bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding drivers of illiberal entrenchment at critical junctures: institutional responses to COVID-19 in Hungary and Poland
Authors: Hajnal György , Jeziorska Iga , Kovács Éva Margit 
Published: January 2021

The present article aims to improve understanding of institution formation in (former) liberal-democratic polities characterized by autocratization tendencies. We examine how the critical juncture created by the COVID-19 pandemic was used, as well as the interplay between antecedent, structural conditions and the particular combinations of political agency and contingency. By comparing the two similar cases of Hungary and Poland – the two European Union countries that have progressed the farthest towards illiberal transformation – and using documentary and interview evidence, we conclude that: (1) whereas Hungary exhibited significant institutional changes, Poland did not; (2) these differences in institutional outcomes can be significantly attributed to differences in certain critical antecedent conditions; and (3) the ability of key political actors – Hungary’s Viktor Orbán and Poland’s Jarosław Kaczyński – to control their own political camp seems to have exerted an unmistakable effect as well. Points for practitioners The build-up and entrenchment of institutions of illiberal rule in (previously) liberal-democratic contexts are encumbered by diverse political and institutional constraints. External shocks, such as the COVID-19 crisis, may offer an opportunity to bypass those constraints and to change institutions permanently. Our study concludes that the extent to which such historical windows of opportunity can indeed be used to achieve lasting institutional changes depends not only on the objective, historically given political and institutional constraints that illiberal reforms face, but also on their subjective ability to act in a controlled, coordinated and coherent manner.
Test and analysis of air flow rate adaptive performance in a distributed fan ventilation system
Authors: Ju Fa-Li , Sun Qinrong , Hou Changlei , Huang Xue , Yu Xiaoping , Liu Liying 
Published: January 2021

In this study, adaptive branch fan performance in a distributed fan ventilation system was tested. The results demonstrate that the adaptive branch fan stabilises the branch air flow rate within a certain air pressure range corresponding to the branch duct inlet, and this range becomes increasingly narrow as the fan control signal is adjusted to reduce the speed of the fan. The adaptive branch fan is less affected by the main fan and other branch fans in the distributed fan ventilation system because it has a good self-adaptive ability of ventilation duct resistance characteristics and anti-interference ability of the air flow rate. Furthermore, the hydraulic characteristics of the branch fans in the distributed fan ventilation system were analysed. The new performance characterisation parameters and method for modifying the engineering design for the adaptive branch fan were presented. Practical application: This study investigates the adaptive performance of the branch fan in a distributed fan ventilation system. Our results demonstrate that the new branch fan can stabilise the air flow rate in a mechanical ventilation system. More importantly, we not only propose performance characterisation parameters of the adaptive branch fan that are important for understanding the operation of a mechanical ventilation system, but also present a method of engineering design application. This study can guide the design and operation of mechanical ventilation systems.
Predicting Adverse Histopathology and Need for Postsurgical Adjuvant Therapy for Human Papilloma Virus–Associated Oropharynx Carcinoma
Authors: Ochoa Edgar , Stanford‐Moore Gaelen , Fakhry Carole , Ryan William R. 
Published: January 2021

ObjectiveFor human papillomavirus–associated oropharynx carcinoma treated with definitive surgery, we aimed to find predictors of adverse histopathology indicating the possible need for adjuvant therapy.Study DesignRetrospective review.SettingNational Cancer Database.MethodsWe analyzed 2347 eligible patients from 2010 to 2015. We evaluated (1) the ability of clinical nodal staging and extranodal extension designation per the AJCC, seventh edition (American Joint Committee on Cancer), to predict histopathology and (2) the likelihoods for adverse postsurgery histopathology by common clinical stages.ResultsClinical nodal staging predicted pathologic nodal staging 65% of the time, with 24% (569/2347) being upstaged and 11% (251/2347) being downstaged. In patients with cN+ disease, clinical extranodal extension distinction had the following accuracy for pathologic extranodal extension: positive predictive value, 81% (88/109); negative predictive value, 73.1% (505/691); sensitivity, 32.1% (88/274); and specificity, 96.0% (505/526). Patients with cT1‐2, N0‐N2c, without clinical extranodal extension had the following proportions of pN2+ without pathologic extranodal extension (indicating consideration for adjuvant radiation): cN0, 11%; cN1, 31%; cN2a, 67% (8% downstaged); cN2b, 66% (6% downstaged); and cN2c, 35% (17% downstaged). From this group, patients had the following proportions of pathologic extranodal extension (indicating consideration for adjuvant chemoradiation): cN0, 6%; cN1, 20%; cN2a, 27%; cN2b, 28%; and cN2c, 48%.ConclusionFor human papillomavirus–associated oropharynx carcinoma, nodal clinical staging per the American Joint Committee on Cancer, seventh edition, predicts pathologic stage about two‐thirds of the time, leading to up‐ and downstaging. Clinical extranodal extension assessment has low sensitivity and moderate predictive capability. With careful selection, definitive surgery can allow patients to often avoid adjuvant chemotherapy and sometimes avoid adjuvant radiation.
Open Door System and Endogenous Growth in Indian Economy: An Empirical Analysis on the Role of Human Capital and R&D in Explaining Industrial Productivity
Authors: Arjun K.  , Kumar Sanjay , Sankaran A. , Das Mousumi 
Published: January 2021

The present study investigates the impact of human capital, knowledge capital which is a function of human capital, and real exchange rate scenario in explaining long-run industrial total factor productivity (TFP) from 1980 to 2015 on the theoretical basis of the open endogenous growth model. The variables employed in the contemporary study include manufacturing value added (MNVA) as industrial output measure, gross fixed capital formation (GFCF) as a measure of capital and labour input which is measured using employment data. Gross enrolment ratio (GER) is taken as a measure for human capital formation, expenditure on research and development (R&D) as a proxy for knowledge capital, and real exchange rate indicates global economic shocks. The study involves estimating TFP for Industrial Sector during the post-liberalization period by employing Cobb-Douglas production function. The ARDL bounds test technique for cointegration revealed long-run relation among the varying factors studied. The Toda-Yamamoto causality test concluded bi-directional causality running between, R&D expenditure and Industrial TFP which sends a strong signal to the policymakers for a well-framed long-term integrated approach for human & knowledge capital formation which will act as a strong impetus for manufacturing firms to come up in terms of augmenting production and productivity and expanding foreign market horizon. JEL Classification: D24, E2, J24
Pre-competition body mass loss characteristics of Brazilian jiu-jitsu competitors in the United Kingdom
Authors: White Tyler , Kirk Christopher 
Published: January 2021

Background: Brazilian jiu-jitsu (BJJ) is a grappling-based combat sport in which competitors engage in pre-competition acute ‘weight’ loss (AWL) and rapid ‘weight’ loss (RWL) to achieve the body mass (BM) required for their desired division. AWL/RWL practices of UK BJJ competitors have not previously been reported. Aim: Our aim in this study was to determine the prevalence, magnitude and stakeholder influences of AWL and RWL amongst BJJ participants in the United Kingdom (UK). A secondary aim was to explore whether there is any influence of time spent in the sport or competition frequency on AWL/RWL practices. Methods: In this study we used the rapid weight loss questionnaire (RWLQ) adapted for BJJ to determine the prevalence and magnitude of AWL/RWL in UK BJJ, the prevalence of methods used and the key stakeholder influences on these practices. As a secondary investigation we aimed to determine whether there was any effect of age starting BJJ on AWL/RWL. Results: Of 115 completed responses, 59% stated they performed AWL/RWL before competition. Mean BM loss for this competition was 1.9 ± 3.8 kg (2.3 ± 4.6%), with 34% of participants starting BM loss 3–7 days prior and 16% starting 0–2 days prior. Methods used tend to be achieving calorie deficit via exercise and diet rather than hypohydration, with little advice from formally qualified personnel. Participants who perform AWL/RWL started training (BF10 = 199, d = .72) and competing (BF10 = 107, d = .68) in BJJ younger than those who do not perform AWL/RWL. Conclusions: AWL/RWL is prevalent in UK BJJ, but not at the magnitude of other combat sports or countries. Though negative effects of extreme hypohydration are unlikely, there may be a higher chance of eating disorders in BJJ, particularly due to the young age of AWL/RWL commencement.
Vancomycin Wrap for Anterior Cruciate Ligament Surgery: Molecular Insights
Authors: Atherton Caroline M. , Spencer Simon J. , McCall Katy , Garcia-Melchor Emma , Leach William J. , Mullen Michael , Rooney Brian P. , Walker Colin , McInnes Iain B. , Millar Neal L. , Akbar Moeed 
Published: January 2021

Background: The use of the vancomycin wrap to pretreat the hamstring graft in anterior cruciate ligament reconstruction (ACLR) has grown in popularity since it was first described in 2012 and has significantly reduced rates of postoperative infection. However, it remains unknown if this antibiotic treatment affects the molecular composition of the graft. Purpose: To establish whether treatment with vancomycin at 5 mg/mL, the most commonly used concentration, alters the molecular function of the hamstring graft in ACLR. Study Design: Controlled laboratory study. Methods: Surplus hamstring tendon collected after routine ACLR surgery was used for in vitro cell culture and ex vivo tissue experiments. Vancomycin was used at 5 mg/mL in RPMI or saline diluent to treat cells and tendon tissue, respectively, with diluent control conditions. Cell viability at 30, 60, and 120 minutes was assessed via colorimetric viability assay. Tendon cells treated with control and experimental conditions for 1 hour was evaluated using semiquantitative reverse transcription analysis, immunohistochemistry staining, and protein quantitation via enzyme-linked immunosorbent assay for changes in apoptotic, matrix, and inflammatory gene and protein expression. Results: Vancomycin treatment at 5 mg/mL significantly reduced tenocyte viability in vitro after 60 minutes of treatment ( P < .05); however, this was not sustained at 120 minutes. Vancomycin-treated tendon tissue showed no significant increase in apoptotic gene expression, or apoptotic protein levels in tissue or supernatant, ex vivo. Vancomycin was associated with a reduction in inflammatory proteins from treated tendon supernatants (IL-6; P < .05). Conclusion: Vancomycin did not significantly alter the molecular structure of the hamstring graft. Reductions in matrix protein and inflammatory cytokine release point to a potential beneficial effect of vancomycin in generating a homeostatic environment. Clinical Relevance: Vancomycin ACL wrap does not alter the molecular structure of the ACL hamstring graft and may improve graft integrity.
Brazilian Older People Hospitalized by COVID-19: Characteristics and Prognostic Factors in a Retrospective Cohort Study
Authors: Santos Marquiony M. , Lucena Eudes E. S. , Bonfada Diego , Santos Aramis Costa , Vechi Hareton Teixeira , Lima Kenio C. 
Published: January 2021

Objective: Analyzing the survival of older people hospitalized due to COVID-19 in Brazil and identifying its main predictive factors for death. Method: This is a retrospective, multicenter cohort study, based on 20,831 records of hospitalizations of older people due to SARS-CoV-2 in Brazil. The observation period was from February 28 to May 18, 2020. Results: There was a reduced overall survival time of 47.70% (95% confidence interval [CI] = [46.72%, 48.67%]) in 10 days. The variables age, race, education, intensive care unit (ICU), region, day of hospitalization, time elapsed between the first symptom and hospitalization, and the municipality that provided assistance showed increased risk of death using the multiple Cox proportional-hazards model. Conclusion: These results emphasize the relevance of inequality and access to health services as determinants for the death of older people with COVID-19.
Albumin-to-globulin ratio (AGR) as a potential marker of predicting lupus nephritis in Chinese patients with systemic lupus erythematosus
Authors: Liu Xin-Ran , Qi Yuan-Yuan , Zhao Ya-Fei , Cui Yan , Wang Xiao-Yang , Zhao Zhan-Zheng 
Published: January 2021

Objectives To evaluate a potential role of albumin-to-globulin ratio (AGR) in the development of lupus nephritis (LN) and determine the potential to use AGR as a marker for future LN in systemic lupus erythematosus (SLE) patients. Methods 194 newly diagnosed SLE patients without renal impairment were followed. The clinical data were collected and analyzed at the time of initial diagnosis of SLE and the end of follow-up. We compared baseline characteristics between those who did or did not develop LN on follow-up. Univariate and multivariate Cox hazard analysis were used to identify predictors of lupus nephritis. Results Among the 194 newly diagnosed SLE patients without renal impairment, 26 (13.40%) patients were diagnosed with LN during a median follow-up of 53.87 months. On univariate Cox analysis, patients with the history of alopecia, higher SBP, lower AGR, lower CRP, lower C3, lower C4, higher anti-dsDNA Ab, presence of ANA homogeneous patterns or higher SLEDAI had an increased probability of developing LN. In a multivariate model, the history of alopecia (adjust hazard ratio, aHR = 3.614, 95%CI 1.365-9.571 P = 0.010), lower AGR (aHR = 6.968, 95%CI 1.873-25.919, P = 0.004), lower CRP (aHR = 4.230, 95%CI 1.591-11.247, P = 0.004) and higher level of anti-dsDNA (aHR = 2.675, 95%CI 1.008-7.093, P = 0.048) were independently associated with an increased risk of developing LN after adjusting for covariates. Conclusion Our findings indicated that SLE patients with low AGR, low CRP, high anti-dsDNA and the history of alopecia were more likely to develop LN in the course of SLE. AGR shown the greatest hazard for developing LN among them, it may be a strong predictor.
Effect of electroacupuncture on the kisspeptin system in a pubertal rat model of polycystic ovary syndrome
Authors: Wang Zhi , Yang Li , Dong Hui , Dong Haoxu , Cheng Ling , Yi Ping , Huang Dongmei 
Published: January 2021

Objective: To explore the effects and mechanism of action of electroacupuncture (EA) in a rat model of pubertal polycystic ovary syndrome (PCOS). Methods: Female offspring of Sprague-Dawley rats receiving dihydrotestosterone (DHT) during pregnancy (days 16–19), as a model of prenatal androgenization, were divided randomly into three groups: model group (M), EA group, and sham acupuncture (SA) group (n = 8 each). A normal (N) group comprising female offspring of healthy pregnant rats not receiving DHT (n = 8) was added. EA was administered at CV6 and bilateral SP6/ST36 with 2 Hz frequency and 2 mA intensity. SA consisted of superficial needling at different locations without electrical stimulation. Results: EA improved the disturbed estrous cycles, while it could not be concluded that SA was effective in this respect. EA improved ovarian morphology including the number of corpora lutea and area of the ovary, whereas SA did not. However, both EA and SA attenuated the increased luteinizing hormone and decreased estradiol and gonadotropin-releasing hormone levels in the serum of PCOS model rats. Levels of testosterone, follicle-stimulating hormone, and progesterone did not significantly differ between groups. EA and SA alleviated the upregulation of kisspeptin protein and mRNA levels in the hypothalamus and kisspeptin protein level in the arcuate nucleus (ARC). No differences were found between groups in protein or mRNA expression of dynorphin (DYN) or neurokinin B (NKB) in the hypothalamus. Co-expression of kisspeptin, NKB, and DYN were observed in ARC. The GnRH level in the median eminence decreased and could be rescued by EA and SA. Intriguingly, kisspeptin levels in the granulosa cells of the ovary decreased in the model group and could be rescued by EA but not SA. Levels of kisspeptin, NKB, and DYN protein and mRNA in the ovary did not differ between any groups. Conclusion: Both EA and SA appeared to improve symptoms of PCOS at puberty by modulating the kisspeptin system in the hypothalamus. EA also had an effect on ovarian kisspeptin expression and a more comprehensive effect with respect to improving PCOS at puberty than SA.
Perioperative Management of Cleft Lip Repair: A Meta-Analysis and Clinical Practice Guideline
Authors: Ranzer Matthew , Daniele Edward , Purnell Chad A. 
Published: January 2021

Objective: Few studies have focused on perioperative management of cleft lip repair. We sought to evaluate the available data on this topic to create evidence-based clinical guidelines. Design: Systematic review, meta-analysis. Methods: A PubMed search was performed focusing on perioperative management of cleft lip repair. Studies were included if they included comparative data. A systematic review and meta-analysis was performed according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Main Outcome Measures: Systematic review of literature regarding wound closure, postoperative arm restraints, perioperative antibiotics, outpatient or ambulatory surgery, or feeding restrictions postoperatively. Results: Twenty-three articles met inclusion criteria after initial screening of 3103 articles. This included 8 articles on wound closure, 2 on postoperative restraints, one on perioperative antibiotics, 6 on outpatient surgery, and 6 on postoperative feeding. Meta-analysis could be performed on dehiscence rates with postoperative feeding regimen and readmission rates after outpatient versus inpatient lip repair. There were few studies with low risk of bias. Outpatient cleft lip repair does not increase readmission (odds ratio [OR]: 0.92, 95% CI: 0.28-3.07). Allowing postoperative breastfeeding or bottle-feeding does not increase dehiscence (OR: 0.61, 95% CI: 0.19-1.95). There was no evidence of publication bias. Conclusion: Within the limitations of available data, there is no evidence of a clearly superior closure material. The evidence does not support use of postoperative arm restraints. The evidence does not support the use of preoperative nasal swabs for antibiotic guidance. With careful patient selection, outpatient cleft lip repair appears safe. The evidence supports immediate breastfeeding or bottle-feeding after cleft lip repair.
Is the duration of castration resistance predictive for sequential treatment responses in the metastatic castration-resistant prostate cancer setting?
Authors: Dülgar Özgecan , Özyükseler Deniz Tataroğlu , Başak Mustafa , Ay Seval , Tural Deniz , Yıldırım Mahmut Emre , Gümüş Mahmut 
Published: January 2021

Objective Prostate cancer is the second leading cause of cancer death in men. Androgen deprivation therapy (ADT) has been the primary therapeutic approach for treatment of prostate cancer. However,nearly all patients develop the castration-resistant disease . We evaluated real-world data with abiraterone and enzalutamide treatment. By this data, we aimed to analyze whether that prior short response to ADT could predict response to subsequent therapy with androgen receptor axis targeted agent (ARATA). Material and Method We collected data from two cancer centers, 151 consecutive patients with treated abiraterone or enzalutamide in the first line of metastatic castration resistant prostat cancer (mCRPC) setting were included. The patients who received docetaxel in castration naive setting is also included. Time to castration resistance (TTCR) was defined as the duration from the initial to failure of primary ADT. Results Patients with treated ARATA were divided into two groups according to the time to castration resistance (TTCR). Patients who became resistant to ADT up to one year had a median PFS of 6.6 months, compared to median PFS of 13.3 months for patients who responded ADT for more than 1 year. (p = 0.002). In the post-docetaxel setting, median PFS is 12.6 months of patients with treated ARATA who had TTCR for more than one year, and median PFS is 6.6 months in those who had TTCR less than one year (p = 0.007).Univariate and multivariate analyses were performed to determine the clinical factors on ARATA outcomes. Eastern Cooperative Oncology Group (ECOG) performance status(PS), median prostate-specific antigen(PSA) and time to CRPC were significantly predicted outcomes of ARATA on multivariate analysis. Conclusion TTCR is also a predictor for PFS of the patients who were treated ARATA both whole cohort and post-docetaxel.
Bilateral congenital hypertropic strabismus fixus: A case report
Authors: Li Qingji , Zhou Feng , Lu Yingying 
Published: January 2021

Purpose: To report an unusual and rare case of both eyes fixed in an extreme superomedial position. Case report: A case of 48-year-old woman presented with both eyes fixed in an extreme superomedial position; the microcorneas were covered almost completely by the upper eyelids even when she opened her eyes. A forced duction test was performed to confirm there were severe restrictions in all directions. She underwent disinsertion of the superior and medial rectus muscle, inferior oblique muscle belly transposition and sclera fixation. At the 1-year follow-up, there was improved ocular alignment. Conclusion: This case may be a special form of myopic strabismus fixus. The infratemporal fossa may be a bony landmark related to the etiology of global fixation.