bluuebunny/crossref_metadata_2025_split huggingface dataset:
Potential Embolic Sources and Outcomes in Embolic Stroke of Undetermined Source in the NAVIGATE-ESUS Trial
Authors: Ntaios George , Pearce Lesly A. , Veltkamp Roland , Sharma Mukul , Kasner Scott E. , Korompoki Eleni , Milionis Haralampos , Mundl Hardi , Berkowitz Scott D. , Connolly Stuart J. , Hart Robert G. ,   on behalf of the NAVIGATE ESUS Investigators
Published: April 2020

Background and Purpose—
Emboli in embolic stroke of undetermined source (ESUS) may originate from various potential embolic sources (PES), some of which may respond better to anticoagulation, whereas others to antiplatelets. We analyzed whether rivaroxaban is associated with reduction of recurrent stroke compared with aspirin in patients with ESUS across different PES and by number of PES.

Methods—
We assessed the presence/absence of each PES (atrial cardiopathy, atrial fibrillation, arterial atherosclerosis, left ventricular dysfunction, cardiac valvulopathy, patent foramen ovale, cancer) in NAVIGATE-ESUS (New Approach Rivaroxaban Inhibition of Factor Xa in a Global Trial Versus ASA to Prevent Embolism in Embolic Stroke of Undetermined Source) participants. Prevalence of each PES, as well as treatment effect and risk of event for each PES were determined. Results by number of PES were also determined. The outcomes were ischemic stroke, all-cause mortality, cardiovascular mortality, and myocardial infarction.

Results—
In 7213 patients (38% women, mean age 67years) followed for a median of 11 months, the 3 most prevalent PES were atrial cardiopathy (37%), left ventricular disease (36%), and arterial atherosclerosis (29%). Forty-one percent of all patients had multiple PES, with 15% having ≥3 PES. None or a single PES was present in 23% and 36%, respectively. Recurrent ischemic stroke risk was similar for rivaroxaban- and aspirin-assigned patients for each PES, except for those with cardiac valvular disease which was marginally higher in rivaroxaban-assigned patients (hazard ratio, 1.8 [95% CI, 1.0–3.0]). All-cause mortality risks were similar across treatment groups for each PES while too few myocardial infarctions and cardiovascular deaths occurred for meaningful assessment. Increasing number of PES was not associated with increased stroke recurrence nor all-cause mortality, and outcomes did not vary between rivaroxaban- and aspirin-assigned patients by number of PES.

Conclusions—
A large proportion of patients with ESUS had multiple PES which could explain the neutral results of NAVIGATE-ESUS. Recurrence rates between rivaroxaban- and aspirin-assigned patients were similar across the spectrum of PES.

Registration—

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02313909.
Soqotrano-Biblica
Authors: Kogan Leonid 
Published: April 2020

Abstract
The article investigates the thematic and stylistic parallelism between Old Testament books (primarily, but not exclusively, Proverbs, Ecclesiastes, and the Song of Songs) and the oral poetry in the Modern South Arabian language Soqotri. Striking similarities between the two corpora, noted already by the father of Soqotri studies in the West, David Heinrich Müller, are investigated in depth on the basis of the author’s fieldwork experience on the island.
Evaluating taxonomic inflation: towards evidence-based species delimitation in Eurasian vipers (Serpentes: Viperinae)
Authors: Freitas Inês , Ursenbacher Sylvain , Mebert Konrad , Zinenko Oleksandr , Schweiger Silke , Wüster Wolfgang , Brito José C. , Crnobrnja-Isailović Jelka , Halpern Bálint , Fahd Soumia , Santos Xavier , Pleguezuelos Juan M. , Joger Ulrich , Orlov Nikolay , Mizsei Edvárd , Lourdais Olivier , Zuffi Marco A.L. , Strugariu Alexandru , Zamfirescu Ştefan Remus , Martínez-Solano Íñigo , Velo-Antón Guillermo , Kaliontzopoulou Antigoni , Martínez-Freiría Fernando 
Published: April 2020

Abstract
The designation of taxonomic units has important implications for the understanding and conservation of biodiversity. Eurasian vipers are a monophyletic group of viperid snakes (Serpentes, Viperinae), currently comprising four genera (Daboia, Macrovipera, Montivipera and Vipera) and up to 40 species. Taxonomic units have been described using a wide variety of methods and criteria, and consequently, considerable controversy still surrounds the validity of some currently listed species. In order to promote a consensus- and evidence-based taxonomy of Eurasian vipers, we analysed published mitochondrial and nuclear DNA sequences for this group to reconstruct phylogenetic relationships among currently recognized viper species. We also compiled information on external morphology to assess their morphological distinctiveness. Phylogenetic inference based on mtDNA sequences shows contrasting levels of divergence across genera and species and identifies several instances of non-monophyly in described species. Nuclear DNA sequences show extremely low levels of genetic variation, with a widespread pattern of allele sharing among distant species, and even among genera. Revision of morphological data shows that most species designations rely on scalation traits that overlap extensively among species of the same genus. Based on our combined assessment, we recognize 15 taxa as valid species, three taxa which likely represent species complexes, 17 taxa of doubtful validity as species, and five taxa for which species status is maintained but further research is highly recommended to assess taxonomic arrangements. We stress the need to implement integrative taxonomic approaches for the recognition of evidence-based taxonomic units in Eurasian vipers.
A Strategy of Non-Participation before International Courts and Tribunals
Authors: Tzeng Peter 
Published: April 2020

Abstract
One of the greatest challenges facing international courts and tribunals today is a State’s decision not to participate in a proceeding. Ever since China refused to take part in the South China Sea arbitration in 2013, there have been no fewer than nine additional inter-State cases of non-participation. The existing literature views this growing phenomenon as a problem. This article, however, takes the perspective of the non-participating State, and thus views non-participation as a strategy. After examining the law and practice of non-participation, the article discusses a series of strategic considerations that States should take into account when deciding whether to participate in a proceeding. In doing so, the article hopes not only to advise States considering non-participation, but also to help others understand the reasons behind a State’s decision of non-participation.
Outsourcing FTA Dispute Settlement Administration to Third-Party International Arbitral Institutions: Opportunities and the Role of the Permanent Court of Arbitration
Authors: Falls Scott 
Published: April 2020

Abstract
With the future viability of WTO dispute settlement being uncertain, states may be required to rely on the dispute settlement mechanisms of their FTAs to provide a forum for litigating international trade disputes. Given however that these mechanisms have historically been inefficient and ineffective, it would be judicious for states to consider delegating the administrative functions of FTA dispute settlement to a third-party arbitral institution in order to remedy these deficiencies. This article analyzes both the factors impelling states to consider contracting out the administrative function of FTA dispute settlement, as well as the potential benefits states can reap by pursuing this strategy. Assessing the strengths and potential drawbacks of delegating FTA dispute settlement administration to the Permanent Court of Arbitration in particular, this article argues that the PCA is well positioned to undertake effective and efficient administration of FTA trade disputes.
Necessity Historically Considered
Authors: Schwartz Daniel 
Published: April 2020

Abstract
The principle of necessity as applied to self-defence requires the use of the least harmful defensively effective means of thwarting a wrongful threat. Yet –so I argue – a harm can be excessive even when it is the least harmful way of dealing with the threat at the time of the attack. I therefore propose a historical view of the requirement of necessity. Historical necessity requires the selection of the least harmful means to thwart a future attack at the point in time at which we have a solid presumption that the future attack will take place. This may happen considerably before the time of the attack. Once you fail to acquire or preserve the least harmful defensive option for thwarting a future attack you may come to be irrevocably in breach of necessity. The paper tackles a number of objections to the view proposed.
Regional Interdependence and the Role of the Lower Body in Elbow Injury in Baseball Players: A Systematic Review
Authors: Deal Matthew Jordan , Richey Bradley P. , Pumilia Cyrus Anthony , Zeini Ibrahim Mamdouh , Wolf Charles , Furman Todd , Osbahr Daryl Christopher 
Published: April 2020

Background: Elbow injuries are exceedingly common in baseball players. Previous studies have identified that upper extremity strength and range of motion deficits pose a risk for these injuries, but few studies have examined the effect of lower extremity deficits. Given the role of the lower extremity in the kinetic chain of the baseball throwing motion, lower body deficits may affect the kinematics of the upper extremity and play a role in the elbow injury of baseball players. Purpose: To systematically review the current literature investigating the association of trunk and lower extremity deficits with elbow pain or injury in baseball players. Study Design: Systematic review. Methods: A systematic review of the literature was performed according to the PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines to identify and analyze all previous studies focused on the association of elbow pain and/or injury with functional deficits of the trunk and lower extremities. Results: A total of 14 studies met inclusion criteria, examining a range of baseball players extending from youth to professional athletes. One of the 14 studies examined other types of overhead throwing athletes alongside baseball players. Lower extremity–related risk factors for elbow pain and injury in these athletes were found and stratified per level of play. Factors included specific hip range of motion, lower extremity injury or pain, balance, and foot arch posture. Associations were also found with lower extremity injury and noncompliance with primary prevention programs. Conclusion: Specific lower extremity deficits were found to be independent risk factors for elbow pain and injury in throwing athletes at certain levels of play. Additionally, prevention programs designed to correct deficits in identified risk factors were effective in reducing the incidence of elbow injury in youth athletes. These results highlight the potential of screening and subsequent intervention to reduce the incidence of elbow injury in certain subsets of baseball players.
Effects of acupuncture on anthropometric and serum metabolic parameters in premenopausal overweight and obese women: a randomized, patient- and assessor-blind, sham-controlled clinical trial
Authors: Kim Koh-Woon , Shin Woo-Chul , Choi Min Sun , Cho Jae-Heung , Park Hi-Joon , Yoo Hye Hyun , Song Mi-Yeon 
Published: April 2020

Objective: The aim of this study was to examine the effect of acupuncture on obesity-related parameters with regard to metabolomics. Methods: This two-arm parallel, patient- and assessor-blind, sham-controlled randomized clinical trial included 120 obese participants. Participants were randomized into two groups. The treatment group received a combined intervention of manual acupuncture (MA) plus electroacupuncture (EA), while the control group received a combination of sham acupuncture interventions consisting of sham MA plus sham EA for 6 weeks. The serum lipid levels were measured as the primary outcome measure and anthropometric parameters and serum metabolic profiles including amino acids and carnitines were measured as secondary outcome measures. Results: The serum lipid levels and anthropometric measurements did not significantly differ between groups, while body weight, body mass index (BMI), and waist circumference were improved within each group and the level of high-density lipoprotein cholesterol increased over time in the treatment group. There were no significant differences in amino acid levels between groups, while certain carnitine (C2, C4, C6, and l-carnitine) levels were significantly increased ( p < 0.05) in the treatment group compared to the control group. Conclusion: In summary, 6 weeks of acupuncture treatment did not affect anthropometric and serum metabolic parameters, with the exception of certain carnitines, when compared to sham acupuncture. The observation of increased carnitine levels in the acupuncture group could result in potential long-term benefits to obese individuals. Additional studies are needed to investigate the long-term effects of acupuncture on lipid metabolism and the underlying mechanism of action. Trial registration number: This study is registered at ClinicalTrials.gov (NCT02066090).
Stability of calcium levofolinate reconstituted in syringes and diluted in NaCl 0.9% and glucose 5% polyolefin/polyamide infusion bags
Authors: Sanogo Seydou , Silimbani Paolo , Gaggeri Raffaella , Masini Carla 
Published: April 2020

Purpose Calcium levofolinate (CaLev) for intravenous administration is commercially available as a powder that must be reconstituted for injection or reconstituted and then diluted before administration. The lack of stability data on CaLev solutions renders necessary extemporaneous manual preparation, preventing the use of automated/semi-automated systems, with a consequent loss in terms of quality and safety. Methods The present work assessed the chemical–physical and microbiological stability of CaLev prepared in sodium chloride 0.9%, glucose 5% and water for injections and stored in polyolefin/polyamide bags and polypropylene syringes at 2–8°C protected from light. For this purpose, we developed and validated a new rapid High Performance Liquid Chromatography with Ultra Violet Diode-Array Detection (HPLC-UV-DAD) method. Results The samples tested were stable for 14 days, retaining >95% of their initial concentration and showing no change in colour, turbidity or pH. Microbiological tests performed on the samples were negative. Conclusions Our results confirmed the analytical stability of CaLev in NaCl 0.9%, glucose 5% and water for injection at concentrations used in clinical practice at our institute. This enables our centralized laboratory to organize the preparation of this drug in advance and the use of robots rather than manual preparation reduces the workload and the risk of preparation errors.
Apoptosis signal‐regulating kinase 1 inhibition in in vivo and in vitro models of pulmonary hypertension
Authors: Wilson Kathryn S. , Buist Hanna , Suveizdyte Kornelija , Liles John T. , Budas Grant R. , Hughes Colin , MacLean Margaret R. , Johnson Martin , Church Alistair C. , Peacock Andrew J. , Welsh David J. 
Published: April 2020

Pulmonary arterial hypertension, group 1 of the pulmonary hypertension disease family, involves pulmonary vascular remodelling, right ventricular dysfunction and cardiac failure. Oxidative stress, through activation of mitogen‐activated protein kinases is implicated in these changes. Inhibition of apoptosis signal‐regulating kinase 1, an apical mitogen‐activated protein kinase, prevented pulmonary arterial hypertension developing in rodent models. Here, we investigate apoptosis signal‐regulating kinase 1 in pulmonary arterial hypertension by examining the impact that its inhibition has on the molecular and cellular signalling in established disease. Apoptosis signal‐regulating kinase 1 inhibition was investigated in in vivo pulmonary arterial hypertension and in vitro pulmonary hypertension models. In the in vivo model, male Sprague Dawley rats received a single subcutaneous injection of Sugen SU5416 (20 mg/kg) prior to two weeks of hypobaric hypoxia (380 mmHg) followed by three weeks normoxia (Sugen/hypoxic), then animals were either maintained for three weeks on control chow or one containing apoptosis signal‐regulating kinase 1 inhibitor (100 mg/kg/day). Cardiovascular measurements were carried out. In the in vitro model, primary cultures of rat pulmonary artery fibroblasts and rat pulmonary artery smooth muscle cells were maintained in hypoxia (5% O2) and investigated for proliferation, migration and molecular signalling in the presence or absence of apoptosis signal‐regulating kinase 1 inhibitor. Sugen/hypoxic animals displayed significant pulmonary arterial hypertension compared to normoxic controls at eight weeks. Apoptosis signal‐regulating kinase 1 inhibitor decreased right ventricular systolic pressure to control levels and reduced muscularised vessels in lung tissue. Apoptosis signal‐regulating kinase 1 inhibition was found to prevent hypoxia‐induced proliferation, migration and cytokine release in rat pulmonary artery fibroblasts and also prevented rat pulmonary artery fibroblast‐induced rat pulmonary artery smooth muscle cell migration and proliferation. Apoptosis signal‐regulating kinase 1 inhibition reversed pulmonary arterial hypertension in the Sugen/hypoxic rat model. These effects may be a result of intrinsic changes in the signalling of adventitial fibroblast.
Perioperative Anticoagulation Management in Spine Surgery: Initial Findings From the AO Spine Anticoagulation Global Survey
Authors: Louie Philip , Harada Garrett , Harrop James , Mroz Thomas , Al-Saleh Khalid , Brodano Giovanni Barbanti , Chapman Jens , Fehlings Michael , Hu Serena , Kawaguchi Yoshiharu , Mayer Michael , Menon Venugopal , Park Jong-Beom , Qureshi Sheeraz , Rajasekaran Shanmuganathan , Valacco Marcelo , Vialle Luiz , Wang Jeffrey C. , Wiechert Karsten , Riew K. Daniel , Samartzis Dino 
Published: April 2020

Study Design: Cross-sectional, international survey. Objectives: This study addressed the global perspectives concerning perioperative use of pharmacologic thromboprophylaxis during spine surgery along with its risks and benefits. Methods: A questionnaire was designed and implemented by expert members in the AO Spine community. The survey was distributed to AO Spine’s spine surgeon members (N = 3805). Data included surgeon demographic information, type and region of practice, anticoagulation principles, different patient scenarios, and comorbidities. Results: A total of 316 (8.3% response rate) spine surgeons completed the survey, representing 64 different countries. Completed surveys were primarily from Europe (31.7%), South/Latin America (19.9%), and Asia (18.4%). Surgeons tended to be 35 to 44 years old (42.1%), fellowship-trained (74.7%), and orthopedic surgeons (65.5%) from academic institutions (39.6%). Most surgeons (70.3%) used routine anticoagulation risk stratification, irrespective of geographic location. However, significant differences were seen between continents with anticoagulation initiation and cessation methodology. Specifically, the length of a procedure ( P = .036) and patient body mass index ( P = .008) were perceived differently when deciding to begin anticoagulation, while the importance of medical clearance ( P < .001) and reference to literature ( P = .035) differed during cessation. For specific techniques, most providers noted use of mobilization, low-molecular-weight heparin, and mechanical prophylaxis beginning on postoperative 0 to 1 days. Conversely, bridging regimens were bimodal in distribution, with providers electing anticoagulant initiation on postoperative 0 to 1 days or days 5-6. Conclusion: This survey highlights the heterogeneity of spine care and accentuates geographical variations. Furthermore, it identifies the difficulty in providing consistent perioperative anticoagulation recommendations to patients, as there remains no widely accepted, definitive literature of evidence or guidelines.
Platelet-Rich Plasma Shortens Return to Play in National Football League Players With Acute Hamstring Injuries
Authors: Bradley James P. , Lawyer Tracye J. , Ruef Sonia , Towers Jeffrey D. , Arner Justin W. 
Published: April 2020

Background: Hamstring injuries are prevalent in professional athletes and can lead to significant time loss, with recurrent injury being common. The efficacy of platelet-rich plasma (PRP) for augmentation of nonoperative treatment of partial musculotendinous hamstring injuries is not well established. Hypothesis: The addition of PRP injections to nonoperative treatment for acute partial musculotendinous hamstring injuries will lead to a shortened return to play in National Football League (NFL) players. Study Design: Cohort study; Level of evidence, 3. Methods: NFL players from a single team who sustained acute grade 2 hamstring injuries, as diagnosed on magnetic resonance imaging (MRI) by a musculoskeletal radiologist from 2009 to 2018, were retrospectively reviewed. Average days, practices, and games missed were recorded. Players who did and did not receive PRP (leukocyte-poor) injections were compared. Those who received PRP did so within 24 to 48 hours after injury. Results: A total of 108 NFL players had MRI evidence of a hamstring injury, and of those, 69 athletes sustained grade 2 injuries. Thirty players received augmented treatment with PRP injections and 39 players underwent nonoperative treatment alone. Average time missed in those treated with PRP injections was 22.5 days, 18.2 practices, and 1.3 games. In those who did not receive PRP injections, time missed was 25.7 days ( P = .81), 22.8 practices ( P = .68), and 2.9 games ( P < .05). Conclusion: Augmentation with PRP injections for acute grade 2 hamstring injuries in NFL players showed no significant difference in days missed or time to return to practice but did allow for faster return to play, with a 1 game overall difference. Owing to the possible large financial impact of returning to play 1 game sooner, PRP injections for treatment of grade 2 hamstring injuries may be advantageous in professional athletes.