bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of three-dimensional printed and virtual reality models in learning the morphology of craniovertebral junction deformities: a multicentre, randomised controlled study
Authors: Cai Siyi , He Yu , Cui Haomin , Zhou Xi , Zhou Dongsheng , Wang Fu , Tian Ye 
Published: September 2020

ObjectivesTo compare the effectiveness of three-dimensional printed (3DP), virtual reality (VR) and conventional normal physical (NP) models in clinical education regarding the morphology of craniovertebral junction (CVJ) deformities.DesignProspective, multicentre, randomised controlled study.SettingThree teaching hospitals in China.ParticipantsOne hundred and fifty-three participants in their first year of a 3-year medical residency programme.InterventionsAll participants were randomised to one of the three groups to learn the morphology of CVJ deformities using 3DP, VR or NP models.Primary outcome measuresThe objective outcomes were evaluated using three-level objective testing. In the first-level test, the participants were required to identify 15 anatomical landmarks on radiographs without CVJ deformities. In the second-level test, all participants were asked to identify the same 15 landmarks on radiographs showing classic CVJ deformities. In the third-level test, the participants were required to describe the key features of three classic cases of CVJ deformities depicted on radiographs. Each participant was also asked to answer four subjective questions to evaluate the importance and usefulness of the educational materials.ResultsIn the first-level test, the 3DP, VR and NP groups achieved similar correct rates. In the second-level test, the correct rate was higher in the 3DP group (82.1%±13.6%) than the VR and NP groups (76.9%±16.9% and 69.9%±20.0%, p=0.002). In the third-level test, the 3DP group achieved better correct rates regarding the description of key CVJ deformities features (66.2%±20.0%, p=0.049) than the other groups. The subjective tests showed that the 3DP model method was considered the most valuable approach for learning CVJ deformities.ConclusionsThe objective and subjective results show that the 3DP model is more effective teaching instrument than the NP model for learning the pathomorphology of CVJ deformities. The VR model also showed great efficacy, second to 3DP model, in improving participants’ understanding of CVJ deformities.
Efficacy and safety of left bundle branch area pacing versus biventricular pacing in heart failure patients with left bundle branch block: study protocol for a randomised controlled trial
Authors: Cheng Liting , Zhang Junmeng , Wang Zefeng , Zhou Mengge , Liang Zhuo , Zhao Lin , Chen Jieruo , Wu Yongquan 
Published: September 2020

IntroductionLeft bundle branch area pacing (LBBaP) has been accepted as a physiological pacing method that can yield narrow paced QRS waves. For patients with failed biventricular pacing (Bi-V), LBBaP is another feasible option. However, no randomised controlled study has evaluated the efficacy and safety of LBBaP in heart failure patients with left bundle branch block (LBBB). Therefore, we aimed to conduct this type of randomised controlled trial.Methods and analysisThis study is a single-centre, randomised controlled non-inferiority trial. This study will be conducted at the cardiac centre of Beijing Anzhen Hospital. From January 2020 to December 2022, 180 heart failure patients with reduced left ventricular ejection fraction (LVEF ≤35%) and LBBB undergoing Bi-V implantation will be consecutively enrolled in this study. Participants will be randomised at a 1:1 ratio into an experimental group (LBBaP) and a control group (Bi-V). The primary outcome is LVEF. The secondary outcomes are NT-proBNP, duration of the QRS complex, end systolic volume, end diastolic volume, the 6-minute walking test and quality of life (SF-36 scale), all causes of mortality, cardiovascular death, rehospitalisation rate of heart failure, other rehospitalisation rates, major complication rates, procedure costs and hospitalised dates.Ethics and disseminationThis study has been approved by the Beijing Anzhen Hospital Medical Ethics Committee (No. ks201932). The results of this study will be presented at domestic and international conferences. We hypothesise that LBBaP is non-inferior compared with Bi-V for treating patients with heart failure and LBBB. This trial will provide evidence-based recommendations for electrophysiologists.Trial registration numberChinese Clinical Trial Registry (ChiCTR2000028726).
Incidence, morbidity and mortality of hip fractures over a period of 20 years in a health area of Southern Spain
Authors: Rey-Rodriguez Marta M , Vazquez-Gamez MA , Giner Mercè , Garrachón-Vallo Fernando , Fernández-López Luis , Colmenero Miguel Angel , Montoya-García María-José 
Published: September 2020

ObjectiveTo evaluate the incidence of osteoporotic hip fracture in the Macarena Health Area (Seville).Setting and participantsThis was a prospective observational study that collected all osteoporotic hip fractures that occurred between March 2013 and February 2014 at the Clinical Unit of Traumatology and Orthopaedics. All cases collected during the first 6 months of the study were followed for 1 year after the occurrence of the event.Outcome measuresWe evaluated the incidence of osteoporotic hip fractures in the Macarena Health Area (Seville) from 1 March 2013 to 28 February 2014, and we compared the incidence with that in 2 previous studies carried out with the same methodology in 1994 and 2006. Furthermore, we calculated the morbidity and degree of disability 1 year after the fracture occurred and determined mortality and the associated factors.ResultsThe overall incidence was 228 per 100 000 individuals/year (95% CI 204.5 to 251.6), and the incidence was higher in women than in men. In women, the incidence rate decreased in all age groups over time, while in men, the incidence rate increased. The mortality rate 1 year after the episode was 27.2%. The factors associated with overall mortality were a body mass index below 25 kg/m2, renal failure and low plasma proteins.ConclusionsOur results show a high incidence of osteoporotic hip fracture that is increasing in men, and in men it is associated with a higher mortality than in women. There is room to improve the modifiable factors associated with mortality and the available rehabilitation interventions to reduce the disability associated with these fractures.
Mixed methods study protocol to examine perceptions of family medicine among long-term patients of a family medicine clinic in Japan
Authors: Sato Kotaro , Michinobu Ryoko , Kusaba Tesshu 
Published: September 2020

IntroductionFamily physicians or general practitioners play central roles in many countries’ primary care systems, but family medicine (FM) remains relatively unestablished in Japan. Previous studies in Japan have examined the general population’s understanding of FM as a medical specialty, but none have explored this topic using actual FM clinic patients. Here, we describe a protocol to explore the perceptions of FM among long-term patients of one of Japan’s oldest FM clinics.Methods and analysisThe study will be conducted at the Motowanishi Family Clinic in Hokkaido, Japan, using patients who have attended the clinic for over 10 years. The analysis will adopt a two-phase explanatory sequential mixed methods design. During phase I, quantitative data from participants’ medical records will be collected and reviewed, and patients’ perceptions of FM will be assessed through a questionnaire. The correlations between participants’ knowledge that the clinic specialises in FM and various characteristics will be examined. In phase II, qualitative data will be collected through semi-structured interviews of approximately 10 participants selected using maximum variation sampling based on phase I results. A thematic analysis will be conducted in phase II to identify patients’ perceptions and changes in perceptions. Finally, each theme identified in phase II will be transformed into a quantitative variable to analyse the relationships between the phases. A joint display will be used to integrate the phases’ findings and examine how phase II results explain phase I results.Ethics and disseminationThe institutional review board of the Japan Primary Care Association has approved this research (2019-003). The results will be presented at the association’s annual academic meeting and submitted for publication in relevant journals. The findings will also be provided to the patients via the clinic’s internal newsletter.
Implementation of regional Acute Stroke Care Map increases thrombolysis rates for acute ischaemic stroke in Chinese urban area in only 3 months
Authors: Sui Yi , Luo Jianfeng , Dong Chunyao , Zheng Liqiang , Zhao Weijin , Zhang Yao , Xian Ying , Zheng Huaguang , Yan Bernard , Parsons Mark , Ren Li , Xiao Ying , Zhu Haoyue , Ren Lijie , Fang Qi , Yang Yi , Liu Weidong , Xu Bing 
Published: September 2020

BackgroundThe rate of intravenous thrombolysis for acute ischaemic stroke remains low in China. We investigated whether the implementation of a citywide Acute Stroke Care Map (ASCaM) is associated with an improvement of acute stroke care quality in a Chinese urban area.MethodsThe ASCaM comprises 10 improvement strategies and has been implemented through a network consisting of 20 tertiary hospitals. We identified 7827 patients with ischaemic stroke admitted from April to October 2017, and 506 patients underwent thrombolysis were finally included for analysis.ResultsCompared with ‘pre-ASCaM period’, we observed an increased rate of administration of tissue plasminogen activator within 4.5 hours (65.4% vs 54.5%; adjusted OR, 1.724; 95% CI 1.21 to 2.45; p=0.003) during ‘ASCaM period’. In multivariate analysis models, ‘ASCaM period’ was associated with a significant reduction in onset-to-door time (114.1±55.7 vs 135.7±58.4 min, p=0.0002) and onset-to-needle time (ONT) (169.2±58.1 vs 195.6±59.3 min, p<0.0001). Yet no change was found in door-to-needle time. Clinical outcomes such as symptomatic intracranial haemorrhage, favourable functional outcome (modified Rankin Scale ≤2) and in-hospital mortality remained unchanged.ConclusionThe implementation of ASCaM was significantly associated with increased rates of intravenous thrombolysis and shorter ONT. The ASCaM may, in proof-of-principle, serve as a model to reduce treatment delay and increase thrombolysis rates in Chinese urban areas and possibly other highly populated Asian regions.
Resistance to Avapritinib in PDGFRA-Driven GIST Is Caused by Secondary Mutations in the PDGFRA Kinase Domain
Authors: Grunewald Susanne , Klug Lillian R. , Mühlenberg Thomas , Lategahn Jonas , Falkenhorst Johanna , Town Ajia , Ehrt Christiane , Wardelmann Eva , Hartmann Wolfgang , Schildhaus Hans-Ulrich , Treckmann Juergen , Fletcher Jonathan A. , Jung Sascha , Czodrowski Paul , Miller Stephen , Schmidt-Kittler Oleg , Rauh Daniel , Heinrich Michael C. , Bauer Sebastian 
Published: September 2020

Abstract

Gastrointestinal stromal tumors (GIST) harboring activating mutations of PDGFRA respond to imatinib, with the notable exception of the most common mutation, D842V. Avapritinib is a novel, potent KIT/PDGFRA inhibitor with substantial clinical activity in patients with the D842V genotype. To date, only a minority of PDGFRA-mutant patients treated with avapritinib have developed secondary resistance. Tumor and plasma biopsies in 6 of 7 patients with PDGFRA primary mutations who progressed on avapritinib or imatinib had secondary resistance mutations within PDGFRA exons 13, 14, and 15 that interfere with avapritinib binding. Secondary PDGFRA mutations causing V658A, N659K, Y676C, and G680R substitutions were found in 2 or more patients each, representing recurrent mechanisms of PDGFRA GIST drug resistance. Notably, most PDGFRA-mutant GISTs refractory to avapritinib remain dependent on the PDGFRA oncogenic signal. Inhibitors that target PDGFRA protein stability or inhibition of PDGFRA-dependent signaling pathways may overcome avapritinib resistance.

Significance:
Here, we provide the first description of avapritinib resistance mechanisms in PDGFRA-mutant GIST.
This article is highlighted in the In This Issue feature, p. 1
A fabricação da crença por imagens, sons, objetos e corpos
Authors: Barreto Marcus Vinícius 
Published: September 2020

Resenha de Meyer, Birgit Meyer. 2019. Como as coisas importam: uma abordagem material da religião. Organizado por E. Giumbelli, J. Rickli e R. Toniol. Porto Alegre: Editora da UFRGS.
Navegar entre silêncios
Authors: Valentini Luísa 
Published: September 2020

Resenha de Cánepa Koch, Gisela e Ingrid Kummels, orgs. 2018. Fotografía en América Latina: imágenes e identidades a través del tiempo y el espacio. Lima: Instituto de Estudios Peruanos.
Fotografia en América Latina (2018), livro editado por Gisela Cánepa Koch e Ingrid Kummels, reúne uma série de artigos sobre diferentes coleções fotográficas produzidas em contextos latino-americanos e as relações implicadas na produção de cada uma delas. O livro oferece uma visão panorâmica das proximidades e lacunas entre diferentes períodos históricos, diferentes perspectivas fornecidas pelos antropólogos e seus colaboradores de pesquisa ao longo do tempo e diferentes tradições dos estudos culturais e antropológicos da América Latina.
Make or Buy? The Provision of Indigent Defense Services in the United States
Authors: Shem-Tov Yotam 
Published: September 2020

Abstract
Most criminal defendants cannot afford to hire an attorney. To provide constitutionally mandated legal services, states commonly use either private court-appointed attorneys or a public defender organization. This paper investigates the relative efficacy of these two modes of indigent defense by comparing outcomes of codefendants assigned to different types of attorneys within the same case. Using data from San Francisco, I show that in multiple defendant cases, public defender assignment is plausibly as good as random. I find that public defenders reduce the probability of any prison sentence by 22% and the length of prison sentences by 10%.
Exchange Rate Reconnect
Authors: Lilley Andrew , Maggiori Matteo , Neiman Brent , Schreger Jesse 
Published: September 2020

Abstract
It is surprisingly difficult to find economic variables that strongly comove with exchange rates, a phenomenon codified in a large literature as “exchange rate disconnect.” We demonstrate that a variety of common proxies for global risk appetite, which did not comove with exchange rates prior to 2007, have provided significant in-sample explanatory power for currencies since then. Furthermore, during the 2007–2012 period, U.S. purchases of foreign bonds were highly correlated with these risk measures and with exchange rates. Our results support the narrative that the U.S. dollar's role as an international and safe-haven currency has surged since the global financial crisis.
Recognising Similarity in ‘Angers’ Across History
Authors: Parrott W. Gerrod 
Published: September 2020

Abstract
A family-resemblance approach to categorisation, such as that developed by Wittgenstein, provides a basis for conceiving how various historical types of ‘anger’ can be recognised as similar despite their variability and lack of core defining features. Thomas Dixon’s essay applies this approach in a way that avoids radical relativism and acknowledges general human emotional capabilities. His approach may arguably be extended to commonalities between emotions of humans and animals, which would have interesting implications for the history of emotion.
Animal-Human Compassion: Structures of Feeling in Dark Pastoral
Authors: Barnes Diana G. 
Published: September 2020

Abstract
This essay argues that animal-human compassion, defined as human fellow-feeling with (and not for) animals, is most urgently articulated at points of crisis in human history, such as the terrible bushfires and drought of the Australian summer of 2019–20. Literary history, particularly of pastoral literature, reveals animal-human compassion as a long-contested structure of feeling. The pastoral template established in classical literature, and refined in early modern literature, sets conventions for proper human-animal emotional relations. These ideals are radically destabilised in Andrew Marvell’s ‘dark pastoral’ civil war poetry. This troubled legacy flows through Australian settler-colonial writing about animals, particularly the kangaroo; Barron Field, Charles Harpur and Ethel Pedley strive to intervene in the patriotic myth-making associated with colonial settlement and Federation.
Compassion in the Garden: Radical Homemakers or Just More Women’s Work?
Authors: Mickelburgh Renée 
Published: September 2020

Abstract
Compassion is key to Australian women’s garden stories and return-to-the-home environmentalism. These stories highlight the gendered power implications of women’s work. Questions about who is suffering and who is caring are paramount. Women’s garden narratives are hopeful: they capture the interconnection between the local and global and the ethics of care promoted by ecofeminists. Yet when women gardeners embrace a care ethic which sees their own domestic workload skyrocket in order to alleviate environmental suffering, their compassion stories risk becoming what Lauren Berlant terms ‘collective norms of obligation’. Through aural storytelling in Pip permaculture magazine podcasts, women gardeners consider how the responsibility of ordinary, caring garden work fits within their already numerous, significant, and everyday caring responsibilities. Their collaboration reveals innovative solutions to this conundrum. Their compassionate garden work becomes a domestic practice of time, effort, and joy.
CD14, CD163, and CCR1 are involved in heart and blood communication in ischemic cardiac diseases
Authors: Chen Chengcong , Peng Hong , Zeng Yongmei , Dong Guoqing 
Published: September 2020

Objective Cardiac diseases lead to heart failure (HF), but the progression can take several years. Using blood samples to monitor changes in the heart before clinical symptoms begin may help to improve patient management. Methods Microarray data GSE42955 and GSE9128 were used as study datasets and GSE16499, GSE57338, and GSE59867 were used as validation groups. The “limma” package from R Language was used to identify differentially expressed genes. Functional enrichment analyses of gene ontology terms and Kyoto Encyclopedia of Genes and Genomes pathways were performed using Database for Annotation, Visualization and Integrated Discovery. We also investigated the correlation between the heart and blood using the mRNA expression level. Results Three hub genes, CD14, CD163, and CCR1, were identified. Functional enrichment analyses showed their involvement in the immune response and in the inflammatory response, which are the critical biochemical processes in ischemic HF. The mRNA expression level further demonstrated that a special model may exist to help to predict the mRNA level in the heart based on that in blood. Conclusions Our study identified three biomarkers that can connect the heart and blood in ischemic heart diseases, which may be a new approach to help better manage ischemic cardiac disease patients.
Technical challenges of performing S1 root block: role for double needle and multilevel needle technique
Authors: Gupta Sanjeeva , Gupta Harun , Baranidharan Ganesan , Sharma Manohar 
Published: September 2020

Introduction: S1 root block is performed for pain in the lower limbs due to S1 nerve root inflammation at the L5/S1 disc level or compression in the lateral recess. We often note anterior or posterior spread of contrast away from the L5/S1 disc through an anatomically appropriate needle tip placement. We frequently encounter vascular spread when performing S1 root blocks, and the reported incidence varies between 10.4% and 27.8%. There is no clear strategy published to manage these challenges. In such clinical scenarios, we propose a double needle and/or a multilevel needle technique. Case: A 39-year-old male presented with radicular pain in the left S1 distribution which matched the magnetic resonance imaging (MRI) scan findings and thus he was listed for a left S1 root block. A 22G needle was placed at the S1 level and upon injecting the contrast, vascular spread and anterior and distal spread along the nerve root were noted and the contrast did not reach the site of the pathology, the L5/S1 disc. The contrast continued to spread anteriorly despite withdrawing the needle. A second needle was placed medial and inferior to the first needle and the contrast spread now was adequate, that is, towards the L5/S1 disc and thus the injection was accomplished in a safe and satisfactory manner without needing to reschedule the procedure. Conclusion: Double needle technique can assist in overcoming problems encountered when performing an S1 root block. The alternatives could be the multilevel technique or to reschedule the procedure or consider a less optimal technique such as a caudal or a lumbar interlaminar epidural. In this technical report, we have highlighted various intervention options to mitigate such challenges and included a flow diagram to assist in decision-making. We have also discussed the possibility of altering the consent to accommodate the changes to the planned procedure.
A high-risk airway mycobiome is associated with frequent exacerbation and mortality in COPD
Authors: Tiew Pei Yee , Dicker Alison J. , Keir Holly R. , Poh Mau Ern , Pang Sze Lei , Mac Aogáin Micheál , Chua Branden Qi Yu , Tan Jiunn Liang , Xu Huiying , Koh Mariko Siyue , Tee Augustine , Abisheganaden John Arputhan , Chew Fook Tim , Miller Bruce E. , Tal-Singer Ruth , Chalmers James D. , Chotirmall Sanjay H. 
Published: September 2020

IntroductionThe chronic obstructive pulmonary disease (COPD) bacteriome associates with disease severity, exacerbations and mortality. While COPD patients are susceptible to fungal sensitisation, the role of the fungal mycobiome remains uncertain.MethodsWe report the largest multicentre evaluation of the COPD airway mycobiome to date, including participants from Asia (Singapore and Malaysia) and the UK (Scotland) when stable (n=337) and during exacerbations (n=66) as well as nondiseased (healthy) controls (n=47). Longitudinal mycobiome analysis was performed during and following COPD exacerbations (n=34), and examined in terms of exacerbation frequency, 2-year mortality and occurrence of serum specific IgE (sIgE) against selected fungi.ResultsA distinct mycobiome profile is observed in COPD compared with controls as evidenced by increased α-diversity (Shannon index; p<0.001). Significant airway mycobiome differences, including greater interfungal interaction (by co-occurrence), characterise very frequent COPD exacerbators (three or more exacerbations per year) (permutational multivariate ANOVA; adjusted p<0.001). Longitudinal analyses during exacerbations and following treatment with antibiotics and corticosteroids did not reveal any significant change in airway mycobiome profile. Unsupervised clustering resulted in two clinically distinct COPD groups: one with increased symptoms (COPD Assessment Test score) andSaccharomycesdominance, and another with very frequent exacerbations and higher mortality characterised byAspergillus,CurvulariaandPenicilliumwith a concomitant increase in serum sIgE levels against the same fungi. During acute exacerbations of COPD, lower fungal diversity associates with higher 2-year mortality.ConclusionThe airway mycobiome in COPD is characterised by specific fungal genera associated with exacerbations and increased mortality.