bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subacute combined degeneration of the spinal cord masking motor neuron disease: a case report
Authors: Loveland Paula , Wong Aaron , Vivekanandam Vinojini , Lim Wen Kwang 
Published: November 2019

Abstract
Background
Subacute combined degeneration of the spinal cord is a potentially reversible myelopathy typically associated with vitamin B12 deficiency. There is predominant involvement of spinal cord posterior and lateral tracts, and manifestations include peripheral paraesthesia, impaired proprioception, gait disturbance, neuropathy and cognitive changes. Motor neuron disease (MND) is an unremittingly progressive neurodegenerative disorder involving upper and lower motor neurons with an average prognosis of 2–3 years. The diagnosis is clinical and may be supported by electromyography. A subset of MND occurs concurrently with frontotemporal dementia (FTD-MND) and may be initially misdiagnosed as a primary psychotic disorder.

Case presentation
We describe a 57-year-old Caucasian woman who presented with confusion and dysarthria. Low vitamin B12 levels and MRI findings led to an initial diagnosis of subacute combined degeneration of the spinal cord. Despite treatment, persistent dysarthria and presence of both upper and lower motor neuron signs on clinical examination prompted further assessment. Electromyography supported the diagnosis of MND. Comorbid chronic paranoid schizophrenia complicated the diagnostic process. We discuss overlapping features between B12 deficiency and MND as well as the neuropsychiatric overlap of B12 deficiency, FTD-MND and chronic schizophrenia.

Conclusions
Firstly, variability in neurocognitive and imaging manifestations of B12 deficiency can limit delineation of other pathologies. Failure to improve following correction of nutritional deficiencies warrants further investigation for an alternate diagnosis. Secondly, re-evaluation of patients with comorbid mental health conditions is important in reaching timely and accurate diagnoses.
Experimental and Numerical Assessment of Reinforced Concrete Beams with Disturbed Depth
Authors: Hamoda A. , Basha A. , Fayed S. , Sennah K. 
Published: November 2019

AbstractThis paper investigates numerically and experimentally the performance of reinforced concrete (RC) beam with unequal depths subjected to combined bending and shear. Such beams can geometrically be considered for unleveled reinforced concrete (RC) floor slab-beam system. However, it may generate critical disturbances in stress flow at the re-entrant corner (i.e. location of drop in beam depth). This research investigates the use of shear reinforcement and geometric properties to enhance cracking characteristics, yielding, ultimate load-carrying capacity, and exhibiting ductile failure mode. Ten reinforced concrete (RC) beams were constructed and tested experimentally considering the following key parameters: recess length, depth of smaller beam nib, and amount and layout of shear reinforcement at re-entrant corner. Finite element analysis (FEA) with material non-linearity was conducted in two RC beams that were tested experimentally to validate the computer modelling. The FEA models were then extended to conduct a parametric study to investigate the influence of geometric parameters (beam shape and width) and amount and arrangement of shear reinforcement on the structural response. Results confirmed that geometric properties and ratio of shear reinforcement at the re-entrant region significantly affect the behavior of reinforced concrete beam with unequal depths in terms of first cracking, yielding level, ultimate load carrying capacity and mode of failure.
Screening freshness of seafood by measuring trimethylamine (TMA) levels using helium-plasma ionization mass spectrometry (HePI-MS)
Authors: Herath Isuru S. , O’Donnell Thomas E. , Pavlov Julius , Attygalle Athula B. 
Published: November 2019

AbstractBackgroundTrimethylamine (TMA) is a marker used for monitoring the quality of seafood because it is the primary component of the “fishy” odor.MethodsThe levels of TMA in seafood samples were directly measured by helium-plasma ionization mass spectrometry (HePI-MS). Each sample was directly exposed to the HePI source, and the intensity of them/z60 signal for protonated TMA was monitored by a selected-ion-recording (SIR) protocol. Using a set of TMA-spiked water standards, the TMA levels in seafood samples were quantified.ResultsThe signal intensity of them/z60 ion from shrimp samples maintained at room temperature for 2 days can be attenuated to baseline levels by adding lime juice. The amounts of TMA in samples of salmon and shrimp recovered from some sushi preparations, and in squid samples, were found to be 0.24 μg, 0.16 μg, and 17.2 μg per gram, respectively.ConclusionsHePI-MS is an efficient technique to screen and monitor the TMA content and assess the quality of seafood.
Clinical application of invalid foods using mealworms and evaluation of nutrition status and immune function: a study protocol for a randomized, double blind, placebo-controlled trial
Authors: Kim Hyung Sun , Lee Yun Sun , Jang Soo Yun , Jun So Young , Lim Jin Hong , Kim Im Kyung , Kim Hyung Mi , Park Joon Seong 
Published: November 2019

Abstract
Background
Protein intake is important for the recovery of the immune system, physical strength, and wound healing after surgery. Sarcopenia is associated with a poor prognosis when compared to patients without sarcopenia in cancer patients. Recently, edible insects, such as mealworms, have been recognized as having a high protein content. In this study, we will evaluate the effect of nutritional status and immune function change based on a patient’s ingestion of mealworms after hepatobiliary pancreatic surgery.

Methods/design
This is a prospective, two-armed, phase III study investigating the effect of mealworm improving nutrition and immune status in patients after hepatobiliary pancreatic surgery. In the trial group, the patients will be provided with mealworms for 2 months after surgery. In the control group, patients will be provided with grain powder for 2 months after surgery. The target for accrual is 168 patients. We divided in to three groups according to the type of surgery.

Discussion
The primary endpoint is to evaluate body cell mass index 2 months postoperatively. Secondary endpoints include other body composition changes as well as nutrition index and immune function change. We expect that ingestion of mealworms can effectively improve the nutritional status and enhance the immune function. Mealworm can be used effectively for nutritional management of patients after surgery.

Trial registration
Clinicaltrials.gov NCT03201926 Registered June 28, 2017, retrospectively registered.
Governance function analysis of the Patriotic Health Movement in China
Authors: Zhao Xuan , Yuan Beibei , Yu Yahang , Jian Weiyan 
Published: November 2019

Abstract
Background
Health system governance is critical to the operation of a country’s health system and its overall performance. This study analyzes the role of health system governance in driving health policy innovation and effective implementation.

Methods
A retrospective review is applied to collect, analyze and synthesize information from publications and policy documents relevant to the implementation of a typical health policy, the Patriotic Health Movement.

Results
The analysis of governance highlighted a number of features underpinning this policy. These included highest authority prioritizing health system development, specific health policies being prioritized within the national development agenda, strong political will to promote the policies drawing on the advantages of the highly hierarchal administrative system in China, and accumulating evidence from local experience to support policy making. It was also found that the formation of these governance practices and how they drove policy innovation and implementation were both closely related to the political and socio-economic contexts in China.

Conclusion
Given that many low- and middle- income countries are strengthening their health systems aimed at UHC, this study demonstrates that along with drawing lessons from health policies or interventions, addressing factors in each governance domain is critical in adapting the policy design to other settings and the effective operation of policies in other settings.
Prospective Decision Analysis Study of Clinical Genomic Testing in Metastatic Breast Cancer: Impact on Outcomes and Patient Perceptions
Authors: Stover Daniel G. , Reinbolt Raquel E. , Adams Elizabeth J. , Asad Sarah , Tolliver Katlyn , Abdel-Rasoul Mahmoud , Timmers Cynthia D. , Gillespie Susan , Chen James L. , Ali Siraj Mahamed , Collier Katharine A. , Cherian Mathew A. , Noonan Anne M. , Sardesai Sagar , VanDeusen Jeffrey , Wesolowski Robert , Williams Nicole , Lee Clara N. , Shapiro Charles L. , Macrae Erin R. , Ramaswamy Bhuvaneswari , Lustberg Maryam B. 
Published: November 2019

PURPOSE To evaluate the impact of targeted DNA sequencing on selection of cancer therapy for patients with metastatic breast cancer (MBC). PATIENTS AND METHODS In this prospective, single-center, single-arm trial, patients with MBC were enrolled within 10 weeks of starting a new therapy. At enrollment, tumor samples underwent next-generation sequencing for any of 315 cancer-related genes to high depth (> 500×) using FoundationOne CDx. Sequencing results were released to providers at the time of disease progression, and physician treatment recommendations were assessed via questionnaire. We evaluated three prespecified questions to assess patients’ perceptions of genomic testing. RESULTS In all, 100 patients underwent genomic testing, with a median of five mutations (range, 0 to 13 mutations) detected per patient. Genomic testing revealed one or more potential therapies in 98% of patients (98 of 100), and 60% of patients (60 of 100) had one or more recommended treatments with level I/II evidence for actionability. Among the 94 genomic text reports that were released, there was physician questionnaire data for 87 patients (response rate, 92.6%) and 31.0% of patients (27 of 87) had treatment change recommended by their physician. Of these, 37.0% (10 of 27) received the treatment supported by genomic testing. We did not detect a statistically significant difference in time-to-treatment failure (log-rank P = .87) or overall survival ( P = .71) among patients who had treatment change supported by genomic testing versus those who had no treatment change. For patients who completed surveys before and after genomic testing, there was a significant decrease in confidence of treatment success, specifically among patients who did not have treatment change supported by genomic testing (McNemar’s test of agreement P = .001). CONCLUSION In this prospective study, genomic profiling of tumors in patients with MBC frequently identified potential treatments and resulted in treatment change in a minority of patients. Patients whose therapy was not changed on the basis of genomic testing seemed to have a decrease in confidence of treatment success.
Use of Standardized Patients in Endocrinology Fellowship Programs to Teach Competent Transgender Care
Authors: Stevenson Mary O , Sineath R Craig , Haw J Sonya , Tangpricha Vin 
Published: November 2019

AbstractPurposeTransgender and gender-nonconforming individuals have unique health care needs and have difficulty accessing health care services because of a lack of qualified health care providers, insurance coverage, mistreatment, and bias by the medical community. Medical trainees and physicians report a lack of education in, and exposure to, the clinical care and unique aspects of this field. We assessed the use of a standardized patient as a tool to evaluate 4 core medical competencies (patient care, medical knowledge, professionalism, and interpersonal communication) of endocrinology fellows at a single training program.MethodsEndocrine fellows were evaluated by faculty in different aspects of transgender care and completed a self-assessment before and after the exercise. Faculty viewed the fellows during the Objective Clinical Structured Examination. Fellows were provided feedback by a faculty member and the standardized patient after the exercise.ResultsDeficits were found in patient care and professionalism. Fellows scored well in medical knowledge. Fellows did not report an improvement in comfort and communication skills after the exercise. Interestingly, fellows’ self-assessment scores in several domains declined after the standardized patient encounter, highlighting an occasion for self-reflection and growth within the realms of cultural competency and medical knowledge.Main conclusionsWe conclude that use of standardized patients to teach medical competencies in transgender medicine may be one approach to improve exposure to, and training in, transgender medicine. Endocrine fellows still had discomfort treating transgender individuals after the standardized patient encounter and require other training activities that may include didactics and clinical case discussions.
Oxygen Demand, Uptake, and Deficits in Elite Cross-Country Skiers during a 15-km Race
Authors: GLØERSEN ØYVIND , GILGIEN MATTHIAS , DYSTHE DAG KRISTIAN , MALTHE-SØRENSSEN ANDERS , LOSNEGARD THOMAS 
Published: November 2019

ABSTRACTPurposeThis study aimed to quantify the repeated oxygen deficits attained during intermittent endurance exercise by measuring oxygen consumption (V˙O2) and oxygen demand (V˙O2dem) throughout a simulated roller ski race.MethodsEight male elite cross-country skiers (V˙O2peak, 77.4 ± 4.4 mL·kg−1⋅min−1) raced a 13.5-km roller ski time trial on a World Cup course. On two additional days, athletes completed (i) six submaximal loads (~5 min) and ~4-min maximal trial to establish athlete-specific estimates of skiing economy, V˙O2peak, and maximal ΣO2def(MAOD); and (ii) a simulation of the time trial on a roller skiing treadmill. During the simulation, external work rate (Pprop) and skiing speed (v) were adjusted to match thePpropandvmeasured during the time trial, and pulmonary V˙O2was measured breath by breath. V˙O2demand ΣO2defwere calculated using an athlete-specific model for skiing economy throughout the treadmill simulation.ResultsDuring the treadmill simulation, V˙O2was on average 0.77 V˙O2peak, and active V˙O2dem(i.e., excluding the time in simulated downhill) was on average 1.01 V˙O2peak. The athletes repeatedly attained substantial oxygen deficits in individual uphill sections of the treadmill simulation, but the deficits were typically small compared with their MAOD (average 14%, range ~0%–50%). However, the ΣO2defsummed over all periods of active propulsion was on average 3.8 MAOD.ConclusionAthletes repeatedly attain substantial oxygen deficits in the uphill segments of a distance cross-country ski race. Furthermore, the total accumulated oxygen deficit of all these segments is several times higher than the athletes’ MAOD. This suggests that the rapid recovery of the energy stores represented by the oxygen deficit is necessary during downhill sections, and that this might be an important determinant of distance skiing performance.
INÉDITOS E DISPERSOS: NOTAS SOBRE AUTONOMIA POÉTICA EM ANA CRISTINA CESAR SOB A ÓTICA DE PIERRE BOURDIEU.
Authors: Bessa Alessandra Zelinda Sousa 
Published: November 2019

Este estudo tem como objetivo fazer um debate acerca da autonomia literária em Inédito e Dispersos (1985) de Ana Cristina Cesar sob o prima de Pierre Bourdieu. Nessa perspectiva faremos uma reflexão sobre a teoria de campos de As regras das artes (1996). Analisaremos a estética da poesia de Cesar em debate com a autonomia literária. Entendemos os aspectos do simbólico, do registro do acaso, da fragmentação do pensamento e do uso excessivo de figuras de linguagem corroboram as concepções de Bourdieu. Já que mostram, no espaço de campos políticos, a ruptura hegemônica da forma. Concluímos que a literatura de Cesar aparece como manifestação artística independente a partir do espaço interpretativo dos leitores, revelando os campos de poderes, amplitude do imaginário e do inconsciente simbólico. ADORNO(2003), AGAMBEN(2008), BARTHES(2010) e RANCIÈRE(2009), dentre outros estudiosos, são alguns dos autores que representam nosso aporte teórico.
Selective laser trabeculoplasty in enhancing glaucoma care
Authors: Rufai Sohaib R , Kamal Mohammed R , Thaker Riddhi D , Mukherji Subhanjan 
Published: November 2019

Background/Aim There is increasing evidence for using selective laser trabeculoplasty as a first line treatment for chronic open angle glaucoma. The current first-line treatment is pharmacological therapy using eye drops. This study aims to assess the outcomes of selective laser trabeculoplasty in patients with glaucoma and ocular hypertension at a district general hospital and consider its role in reducing cost and treatment burden when treating patients with these conditions. Methods A single centre, retrospective case-note audit involving 58 eyes from 31 patients with a minimum follow-up of 4 months. Results Post selective laser trabeculoplasty, 62% had intraocular pressure <20 mmHg on latest follow up (36/58 eyes). Post selective laser trabeculoplasty, 10 patients (32%) were prescribed one fewer topical medication, while 20 patients (65%) were prescribed the same number of topical medications. Only 1 patient (3%) was prescribed one additional topical medication. Conclusion Selective laser trabeculoplasty is a safe and effective option for managing glaucoma and ocular hypertension. Selective laser trabeculoplasty may represent a cost-effective solution for healthcare providers as compared to pharmacological treatment.
Análise do Discurso da Sustentabilidade em uma Empresa do Setor de Energia Elétrica
Authors: Coelho Ana Lúcia de Araújo Lima , Godoi Christiane Kleinübing , Coelho Christiano , Pascual Araceli Serrano 
Published: November 2019

DOI: http://dx.doi.org/10.13071/regec.2317-5087.2012.1.1.4058.122-158O objetivo desta pesquisa consiste em analisar a construção do discurso da sustentabilidade em uma multinacional do setor de energia elétrica a partir das falas de pessoas diretamente relacionadas à elaboração dos Relatórios de Sustentabilidade. A Análise Sociológica do Discurso (ASD), abordagem metodológica utilizada neste estudo, é vinculada à Tradição Espanhola de Pesquisa Social Qualitativa. Enquanto método, permitiu revelar o discurso da sustentabilidade na empresa considerando a questão social e os espaços comunicativos concretos que formaram e elaboraram os discursos dos atores como práticas significantes. A análise dos estilos discursivos, posições discursivas, configurações narrativas e espaços semânticos foram realizadas em busca da construção do discurso da sustentabilidade. A empresa apresenta-se por meio de um discurso alinhado a objetivos econômicos, considerando também outras dimensões da sustentabilidade – ambiental e social, manifestando sua responsabilidade ambiental e social.
Experiências e Iniciativas em Acessibilidade e Inclusão na UFRN: o Laboratório de Acessibilidade da Biblioteca Central Zila Mamede
Authors: Melo Francisco Ricardo Lins Vieira de , Furtado Margareth Maciel Figueiredo  Dias , Ribeiro Elizabeth S. Kanzaki , Melo Érica Simony Fernandes de , Araújo Audinêz Barreto , Trindade Sidney 
Published: November 2019

DOI: http://dx.doi.org/10.13071/regec.2317-5087.2014.3.1.5052.43-67. Este artigo socializa a experiência de implantação do Laboratório de Acessibilidade da Biblioteca Central Zila Mamede. Aborda a relação entre bibliotecas e acessibilidade, seja informacional ou física. Faz um relato histórico sobre as ações voltadas à inclusão no âmbito da UFRN, desde os primeiros projetos, passando pela criação da Comissão Permanente de Apoio ao Estudante com Necessidades Educacionais Especiais (Caene) até a implantação do Laboratório de Acessibilidade. Adota como metodologia um relato de experiência baseado em levantamento teórico e histórico e análise estatística dos resultados da implantação laboratório. Apresenta resultados quantitativos e qualitativos. Conclui-se que a missão das bibliotecas universitárias não pode ser concretizada se não houver condições igualitárias de acesso ao conhecimento.
Fear, Flight, and Freedom: On Anti-colonial Countermasteries and Ontological Insecurities
Authors: Shahar Zaynab 
Published: November 2019

Abstract in EnglishInUnthinking MasteryJulietta Singh argues that anticolonial discourse hinges on the contradiction of both repudiating the “mastery” of colonialism and at the same time reproducing and advocating mastery towards anticolonial liberation. Through a close reading of Fanon, Singh demonstrates the ways in which he understood countermastery as the production of “new masterful subjects.” This paper deconstructs Fanon's countermastery through the lens of ontological insecurities to illuminate how it informs the production of contemporary decolonial discourse. This paper expands Fanon's conception of decolonial embodiment through proffering queer failure and queer of color disidentification as ways of etching towards decolonial queer-feminist praxis.Key words: Coloniality, Ontology, Queer Studies, Feminist Thinking, Frantz Fanon.
Languages Canada: The Paradoxes of Linguistic Inclusivity – Colonial/ Founding, Aboriginal and Immigrant language rights
Authors: Battarbee Keith 
Published: November 2019

AbstractThis article approaches the question of inclusivity in contemporary Canadian society through the lens of official language policy. Although Canada has well-developed bilingual policies for English and French at the federal and provincial levels, the only jurisdictions which (at the time of writing) afford official language status to Aboriginal languages in addition to English and French are the Northwest Territories (nine First Nations and Inuit languages) and Nunavut (the Inuit language/s). The article situates the development of these territorial language policies within the contexts of Canadian history, the emergence of language policy more generally in Western societies, and the human rights revolution, and offers a tentative evaluation of them in terms of inclusivity, noting the paradox that inclusive recognition of the territories’ indigenous languages has not been extended to the immigrant languages, whose speakers partly outnumber the smaller Aboriginal-language communities, as well as the daunting problems faced in turning official recognition into practical implementation.
‘The fight on educating the public to equal treatment for all will have to come later’: Jewish Refugee Activism and Anti-Immigration Sentiment in Immediate Post-War Canada
Authors: Burgard Antoine 
Published: November 2019

AbstractCanadian immigration policy of the 1930s and 1940s was the most restrictive and selective in the country’s history, making it one of the countries to take the smallest number of Jewish refugees fleeing the Nazi persecution. After the war, Canada slowly opened its borders, but only through small token gestures in 1947 and 1948. This article explores how the main Canadian Jewish organization lobbied for the welcoming of more Jewish refugees and migrants in the immediate aftermath of the war. It examines how their perception of the public’s anti-Jewish immigrant sentiment and of the Canadian immigration policy’s discriminatory mechanisms informed their strategies. During that period, the Canadian Jewish Congress prioritized constant and subtle action with the government instead of trying to set up mass mobilization campaigns. This strategic shift is an overshadowed but essential chapter of both Jewish and human rights histories in Canada. This article invites a re-evaluation of Jewish activism’s role in ending ethnic selection in the Canadian immigration policy and promoting refugee rights. It contributes to broadening our understanding of how minority groups lobbied and worked with hostile media and authorities.