bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergent Transjugular Intrahepatic Portosystemic Shunt Creation in Acute Variceal Bleeding
Authors: Pandhi Mithil B. , Kuei Andrew J. , Lipnik Andrew J. , Gaba Ron C. 
Published: March 2020

AbstractEmergent transjugular intrahepatic portosystemic shunt (TIPS) creation is most commonly employed in the setting of acute variceal hemorrhage. Given a propensity for decompensation, these patients often require a multidisciplinary, multimodal approach involving prompt diagnosis, pharmacologic therapy, and endoscopic intervention. While successful in the majority of cases, failure to medically control initial bleeding can prompt interventional radiology consultation for emergent portal decompression via TIPS creation. This article discusses TIPS creation in emergent, acute variceal hemorrhage, reviewing the natural history of gastroesophageal varices, presentation and diagnosis of acute variceal hemorrhage, pharmacologic therapy, endoscopic approaches, patient selection and risk stratification for TIPS, technical considerations for TIPS creation, adjunctive embolotherapy, and the role of salvage TIPS versus early TIPS in acute variceal hemorrhage.
Concussion and Mild-Traumatic Brain Injury in Rural Settings: Epidemiology and Specific Health Care Considerations
Authors: Yue John K. , Upadhyayula Pavan S. , Avalos Lauro N. , Phelps Ryan R L. , Suen Catherine G. , Cage Tene A. 
Published: March 2020

Abstract

Background Mild-traumatic brain injury (mTBI) and concussions cause significant morbidity. To date, synthesis of specific health care disparities and gaps in care for rural mTBI/concussion patients remains needed.

Methods A comprehensive literature search was performed using PubMed database for English articles with keywords “rural” and (“concussion” or “mild traumatic brain injury”) from 1991 to 2019. Eighteen articles focusing on rural epidemiology (n = 5), management/cost (n = 5), military (n = 2), and concussion prevention/return to play (n = 6) were included.

Results mTBI/concussion incidence was higher in rural compared with urban areas. Compared with urban patients, rural patients were at increased risk for vehicular injuries, lifetime number of concussions, admissions for observation without neuroimaging, and injury-related costs. Rural patients were less likely to utilize ambulatory and mental health services following mTBI/concussion. Rural secondary schools had decreased access to certified personnel for concussion evaluation, and decreased use of standardized assessment instruments/neurocognitive testing. While school coaches were aware of return-to-play laws, mTBI/concussion education rates for athletes and parents were suboptimal in both settings. Rural veterans were at increased risk for postconcussive symptoms and posttraumatic stress. Telemedicine in rural/low-resource areas is an emerging tool for rapid evaluation, triage, and follow-up.

Conclusions Rural patients are at unique risk for mTBI/concussions and health care costs. Barriers to care include lower socioeconomic status, longer distances to regional medical center, and decreased availability of neuroimaging and consultants. Due to socioeconomic and distance barriers, rural schools are less able to recruit personnel certified for concussion evaluation. Telemedicine is an emerging tool for remote triage and evaluation.
A 360-Degree Surgical Approach for Correction of Cervical Kyphosis and Atlantoaxial Dislocation in the Case of Larsen Syndrome
Authors: Deora Harsh , Singh Suyash , Sardhara Jayesh , Behari Sanjay 
Published: March 2020

Abstract
Larsen syndrome is chronic debilitating disease that presents with multiple joint dislocations and severely affects the cervical spine in the form of cervical kyphosis and atlantoaxial dislocation. Children usually present in early with a myriad of deficits, compressive myelopathy being the most common. In addition to a bony compression, there is sometimes a soft tissue component, which is seldom addressed. We present here a case of atlantoaxial dislocation with cervical kyphosis due to Larsen syndrome, and along with our previous experience on syndromic atlantoaxial dislocations, we try to define an algorithm for the treatment approach of these onerous challenges. The importance of early intervention is also emphasized with a literature review of similar cases. In addition to the obvious physical damage, early intervention can also avoid the more sinister socioeconomic face of this debilitating disease.
Evaluating the Role of Oxidative Stress in Acute Ischemic Stroke
Authors: Menon Bindu , Ramalingam Krishnan , Kumar Rajeev 
Published: March 2020

Abstract

Background The role of oxidative stress in neuronal injury due to ischemic stroke has been an interesting topic in stroke research. Malondialdehyde (MDA) has emerged as a sensitive oxidative stress biomarker owing to its ability to react with the lipid membranes. Total antioxidant power (TAP) is another biomarker to estimate the total oxidative stress in stroke patients. We aimed to determine the oxidative stress in acute stroke patients by measuring MDA and TAP.

Materials and Methods MDA and TAP were determined in 100 patients with ischemic stroke and compared with that in 100 age- and sex-matched healthy adults. Demographic data, stroke severity measured by the National Institutes of Health Stroke Scale (NIHSS), and disability measured by the Barthel index (BI) were recorded. The association of MDA and TAP with other variables was analyzed by paired t-test.

Results Of the whole sample, 74% represented males. The mean NIHSS score was 13.11 and BI was 38.87. MDA was significantly higher in stroke patients (7.11 ± 1.67) than in controls (1.64 ± 0.82; p = 0.00). TAP was significantly lower in stroke patients (5.72 ± 1.41) than in controls (8.53 ± 2.4; p = 0.00). The lipid profile and blood sugar levels were also significantly higher in stroke patients. There was no association of MDA and TAP with other variables.

Conclusion We found that oxidative stress was associated with acute ischemic stroke. However, we could not establish an association between oxidative stress and the severity of acute stroke.
Mind the age gap
Authors: Fians Guilherme 
Published: March 2020

Abstract
Esperanto is neither an official nor a commonly spoken language anywhere in the world and, due to the limited number of people who speak this language from birth and who teach it to the next generation, the persistence of this speech community cannot rely on intergenerational language transmission. Based on a year of ethnographic fieldwork in France, mainly in Paris, this article explores continuities and discontinuities in the Esperanto community and movement bylooking at how present-day young Esperanto speakers use the language online and through networks of sociability. In asking what is transmitted from one generation of Esperanto speakers to the next, and how new communication technologies impact the ways in which people use the language, I analyse how the concentration of speakers from different age groups around distinct technologies creates a segmentation in this community that leaves some issues incommunicable and hard to transmit. I argue that, on the one hand, engaging with Esperanto through Esperanto associations and, on the other hand, through social media and non-institutionalised gatherings, shapesdifferent perceptions of the language, marking a shift from Esperanto as a forward-looking cause for activists to Esperanto as a tool for sociability and an intellectual game for language-lovers.
No thermoregulatory or ergogenic effect of dietary nitrate among physically inactive males, exercising above gas exchange threshold in hot and dry conditions
Authors: Fowler Rebecca , Jeffries Owen , Tallent Jamie , Theis Nicola , Heffernan Shane M. , McNarry Melitta A. , Kilduff Liam , Waldron Mark 
Published: March 2020

AbstractThe aim of this study was to determine the effect of five days dietary nitrate (NO3 −) consumption on exercise tolerance and thermoregulation during cycling in hot, dry conditions. In a double‐blind, randomised crossover design, 11 healthy males participated in an exercise tolerance test (Tlim) in the heat (35°C, 28% relative humidity), cycling above the thermoneutral gas exchange threshold, after five days of dietary supplementation, with either NO3 –rich beetroot juice (BR; ∼ 9.2 mmol NO3 −) or placebo (PLA). Changes in plasma [NO3 −] and nitrite [NO2 −], core and mean skin temperatures, mean local and whole‐body sweat rates, heart rate, perceptual ratings and pulmonary gas exchange were measured during exercise, alongside calorimetric estimations of thermal balance. Mean arterial pressures (MAP) were recorded pre‐Tlim. There were no differences in Tlim between conditions (BR = 22.8 ± 8.1 min; Placebo = 20.7 ± 7.9 min) (P = 0.184), despite increases in plasma [NO3 −] and [NO2 −] (P < 0.001) and a 3.8% reduction in resting MAP (P = 0.004) in the BR condition. There were no other differences in thermoregulatory, cardio‐metabolic, perceptual or calorimetric responses to the Tlim between conditions (P > 0.05). Dietary NO3 − supplementation had no effect on exercise tolerance or thermoregulation in hot, dry conditions, despite reductions in resting MAP and increases in plasma [NO3 −] and [NO2 −]. Healthy, yet physically inactive individuals with no known impairments in vasodilatory and sudomotor function do not appear to require BR for ergogenic or thermolytic effects during exercise in the heat.
Final report on supplementary comparison APMP.M.P-S9 in gas gauge pressure from 2 MPa to 20 MPa
Authors: Sainoo Likit , Khamnounsak Chaveng , Priruenrom Tasanee , Sabuga Wladimir , Ott Oliver , Manalo Radley F , Salazar Maryness I 
Published: March 2020

This report describes the results of a supplementary comparison of gas pressure standards at three National Metrology Institutes - National Institute of Metrology (Thailand) (NIMT), Physikalisch-Technische Bundesanstalt (PTB) and National Metrology Laboratory of the Philippines (NMLPHIL) - carried out within the framework of Asia-Pacific Metrology Programme (APMP) in order to determine their degrees of equivalence at pressures in the range from 2 MPa to 20 MPa for gauge mode. The pilot institute was NIMT. The measurements were carried out from February 2016 to July 2016. All participating institutes used pressure balances as their pressure standards. A reference pressure monitor was used as a transfer standard. Characteristics of the transfer standard were evaluated at the pilot institute and then used for uncertainty estimations. After completing the comparison measurements, the transfer standard showed a less stable behaviour than expected, resulting in a significant contribution to the uncertainties of the results. The degrees of equivalence that were evaluated in terms of differences of the participant's results and the comparison reference values divided by their expanded uncertainties (k=2) are all within the unity. This demonstrates equivalence of the compared standards on the uncertainty level, which is unfortunately dominated by the uncertainty of the transfer standard.

Main text

To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.
The final report has been peer-reviewed and approved for publication by the CCM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
Volume comparison at 10 μL, 100 μL and 1000 μL—calibration of micropipettes. Volume comparison at 10 mL—calibration of burette
Authors: Rurua Irma , Batista Elsa 
Published: March 2020

This report describes the results of international comparison within COOMET.M.FF-S8 (also known as supplementary comparison COOMET.M no. 767/GE/18). The comparison measurements between the two participants GEOSTM (pilot laboratory) and IPQ started in August 2018 and finished in December 2018.

Main text

To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.
The final report has been peer-reviewed and approved for publication by the CCM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
Analyzing the state of high-density areas in Japan after redevelopment projects
Authors: Tomita K , Kajita Y 
Published: March 2020

Abstract
Japan has many high-density residential areas that are prone to disasters. Therefore, the Ministry of Land, Infrastructure, Transport, and Tourism has conducted various projects to improve these areas. Housing environment issues have also become a major issue. Consequently, this study considers the activities in the redevelopment project and the issues that emerge afterward in the Setagaya ward (Tokyo), where the high-density area redevelopment was conducted. A result is the increase of young people and households in the area although the number of old people is still increasing. However, in the Setagaya area, a comparison of the population density and the green area ratio in 2011 and 2016 shows that the green area ratio increased although the population density in 2016 was higher than in 2011. This occurred due to the redevelopment of the ruins of the National Children’s Hospital into a condominium in 2008 and the efforts to achieve a green rate area ratio of 33% in Setagaya Ward by 2032. Green space has various functions in cities including in disaster prevention. As Japan is prone to disasters, the provision of green space is crucial.
An analysis of the spatial phenomena of women in Cigondewah Fabric Centre, Bandung, Indonesia
Authors: Agustina I H , Lingga N 
Published: March 2020

Abstract
The Bandung City government has established the Cigondewah fabric centre as a strategic commercial location in Bandung. This policy leads to the conversion of the settlement area into a commercial area, which creates spatial limitations for women in this area. Yet, it vital to consider the subject of space as the sustainability of the environment depends on human as the subjects in the space. In the case of Cigondewah fabric centre, the government should consider women because women experience space differently to men. Men can freely adapt to changes in space but women should be given more freedom. This is the case because women have specific physical values and religious limitations affect cultural norms.The objective of this paper is to reconstruct the spatial phenomena of women in Cigondewah. This study uses a qualitative method with an inductive approach based on several established spatial theories. Based on the findings, the study proposes a zoning classification that reflects the spatial phenomena of the women. Moreover, the paper proposes policy recommendations regarding the spatial conversion to have more consideration for women as subjects of space.
The Y-chromosome F haplogroup contributes to the development of Barrett’s esophagus-associated esophageal adenocarcinoma in a white male population
Authors: Westra W M , Rygiel A M , Mostafavi N , de Wit G M J , Roes A L , Moons L M G , Peppelenbosch M P , Ouburg S , Morré S A , Jacobs M , Siersema P D , Repping S , Wang K K , Krishnadath K K 
Published: March 2020

Summary
Barrett’s esophagus (BE) is a metaplastic condition of the distal esophagus, resulting from longstanding gastroesophageal reflux disease (GERD). BE predisposes for the highly malignant esophageal adenocarcinoma (EAC). Both BE and EAC have the highest frequencies in white males. Only a subset of patients with GERD develop BE, while &lt;0.5% of BE will progress to EAC. Therefore, it is most likely that the development of BE and EAC is associated with underlying genetic factors. We hypothesized that in white males, Y-chromosomal haplogroups are associated with BE and EAC. To investigate this we conducted a multicenter study studying the frequencies of the Y-chromosomal haplogroups in GERD, BE, and EAC patients. We used genomic analysis by polymerase chain reaction and restriction fragment length polymorphism to determine the frequency of six Y-chromosomal haplogroups (DE, F(xJ,xK), K(xP), J, P(xR1a), and R1a) between GERD, BE, and EAC in a cohort of 1,365 white males, including 612 GERD, 753 BE patients, while 178 of the BE patients also had BE-associated EAC. Univariate logistic regression analysis was used to compare the outcomes. In this study, we found the R1a (6% vs. 9%, P = 0.04) and K (3% vs. 6%, P = 0.035) to be significantly underrepresented in BE patients as compared to GERD patients with an odds ratio (OR) of 0.63 (95% CI 0.42–0.95, P = 0.03) and of 0.56 (95% CI 0.33–0.96, P = 0.03), respectively, while the K haplogroup was protective against EAC (OR 0.30; 95% CI 0.07–0.86, P = 0.05). A significant overrepresentation of the F haplogroup was found in EAC compared to BE and GERD patients (34% vs. 27% and 23%, respectively). The F haplogroup was found to be a risk factor for EAC with an OR of 1.5 (95% CI 1.03–2.19, P = 0.03). We identified the R1a and K haplogroups as protective factors against development of BE. These haplogroups have low frequencies in white male populations. Of importance is that we could link the presence of the predominantly occurring F haplogroup in white males to EAC. It is possible that this F haplogroup is associated to genetic variants that predispose for the EAC development. In future, the haplogroups could be applied to improve stratification of BE and GERD patients with increased risk to develop BE and/or EAC.
T5 Preliminary Analysis of a Phase 3 Open-label, Controlled, Randomized Trial Evaluating the Efficacy and Safety of a Bioengineered Regenerative Skin Construct in Patients with Deep Partial-thickness Thermal Burns
Authors: Holmes James H , Shupp Jeffrey W , Smith David J , Joe Victor C , Carson Joshua S , Litt Jeffrey , Kahn Steven , Short Tracee , Cancio Leopoldo C , Rizzo Julie A , Carter Jeffrey E , Foster Kevin N , Gibson Angela 
Published: March 2020

Abstract

Introduction
Autograft (AG) is the standard of care for treatment of severe burns. While AG provides effective wound closure (WC), the procedure creates a donor-site wound prone to dyspigmentation, infection, scarring, and pain. In a phase 1b trial, no deep partial-thickness (DPT) wound treated with a bioengineered regenerative skin construct (BRSC) required AG by Day 28 and WC at the BRSC site was achieved in 93% of patients by Month 3 (Holmes et al 2019). This phase 3 study evaluated the efficacy and safety of this BRSC in patients with DPT burns.

Methods
This phase 3 study (NCT03005106) enrolled patients aged ≥18 years with 3–49% total body surface area (TBSA) thermal burns on the torso or extremities. In each patient, two DPT areas (≤2,000 cm2 total) deemed comparable following excision were randomized to treatment with either cryopreserved BRSC or AG. Coprimary endpoints were 1) the difference in percent area of BRSC treatment site and AG treatment site autografted at 3 months and 2) the proportion of patients achieving durable WC of the BRSC treatment site without AG at 3 months. Safety assessments were performed in all patients. Efficacy was analyzed at 3 months and safety and scar follow-up continues to one year.

Results
A total of 71 patients were enrolled (mean [SD] age 44 [16] years; mean [SD] %TBSA 12.0 [8.4]). By Month 3, 4.3% (SD 21.6%) of all BRSC-treated area required AG compared with an additional regrafting of 2.1% of all AG-treated area (total 102.1% SD 13.1%; P&lt; .0001). Three patients subsequently required AG at their BRSC site, 2 of whom also required it at their AG sites; Durable WC without autografting at the BRSC treatment site was achieved at Month 3 in 83% of patients compared with 86% of patients at the AG site. The most common BRSC-related adverse event (AE) was pruritus, occurring in 11 (15%) patients. All BRSC-related AEs were mild or moderate in severity.

Conclusions
This phase 3 study achieved both coprimary endpoints, including significant autograft sparing and durable WC in DPT burns. This BRSC may offer a new treatment for severe burns to reduce or eliminate the need for AG.

Applicability of Research to Practice
This BRSC has shown clinical benefit in patients with DPT thermal burns, potentially mitigating donor site morbidity.

External Funding
Stratatech, a Mallinckrodt Company; Funding and technical support for the Phase 3 clinical study were provided by the Biomedical Advanced Research and Development Authority (BARDA), under the Assistant Secretary for Preparedness and Response, within the U.S. Department of Health and Human Services, under Project BioShield Contract No. HHSO100201500027C.
21 Racial Disparities in Outcomes After Burn Injury in a Universally Insured Military Population
Authors: Castillo-Angeles Manuel , Burns Christopher J , Kubasiak John , Riviello Robert , Salim Ali , Nitzschke Stephanie 
Published: March 2020

Abstract

Introduction
In our healthcare system, racial disparities are estimated to account for more than 83,000 deaths and an average of more than $57 billion per year. These disparities have been well described in the surgical and trauma setting. Lack of insurance has frequently been blamed for the persistence of racial disparities in healthcare. The objective of the current study was to determine whether racial disparities in outcomes exist in a universally insured population of military-/civilian-dependent burn patients.

Methods
The 2006–2014 TRICARE military insurance database was queried for patients 18–64 years, who had a diagnosis of thermal burns. The Department of Defense Military Health System provides full insurance coverage for active/reserve/retired members of the Armed Services and their dependents. Basic demographic data and clinical characteristics were obtained. Our main outcome was in-hospital mortality. Multivariable logistic regression models were built to determine the association between race and the primary outcome.

Results
A total of 6,206 patients with diagnosis of burn injury were included: 69.7% white, 13.4% black, 6.8 % Hispanic, and 10% other. Median age was 29 years (IQR 23 - 40), and 63.1% were female. Overall mortality was 1.03%. In unadjusted analysis, there was no significant association between race and mortality (p=0.963). After multivariate analysis, no significant differences were found among racial minorities relative to racially white patients. Even though not significant, black patients had lower odds of mortality (OR 0.49, 95% CI 0.18 – 1.32) and Hispanic patients had higher odds (OR 1.33, 95% CI 0.39 – 4/52) when compared to white patients.

Conclusions
Risk-adjusted analysis did not show a significant difference in mortality among minority burn patients when compared to white patients. Our findings show that in a population with universal insurance and virtual equal access to care, racial disparities are mitigated. This data will help to the development of disparities interventions and its applicability nationwide.

Applicability of Research to Practice
The apparent mitigation of racial disparities among universally insured burn patients reinforces the association of insurance and access to care to outcomes in healthcare.