bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of rare acquired bleeding disorders
Authors: Menegatti Marzia , Biguzzi Eugenia , Peyvandi Flora 
Published: December 2019

AbstractAutoantibodies toward clotting factors may develop in people suffering from autoimmune or neoplastic diseases, after drug intake or even in subjects without apparent conditions. They are more commonly directed against factor VIII (FVIII) or von Willebrand factor leading to acquired hemophilia A or acquired von Willebrand syndrome, respectively. Rarely, autoantibodies develop against other clotting factors, such as fibrinogen, FII, FV, FVII, FX, FXI, and FXIII. The clinical picture of an acquired bleeding disorder includes a wide spectrum of clinical manifestations ranging from minimal or no bleeding to life-threatening events. Patients with no previous personal or family history of bleeding may have sudden-onset hemorrhagic manifestations, sometimes fatal, especially if an early diagnosis is not made. On the other hand, some patients may not have hemorrhagic symptoms at onset, and their diagnosis can therefore be delayed. The laboratory diagnostic assessment is performed by screening coagulation tests followed by specific factor-level measurement and inhibitor-titrating assays. An early diagnosis of acquired coagulopathies is mandatory for starting the appropriate treatment aimed at both controlling the acute bleeding episode mainly using the bypassing agents, and eradicating the anticlotting factor autoantibody, using immunosuppressive treatment. Therefore, prompt intervention by an expert and a specialized center is needed for immediate recognition and treatment of the disease.
Case-based discussion on the implications of exogenous estrogens in hemostasis and thrombosis: the obstetrician’s view
Authors: James Andra H. 
Published: December 2019

Abstract
This is the obstetrician’s view on 3 different clinical scenarios involving bleeding and thrombotic disorders. In the first scenario, an 18 year old with a history of heavy menstrual bleeding since menarche presents with abdominal pain and ultrasound findings suggestive of a hemorrhagic ovarian cyst. The association with an underlying bleeding disorder is recognized. The goals of management, which are controlling hemorrhage and preserving fertility, are stated. Ovarian suppression, the most effective method to prevent recurrent hemorrhagic ovarian cysts, is outlined. Long-term management of heavy menstrual bleeding with hormonal contraception is described. In the second scenario, the same patient returns 5 years later for a preconception visit. The potential risks to an unborn baby with von Willebrand disease (VWD) are addressed. The natural rise in von Willebrand factor (VWF) during pregnancy is discussed, but the fact that women with VWD do not achieve the same VWF levels as women without VWD is emphasized and the implications are presented. In anticipation of pregnancy, the need for nonhormonal management of heavy menstrual bleeding and hemorrhagic ovarian cysts is mentioned. In the third and final scenario, the patient’s cousin with factor V Leiden seeks consultation regarding the risks of thrombosis with in vitro fertilization. The steps of assisted reproductive technology are described. The strategies to prevent venous thromboembolism by preventing ovarian hyperstimulation and reducing the likelihood of multiple gestation are detailed.
Evidence-Based Minireview: Longitudinal geriatric assessment in quality care for older patients with hematologic malignancies
Authors: Lin Richard J. , Klepin Heidi D. 
Published: December 2019

Abstract
A 65-year-old women was diagnosed with acute myeloid leukemia (AML; normal cytogenetics, NPM1 mutated, FLT3-ITD wild type). Preinduction screening geriatric assessment (GA) did not reveal any significant deficit, because she was independent of basic activities of daily living (ADLs) and instrumental activities of daily living (IADLs), had normal cognition, and scored 10 (range 0-12) on the short physical performance battery (SPPB). She underwent standard 7 + 3 induction and achieved a complete remission, although her course was complicated by neutropenic sepsis and bacteremia. She is being evaluated for postremission therapy. Would you recommend a follow-up GA at this time?
New therapies for von Willebrand disease
Authors: Mannucci Pier Mannuccio 
Published: December 2019

Abstract
The management of von Willebrand disease (VWD) is based upon the dual correction of the primary hemostasis defect, due to the inherited deficiency of von Willebrand factor (VWF), and of the secondary defect of factor VIII coagulant activity (FVIII:C), due to the loss of binding and stabilization by VWF of this intrinsic coagulation factor in flowing blood. The traditional therapeutic weapons (the synthetic derivative of the antidiuretic hormone desmopressin and plasma-derived VWF/FVIII concentrates) are able to transiently correct both the defects. With the goal of tackling the primary deficiency in the disease, that is, VWF, but at the same time exploiting the normal capacity of patients to produce FVIII, the novel approach of replacing only VWF was implemented in the last 10 years. Following the manufacturing of a concentrate fractionated from human plasma and of one obtained by recombinant DNA technology, clinical studies have shown that VWF-only products correct not only the primary VWF deficiency but also the secondary FVIII:C deficiency. The demonstrated efficacy of these products in various clinical situations and, ultimately, in such a hemostasis-challenging context as surgery testifies to the effectiveness and safety of this approach. It remains to be seen whether VWF-only products are efficacious and safe in still-unexplored situations, such as use in children; the long-term use for prophylaxis; and in recurrent gastrointestinal (GI) bleeding due to angiodysplasia, a major therapeutic problem in VWD.
Ready for prime time: role for geriatric assessment to improve quality of care in hematology practice
Authors: Klepin Heidi D. 
Published: December 2019

Abstract
Older adults represent the growing majority of patients diagnosed with hematologic disorders, yet they remain underrepresented on clinical trials. Older patients of the same chronologic age differ from one another with varying comorbidity and functional reserve. The concepts of frailty and resilience are important to patient-centered care and are patient and setting specific. The use of geriatric assessment to inform tailored decision making and management can personalize care for older adults with hematologic malignancies. This article will highlight available evidence to support the role of geriatric assessment measures to enhance quality of care for older adults diagnosed with hematologic malignancies.
Economic feasibility of gasoline production from lignocellulosic wastes in Hong Kong
Authors: Guan Weixiang , Chua Sim-Ying , Tsang Chi-Wing , Chen Xiao , Lin Carol Sze Ki , Fu Raymond Sze Wai , Hu Haoquan , Liang Changhai 
Published: December 2019

AbstractIn this study, the conceptual process flowsheet was developed and the economic feasibility of woody biomass conversion to biofuel as feedstock was analysed by considering several promising experimental processes for lignin depolymerization, such as hydrodeoxygenation and hydrogenolysis, along with lignocellulosic biomass fractionation processes. The engineering simulation process toward the commercial production of bio-gasoline from lignocellulosic biomass using SuperPro Designer® was modeled. The compatibility of the end products with the current gasoline specifications was evaluated and various blending options were investigated to meet the octane number and Reid vapor pressure requirement of the product. The economic potential of the simulated engineering process was then evaluated from an economic perspective. The operating costs and capital investment of three scenario using three different catalytic systems were estimated and discussed to assess of the potential of commercializing of woody biomass valorization process. The main potential market segments were identified, including the process by-products such as xylose and cellulose pulp. From the economic evaluation study, it was found that selling the biomass fractionation products alone does have a greater profit than valorization of lignin to produce bio-gasoline, with net present value of RMB 22,653,000 and RMB 177,000, respectively at the same return on investment if the plant is set up in Hong Kong. It was also found that catalysts play a pivotal role in determination of the profitability in the valorization process, not only because of the price of the catalyst, but also the product distributions obtained with various types of it. To obtain the same gross profit, the sale price of bio-gasoline has to be set higher with platinum catalysts than with ruthenium catalysts (nearly 10 folds). Thus, catalyst development and process improvement are crucial in the establishment of bio-based circular economy.
Will artificial intelligence eventually replace psychiatrists?
Authors: Brown Christian , Story Giles William , Mourão-Miranda Janaina , Baker Justin Taylor 
Published: December 2019

SummaryThe dystopian scenario of an ‘artificial intelligence takeover’ imagines artificial intelligence (AI) becoming the dominant form of intelligence on Earth, rendering humans redundant. As a society we have become increasingly familiar with AI and robots replacing humans in many tasks, certain jobs and even some areas of medicine, but surely this is not the fate of psychiatry?Here a computational neuroscientist (Janaina Mourão-Miranda) and psychiatrist (Justin Taylor Baker) suggest that psychiatry as a profession is relatively safe, whereas psychiatrists Christian Brown and Giles William Story predict that robots will be taking over the asylum.
Prognostic Impact of the 21-Gene Recurrence Score Assay Among Young Women With Node-Negative and Node-Positive ER-Positive/HER2-Negative Breast Cancer
Authors: Poorvu Philip D. , Gelber Shari I. , Rosenberg Shoshana M. , Ruddy Kathryn J. , Tamimi Rulla M. , Collins Laura C. , Peppercorn Jeffrey , Schapira Lidia , Borges Virginia F. , Come Steven E. , Warner Ellen , Jakubowski Debbie M. , Russell Christy , Winer Eric P. , Partridge Ann H. 
Published: December 2019

PURPOSE The 21-gene recurrence score (RS) assay is prognostic among women with early-stage estrogen receptor–positive (ER+) and human epidermal growth factor receptor 2–negative (HER2−) breast cancer and is used to inform recommendations for chemotherapy. Women ≤ 40 years of age represent a minority of patients studied using gene expression profiles. METHODS The Young Women's Breast Cancer Study is a prospective cohort of women diagnosed with breast cancer at age ≤ 40 years and enrolled patients between 2006 and 2016 (N = 1,302). We identified patients with stage I-III ER+/HER2− breast cancer. The RS assay was performed on banked specimens for patients who had not been tested clinically. Distant recurrence-free survival (DRFS) was assessed by TAILORx and traditional RS risk groups among patients with axillary node–negative (N0) and limited node–positive (N1) breast cancer. RESULTS Among eligible women (N = 577), 189 (33%) had undergone RS testing, and 320 (56%) had banked specimens sufficient for testing. Median follow-up was 6.0 years. Median age at diagnosis was 37.2 years; 300 of 509 patients (59%) had N0 breast cancer, of whom 195 (65%) had an RS of 11-25 and fewer than half (86 of 195; 44%) received chemotherapy. Six-year DRFS rates were 94.4% and 92.3% (RS < 11), 96.9% and 85.2% (RS 11-25), and 85.1% and 71.3% (RS ≥ 26) among women with N0 and N1 disease, respectively. CONCLUSION The RS assay is prognostic among young women with node-negative and limited node-positive breast cancer, representing a valuable tool for risk stratification. Disease outcomes with a median follow-up of 6 years among young women with N0 disease and an RS of 0-25, a minority of whom received chemotherapy, and node-positive disease with an RS < 11 were very good, whereas those with N0 disease and an RS ≥ 26 or N1 disease with an RS ≥ 11 experienced substantial risk of early distant recurrence.
Why Policies Fail: The Illusion of Services in the Opioid Epidemic
Authors: Strach Patricia , Zuber Katie , Pérez-Chiqués Elizabeth 
Published: December 2019

Abstract
Context: Although New York State is a generous provider of substance-use treatment, people who ask for help have difficulty accessing services. If the laws are on the books, the agency is there to act, and the options are available, why is treatment so hard to get?
Methods: The authors conducted 87 open-ended interviews and observed local task force meetings in Sullivan County, New York. They open coded data, identifying key topics and themes.
Findings: Even though New York is a best-case scenario for treatment, people who seek help cannot always access it. The state sees the problem as a lack of beds or information about beds, but people on the ground face real barriers that make it difficult to get treatment, including the medical model of detoxification, admissions criteria, staff shortages, and other life complications.
Conclusions: Contrary to the policy literature, this article shows that policies may fail not because they are poorly designed or implemented but because the policy itself does not address the actual underlying problem. Furthermore, in the case of opioids, it shows how misplaced solutions can hide evidence of the underlying problem, exacerbating the very issue that policy makers want to fix.
Bilateral Gait 6 and 12 Months Post–Anterior Cruciate Ligament Reconstruction Compared with Controls
Authors: DAVIS-WILSON HOPE C. , PFEIFFER STEVEN J. , JOHNSTON CHRISTOPHER D. , SEELEY MATTHEW K. , HARKEY MATTHEW S. , BLACKBURN J. TROY , FOCKLER RYAN P. , SPANG JEFFREY T. , PIETROSIMONE BRIAN 
Published: December 2019

ABSTRACT

Purpose
To compare gait biomechanics throughout stance phase 6 and 12 months after unilateral anterior cruciate ligament reconstruction (ACLR) between ACLR and contralateral limbs and compared with controls.

Methods
Vertical ground reaction force (vGRF), knee flexion angle (KFA), and internal knee extension moment (KEM) were collected bilaterally 6 and 12 months post-ACLR in 30 individuals (50% female, 22 ± 3 yr, body mass index = 23.8 ± 2.2 kg·m−2) and at a single time point in 30 matched uninjured controls (50% female, 22 ± 4 yr, body mass index = 23.6 ± 2.1 kg·m−2). Functional analyses of variance were used to evaluate the effects of limb (ACLR, contralateral, and control) and time (6 and 12 months) on biomechanical outcomes throughout stance.

Results
Compared with the uninjured controls, the ACLR group demonstrated bilaterally lesser vGRF (ACLR, 9% body weight [BW]; contralateral, 4%BW) during early stance and greater vGRF during midstance (ACLR, 5%BW; contralateral, 4%BW) 6 months post-ACLR. Compared to the uninjured controls, the ACLR group demonstrated bilaterally lesser vGRF (ACLR, 10%BW; contralateral, 8%BW) during early stance and greater vGRF during midstance (ACLR, 5%BW; contralateral, 5%BW) 12 months post-ACLR. Compared with controls, the ACLR limb demonstrated lesser KFA during early stance at 6 (2.3°) and 12 months post-ACLR (2.0°), and the contralateral limb demonstrated lesser KFA during early stance at 12 months post-ACLR (2.8°). Compared with controls, the ACLR limb demonstrated lesser KEM during early stance at both 6 months (0.011BW × height) and 12 months (0.007BW × height) post-ACLR, and the contralateral limb demonstrated lesser KEM during early stance only at 12 months (0.006BW × height).

Conclusions
Walking biomechanics are altered bilaterally after ACLR. During the first 12 months post-ACLR, both the ACLR and contralateral limbs demonstrate biomechanical differences compared with control limbs. Differences between the contralateral and control limbs increase from 6 to 12 months post-ACLR.
Energy Deficit Required for Exercise-induced Improvements in Glycemia the Next Day
Authors: SCHLEH MICHAEL W. , PITCHFORD LISA M. , GILLEN JENNA B. , HOROWITZ JEFFREY F. 
Published: December 2019

ABSTRACT

Purpose
This study determined the impact of an exercise-induced energy deficit on postprandial and 24 h glycemic control the day after a session of exercise.

Methods
Fifteen healthy participants (m/f = 5/10, 27 ± 6 yr, body mass index = 24 ± 3 kg·m−2, peak oxygen consumption [V˙O2peak] = 36 ± 9 mL·kg−1·min−1) completed two separate 5-d experimental trials performed under “free-living” conditions. On day 1 of each trial, participants were fitted with a continuous glucose monitor and abstained from exercise. Day 2 served as a nonexercise control (NoEx). On day 3, participants exercised at 3:00 pm (65% V˙O2peak) until they expended 350 kcals (~45 min). The diet during both experimental trials was identical with the exception of meals after this exercise session. During one trial, the dinner after exercise did not replenish the 350 kcal expended during exercise, thereby establishing an exercise energy deficit (ExDEF). During the other experimental trial, the dinner after exercise contained an additional 350 kcal to compensate for the energy expended during exercise, and thereby maintained energy balance after exercise (ExBAL). Free-living glycemia was measured the day before exercise (NoEx) and the day after exercise under ExDEF and ExBAL conditions.

Results
The day after exercise, 3 h postprandial area under the curve was lower after breakfast in ExDEF compared with ExBAL (16.0 ± 1.8 vs 17.0 ± 1.6 mmol·L−1·h−1 per 3 h, P = 0.01), but did not differ between groups after lunch (P = 0.24), dinner (P = 0.39), or evening snack (P = 0.45). Despite differences in the glycemic response to breakfast, 24 h glycemia did not differ between ExDEF and ExBAL (area under the curve = 128 ± 10 vs 131 ± 10 mmol·L−1·h−1 per 24 h, respectively; P = 0.54).

Conclusions
An exercise-induced energy deficit lowered the glycemic response to breakfast the next day—but this energy deficit did not impact total 24 h glycemia, the day after exercise in metabolically healthy adults.
Smoking and Biochemical, Performance, and Muscle Adaptation to Military Training
Authors: SIDDALL ANDREW , BILZON JAMES , THOMPSON DYLAN , TAULER PEDRO , GREEVES JULIE , IZARD RACHEL , STOKES KEITH 
Published: December 2019

ABSTRACT

Purpose
To determine whether physical performance adaptation is impaired in smokers during early stages of military training and to examine some of the putative mechanistic candidates that could explain any impairment.

Methods
We examined measures of oxidative stress (malondialdehyde [MDA], lipid hydroperoxides), inflammation (C-reactive protein, interleukin-6), antioxidants (vitamins A and E and carotenes) and hormones (cortisol, testosterone, insulin-like growth factor-1) in 65 male British Army Infantry recruits (mean ± SD age, 21 ± 3 yr; mass, 75.5 ± 8.4 kg; height, 1.78 ± 0.07 m) at week 1, week 5, and week 10 of basic training. Physical performance (static lift, grip strength, jump height, 2.4 km run time, and 2-min press up and sit up scores) was examined and lower-leg muscle and adipose cross-sectional area and density measured by peripheral Quantitative Computed Tomography.

Results
Basic military training, irrespective of smoking status, elicited improvement in all physical performance parameters (main time effect; P < 0.05) except grip strength and jump height, and resulted in increased muscle area and decreased fat area in the lower leg (P < 0.05). MDA was higher in smokers at baseline, and both MDA and C-reactive protein were greater in smokers during training (main group effect; P < 0.05) than nonsmokers. Absolute performance measures, muscle characteristics of the lower leg and other oxidative stress, antioxidant, endocrine, and inflammatory markers were similar in the two groups.

Conclusions
Oxidative stress and inflammation were elevated in habitual smokers during basic military training, but there was no clear evidence that this was detrimental to physical adaptation in this population over the timescale studied.
Distinct Coordination Strategies Associated with the Drop Vertical Jump Task
Authors: DICESARE CHRISTOPHER ANDREW , MINAI ALI A. , RILEY MICHAEL A. , FORD KEVIN R. , HEWETT TIMOTHY E. , MYER GREGORY D. 
Published: December 2019

ABSTRACT

Introduction
Coordination of multiple degrees of freedom in the performance of dynamic and complex motor tasks presents a challenging neuromuscular control problem. Experiments have inferred that humans exhibit self-organized, preferred coordination patterns, which emerge due to actor and task constraints on performance. The purpose of this study was to determine if the set of effective coordination strategies that exist for a task centers on a small number of robust, invariant patterns of behavior.

Methods
Kinetic movement patterns computed from a cohort of 780 primarily female adolescent athletes performing a drop vertical jump (DVJ) task were analyzed to discover distinct groups into which individuals could be classified based on the similarity of movement coordination solutions.

Results
Clustering of reduced-dimension joint moment of force time series revealed three very distinct, precisely delineated movement profiles that persisted across trials, and which exhibited different functional performance outcomes, despite no other apparent group differences. The same analysis was also performed on a different task—a single-leg drop landing—which also produced distinct movement profiles; however, the three DVJ profiles did not translate to this task as group assignment was inconsistent between these two tasks.

Conclusion
The task demands of the DVJ and single-leg drop—successful landing, reversal of downward momentum, and, in the case of the DVJ, vertical propulsion toward a maximally positioned target—constrain movement performance such that only a few successful outcomes emerge. Discovery of the observed strategies in the context of associated task constraints may help our understanding of how injury risk movement patterns emerge during specific tasks, as well as how the natural dynamics of the system may be exploited to improve these patterns.
GESTÃO SUSTENTÁVEL – MOTIVADORES, BARREIRAS E PERCEPÇÃO DE MICRO E PEQUENOS EMPRESÁRIOS
Authors: Rocha Rafael Toniolo da , Introvini Rodrigo Faria , Caldana Adriana Cristina Ferreira , Krauter Elizabeth , Liboni Lara Bartocci 
Published: December 2019

A demanda por uma administração mais sustentável das organizações é crescente. No entanto, poucos estudos direcionam a tomada de decisão sobre gestão sustentável em empresas de pequeno porte. Este estudo se propôs identificar principais motivadores e barreiras para adoção da gestão sustentável segundo percepção de micro e pequenos empresários. A coleta de dados foi realizada por meio de questionário que foi respondido por 72 empresas dos estados de São Paulo, Paraná e Mato Grosso. Para a análise dos dados foram utilizadas as técnicas de análise fatorial e análise de conglomerados. Por meio deste estudo foi possível estabelecer um conjunto de oito fatores que influenciam na gestão sustentável de empresas de pequeno porte e traçar três perfis de empresas no quesito gestão sustentável. Verificou-se que a maioria das empresas se enquadraram numa abordagem preventiva em relação a gestão sustentável. Estudos em profundidade são recomendados para explicar os resultados.