bluuebunny/crossref_metadata_2025_split huggingface dataset:
Constitutional Change Outside the Courts: Citizen Deliberation and Constitutional Narrative(s) in Ireland’s Abortion Referendum
Authors: Carolan Eoin 
Published: September 2020

AbstractThis article considers how the use of referenda to enact constitutional change relates to the concept of a ‘constitution outside the courts’. It argues that the referendum is a challenge to this concept but that these challenges arise in a more complex manner than might first be assumed. First, a referendum occurs within a legal framework which calls into question the notion of the referendum as an extra-legal interruption to the constitutional order. Secondly, this suggests that the referendum is more likely to be the end point of a process of constitutional change rather than the vehicle or impetus for it. This means that the relevant developments may occur elsewhere in society. Using Ireland as a case study, the article argues that there is a constitution outside the courts which depends to a significant extent on the mediating influence of multiple actors—including the courts.
Assessment of the cross-sectional areas of the psoas major in patients with adolescent idiopathic scoliosis before skeletal maturity
Authors: Xu Jia-Jing , Zhu Xiu-Liang , Li Tian , Lin Yan , Luo Xin , Wu Yao-Sen , Dou Hai-Cheng 
Published: September 2020

Background The psoas major (PM) can support the lumbar spine and plays an important role in lumbar movement and maintaining lumbar curvature. Purpose To analyze morphological changes of PM and its relation with the severity of adolescent idiopathic scoliosis (AIS). Material and Methods The study was conducted on patients with AIS (age range = 10–18 years) with primary lumbar scoliosis. The cross-sectional area (CSA) of the PM at the L1–L5 levels were measured. The CSA of the PM in patients with AIS was compared with the average CSA of the PM in age-matched controls. The difference in PM at the apical vertebrae level was compared with the Cobb angle to determine the association between PM imbalance and severity of scoliosis. Results The CSA of the PM was larger on the concave side than the convex side at the apical vertebrae level and other lumber levels. Patients with a larger Cobb angle had statistically higher PM imbalance at the apical vertebrae level. The CSA of the PM on both the concave and convex sides of patients with AIS were larger than the average CSA of controls aged 16–18 years; however, there was no significant difference between patients with AIS and controls aged 10–15 years. Conclusion There is a significant PM imbalance in patients with AIS before skeletal maturity, and the imbalance is related to the severity of scoliosis. The morphology of PM changed with the progression of scoliosis.
Optimal Treatment of Cam Morphology May Change the Natural History of Femoroacetabular Impingement
Authors: Domb Benjamin G. , Annin Shawn , Chen Jeffrey W. , Kyin Cynthia , Rosinsky Philip J. , Maldonado David R. , Meghpara Mitchell B. , Lall Ajay C. , Shapira Jacob 
Published: September 2020

Background: There is debate in the literature whether cam morphology is associated with increased risk for hip osteoarthritis. The capability of femoroplasty to alter the natural history of cam morphology is still in question. Purpose: To (1) investigate the correlation between cam morphology and damage to the articular cartilage and (2) assess whether correction of the cam morphology affects survivorship of the joint, progression to arthroplasty, and functional patient-reported outcome scores. Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected for patients presenting for hip arthroscopy between February 2008 and April 2017. Cases were divided into 3 groups: control group with an alpha angle <50° pre- and postoperatively, treated group with an alpha angle >55° preoperatively and <50° postoperatively, and a group with an alpha angle >55° pre- and postoperatively. All patients had minimum 2-year postoperative follow-up for the modified Harris Hip Score, the Non-arthritic Hip Score, and visual analog scale for pain. Conversion to total hip arthroplasty was recorded. Results: A 1:1:1 match successfully yielded 98 hips for each group. Follow-up time was 50.77 ± 24.60 months (mean ± SD). The pre- and postoperative mean alpha angles were 45.2°± 3.4° and 40.6°± 4.3° in the control group, respectively; 66.2°± 8.4° and 42.3°± 5.9° in the treated group; and 68.5°± 9.4° and 61.4°± 7.6° in the alpha >55° group. Intraoperatively, the alpha >55° and treated groups had greater acetabular cartilage damage than the control group ( P = .0245 and P = .0036, acetabular labrum articular disruption, respectively; P = .0347 and P = .0211, acetabular Outerbridge). The alpha >55° group achieved the patient acceptable symptomatic state for the modified Harris Hip Score (58.2%) significantly less than the treated (75.5%; P = .0100) and control (73.5%; P = .0239) groups. Progression to arthroplasty was significantly higher in the alpha >55° group (n = 17) when compared with the control (n = 8) and treated (n = 10) groups ( P = .0034 and P = .0338, respectively). Conclusion: Cam deformity was associated with higher-grade damage of the acetabular articular cartilage. An alpha angle >55° after surgery was associated with lower native hip joint survivability and less successful functional outcomes when compared with that of treated cam deformity as well as no deformity. These data suggest that correcting the cam deformity may positively affect the natural history of these patients.
A multivariate factor analysis of the high plasma concentration of cyclic AMP in patients with chronic renal failure
Authors: Marumo F. , Sakai T. , Shirataka M. 
Published: September 2020

The concentration of cyclic AMP which is known as an intracellular mediator of hormone action increased in the plasma of patients with chronic renal failure (CRF). In the present study, the plasma concentration of cyclic AMP significantly correlated not only with serum, creatinine, and urea levels, but also with plasma PTH and glucagon in patients with CRF. Furthermore, plasma concentrations of PTH and glucagon correlated with the serum creatinine concentration to a significant extent. To discuss the cause of the increased cyclic AMP concentration in plasma of patients with CRF, multivariate analyses were carried out on the obtained clinical data from patients and normal subjects. In the factor analysis on the clinical data from 61 subjects, cyclic AMP, creatinine and BUN correlated with the first factor and PTH correlated with the second factor. The cumulative contribution ratio by the second factor was 76%. The results of the cluster analysis indicated that cyclic AMP, creatinine, and BUN formed a cluster and PTH glucagon made another cluster. These results suggest that the elevated plasma concentration of cyclic AMP in patients with CRF was mainly introduced not by overproduction but by the retention of cyclic AMP due to the decreased renal function.
CT Abdominal Tomography Indications: Are We All Sticking to the Plan?
Authors: Pyper Michael , Sidiqi Abdulwahab , Rogalla Patrik , Sabbah Sam , Kielar Ania 
Published: September 2020

Objective: Ultra-low radiation dose computed tomography (CT) abdominal tomography was introduced in our institution in 2016 to replace standard abdominal radiography in the investigation of emergency department patients. This project aims to ascertain whether investigation of emergency department patients using ultra-low radiation dose CT abdominal tomography complies with original indication guidelines and/or if there has been any “indication creep” 3 years after inception. Methods: Retrospective, quality assurance project with research ethics waiver. A review of 200 consecutive patients investigated with CT abdominal tomography between February and May 2017 was performed. This was compared with 200 consecutive patients investigated between February and May 2019. Data analyzed included patient demographics, indication for scan, as well as scan and patient outcomes. Results: In the 2017 group, 29/200 scans were noncompliant with approved indication guidelines. In the 2019 group, 30/200 scans were also noncompliant. There was no statistically significant difference between groups ( P < .05) regarding the use of approved indications. Forty of 200 scans performed in 2017 revealed additional findings which are not specifically addressed on the reporting template. Forty-one of 200 scans in 2019 revealed these findings. Conclusions: There has been no “indication creep” for CT abdominal tomography over time.
Serum Albumin Levels: Who Needs Them?
Authors: Erstad Brian L. 
Published: September 2020

Objectives The purpose of this critical narrative review is to discuss common indications for ordering serum albumin levels in adult critically ill patients, evaluate the literature supporting these indications, and provide recommendations for the appropriate ordering of serum albumin levels. Data Sources PubMed (1966 to August 2020), Cochrane Library, and current clinical practice guidelines were used, and bibliographies of retrieved articles were searched for additional articles. Study Selection and Data Extraction Current clinical practice guidelines were the preferred source of recommendations regarding serum albumin levels for guiding albumin administration and for nutritional monitoring. When current comprehensive reviews were available, they served as a baseline information with supplementation by subsequent studies. Data Synthesis Serum albumin is a general marker of severity of illness, and hypoalbuminemia is associated with poor patient outcome, but albumin is an acute phase protein, so levels vacillate in critically ill patients in conjunction with illness fluctuations. The most common reasons for ordering serum albumin levels in intensive care unit (ICU) settings are to guide albumin administration, to estimate free phenytoin or calcium levels, for nutritional monitoring, and for severity-of-illness assessment. Relevance to Patient Care and Clinical Practice Because hypoalbuminemia is common in the ICU setting, inappropriate ordering of serum albumin levels may lead to unnecessary albumin administration or excessive macronutrient administration in nutritional regimens, leading to possible adverse effects and added costs. Conclusions With the exception of the need to order serum albumin levels as a component of selected severity-of-illness scoring systems, there is little evidence or justification for routinely ordering levels in critically ill patients.
Long term stability of an admixture of alizapride and ondansetron in 0.9% sodium chloride solution polyolefin bags stored at 5±3°C
Authors: Closset Mélanie , Goderniaux Nicolas , Colsoul Marie-Lise , Soumoy Laura , Bihin Benoit , Jamart Jacques , Odou Pascal , Hecq Jean-Daniel , Galanti Laurence 
Published: September 2020

Background Patients undergoing chemotherapeutic treatment are currently treated by a concomittent infusion of alizapride and ondansetron. To optimise the procedure and to ensure patients’ safety, the admixture could be prepared in advance by the Centralized Intravenous Additive Service (CIVAS) provided that the stability of the mixture has been proven beforhand to reduce nausea and vomiting. Aim of the study: to evaluate the long-term stability of an admixture of alizapride 0.926 mg/l and ondansetron 0.074 mg/ml in 0.9% sodium chloride polyolefin bags stored at 5 ± 3°C. Material and methods Five polyolefin bags containing 100 ml sodium chloride 0.9% added with 4 ml alizapride (100 mg) and 4 ml ondansetron (8 mg) were prepared in aseptic conditions and stored at 5 ± 3°C for 56 days. Periodically, physical stability tests were performed including: pH measurements, optical density measurements at 350, 410 and 550 nm to track turbidity appearance, visual and microscopical inspections to detect colour changes, precipitation, microaggregates or crystals. The concentrations of the solutions were measured by High Performance Liquid Chromatography coupled with an UV detector. Results There was no change in pH and optical densities during the study period. Visual and microscopical inspections didn’t show any change of colour neither precipitation, microaggregate or crystal. The alizapride and ondansetron concentrations remained stable over the study. Conclusion The admixture of alizapride and ondansetron in 0.9% sodium chloride solution polyolefin bags is physicochemically stable up to 56 days at 5 ± 3°C. These results support the possibility of preparing the solutions in advance by a CIVAS.
Specialized primary care medical home: A positive impact on continuity of care among autistic adults
Authors: Hand Brittany N , Coury Daniel L , White Susan , Darragh Amy R , Moffatt-Bruce Susan , Harris Lauren , Longo Anne , Garvin Jennifer H 
Published: September 2020

While the medical home has proven effective at improving continuity of care among other populations, there is a paucity of literature testing the effectiveness of medical homes in serving the healthcare needs of autistic adults. We conducted a retrospective cohort study to compare the continuity of care of autistic adult patients at a specialized primary care medical home designed to remove barriers to care for autistic adults, called the Center for Autism Services and Transition (CAST), to propensity score matched national samples of autistic adults with private insurance or Medicare. The unadjusted median Bice–Boxerman continuity of care index was 0.6 (interquartile range = 0.4–1.0) for CAST patients, 0.5 (interquartile range = 0.3–1.0) for Medicare beneficiaries, and 0.6 (interquartile range = 0.4–1.0) for privately insured autistic adults. In multivariable models controlling for demographic characteristics, on average, CAST patients had continuity of care indices that were 10% higher than national samples of autistic adult Medicare beneficiaries (p < 0.0001). Continuity of care among CAST patients did not significantly differ from that of the national sample of privately insured autistic adults (p = 0.08). Our findings suggest that medical homes, like CAST, may be a promising solution to improve healthcare delivery for the growing population of autistic adults. Lay abstract There is a nationally recognized need for innovative healthcare delivery models to improve care continuity for autistic adults as they age out of pediatric and into adult healthcare systems. One possible model of care delivery is called the “medical home”. The medical home is not a residential home, but a system where a patient’s healthcare is coordinated through a primary care physician to ensure necessary care is received when and where the patient needs it. We compared the continuity of care among autistic adult patients at a specialized primary care medical home designed to remove barriers to care for autistic adults, called the CAST, to matched national samples of autistic adults with private insurance or Medicare. Continuity of primary care among CAST patients was significantly better than that of matched national samples of autistic adult Medicare beneficiaries and similar to that of privately insured autistic adults. Our findings suggest that medical homes, like CAST, are a promising solution to improve healthcare delivery for the growing population of autistic adults.
Treatment of anemia in cancer patients undergoing chemotherapy with intravenous ferric carboxymaltose without erythropoiesis-stimulating agents
Authors: Abdel-Razeq Hikmat , Saadeh Salwa S. , Malhis Razan , Yasser Sameer , Abdulelah Hazem , Eljaber Rana , Kleib Amer , Ismael Rouba 
Published: September 2020

Background: Anemia is commonly encountered in cancer patients receiving active chemotherapy. Due to adverse events and presumed negative effects on disease-progression and survival, erythropoiesis-stimulating agents are not frequently used. In this study, we assess the efficacy and safety of intravenous ferric carboxymaltose (FCM) to treat cancer-induced anemia (CIA). Patients and Methods: We recruited adult cancer patients on active chemotherapy with a hemoglobin (Hb) level ⩽11.0 g/dL. Based on serum ferritin (sFr) and transferrin saturation (TSAT), patients were divided into 3 groups: group I (absolute iron deficiency, n = 26) with sFr < 30 ng/mL and TSAT < 20%; group II (functional iron deficiency, n = 24) with sFr 30–800 ng/mL and TSAT < 20%; and patients with TSAT ⩾ 20% were placed in group III as “others” ( n = 34). All patients were treated with intravenous FCM. Serum hepcidin and C-reactive protein were used as biomarkers to predict response. Results: A total of 84 patients with a median age (SD) of 53.8 (10.6) were recruited. Baseline median Hb level was 10.2 (range: 8.3–11.0) gm/dL. At week 12, there was a significant increment in Hb level for patients in groups I and II (median increment: 2.35 and 1.5 gm/dL, respectively), with limited response observed in group III, and most of the increment noted as early as week 3 (⩾1.0 g/dL). Responders tended to have lower levels of hepcidin. No clinically significant adverse events were reported; however, asymptomatic hypophosphatemia was observed in 39 (46.4%) patients. Conclusions: Intravenous FCM is a safe and effective treatment option for the management of a subgroup of patients with CIA. The study was registered at ClinicalTrials.gov [Identifier: NCT04246021]
Exploring Armenian Ethnicity as an Independent Risk Factor for Cardiovascular Disease: Findings from a Prospective Cohort of Patients in a County Hospital
Authors: Rostomian Ara H , Soverow Jonathan , Sanchez Daniel R 
Published: September 2020

Objectives While several studies have examined the risk of cardiovascular disease (CVD) in larger racial and ethnic groups within the United States, limited information is available on smaller sub-populations, such as Armenians, with high rates of CVD in their home country. This study examined the association between Armenian ethnicity and a positive exercise treadmill test (ETT). Design Prospective cohort study of patients at a 377-bed county hospital in Los Angeles, California from 2008–2011. Setting All patients were interviewed at the time of ETT to assess their cardiovascular risk factors at the cardiac laboratory of the hospital. Participants 5,006 patients between 18–89 years of age, of whom 12.6% were of Armenian ethnicity and 54.4% were female. Main Outcome Measure: ETT results as a proxy for CVD risk. Results After adjusting for cardiovascular risk factors, Armenian ethnicity was significantly associated with higher odds of positive ETT (OR = 1.40, p = 0.01). Known coronary artery disease CAD (OR = 2.28, p < 0.01), hyperlipidemia (OR = 1.37, p < 0.01), and hypertension (OR = 1.24, p = 0.05) were significantly associated with higher odds of a positive ETT. In subgroup analyses, hyperlipidemia was the only significant predictor of positive ETT (OR = 1.92, p = 0.02) among Armenians, while patient history of CAD (OR = 2.49, p < 0.01), hyperlipidemia (OR = 1.29, p = 0.03), and age (OR = 1.04, p < 0.01) were significant predictors among non-Armenians. Armenian ethnicity remained associated with higher odds of positive ETT (OR = 1.40, p < 0.01) when patients with CAD were excluded. Conclusion Armenian ethnicity may be an independent risk factor for CVD, influenced by the uniformity of the genetic pool and cultural and dietary exposures.
Faith in Trump, Moral Foundations, and Social Distancing Defiance during the Coronavirus Pandemic
Authors: Graham Amanda , Cullen Francis T. , Pickett Justin T. , Jonson Cheryl Lero , Haner Murat , Sloan Melissa M. 
Published: September 2020

Purpose: Over the past several months, the coronavirus has infected more than six million Americans and killed nearly 200,000. Governors have issued stay-at-home orders, and prosecutors have filed criminal charges against individuals for defying those orders. And yet many Americans have still refused to keep their distance from their fellow citizens, even if they had symptoms of infection. The authors explore the underlying causes for those who intend to defy these norms. Methods: Using national-level data from a March 2020 survey of 989 Americans, the authors explore intentions to defy social distancing norms by testing an interactionist theory of foundation-based moral behavior in combination with faith in President Trump during the coronavirus pandemic. The analysis controls for a range of variables, including measures of low self-control and deterrence. Results: Low self-control is the strongest predictor of defiance intentions. Consistent with interactionist theory, defiance intentions are significantly higher for those holding specific faith in Trump and those endorsing binding foundations. Furthermore, the interaction of these two variables is significant and in the predicted direction. The results hold for two different measures of faith in Trump. Conclusions: Even with a strong effect for low self-control, faith in President Trump is a strong predictor of refusal to social-distance, and its effect is largest among individuals high in binding foundations.
Targeting a cytokine checkpoint enhances the fitness of armored cord blood CAR-NK cells
Authors: Daher May , Basar Rafet , Gokdemir Elif , Baran Natalia , Uprety Nadima , Nunez Cortes Ana Karen , Mendt Mayela , Kerbauy Lucila Nassif , Banerjee Pinaki P. , Shanley Mayra , Imahashi Nobuhiko , Li Li , Lim Francesca Lorraine Wei Inng , Fathi Mohsen , Rezvan Ali , Mohanty Vakul , Shen Yifei , Shaim Hila , Lu Junjun , Ozcan Gonca , Ensley Emily , Kaplan Mecit , Nandivada Vandana , Bdiwi Mustafa , Acharya Sunil , Xi Yuanxin , Wan Xinhai , Mak Duncan , Liu Enli , Jiang Xin Ru , Ang Sonny , Muniz-Feliciano Luis , Li Ye , Wang Jing , Kordasti Shahram , Petrov Nedyalko , Varadarajan Navin , Marin David , Brunetti Lorenzo , Skinner Richard J. , Lyu Shangrong , Silva Leiser , Turk Rolf , Schubert Mollie S. , Rettig Garrett R. , McNeill Matthew S. , Kurgan Gavin , Behlke Mark A. , Li Heng , Fowlkes Natalie W. , Chen Ken , Konopleva Marina , Champlin Richard E. , Shpall Elizabeth J. , Rezvani Katayoun 
Published: September 2020

Abstract
Immune checkpoint therapy has resulted in remarkable improvements in the outcome for certain cancers. To broaden the clinical impact of checkpoint targeting, we devised a strategy that couples targeting of the cytokine-inducible Src homology 2–containing (CIS) protein, a key negative regulator of interleukin 15 (IL-15) signaling, with fourth-generation “armored” chimeric antigen receptor (CAR) engineering of cord blood–derived natural killer (NK) cells. This combined strategy boosted NK cell effector function through enhancing the Akt/mTORC1 axis and c-MYC signaling, resulting in increased aerobic glycolysis. When tested in a lymphoma mouse model, this combined approach improved NK cell antitumor activity more than either alteration alone, eradicating lymphoma xenografts without signs of any measurable toxicity. We conclude that targeting a cytokine checkpoint further enhances the antitumor activity of IL-15–secreting armored CAR-NK cells by promoting their metabolic fitness and antitumor activity. This combined approach represents a promising milestone in the development of the next generation of NK cells for cancer immunotherapy.