bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimally Invasive Thoracic Surgery
Authors: Capone Joseph , Tharian Antony 
Published: May 2021

Abstract
This chapter on novel approaches to minimally invasive thoracic surgery explores the latest techniques being utilized in thoracic surgery. It reviews anesthetic considerations including patient positioning, intraoperative monitoring, and temperature management. It also reviews commonly utilized anesthetic approaches to thoracic surgery such as general endotracheal anesthesia with lung isolation as well as nonintubated anesthesia, regional anesthetic techniques, and approaches to postoperative pain management. This chapter also provides an up-to-date review of the latest approaches being utilized for thoracic surgery including single port video assisted thoracic surgery, robot-assisted thoracic surgery, and single port robotic surgery.
Enhanced Recovery in Thoracic Surgery
Authors: Zhao Manxu , Xia Zhongyuan , Liu Henry 
Published: May 2021

Abstract
With the development and improvement of enhanced recovery after surgery protocol over the past 20 years, there is an increasing acceptance and application of enhanced recovery after surgery in many surgical subspecialties. Thoracic surgery has also started adopting the practice of enhanced recovery after surgery, and some hospitals have already implemented elements of enhanced recovery after surgery pertinent to thoracic surgical patients such as optimization of preoperative pulmonary rehabilitation, increasing application of regional anesthesia in multimodal analgesia, single chest tube placement, and early removal of chest tube. Enhanced recovery in thoracic surgery has resulted some improved clinical outcomes with multidisciplinary multimodal perioperative approach.
Memory and Attention Adaptation Training
Authors: Ferguson Robert , Gillock Karen 
Published: May 2021

Abstract
Memory and Attention Adaptation Training (MAAT) is a cognitive-behavioral therapy (CBT) designed to help cancer survivors self-manage and mitigate the late and long-term effects of cancer and cancer therapy on memory function. Cancer-related cognitive impairment (CRCI) is a set of mild to moderate memory and attention impairments that can have an adverse influence on quality of life. CRCI symptoms tend to present during active treatment, but for some individuals cognitive changes can persist for years. While the exact prevalence of CRCI is unknown, review of the literature estimates that nearly half of all survivors may experience some form of CRCI. Causes of CRCI are multiple and are the subject of continued research. Chemotherapy, genetic vulnerability, neurovascular damage, inflammation, and hormonal/endocrine disruption have all been identified as candidate mechanisms of persistent cognitive change. Given the multiple causal mechanisms, finding a biomedical treatment for CRCI remains elusive. MAAT was developed as a CBT to help cancer survivors make adaptive behavioral and cognitive changes to improve performance in the valued activities that CRCI hinders. MAAT consists of eight visits and has been designed for administration through telehealth technology, improving access to the survivorship care that so many cancer survivors may lack after the time and expense of cancer treatment. Survivors can use this workbook to reinforce their in-session learning and continue to build adaptive coping.
Visit 1
Authors: Ferguson Robert J. , Gillock Karen Lee 
Published: May 2021

Abstract
During Visit 1, Clinicians and survivors review the introduction and overview of MAAT and the eight-session training schedule. The education component covers cancer background, significance, and causes topics as well as helping survivors recognize that not all memory/attention failures are cancer/treatment related (re-attribution). MAAT highlights the important rationale that, while we can’t know at the causes of cancer-related memory problems, we do know that factors such as stress, fatigue, and the divided attention of busy, daily life also contribute to memory problems—and we can change environment, stress response, and manage fatigue through the use of compensatory strategies aimed a minimizing the effects of memory failures. Self-awareness is introduced, and self-monitoring forms are explained and assigned for homework in order to identify the environmental, affective, and cognitive antecedents of memory failures in daily life. Survivors are guided through a Progressive Muscle Relaxation procedure and instructed for home practice with a provided recording.
Visit 2
Authors: Ferguson Robert J. , Gillock Karen Lee 
Published: May 2021

Abstract
In Visit 2, the survivor and clinician review homework from Visit 1. Any difficulty in applying compensatory strategies is reviewed and problem-solved. A review of memory and attention problem records is aimed at identifying themes in memory and attention failures (e.g., verbal-auditory, visual-attention, recall of written or auditory information, ability to follow instruction) while acknowledging the role of environmental factors and inner physical and emotional states (e.g., anxiety, frustration, fatigue, hunger, pain, etc.). A review of progressive muscle relaxation sets the stage for learning quick relaxation. An important internal strategy—self-instructional training—is reviewed and rehearsed so that the survivor can apply it in daily life in a practical way.
Visit 7
Authors: Ferguson Robert J. , Gillock Karen Lee 
Published: May 2021

Abstract
The first goal of the penultimate visit is to review active listening and verbal rehearsal skills for socializing by asking about what strategies were used, for what, when, and where and modifying as needed. The second goal is to review fatigue management and sleep quality improvement by asking what strategies were used, for what, when, and where and modifying as needed. The third goal is to introduce the internal strategy of visualization, including the rationale and reviewing visual–auditory associations. Emphasizing novelty and humor to evoke emotion and deepen memory is also covered. The strategies taught are simple visualization, name–face mnemonic, and the method of loci. The final goal, as customary, is to assign homework, including identifying, practicing, and applying relevant visualization strategies “in the real world.”
Opioid pharmacology in obese patients
Authors: Mulier Jan P. , Wouters Ruben 
Published: May 2021

Abstract
A primary goal in the care of surgery patients is adequate treatment of their perioperative pain. The guidelines from The Joint Commission described the measurement of pain as the ‘fifth vital signal’. Consequently, pain alleviation is a top priority in postoperative management. Most anaesthesiologists worldwide use opioids as one of the primary components of general anaesthesia for achieving haemodynamic stability and for postoperative pain relief. There are medical conditions associated with obesity that must be considered when using postoperative opioids to avoid deleterious effects in these patients. The intraoperative use of opioids is less dangerous but induces rapid tolerance and hyperalgesia, requiring higher postoperative opioid dosages. The physiological differences between obese and non-obese patients can have repercussions on the pharmacokinetics and pharmacodynamics of opioid drug use for this patient population.
Healthy obese
Authors: Wadhwa Anupama , Obal Detlef 
Published: May 2021

Abstract
At least 30% of the surgical population consists of ‘obese’ patients, mirroring the obesity epidemic in the general population in the United States. Nearly 74% of participants in the American College of Surgery’s National Surgical Quality Improvement Program had an abnormally high body mass index, including 17% of patients under the age of 18 years. This development is particularly concerning as obesity is associated with increased risk of metabolic syndrome, hypertension, coronary artery disease, and diabetes mellitus. However, physicians, nutritionists, and the general public struggle with definitions of obesity based only on total body weight proportionate to height and, therefore, body mass index. This leads to the question of whether body mass index is adequate to describe the physical condition and potential risk of our patients.
Tissue oxygenation in the obese patient
Authors: Singh Shubhangi , Singh Prashant , Singh Preet M. 
Published: May 2021

Abstract
Tissue oxygenation refers to the amount of oxygen available at the level of the tissues for cellular metabolism. Due to a much higher increase in the subcutaneous fat volume as compared to the blood volume, obese patients at baseline are at a lower level of tissue oxygenation as compared to their lean counterparts. Increased basal metabolism (higher oxygen need), decreased functional residual capacity, and propensity for obstructive sleep apnoea (lower oxygen supply) increase their risk of hypoxic injury further. Tissue oxygenation is further adversely affected by pathological conditions such as sepsis and haemorrhage that have higher incidences in the obese patient. This leads to further increased expression of proinflammatory cytokines and downregulation of the anti-inflammatory cytokines in the obese patient. This chapter deals with the current knowledge of the concept of tissue oxygenation with a special focus on the obese population.
Guidelines and equipment in obese patients
Authors: Balabanoff-Acosta Christian , Fleckenstein Clint , Gewirtz Eric 
Published: May 2021

Abstract
This chapter of the textbook aims to improve the reader’s understanding of the term ‘difficult airway’ in the obese patient and provides personal insight about and general perioperative recommendations for assessing the airways of, using equipment on, and monitoring obese, morbidly obese, and super-morbidly obese patients. Coupling the suggestions in this chapter with the guidelines of the reader’s home institution will ensure that surgeries for obese, morbidly obese, and super-morbidly obese patients will go as smoothly and as safely as is possible.
Historical background, classification, and diagnostic criteria
Authors: Shiboski Caroline H. , Daniels Troy E. 
Published: May 2021

Abstract
The objective of this chapter is to describe the evolution of, and critically assess, the various diagnostic and classification criteria for Sjögren’s syndrome (SS) first published in 1965. This chapter provides a historical perspective on the natural history of SS and the various diagnostic tests that have proven useful over time and are individual criteria items within the classification criteria set for SS most recently approved by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR). We also summarize the guidelines and important steps recommended by the relevant ACR and EULAR committees for the development and validation of criteria for the rheumatic diseases. Finally, we describe the development and validation of the 2016 ACR-EULAR classification criteria for SS as part of a large international collaborative effort.
Biomarkers in primary Sjögren’s syndrome
Authors: Berardicurti Onorina , Smith Charlotte G. , Giacomelli Roberto , Price Elizabeth J. , Barone Francesca 
Published: May 2021

Abstract
Primary Sjögren’s syndrome (pSS) is an autoimmune disease characterized by lymphocytic infiltrates in exocrine glands and a heterogeneous presentation with a wide spectrum of clinical and serological manifestations. Early diagnosis, treatment choice, and prognostic stratification are all unmet needs in pSS. Biomarkers - objective items measurable or quantifiable in an accurate, reproducible and easy manner - could improve patient identification and treatment. In this review, we summarize the state of the art of ‘traditional’ recognized clinical, serological, and histologic biomarkers for pSS. We also discuss some of the ‘novel’ biomarkers, presenting the evidence in favour of their use in disease assessment. Finally, we highlight biomarkers’ relevance and limitations in current clinical practice and future perspectives.
Autoantibodies and autoantigens in Sjögren’s syndrome
Authors: Ambrosi Aurélie , Björk Albin , Wahren-Herlenius Marie 
Published: May 2021

Abstract
Autoantibodies are a key serological feature of Sjögren’s syndrome (SS). The presence of Ro/Sjögren’s syndrome-related antigen A (SSA) autoantibodies is one of the items with the highest weight in the 2016 joint ACR/EULAR SS classification criteria. Autoantibodies appear before overt clinical disease manifestations, and patient autoantibody profiles seem stable over time, even after B-cell depleting therapy. Expression of Ro/SSA and La/Sjögren’s syndrome-related antigen B (SSB), the major autoantigens in SS, in the target organs (exocrine glands), local autoantibody production, and the capacity of autoantigen-containing immune complexes to induce interferon production all point to a central involvement of autoantibodies in disease pathogenesis. Here, we review the main autoantibody specificities reported in SS, their clinical associations, the current understanding of how autoantibody production is initiated and maintained, and how autoantibodies may exert pathogenic effects. We provide a comprehensive overview of the nature and biological function of the three main autoantigens, Ro52, Ro60, and La (Ro/SSA and La/SSB) found in SS.
Dental-related disease
Authors: Fuller Jennifer , Shahdad Shakeel 
Published: May 2021

Abstract
Saliva contains a complex mixture of organic and inorganic molecules, enabling it to play many roles within the oral cavity, including lubrication, protection of the mucosa and maintenance of dental hard tissues, antibacterial activity, digestion, and taste perception. Hyposalivation in Sjögren’s syndrome (SS) patients leads to dry mouth, rampant dental caries, increased risk of oral infections, difficulty in speaking and swallowing food, and dysgeusia (altered taste perception). SS patients have higher rates of decayed, missing, and filled teeth and increased rates of edentulousness. Rehabilitation with dental prosthesis for these patients can be problematic, as this can increase the risk of plaque stagnation and further dental disease, leading to failure of treatment. Saliva is pivotal in retention of certain types of dental prosthesis and protection of mucosal damage. SS patients may benefit from implant-retained prosthesis. In this chapter dental disease in SS patients and appropriate management are discussed.
Gynaecologic and obstetric aspects in Sjögren’s syndrome
Authors: Priori Roberta , Minniti Antonina , Colafrancesco Serena 
Published: May 2021

Abstract
Although primary Sjögren’s syndrome (SS) mainly affects women, its gynaecological, obstetric, and sexual aspects have been largely overlooked. Data regarding the impact of the disease on pregnancy and vice versa are scant. Primary SS can occur in all age groups but usually starts after the fifth decade, often beyond the childbearing age; however, at least in the Western world, the age of first pregnancy is increasingly delayed, so pregnancy in SS is being encountered more frequently. Vaginal dryness represents the main cause of dyspareunia, which seriously affects individuals’ quality of life, but data regarding this aspect of the disease are scarce. In this chapter we review the main gynaecologic complications of SS, focusing on their prevalence and impact on daily life. In addition we review pregnancy outcome in primary SS including obstetric complications, pregnancy outcome, and manifestations of neonatal lupus.
Sjögren’s syndrome–associated lymphoma
Authors: Rassam Saad M. B. 
Published: May 2021

Abstract
Non-Hodgkin’s lymphoma (NHL), predominantly of the B-cell type, affects a significant proportion of patients with Sjögren’s syndrome (SS). SS carries the highest NHL risk among all systemic autoimmune diseases. Although marginal zone lymphomas (MZL) of the mucosa-associated lymphoid tissue (MALT) type of the salivary glands is the commonest histological type, other indolent and more aggressive subtypes can occur. NHL and its treatment adds to the morbidity and mortality in SS. Early detection and management can improve survival and quality of life in SS patients. This chapter will review some basics of the immune system; expand on NHL incidence and predictive risk factors, pathogenesis, and subtypes of NHL seen in SS; clinical presentation; diagnosis; management; treatment modalities; and complications of therapy. Recent advances in therapy using our expanding knowledge of the molecular pathways seen in NHL will be discussed, as well as novel molecules and innovative immunotherapy.
Sjögren’s syndrome overlaps
Authors: Waller Arabella , Sutcliffe Nurhan 
Published: May 2021

Abstract
Up to one-third of those with Sjögren’s syndrome (SS) have at least one additional autoimmune disease, and 8% have more than two such conditions. The most commonly seen additional autoimmune disease is autoimmune thyroid disease. Systemic lupus erythematosus represents the most closely related systemic autoimmune disease to SS, with significant overlap in clinical and immunological expression. The clinical phenotype of these ‘overlap’ patients often differs considerably from those with ‘pure’ disease. This chapter discusses the epidemiological, clinical, and laboratory features of the commonly seen overlap syndromes with SS, including that with systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, autoimmune liver and thyroid disease, and coeliac disease.
Experimental therapies in primary Sjögren’s syndrome
Authors: Fisher Benjamin 
Published: May 2021

Abstract
Recently there has been a large increase in the number of clinical trials assessing systemic immunomodulatory drugs in Sjögren’s syndrome. This has occurred for a number of reasons including a growing appreciation of the direct and indirect costs and quality-of-life impairment associated with Sjögren’s syndrome, as well as the development of validated outcome measures. Early studies with antitumour necrosis factor demonstrated that a greater understanding of the pathogenic role of a putative target is required since some typically proinflammatory cytokines may also have a negative regulatory role in a context-dependent fashion. Despite the disappointing results of two phase 3 studies of rituximab, novel approaches to B-cell depletion are currently being studied, alongside trials targeting IL-6, intracellular signalling, and co-stimulation pathways.
Off-axis jet scenario for early afterglow emission of low-luminosity gamma-ray burst GRB 190829A
Authors: Sato Yuri , Obayashi Kaori , Yamazaki Ryo , Murase Kohta , Ohira Yutaka 
Published: May 2021

ABSTRACTRecently, ground-based Imaging Atmospheric Cherenkov Telescopes have reported the detection of very-high-energy (VHE) gamma-rays from some gamma-ray bursts (GRBs). One of them, GRB 190829A, was triggered by the Swift satellite, and about 2 × 104 s after the burst onset the VHE gamma-ray emission was detected by H.E.S.S. with ∼5σ significance. This event had unusual features of having much smaller isotropic equivalent gamma-ray energy than typical long GRBs and achromatic peaks in X-ray and optical afterglow at about 1.4 × 103 s. Here, we propose an off-axis jet scenario that explains these observational results. In this model, the relativistic beaming effect is responsible for the apparently small isotropic gamma-ray energy and spectral peak energy. Using a jetted afterglow model, we find that the narrow jet, which has the initial Lorentz factor of 350 and the initial jet opening half-angle of 0.015 rad, viewed off-axis can describe the observed achromatic behaviour in the X-ray and optical afterglow. Another wide, baryon-loaded jet is necessary for the later-epoch X-ray and radio emissions. According to our model, the VHE gamma rays observed by H.E.S.S. at 2 × 104 s may come from the narrow jet through the synchrotron self-Compton process.
An upper limit for the growth of inner planets?
Authors: Winter Andrew J , Alexander Richard 
Published: May 2021

ABSTRACT
The exotic range of known planetary systems has provoked an equally exotic range of physical explanations for their diverse architectures. However, constraining formation processes requires mapping the observed exoplanet population to that which initially formed in the protoplanetary disc. Numerous results suggest that (internal or external) dynamical perturbation alters the architectures of some exoplanetary systems. Isolating planets that have evolved without any perturbation can help constrain formation processes. We consider the Kepler multiples, which have low mutual inclinations and are unlikely to have been dynamically perturbed. We apply an adaption of previous modelling efforts, accounting for the two-dimensionality of the radius ($R_\mathrm{pl} =0.3\!-\!20\, R_\oplus$) and period (Porb = 0.5–730 d) distribution. We find that an upper limit in planet mass of the form $M_\mathrm{lim} \propto a_\mathrm{pl}^{\beta } \exp (-a_\mathrm{in}/a_\mathrm{pl})$, for semimajor axis apl and a broad range of ain and β, can reproduce a distribution of Porb, Rpl that is indistinguishable from the observed distribution by our comparison metric. The index is consistent with β = 1.5, expected if growth is limited by accretion within the Hill radius. This model is favoured over models assuming a separable PDF in Porb, Rpl. The limit, extrapolated to longer periods, is coincident with the orbits of RV-discovered planets (apl &gt; 0.2 au, $M_\mathrm{pl}\gt 1\, M_\mathrm{J}$) around recently identified low density host stars, hinting at isolation mass limited growth. We discuss the necessary circumstances for a coincidental age-related bias as the origin of this result; such a bias is possible but unlikely. We conclude that, in light of the evidence suggesting that some planetary systems have been dynamically perturbed, simple models for planet growth during the formation stage are worth revisiting.
New archeological marvels of ancient Shu civilization
Authors: Zhao Weijie 
Published: May 2021

Abstract
China Central Television broadcasted live reports on the latest archaeological excavation at the Sanxingdui site over four consecutive days, from 20–23 March 2021. Exquisite large golden mask fragments, as well as numerous bronze, jade, pottery and ivory artefacts, were unearthed in six newly discovered pits at the site. Following the public presentation of these ancient cultural relics, along with the contemporary archaeological excavation technologies, the mysterious Sanxingdui civilization has become a hot topic within the Chinese media and scientific community.
Identification of H3N2 NA and PB1-F2 genetic variants and their association with disease symptoms during the 2014–15 influenza season
Authors: Blumenkrantz Deena R , Mehoke Thomas , Shaw-Saliba Kathryn , Powell Harrison , Wohlgemuth Nicholas , Liu Hsuan , Macias Elizabeth , Evans Jared , Lewis Mitra , Medina Rebecca , Hardick Justin , Sauer Lauren M , Dugas Andrea , DuVal Anna , Lane Andrew P , Gaydos Charlotte , Rothman Richard , Thielen Peter , Pekosz Andrew 
Published: May 2021

Abstract
The 2014–15 influenza season saw the emergence of an H3N2 antigenic drift variant that formed the 3C.2a HA clade. Whole viral genomes were sequenced from nasopharyngeal swabs of ninety-four patients with confirmed influenza A virus infection and primary human nasal epithelial cell cultures used to efficiently isolate H3N2 viruses. The isolates were classified by HA clade and the presence of a new set of co-selected mutations in NA (a glycosylation site, NAg+) and PB1-F2 (H75P). The NA and PB1-F2 mutations were present in a subset of clade 3C.2a viruses (NAg+F2P), which dominated during the subsequent influenza seasons. In human nasal epithelial cell cultures, a virus with the novel NAg+F2P genotype replicated less well compared with a virus with the parental genotype. Retrospective analyses of clinical data showed that NAg+F2P genotype viruses were associated with increased cough and shortness of breath in infected patients.