bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intravenous lipid emulsion as an adjuvant therapy of acute clozapine poisoning
Authors: Elgazzar Fatma M , Elgohary Mona S , Basiouny Sara M , Lashin Heba I 
Published: January 2021

Introduction: Clozapine is a frequently prescribed atypical antipsychotic drug. Various case reports documented the successful recovery of acute antipsychotics toxicity in association with the administration of intralipid emulsion (ILE). Aim: This study aimed to assess the adjuvant therapeutic role of SMOF Lipid administration on the outcomes of acute clozapine poisoning. Methods: Forty patients with acute clozapine poisoning were randomly allocated into two equal groups. The control group received the standard supportive treatment only, whereas the intervention group received the standard supportive treatment plus SMOF Lipid 20% infusion. All patients were subjected to history taking, full clinical examination, and laboratory investigations. The study outcomes were evaluated. Results: The mean Glasgow Coma Scale (GCS) at 6 hours (13.1 ± 2.3 vs 9.2 ± 2, p < 0.001) and 12 hours (14.3 ± 1.5 vs 9.6 ± 2, p < 0.001) after admission was significantly higher in the intervention group compared to the control group. The intervention group showed a significantly lower frequency of prolonged QTc interval 12 hours after admission (p = 0.003), as well as a significantly shorter hospital stay (p < 0.001). Conclusions: SMOF Lipid infusion seemed to have improved GCS, the prolonged QTc interval, and shortened the length of hospital stay. Furthermore, there were no adverse effects related to its administration.
Illness identity on social media: a qualitative content analysis of #bpd
Authors: Chan Alyssa 
Published: January 2021

Objective: To explore the themes related to self and illness representations in a public online community. Method: This project utilised an inductive process of data analysis with a phenomenological approach. Two hundred images from the social media image-sharing platform Instagram were described, coded and organised into themes. Results: Five themes were identified: the fragmented and obscured self; trepidation and disappointment about the threatening and persecutory world; an existence built of illness and symptoms; finding comfort in the natural and built environment; and sharing hope and positive experiences of growth. Conclusions: #bpd encompassed a variety of content types, with a wide spectrum of emotional tones expressed through photographs, written communication and artwork.
Traumatic joint luxations in cats: Reduce, repair, replace, remove
Authors: Meeson Richard L , Strickland Rhiannon 
Published: January 2021

Practical relevance: Traumatic joint luxations are usually associated with significant trauma and there may be concomitant systemic injury. Joints are unstable as a result of injury to one or more supporting structures and the clinician should aim to determine which structures are damaged with physical examination, diagnostic imaging and careful assessment under sedation/anaesthesia. The aim is to reduce the joint back to its anatomical position, and then to maintain this through repair of damaged structures. However, where this is not possible, replacement or removal (arthrodesis/excision arthroplasty) of the joint remain viable options. Clinical challenges: Owing to the small size of feline joints and the severity of damage often seen, surgical management of these cases can be challenging. The first priority is to ensure the patient is systemically well before embarking on any specific surgical treatment of a luxated joint. Cats also present challenges in the postoperative period and a lack of patient and owner compliance can be detrimental to postoperative outcomes. Aims: This article aims to help the reader diagnose joint luxations and to assist decision-making with an overview of the management and treatment options available. Evidence base: There are a number of original articles and textbook chapters in the literature covering aspects of different joint luxations, particularly for the more common luxations. This article draws on information from key feline research and, where necessary, extrapolates from relevant canine research. The authors also offer practical guidance based on their own clinical experience.
Accelerated Epigenetic Age in Normal Cognitive Aging of Korean Community-Dwelling Older Adults
Authors: Park Jongmin , Won Chang Won , Saligan Leorey N. , Kim Youn-Jung , Kim Yoonju , Lukkahatai Nada 
Published: January 2021

Background: Epigenetic age acceleration has been studied as a promising biomarker of age-related conditions, including cognitive aging. This pilot study aims to explore potential cognitive aging-related biomarkers by investigating the relationship of epigenetic age acceleration and cognitive function and by examining the epigenetic age acceleration differences between successful cognitive aging (SCA) and normal cognitive aging (NCA) among Korean community-dwelling older adults (CDOAs). Methods: We used data and blood samples of Korean CDOAs from the Korean Frailty and Aging Cohort Study. The participants were classified into two groups, SCA (above the 50th percentile in all domains of cognitive function) and NCA. The genome-wide DNA methylation profiling array using Illumina Infinium MethylationEPIC BeadChip was used to calculate the following: the DNA methylation age, universal epigenetic age acceleration, intrinsic epigenetic age acceleration (IEAA), and extrinsic epigenetic age acceleration (EEAA). We also used Pearson correlation analysis and independent t-tests to analyze the data. Results: Universal age acceleration correlated with the Frontal Assessment Battery test results ( r = −0.42, p = 0.025); the EEAA correlated with the Word List Recognition test results ( r = −0.41, p = 0.027). There was a significant difference between SCA and NCA groups in IEAA ( p = 0.041, Cohen’s d = 0.82) and EEAA ( p = 0.042, Cohen’s d = 0.78). Conclusions: Epigenetic age acceleration can be used as a biomarker for early detection of cognitive decline in Korean community-dwelling older adults. Large longitudinal studies are warranted.
Survival With Respect to Morphology in Pulmonary Atresia and Intact Ventricular Septum in Sweden
Authors: Manhem Stina , Hanséus Katarina , Berggren Håkan , Ekman-Joelsson Britt-Marie 
Published: January 2021

Background: Patients born with pulmonary atresia and intact ventricular septum represent a challenge to pediatric cardiologists. Our objective was to study changes in survival with respect to morphology in all children born with pulmonary atresia and intact ventricular septum in Sweden during 36 years. Methods: A retrospective, descriptive study based on medical reports and echocardiographic examinations consisting of those born between 1980 and 1998 (early group) and those born between 1999 and 2016 (late group). Results: The cohort consists of 171 patients (early group, n = 86 and late group, n = 85) yielding an incidence of 4.35 and 4.46 per 100,000 live births, respectively. One-year survival in the early group was 76% compared to 92% in the late group ( P = .0004). For patients with membranous atresia, one-year survival increased from 78% to 98%, and for muscular pulmonary atresia, from 68% to 85%. In patients with muscular pulmonary atresia and ventriculocoronary arterial communications, there was no significant increase in survival. Risk factors for death were being born in the early time period hazard ratio (HR), 6; 95% CI (2.33-14.28) P = .0002, low birth weight HR, 1.26; 95% CI (1.14-1.4) P < .0001 and having muscular pulmonary atresia HR, 3.74; 95% CI (1.71-8.19) P = .0010. Conclusion: The incidence of pulmonary atresia and intact ventricular septum remained unchanged during the study period. Survival has improved, especially for patients with membranous pulmonary atresia, while being born with muscular pulmonary atresia is still a risk factor for death. To further improve survival, greater focus on patients with muscular pulmonary atresia and ventriculocoronary arterial communications is required.
Mid-Term Outcomes After Unifocalization Guided by Intraoperative Pulmonary Flow Study
Authors: Goodman Ariana , Ma Michael , Zhang Yulin , Ryan Kathleen R. , Jahadi Ozzie , Wise-Faberowski Lisa , Hanley Frank L. , McElhinney Doff B. 
Published: January 2021

Background: Repair of tetralogy of Fallot (TOF) with major aortopulmonary collateral arteries (MAPCAs) requires unifocalization of pulmonary circulation, intracardiac repair with the closure of the ventricular septal defect, and placement of a right ventricle (RV) to pulmonary artery (PA) conduit. The decision to perform complete repair is sometimes aided by an intraoperative flow study to estimate the total resistance of the reconstructed pulmonary circulation. Methods: We reviewed patients who underwent unifocalization and PA reconstruction for TOF/MAPCAs to evaluate acute and mid-term outcomes after repair with and without flow studies and to characterize the relationship between PA pressure during the flow study and postrepair RV pressure. Results: Among 579 patients who underwent unifocalization and PA reconstruction for TOF/MAPCAs, 99 (17%) had an intraoperative flow study during one (n = 91) or more (n = 8) operations to determine the suitability for a complete repair. There was a reasonably good correlation between mean PA pressure at 3 L/min/m2 during the flow study and postrepair RV pressure and RV:aortic pressure ratio. Acute and mid-term outcomes (median: 3.8 years) after complete repair in the flow study patients (n = 78) did not differ significantly from those in whom the flow study was not performed (n = 444). Furthermore, prior failed flow study was not associated with differences in outcome after subsequent intracardiac repair. Conclusions: The intraoperative flow study remains a useful adjunct for determining the suitability for complete repair in a subset of patients undergoing surgery for TOF/MAPCAs, as it is reasonably accurate for estimating postoperative PA pressure and serves as a reliable guide for the feasibility of single-stage complete repair.
Respiratory Compromise After Anterior Cervical Spine Surgery: Incidence, Subsequent Complications, and Independent Predictors
Authors: Boddapati Venkat , Lee Nathan J. , Mathew Justin , Held Michael B. , Peterson Joel R. , Vulapalli Meghana M. , Lombardi Joseph M. , Dyrszka Marc D. , Sardar Zeeshan M. , Lehman Ronald A. , Riew K. Daniel 
Published: January 2021

Study design: Retrospective cohort study. Objective: Respiratory compromise (RC) is a rare but catastrophic complication of anterior cervical spine surgery (ACSS) commonly due to compressive fluid collections or generalized soft tissue swelling in the cervical spine. Established risk factors include operative duration, size of surgical exposure, myelopathy, among others. The purpose of this current study is to identify the incidence and clinical course of patients who develop RC, and identify independent predictors of RC in patients undergoing ACSS for cervical spondylosis. Methods: A large, prospectively-collected registry was used to identify patients undergoing ACSS for spondylosis. Patients with posterior cervical procedures were excluded. Baseline patient characteristics were compared using bivariate analysis, and multivariate analysis was employed to compare postoperative complications and identify independent predictors of RC. Results: 298 of 52,270 patients developed RC (incidence 0.57%). Patients who developed RC had high rates of 30-day mortality (11.7%) and morbidity (75.8%), with unplanned reoperation and pneumonia the most common. The most common reason for reoperations were hematoma evacuation and tracheostomy. Independent patient-specific factors predictive of RC included increasing patient age, male gender, comorbidities such as chronic cardiac and respiratory disease, preoperative myelopathy, prolonged operative duration, and 2-level ACCFs. Conclusion: This is among the largest cohorts of patients to develop RC after ACSS identified to-date and validates a range of independent predictors, many previously only described in case reports. These results are useful for taking preventive measures, identifying high risk patients for preoperative risk stratification, and for surgical co-management discussions with the anesthesiology team.
The SNAP Trial: 2-Year Results of a Double-Blind Multicenter Randomized Controlled Trial of a Silicon Nitride Versus a PEEK Cage in Patients After Lumbar Fusion Surgery
Authors: Kersten R. F. M. R. , Öner F. C. , Arts M. P. , Mitroiu M. , Roes K. C. B. , de Gast A. , van Gaalen S. M. 
Published: January 2021

Study Design: Randomized controlled trial. Objectives: Lumbar interbody fusion with cages is performed to provide vertebral stability, restore alignment, and maintain disc and foraminal height. Polyetheretherketone (PEEK) is commonly used. Silicon nitride (Si3N4) is an alternative material with good osteointegrative properties. This study was designed to assess if Si3N4 cages perform similar to PEEK. Methods: A non-inferiority double-blind multicenter RCT was designed. Patients presenting with chronic low-back pain with or without leg pain were included. Single- or double-level instrumented transforaminal lumbar interbody fusion (TLIF) using an oblique PEEK or Si3N4 cage was performed. The primary outcome was the Roland-Morris Disability Questionnaire (RMDQ). The non-inferiority margin for the RMDQ was 2.6 points on a scale of 24. Secondary outcomes included the Oswestry Disability Questionnaire (ODI), Visual Analogue Scales (VAS), SF-36 Physical Function, patient and surgeon Likert scores, radiographic evaluations for subsidence, segmental motion, and fusion. Follow-up was planned at 3, 6, 12, and 24-months. Results: Ninety-two patients were randomized ( i.e. 48 to PEEK and 44 to Si3N4). Both groups showed good clinical improvements on the RMDQ scores of up to 5-8 points during follow-up. No statistically significant differences were observed in clinical and radiographic outcomes. Mean operative time and blood loss were statistically significantly higher for the Si3N4 cohort. Although not statistically significant, there was a higher incidence of complications and revisions associated with the Si3N4 cage. Conclusions: There was insufficient evidence to conclude that Si3N4 was non-inferior to PEEK.
Experimental Investigation and Optimization Design of Multi-Support Pipeline System
Authors: Zhang Xiantao , Liu Wei , Zhang Yamei , Zhao Yujie 
Published: January 2021

AbstractThe design of aircraft hydraulic pipeline system is limited by many factors, such as the integrity of aviation structure or narrow installation space, so the limited clamp support position should be considered. This paper studied the frequency adjustment and dynamic responses reduction of the multi-support pipeline system through experiment and numerical simulation. To avoid the resonance of pipeline system, we proposed two different optimization programs, one was to avoid aero-engine working range, and another was to avoid aircraft hydraulic pump pulsation range. An optimization method was introduced in this paper to obtain the optimal clamp position. The experiments were introduced to validate the optimization results, and the theoretical optimization results can agree well with the test. With regard to avoiding the aero-engine vibration frequency, the test results revealed that the first natural frequency was far from the aero-engine vibration frequency. And the dynamic frequency sweep results showed that no resonance occurred on the pipeline in the engine vibration frequency range after optimization. Additionally, with regard to avoiding the pump vibration frequency, the test results revealed that natural frequencies have been adjusted and far from the pump vibration frequency. And the dynamic frequency sweep results showed that pipeline under optimal clamp position cannot lead to resonance. The sensitivity analysis results revealed the changing relationships between different clamp position and natural frequency. This study can provide helpful guidance on the analysis and design of practical aircraft pipeline.
Utilization of Chinese fast-growing trees and the effect of alternating lamination using mixed-species eucalyptus and poplar veneers
Authors: Murata Koji , Nakano Mao , Miyazaki Kaoru , Yamada Norihiko , Yokoo Yoshihiro , Yokoo Kuniharu , Umemura Kenji , Nakamura Masashi 
Published: January 2021

AbstractOver the past few decades, the sustainable forest area in China has increased remarkably, with 2400 million cubic meters of eucalyptus produced in 2018 in Guangxi which is the largest plantation area in China. In this study, the effect of alternating lamination using soft poplar veneers and hard eucalyptus veneers, on the mechanical properties of laminated veneer lumber (LVL), was examined. Eucalyptus and poplar veneers were imported from China to Japan to manufacture the LVL. For both eucalyptus and poplar veneers, the pith side (innerwood) sheets were lighter in density than the bark side (outerwood) sheets. The specific Young’s modulus of alternating LVL with hard eucalyptus veneers and soft poplar veneers was smaller than that of the mono-species LVL of eucalyptus and poplar. Strain distributions were obtained with the compression test by using the digital image correlation method. Normal strains showed that the hard eucalyptus layer behaved as a thin plate, whereas the soft poplar layer mitigated the movement of the hard eucalyptus layer. Alternating lamination decreased the variation in the elastic modulus of LVL made from fast-growing species. Therefore, the soft layers mitigated the movement of the hard layers, which had large variations in mechanical properties.
Improvements in pain, medication use and quality of life in onabotulinumtoxinA-resistant chronic migraine patients following erenumab treatment – real world outcomes
Authors: Talbot J. , Stuckey R. , Crawford L. , Weatherby S. , Mullin S. 
Published: January 2021

Abstract
Background
The CGRP antagonists offer a novel therapeutic approach in migraine. Their utility in patients with severe forms of chronic migraine is a subject of particular interest. We present outcomes of 9 months of erenumab treatment in a cohort of patients with difficult-to-control chronic migraine, all of whom had prior unsatisfactory response to onabotulinumtoxinA.

Methods
We offered erenumab to 98 patients with a prior unsatisfactory response to onabotulinumtoxinA. Eighty of 98 had trialled greater occipital nerve injections (82%), 32/98 peripheral neurostimulation (33%) and 18/98 intravenous dihydroergotamine (18%). Thirty eight of 98 (39%) met the definition of triptan overuse and 43/98 (44%) analgesic overuse. All patients met the EHF criteria for ‘resistant migraine’. Outcome measures (recorded monthly) included days with headache limiting activities of daily living (“red”), not limiting (“amber”), headache free (“green”), and requiring triptans or other analgesics. Quality of life scores - headache impact test 6 (HIT-6), patient health questionnaire 9 (PHQ-9) and pain disability index (PDI) - were also measured.

Results
Mean number of red days improved by − 6.4 days (SE 0.67, 95%CI − 7.7 to − 5.1, p=0.001) at 3 months; − 6.8 days (SE 0.96, 95%CI − 8.80 to − 4.9, p=0.001) at 6 months and − 6.5 days (SE 0.86, 95%CI − 8.3 to − 4.8, p=0.001) at 9 months. Repeated measures ANOVA confirmed improvements in the number of red (p=0.001), green (p=0.001), triptan (p=0.001) and painkiller days (p=0.001) as well as scores of the HIT-6 (p=0.001), PHQ-9 (p=0.001), and PDI (p=0.001) across the duration of study.

Conclusion
We observed improvements in pain, medication use and quality of life in onabotulinumtoxinA-resistant chronic migraine patients following erenumab treatment.
OsNBL1, a Multi-Organelle Localized Protein, Plays Essential Roles in Rice Senescence, Disease Resistance, and Salt Tolerance
Authors: Zhao Xiaosheng , Zhang Tianbo , Feng Huijing , Qiu Tiancheng , Li Zichao , Yang Jun , Peng You-Liang , Zhao Wensheng 
Published: January 2021

Abstract
Background
Plant senescence is a complicated process involving multiple regulations, such as temperature, light, reactive oxygen species (ROS), endogenous hormone levels, and diseases. Although many such genes have been characterized to understand the process of leaf senescence, there still remain many unknowns, and many more genes need to be characterized.

Results
We identified a rice mutant nbl1 with a premature leaf senescence phenotype. The causative gene, OsNBL1, encodes a small protein with 94 amino acids, which is conserved in monocot, as well as dicot plants. Disruption of OsNBL1 resulted in accelerated dark-induced leaf senescence, accompanied by a reduction in chlorophyll content and up-regulation of several senescence-associated genes. Notably, the nbl1 mutant was more susceptible to rice blast and bacterial blight but more tolerant to sodium chloride. Several salt-induced genes, including HAK1, HAK5, and three SNAC genes, were also up-regulated in the nbl1 mutant. Additionally, the nbl1 mutant was more sensitive to salicylic acid. Plants overexpressing OsNBL1 showed delayed dark-induced senescence, consistent with a higher chlorophyll content compared to wild-type plants. However, the overexpression plants were indistinguishable from the wild-types for resistance to the rice blast disease. OsNBL1 is a multi-organelle localized protein and interacts with OsClpP6, which is associated with senescence.

Conclusions
We described a novel leaf senescence mutant nbl1 in rice. It is showed that OsNBL1, a multi-organelle localized protein which interacts with a plastidic caseinolytic protease OsClpP6, is essential for controlling leaf senescence, disease resistance, and salt tolerance.
Conservative management of chylous leak after open radical nephrectomy in an adult patient: a case report and literature review
Authors: Alrabadi Adel , Ihmeidan Mohammad , Al Demour Saddam 
Published: January 2021

Abstract
Background
Chylous ascites is rare but still a recognized complication of retroperitoneal surgeries caused mostly by inadvertent trauma to lymphatic channels. In this article, we present a case report and literature review of adult patient, with malignant tumor of upper urinary tract, who developed chylous leak after open nephrectomy.

Case presentation
We present a case of chylous leak for a 67-year-old female patient, presented to urology clinic with complaining of left loin pain and gross hematuria, found to have upper urinary tract tumor, she underwent open radical nephrectomy with lymph nodes dissection, and postoperatively she had chylous leak that is treated conservatively using octreotide and spironolactone without the need for total parenteral nutrition.

Conclusion
Conservative management should always be the first choice of management of chylous leak and chylous ascites. Careful anatomical identification and securing of the periaortic lymphatics are needed to decrease the risk of postoperative chylous leak and ascites.