds of networks that avoid multilateral arenas such as the UN. This article exposes concealed and informal aspects of diplomatic practices.
Stäckel transform of Lax equations
Authors: Błaszak Maciej , Marciniak Krzysztof 
Published: June 2020

AbstractWe construct a map between Lax equations for pairs of Liouville integrable Hamiltonian systems related by a multiparameter Stäckel transform. Using this map, we construct Lax representation for a wide class of separable systems by applying the multiparameter Stäckel transform to Lax equations of suitably chosen systems from a seed class. For a given separable system, we obtain in this way a set of nonequivalent Lax equations parameterized by an arbitrary function of the spectral parameter, as it is in the case of a related seed system.
Combat Experience and the Foreign Policy Positions of Veterans
Authors: Endicott Travis W. 
Published: June 2020

ObjectivePrior work on the effect of combat on veterans typically measures combat experience as a dichotomous event. I extend work in this area by theorizing and empirically accounting for the number of unique combat experiences a veteran endures and how that associates with the veteran's outlook on foreign policy.MethodsI utilize an original survey that asks for multiple types of military combat experience, as well as foreign policy positions.FindingsConsistent with previous research, I find that veterans tend to be more hawkish than civilians. When I account for veterans’ number of unique combat experiences, however, I find that the more combat experiences that veterans endure, the less hawkish their foreign policy positions are. Moreover, consistent with literature from military psychology, this association only holds for veterans who express more regret about their time in the military.ConclusionsThe results should encourage public opinion scholars to consider the effects that the number of individual combat event experiences and regret have on veterans' issue positions more broadly.
Modified cranial closing wedge osteotomy to treat cranial cruciate ligament deficient stifles with excessive tibial plateau angles: Complications, owner satisfaction, and midterm to long‐term outcomes
Authors: Terreros Alex , Daye R. Mark 
Published: June 2020

AbstractObjectiveTo report midterm to long‐term outcomes of dogs with cranial cruciate ligament (CCL) rupture and excessive tibial plateau angles (TPA) treated with a modified cranial closing wedge osteotomy (m‐CCWO).Study designRetrospective case series.Study populationDogs (n = 21) with CCL rupture and excessive TPA treated with m‐CCWO (n = 28).MethodsMedical records, midterm and long‐term follow‐up radiographic examination records, Canine Orthopedic Index data, and owner surveys were reviewed to determine functional outcomes, owner satisfaction, and complications associated with the technique.ResultsTibial plateau angle decreased from 42.3° ± 4.8° preoperatively to 4.8° ± 3.3° after m‐CCWO. No catastrophic complications occurred, while major and minor complications occurred in three of 28 and six of 28 stifles, respectively. Canine Orthopedic Index scores and owner surveys were available in 16 of 21 dogs at a median of 608 days postoperatively (range 279‐1225). Functional midterm or long‐term outcomes for these dogs treated with m‐CCWO were excellent in eight dogs, acceptable in seven dogs, and unacceptable in one dog. Progression of osteoarthritis was noted on all midterm and long‐term follow‐up radiographs. All owners but one were satisfied.ConclusionModified cranial closing wedge osteotomy was associated with an acceptable morbidity and resulted in satisfactory functional outcomes in most dogs of this series.Clinical significanceModified cranial closing wedge osteotomy should be considered as an alternative to treat CCL rupture in dogs with excessive TPA.
Buckling of Externally Pressurized Toroidal Shell With Stiffened Ribs
Authors: Zhu Yongmei , Zhao Bo , Chen Binbin , Zhao Xilu , Tang Wenxian , Wang Xiaorong 
Published: June 2020

Abstract
The buckling characteristics of toroidal shells with closed circular cross sections loaded with a static external pressure were investigated. Eight toroidal shell test models were developed: two ribless, two semicircular discrete ribs, two rectangular discrete ribs, and two rectangular continuous ribs. The geometry, toroidal shell thickness, buckling load, and failure of each model were measured and compared. The effects of different ribbing methods (discrete, continuous unidirectional single-wire, continuous unidirectional multiwire wound, and continuous bidirectional wound ribs) on the buckling behavior of a ribbed toroidal shell were investigated, and the results provide guidance for practical engineering.
Effects of Boot-Shaped Rib on Heat Transfer Characteristics of Internal Cooling Turbine Blades
Authors: Pham Ky-Quang , Nguyen Quang-Hai , Vu Tai-Duy , Dinh Cong-Truong 
Published: June 2020

Abstract
Gas turbine engine has been widely applied to many heavy industries, such as marine propulsion and aerospace fields. Increasing turbine inlet temperature is one of the major ways to improve the thermal efficiency of gas turbines. Internal cooling for gas turbine cooling system is one of the most commonly used approaches to reduce the temperature of blades by casting various kinds of ribs in serpentine passages to enhance the heat transfer between the coolant and hot surface of gas turbine blades. This paper presents an investigation of the boot-shaped rib design to increase the heat transfer performances in the internal cooling turbine blades for gas turbine engines. By varying the design parameter configuration, the airflow is taken with higher momentum, and the minor vortex being at the front rib is relatively removed. The object of this investigation is increasing the reattachment airflow to the heated wall and reducing the vortex occurring near the rib for improving the performances of heat transfer using three-dimensional (3D) Reynolds-averaged Navier–Stokes (RANS) with the SST model. A parametric study of the boot-shaped rib design was performed using various geometric parameters related to the heel-angle, toe-angle, slope-height, and rib-width to find their effect on the Nusselt number, temperature on the ribbed wall, friction factor ratio of the channel, and thermal performance factor. The numerical results showed that the heat transfer performances are significantly increased with the heel-angle, toe-angle, slope-height, while that remained relatively constant with the rib width.
Cardiovascular risk in patients receiving ranibizumab for exudative
age-related macular degeneration: a nationwide self-controlled case-series
study
Authors: Jeon Ha-Lim , Byun Seong Jun , Pratt Nicole L , Sultana Janet , Park Sang Jun , Shin Ju-Young 
Published: June 2020

Aims
To identify the association between ranibizumab and risk of stroke and
acute myocardial infarction (AMI) in patients with exudative age-related
macular degeneration (AMD).

Methods
We identified patients aged ≥45 years who received ranibizumab for
exudative AMD from the Korean National Health Insurance database. Of these, we
selected patients suffering stroke or AMI for the self-controlled case series.
We estimated incidence rate ratios (IRR) for stroke or AMI by comparing
incidence rates of ranibizumab-exposed periods to that of baseline using
conditional Poisson regression. The risks of haemorrhagic and ischaemic strokes
were also calculated separately.

Results
Among 33 134 patients receiving ranibizumab, 2397 patients had stroke or
AMI. The risk of stroke (IRR=0.83, 95% CI 0.75 to 0.91) was not increased
during the overall exposed period; however, there was a marginally elevated
risk in ≥57 days exposed period (IRR=1.14, 95% CI 1.001 to 1.31). When
analysing by the types of stroke, no increased risks of haemorrhagic (IRR=1.01,
95% CI 0.80 to 1.26) and ischaemic stroke (IRR=0.78, 95% CI 0.71 to 0.86) were
observed during the exposed period, although the risks of ischaemic and
haemorrhagic stroke were slightly elevated during ≥57 days exposed period. We
could not find an association between ranibizumab and AMI.

Conclusions
Ranibizumab intravitreal injections did not increase the overall risk of
stroke or AMI. Although the cardiovascular risk in patient receiving
ranibizumab seems to be low, continuous monthly use of ranibizumab for
high-risk patients should be judged carefully.
Interventions supporting long term adherence and decreasing cardiovascular events after myocardial infarction (ISLAND): pragmatic randomised controlled trial
Authors: Ivers Noah M , Schwalm Jon-David , Bouck Zachary , McCready Tara , Taljaard Monica , Grace Sherry L , Cunningham Jennifer , Bosiak Beth , Presseau Justin , Witteman Holly O , Suskin Neville , Wijeysundera Harindra C , Atzema Clare , Bhatia R Sacha , Natarajan Madhu , Grimshaw Jeremy M 
Published: June 2020

Abstract

Objective
To test a scalable health system intervention to improve long term adherence to secondary prevention treatments among patients who have had a recent myocardial infarction.

Design
Three arm, pragmatic randomised controlled trial with blinded outcome assessment.

Setting
Nine cardiac centres in Ontario, Canada.

Participants
2632 patients with obstructive coronary artery disease after a myocardial infarction, identified from a centralised cardiac registry.

Interventions
Participants were randomised 1:1:1 to receive usual care, five mail-outs developed through a user centred design process, or mail-outs plus phone calls. The phone calls were delivered first by an interactive automated system to screen for non-adherence to treatment. Trained lay health workers followed up as necessary. Interventions were coordinated centrally but delivered from each patient’s hospital site.

Main outcome measures
Co-primary outcomes were completion of cardiac rehabilitation and adherence to recommended medication. Data were collected by blinded assessors through patient report and from administrative health databases at 12 months.

Results

2632 patients (mean age 66, 71% male) were randomised: 878 to the full intervention (mail plus phone calls), 878 to mail only, and 876 to usual care. Of the respondents, 174 (27%) of 643 in the usual care group, 200 (32%) of 628 in the mail only group, and 196 (37%) of 531 allocated to the full intervention completed cardiac rehabilitation (adjusted odds ratio 1.55, 95% confidence interval 1.18 to 2.03). In the mail plus phone group, 11.7%, 6.0%, 14.4%, 32.9%, and 35.0% reported adherence to 0, 1, 2, 3, and 4 drug classes after one year, respectively, in comparison with 12.5%, 6.8%, 13.6%, 30.2%, and 36.8% in the mail only group, and 12.2%, 8.4%, 13.1%, 30.3%, and 36.1% in the usual care group, respectively (mail only
v
usual care, odds ratio 0.98, 95% confidence interval 0.81 to 1.19; full intervention
v
usual care, 0.99, 0.82 to 1.20).

Conclusions
Scalable interventions delivered by mail plus phone can increase completion of cardiac rehabilitation after myocardial infarction but not adherence to medication. More intensive interventions should be tested to improve adherence to medication and to evaluate the association between attendance at cardiac rehabilitation and adherence to medication.

Trial registration

ClinicalTrials.gov
NCT02382731
, registered 9 March 2015 before any patient enrolment.
A detailed analysis of patients included in the Summary Hospital-level Mortality Indicator (SHMI) for myocardial infarction (MI)—all is not what it seems?
Authors: Sharma Vinoda , Chowdhary Saqib , Abdul Fairoz , Džavík Vladimír , Varma Chetan 
Published: June 2020

BackgroundThe Summary Hospital-level Mortality Indicator (SHMI) for Myocardial Infarction (MI) is the ratio of the observed to the expected number of deaths due to MI. We aimed to assess (1) the accuracy of MI as a diagnosis in the SHMI for MI and (2) the healthcare received by patients with type 1 MI included in the SHMI for MI.MethodsRetrospective review of patients included in SHMI for MI from April 2017 to March 2018. The diagnosis of MI was divided into type 1, type 2 and non-MI. For patients with type 1 MI who underwent intervention, we applied the prognostic Toronto Risk Score (TRS) and classified into group 0: score <13 (mortality risk 0%–4%, lowest risk), group 1: score 13–16 (mortality risk 6%–19.6%), group 2: score 17–19 (mortality risk 27.4%–47.6%) and group 3: score ≥20 (mortality risk 58%–92%). For patients with type 1 MI who underwent conservative management, we reviewed appropriateness of conservative management.ResultsSHMI for MI was 96 (41/42.83) falling to 65.4 with the inclusion of only type 1 MI (28 patients, 28/42.83). About 41.5% (n=17) underwent intervention of whom three were in the lowest risk TRS (group 0) and all received appropriate healthcare. Conservative management was appropriate for the 26.8% (n=11) treated medically, the most common reason was severe cognitive dysfunction.ConclusionsWe have demonstrated that SHMI for MI can be inaccurate due to the inclusion of type 2 MI or non-MI. Grouping patients into intervention versus conservative management helps in assessment of healthcare.
Improving access in a VA primary care clinic using an innovative Panel Retention Tool: a quality improvement report
Authors: Harris Andrew T , Hoover Catherine , Cmolik Brendan , Zaun Mariel , Falck-Ytter Corinna , Singh Mamta K 
Published: June 2020

BackgroundLoss to follow-up is an under-recognised problem in primary care. Continuity with a primary care provider improves morbidity and mortality in the Veterans Health Administration. We sought to reduce the percentage of patients lost to follow-up at the Northeast Ohio Veterans Affairs Healthcare System from October 2017 to March 2019.MethodsThe Panel Retention Tool (PRT) was developed and tested with primary care teams using multiple Plan, Do, Study and Act cycles to identify and schedule lost to follow-up patients. Baseline data on loss to follow-up, defined as the percentage of panelled patients not seen in primary care in the past year, was collected over 6 months during tool development. Outcomes were tracked from implementation through spread and sustainment (12 months) across 14 primary care clinics.ResultsOf the 96 170 panelled patients at the beginning of the study period, 2715 (2.8%) were found to be inactive and removed from provider panels, improving panel reliability. Among the remaining, 1856 (1.9%) patients without scheduled follow-up were scheduled for future care, and 1239 (1.3%) without recent prior care completed encounters during the study period. The percentage of patients lost to follow-up decreased from 10.1% (lower control limit (LCL) 9.8%–upper control limit (UCL) 10.4%) at baseline to 6.4% (LCL 6.2%–UCL 6.7%) postintervention and patients without planned future care decreased from 21.7% (LCL 21.3%–UCL 22.1%) to 17.1% (LCL 16.7%–UCL 17.5%).ConclusionsThe PRT allowed primary care teams in an integrated health system to identify and schedule lost to follow-up patients. Ease of use, adaptability and encouraging outcomes facilitated spread. This has the potential to contribute to more appropriate utilisation of healthcare resources and improved access to primary care.