bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rights to Weapons: Rights as a Resource in Workplace Conflicts in Late Socialist Bulgaria
Authors: Hristov Todor 
Published: November 2019

Social rights are essentially rights to the betterment of life. And because of this, they lack any internal principle of limitation. Socialist governments recognized social rights as the core of human rights and therefore as legal rights, the implementation of which was a matter of obligation rather than policy. However, since the governments commanded limited resources, they had to limit the implementation of social rights. The article describes the ad hoc limitations on the implementation of social rights, developed by the Bulgarian Communist Party, which brought forth their transformation into instruments of government, and their appropriation by different forms of counter-conduct.
Reduction in Ocean Heat Transport at 26°N since 2008 Cools the Eastern Subpolar Gyre of the North Atlantic Ocean
Authors: Bryden Harry L. , Johns William E. , King Brian A. , McCarthy Gerard , McDonagh Elaine L. , Moat Ben I. , Smeed David A. 
Published: December 2019

AbstractNorthward ocean heat transport at 26°N in the Atlantic Ocean has been measured since 2004. The ocean heat transport is large—approximately 1.25 PW, and on interannual time scales it exhibits surprisingly large temporal variability. There has been a long-term reduction in ocean heat transport of 0.17 PW from 1.32 PW before 2009 to 1.15 PW after 2009 (2009–16) on an annual average basis associated with a 2.5-Sv (1 Sv ≡ 106 m3 s−1) drop in the Atlantic meridional overturning circulation (AMOC). The reduction in the AMOC has cooled and freshened the upper ocean north of 26°N over an area following the offshore edge of the Gulf Stream/North Atlantic Current from the Bahamas to Iceland. Cooling peaks south of Iceland where surface temperatures are as much as 2°C cooler in 2016 than they were in 2008. Heat uptake by the atmosphere appears to have been affected particularly along the path of the North Atlantic Current. For the reduction in ocean heat transport, changes in ocean heat content account for about one-quarter of the long-term reduction in ocean heat transport while reduced heat uptake by the atmosphere appears to account for the remainder of the change in ocean heat transport.
Development and Evaluation of the Raindrop Size Distribution Parameters for the NASA Global Precipitation Measurement Mission Ground Validation Program
Authors: Tokay Ali , D’Adderio Leo Pio , Wolff David B. , Petersen Walter A. 
Published: December 2019

AbstractThe National Aeronautics and Space Administration Global Precipitation Measurement (GPM) mission ground validation program uses dual-polarization radar moments to estimate raindrop size distribution (DSD) parameters, the mass-weighted mean drop diameter Dmass, and normalized intercept parameter NW, to validate the GPM Core Observatory–derived DSD parameters. The disdrometer-based Dmass and NW are derived through empirical relationships between Dmass and differential reflectivity ZDR, and between NW, reflectivity ZH, and Dmass. This study employs large datasets collected from two-dimensional video disdrometers (2DVD) during six different field studies to derive the requisite empirical relationships. The uncertainty of the derived Dmass(ZDR) relationship is evaluated through comparisons of 2DVD-calculated and ZDR-estimated Dmass, where ZDR is calculated directly from 2DVD observations. Similarly, the uncertainty of the NW(ZH, Dmass) relationship is evaluated through 2DVD-calculated and Dmass and ZH-estimated NW, where Dmass and ZH are directly calculated from 2DVD observations. This study also presents the sensitivity of Dmass(ZDR) relationships to climate regime and to disdrometer type after developing three additional Dmass(ZDR) relationships from second-generation Particle Size Velocity (PARSIVEL2) disdrometer (P2) observations collected in the Pacific Northwest, in Iowa, and at Kwajalein Atoll in the tropical Pacific Ocean. The application of P2-derived Dmass(ZDR) relationship based on precipitation in the northwestern United States to P2 observations collected over the tropical ocean resulted in the highest error among comparisons of the three datasets.
Diagnostic performance of adrenal CT in the differentiation of adenoma and pheochromocytoma
Authors: Altinmakas Emre , Perrier Nancy D , Grubbs Elizabeth G , Lee Jeffrey E , Prieto Victor G , Ng Chaan S 
Published: December 2019

Background Differentiation of adenoma and pheochromocytoma on computed tomography (CT) may be problematic. Purpose To investigate if adenoma and pheochromocytoma can be differentiated with adrenal CT. Material and Methods A total of 147 pathologically proven adrenal masses (119 adenomas, 28 pheochromocytomas) that had undergone adrenal CT were retrospectively evaluated. Lesion attenuation on unenhanced phase (UEP), portal phase (PP), 15-min delayed phase (DP), absolute/relative percentage enhancement wash-out (APEW/RPEW), and qualitative features were recorded. Student’s t-test for parametric data, Mann–Whitney U test for non-parametric data, and Fisher’s exact test for categorical data were used. Diagnostic performance of CT attenuation was assessed by area under the curve (AUC) of the receiver operating characteristics. Results APEW of adenomas was not significantly different from pheochromocytomas; 68.4% and 59% ( P =  0.284). Adenomas had significantly higher RPEW; 57.3% vs. 37.4% ( P =  0.004). Of pheochromocytomas, 50% met APEW >60% or RPEW >40% criteria, and therefore were misclassified as adenoma on wash-out CT. Of those, 80% (4/5) were < 3 cm. UEP, PP, and DP attenuations of pheochromocytomas were significantly higher than adenomas; however, they were overlapping. AUC for UEP, PP, and DP was 0.906, 0.784, and 0.926, respectively. Larger pheochromocytomas were more likely to contain necrosis compared to smaller pheochromocytomas and adenomas; 41.6% vs. 12.5% vs. 3%. Homogeneous enhancement was seen in 25% of pheochromocytomas and 49% of adenomas ( P =  0.018). No significant difference was found in terms of lesion borders and presence of fat/calcification ( P >  0.05). Conclusions A considerable percentage of pheochromocytomas, especially smaller ones, demonstrate adenoma-like wash-out on CT. Heterogeneous enhancement, higher attenuation, and necrosis are more suggestive of pheochromocytoma.
Effects of Inotropes on the Mortality in Patients With Septic Shock
Authors: Sato Ryota , Ariyoshi Nobuhiro , Hasegawa Daisuke , Crossey Erin , Hamahata Natsumi , Ishihara Takuma , Nasu Michitaka , Devendra Gehan 
Published: December 2019

Background: Although surviving sepsis campaign guidelines recommend the use of inotropes in the presence of myocardial dysfunction, the effects of inotropes, including epinephrine, dobutamine, and milrinone, on in-hospital mortality in patients with septic shock remains unclear. Materials and Methods: We conducted an international,2-center, retrospective cohort study. The Cox proportional hazards regression model with time-varying covariates was used to investigate whether epinephrine, milrinone, or dobutamine reduces in-hospital mortality in patients with septic shock. Sensitivity analysis was performed using propensity score matching. The primary outcome was in-hospital mortality. The secondary outcome included atrial fibrillation (Afib) with a rapid ventricular response (RVR) in the intensive care unit (ICU) and ICU-free days. Results: A total of 417 patients with septic shock were included, 72 (17.3%) of whom received inotropes. The use of epinephrine and dobutamine was associated with significantly higher in-hospital mortality (epinephrine, hazard ratio [HR]: 4.79, 95% confidence interval [CI]: 2.12-10.82, P = .001; dobutamine, HR: 2.53, 95% CI: 1.30-4.95, P = .046). The effects of epinephrine and dobutamine were time- and dose-dependent. The use of milrinone was not associated with increased mortality (HR: 1.07, 95% CI: 0.42-2.68, P = .345). The use of epinephrine, dobutamine, and milrinone was associated with significantly increased odds of Afib with RVR (epinephrine, odds ratio [OR]: 3.88, 95% CI: 1.11-13.61, P = .034; dobutamine, OR: 3.95, 95% CI: 1.14-13.76; and milrinone, OR: 3.77, 95% CI: 1.05-13.59). On the other hand, the use of epinephrine, dobutamine, and milrinone was not associated with less ICU-free days (epinephrine, adjusted OR: 0.30, 95% CI: 0.09-1.01, P = .053; dobutamine, adjusted OR: 0.91, 95% CI: 0.29-2.84; and milrinone, adjusted OR: 0.60, 95% CI: 0.19-1.87). Conclusion: The present study showed that the use of epinephrine and dobutamine was associated with significantly increased in-hospital mortality in patients with septic shock. These effects were both time- and dose-dependent. On the other hand, the use of milrinone was not associated with increased in-hospital mortality.
Characteristics of Chinese patients with primary Sjögren’s syndrome: preliminary report of a multi-centre registration study
Authors: Xu D , Zhao S , Li Q , Wang Y H , Zhao J L , Li M T , Zhao Y , Zeng X F 
Published: December 2019

Background We established a multi-centre online registry for primary Sjögren’s syndrome (pSS) in China, and compared Chinese patients with those from other countries. Methods Data were from 87 rheumatology centres in 27 provinces. All 2986 patients had pSS according to the 2002 American-European Consensus Group or the 2016 American College of Rheumatology/European League Against Rheumatism. All centres used the same methods. Data on demographics, clinical parameters, laboratory results, disease activity and treatments were examined. Results The female:male ratio was 22.9:1, and the mean age at onset was 46.31 years. A total of 332 (11.1%) patients had thyroid disease, including hyperthyroidism (1.2%), hypothyroidism (6.0%) and subacute thyroiditis (3.9%). Dry eye had a prevalence of 68.59% in Chinese patients, 93.7–96% in European patients and 97.3% in American patients. Dry mouth had a prevalence of 86.5% in Chinese patients, 93.2–96% in European patients and 97.9% in American patients. Fewer Chinese than European patients had arthritis (6.9% vs. 15–19.3%). ANA positivity was 90.7% in Chinese, 81.3% in European and 77.6% in American patients. Anti-SSA antibody positivity was 84.6% in Chinese, 71% in European and 68.2% in American patients. The most commonly used drugs in Chinese patients were hydroxychloroquine ( n = 1818; 67.5%), glucocorticoids ( n = 1720; 63.9%) and total glucosides of paeony ( n = 1120; 41.7%). Conclusions This study provided information on the phenotypes of Chinese patients with pSS, and identified several differences with patients from other geographical regions.
The effectiveness of acupuncture for pain reduction in delayed-onset muscle soreness: a systematic review
Authors: Ko Gloria Wing Yan , Clarkson Carl 
Published: December 2019

Objective:The aim of this study was to systematically review the literature on acupuncture for delayed-onset muscle soreness (DOMS) and report upon study quality and treatment outcomes.Design:Systematic review.Data sources:Searches were conducted in the following electronic databases from their inception to 31 March 2018: CINAHL, MEDLINE, Allied and Complementary Medicine (AMED) and SPORTDiscus. Reference lists of all included studies and relevant reviews were hand-searched for additional studies.Eligibility criteria for selecting studies:Randomised controlled trials (RCTs) that evaluated the effectiveness of acupuncture in DOMS in adults measuring the pre-specified primary outcome (pain) were included.Data collection and analysis:Data were extracted using pre-defined extraction forms and the Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) checklist. Quality of studies was evaluated based on the Cochrane risk of bias assessment.Results:Five RCTs investigating laboratory-induced DOMS in the upper limbs with a total sample size of 182 healthy participants were included. Of the included studies, three reported superiority of acupuncture over no treatment in DOMS pain reduction as measured by visual analogue scale, pressure pain threshold or electrical pain threshold, while two studies yielded non-significant results. All studies demonstrated risk of bias in one or more areas, commonly lack of blinding of participants and personnel.Summary/conclusion:There is conflicting to limited evidence to support the effects of acupuncture on the relief of pain associated with DOMS. The findings were confounded by methodological limitations and reporting insufficiency. More rigorous, high-quality, and well-reported RCTs are required to further evaluate the effectiveness of acupuncture for DOMS.
Trends of Hospital Palliative Care Utilization and Its Associated Factors Among Patients With Systemic Lupus Erythematosus in the United States From 2005 to 2014
Authors: Yu Kaylee G. , Shen Jay J. , Kim Pearl C. , Kim Sun Jung , Lee Se Won , Byun David , Yoo Ji Won , Hwang Jinwook 
Published: December 2019

Objective: To investigate trends and associated factors of utilization of hospital palliative care among patients with systemic lupus erythematosus (SLE) and analyze its impact on length of hospital stay, hospital charges, and in-hospital mortality. Methods: Using the 2005-2014 National Inpatient Sample in the United States, the compound annual growth rate was used to investigate the temporal trend of utilization of hospital palliative care. Multivariate multilevel logistic regression analyses were performed to analyze the association with patient-related factors, hospital factors, length of stay, in-hospital mortality, and hospital charges. Results: The overall proportion of utilization of hospital palliative care for the patient with SLE was 0.6% over 10 years. It increased approximately 12-fold from 0.1% (2005) to 1.17% (2014). Hospital palliative care services were offered more frequently to older patients, patients with high severity illnesses, and in urban teaching hospitals or large size hospitals. Patients younger than 40 years, the lowest household income group, or Medicare beneficiaries less likely received palliative care during hospitalization. Hospital palliative care services were associated with increased length of stay (β = 1.407, P < .0001) and in-hospital mortality (odds ratio, 48.18; 95% confidence interval, 41.59-55.82), and reduced hospital charge (β = −0.075, P = .009). Conclusion: Hospital palliative care service for patients with SLE gradually increased during the past decade in US hospitals. However, this showed disparities in access and was associated with longer hospital length of stay and higher in-hospital mortality. Nevertheless, hospital palliative care services yielded a cost-saving effect.
Impact of the Charlson Comorbidity Index on dose-limiting toxicity and survival in locally advanced and metastatic renal cell carcinoma patients treated with first-line sunitinib or pazopanib
Authors: Demircan Nazım C , Alan Özkan , Başoğlu Tüylü Tuğba , Akın Telli Tuğba , Arıkan Rukiye , Çiçek Furkan C , Ercelep Özlem , Öztürk Mehmet A , Alsan Çetin İlknur , Ergelen Rabia , Tinay İlker , Akgül Babacan Nalan , Kaya Serap , Dane Faysal , Yumuk Perran F 
Published: December 2019

Background Anti-angiogenic tyrosine kinase inhibitors, sunitinib and pazopanib, have proven efficacy in advanced renal cell carcinoma, with specific adverse events occurring during treatment process. Comorbidities can reflect functional status and have prognostic value in oncology patients. We aimed to assess the association of the Charlson Comorbidity Index with severe toxicities and mortality in renal cell carcinoma cases treated with front-line sunitinib or pazopanib. Methods Files of locally advanced and metastatic renal cell carcinoma patients who received first-line sunitinib or pazopanib were retrospectively examined. Charlson Comorbidity Index of each patient was calculated. Patients were also stratified into Memorial Sloan-Kettering Cancer Center risk groups. Predictors of dose-limiting toxicity were evaluated with binomial logistic regression analysis. Univariate and multivariate Cox regression models were utilized to determine prognostic factors for survival. Results The study included 102 patients, 64 were treated with first-line sunitinib and 38 with pazopanib. In 42 patients (41.9%), Charlson Comorbidity Index was 9 or more. Dose-limiting toxicities were significantly more frequent in Charlson Comorbidity Index ≥9 group (69% vs. 40%, p = 0.004), and Charlson Comorbidity Index independently predicted dose-limiting toxicity (Hazard ratio (HR) = 4.30, p = 0.002). After adjusting for other variables, a Charlson Comorbidity Index of ≥9 is also a significant prognostic factor for progression-free (HR = 1.76, p = 0.02) and overall survival (HR = 1.75, p = 0.03). Conclusions Charlson Comorbidity Index may be a valuable method to estimate prognosis and optimize therapy in patients with advanced renal cell carcinoma receiving first-line sunitinib or pazopanib.
Templating in shoulder arthroplasty – A comparison of 2D CT to 3D CT planning software: A systematic review
Authors: Olaiya Oluwatobi R , Nadeem Ibrahim , Horner Nolan S , Bedi Asheesh , Leroux Timothy , Alolabi Bashar , Khan Moin 
Published: December 2019

Background Computed tomography (CT) utilizing computer software technology to generate three-dimensional (3D) rendering of the glenoid has become the preferred method for preoperative planning. It remains largely unknown what benefits this software may have to the intraoperative placement of the components and patient outcomes. Purpose The purpose of this systematic review is to compare 2D CT to 3D CT planning in total shoulder arthroplasty. Study design Systematic review. Methods A systematic database search was conducted for relevant studies evaluating the role of 3D CT planning in total shoulder arthroplasty. The primary outcome was component placement variability, and the secondary outcomes were intra- and inter-observer reliability in the context of preoperative planning. Results Following title-abstract and full-text screening, six eligible studies were included in the review (n = 237). The variability in glenoid measurements between 3D CT and 2D CT planning ranged from no significant difference to a 5° difference in version and 1.7° difference in inclination (p<0.05). Posterior bone loss was underestimated in 52% of the 2D measured patients relative to 3D CT groups. Irrespective of 2D and 3D planning (39% and 43% of cases respectively), surgeons elected to implant larger components than those templated. There was no literature identified comparing differences in time, cost, functional outcomes, complications, or patient satisfaction. Conclusion The paucity of evidence exploring clinical parameters makes it difficult to comment on clinical outcomes using different methods of templating. More studies are required to identify how improved radiographic outcomes translate into improvements that are clinically meaningful to patients.
Radiographic Value of the Lisfranc Diastasis in a Standardized Population
Authors: Thomas James L. , Kopiec Adam , Mark Kunkel , Chandler L. Mae 
Published: December 2019

Introduction. Injury to the Lisfranc’s joint, in particular to the second metatarsal–medial cuneiform (second MMC) joint, can be difficult to evaluate, especially in subtle Lisfranc injuries. The purpose of this study was to determine the value of the Lisfranc joint width (diastasis) of the adult foot in a standardized population thereby establishing a potential reference range when investigating this area for potential injury. Methods. The 2nd MMC joint in 50 men and 50 women was evaluated. Individuals with a history of foot/ankle pain, previous foot/ankle operation or fracture, or a history of systemic disease were excluded from the study. Bilateral weightbearing digital anterior-posterior and lateral radiographs were taken using a standardized method. Results. The mean 2nd MMC diastasis in 200 feet was 5.6 mm (95% CI 5.39-5.81). In the female population, the mean 2nd MMC diastasis was 5.8 mm (95% CI 5.51-6.09) as compared with 5.6 mm (95% CI 5.31-5.89) in males. The mean distance between the fifth metatarsal base and first cuneiform in the entire study population was 16.3 mm (95% CI 15.57-17.03). Conclusion. This study helps define baseline measurements of the Lisfranc joint for the general population, which can provide a standard measurement against which suspected foot injuries can be compared. Level of Evidence: Level IV.
Integrative analysis of spontaneous CLL regression highlights genetic and microenvironmental interdependency in CLL
Authors: Kwok Marwan , Oldreive Ceri , Rawstron Andy C. , Goel Anshita , Papatzikas Grigorios , Jones Rhiannon E. , Drennan Samantha , Agathanggelou Angelo , Sharma-Oates Archana , Evans Paul , Smith Edward , Dalal Surita , Mao Jingwen , Hollows Robert , Gordon Naheema , Hamada Mayumi , Davies Nicholas J. , Parry Helen , Beggs Andrew D. , Munir Talha , Moreton Paul , Paneesha Shankara , Pratt Guy , Taylor A. Malcolm R. , Forconi Francesco , Baird Duncan M. , Cazier Jean-Baptiste , Moss Paul , Hillmen Peter , Stankovic Tatjana 
Published: December 2019

Abstract
Spontaneous regression is a recognized phenomenon in chronic lymphocytic leukemia (CLL) but its biological basis remains unknown. We undertook a detailed investigation of the biological and clinical features of 20 spontaneous CLL regression cases incorporating phenotypic, functional, transcriptomic, and genomic studies at sequential time points. All spontaneously regressed tumors were IGHV-mutated with no restricted IGHV usage or B-cell receptor (BCR) stereotypy. They exhibited shortened telomeres similar to nonregressing CLL, indicating prior proliferation. They also displayed low Ki-67, CD49d, cell-surface immunoglobulin M (IgM) expression and IgM-signaling response but high CXCR4 expression, indicating low proliferative activity associated with poor migration to proliferation centers, with these features becoming increasingly marked during regression. Spontaneously regressed CLL displayed a transcriptome profile characterized by downregulation of metabolic processes as well as MYC and its downstream targets compared with nonregressing CLL. Moreover, spontaneous regression was associated with reversal of T-cell exhaustion features including reduced programmed cell death 1 expression and increased T-cell proliferation. Interestingly, archetypal CLL genomic aberrations including HIST1H1B and TP53 mutations and del(13q14) were found in some spontaneously regressing tumors, but genetic composition remained stable during regression. Conversely, a single case of CLL relapse following spontaneous regression was associated with increased BCR signaling, CLL proliferation, and clonal evolution. These observations indicate that spontaneously regressing CLL appear to undergo a period of proliferation before entering a more quiescent state, and that a complex interaction between genomic alterations and the microenvironment determines disease course. Together, the findings provide novel insight into the biological processes underpinning spontaneous CLL regression, with implications for CLL treatment.