bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal study of the morphological and T2* changes of knee cartilages of marathon runners using prototype software for automatic cartilage segmentation
Authors: Zhang Ping , Yu Baohai , Zhang Ranxu , Chen Xiaoshuai , Shao Shuying , Zeng Yan , Cui Jianling , Zhao Jian 
Published: February 2021

Objective:
To study the effect of long-distance running on the morphological and T2* assessment of knee cartilage.

Methods:
3D-DESS and T2* mapping was performed in 12 amateur marathon runners (age: between 21 and 37 years) without obvious morphological cartilage damage. MRI was performed three times: within 24 h before the marathon, within 12 h after the marathon, and after a period of convalescence of two months. An automatic cartilage segmentation method was used to quantitatively assessed the morphological and T2* of knee cartilage pre- and post-marathon. The cartilage thickness, volume, and T2* values of 21 sub-regions were quantitatively assessed, respectively.

Results:
The femoral lateral central (FLC) cartilage thickness was increased when 12-h post-marathon compared with pre-marathon. The tibial medial anterior (TMA) cartilage thickness was decreased when 2 months post-marathon compared with pre-marathon. The tibial lateral posterior (TLP) cartilage volume was increased when 12-h post-marathon compared with pre-marathon. The cartilage T2* value in most sub-regions had the upward trend when 12-h post-marathon and restored trend when 2 months post-marathon, compared with pre-marathon. The femoral lateral anterior (FLA) and TMA cartilage volumes were decreased 2 months post-marathon compared with pre-marathon.

Conclusions:
The marathon had some effects on the thickness, volume, and T2* value of the knee cartilages. The thickness and volume of knee cartilage in most sub-regions were without significantly changes post-marathon compared with pre-marathon. T2* value of knee cartilage in most sub-regions was increased right after marathon and recovered 2 months later. The TLP and TMA subregions needed follow-up after marathon.

Advances in knowledge:
The morphological and T2* changes of knee cartilage after marathon were evaluated by MRI and automatic segmentation software. This study was the first to use cartilage automatic segmentation software to evaluate the effects of marathon on the morphology and biochemical components of articular cartilage, and to predict the most vulnerable articular cartilage subregions, for the convenience of future exercise adjustment and the avoidance of sports cartilage injury.
A SOJA EM FACE DAS EMPRESAS RURAIS SUSTENTÁVEIS: O BALIZAMENTO AMBIENTAL CONSTITUCIONAL DAS ATIVIDADES ECONÔMICAS VINCULADAS À SOJA NO ÂMBITO DO DIREITO BRASILEIRO
Authors: Fiorillo Celso Antonio Pacheco , Vadell Lorenzo M. Bujosa 
Published: February 2021

Objetivo: O objetivo deste artigo foi analisar o balizamento normativo das atividades econômicas vinculadas à soja no âmbito do sistema normativo brasileiro, com destaque para o que determina o direito ambiental constitucional, como principal produto exportado pelo Brasil e merecedor de grande destaque na atual economia de nosso País.Metodologia: A pesquisa foi estruturada bem como realizada a partir do método hermenêutico, por meio do levantamento dos trabalhos doutrinários elaborados por estudiosos especializados atuantes no âmbito da matéria investigada e da análise jurídica vinculada ao direito ambiental constitucional assim como das normas infraconstitucionais tudo com o objetivo de adequar de forma satisfatória o enquadramento do tema em face de nosso sistema jurídico em vigor.Resultados: Ficou claramente demonstrado que, para as atividades econômicas subordinadas à soja serem desenvolvidas licitamente, suas funções submetidas ao uso do referido recurso ambiental devem obrigatoriamente obedecer à legislação ambiental constitucional balizadora do tema.Contribuições: A principal contribuição deste estudo foi a de indicar que referidas atividades econômicas de grande relevância para a economia brasileira somente podem desenvolver licitamente seus negócios em face de sua necessária obediência ao nosso ordenamento jurídico ambiental em vigor, observando-se particularmente os regramentos específicos do direito ambiental constitucional (particularmente os arts. 225,225 § 1º, IV e 225, § 3º da CF) bem como os aspectos estruturais da causa geradora das obrigações ambientais (obrigações de fazer ou não fazer subordinadas aos princípios da prevenção e do poluidor pagador.
Prices and sold amount dynamics, endogenous knowledge and distribution of Picralima nitida (Stapf) T. Durand and H. Durand across in the Dahomey Gap and Guinea-Congolese regions
Authors: Akabassi Ghislain Comlan , Padonou Elie Antoine , Assogbajo Achille Ephrem , Zirihi Guede Noël 
Published: February 2021

Picralima nitida (Apocynaceae) represents is an important African medicinal plant species. It is frequently used in traditional medicine and pharmaceutical industries for drugs manufacturing against infectious diseases, malaria and diabetes and commercially traded as well. Despite its importance, the species is becoming rare, especially in the Dahomey Gap because of it is commercial importance. There is an issue about the controversy of the plant species on its distribution across both regions. Without further forest resources inventory, it is difficult to address efficiently the issue of the controversy of its distribution, the unsustainable use and the endogenous knowledge about of plant species usages. Ethnobotanical surveys were conducted in the Dahomey Gap with 120 informants randomly selected and interviewed. A literature review of scientific papers and books was also used to provide information on the sale prices dynamic, amount sold per units, uses, distribution area using the GBIF Platform, and threats of the species in both climatic regions. P. nitida products were more expensive (per sale unit) in the DG than the GC region. All parts of the species were collected and used to treat 34 diseases. The plant species appear to be poorly distributed in the DG than the GC region. The overuse, endogenous knowledge loss in DG and deforestation in GC region appeared the main driver of scarcity of the species. P. nitida has various medicinal uses across both regions. The sale price and amount sold per unit tend all to vary across both regions as well. However, the plant species is becoming scarcer in the DG than CG region. The issue of resource scarcity may drive loss of endogenous knowledge about the plant species uses. A forest inventory and documentation of uses are highly needed to assess the exact density and distribution area of P.nitida across both regions
Patient-centered benefit-risk analysis of transcatheter aortic valve replacement
Authors: Marsh Kevin , Hawken Natalia , Brookes Ella , Kuehn Carrie , Liden Barry 
Published: February 2021

Background: Aortic stenosis (AS) treatments include surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). Choosing between SAVR and TAVR requires patients to trade-off benefits and risks. The objective of this research was to determine which TAVR and SAVR outcomes patients consider important, collect quantitative data about how patients weigh benefits and risks, and evaluate patients’ preferences for SAVR or TAVR. Methods: Patients were recruited from advocacy organization databases. Patients self-reported as being diagnosed with AS, and as either having received AS treatment or as experiencing AS-related physical activity limitations. An online adapted swing weighting (ASW) method – a pairwise comparison of attributes – was used to elicit attribute trade-offs from 219 patients. Survey data were used to estimate patients’ weights for AS treatment attributes, which were incorporated into a quantitative benefit-risk analysis (BRA) to evaluate patients’ preferences for TAVR and SAVR. Results: On average, patients put greater value on attributes that favored TAVR than SAVR. Patients’ valuation of the lower mortality rate, reduced procedural invasiveness, and quicker time to return to normal quality of life associated with TAVR, offset their valuation of the time over which SAVR has been proven to work. There was substantial heterogeneity in patients’ preferences. This was partly explained by age, with differences in preference observed between patients <60 years to those ≥60 years. A Monte Carlo Simulation found that 79.5% of patients prefer TAVR. Conclusions: Most AS patients are willing to tolerate sizable increases in clinical risk in exchange for the benefits of TAVR, resulting in a large proportion of patients preferring TAVR to SAVR. Further work should be undertaken to characterize the heterogeneity in preferences for AS treatment attributes. Shared decision-making tools based on attributes important to patients can support patients’ selection of the procedure that best meets their needs.
Retrospective analysis of antipsychotic prescription models in correlation with symptoms of residual schizophrenia. Part 1
Authors: Safonov D. N. 
Published: February 2021

Relevance. The therapeutic models of antipsychotic prescription in residual schizophrenia in highly dependent on various context factors, major – relevant treatment guidelines, local drug legal and registration status, local availability etc. and minor – psychiatrist personal experience, patients individual response and comorbid pathology profile etc. therefore it’s almost impossible to track down links between specific treatment model, possible NIDS manifestations or protective antipsychotic effects on negative symptoms in real clinical environment. Nevertheless finding the correlations between specific antipsychotic prescriptions and residual schizophrenia symptoms could highlight possible influence of some antipsychotics on specific symptoms in long term perspective.Aim – to evaluate correlations between antipsychotic prescription models and negative symptoms profile in patients with residual schizophrenia.Materials and methods. A study was performed on 60 case histories of patients of Zaporozhye Regional Clinical Psychiatric Hospital who were treated as inpatients with diagnosis of recurrent schizophrenia (ICD-10:F20.5) in time period from 2010 to 2020.Results. In the first section of a study we gathered clinical data on intensity of main positive and negative recurrent schizophrenia symptoms using as a clinical tools PSS and NSS subscales of PANSS. On the second section our study reveled pool of most common prescribed antipsychotics which are: chlorpromazine, haloperidol, trifluoperazine, clozapine, levomepromazine, chlorprothixene, quetiapine, risperidone, thioridazine, fluphenazine, amisulpride, zuclopenthixol and their various combinations. The third study section was dedicated to analysis of correlations between particular PSS and NSS categories and antipsychotic course experience.Conclusions. Study have found frequency and correlations of most common antipsychotic prescribed in inpatients with residual schizophrenia in time period between 2010 and 2020. The most frequently chlorpromazine, haloperidol, trifluoperazine, clozapine, chlorprothixene, risperidone and zuclopenthixol and its combinations were prescribed. The concept of “antipsychotic course experience was introduced. Chlorpromazine and haloperidol or risperidone and haloperidol are frequently prescribed as combination, while clozapine and chlorprothixene, chlorpromazine and chlorprothixene, haloperidol and trifluoperazine, chlorpromazine and trifluoperazine have low probability of combined prescription. Positive and negative symptoms of residual schizophrenia correlations with specific antipsychotic course experience were established.
Acromegaly - dealing with an uncooperative patient
Authors: Obel Michał , Mazurek Ewelina , Kuś Adrian , Szypłowska Małgorzata , Gorecka Adrianna , Zaremba Bartłomiej 
Published: February 2021

Introduction: Acromegaly is a chronic disease resulting from increased secretion of growth hormone. The main reason of elevated GH concentration is pituitary adenoma that originates from somatotropic cells. As a consequence, several changes in the organism appear such as progressive deformation of the skeleton with enlargement of the skull, hands and feet, growth of soft tissues, bones and internal organs as well as many other systemic complications which are responsible for increased mortality in untreated patients. Case report: A 60-year-old patient was diagnosed with acromegaly due to the pituitary macroadenoma and associated hypopituitarism in the thyroid and gonadotropic axis 4 years ago. The disease was suspected in April 2016 by a rheumatologist, and then confirmed on the basis of hormonal tests in the Endocrinology Clinic (IGF1 - 754.7 ng/ml, N: 77-224; GH - 2.51 ng/ml, no inhibition in OGTT). The imaging examination revealed a pituitary macroadenoma with dimensions of 17x15x19 mm. The medical history revealed the characteristic symptoms of acromegaly like enlargement and deformation of the fingers, enlarged nose, excessive sweating and headaches for the last 12 years. There have been several studies investigating the complications of acromegaly that found abnormalities in the cardiovascular system, metabolic disorders (dyslipidemia, abnormal fasting glycaemia), arthropathies, sigmoid polyps and nodular goiter. Due to the patient's lack of consent to the surgical intervention, treatment with a somatostatin analogue was introduced. During 2-year therapy, the normalization of IGF-1 concentration was not achieved. In October 2018 patient completely abandoned therapy with somatostatin analogue. In 2019 the lack of control of acromegaly was confirmed. During hospitalization in 2020 the uncontrolled acromegaly was stated once again. The patient still does not consent to the surgical procedure to remove pituitary macroadenoma, however, he agreed for systematic re-treatment with a somatostatin analogue. Conclusions: Isolated pharmacological treatment doesn’t always allow for sufficient control of an illness. Effective treatment of acromegaly should consist of surgery as well as conservative treatment. The introductinon of both 2nd generation analogues and GH receptor antagonists in therapeutic programs makes effective pharmacological treatment possible.
Studying fatty acid content in red blood cell membranes in diabetic retinopathy of type 2 diabetes patients
Authors: Bykhovets Mykhailo 
Published: February 2021

Introduction. Studying pathogenetic pathways that are formed under conditions of hyperglycaemia and trigger further metabolic changes resulting in diabetes complications over time are of special interest both in theoretical and practical medicine. Membrane of the red blood cell that stays in blood constantly and relatively durable is an obvious participant of all metabolic changes and cannot but reflect changes in metabolism. Objective: to study content of fatty acids (FAs) in red blood cell membranes of patients with diabetic retinopathy (DR) with type 2 diabetes (T2D). Materials and methods. The study enrolled 73 subjects maximally matched by age and gender: 50 patients with established long-lasting T2D complicated with DR and 23 patients in the control group. All the biochemical tests were performed at the certified laboratory under the standard methods. Gas chromatography was applied to study FA spectrum. Statistical analysis was performed in IBM SPSS Statistics 23. Results and discussion. The key difference between the lipid metabolism of patients with complicated long-lasting T2D and healthy subjects was a significant difference in FA content redistribution in the red blood cell membranes represented by increased “saturation”. The content of saturated FAs (SAFAs)in patients with DR was higher than in the CG: 1.5-fold for palmitic (С:16), 2-fold for myristic(С:14), pentadecanoic (С:15) and margaric (С:17) (Р < 0.05). The content of saturated stearic (С:18) FA was not changed significantly.The content of unsaturated FAs(USFAs) have changed multidirectionally: the content of linoleic (С18:2) and arachidonic (С20:4) decreased 1.5-1.7-fold, respectively. The content of linolenic (С18:3) increased 2-fold, and content of oleic FA (С18:1) was not changed significantly. Conclusion. Study of the fluctuations of FA levels in red blood cell membranesplays animportant role in the development of insulin resistance, T2D and its microvascular complicationsthat can be applied in creating treatment and prevention strategies ofDRin type 2 diabetes patients.
The white blood cell count (WBC) and neutrophil-to-lymphocyte ratio (NRL) in multiple sclerosis
Authors: Vivchar R. Ya. , Akimova V. M. , Lapovets L. Ye. , Lapovets N. Ye. 
Published: February 2021

Introduction. Multiple sclerosis (MS) is one of the main chronic inflammatory diseases of the central nervous system that causes functional disability in people. Assessment of the state of the immune system begins with an analysis of the total number of blood leukocytes and their population composition (the number of neutrophils and lymphocytes). The ratio of neutrophils and lymphocytes (NRL) is a marker of inflammation.The aim of the study. The aim of this study was to investigate the WBC and neutrophil-to-lymphocyte ratio in patients with different forms of MS. Results. In patients with MS in 23.5% of cases the WBC is higher than 9×109/L. In 5.9% of МS cases leukopenia is observed, and in the vast majority of cases (70, 6%) the level of blood leukocytes was in the range of 4-9×109/L. Leukopenia and leukocytosis are more common in women than in men (p<0.05). Leukocytosis and leukopenia are most often found in RRMS form, while in the SPMS form patients in 93.8 % of cases the normal level of leukocytes found. MS's patients had a significantly higher NLR (p < 0.05) than the control group. No significant difference in WBC and NLR was found between groups of MS clinical forms. No association was found between NLR and an age and sex.Conclusions. NRL is an inexpensive and affordable indicator, which is determined by the automatic determination of the total number of leukocytes in the blood. It can be an additional informative indicator of inflammation against the background of normal leukocyte levels.
História Regional: novas perspectivas
Authors: Maleval Isadora Tavares , Atallah Cláudia , Cesco Susana 
Published: February 2021

Apresentação. Revista Maracanan, PPGH-UERJ, Rio de Janeiro, n. 26 - "História Regional: novas perspectivas", p. 7-12, jan.-abr. 2021.
The impact of GP referrals on overcrowding in emergency departments and acute medicine
Authors: Abbasi Ayaz A , Khan Shams , Ameh Victor , Muhammad Ilyas 
Published: February 2021

Background/Aims A long-standing issue common to most emergency departments worldwide is overcrowding, and the UK is no exception. Overcrowding can have many adverse consequences, such as increased medical errors, decreased quality of care and poor patient outcomes. This service evaluation aimed to review the number of patients referred to acute specialties by their GPs and to evaluate the impact of these referrals on the flow of patients in and out of the emergency department and acute medicine. Methods GP referral letters were collected at an emergency department in Greater Manchester, England, between 15 May 2019 and 28 May 2019. A proforma was used by a consultant in acute medicine and a consultant in emergency medicine to evaluate each letter. Result A total of 139 GP referrals were received by the emergency department, of which 43 were to general medicine and 96 to other specialties. Of the latter, 54 cases were directed to the emergency department, 20 were directed to a different specialty and 23 did not have a specialty clearly specified. The majority of referrals were for gastrointestinal conditions or abdominal pain, with the next largest category being chest infections. Most of these patients were eventually seen in the trust's ambulatory assessment area to relieve pressure on the emergency department. Conclusions Planned and specific use of urgent care centres and ambulatory assessment areas can help to relieve pressure on emergency departments, but appropriate intervention at the primary care level is also necessary to improve patient flow.
Managed Care and Value-Based Payment: The Relationship Between Quality of Life Outcomes and Emergency Room Utilization
Authors: Friedman Carli 
Published: February 2021

Abstract
Although Medicaid managed care is a growing service model, there is a limited evidence base regarding quality and value-based payment standards for people with intellectual and developmental disabilities (IDD). This study examined the relationship between emergency room utilization and quality of life outcomes. We analyzed secondary Personal Outcome Measures quality of life and emergency room utilization data from 251 people with IDD. According to our findings, people with IDD with continuity and security in their lives and/or who participated in the life of the community had fewer emergency room visits, regardless of their impairment severity or dual diagnosis status. As such, the number of emergency room visits needed, and the potential expenditures associated, may be reduced by focusing on quality outcomes.
Development, Implementation, and Evaluation of an Advance Care Planning Program for Professionals in Palliative Care of People With Intellectual Disability
Authors: Voss Hille , Vogel Anique G.F.M , Wagemans Annemieke M.A , Francke Anneke L. , Metsemakers Job F.M. , Courtens Annemie M. , de Veer Anke J.E. 
Published: February 2021

Abstract
In this article we describe how an advance care planning (ACP) program was developed, implemented, and evaluated. Our aim was to improve ACP in palliative care for people with intellectual disability (ID). The program was based on 10 competencies needed for ACP and was developed in a co-design process with people with ID, relatives, and professionals. The program was implemented in six ID care organizations in the Netherlands and consisted of an information pack, a training course, and an implementation interview about implementing ACP. Professionals indicated that their competencies had improved, particularly regarding communication and the application of ACP as a standard element in palliative care practice. This program therefore seems helpful in training ID care professionals in the competencies needed for ACP.
Racial and Ethnic Disparities in Perceived Barriers to Health Care Among U.S. Adults With Intellectual and Developmental Disabilities
Authors: Li Henan , Parish Susan L. , Magaña Sandra , Morales Miguel A. 
Published: February 2021

Abstract
Barriers to health care access can greatly affect one's health status. Research shows that U.S. adults with intellectual and developmental disabilities (IDD) have poor health and face barriers such as long waits for appointments. However, whether barriers differ by race and ethnicity has not been examined. We conducted a secondary data analysis using the 2002–2011 Medical Expenditure Panel Survey dataset, and compared perceived barriers of community-living U.S. adults with IDD in three racial and ethnic groups (White, Black, and Latinx). Specifically, we examined the top reasons for not having usual source of care, delaying or foregoing medical care. For Black and Latinx adults with IDD, the most-mentioned reasons for not having usual source of care, delaying or foregoing medical care were “don't like/don't trust doctors,” “don't use doctors,” and “don't know where to get care.” In comparison, the White adults with IDD group's biggest perceived barriers were location and insurance related. All groups cited that being unable to afford care was a top reason for delaying or foregoing care. Policies/interventions to improve health care access in racial/ethnic minorities with IDD must first address the topic of developing trust between patients and the health professions. Insurance and the rising costs of care are also key areas that need attention.