bluuebunny/crossref_metadata_2025_split huggingface dataset:
Training response to 8 weeks of blood flow restricted training is not improved by preferentially altering tissue hypoxia or lactate accumulation when training to repetition failure
Authors: Morley W.N. , Ferth S. , Debenham M.I.B. , Boston M. , Power G.A. , Burr J.F. 
Published: April 2021

Despite compelling muscular structure and function changes resulting from blood flow restricted (BFR) resistance training, mechanisms of action remain poorly characterized. Alterations in tissue O2 saturation (TSI%) and metabolites are potential drivers of observed changes, but their relationships with degree of occlusion pressure are unclear. We examined local TSI% and blood lactate (BL) concentration during BFR training to failure using different occlusion pressures on strength, hypertrophy, and muscular endurance over an 8-week training period. Twenty participants (11 males/9 females) trained 3/wk for 8 wk using high pressure (100% resting limb occlusion pressure, LOP; 20% one-repetition maximum (1RM)), moderate pressure (50% LOP, 20%1RM), or traditional resistance training (TRT; 70%1RM). Strength, size, and muscular endurance were measured pre/post training. TSI% and BL were quantified during a training session. Despite overall increases, no group preferentially increased strength, hypertrophy, or muscular endurance (p > 0.05). Neither TSI% nor BL concentration differed between groups (p > 0.05). Moderate pressure resulted in greater accumulated deoxygenation stress (TSI% × time) (–6352 ± 3081, –3939 ± 1835, –2532 ± 1349 au for moderate pressure, high pressure, and TRT, p = 0.018). We demonstrate that BFR training to task-failure elicits similar strength, hypertrophy, and muscular endurance changes to TRT. Further, varied occlusion pressure does not impact these outcomes or elicit changes in TSI% or BL concentrations. Novelty: Training to task failure with low-load blood flow restriction elicits similar improvements to traditional resistance training, regardless of occlusion pressure. During blood flow restriction, altering occlusion pressure does not proportionally impact tissue O2 saturation nor blood lactate concentrations.
Efficacy and Safety of Using Dual Versus Monotherapy Antiplatelet Agents in Secondary Stroke Prevention: Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials
Authors: Trifan Gabriela , Gorelick Philip B. , Testai Fernando D. 
Published: April 2021

Background:
Dual antiplatelet treatment (DAPT) with aspirin plus clopidogrel for a limited time is recommended after minor noncardioembolic stroke.

Methods:

We performed a meta-analysis of all major studies that compared the efficacy and safety of DAPT versus monotherapy for the secondary prevention of recurrent stroke or transient ischemic attack. The primary outcomes were stroke and the composite of stroke, transient ischemic attack, acute coronary syndrome, and death from any cause. The safety outcome was major hemorrhage. Relative risk (RR) and 95% CIs were calculated. Heterogeneity was assessed by
I
2
and Cochrane Q statistics.

Results:

The analysis included 27 358 patients, the quality of evidence was moderate to low, and the heterogeneity for all the comparisons was low (
I
2
≤25%). Compared with monotherapy, DAPT reduced the risk of recurrent stroke (RR, 0.71 [95% CI, 0.63–0.81]) and composite outcome (RR, 0.76 [95% CI, 0.69–0.83]) but increased the risk of major bleeding (RR, 2.17 [95% CI, 1.45–3.25]). In the subgroup analysis, ≤30 days of DAPT increased the risk of hemorrhage relative to monotherapy (RR, 1.94 [95% CI, 1.08–3.52]). In the sensitivity analysis, the risk for hemorrhage with ≤30 days of DAPT after excluding the combination of aspirin plus ticagrelor was comparable to monotherapy (RR, 1.42 [95% CI, 0.77–2.60]). However, the risk for stroke recurrence and composite outcomes in the subgroup and sensitivity analyses remain decreased compared with monotherapy.

Conclusions:
DAPT decreases the risk of recurrent stroke and composite events compared with monotherapy. DAPT increases the risk of major hemorrhage, except if the treatment is limited to 30 days and does not include the combination of aspirin plus ticagrelor.
A Room with a landscape: Vedute from the Palace of
the Privileged Company of Trieste and Rijeka
Authors: Grupa Fokus 
Published: April 2021

Abstract
In the oldest Austro-Hungarian sugar refinement plant opened in mid 18thcentury in Rijeka, today Croatia, a series of “idealized” landscapes pained by unknown artisans include depictions of slaves. The so-called Vedute ideate are a rare depiction of the racialized slave labor in the Austro-Hungarian Empire that points to the invisible labor, which enabled industrial production of sugar and made visible the relation of the Austro-Hungarian Empire, together with the peripheral port town of Rijeka, to the global flow of capital and the history of colonialism. By drawing on Catherine Baker’s recently published “Race in Yugoslavia” we look at how representation of slavery did not receive critical assessment while the resentment for the racialization across ethnic lines, in relation to Europe proper where the inhabitants ex-Yugoslavia are themselves racialized as the European other, perseveres. With the repurposing of the industrial building in the framework of European Capital of Culture project, Rijeka 2020 – Port of Diversity, the Vedute ideate will be publicly displayed as part of the Museum of the City of Rijeka display but it is uncertain whether the museum will recognize colonialism as a constituent part of Rijeka’s industrialization and development.
The Pathway to Enrolling in a High-Performance High School: Understanding Barriers to Access
Authors: Sartain Lauren , Barrow Lisa 
Published: April 2021

Abstract
In 2017, Chicago Public Schools adopted an online universal application system for all high schools with the hope of providing more equitable access to high-performance schools. Despite the new system, black students and students living in low socioeconomic status (SES) neighborhoods remained less likely than their peers to enroll in a high-performance high school. In this paper, we characterize various constraints that students and families may face in enrolling in a high-performance high school, including eligibility to programs based on prior academic achievement, distance from high-performance options, elementary school performance ratings, and neighborhood SES. After adjusting for differences in these access factors, we find the gap between black and Latinx students’ likelihood of enrolling in a high-performing high school is reduced by about 80 percent. We find a similarly large reduction in the enrollment gap between students from low and middle SES neighborhoods after adjusting for eligibility and distance factors. These findings have implications for policies that may help equalize access to high-performance schools through changes to eligibility requirements and improved transportation options.
<p><strong><em>Beilschmiedia osacola</em> (Lauraceae) a new species from the Osa Peninsula, Costa Rica</strong></p>
Authors: SANTAMARÍA-AGUILAR DANIEL , AGUILAR FERNÁNDEZ REINALDO , VAN DER WERFF HENK 
Published: April 2021

We describe and illustrate a new species of Beilschmiedia, from the Osa Peninsula of Costa Rica. It is distinguished by its small flowers, which are turbinate to campanulate, with six fertile stamens and pubescent ovary, in addition it has alternate leaves along the twigs, with the lower leaf surface glabrous and not glaucous. In the field, it can be recognized by its stature, a very large tree, with the bark reddish, and peeling in large plates. Among described congeners it is superficially similar to B. hexanthera, from French Guiana, which also has six fertile stamens, and staminodes of whorl III columnar, but differs in having a pubescent ovary and larger, more branched inflorescences.
Intrinsic Oceanic Decadal Variability of Upper-Ocean Heat Content
Authors: Constantinou Navid C. , Hogg Andrew McC. 
Published: April 2021

AbstractAtmosphere and ocean are coupled via air–sea interactions. The atmospheric conditions fuel the ocean circulation and its variability, but the extent to which ocean processes can affect the atmosphere at decadal time scales remains unclear. In particular, such low-frequency variability is difficult to extract from the short observational record, meaning that climate models are the primary tools deployed to resolve this question. Here, we assess how the ocean’s intrinsic variability leads to patterns of upper-ocean heat content that vary at decadal time scales. These patterns have the potential to feed back on the atmosphere and thereby affect climate modes of variability, such as El Niño or the interdecadal Pacific oscillation. We use the output from a global ocean–sea ice circulation model at three different horizontal resolutions, each driven by the same atmospheric reanalysis. To disentangle the variability of the ocean’s direct response to atmospheric forcing from the variability due to intrinsic ocean dynamics, we compare model runs driven with interannually varying forcing (1958–2018) and model runs driven with repeat-year forcing. Models with coarse resolution that rely on eddy parameterizations show (i) significantly reduced variance of the upper-ocean heat content at decadal time scales and (ii) differences in the spatial patterns of low-frequency variability compared with higher-resolution models. Climate projections are typically done with general circulation models with coarse-resolution ocean components. Therefore, these biases affect our ability to predict decadal climate modes of variability and, in turn, hinder climate projections. Our results suggest that for improving climate projections, the community should move toward coupled climate models with higher oceanic resolution.
Changes to Timeliness and Completeness of Infectious Disease Reporting in Texas After Implementation of an Epidemiologic Capacity Program
Authors: Stone Kahler W. , Felkner Marilyn , Garza Eric , Perez-Patron Maria , Schmit Cason D. , McDonald Thomas J. , Horney Jennifer A. 
Published: April 2021

Objectives The objective of this study was to characterize the changes in timeliness and completeness of disease case reporting in Texas in response to an increasing number of foodborne illnesses and high-consequence infectious disease investigations and the Texas Department of State Health Services’ new state-funded epidemiologist (SFE) program. Methods We extracted electronic disease case reporting data on 42 conditions from 2012 through 2016 in all local health department (LHD) jurisdictions. We analyzed data on median time for processing reports and percentage of complete reports across time and between SFE and non-SFE jurisdictions using Mann–Whitney t tests and z scores. Results The median time of processing improved from 13 days to 10 days from 2012 to 2016, and the percentage of disease case reports that were complete improved from 19.6% to 27.7%. Most reports were for foodborne illnesses; both timeliness (11 to 7 days) and completeness (20.9% to 23.5%) improved for these reports. Conclusions Disease reporting improvements in timeliness and completeness were associated with the SFE program and its enhancement of epidemiologic capacity. SFEs were shown to improve surveillance metrics in LHDs, even in jurisdictions with a high volume of case reports. Adding epidemiologist positions in LHDs produces a tangible outcome of improved disease surveillance.
Traumatic respiratory failure and veno-venous extracorporeal membrane oxygenation support
Authors: Salas De Armas Ismael A , Akkanti Bindu , Doshi Pratik B , Patel Manish , Kumar Sachin , Akay M Hakan , Hussain Rahat , Dinh Kha , Baloch Muhammad Yasir , Ahmed Mahmoud Samy , Banjac Igor , Jumean Marwan F , McGinness Kelly , Janowiak Lisa M , Mittal Agrawal Kriti , Nathan Sriram , Zaki John , Nieto Luis , Klein Kimberly , Taub Ethan , Tint Hlaing , Patel Jayeshkumar A , Nascimbene Angelo , Kar Biswajit , Gregoric Igor D 
Published: April 2021

Background: Respiratory failure (RF) is a common cause of death and morbid complication in trauma patients. Extracorporeal membrane oxygenation (ECMO) is increasingly used in adults with RF refractory to invasive mechanical ventilation. However, use of ECMO remains limited for this patient population as they often have contraindications for anticoagulation. Study design: Medical records were retroactively searched for all adult patients who were admitted to the trauma service and received veno-venous ECMO (VV ECMO) support between June 2015 and August 2018. Survival to discharge and ECMO-related complications were collected and analyzed. Results: Fifteen patients from a large Level I trauma center met the criteria. The median PaO2/FiO2 ratio was 53.0 (IQR, 27.0–76.0), median injury severity score was 34.0 (IQR, 27.0–43.0), and the median duration of ECMO support was 11 days (IQR, 7.5–20.0). For this cohort, the survival-to-discharge rate was 87% (13/15). The incidence of neurologic complications was 13%, and deep vein thrombosis was reported in two cases (13%). Conclusions: Survival rates of trauma patients in this study are equivalent to, or may exceed, those of non-trauma patients who receive ECMO support for other types of RF. With the employment of a multidisciplinary team assessment and proper patient selection, early cannulation, traumatic RF may be safely supported with VV ECMO in experienced centers.
Prevalence and Detection of Meniscal Ramp Lesions in Pediatric Anterior Cruciate Ligament–Deficient Knees
Authors: Bernardini Isabelle , N’Dele Daniel , Faruch Bilfeld Marie , Thevenin-Lemoine Camille , Vial Julie , Cavaignac Etienne , Accadbled Franck 
Published: April 2021

Background: Anterior cruciate ligament (ACL) tears represent 13% of knee injuries in children. Medial meniscal tears are commonly associated with ACL ruptures. Ramp lesions correspond to posterior meniscocapsular tears of the medial meniscus. Depending on the study, the prevalence of ramp lesions is inconsistent. Purpose: To describe the prevalence of ramp lesions in children and adolescents and to investigate the sensitivity of magnetic resonance imaging (MRI) for diagnosing such lesions. Study Design: Cohort study (Diagnosis); Level of evidence, 3. Methods: We analyzed videos from arthroscopic ACL reconstruction (ACLR) in children. During these procedures, we systematically looked for potential ramp lesions. To do so, an arthroscope was passed through the intercondylar notch to visualize the posteromedial compartment. A needle was introduced at the site of a posteromedial portal to unfold the meniscocapsular junction to reveal any hidden meniscal tear. Surgical procedures were performed by 2 senior surgeons. Videos were blindly analyzed by a third surgeon. Preoperative MRIs were screened by 2 blinded, independent senior radiologists to look specifically for ramp lesions. Results: Videos of 50 consecutive arthroscopic ACLRs concerning 32 boys and 18 girls were analyzed. Mean age at surgery was 14.2 years (range, 8.5-17.6 years). A total of 14 ramp lesions (28%) in 8 boys and 6 girls were identified. In addition, there were 22 tears of the meniscal body in 20 patients (40%). Arthroscopic and MRI findings did not correlate. Among 14 arthroscopically diagnosed ramp lesions, only 8 were detected on the MRI. Conversely, 12 patients had a ramp lesion detected on the MRI, which could not be confirmed intraoperatively. The sensitivity of MRI was 57% and the positive predictive value was 40%. Conclusion: A meniscal ramp lesion was present in 14 of 50 children (28%) undergoing ACLR. MRI has a low sensitivity for diagnosis of ramp lesions in children. Careful exploration of the posteromedial compartment is strongly recommended. Overlooking such lesions during ACLR may contribute to ongoing instability and higher re-rupture rates in these young patients.
Association Between Unbalanced Solutions and Acute Kidney Injury During Fluid Resuscitation in Children With Sepsis
Authors: Fernández-Sarmiento Jaime , Alcalá-Lozano Catalina , Barrera Pedro Alexander , Erazo Vargas Sofía Camila , Gómez Cortes Laura Bibiana , Reyes C Martha 
Published: April 2021

Objective: To evaluate the outcomes of patients with sepsis-associated organ dysfunction and septic shock who receive fluid resuscitation with balanced and unbalanced solutions in a middle-income country. Design: An observational, analytical cohort study with propensity score matching (PSM) in children admitted to a pediatric intensive care unit (PICU). Patients from one month to 17 years old who required fluid boluses due to hemodynamic instability were included. The primary outcome was the presence of acute kidney injury and the secondary outcomes were the need to begin continuous renal replacement therapy (CRRT), metabolic acidosis, PICU length of stay and mortality. Measurements and Main Results: Out of the 1,074 admissions to the PICU during the study period, 99 patients had sepsis-associated organ dysfunction and septic shock. Propensity score matching was performed including each patient´s baseline characteristics. The median age was 9.9 months (IQR 4.9-22.2) with 55.5% of the patients being male. Acute kidney injury was seen less frequently in children who received a balanced solution than in those who received an unbalanced solution (20.3% vs 25.7% P = 0.006 ORa, 0.75; 95% CI, 0.65-0.87), adjusted for disease severity. In addition, the group that received balanced solutions had less need for CRRT (3.3 % vs 6.5%; P = 0.02 ORa 0.48; 95% CI, 0.36-0.64) and a shorter PICU stay (6 days IQR 4.4-20.2 vs 10.2 days IQR 4.7-26; P < 0.001) than the group with unbalanced solutions. We found no difference in the frequency of metabolic acidosis ( P = 0.37), hyperchloremia ( P = 0.11) and mortality ( P = 0.25) between the 2 groups. Conclusion: In children with sepsis-associated organ dysfunction and septic shock, the use of unbalanced solutions for fluid resuscitation is associated with a higher frequency of acute kidney injury, a greater need for continuous renal support and a longer PICU stay compared to the use of balanced solutions, in a middle-income country.
Evaluating the Demographic and Health Surveys Mode Switch From PAPI to CAPI: An Experiment From Turkey
Authors: Adalı Tuğba , Türkyılmaz Ahmet Sinan , Lepkowski James M. 
Published: April 2021

The Demographic and Health Surveys (DHS) have been carried out in over 90 countries since 1984, as interviewer administered household surveys conducted initially by paper and pencil interviews (PAPI). Computer assisted personal interviews (CAPI) were introduced in the 2004 Peru DHS, and since then numerous countries have also switched. However, DHS randomized mode comparisons have been limited. The 2018 Sixth Turkey DHS was conducted using CAPI but allocated one household from 21 in each of 754 clusters to PAPI. This analysis examines a wide range of potential differences between modes: interviewer attitudes toward modes; response rates, underreporting and misreporting of persons or events, number of selections to “check all that applies” questions, respondents' attitudes towards modes reflected by responses to sensitive questions, satisficing behavior such as age heaping, straight-line response patterns, and use of don’t know options; and some operational aspects of modes such as retrospective monthly contraceptive prevalence rates, presence of others during interview, and interview length. Findings show that, despite strong interviewer CAPI preference, CAPI and PAPI were on average almost identical in terms of responses. CAPI took 11 min less (total duration of 33 min). Analysis of retrospective monthly contraception use indicated potential underreporting by CAPI for past use, an issue highlighted before in DHS literature. Overall, the switch to computer technology in DHS surveys does not appear to change estimates or levels of nonsampling errors, although some differences with respect to PAPI mode may need DHS designer attention.
Bereaved Informal Caregivers Rarely Recall a Relationship Between Transfusions and Hospice in Acute Myeloid Leukemia
Authors: Cripe Larry D. , Cottingham Ann H. , Martin Caroline E. , Hoffmann Mary Lynn , Sargent Katherine , Baker Layla B. 
Published: April 2021

Aims: The inability to prescribe blood transfusions is a potential barrier to timely hospice enrollment for patients with blood cancers. The benefits and harms of transfusions near the end of life (EOL), however, are poorly characterized and patients’ preferences are unknown. We sought to characterize the recollections of bereaved caregivers about the relationships between transfusions and hospice enrollment decisions. Methods: We recruited 18 bereaved caregivers of 15 decedents who died within 6-18 months of the interview. Interviews focused on caregivers’ recollections of transfusion and hospice enrollment decisions. Transcripts were analyzed for themes. Results: We identified 2 themes. First, caregivers described that transfusions were necessary and the decisions to receive transfusions or not were deferred to the clinicians. Second, only 1 caregiver recalled transfusions as relevant to hospice decisions. In that instance there was a delay. Caregivers identified difficulties recognizing death was imminent, hope for miracles, and the necessity of accepting life was ending as more relevant barriers. Conclusions: The results indicate clinicians’ beliefs in transfusion at EOL may be a more relevant barrier to hospice enrollment than patients’ preferences. Strategies to evaluate accurately and discuss the actual benefits and harms of transfusions at the EOL are necessary to advise patients and integrate their preferences into decisions.
Living Donor Liver Transplantation: The Optimal Curative Treatment for Hepatocellular Carcinoma Even Beyond Milan Criteria
Authors: Alim Altan , Erdogan Yalcin , Dayangac Murat , Yuzer Yildiray , Tokat Yaman , Oezcelik Arzu 
Published: April 2021

Introduction: Liver transplantation offers the most reasonable expectation for curative treatment for hepatocellular carcinoma. Living-donor liver transplantation represents a treatment option, even in patients with extended Milan criteria. This study aimed to evaluate the outcomes of hepatocellular carcinoma patients, particularly those extended Milan criteria. Materials and Patients: All HCC patients who received liver transplant for HCC were included in this retrospective study. Clinical characteristics including perioperative data and survival data (graft and patient) were extracted from records. Univariate and multivariate analyses was performed to identify significant prognostic factors for survival, postoperative complications and recurrence. Results: Two-hundred and two patients were included. The median age was 54.8 years (IQR 53-61). Fifty-one patients (25.3%) underwent deceased donors liver transplantation and 151 patients (74.7%) underwent living donor liver transplantation. Perioperative mortality rate was 5.9% (12 patients). Recurrent disease occurred in 43 patients (21.2%). The overall 1-year and 5-year survival rates were 90.7% and 75.6%, respectively. Significant differences between patients beyond Milan criteria compared to those within Milan criteria were not found. Alpha-fetoprotein level >300 ng/mL, vascular invasion, and bilobar tumor lesions were independent negative prognostic factors for survival. Conclusion: Liver transplantation is the preferred treatment for hepatocellular carcinoma and it has demonstrated an excellent potential to cure even in patients with beyond Milan criteria. This study shows that the Milan criteria alone are not sufficient to predict survival after transplantation. The independent parameters for survival prediction are Alpha-Fetoprotein-value and status of vascular invasion.