bluuebunny/crossref_metadata_2025_split huggingface dataset:
SUN-195 Bilateral Aldosterone-Producing Adenomas: A New Subtype of Bilateral Primary Aldosteronism?
Authors: Maciel Ana Alice Wolf , de Freitas Thaís Castanheira , Balancin Marcelo L , Ledesma Felipe L , Goldbaum Tatiana S , Guimaraes Augusto , Silvino Junea P P , Petenuci Janaina , Cavalcante Aline C B S , Francisco C. Carnevale , Pilan Bruna , Yamauchi Fernando , Srougi Vitor , Tanno Fabio , Jose L Chambo , Latronico Ana Claudia , Zerbini Maria Claudia N , Fragoso Maria Candida B V , Mendonca Berenice Bilharinho , Almeida Madson Q 
Published: May 2020

Abstract
Background: Primary aldosteronism (PA) is the most common cause of endocrine hypertension (HT). PA subtypes include aldosterone-producing adenomas (APA) and bilateral adrenal hyperplasia. To date, few PA patients with bilateral adenomas have been reported, but only one case was well characterized by anatomopathological analysis and clinical outcome after adrenal sparing surgery (1).
Clinical case: A 53-year-old woman was referred to investigate resistant HT and hypokalemia. (3.0 mEq/L). PA screening revealed aldosterone (A) of 37.9 ng/dL, renin (R) &lt; 1.6 (4.4-46.1 mUI/L), A/R ratio of 24.8. Confirmatory testing confirmed PA diagnosis: seated saline infusion test (A= 83.3 ng/dL) and intravenous furosemide test (R= 3.1 mUI/L; positive test &lt;13 mUI/L). Hypercortisolism investigation revealed a non-suppressible cortisol after an overnight 1 mg low-dose dexamethasone suppression [cortisol (C)= 2.9 μg/dL and dexamethasone= 701 (˃130 ng/dL)], and normal urinary free cortisol, midnight salivary cortisol, plasma DHEAS and ACTH levels. Computed tomography demonstrated bilateral adrenal nodules without adrenal thickening: 3.5 cm right nodule (pre-contrast density of 7UH density; absolute wash-out of 71%) and 2.5 cm left nodule (pre-contrast density of 8UH density; absolute wash-out of 78%). Sequential adrenal venous (AV) sampling (AVS) under continuous cosyntropin infusion showed a lateralization index of 3.4 (bilateral disease &lt;4). Then, the patient underwent right adrenalectomy and left nodulectomy. In the postoperative period, she presented normalization of K+ levels and complete HT remission. She remained under hydrocortisone replacement for 2 months. After 2 months, biochemical evaluation revealed normal basal cortisol levels (13.3 µg/dL) and biochemical cure of PA (A= 3.1 ng/dL and R= 15.3 mUI/L). Currently, she doesn’t have symptoms of adrenal insufficiency after discontinuation of hydrocortisone. Anatomopathological analysis showed bilateral adenomas (Weiss score of 0) in both sides without adjacent hyperplasia. CYP11B2 immunohistochemistry displayed a strong staining in 50% of cells in the right adenoma and in 30% of cells in the left adenoma. Few aldosterone-producing cell clusters (APCC) were identified in the right zona glomerulosa, which is a frequent finding in normal adrenals.
Conclusion: We herein described a very rare case of PA caused by bilateral-producing adenomas, confirmed by AVS and CYP11B2 staining after adrenal sparing surgery.
SAT-242 Isolated Adrenocorticotropic Hormone Deficiency Secondary to the PD-1 Inhibitor Pembrolizumab
Authors: Mathew Justin , Mathias Priyanka , Bloomgarden Noah 
Published: May 2020

Abstract
Background: Immune checkpoint inhibitors (ICI’s) are now indicated in the treatment of several solid tumors and have improved the prognosis of patients with advanced malignancy. The expanded use of ICI’s has led to the rise of otherwise rare autoimmune sequelae. The overall incidence of ICI-induced autoimmune hypophysitis has increased to approximately 10%, but is only estimated to be 0.4% with PD-1 inhibitors specifically (1). Isolated ACTH deficiency from immune checkpoint inhibitors is rare, and very few cases secondary to the PD-1 inhibitor pembrolizumab have thus far been reported.
Clinical Case: A 75-year old woman with history of Stage IV lung adenocarcinoma presented to oncology clinic in July 2019 with progressive weakness, weight loss, and confusion for several weeks. She was found to be hypotensive and dehydrated in the clinic and subsequently was admitted to the hospital. A comprehensive infectious work-up was non-contributory. History revealed that after treatment failure with carboplatin, she was treated with pembrolizumab from January 2017 to June 2019 with excellent response. Laboratory evaluation on admission demonstrated an undetectable AM cortisol level of &lt; 1 ug/dL (n 5-25 ug/dL) with concomitant ACTH &lt; 5pg/mL (Roche cobas, n 7.2-63 pg/mL), consistent with central adrenal insufficiency. Testing of the remainder of the pituitary axis, including TSH (0.83uU/mL, n 0.4-4.6 uU/mL), FSH (34.7 mIU/mL, n &lt;150mIU/mL), LH (12.6mIU/mL, n &lt;60 mIU/mL), and IGF-1 (33ng/mL, n 34-245ng/mL), all returned within normal limits. Further chart review verified that she had not been exposed to any form of glucocorticoids within the past 6 months. MRI brain with contrast demonstrated no obvious pituitary disease. The patient was started on 5mg of prednisone daily, with significant improvement in mental status, appetite, and blood pressure. She was discharged home on maintenance prednisone for adrenal insufficiency due to presumed isolated corticotroph destruction.
Conclusions: Isolated ACTH deficiency is a very rare but potential consequence of pembrolizumab use. It can be especially difficult to diagnose in patients on chemotherapy who are at higher risk for dehydration and failure to thrive. Duration of pembrolizumab therapy should not preclude the diagnosis of isolated ACTH deficiency, as it can occur even as late as 2.5 years into therapy.
Reference: (1) Chang, L., Barroso-Sousa, R., Tolaney S., Hodi F.S., Kaiser, U.B., Min, L. Endocrine Toxicity of Cancer Immunotherapy Targeting Immune Checkpoints, Endocr Rev. 2019;40;17–65.
SAT-495 Thyrotoxicosis Presenting as Right Sided Heart Failure: Two Case Reports, Two Differing Outcomes Illustrating the Importance of Early Aggressive Treatment to Reverse Cardiac Dysfunction
Authors: Shah Pratik B , Dao Lisa , Andersen Bogi , Levin Ellis R 
Published: May 2020

Abstract
Background: Graves’ thyrotoxicosis can lead to life-threatening right heart failure requiring urgent treatment. We present two such cases to illustrate management challenges and the importance of early definitive treatment.
Clinical cases: The first case is a 41 year old female with Graves’ hyperthyroidism and severe right heart failure. Cardiac ECHO showed LVEF 76% with severe biatrial enlargement, TV regurgitation, and an enlarged RV. The liver was enlarged, transaminases were high, bilirubin was 24 mg/dl (0-1.4), and clotting was prolonged. Due to hepatic dysfunction, methimazole was held. She was not a candidate for I-131 as she had received iodinated contrast. Treatment with dexamethasone and SSKI normalized thyroid function over four days. She was discharged but presented two months later with worsened hyperthyroidism and right heart failure. She was a poor surgical candidate and I-131 was administered as definitive therapy. She developed PEA arrest the following day without recovery leading to withdrawal of care and death eight days later.
The second case is also a 41 year old female with an 18 year history of Graves’ disease, intermittently compliant with methimazole. She presented with hyperthyroidism and severe right heart failure. The liver was enlarged, transaminases were high, bilirubin was 5.1 mg/dl, and clotting was prolonged. Cardiac ECHO showed LVEF 66% with severe biatrial enlargement, TV and MV regurgitation, enlarged RV, and increased RA pressure. Due to hepatic dysfunction, methimazole was held. She was not a candidate for I-131 as she had received iodinated contrast. She was prepared for thyroidectomy with aggressive heart failure treatment, dexamethasone, SSKI, and cholestyramine. Thyroid function normalized over six days and she underwent total thyroidectomy eight days after admission without complications. Postoperative cardiac ECHO showed marked improvement of cardiac parameters.
Conclusion: Right heart failure is an uncommon and often overlooked complication that can arise in poorly managed or treatment-resistant Graves’ disease. It is life-threatening and requires aggressive normalization of thyroid function, treatment of heart failure, and timely definitive therapy with I-131 or thyroidectomy. Frequently complicated by liver abnormalities, the use of thionamides is questionable. Additionally, hospitalized patients have often been evaluated with iodinated contrast studies or treated with SSKI during the acute phase, which limit the use of I-131. Our cases show that dexamethasone, SSKI, and cholestyramine can rapidly normalize thyroid function. The first case ended in death, probably due to delay in definitive treatment, whereas the second patient had an early thyroidectomy with good outcome. We recommend aggressive treatment to normalize thyroid function and reverse cardiac dysfunction followed by early definitive therapy.
The Association of Frailty With Adverse Outcomes After Multisystem Trauma: A Systematic Review and Meta-analysis
Authors: Poulton Alexander , Shaw Julia F. , Nguyen Frederic , Wong Camilla , Lampron Jacinthe , Tran Alexandre , Lalu Manoj M. , McIsaac Daniel I. 
Published: May 2020

BACKGROUND:
Frailty strongly predicts adverse outcomes in a variety of clinical settings; however, frailty-related trauma outcomes have not been systematically reviewed and quantitatively synthesized. Our objective was to systematically review and meta-analyze the association between frailty and outcomes (mortality-primary; complications, health resource use, and patient experience-secondary) after multisystem trauma.

METHODS:
After registration (CRD42018104116), we applied a peer-reviewed search strategy to MEDLINE, EMBASE, and Comprehensive Index to Nursing and Allied Health Literature (CINAHL) from inception to May 22, 2019, to identify studies that described: (1) multisystem trauma; (2) participants ≥18 years of age; (3) explicit frailty instrument application; and (4) relevant outcomes. Excluded studies included those that: (1) lacked a comparator group; (2) reported isolated injuries; and (3) reported mixed trauma and nontrauma populations. Criteria were applied independently, in duplicate to title/abstract and full-text articles. Risk of bias was assessed using the Risk of Bias in Nonrandomized Studies-of Interventions (ROBINS-I) tool. Effect measures (adjusted for prespecified confounders) were pooled using random-effects models; otherwise, narrative synthesis was used.

RESULTS:
Sixteen studies were included that represented 5198 participants; 9.9% of people with frailty died compared to 4.2% of people without frailty. Frailty was associated with increased mortality (adjusted odds ratio [OR], 1.53; 95% confidence interval [CI], 1.37–1.71), complications (adjusted OR, 2.32; 95% CI, 1.72–3.15), and adverse discharge (adjusted OR, 1.78; 95% CI, 1.29–2.45). Patient function, experience, and resource use outcomes were rarely reported.

CONCLUSIONS:
The presence of frailty is significantly associated with mortality, complications, and adverse discharge disposition after multisystem trauma. This provides important prognostic information to inform discussions with patients and families and highlights the need for trauma system optimization to meet the complex needs of older patients.
Urban Air
Authors: Negi Rohit 
Published: May 2020

Abstract
With toxic air emerging as one of the biggest risks facing urban residents globally, alongside the possibilities of designing “domes” of purified atmospheres, air has lately emerged as a productive object of critical urban inquiry. This essay delves into the manner in which air is being thought and written about, the various attempts to govern it, the production of identities and solidarities around it, and what it means to live with toxic air across urban regions. It argues that the debate on urban air contributes strongly to current thinking around questions of citizenship, science, and justice.
The Camp
Authors: Abourahme Nasser 
Published: May 2020

Abstract
The figure of the camp towers over our present. Our planners find it indispensable. Our political grammar finds it unavoidable. Our very conceptions of “the city,” and its once stable inside/outside demarcations, find its challenge insuperable. Not only do more people and more categories of people inhabit camps than ever before, from refugees and migrants to the homeless and detainees, but the camp form today proliferates at the heart of urban space and across the global North/global South divide. Camps are no longer temporary sites of emergency management. They are a global logic of government, an enduring colonial technology at the heart of the response to the climate/border crisis. Taking up the example of the Palestinian refugee camp, this article argues that camps no longer teach us anything about legal exceptions; rather they underline the politics of inhabitation. Camps enact the collapse of the separation between life and politics by making the very fact of inhabitation in itself the basis of political control and contestation. If our world is becoming uninhabitable, the camp, the most common defense against racialized bodies moving to find a place to live, becomes the place where the very political stakes of inhabitation come to the fore.
The Concrete Jungle
Authors: Martinez Diana 
Published: May 2020

Abstract
Focusing on reinforced concrete technology, the purpose of this essay is to underscore the particular material conditions that made the concrete city—presented as synonymous with the modern urban condition—not only possible but global. By examining Chicago and Manila through the technologies that drove their tandem growth, this essay also argues for a different view of urbanization in the developing world, as a part of and not distinct from the urbanization of the colonial metropole.
Skill as Problem-Space in the Contemporary Mumbai Construction Industry
Authors: Sturman Rachel 
Published: May 2020

Abstract
The ubiquity of building construction in contemporary Mumbai is transforming everyday urban life and landscape. This article examines one facet of the building construction industry: its organization of labor through distinctions of skill. Distinctions among skilled, semiskilled, and unskilled labor shape the everyday work of building, yet these terms only partially map onto hierarchies of embodied capacities and know-how. At least two vectors are producing what I term a “problem-space” concerning skill. On one hand, long-standing patterns of informal learning by doing and solving problems at hand are now being challenged by a new industry emphasis on formal training as the basis for skill. On the other hand, builders do not necessarily seek to change their heavy reliance on labor categorized as unskilled, at times viewing technology as an ultimate solution to what they see as the limitation of the majority of workers. Workers, for their part, while largely eschewing a language of skill, nonetheless valorize a variety of forms of embodied knowledge and ability, including those involved in exiting the strenuous work of building to become a contractor of construction labor.
Translocal Householding
Authors: Ramamurthy Priti 
Published: May 2020

AbstractThe urban experience remains inextricably entangled with the rural for millions of poor migrants to cities in the global South who labor in informal economies. Translocal households, households that share the labor and costs of social reproduction spatially across the city and the country, are an important site of entanglement, empirically and imaginatively. The dynamics of translocal householding in the oral histories of two migrants to Delhi reveal intermittent pathways of escape from and recuperation of normative hierarchies of social difference—especially of gender and caste—over life times and spaces. The need for care and rejuvenation lead to creating new forms of community and unexpected friendships in cities, with village households a fallback. In the process of seeking aspirations, refuge, belonging, and a final resting place, it is likely that hierarchies based on social difference shift but are recuperated in translocal households.
Disidentification with Nationalist Conflict
Authors: Drury Mark 
Published: May 2020

AbstractThis article explores how physical movement and political mobility have been central to different forms of loyalty and critique that have historically underpinned political authority in the Sahara. After outlining several expressions of loyalty characteristic of political authority in the Sahara and their interrelationship with movement and mobility, the article focuses on the figure of the ‘a'id, or returnee, a subject position that has been produced by the conflict between Morocco and the Sahrawi Arab Democratic Republic state-in-exile. Defined as someone who leaves Sahrawi refugee camps and “returns” to Morocco, the ‘a'id has been associated with betrayal and opportunism since emerging as a subject position near the end of armed conflict in the late 1980s. As the significance of this subject position has changed, the article considers how the ‘a'id illustrates the politics of disidentification for those subjected to the binaries of prolonged nationalist conflict.
Is Orientalism Islamic?
Authors: Amer Meziane Mohamed 
Published: May 2020

Abstract
Since many orientalists make Revelation to Muhammad meaningful in terms of hermeneutical engagement, does it mean that orientalism should be deemed Islamic? By raising this deliberately provocative question, this essay examines the ways in which definitions of Islam do or do not challenge orientalism. Is it possible to construct a “post-orientalist” definition of Islam without enacting a continuous critique of orientalism? Is such a critique exhausted by Edward W. Said's famous book, Orientalism, as it is too often assumed, or are we still confined by its impasses? These questions define the method that structures the essay's argument.
“Removed from Nature”
Authors: Anderson Kay , Perrin Colin 
Published: May 2020

AbstractIn the context of current concerns within the environmental humanities to challenge the idea that humans are somehow irreducible to nature, this article takes up the much-neglected history of the idea of human exceptionality itself. According to now familiar accounts, metaphysical assumptions about the unique status of the human are considered to have persisted—including to the present day—despite evolutionary contentions that the human should be understood as a purely physical being. Such, largely Christian and Cartesian, metaphysical notions of a human soul or mind doubtlessly endure. But in this article we consider the—largely ignored, yet now arguably more prevalent—idea that humans are exceptional because of their physicality. Here, then, we outline the emergence of the scientific claim that a uniquely human condition of nature transcendence is owed not to some immaterial quality of mind or soul, but rather to the distinctiveness of human anatomy. It was, we will argue, the body—and, above all, the head—which provided the basis of a modern attempt to establish that humans were creatures of a categorically different order from all other animals. More precisely, it was as human cultural differences were correlated with variations in the size and shape of the head that the human body, in its upright stature, came to provide an explicitly materialist—and, as we shall see, potently ethnocentric—foundation for the claim that human beings are exceptional. The modern idea of human exceptionality is thus shown to be based in large part on a scientifically dubious, and culturally specific, argument about the nature-transcendent quality of beings that walk upright. This is a particular form of humanist discourse that often forgets its own contingencies and instabilities, as well as its comprehensively violent inheritances.
Dynamic Matching in School Choice: Efficient Seat Reassignment After Late Cancellations
Authors: Feigenbaum Itai , Kanoria Yash , Lo Irene , Sethuraman Jay 
Published: May 2020

In the school choice market, where scarce public school seats are assigned to students, a key operational issue is how to reassign seats that are vacated after an initial round of centralized assignment. Practical solutions to the reassignment problem must be simple to implement, truthful, and efficient while also alleviating costly student movement between schools. We propose and axiomatically justify a class of reassignment mechanisms, the permuted lottery deferred acceptance (PLDA) mechanisms. Our mechanisms generalize the commonly used deferred acceptance (DA) school choice mechanism to a two-round setting and retain its desirable incentive and efficiency properties. School choice systems typically run DA with a lottery number assigned to each student to break ties in school priorities. We show that under natural conditions on demand, the second-round tie-breaking lottery can be correlated arbitrarily with that of the first round without affecting allocative welfare and that reversing the lottery order between rounds minimizes reassignment among all PLDA mechanisms. Empirical investigations based on data from New York City high school admissions support our theoretical findings. This paper was accepted by Gad Allon, operations management.
Zeros
Authors: Bandi Federico M. , Kolokolov Aleksey , Pirino Davide , Renò Roberto 
Published: May 2020

Asset prices can be stale. We define price staleness as a lack of price adjustments yielding zero returns (i.e., zeros). The term idleness (respectively, near idleness) is, instead, used to define staleness when trading activity is absent (respectively, close to absent). Using statistical and pricing metrics, we show that zeros are a genuine economic phenomenon linked to the dynamics of trading volume and, therefore, liquidity. Zeros are, in general, not the result of institutional features, like price discreteness. In essence, spells of idleness or near idleness are stylized facts suggestive of a key, omitted market friction in the modeling of asset prices. We illustrate how accounting for this friction may generate sizable risk compensations in short-dated option returns. This paper was accepted by Kay Giesecke, finance.
Guerras por recursos: o petróleo no Brasil | Resource wars: the petroleum in Brazil
Authors: Alvarenga Alexandre Andrade 
Published: May 2020

O objetivo desse artigo foi analisar o setor de petróleo no Brasil a partir de uma perspectiva geopolítica de “guerras por recursos”, que caracteriza a geopolítica moderna como uma ordem internacional marcada por crescentes disputas e conflitos por recursos naturais e energéticos estratégicos. Entendendo “guerras por recursos” tanto como disputas e conflitos bélicos e militares quanto disputas e conflitos políticos, econômicos e sociais pelo acesso e controle de recursos estratégicos, como o petróleo, o artigo procurou entender como esse fenômeno se manifesta no Brasil e identificar os principais atores, estratégias, ações, reações e pressões relacionadas ao tema. Para tanto, realizou-se uma breve apresentação conceitual sobre “guerras por recursos” e uma revisão bibliográfica e de notícias relacionadas ao petróleo no Brasil.Palavras-chave: Guerras por recursos; Petróleo; Brasil.ABSTRACTThis article proposes a reflection on the oil sector in Brazil according to the perspective of “resource wars”, which characterizes the modern geopolitics as an international order marked by growing disputes and conflicts for strategic natural and energy resources. Understanding “resource wars” as much as warlike disputes and conflicts, as political, economic and social disputes promoted by different actors over natural resources access and control, the article sought, more specifically, to understand how this disputes and conflicts occur in Brazil and to identify the main actors, context, strategies and actions related to the subject. To achieve this goal, a brief conceptual presentation about resource war was made along with a literature and news review.Keywords: Resource wars; Petroleum; Brazil. Recebido em: 16 Dez.2019 | Aceito em: 02 Mar. 2020