bluuebunny/crossref_metadata_2025_split huggingface dataset:
East Asia’s Other New World, China and the Viceroyalty of Peru: A Neglected Aspect of Early Modern Maritime History
Authors: Schottenhammer Angela 
Published: May 2020

At least officially, the Chinese government showed little to no interest in the Asia-Pacific region. We also know very little about Chinese state interference except for attempts to fight against piracy in the Southeast Asian waters. This article will consequently address and survey a neglected aspect of China’s maritime history, namely China’s (indirect) relationship with the Viceroyalty of Peru, its capital Lima (= Ciudad de los Reyes), and its port of Callao, and with the ‘silver centre’ in the Spanish Indies—the Villa Imperial (= Potosí), in the hinterlands of the Viceroyalty of Peru. These active, but at first sight less obvious and frequently neglected parts of the trans-Pacific trade, I would like to call ‘the other New World’. The article introduces a variety of micro-historical bottom-up insights into connections between two places that at first sight seem related to each other only through the shipments of huge quantities of silver from the Cerro Rico in Potosí via Acapulco and Manila to China, in exchange for Chinese silks and porcelains, looking specifically at some micro networks, contraband, informal, accidental, and undesired exchanges. It offers preliminary results and a general framework and survey of trade connections, routes and information on the variety of Chinese products that reached Peru.
Suicide and ‘hidden suicide’: a comparison of rates in selected countries
Authors: Snowdon John 
Published: May 2020

Objective: To review rates of suicide and ‘hidden suicide’ in New Zealand (NZ), Australia, Ireland and Spain. Method: Using estimated population figures and online cause-of-death data from four countries, rates of suicide and ‘hidden suicide’ in 2014–2016 were calculated and compared. Results: Age patterns and rates of suicide and ‘hidden suicide’ differ between these countries. The male suicide rate progressively rises across the age range in Spain but becomes lower in late life in Ireland. The male patterns in NZ and Australia are bimodal; male and female rates decrease in late life, with NZ lower than Australia. Māori age patterns are downward-sloping. Suicide rates of young Māori considerably exceed those of young non-Māori in NZ. Conclusions: The NZ youth suicide peaks are attributable to high rates of Māori youth suicide. Rates of ‘hidden suicide’ are relatively low in the four countries.
The fentanyls: a ‘future threat’ for Australia?
Authors: Scamvougeras Anton , Greene Shaun L , Norman Amanda , Bonomo Yvonne , Castle David J 
Published: May 2020

Objective: The fentanyls have emerged as a significant public health threat in North America but much less so in Australia. We sought to identify reasons for this discrepancy and highlight harm reduction approaches that may mitigate a future Australian fentanyl epidemic. Conclusions: Differences in drug use ‘culture’ and a supply of cheap high-quality methamphetamine in Australia may be reasons for the observed difference in fentanyl-related harm. More worryingly, it is possible that Australia is following North American trends and that the fentanyl epidemic is still to come.
Obesity, physical activity and sleep quality in patients admitted to a posttraumatic stress inpatient ward
Authors: Chen Andrew , Rosenbaum Simon , Wells Ruth , Gould Kirrily , Ward Philip B. , Steel Zachary 
Published: May 2020

Objective: The aim of this paper was to cross-sectionally examine the association between physical health indicators and PTSD symptomatology. Method: A cross-sectional study was conducted among inpatients of a service related trauma-focused ward. Physical and mental health indicators including sleep quality, fitness, physical activity, body mass index and PTSD symptomatology were assessed. Results: Among 60 inpatients, significant associations were found between sedentary time ( r = 0.42; p < .001) and sleep quality ( r = 0.40; p < .001) with PTSD symptomatology. The vast majority of inpatients ( n = 56; 93%) were found to be either overweight or obese according to body mass index. Conclusion: Inpatients of a PTSD treatment facility had extremely high rates of obesity, physical inactivity, poor cardiorespiratory fitness and poor sleep quality. Sedentary behaviour is a modifiable risk factor associated with symptoms and physical health.
Genetic Variation Near chrXq22-q23 Is Linked to Emotional Functioning in Cystic Fibrosis
Authors: Barbato Eric , Daly Barbara , Douglas Sara , Kerr Mary , Litman Paul , Darrah Rebecca 
Published: May 2020

Introduction: Cystic fibrosis (CF) is an autosomal recessive disease that affects many organ systems, most notably the pulmonary and gastrointestinal systems. Through genome-wide association studies, multiple genetic regions modifying CF-related pulmonary and gastrointestinal symptoms have been identified, but translation of these findings to clinical benefit remains elusive. Symptom variation in CF patients has been associated with changes in health-related quality of life (HRQOL), but the relationship between CF symptom-modifying genetic loci and HRQOL has not been explored. The purpose of this study was to determine whether two previously identified genetic modifiers of CF-related pathology also modify the subscales of HRQOL. Methods: HRQOL and genotype data were obtained and analyzed. Linear regressions were used to examine the amount of variance in HRQOL subscales that could be explained by genotype for each modifier locus. Results: A significant regression equation was found between genotype for rs5952223, a variant near chrXq22-q23, and emotional functioning in a sample of 129 CF patients. Discussion: These data suggest that genotype for this single-nucleotide polymorphism is associated with emotional functioning in CF patients and highlight this genetic region as a potential therapeutic target, irrespective of CF transmembrane conductance regulator genotype.
Surgical management of chronic pelvic instability following periacetabular osteotomy nonunion
Authors: Shearman Alexander D , Hashemi-Nejad Aresh , Bankes Marcus JK , Lewis Angus D 
Published: May 2020

Introduction: Periacetabular osteotomy (PAO) is an established treatment for symptomatic acetabular dysplasia in skeletally mature individuals without arthritis. Pelvic nonunion and associated stress fractures are under-reported. Nonunited stress fractures can cause continued buttock pain and pelvic instability. The aim of this study is to report on our experience managing patients with ongoing pain following nonunion of PAO. Patients and methods: 8 patients presented to a tertiary referral pelvic service with symptomatic PAO nonunion between 2015-2018. All patients underwent open reduction internal fixation of the superior pubic ramus nonunion, with ipsilateral iliac autograft, at an average of 48.1 (15–82) months following initial osteotomy. Demographic and perioperative data were recorded. Follow-up was on average to 9.9 months, once union was confirmed radiographically. Results: All patients were female and average age was 31.8 (18–41) years. In 7/8 (87.5%) patients a modified Stoppa approach was successfully utilised. 1 patient required an ilioinguinal approach due to the amount of rotational correction. All patients went on to union at the superior pubic ramus and reported improvement in mechanical symptoms. 5/8 (62.5%) patients were noted to develop union of the posterior column or inferior pubic ramus stress fracture indirectly. 2/8 (25%) patients developed progression of intra-articular pain, despite restoration of pelvic stability. 1 patient required intraoperative transfusion due to femoral vein injury. There were no other complications seen in this series. Conclusions: To our knowledge, this is the largest case series of surgically managed PAO nonunion. Pelvic instability resulting from nonunion and stress fracture can be satisfactorily addressed by mobilising, grafting and plating the nonunion at the superior pubic ramus. The modified Stoppa approach is suitable in most cases, allowing excellent exposure whilst minimising the insult to soft tissues. The altered anatomy of the pelvis following PAO should be anticipated to reduce the risk to nearby neurovascular structures.
Long-term results of metal-on-metal hip resurfacing in patients 65 years of age or older
Authors: Amstutz Harlan C , Le Duff Michel J 
Published: May 2020

Background: Metal-on-metal hip resurfacing arthroplasty (MMHRA) is typically used in young and active patients because they have the most to gain from this bone-preserving procedure. However, there is very little long-term data on the performance of MMHRA in patients 65 years of age or older because of the efficacy of conventional total hip arthroplasty in this patient population. Methods: 109 patients (124 hips) age ⩾65 years were treated with Conserve Plus MMHRA. There were 83 male and 26 female patients. Their mean age at surgery was 69.5 (range 65–83) years. UCLA hip scores, SF-12 quality of life score were collected at follow-up visits. Radiographic and survivorship analyses were performed. Results: SF-12 scores and UCLA scores were maintained over time except for a small decrease in activity. 4 patients underwent revision surgery. The 15-year Kaplan-Meier survivorship of the cohort was 93.7%. All revisions surgeries were successful at a mean follow-up time of 113 (range 30–218) months. Unusual radiographic findings from our previous publication did not progress over time except for 1 hip that showed a complete radiolucency around the acetabular component. Conclusions: Our results clearly show that HRA is a viable prosthetic solution with many advantages for all active patients, regardless of their age at the time of surgery.
Cortical axonal loss is associated with both gray matter demyelination and white matter tract pathology in progressive multiple sclerosis: Evidence from a combined MRI-histopathology study
Authors: Kiljan Svenja , Preziosa Paolo , Jonkman Laura E , van de Berg Wilma DJ , Twisk Jos , Pouwels Petra JW , Schenk Geert J , Rocca Maria A , Filippi Massimo , Geurts Jeroen JG , Steenwijk Martijn D 
Published: May 2020

Background: Neuroaxonal degeneration is one of the hallmarks of clinical deterioration in progressive multiple sclerosis (PMS). Objective: To elucidate the association between neuroaxonal degeneration and both local cortical and connected white matter (WM) tract pathology in PMS. Methods: Post-mortem in situ 3T magnetic resonance imaging (MRI) and cortical tissue blocks were collected from 16 PMS donors and 10 controls. Cortical neuroaxonal, myelin, and microglia densities were quantified histopathologically. From diffusion tensor MRI, fractional anisotropy, axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) were quantified in normal-appearing white matter (NAWM) and white matter lesions (WML) of WM tracts connected to dissected cortical regions. Between-group differences and within-group associations were investigated through linear mixed models. Results: The PMS donors displayed significant axonal loss in both demyelinated and normal-appearing (NA) cortices ( p < 0.001 and p = 0.02) compared with controls. In PMS, cortical axonal density was associated with WML MD and AD ( p = 0.003; p = 0.02, respectively), and NAWM MD and AD ( p = 0.04; p = 0.049, respectively). NAWM AD and WML AD explained 12.6% and 22.6%, respectively, of axonal density variance in NA cortex. Additional axonal loss in demyelinated cortex was associated with cortical demyelination severity ( p = 0.002), explaining 34.4% of axonal loss variance. Conclusion: Reduced integrity of connected WM tracts and cortical demyelination both contribute to cortical axonal loss in PMS.
Single-stage basilic vein transposition—An effective and viable autogenous access for dialysis
Authors: Basavanthappa Rajendraprasad , Luthra Luv , Gangadharan Ashwini Naveen , A Ranjith Kumar , M Adharsh Kumar , JP Vivek Vardhan , AR Chandrashekar , Desai Sanjay C 
Published: May 2020

Introduction The National Kidney Foundation’s/Kidney Disease Outcomes Quality Initiative recommends autogenous arteriovenous fistulas as the preferred method for long-term hemodialysis access. Basilic vein transposition is not only an alternative in patients with failed arteriovenous access but also can be the first option for arteriovenous access in patients with inadequate cephalic vein. Several studies have shown better patency rates, cost-effectiveness, and fewer complications of autogenous access over prosthetic arteriovenous grafts. Aims and objectives To analyze patency, complication rates, and outcomes of single-stage basilic vein transposition. Materials and methods A single-center retrospective non-randomized study conducted at Ramaiah Medical College and Hospitals, Bangalore from July 2015 to June 2018. A total of 94 consented patients who underwent single-stage basilic vein transposition were included in the study. All the surgeries were done in a single stage under regional anesthesia. All the complications and patency rates were calculated at the end of one year. Statistical analysis was performed using the Chi-square test, and patency rates were assessed using the Kaplan–Meir survival curve. Results A total of 94 single-stage basilic vein transposition was performed. Fifty-four patients had a previous failed autogenous access and 40 had either absent or thrombosed cephalic vein. The mean age was 56.6 years with 59.57% males. The mean basilic vein and brachial artery diameter was 3.6 and 3.8 mm, respectively. The primary patency rate at one year was 84%. Edema and thrombosis were the most common complication in our study. Conclusion Single-stage basilic vein transposition is a feasible surgical option in end-stage renal disease patients and provides durable autogenous access with very reasonable outcomes in terms of complication rates and patency rates.
Diagnostic Value of Albumin to Fibrinogen Ratio in Cervical Cancer
Authors: Huang Li , Mo Zhuning , Zhang Linyan , Qin Shanzi , Qin Simeng , Li Shan 
Published: May 2020

Background: Albumin to fibrinogen ratio (AFR) play a crucial role in the progression and prognosis of many malignant tumors. This study aimed to comprehensively assess the diagnostic value of AFR as single markers or in combination with squamous cell carcinoma antigen (SCC-Ag), cancer antigen 125 (CA-125) in cervical cancer. Methods: A total of 323 cervical cancer inpatients, 143 patients with cervical intraepithelial neoplasia (CIN) and 317 healthy controls were analyzed. Differences in laboratory parameters and clinicopathological features were calculated using the Mann–Whitney U or Kruskal–Wallis H test. The receiver operating characteristic (ROC) curve was used to evaluate the predicted value of AFR, alone or combined with SCC-Ag, CA-125 for the diagnosis of cervical cancer. Results: The levels of AFR in patients with cervical cancer were significantly lower than those in the CIN patients and the control subjects. AFR were not only negatively correlated with the tumor stage, but also related to histology typing, lymph node metastasis, distant metastasis, depth of stromal infiltration, tumor size, and tumor stage; however, it was not associated with the blood group. AFR combined with SCC-Ag possessed a larger area under the curve (AUC; AUCAFR+SCC-Ag = 0.924, 95% confidence interval (CI) 0.900, 0.944) than AFR ( P < 0.001), SCC-Ag ( P < 0.001), or CA-125 ( P < 0.001) did alone. Conclusions: The pretreatment levels of AFR, alone or combined with SCC-Ag, CA-125 could improve the diagnostic efficiency of cervical cancer.
Frailty assessment in older urological patients prior to surgery: a systematic review and narrative synthesis
Authors: Haren Andrea , Lal Rajni , Walker David , Nair Rajesh , Partridge Judith , Dhesi Jugdeep 
Published: May 2020

Background: Radical cystectomy (RC) and urinary diversion are the recommended treatment for patients with muscle invasive bladder cancer. This is complex surgery, associated with significant patient morbidity and mortality. Frailty has been shown to be an independent risk factor for adverse outcomes in several surgical populations. Preoperative assessment of frailty is advocated in current guidelines but is not yet standard clinical practice. Aims: This systematic review and narrative synthesis aims to examine whether patients undergoing RC are assessed for frailty, what tools are used, and whether an association is found between frailty and adverse outcomes in this population. Results: Nine studies, published within the last 4 years, describe the use of tools reporting to measure frailty in the RC population. All demonstrate increased risk of adverse postoperative outcomes with higher frailty levels. Only one study used a validated frailty tool. The majority of studies measure frailty using variations on a tool derived from a large database (ACS-NSQIP) effectively counting co-morbidities, rather than assessing the multidomain nature of the frailty syndrome. Conclusion: The recognition of frailty as an important consideration in the perioperative period is welcome. This systematic review and narrative synthesis demonstrates the need for collaboration in research and delivery of clinical care for older surgical patients. Such collaboration may provide clarity regarding terms such as frailty and multimorbidity, preventing the development of assessment tools inaccurately measuring these discreet syndromes interchangeably. More accurate assessment of patients in terms of frailty, multimorbidity and functional status may allow better modification and shared decision making leading to improved postoperative outcomes in older patients undergoing RC.
Christian Medical College and Hospital: Serving with a Sense of Calling
Authors: Jain Puja 
Published: May 2020

Doctors of Christian Medical College and Hospital (CMC&H), Ludhiana do not moonlight. In today’s world where people run behind money, there are doctors who do not do private practice and instead have chosen to work with CMC&H. Due to financial constraints, CMC&H neither is a very good paymaster nor has swanky infrastructure. The case study tries to explore answers to certain questions like what is the approach of doctors towards their work, and what is there in this charismatic CMC&H due to which doctors decide to stay with it? The case discusses the measures taken by CMC&H to pursue its mission to serve the society, especially the poor and the marginalized ones. The case also discusses the challenges which CMC&H is facing, which further raise questions like: will its financial constraints allow it to maintain its momentum to serve the society and continue with its legacy of healing and education? The case can be used to teach certain Human Resource Management/Organisational Behaviour (HR/OB) concepts like sense of calling, perception, HR practices, culture and moonlighting Dilemma: Should CMC&H continue with the existing systems/practices or should it bring some changes? Should doctors continue avoiding moonlighting in order to pursue their sense of calling? They stay longer even with low compensation. Moreover, they do not practise in private. Theory: Unique business model of the hospital Type of the case: Experience-based applied single case study Protagonist: Not needed Options Build a value-based culture. Invoke sense of calling. Redefine the purpose in life with a higher cause of helping others. Discussions and case Questions Analyse the reasons for the stay of doctors with CMC&H. What are the steps taken by CMC&H and its doctors to continue moving ahead on the road of its mission? How has CMC&H maintained its momentum to serve the society and continued with its legacy of healing and education? Will it be possible for CMC&H to continue doing so in the competitive environment that offers attractive alternatives for doctors as well as for patients? Should the doctors continue avoiding moonlighting?
Medical Student Workshop Improves Student Confidence in Working With Trained Medical Interpreters
Authors: Coetzee Donna , Pereira Anne G. , Scheurer Johannah M , Olson Andrew PJ 
Published: May 2020

Introduction: Many physicians care for patients whose primary spoken language is not English, and these interactions present challenges in physician-patient communication. These challenges contribute to the significant health disparities experienced by populations with limited English proficiency (LEP). Using trained medical interpreters is an important step in addressing this problem, as it improves communication outcomes. Despite this, many medical education programs have little formal instruction on how to work effectively with interpreters. Methods: To address this gap, we created an interactive workshop led by professional trained interpreters and faculty facilitators for medical students in their clinical years. Students were asked to evaluate the session based on relevance to their clinical experiences and helpfulness in preparing them for interactions with patients with LEP. Results: Immediately after the session, students reported that the clinical scenarios presented were similar those seen on their clinical clerkships. They also reported increased confidence in their ability to work with interpreters. On later follow-up, students reported that the instruction helped prepare them for subsequent patient interactions that involved interpreters. Conclusion: A workshop is an effective method for improving medical student comfort and confidence when working with interpreters for populations with LEP.
Methylation analysis of NPTX2 and SH2D5 genes in chronic migraine: A case–control study
Authors: Pérez Pereda Sara , Toriello Suárez María , González Quintanilla Vicente , Oterino Agustín 
Published: May 2020

Background: Methylation of two CpG sites related to neuronal pentraxin II protein (NPTX2) and SH2 domain containing 5 protein (SH2D5), corresponding to two neuroplasticity genes, has been associated to headache chronification. We aimed to investigate the epigenetic modification of these two genes in chronic migraine (CM). Methods: We conducted a case–control study in which the DNA of 305 age- and sex-matched subjects classified according to the International Classification of Headache Disorders version beta (ICHD-III β) in CM (109), episodic migraine (EM; n = 98), and healthy controls (HC; 98) was analyzed. Real-time quantitative methylation-specific PCR was performed using specific methylation primers for two representative CpG sites within these genes. Results: We found no significant differences in methylation level between CM, EM, and HC in the first exon of the NPTX2 gene nor in the 5′ upstream region of the SH2D5 gene. Methylation level in the first exon of the NPTX2 showed a low correlation with age ( r = 0.266; p < 0.005). Conclusion: We did not find methylation level differences in analyzed regions related to NPTX2 and SH2D5 in our CM sample. Despite the potential relevance of neuroplasticity genes in headache chronification, we conclude that CM is a more heterogeneous clinical diagnosis than desired and that an epigenetic marker remains elusive.