bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac Responses to Prenatal Resistance Exercise with and without the Valsalva Maneuver
Authors: MEAH VICTORIA L. , STRYNADKA MORGAN C. , STEINBACK CRAIG D. , DAVENPORT MARGIE H. 
Published: December 2020

ABSTRACT

Purpose
Exercise guidelines recommend incorporating resistance exercise (RE) into a regular aerobic training program during pregnancy. However, few women do so because of uncertainties about the safety of prenatal RE, particularly regarding the Valsalva maneuver (VM). The aim of this study was to determine the acute cardiovascular responses to prenatal RE at different intensities, with and without VM.

Methods
Healthy pregnant (n = 15; 22.9 ± 5.9 wk of gestation) and nonpregnant women (n = 15) were recruited. Maximal strength over 10 repetitions (10RM) for semireclined leg press was determined. Women underwent standardized assessments of cardiac structure, function and mechanics (echocardiography), heart rate (ECG), and blood pressure (photoplethysmography) at baseline, during RE at 20%, 40%, and 60% 10RM while free-breathing, and at 40% 10RM with VM. Significant differences were identified between subjects at baseline (independent t-tests), between and within subjects during free-breathing RE (general linear model, baseline as a covariate), and between and within subjects for 40% 10RM free-breathing versus VM (mixed-effects model).

Results
Resting cardiac output, heart rate, and stroke volume were greater in pregnant women, without differences in blood pressure, ejection fraction, or cardiac mechanics. During free-breathing RE, pregnant women had a greater ejection fraction compared with nonpregnant women; however, all other hemodynamic variables were not different between groups. Cardiac mechanics during free-breathing RE across all intensities were not different between groups, with the exception that pregnant women had a lower apical circumferential strain that did not affect global cardiac function. No differences were observed between groups during 40% 10RM RE with and without VM.

Conclusions
Pregnant women have proportionate cardiac responses to light-moderate RE, both with and without the VM. These findings reinforce the safety of RE in healthy pregnancy.
Eurosceptycyzm w doktrynie partii konserwatywnej
Authors: SADOWSKA-WIECIECH Elżbieta 
Published: December 2020

Euroscepticism in the Conservative Party
Membership in European Union has become one of the most crucial and controversial issues in British politics in recent years. Eurosceptics from United Kingdom Independent Party were exhorting to leave the EU and more and more British people had supported them. David Cameron who was leading the government since 2010 had to express a conservative view on the matter. He had announced his plan to renegotiate the terms of EU membership and hold a referendum on the results, asking British people to vote for what he thought the only right choice – staying in European Union. But not all Tories shared that belief. This article examines the issue of Euroscepticism in Conservative Party analyzing its doctrinal as well as political origins and its influence on the government.
Finite-State Contract Theory with a Principal and a Field of Agents
Authors: Carmona René , Wang Peiqi 
Published: December 2020

We use the recently developed probabilistic analysis of mean field games with finitely many states in the weak formulation to set up a principal/agent contract theory model where the principal faces a large population of agents interacting in a mean field manner. We reduce the problem to the optimal control of dynamics of the McKean-Vlasov type, and we solve this problem explicitly for a class of models with concave rewards. The paper concludes with a numerical example demonstrating the power of the results when applied to an example of epidemic containment. This paper was accepted by Baris Ata, stochastic models and simulation.
Numerical analysis of tiny-focal-spot generation by focusing linearly, circularly, and radially polarized beams through a micro/nanoparticle
Authors: Shi Rui , Wang Zongzhao , Hung Shih-Te , Hellmann Christian , Wyrowski Frank 
Published: December 2020

Obtaining a tiny focal spot is desired for super resolution. We do a vectorial numerical analysis of the linearly, circularly, and radidally polarized electromagnetic fields being focused through a dielectric micro/nanoparticle of size comparable to the wavelength. We find tiny focal spots (up to

∼
0.05

λ

2

) can be obtained behind micro/nanoparticles of various shapes, e.g. spherical, disk-shaped, and cuboid micro/nanoparticles. Furthermore, we also investigate the influence of the misalignment of a real lens system on the tiny focal spots. We find that tiny focal spots can still be generated even though they are distorted due to the misalignment.
Immunohistological detection of small particles of Echinococcus multilocularis and Echinococcus granulosus in lymph nodes is associated with enlarged lymph nodes in alveolar and cystic echinococcosis
Authors: Grimm Johannes , Nell Juliane , Hillenbrand Andreas , Henne-Bruns Doris , Schmidberger Julian , Kratzer Wolfgang , Gruener Beate , Graeter Tilmann , Reinehr Michael , Weber Achim , Deplazes Peter , Möller Peter , Beck Annika , Barth Thomas F. E. 
Published: December 2020

BackgroundAlveolar (AE) and cystic echinococcosis (CE) in humans are caused by the metacestode of the tapewormsEchinococcus multilocularisandEchinococcus granulosus sensu lato (s.l.). Immunohistochemistry with the monoclonal antibodies (mAb) Em2G11, specific for AE, and the mAb EmG3, specific for AE and CE, is an important pillar of the histological diagnosis of these two infections. Our aim was to further evaluate mAb EmG3 in a diagnostic setting and to analyze in detail the localization, distribution, and impact ofsmallparticles ofEchinococcusmultilocularis(spems) andsmallparticles ofEchinococcusgranulosuss.l. (spegs) on lymph nodes.Methodology/principal findingsWe evaluated the mAb EmG3 in a cohort of formalin-fixed, paraffin embedded (FFPE) specimens of AE (n = 360) and CE (n = 178). These samples originated from 156 AE-patients and 77 CE-patients. mAb EmG3 showed a specific staining of the metacestode stadium ofE.multilocularisandE.granulosus s.l. and had a higher sensitivity for spems than mAb Em2G11. Furthermore, we detected spegs in the surrounding host tissue and in almost all tested lymph nodes (39/41) of infected patients. 38/47 lymph nodes of AE showed a positive reaction for spems with mAb EmG3, whereas 29/47 tested positive when stained with mAb Em2G11. Spegs were detected in the germinal centers, co-located with CD23-positive follicular dendritic cells, and were present in the sinuses. Likewise, lymph nodes with spems and spegs in AE and CE were significantly enlarged in size in comparison to the control group.Conclusions/significancemAb EmG3 is specific for AE and CE and is a valuable tool in the histological diagnosis of echinococcosis. Based on the observed staining patterns, we hypothesize that the interaction between parasite and host is not restricted to the main lesion since spegs are detected in lymph nodes. Moreover, in AE the number of spems-affected lymph nodes is higher than previously assumed. The enlargement of lymph nodes with spems and spegs points to an immunological interaction with the small immunogenic particles (spems and spegs) ofEchinococcus spp.
Clopidogrel responder status is uninfluenced by CYP2C19*2 in Danish patients with stroke
Authors: Rath Charlotte Lützhøft , Jørgensen Niklas Rye , Wienecke Troels 
Published: December 2020

Background
Antiplatelet therapy is a cornerstone of secondary stroke prevention, but the responsiveness to antiplatelet medication varies among patients. Clopidogrel is a pro-drug that requires hepatic transformation to reach its active metabolite. Single nucleotide polymorphisms (SNPs) in key enzymes or the target adenosine diphosphate (ADP) receptor on the platelet surface are believed to be involved in clopidogrel-mediated platelet inhibition and decreased antiplatelet effect with high-on-treatment platelet reactivity (HTPR).

Objective
This study investigated whether specific SNPs in key hepatic enzymes (CYP2C19*2, *3, *17, CYP3A4*1G, and NR1I2) or the ADP receptor (PR2Y12) are associated with HTPR to clopidogrel.

Patients & methods
This observational study included patients with ischemic stroke (IS) and transient ischemic attacks (TIAs) receiving clopidogrel at a dose of 75 mg/day. Patients were genotyped for eight different SNPs in the genes encoding CYP2C19, CYP3A4, NR1I2, and the P2Y12 receptor.

Results
Of the 103 patients that were included, 30.7% carried the CYP2C19*2 allele and had higher platelet reaction unit (PRU) values than non-carriers, but no patients showed HTPR. Carriers of the *17 allele had higher platelet inhibition but showed no difference in PRU values compared with non-carriers. The remaining SNPs were neither associated with PRU nor with platelet inhibition.

Conclusions
Patients with IS and TIAs treated with 75 mg clopidogrel/day do not have HTPR. A genetic analysis of CYP2C19*2, *3, *17, CYP3A4*1G, and NR1I2 revealed no associations with clopidogrel HTPR. CYP2C19*2 carriers and patients with HTPR in the acute phase after ischemic stroke or transient ischemic attacks exhibit higher PRU values, but not long-term treatment HTPR.
Prevalence and correlates of job loss among schizophrenia outpatients at St. AmanuelMental Specialized Hospital, Addis Ababa, Ethiopia; cross sectional study
Authors: Chafi Yohannes Kifle , Amare Tadele , Haile Kelemua , Damene Woynabeba , Tesfaye Getaneh , Minichil Woredaw 
Published: December 2020

Background
Job loss in patient with chronic illness like schizophrenia is the most serious public concern in the clinical and socio-economic terms worldwide. Patients with schizophrenia usually have unsatisfactory job termination like quitting or getting fired which results well-established negative outcomes. The complex interplay between one another has made job and mental illness the focus areas. In the developing nations, there is limited study on these areas in spite of higher rates of job loss.

Objectives
This study aimed to assess the prevalence and correlates of job loss among schizophrenia outpatient units in Addis Ababa, Ethiopia.

Methods
Institutional based cross-sectional study was conducted at Saint Amanuel Mental Specialized Hospital among schizophrenia outpatient units in Addis Ababa from May to June 2018. A total of 421 study subjects were interviewed using Positive and Negative Syndrome Scale and Perceived devaluation and discrimination scale. Out of the total study participants, female populations were slightly higher (50.4%) and the majorities (38.6%) were orthodox religion followers. Study characteristics was summarized using descriptive statistics and bi-variable and multivariable analysis was performed using Statistical Package for Social Science version 24. Furthermore, those factors at p value ≤ 0.05 were considered as statistically significant.

Results
The prevalence of job loss among patients with schizophrenia was 37.3%. Factors including unmarried [AOR = 2.42:95% CI (1.28, 4.54)], divorced [AOR = 2.34: 95% CI (1.16, 4.71)], severe positive symptoms [AOR = 2.03: 95% CI (1.15, 3.60)], severe general psychopathology [AOR = 1.76: 95% CI (1.01, 3.08)], and poor level of social and occupational functioning [AOR = 5.05: 95% CI (2.81, 9.09)] were significantly associated with job loss among schizophrenia people.

Conclusion
This study suggested that job loss among schizophrenia outpatients was high. There was significant association among people with unmarried, divorced, severe positive symptoms, poor functionality and higher general psychopathology. Therefore, clinical and psychosocial factors were responsible for job loss which warrant further attention and investigation.
Variation in breast cancer grading in 1,636 resections assessed using control charts and in silico kappa
Authors: Moodley Jinesa , Williams Phillip , Gohla Gabriela , Major Pierre , Bonert Michael 
Published: December 2020

Objective
Assess interpretative variation in Nottingham grading using control charts (CCs) and in silico kappa (ISK).

Methods
In house invasive breast cancer cases (2011–2019) at two institutions with a synoptic report were extracted. Pathologist interpretative rates (PIRs) were calculated and normed for Nottingham grade (G) and its components (tubular score (TS), nuclear score (NS), mitotic score (MS)) for pathologists interpreting >35 cases. ISKs were calculated using the ordered mutually exclusive category assumption (OMECA) and maximal categorical overlap assumption (MCOA).

Results
The study period included 1,994 resections. Ten pathologists each assessed 38–441 cases and together saw 1,636; these were further analyzed. The PIR medians (normed ranges) were: G1:24%(18–27%), G2:53%(43–56%) and G3:26%(19–33%). The MCOA ISK and the number of statistical outliers (p< 0.05/p< 0.001) to the group median interpretive rate (GMIR) for the ten pathologists was G1: 0.82(2/0 of 10), G2: 0.76(1/1), G3: 0.71(3/1), TS1: 0.79(1/0), TS2: 0.63(5/1), TS3: 0.66(5/1), NS1: 0.37(5/4), NS2: 0.60(4/3), NS3: 0.59(4/4), MS1: 0.78(3/1), MS2: 0.78(3/1), MS3: 0.77(2/0). The OMECA ISK was 0.62, 0.49, 0.69 and 0.71 for TS, NS, MS and G.

Conclusions
The nuclear score has the most outliers. NS1 appears to be inconsistently used. ISK mirrors trends in conventional kappa studies. CCs and ISK allow insight into interpretive variation and may be essential for the next generation in quality.
Parents’ and guardians’ views and experiences of accessing routine childhood vaccinations during the coronavirus (COVID-19) pandemic: A mixed methods study in England
Authors: Bell Sadie , Clarke Richard , Paterson Pauline , Mounier-Jack Sandra 
Published: December 2020

Objective
To explore parents’ and guardians’ views and experiences of accessing National Health Service (NHS) general practices for routine childhood vaccinations during the coronavirus (COVID-19) pandemic in England.

Design
Mixed methods approach involving an online cross-sectional survey (conducted between 19th April and 11th May 2020) and semi-structured telephone interviews (conducted between 27th April and 27th May 2020).

Participants
1252 parents and guardians (aged 16+ years) who reported living in England with a child aged 18 months or under completed the survey. Nineteen survey respondents took part in follow-up interviews.

Results
The majority of survey respondents (85.7%) considered it important for their children to receive routine vaccinations on schedule during the COVID-19 pandemic; however, several barriers to vaccination were identified. These included a lack of clarity around whether vaccination services were operating as usual, particularly amongst respondents from lower income households and those self-reporting as Black, Asian, Chinese, Mixed or Other ethnicity; difficulties in organising vaccination appointments; and fears around contracting COVID-19 while attending general practice.
Concerns about catching COVID-19 while accessing general practice were weighed against concerns about children acquiring a vaccine-preventable disease if they did not receive scheduled routine childhood vaccinations. Many parents and guardians felt their child’s risk of acquiring a vaccine-preventable disease was low as the implementation of stringent physical distancing measures (from March 23rd 2020) meant they were not mixing with others.

Conclusion
To promote routine childhood vaccination uptake during the current COVID-19 outbreak, further waves of COVID-19 infection, and future pandemics, prompt and sustained national and general practice level communication is needed to raise awareness of vaccination service continuation and the importance of timely vaccination, and invitation-reminder systems for vaccination need to be maintained. To allay concerns about the safety of accessing general practice, practices should communicate the measures being implemented to prevent COVID-19 transmission.
Social exclusion and the perspectives of health care providers on migrants in Gauteng public health facilities, South Africa
Authors: White Janine A. , Blaauw Duane , Rispel Laetitia C. 
Published: December 2020

Background
Universal health coverage (UHC) for all people, regardless of citizenship, is a global priority. Health care providers are central to the achievement of UHC, and their attitudes and behaviour could either advance or impede UHC for migrants. Using a social exclusion conceptual framework, this study examined the perspectives of health care providers on delivering health services to migrants in public health facilities in Gauteng Province, South Africa.

Methods
We used stratified, random sampling to select 13 public health facilities. All health care providers working in ambulatory care were invited to complete a self-administered questionnaire. In addition to socio-demographic information, the questionnaire asked health care providers if they had witnessed discrimination against migrants at work, and measured their perspectives on social exclusionary views and practices. Multiple regression analysis was used to identify predictors of more exclusionary perspectives for each item.

Results
277 of 308 health care providers participated in the study–a response rate of 90%. The participants were predominantly female (77.6%) and nurses (51.9%), and had worked for an average of 6.8 years in their facilities. 19.2% of health care providers reported that they had witnessed discrimination against migrants, while 20.0% reported differential treatment of migrant patients. Exclusionary perspectives varied across the different items, and for different provider groups. Enrolled nurses and nursing assistants were significantly more exclusionary on a number of items, while the opposite was found for providers born outside South Africa. For some questions, female providers held more exclusionary perspectives and this was also the case for providers from higher levels of care.

Conclusion
Health care providers are critical to inclusive UHC. Social exclusionary views or practices must be addressed through enabling health policies; training in culture-sensitivity, ethics and human rights; and advocacy to ensure that health care providers uphold their professional obligations to all patients.
High rate of renal recovery in survivors of COVID-19 associated acute renal failure requiring renal replacement therapy
Authors: Stevens Jacob S. , King Kristen L. , Robbins-Juarez Shelief Y. , Khairallah Pascale , Toma Katherine , Alvarado Verduzco Hector , Daniel Emily , Douglas Denzil , Moses Andrew A. , Peleg Yonatan , Starakiewicz Piotr , Li Miah T. , Kim Daniel W. , Yu Kathleen , Qian Long , Shah Vaqar H. , O'Donnell Max R. , Cummings Matthew J. , Zucker Jason , Natarajan Karthik , Perotte Adler , Tsapepas Demetra , Krzysztof Kiryluk , Dube Geoffrey , Siddall Eric , Shirazian Shayan , Nickolas Thomas L. , Rao Maya K. , Barasch Jonathan M. , Valeri Anthony M. , Radhakrishnan Jai , Gharavi Ali G. , Husain S. Ali , Mohan Sumit 
Published: December 2020

Introduction
A large proportion of patients with COVID-19 develop acute kidney injury (AKI). While the most severe of these cases require renal replacement therapy (RRT), little is known about their clinical course.

Methods
We describe the clinical characteristics of COVID-19 patients in the ICU with AKI requiring RRT at an academic medical center in New York City and followed patients for outcomes of death and renal recovery using time-to-event analyses.

Results
Our cohort of 115 patients represented 23% of all ICU admissions at our center, with a peak prevalence of 29%. Patients were followed for a median of 29 days (2542 total patient-RRT-days; median 54 days for survivors). Mechanical ventilation and vasopressor use were common (99% and 84%, respectively), and the median Sequential Organ Function Assessment (SOFA) score was 14. By the end of follow-up 51% died, 41% recovered kidney function (84% of survivors), and 8% still needed RRT (survival probability at 60 days: 0.46 [95% CI: 0.36–0.56])). In an adjusted Cox model, coronary artery disease and chronic obstructive pulmonary disease were associated with increased mortality (HRs: 3.99 [95% CI 1.46–10.90] and 3.10 [95% CI 1.25–7.66]) as were angiotensin-converting-enzyme inhibitors (HR 2.33 [95% CI 1.21–4.47]) and a SOFA score >15 (HR 3.46 [95% CI 1.65–7.25).

Conclusions and relevance
Our analysis demonstrates the high prevalence of AKI requiring RRT among critically ill patients with COVID-19 and is associated with a high mortality, however, the rate of renal recovery is high among survivors and should inform shared-decision making.
Application and utility of a clinical framework for spinally referred neck-arm pain: A cross-sectional and longitudinal study protocol
Authors: Kapitza Camilla , Lüdtke Kerstin , Tampin Brigitte , Ballenberger Nikolaus 
Published: December 2020

Background
The clinical presentation of neck-arm pain is heterogeneous with varying underlying pain types (nociceptive/neuropathic/mixed) and pain mechanisms (peripheral/central sensitization). A mechanism-based clinical framework for spinally referred pain has been proposed, which classifies into (1) somatic pain, (2) neural mechanosensitivity, (3) radicular pain, (4) radiculopathy and mixed pain presentations. This study aims to (i) investigate the application of the clinical framework in patients with neck-arm pain, (ii) determine their somatosensory, clinical and psychosocial profile and (iii) observe their clinical course over time.

Method
We describe a study protocol. Patients with unilateral neck-arm pain (n = 180) will undergo a clinical examination, after which they will be classified into subgroups according to the proposed clinical framework. Standardized quantitative sensory testing (QST) measurements will be taken in their main pain area and contralateral side. Participants will have to complete questionnaires to assess function (Neck Disability Index), psychosocial factors (Tampa Scale of Kinesiophobia, Pain Catastrophizing Scale, Depression, anxiety and stress scale), neuropathic pain (Douleur Neuropathique 4 Questions, PainDETECT Questionnaire) and central sensitization features (Central Sensitization Inventory). Follow-ups at three, six and 12 months include the baseline questionnaires. The differences of QST data and questionnaire outcomes between and within groups will be analyzed using (M)AN(C)OVA and/or regression models. Repeated measurement analysis of variance or a linear mixed model will be used to calculate the differences between three, six, and 12 months outcomes. Multiple regression models will be used to analyze potential predictors for the clinical course.

Conclusion
The rationale for this study is to assess the usability and utility of the proposed clinical framework as well as to identify possible differing somatosensory and psychosocial phenotypes between the subgroups. This could increase our knowledge of the underlying pain mechanisms. The longitudinal analysis may help to assess possible predictors for pain persistency.