bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurocognitive Outcomes in Children with Brain Tumors
Authors: Kline Cassie N. , Mueller Sabine 
Published: May 2020

AbstractBrain tumors are the most common solid tumor in childhood, and although survival outcomes continue to improve, survival is frequently offset by devastating late effects from tumor and treatment. The long-term effects of brain tumors and the therapy necessary to treat them range from sensory and neuroendocrine abnormalities to neurocognitive deficits leading to inferior quality of life. The multifactorial neurocognitive injury is one of the most broadly impacting and challenging late effects to predict and subsequently treat. Certain treatment modalities, such as intrathecal methotrexate and radiation, have been shown to be associated with poor neurocognition; however, long-term outcomes remain highly variable. There are efforts underway to investigate how to better predict, identify, and manage such neurocognitive injury in survivors of pediatric brain tumors. Herein, we focus on the current knowledge of neurocognitive outcomes and potential treatment strategies for this high-risk group.
Ultra-Early Versus Early Aneurysm Surgery After Subarachnoid Hemorrhage: A Retrospective Outcome Analysis
Authors: Carvalho Miguel Trigo , Canotilho Lage António , Pereira Ricardo , Gonçalves Jorge , Matos Ana , Henriques Carla , Barbosa Marcos 
Published: May 2020

Abstract
Object The timing of definitive management of ruptured intracranial aneurysms has been the subject of considerable debate, although the benefits of early surgery (until 72 hours postictus) are widely accepted. The aim of the present study is to evaluate the potential benefit of ultra-early surgery (until 24 hours) when compared with early surgery, in those patients who were treated by surgical clipping at the Neurosurgery Department of the Coimbra Hospital and University Centre.
Methods A 17-year database of consecutive ruptured and surgically treated intracranial aneurysms was analyzed. Outcome was measured by the Glasgow Outcome Scale (GOS). Baseline characteristics were analyzed by the Fisher exact test, the chi-squared and Mann-Whitney tests. Logistic regression was used to assess the impact of good grade according to the World Federation of Neurological Surgeons (WFNS) scale and ultra-early surgery in a good GOS outcome.
Results 343 patients who were submitted to surgical clipping in the first 72 hours post-ictus were included, 165 of whom have undergone ultra-early surgery. Demographics and preoperative characteristics of ultra-early and early surgery patients were similar. Good-grade patients according to the WFNS scale submitted to ultra-early surgery demonstrated an improved GOS at discharge and at 6 months. Poor-grade patients according to the WFNS scale submitted to ultra-early surgery demonstrated an improved GOS at discharge.
Conclusions Ultra-early surgery for aneurysmal subarachnoid hemorrhage patients improves outcome mainly on good-grade patients. Efforts should be made on the logistics of emergency departments to consider achieving treatment on this timeframe as a standard of care.
Spheno-Orbital Meningiomas: Optimizing Visual Outcome
Authors: Menon Sudha , O. Sandesh , Anand Debish , Menon Girish 
Published: May 2020

Abstract

Background Spheno-orbital meningiomas (SOMs) constitute a rare cause for orbital proptosis and visual impairment. This study aims to share our outcome experience with regard to vision and exophthalmos following the surgical management of 17 patients with SOM.

Methods Retrospective analysis of the case records of all surgically treated SOMs in the last 10 years. Exophthalmos index (EI) was calculated based on preoperative magnetic resonance imaging/computed tomography imaging. Vision was assessed using the Snellen’s chart and Goldman’s perimeter. Orbital volume was calculated using three-dimensional volume rendering assisted region-of-interest computation. Preoperative duration of symptoms and extent of surgery were the other predictors analyzed.

Results Patients’ age ranged from 17 to 72 years (mean, 50.57 y; median, 50.0 years). Women represented 13 (76.4%) of the entire study group. Proptosis (14/17; 82.4%) and visual impairment (14/17; 82.3%) were the two most common presenting complaints followed by headache (12/17; 70.1%). Gross total resection (GTR) was achieved in only 2 of the 17 patients (11.8%). Majority of the tumors were benign World Health Organization Grade I meningiomas (14/17; 84%). Mean follow-up time for the entire cohort was 56 months. Postoperatively, proptosis improved in nine (64.3%) and remained static in the rest five (35.7%) of patients. Four patients (28.6%) improved in vision following surgery. Vision remained static in eight patients (57.1%). Vision deteriorated in two (14.3%) patients who had severe preoperative visual deficits. New onset oculomotor palsy, trigeminal dysfunction, and mechanical ocular motility restriction were noticed in three (17.6%), two (11.2%), and six (35.3%) patients, respectively. The mean preoperative orbital volume was 21.68 ± 3.2 cm﻿﻿3 and the mean postoperative orbital volume was 23.72 ± 3.4 cm﻿﻿3. Orbital volume was inversely related to EI. Optic canal (OC) deroofing and extensive orbital wall decompression facilitated visual improvement and proptosis reduction. None of the variables including orbital volume proved to be statistically significant in predicting outcome.

Conclusion SOMs constitute a rare subgroup of skull base meningiomas that pose considerable surgical challenges. A surgical strategy aimed at safe maximal resection rather than aggressive GTR provides favorable outcome with less morbidity. Adequate bony decompression of the orbital walls and OC provides satisfactory improvements in proptosis and vision. Residual disease is common, but the risk of symptomatic recurrence is low especially when combined with adjuvant radiotherapy. Visual outcome is likely to be poor in patients presenting with severely compromised vision.
COVID-19-Related Severe Hypercoagulability in Patients Admitted to Intensive Care Unit for Acute Respiratory Failure
Authors: Spiezia Luca , Boscolo Annalisa , Poletto Francesco , Cerruti Lorenzo , Tiberio Ivo , Campello Elena , Navalesi Paolo , Simioni Paolo 
Published: May 2020

AbstractIn late December 2019 an outbreak of a novel coronavirus (SARS-CoV-2) causing severe pneumonia (COVID-19) was reported in Wuhan, Hubei Province, China. A common finding in most COVID-19 patients is high D-dimer levels which are associated with a worse prognosis. We aimed to evaluate coagulation abnormalities via traditional tests and whole blood thromboelastometry profiles in a group of 22 (mean age 67 ± 8 years, M:F 20:2) consecutive patients admitted to the Intensive Care Unit of Padova University Hospital for acute respiratory failure due to COVID-19. Cases showed significantly higher fibrinogen and D-dimer plasma levels versus healthy controls (p < 0.0001 in both comparisons). Interestingly enough, markedly hypercoagulable thromboelastometry profiles were observed in COVID-19 patients, as reflected by shorter Clot Formation Time (CFT) in INTEM (p = 0.0002) and EXTEM (p = 0.01) and higher Maximum Clot Firmness (MCF) in INTEM, EXTEM and FIBTEM (p < 0.001 in all comparisons). In conclusion, COVID-19 patients with acute respiratory failure present a severe hypercoagulability rather than consumptive coagulopathy. Fibrin formation and polymerization may predispose to thrombosis and correlate with a worse outcome.
Comparison of Clinical and Radiological Parameters with Two Different Surgical Methods for Anterior Cruciate Ligament Reconstruction
Authors: Çiloğlu Osman , Çiçek Hakan , Yılmaz Ahmet , Özalay Metin , Söker Gökhan , Leblebici Berrin 
Published: May 2020

AbstractThis study compared the clinical and radiological findings of nonanatomic transtibial (TT) technique with intraspongious fixation and anatomical anteromedial portal (AMP) technique with extracortical button implant in anterior cruciate ligament (ACL) reconstruction. A total of 54 patients with isolated ACL rupture were included in this prospective study. The patients who had the intraspongious fixation by nonanatomical TT technique were allocated to Group 1 (n = 27). The patients with extracortical fixation by anatomical AMP technique were placed in Group 2 (n = 27). The clinical scores of the patients were evaluated with the International Knee Documentation Committee Evaluation Form, Tegner activity score, and Lysholm II Functional Scoring. The tibial and femoral tunnels were evaluated with three-dimensional computed tomography. The kinematic examinations were performed with a Biodex System 3 Pro isokinetic dynamometer. There was no significant difference between the groups in terms of demographic data (p > 0.05). The postoperative clinical scores improved significantly in both the groups compared with the preoperative levels (p = 0.001), but there was no significant difference in the postoperative clinical scores between the groups (p > 0.05). In the extension and flexion of 60 to 180 degrees/s, the peak torque and the peak torque/body weight values of the repaired knee to intact knee ratios showed significant differences in favor of Group 2 (p = 0.001). In both the groups, no significant difference was found between the mean extent of the tunnel enlargement (p > 0.05). The mean tunnel height was significantly greater in Group 1 (45% ± 9.86 vs. 34.11% ± 10.0%) (p = 0.001). When the localization of the tunnel enlargements (proximal-middle-distal) was examined, a significant difference was found between the groups (p = 0.001). Although the AMP technique, which is a more anatomic reconstruction, had an advantage with regard to tunnel enlargement and the isokinetic muscle studies, there was no difference between the two techniques in terms of the clinical results.
Green clashes: cultural dynamics of scales in sustainability transitions in European peripheries
Authors: Häyrynen Simo , Hämeenaho Pilvi 
Published: May 2020

AbstractA multi-level perspective (MLP) in studying sustainability transitions has proved its relevance in explaining the institutionalisation of sustainability ideas. However, MLP does not offer tools to grasp the dynamics of culture between knowledge regimes that occur in different loci in global-local scales. The article introduces a framework for cultural analysis by creating a crossover conceptual approach to culture in different spatial scales combining elements of MLP logic with Thomas Eriksen’s idea of the ‘clashes of scales’. Scalar dynamics related to sustainability transitions are explored through the centre–periphery patterns by reanalysing empirical data from the authors’ previous projects, which examine local responses to meet the ideas or assignments given by upscale actors. The article shows that culture is a factor that does not stick to one level of development but crosscuts through spatial scales, thus providing transitional corridors. Through various representations, culture anchors floating sustainability to a certain mentality of rule and constitutes an implicit element of the whole transition process, providing a challenge for the traditional grammar of pro-environmental diffusion. In this process, peripheral states of mind tend to mediate and integrate different ideological motivations into a local cultural reaction to sustainability transition.
Structural electronic and vibrational properties analysis of Li2CaX (X = Sn, Pb) heusler alloys: a comparative study
Authors: Gulebaglan Sinem Erden 
Published: May 2020

Abstract
This study was focused on structural, electronic and vibrational properties of Li2CaSn and Li2CaPb with density functional theory. All properties of these compounds were computed by implementing General Gradient Approximation and using Quantum Espresso software programme. As a result of the calculations, it was found that the lattice parameter is 6.967 Å and bulk modulus is 33.94 GPa for Li2CaSn. Also, these values are 7.062 Å and 29.574 GPa for Li2CaPb. The calculated lattice parameters are in good agreement with the available experimental data. There is no previous theoretical calculation for Li2CaSn and Li2CaPb compounds. It was calculated that Li2CaSn and Li2CaPb have a semi-metal property. The full phonon dispersion curves of Li2CaSn and Li2CaPb compounds in the Heusler type structure were examined using the linear response method. Under 0 kbar pressure, Li2CaPb was unstable while Li2CaSn was dynamically stable. Calculations showed that when 38.42 kbar pressure is applied to the Li2CaPb compound, the Li2CaPb compound becomes dynamically stable. It is believed that this study will shape future studies.
Vascularization is the next challenge for skin tissue engineering as a solution for burn management
Authors: Shahin Hady , Elmasry Moustafa , Steinvall Ingrid , Söberg Folke , El-Serafi Ahmed 
Published: May 2020

AbstractSkin regeneration represents a promising line of management for patients with skin loss, including burn victims. The current approach of spraying single cells over the defective areas results in variable success rates in different centers. The modern approach is to synthesize a multilayer skin construct that is based on autologous stem cells. One of the main complications with different types of transplants is sloughing due to the absence of proper vascularization. Ensuring proper vascularization will be crucial for the integration of skin constructs with the surrounding tissues. Combination of the right cells with scaffolds of proper physico-chemical properties, vascularization can be markedly enhanced. The material effect, pore size and adsorption of certain proteins, as well as the application of appropriate growth factors, such as vascular endothelial growth factors, can have an additive effect. A selection of the most effective protocols is discussed in this review.
Functional Molecular Network Analysis Enables Prediction of Response to Vedolizumab Therapy in Anti-TNF Refractory IBD Patients
Authors: Breidert Matthias , Eftekhari Pierre , Louis François , Rotoiu Claudia , Rath Timo , Neurath Markus F , Atreya Raja 
Published: May 2020

AbstractBackgroundWe applied for the first time 2 label-free technologies, physiological intermolecular modulation spectroscopy (PIMS) and nematic protein organization technic (NPOT) in anti-tumor necrosis factor (TNF) refractory inflammatory bowel disease (IBD) patients to identify clinical responders to vedolizumab therapy and elucidate their underlying functional molecular network.MethodsPIMS analysis was performed in peripheral blood taken prior to the first vedolizumab application in 20 IBD patients (Crohn disease n = 13; ulcerative colitis n = 7) refractory to at least 1 previous anti-TNF agent therapy. Peripheral blood taken from clinical responders and nonresponders at week 14 of vedolizumab therapy were additionally subjected to NPOT analysis. Response to therapy was assessed by respective clinical disease activity scores (partial Mayo Score and Harvey–Bradshaw Index).ResultsClinical response to vedolizumab treatment was observed in 7 of 13 Crohn disease and 4 of 7 ulcerative colitis patients at week 14. Response to therapy was accurately predicted by PIMS blood analysis in 100% of ulcerative colitis and 77% of Crohn disease patients. Overall prediction of clinical response with PIMS blood analysis was achieved with a 89% positive predictive value and a 82% negative predictive value. NPOT analysis revealed the heightened expression of the proteins ITGB7, ITGAV, ITG3, PF4, and ASGH in the peripheral blood of vedolizumab responders compared to nonresponders.ConclusionsPIMS analysis of the blood of anti-TNF refractory IBD patients was able to stratify responders to vedolizumab therapy with high accuracy and specificity. NPOT technology could decipher underling molecular networks in the blood of responders, enabling subsequent personalized therapeutic approaches in IBD.
Sources of Borrowing and Fiscal Multipliers
Authors: Priftis Romanos , Zimic Srec̆ko 
Published: May 2020

AbstractThis paper finds that debt-financed fiscal multipliers vary depending on the location of the debt buyer. In a sample of 33 countries fiscal multipliers are larger when government purchases are financed by issuing debt to foreign investors (non-residents), compared to when they are financed by issuing debt to home investors (residents). In a theoretical model, the location of the government creditor produces these differential responses through the extent that private investment is crowded out. International capital mobility of the resident private sector decreases the difference between the two types of financing both in the model and in the data.
The results of an entry-oriented strategy for acute type A aortic dissection in octogenarians: an 18-year experience
Authors: Igarashi Takashi , Sato Yoichi , Satokawa Hirono , Takase Shinya , Wakamatsu Hiroki , Seto Yuki , Iwai-Takano Masumi , Fujimiya Tsuyoshi , Shinjo Hiroharu , Yokoyama Hitoshi 
Published: May 2020

Abstract

OBJECTIVES

The aim of this study was to evaluate the 18-year results of emergency operations for acute type A aortic dissection, especially in octogenarians.

METHODS
We reviewed 199 patients who underwent surgical aortic repair of an acute type A aortic dissection from January 2001 to December 2018. If the primary entry existed in the ascending aorta, we limited the extent of the replacement to within the ascending aorta. We analysed the early and late outcomes and identified the predictive factors for in-hospital death and difficulty of direct discharge to home.

RESULTS
The hospital mortality was 16%. The causes of death were postoperative bleeding (n = 8, 4%), intestinal ischaemia (n = 6, 3%), respiratory failure (n = 5, 3%), systemic inflammatory response syndrome (n = 4, 2%), low output syndrome (n = 3, 2%), sudden death (n = 3, 2%), myonephrotic metabolic syndrome (n = 2, 1%) and stroke (n = 1, 1%). Multivariable analysis revealed that an estimated glomerular filtration rate &lt;30 (P = 0.006), malperfusion (P = 0.001), rupture (P &lt; 0.001) and cross-clamping time (P = 0.003) were independent predictive factors of in-hospital death. Age was not a significant factor for predicting in-hospital death. Ascending aorta replacement (P = 0.013), advanced age (P = 0.002) and prolonged extracorporeal circulation time (P = 0.009) were independent predictive factors of difficulty in direct discharge to home. In the late follow-up period, the 5-year survival and aortic event-free rates were 62.2% and 88.9% in octogenarians, respectively.

CONCLUSIONS
From the perspective of saving lives, the results of emergency surgery for octogenarians were acceptable. Avoiding the postoperative decline in activities of daily living in octogenarians is a consideration going forward.
Biospytial: spatial graph-based computing for ecological Big Data
Authors: Escamilla Molgora Juan M , Sedda Luigi , Atkinson Peter M 
Published: May 2020

Abstract

Background
The exponential accumulation of environmental and ecological data together with the adoption of open data initiatives bring opportunities and challenges for integrating and synthesising relevant knowledge that need to be addressed, given the ongoing environmental crises.

Findings
Here we present Biospytial, a modular open source knowledge engine designed to import, organise, analyse and visualise big spatial ecological datasets using the power of graph theory. The engine uses a hybrid graph-relational approach to store and access information. A graph data structure uses linkage relationships to build semantic structures represented as complex data structures stored in a graph database, while tabular and geospatial data are stored in an efficient spatial relational database system. We provide an application using information on species occurrences, their taxonomic classification and climatic datasets. We built a knowledge graph of the Tree of Life embedded in an environmental and geographical grid to perform an analysis on threatened species co-occurring with jaguars (Panthera onca).

Conclusions
The Biospytial approach reduces the complexity of joining datasets using multiple tabular relations, while its scalable design eases the problem of merging datasets from different sources. Its modular design makes it possible to distribute several instances simultaneously, allowing fast and efficient handling of big ecological datasets. The provided example demonstrates the engine's capabilities in performing basic graph manipulation, analysis and visualizations of taxonomic groups co-occurring in space. The example shows potential avenues for performing novel ecological analyses, biodiversity syntheses and species distribution models aided by a network of taxonomic and spatial relationships.
Global ocean resistome revealed: Exploring antibiotic resistance gene abundance and distribution in TARA Oceans samples
Authors: Cuadrat Rafael R C , Sorokina Maria , Andrade Bruno G , Goris Tobias , Dávila Alberto M R 
Published: May 2020

Abstract

Background
The rise of antibiotic resistance (AR) in clinical settings is of great concern. Therefore, the understanding of AR mechanisms, evolution, and global distribution is a priority for patient survival. Despite all efforts in the elucidation of AR mechanisms in clinical strains, little is known about its prevalence and evolution in environmental microorganisms. We used 293 metagenomic samples from the TARA Oceans project to detect and quantify environmental antibiotic resistance genes (ARGs) using machine learning tools.

Results
After manual curation of ARGs, their abundance and distribution in the global ocean are presented. Additionally, the potential of horizontal ARG transfer by plasmids and their correlation with environmental and geographical parameters is shown. A total of 99,205 environmental open reading frames (ORFs) were classified as 1 of 560 different ARGs conferring resistance to 26 antibiotic classes. We found 24,567 ORFs in putative plasmid sequences, suggesting the importance of mobile genetic elements in the dynamics of environmental ARG transmission. Moreover, 4,804 contigs with &gt;=2 putative ARGs were found, including 2 plasmid-like contigs with 5 different ARGs, highlighting the potential presence of multi-resistant microorganisms in the natural ocean environment. Finally, we identified ARGs conferring resistance to some of the most relevant clinical antibiotics, revealing the presence of 15 ARGs similar to mobilized colistin resistance genes (mcr) with high abundance on polar biomes. Of these, 5 are assigned to Psychrobacter, a genus including opportunistic human pathogens.

Conclusions
This study uncovers the diversity and abundance of ARGs in the global ocean metagenome. Our results are available on Zenodo in MySQL database dump format, and all the code used for the analyses, including a Jupyter notebook js avaliable on Github. We also developed a dashboard web application (http://www.resistomedb.com) for data visualization.