bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic impact of hyponatraemia and hypernatraemia at admission and discharge in heart failure patients with preserved, mid‐range and reduced ejection fraction
Authors: Vicent Lourdes , Alvarez‐Garcia Jesús , Gonzalez‐Juanatey José Ramón , Rivera Miguel , Segovia Javier , Worner Fernando , Bover Ramón , Pascual‐Figal Domingo , Vázquez Rafael , Cinca Juan , Fernandez‐Aviles Francisco , Martinez‐Sellés Manuel 
Published: April 2020

AbstractBackgroundHyponatraemia is common in patients with acute heart failure (HF). Aims: To determine the impact of sodium disturbances on mortality and readmissions in HF with reduced left ventricular ejection fraction (HFrEF), preserved ejection fraction (HFpEF) and mid‐range ejection fraction (HFmrEF).MethodsThis study was a prospective multicentre consecutive registry in 20 hospitals, including patients admitted due to acute HF in cardiology departments. Sodium <135 mmol/L was considered hyponatraemia, >145 mmol/L hypernatraemia and 135–145 mmol/L normal.ResultsA total of 1309 patients was included. Mean age was 72.0 ± 11.9 years, and 810 (61.9%) were male. Mean serum sodium level was 138.6 ± 4.7 mmol/L at hospital admission and 138.1 ± 4.1 mmol/L at discharge. The evolution of sodium levels was: normal‐at‐admission/normal‐at‐discharge 941 (71.9%), abnormal‐at‐admission/normal‐at‐discharge 127 (9.7%), normal‐at‐admission/abnormal‐at‐discharge 155 (11.8%) and abnormal‐at‐admission/abnormal‐at‐discharge 86 (6.6%). Hyponatraemia at discharge was more common in HFrEF (109 (20.7%)) than in HFpEF (79 (13.9%)) and HFmrEF (27 (12%)), P = 0.003. The prevalence of hypernatraemia at discharge was similar in the three groups: HFrEF (10 (1.9%)), HFpEF (12 (2.1%)) and HFmrEF (4 (1.9%)), P = 0.96. In multivariate analysis, abnormal sodium concentrations at hospital admission (hazard ratio (HR) 1.42, 95% confidence interval (CI) 1.15–1.76, P = 0.001) and discharge (HR 1.33, 95% CI 1.08–1.64, P = 0.007) were both independently associated with increased mortality and readmissions at 12 months.ConclusionsHyponatraemia and hypernatraemia at admission and discharge predict a poor outcome in patients with acute HF regardless of left ventricular ejection fraction. Hyponatraemia at discharge is more frequent in HFrEF than in the other groups.
Risk factors for pregnancy outcomes in Type 1 and Type 2 diabetes
Authors: Seah Jas‐mine , Kam Ning M. , Wong Lydia , Tanner Cara , Shub Alexis , Houlihan Christine , Ekinci Elif I. 
Published: April 2020

AbstractBackgroundUnderstanding the risk factors and pregnancy outcomes in women affected by Type 1 and Type 2 diabetes is important for pre‐pregnancy counselling.AimTo explore differences in pregnancy outcomes between women with Type 1 and Type 2 diabetes, and healthy controls, and to examine the relationships between potential adverse risk factors and pregnancy outcomes in this cohort of women.MethodsThis is a 10‐year retrospective study of women with Type 1 diabetes (n = 92), Type 2 diabetes (n = 106) and healthy women without diabetes (controls) (n = 119) from a tertiary obstetric centre. Clinical and biochemical characteristics of women with Type 1 and Type 2 diabetes were determined and related to major obstetric outcomes using univariate analysis.ResultsWomen with pre‐existing diabetes had higher adverse pregnancy outcomes (preeclampsia, emergency caesarean section, preterm birth <32 and 37 weeks, large for gestational age, neonatal jaundice, Apgar score < 7 at 5 min, neonatal intensive care admission and neonatal hypoglycaemia) compared to controls. A higher birth weight gestational centile (97.4% vs 72.4%, P = 0.001) and large for gestational age rate (63.4% vs 35.8%, P = 0.001) were observed in Type 1 diabetes compared to Type 2 diabetes. There were no differences in other outcomes between women with Type 1 and 2 diabetes.ConclusionIn this exploratory study, risk factors for maternal adverse outcomes differ between Type 1 and Type 2 diabetes. Maternal and foetal adverse outcomes were higher in pregnancies affected by diabetes compared to healthy women but occurred with similar frequency in women with Type 1 and Type 2 diabetes.
Genomic selection strategies to improve maternal traits in Norwegian White Sheep
Authors: Lillehammer Marie , Sonesson Anna K. , Klemetsdal Gunnar , Blichfeldt Thor , Meuwissen Theo H. E. 
Published: April 2020

AbstractThis study tested and compared different implementation strategies for genomic selection for Norwegian White Sheep, aiming to increase genetic gain for maternal traits. These strategies were evaluated for their genetic gain ingrowth, carcass and maternal traits, total genetic gain, a weighted sum of the gain in each trait and rates of inbreeding through a full‐scale stochastic simulation. Results showed genomic selection schemes to increase genetic gain for maternal traits but reduced genetic gain for other traits. This could also be obtained by selecting rams for artificial selection at a higher age. Implementation of genomic selection in the current breeding structure increased genetic gain for maternal traits up to 57%, outcompeted by reducing the generation interval for artificial insemination rams from current 3 to 2 years. Then, total genetic gain for maternal traits increased by 65%–77% and total genetic gain by18%–20%, but at increased rates of inbreeding.
Is experimentalist governance self‐limiting or self‐reinforcing? Strategic uncertainty and recursive rulemaking in European Union electricity regulation
Authors: Rangoni Bernardo , Zeitlin Jonathan 
Published: April 2020

AbstractIs experimentalist governance (XG) self‐limiting or self‐reinforcing by virtue of its relationship to strategic uncertainty as an essential scope condition? This article tackles this important but understudied question by elaborating a series of idealtypical pathways for the temporal evolution of XG in specific policy domains, ranging from reversion to hierarchical governance through endogenous reduction of strategic uncertainty at one extreme to institutionalization of experimentalism as a multipurpose governance architecture at the other. It then goes on to test the empirical validity of these contrasting theoretical expectations about the long‐term relationship between XG and strategic uncertainty through a process‐tracing analysis of electricity regulation in the European Union over a series of policy cycles since the 1990s. Building on and extending previous research in this domain, this article's findings strengthen empirical confidence in the theoretical expectation that XG is self‐reinforcing, while diminishing confidence in the claim that it is self‐limiting.
Evaluating the value of ecological water considering water quality and quantity simultaneously
Authors: Liu Jiyao , Zhao Minjuan , Yao Liuyang , Liu Wenxin , Fan Gongyuan 
Published: April 2020

AbstractThis study applies a choice experiment to evaluate the value of ecological water and investigate public preferences in the Shiyang River Basin, which is an ecologically fragile region in China. The four ecological attributes were ecological water quantity in the upper sub‐basin, ecological water quantity in the middle sub‐basin, ecological water quantity in the lower sub‐basin, water quality in Hongyashan Reservoir. The results show that water quality was the most preferred attribute among all the chosen attributes, and public prefer the increase of the ecological water quantity in the lower sub‐basin. In addition, it was concluded that increases of 40 million m3 and 60 million m3 of the ecological water quantity in the middle and lower sub‐basins, respectively, with the ecological water quality improved from Class IV to III, would be worth 2.82 billion RMB. The research findings are expected to support strategies for regional water resources allocation as well as help to understand public support for the policy.
Examining Program Quality in a National Junior Golf Development Program
Authors: Kramers Sara , Camiré Martin , Bean Corliss 
Published: April 2020

Golf Canada recently restructured its national junior golf development program, Learn to Play, going from an original curriculum that focused on teaching golf skills to an updated curriculum that integrates the teaching of golf and life skills. The purpose of the study was to examine whether there were differences in program quality through implementation of the original program compared with the updated program. Five coaches using the original program and nine coaches using the updated program took part in the study over an entire summer golf season. The 14 coaches (Mage = 40 years) were each systematically observed on three occasions (i.e., total of 42 observations) and completed an end-of-season program quality questionnaire. The data were subjected to descriptive statistical analyses. Results demonstrated that (a) coaches who implemented the updated program were observed fostering higher levels of program quality than coaches who implemented the original program and (b) researcher observation scores were significantly lower than coach questionnaire scores of program quality. Results are discussed to situate the influence of the updated program on markers of quality. Practical implications for coach education and explicit life skills curricula are discussed.
Implementation of a patient-specific tapering protocol at discharge decreases total opioid dose prescribed for 6 weeks after elective primary spine surgery
Authors: Joo Sarah S , Hunter Oluwatobi O , Tamboli Mallika , Leng Jody C , Harrison T Kyle , Kassab Kate , Keeton Jody D , Skirboll Stephen , Tharin Suzanne , Saleh Emam , Mudumbai Seshadri C , Wang Rachel R , Kou Alex , Mariano Edward R 
Published: April 2020

Background and objectivesAt our institution, we developed an individualized discharge opioid prescribing and tapering protocol for joint replacement patients and implemented the same protocol for neurosurgical spine patients. We then tested the hypothesis that this protocol will decrease the oral morphine milligram equivalent (MME) dose of opioid prescribed postdischarge after elective primary spine surgery.MethodsIn this retrospective cohort study, we identified all consecutive elective primary spine surgery cases 1 year before and after introduction of the protocol. This protocol used the patient’s prior 24-hour inpatient opioid consumption to determine discharge opioid pill count and tapering schedule. The primary outcome was total opioid dose prescribed in oral MME from discharge through 6 weeks. Secondary outcomes included in-hospital opioid consumption in MME, hospital length of stay, MME prescribed at discharge, opioid refills, and rates of minor and major adverse events.ResultsEighty-three cases comprised the final sample (45 preintervention and 38 postintervention). There were no differences in baseline characteristics. The total oral MME (median (IQR)) from discharge through 6 weeks postoperatively was 900 (420–1440) preintervention compared with 300 (112–806) postintervention (p<0.01, Mann-Whitney U test), and opioid refill rates were not different between groups. There were no differences in other outcomes.ConclusionsThis patient-specific prescribing and tapering protocol effectively decreases the total opioid dose prescribed for 6 weeks postdischarge after elective primary spine surgery. Our experience also demonstrates the potential generalizability of this protocol, which was originally designed for joint replacement patients, to other surgical populations.
Cockeysville marble: a heritage stone from Maryland, USA
Authors: Hannibal Joseph T. , Schnabel Lorraine 
Published: April 2020

Abstract
By virtue of its use in iconic monuments and historic buildings in the USA, Cockeysville marble, a dolomitic to calcitic lower Paleozoic (Cambrian/Ordovician) marble quarried in Baltimore County and adjacent areas in Maryland, is proposed as a potential Global Heritage Stone Resource. The most important use of this stone was for the Washington Monument in Washington, DC whose construction began in 1848; the second most important use was for the 108 columns of the United States Capitol's wings, completed in 1868. It was also used for two of the oldest major marble monuments in the USA, Baltimore's Battle Monument (dedicated in 1827) and Washington Monument (completed in 1829), as well as Baltimore's City Hall, Buffalo's Adkins Art Museum, Detroit's Fisher Building and parts of St Patrick's Cathedral in New York City. During the nineteenth century white Cockeysville was most desired, but a colourful variety, Mar Villa marble, was also used in the first decades of the twentieth century. Cockeysville marble is no longer quarried for dimension stone. All Cockeysville used outdoors has weathered to a lesser or great extent, but early testing indicating that the dolomitic marble would be more durable has proved to be true.
Protected Code Stroke
Authors: Khosravani Houman , Rajendram Phavalan , Notario Lowyl , Chapman Martin G. , Menon Bijoy K. 
Published: April 2020

Background and Purpose—
Hyperacute assessment and management of patients with stroke, termed code stroke, is a time-sensitive and high-stakes clinical scenario. In the context of the current coronavirus disease 2019 (COVID-19) pandemic caused by the SARS-CoV-2 virus, the ability to deliver timely and efficacious care must be balanced with the risk of infectious exposure to the clinical team. Furthermore, rapid and effective stroke care remains paramount to achieve maximal functional recovery for those needing admission and to triage care appropriately for those who may be presenting with neurological symptoms but have an alternative diagnosis.

Methods—
Available resources, COVID-19-specific infection prevention and control recommendations, and expert consensus were used to identify clinical screening criteria for patients and provide the required nuanced considerations for the healthcare team, thereby modifying the conventional code stroke processes to achieve a protected designation.

Results—
A protected code stroke algorithm was developed. Features specific to prenotification and clinical status of the patient were used to define precode screening. These include primary infectious symptoms, clinical, and examination features. A focused framework was then developed with regard to a protected code stroke. We outline the specifics of personal protective equipment use and considerations thereof including aspects of crisis resource management impacting team role designation and human performance factors during a protected code stroke.

Conclusions—
We introduce the concept of a protected code stroke during a pandemic, as in the case of COVID-19, and provide a framework for key considerations including screening, personal protective equipment, and crisis resource management. These considerations and suggested algorithms can be utilized and adapted for local practice.
Journeying into the Diplomatic Unknown: The Vergesellschaftung of the German Auswärtiges Amt
Authors: Bartonek Emilie 
Published: April 2020

Summary
All branches of modern governments struggle to adapt to social and political changes today, in an age when such changes follow each other with speed, and change the very fabric of society. Foreign ministries are doubly challenged as they not only are confronted with the changes of their domestic environment, but they also have to navigate the international arena which is another stage of frequent upheavals. As a consequence, the German Federal Foreign Office has ventured on a path of continuing reforms that have led to new structures in the organisation, human resources management and the use of new technologies. Compared to former ages, the German foreign ministry has turned into a complex, multifaceted bureaucratic apparatus with fluid borderlines, recognisably more of the same nature as German society as a whole.
Disabling Stereotypes: the Perception and Representation of Disability in Swahili Oral and Written Literature
Authors: Acquaviva Graziella 
Published: April 2020

Abstract
This article aims to investigate the ways in which the various forms of physical and mental disabilities are perceived and represented in Swahili oral and written literature (proverbs and some selected Swahili novels and short stories). Thinking about the concept of disability as a cultural construct – strictly connected to a rooted belief system – and to local policies related to the problem of social exclusion that in recent years have increasingly developed in the Swahili-speaking East African context, disability continues to be an interesting research topic. Although the movement for the rights of the people with disabilities (PWD) dates back to the colonial period, local media (newspapers and television) continue to propose images of deformed bodies feeding the stereotype of the disabled as a representation of the “other”, creating ever more discrimination. In such a context full of contradictions I will try to explore the role of literature and media in its educational and popularizing function and, in particular, how disabled people are perceived in collective imaginary.
The Nabhānīs: A Sketch for Understanding
Authors: al-Salimi Abdulrahman 
Published: April 2020

Abstract
The Nabhānī State first appeared in Oman in the 6th/12th century and lasted till the 11th/17th century. During this period the fall of Baghdad, which occurred in 656/1258, led to a number of radical political and cultural changes in the Gulf region, and the aim of the present study is to re-evaluate the conclusions of the (2002) study against a wider background. In doing so it will firstly re-evaluate the original and modern sources dealing with that period. Secondly, it will take a broader look at the political and regional situation at that time and its impact on the course of Oman’s historical development – in other words, it will consider Omani history within a regional context. Thirdly, it will look for the roots of that state and relate it more accurately to Oman’s historical chronology and regional context.
Can the Issuance of Hazardous-Weather Warnings Inform the Attribution of Extreme Events to Climate Change?
Authors: Durran Dale R. 
Published: April 2020

AbstractWhen extreme weather occurs, the question often arises whether the event was produced by climate change. Two types of errors are possible when attempting to answer this question. One type of error is underestimating the role of climate change, thereby failing to properly alert the public and appropriately stimulate efforts at adaptation and mitigation. The second type of error is overestimating the role of climate change, thereby elevating climate anxiety and potentially derailing important public discussions with false alarms. Long before societal concerns about global warming became widespread, meteorologists were addressing essentially the same trade-off when faced with a binary decision of whether to issue a warning for hazardous weather. Here we review forecast–verification statistics such as the probability of detection (POD) and the false alarm ratio (FAR) for hazardous-weather warnings and examine their potential application to extreme-event attribution in connection with climate change. Empirical and theoretical evidence suggests that adjusting tornado-warning thresholds in an attempt to reduce FAR produces even larger reductions in POD. Similar tradeoffs between improving FAR and degrading POD are shown to apply using a rubric for the attribution of extreme high temperatures to climate change. Although there are obviously significant differences between the issuance of hazardous-weather warnings and the attribution of extreme events to global warming, the experiences of the weather forecasting community can provide qualitative guidance for those attempting to set practical thresholds for extreme-event attribution in a changing climate.
Trade Openness and Diversification of External Financial Flows for Development: An Empirical Analysis
Authors: Gnangnon Sèna Kimm 
Published: April 2020

The implementation of sustainable development goals (SDGs) adopted in 2015 by the international community in the Agenda 2030 requires a substantial mobilization of financial resources. In the meantime, Goal 17 of this Agenda recognizes trade as an important means of the implementation of the SDGs. The current article investigates empirically the impact of openness to international trade on the diversification of external financial flows for development, which could help developing countries achieve the SDGs by 2030. To that end, three major external flows for development have been considered: development aid inflows, migrants’ remittances inflows and foreign direct investment (FDI) inflows. The analysis relies on a panel data set comprising 116 countries, over the period 1970–2017. The empirical analysis relies primarily on the two-step system generalized method of moments (GMM) approach and shows that greater trade openness exerts a positive and significant impact on the diversification of external financial flows for development, in particular, in the least developed countries (LDCs). As a result, greater openness to international trade could be an important tool for external capital flows diversification in developing countries. JEL Classification: F13, F14, F21, F24, F35, O20
Idiopathic refractory ascites after allogeneic stem cell transplantation: a previously unrecognized entity
Authors: Varma Ankur , Abraham Susan C. , Mehta Rohtesh S. , Saini Neeraj Y. , Honhar Medhavi , Rashid Munazza , Chen Julianne , Srour Samer A. , Bashir Qaiser , Rondon Gabriela , Oran Betul , Hosing Chitra M. , Nieto Yago , Kebriaei Partow , Alousi Amin M. , Ahmed Sairah , Marin David , Khouri Issa F. , Ciurea Stefan O. , Qazilbash Muzaffar H. , Rezvani Katy , Anderlini Paolo , Andersson Borje S. , Shpall Elizabeth J. , Champlin Richard E. , Popat Uday R. 
Published: April 2020

Abstract
At our center, we observed a series of patients who developed transudative refractory ascites secondary to noncirrhotic, non-veno-occlusive disease (VOD)–related portal hypertension after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Patients were considered to have idiopathic portal hypertension-related refractory ascites (IRA) if they developed ascites secondary to intrahepatic portal hypertension (serum ascites albumin gradient ≥1.1 g/dL or hepatic venous pressure gradient [HVPG] &gt;5 mm Hg), but did not meet the clinical criteria for classical VOD/sinusoidal obstructive syndrome (SOS) and did not have any alternate etiology of portal hypertension. From our institutional database, we identified 40 patients who developed IRA after allo-HSCT between 2004 and 2018. The patients’ median age at the time of allo-HSCT was 54 years (range, 21-73 years). The median time to development of IRA after allo-HSCT was 80 days (range, 16-576 days). The median number of paracentesis was 3 (range, 1-11), and 15 (38%) patients had an intraperitoneal catheter placed for continued drainage of the rapidly accumulating ascites. Portal pressures were measured in 19 patients; 6 (15%) had moderate portal hypertension (HVPG 6-9 mm Hg), and 13 (33%) had severe portal hypertension (HVPG ≥ 10 mm Hg). Liver biopsy was performed in 24 patients. None of the patients met the criteria for classical VOD/SOS (clinical/histological) or cirrhosis (histological). The cumulative incidence of nonrelapse mortality was 63%, and the median survival duration after the development of the IRA was 7 months (range, 0.8-125.6 months). IRA is a poorly understood and often fatal complication of allo-HSCT.