bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survey evaluating clinical equipoise around platelet transfusion after head injury and traumatic intracranial haemorrhage (ICH) in patients on antiplatelet medications
Authors: Ashton Catherine , Laffan M , Hutchinson P J , Lecky Fiona , Ralhan S , Smith Jason E , Coles Jonathan P , Stanworth Simon , Curry Nicola 
Published: June 2021

IntroductionPatients aged 60 or over account for over half of the severely injured trauma patients and a traumatic brain injury is the most common injury sustained. Many of these patients are taking antiplatelet medications but there is clinical equipoise about the role of platelet transfusion in patients with traumatic intracranial haemorrhage (ICH) taking prior antiplatelet medications.MethodA prepiloted survey was designed to explore a range of clinical issues in managing patients taking antiplatelet medications admitted with a traumatic brain injury. This was sent via email to consultants and specialty registrar members of a variety of relevant UK societies and working groups in the fields of emergency medicine, critical care, neurosurgery and haematology.Results193 responses were received, mostly from colleagues in emergency medicine, neurosurgery, anaesthesia and haematology. Respondents indicated that there is a lack of evidence to support the use of platelet transfusion in this patient population but also lack of evidence of harm. Results also demonstrate uncertainties as to whether platelets should be given to all or some patients and doubt regarding the value of viscoelastic testing.DiscussionOur survey demonstrates equipoise in current practice with regards to platelet transfusion in patients with a traumatic ICH who are taking antiplatelet medication. There is support for additional trials to investigate the effect of platelet transfusion in this rising population of older, high-risk patients, in order to provide a better evidence-base for guideline development.
Incidence of immune checkpoint inhibitor–mediated diarrhea and colitis (imDC) in patients with cancer and preexisting inflammatory bowel disease: a propensity score–matched retrospective study
Authors: Sleiman Joseph , Wei Wei , Shah Ravi , Faisal Muhammad Salman , Philpott Jessica , Funchain Pauline 
Published: June 2021

Background and aimsThe risk of use of immune-mediated diarrhea and colitis (imDC) in patients with preexisting inflammatory bowel disease (IBD) is not fully understood. We report the incidence of imDC in these patients, and compare with a matched cohort of patients with cancer and without IBD.MethodsPatients with IBD from a tertiary center cancer registry who underwent immune checkpoint inhibitor (ICI) therapy from 2011 to 2019 were identified. A 1:5 matched cohort of patients with and without a history of IBD was created, based on age, ICI therapy, and cancer type. Demographic data, clinical history of IBD, cancer, ICI agent, imDC events after ICI therapy, and overall survival were analyzed. Overall survival and time-to-imDC (TTimDC) were estimated by Kaplan-Meier and multivariate Cox proportional-hazards models.ResultsFrom a retrospective cohort of 3900 patients who received ICI therapy, 30 patients with IBD were matched with 150 patients without a history of IBD. Most patients received PD-1/PD-L1 inhibitor monotherapy (154/180, 85.6%). Individuals with preexisting IBD showed significantly shorter TTimDC than those in the non-IBD group (1-year imDC-free rate 67% vs 93%; HR 7.59, 95% CI 3.00 to 19.15, p<0.0001). Eleven (36%) from the IBD cohort experienced imDC events; none led to life-threatening conditions needing surgical interventions or death. Corticosteroids or biologics were needed in 8/11 (73%) patients, and discontinuation of therapy improved imDC in the remaining three. Half of patients required hospitalization. In contrast, no significant difference in overall survival was observed between IBD and non-IBD cohorts (HR 0.89, 95% CI 0.54 to 1.48). Both groups had overall comparable rates of other non-imDC immune-related adverse events.ConclusionPatients with preexisting IBD had worse time-to-imDC than non-IBD matched controls, yet did not exhibit worse overall survival. While close monitoring of patients with preexisting IBD is warranted while on immunotherapy, this comorbidity should not preclude ICI therapy if clinically required.
Discordant severity criteria in patients with moderate aortic stenosis: prognostic implications
Authors: Pio Stephan M , Amanullah Mohammed R , Butcher Steele C , Sin Kenny Y , Ajmone Marsan Nina , Pibarot Philippe , Van Mieghem Nicolas M , Ding Zee Pin , Généreux Philippe , Leon Martin B , Ewe See Hooi , Delgado Victoria , Bax Jeroen J 
Published: June 2021

BackgroundThe criteria to define the grade of aortic stenosis (AS)—aortic valve area (AVA) and mean gradient (MG) or peak jet velocity—do not always coincide into one grade. Although in severe AS, this discrepancy is well characterised, in moderate AS, the phenomenon of discordant grading has not been investigated and its prognostic implications are unknown.ObjectivesTo investigate the occurrence of discordant grading in patients with moderate AS (defined by an AVA between 1.0 cm² and 1.5 cm² but with an MG <20 mm Hg) and how these patients compare with those with concordant grading moderate AS (AVA between 1.0 cm² and 1.5 cm² and MG ≥20 mm Hg) in terms of clinical outcomes.MethodsFrom an ongoing registry of patients with AS, patients with moderate AS based on AVA were selected and classified into discordant or concordant grading (MG <20 mm Hg or ≥20 mm Hg, respectively). The clinical endpoint was all-cause mortality.ResultsOf 790 patients with moderate AS, 150 (19.0%) had discordant grading, moderate AS. Patients with discordant grading were older, had higher prevalence of previous myocardial infarction and left ventricular (LV) hypertrophy, larger LV end-diastolic and end-systolic volume index, higher LV filling pressure and lower LV ejection fraction and stroke volume index as compared with their counterparts. After a median follow-up of 4.9 years (IQR 3.0–8.2), patients with discordant grading had lower aortic valve replacement rates (26.7% vs 44.1%, p<0.001) and higher mortality rates (60.0% vs 43.1%, p<0.001) as compared with patients with concordant grading. Discordant grading moderate AS, combined with low LV ejection fraction, presented the higher risk of mortality (HR 2.78 (2.00–3.87), p<0.001).ConclusionDiscordant-grading moderate AS is not uncommon and, when combined with low LV ejection fraction, is associated with high risk of mortality.
Logarithmic expansion of field theories: higher orders and resummations
Authors: Branchina Vincenzo , Chiavetta Alberto , Contino Filippo 
Published: June 2021

AbstractA formal expansion for the Green’s functions of a quantum field theory in a parameter $$\delta $$
δ
that encodes the “distance” between the interacting and the corresponding free theory was introduced in the late 1980s (and recently reconsidered in connection with non-hermitian theories), and the first order in $$\delta $$
δ
was calculated. In this paper we study the $${\mathcal {O}}(\delta ^2)$$

O
(

δ
2

)

systematically, and also push the analysis to higher orders. We find that at each finite order in $$\delta $$
δ
the theory is non-interacting: sensible physical results are obtained only resorting to resummations. We then perform the resummation of UV leading and subleading diagrams, getting the $${\mathcal {O}}(g)$$

O
(
g
)

and $${\mathcal {O}}(g^2)$$

O
(

g
2

)

weak-coupling results. In this manner we establish a bridge between the two expansions, provide a powerful and unique test of the logarithmic expansion, and pave the way for further studies.
Holographic RG flows and Janus solutions from matter-coupled $$N=4$$ gauged supergravity
Authors: Karndumri Parinya 
Published: June 2021

AbstractWe study an $$SO(2)\times SO(2)\times SO(2)\times SO(2)$$

S
O
(
2
)
×
S
O
(
2
)
×
S
O
(
2
)
×
S
O
(
2
)

truncation of four-dimensional $$N=4$$

N
=
4

gauged supergravity coupled to six vector multiplets with $$SO(4)\times SO(4)$$

S
O
(
4
)
×
S
O
(
4
)

gauge group and find a new class of holographic RG flows and supersymmetric Janus solutions. In this truncation, there is a unique $$N=4$$

N
=
4

supersymmetric $$AdS_4$$

A
d

S
4

vacuum dual to an $$N=4$$

N
=
4

SCFT in three dimensions. In the presence of the axion, the RG flows generally preserve $$N=2$$

N
=
2

supersymmetry while the supersymmetry is enhanced to $$N=4$$

N
=
4

for vanishing axion. We find solutions interpolating between the $$AdS_4$$

A
d

S
4

vacuum and singular geometries with different residual symmetries. We also show that all the singularities are physically acceptable within the framework of four-dimensional gauged supergravity. Accordingly, the solutions are holographically dual to RG flows from the $$N=4$$

N
=
4

SCFT to a number of non-conformal phases in the IR. We also find $$N=4$$

N
=
4

and $$N=2$$

N
=
2

Janus solutions with $$SO(4)\times SO(4)$$

S
O
(
4
)
×
S
O
(
4
)

and $$SO(2)\times SO(2)\times SO(3)\times SO(2)$$

S
O
(
2
)
×
S
O
(
2
)
×
S
O
(
3
)
×
S
O
(
2
)

symmetries, respectively. The former is obtained from a truncation of all scalars from vector multiplets and can be regarded as a solution of pure $$N=4$$

N
=
4

gauged supergravity. On the other hand, the latter is a genuine solution of the full matter-coupled theory. These solutions describe conformal interfaces in the $$N=4$$

N
=
4

SCFT with $$N=(4,0)$$

N
=
(
4
,
0
)

and $$N=(2,0)$$

N
=
(
2
,
0
)

supersymmetries.
Relativistic compact stars in Tolman spacetime via an anisotropic approach
Authors: Bhar Piyali , Rej Pramit , Takisa P. Mafa , Zubair M. 
Published: June 2021

AbstractIn this present work, we have obtained a singularity-free spherically symmetric stellar model with anisotropic pressure in the background of Einstein’s general theory of relativity. The Einstein’s field equations have been solved by exploiting Tolman ansatz [Richard C Tolman, Phys. Rev. 55:364, 1939] in $$(3+1)$$

(
3
+
1
)

-dimensional space-time. Using observed values of mass and radius of the compact star PSR J1903+327, we have calculated the numerical values of all the constants from the boundary conditions. All the physical characteristics of the proposed model have been discussed both analytically and graphically. The new exact solution satisfies all the physical criteria for a realistic compact star. The matter variables are regular and well behaved throughout the stellar structure. Constraints on model parameters have been obtained. All the energy conditions are verified with the help of graphical representation. The stability condition of the present model has been described through different testings.
Sources of Nitrate in Ground Water Aquifers of the Semiarid Region of Tanzania
Authors: Alex Rita , Kitalika Aldo , Mogusu Emmanuel , Njau Karoli 
Published: June 2021

Nitrate isotopic values are often used as a tool to identify sources of nitrate in order to effectively manage ground water quality. In this study, the concentrations of NO3−, NO2−, and NH4+ from 50 boreholes and shallow wells in the Singida and Manyoni Districts were analyzed during the dry and wet seasons, followed by identification of nitrate sources using the hydrochemical method (NO3−/Cl−) and stable isotope (δ15N and δ18O) techniques. Results showed that NO2− and NH4+ concentrations were very low in both seasons due to the nitrification process. The concentrations of NO3− ranged from 2.4 ppm to 929.6 ppm with mean values of

118.5

ppm
±
118.5

ppm

, during the dry season and from 2.4 ppm to 1620.0 ppm with mean values of

171.6

ppm
±
312.3

ppm

, during the wet season. The higher NO3− contamination observed in the wet season could be due to rainfall which accelerated the surface runoff that collects different materials from various settings into the ground water sources. Nitrate source identification through hydrochemical technique revealed that most nitrates originated from sewage effluents and/or organic wastes such as manure. Likewise, the mean values of δ15N-NO3− (

+
20.90
‰
±
5.17
‰

and

+
18.30
‰
±
6.33
‰

) and the mean values of δ18O-NO3−(

+
13.86
‰
±
3.18
‰

and

+
13.69
‰
±
3.97
‰

) suggest that 80% of boreholes and 52% of shallow wells were dominated with nitrate from sewage effluents and/or manure as most ground water sources were situated in densely populated areas with congested and poorly constructed onsite sanitation facilities such as pit latrines and manure. Therefore, to reduce nitrate pollution in the study area, a central sewer must be constructed to treat the discharged wastes. Also, groundwater harvesting should consider the proper principles for groundwater harvesting recommended by the respective authority to minimize chances of contamination and hence prevention of health risk.
Lei nº 13.465: a Regularização Fundiária no Brasil e suas novas injunções
Authors: Gonçalves Ana Luiza Vieira , Rizek Cibele Saliba 
Published: June 2021

Esse artigo se dedica a explorar as injunções que se desenham com a nova lei de regularização fundiária (13.465/2017), a partir de uma concepção do contexto de elaboração e aprovação da lei e da perspectiva de redução do caráter anterior de resistência que marcava os processos de regularização fundiária de interesse social e da ruptura que se coloca com relação à política vigente em âmbito nacional de formação e capacitação dos gestores públicos para atuação em processos de regularização fundiária. O trabalho se realiza a partir de uma Iniciação Científica financiada pelo CNPq, entre agosto de 2018 e julho de 2019.
Temporal Trends and Drivers of Heart Team Utilization in Transcatheter Aortic Valve Replacement: A Population‐Based Study in Ontario, Canada
Authors: Marcus Gil , Qiu Feng , Manoragavan Ragavie , Ko Dennis T. , Elbaz‐Greener Gabby , Chung Jennifer C. Y. , Sud Maneesh , Farkouh Michael E. , Madan Mina , Fremes Stephen E. , Wijeysundera Harindra C. 
Published: June 2021

Background
The multidisciplinary Heart Team (HT) is recommended for management decisions for transcatheter aortic valve replacement (TAVR) candidates, and during TAVR procedures. Empiric evidence to support these recommendations is limited. We aimed to explore temporal trends, drivers, and outcomes associated with HT utilization.

Methods and Results
TAVR candidates were identified in Ontario, Canada, from April 1, 2012 to March 31, 2019. The HT was defined as having a billing code for both a cardiologist and cardiac surgeon during the referral period. The procedural team was defined as a billing code during the TAVR procedure. Hierarchical logistical models were used to determine the drivers of HT. Median odds ratios were calculated to quantify the degree of variation among hospitals. Of 10 412 patients referred for TAVR consideration, 5489 (52.7%) patients underwent a HT during the referral period, with substantial range between hospitals (median odds ratio of 1.78). Utilization of a HT for TAVR referrals declined from 69.9% to 41.1% over the years of the study. Patient characteristics such as older age, frailty and dementia, and hospital characteristics including TAVR program size, were found associated with lower HT utilization. In TAVR procedures, the procedural team included both cardiologists and cardiac surgeons in 94.9% of cases, with minimal variation over time or between hospitals.

Conclusions
There has been substantial decline in HT utilization for TAVR candidates over time. In addition, maturity of TAVR programs was associated with lower HT utilization.
‘Guilty of Having Been Obedient’
Authors: Owusu Emmanuel Sarpong 
Published: June 2021

Abstract
One of the most debated subjects among academics and experts in the fields of International Humanitarian Law and International Criminal Law is the principle of individual criminal responsibility for war crimes. Even more contentious is that aspect of the principle relating to crimes committed under superior orders – a legal strategy employed by many defendants at the Nuremberg war crimes trials. This paper contributes to the debate by establishing the extent to which Article 33 of the Rome Statute, which adopts the conditional liability approach, is justified. The article achieves its objective by critically discussing the subject from a combination of legal, psychological and moral philosophical perspectives. It presents a historical account of the superior orders defence, highlighting how two conflicting liability doctrines, absolute liability and conditional liability, have traditionally been applied by the courts, and taking a stance in favour of the latter. The article, however, underlines some pressing questions that Article 33 raises. It offers a brief exegesis of the emotion of fear to show how it may destroy voluntariness, arguing that as a modifier of voluntariness, grave fear, in certain circumstances, should exculpate perpetrators in claims of crime under superior orders, even where the orders were manifestly unlawful.
The Narrowing of the European Court of Human Rights? Legal Diplomacy, Situational Self-Restraint, and the New Vision for the Court
Authors: Madsen Mikael Rask 
Published: June 2021

Abstract
In recent years, the European Court of Human Rights (ECtHR) has faced a growing number of challenges, stemming, among other reasons, from problems with the implementation of some of its judgments, an upsurge of sovereigntist sentiments in some member states, and the rise of de facto illiberal democracies within its jurisdiction. This article examines the effects that these changing contexts have had on the operation of the ECtHR. In very general terms, the article finds that the ECtHR has become increasingly more restrained, but that this restraint plays out in multiple different ways which reflect the structural differences among the member states with regard to the protection of human rights. The article argues that the ECtHR has developed a new and differentiated legal rationality that combines elements of its original legal diplomacy with new forms of self-restraint and a new, revised vision for its overarching role in the protection of European human rights. The overall result is a narrowing of the role of the Court.
Using the Comparative Method in Democratic Theory: A Solution to the “File Drawer Problem”?
Authors: Dimova Gergana 
Published: June 2021

Abstract
There are currently dozens of conceptions in democratic theory of what constitutes democratic progress and even more concepts of the crisis of democracy. This plethora of ideas is both good news and bad news. The boom in theorizing means that specializations have allowed political scientists to fine-tune their in-depth analysis in order to capture smaller and more specific movements of democratic progress and regress. But the multiplicity of models of the crisis and transformation of democracy also spells some bad news, which is far less often acknowledged and far less understood. This article seeks to shed light on the dangers of not comparing and integrating various models of democracy and to extrapolate the benefits of using the comparative method to do so.
Seamless Detection of Cutoff Lows and Preexisting Troughs
Authors: Kasuga Satoru , Honda Meiji , Ukita Jinro , Yamane Shozo , Kawase Hiroaki , Yamazaki Akira 
Published: June 2021

AbstractWe propose a new scheme based on geopotential height fields to detect cutoff lows starting in the preexisting trough stage. The intensity and scale derived from the proposed scheme will allow for a better understanding of the cutoff low life cycle. These cutoff lows often accompany mesoscale disturbances, causing adverse weather-related events, such as intense torrential rainfall and/or tornadoes. The proposed scheme quantifies the geometric features of a depression from its horizontal height profile. The height slope of a line intersecting the depression bottom and the nearest tangential point (optimal slope) locally indicates the intensity and scale of an isolated depression.The strength of the proposed scheme is that, by removing a local background height slope from a geopotential height field, the cutoff low and its preexisting trough are seamlessly detected as an identical depression. The distribution maps for the detected cutoff lows and preexisting troughs are illustrated along with their intensities, sizes, and local background flows estimated from snapshot height fields. We conducted climatological comparisons of cutoff lows to determine the utility of the proposed scheme.
Otolaryngology Manifestations of Primary Ciliary Dyskinesia: A Multicenter Study
Authors: Zawawi Faisal , Shapiro Adam J. , Dell Sharon , Wolter Nikolaus E. , Marchica Cinzia L. , Knowles Michael R. , Zariwala Maimoona A. , Leigh Margaret W. , Smith Mariana , Gajardo Pilar , Daniel Sam J. 
Published: June 2021

ObjectiveThis project aims to prospectively and objectively assess otolaryngological manifestations and quality of life of children with primary ciliary dyskinesia (PCD) and compare these findings with healthy pediatric controls.Study DesignCross‐sectional.SettingTwo high‐volume pediatric PCD specialty centers.MethodsStandardized clinical assessment; Sino‐Nasal Outcome Test 22 (SNOT‐22); Hearing Environment and Reflection Quality of Life (HEAR‐QL); Reflux Symptom Index (RSI); standardized physical examination of the sinonasal, laryngeal, and otological systems; and investigations including pure‐tone audiograms (PTAs) and sinonasal cultures were collected.ResultsForty‐seven children with PCD and 25 control participants were recruited. Children with PCD had more upper airway symptoms than healthy children. They had significantly higher scores in both SNOT‐22 and RSI, indicating worse sinonasal and reflux symptoms, with worse quality of life on the HEAR‐QL index compared to healthy children (P<. 05). Fifty‐two percent of children with PCD‐related hearing loss were not aware of their hearing deficit that was present on audiological assessment, and only 23% of children who had ventilation tubes had chronic otorrhea, most of which was easily controlled with ototopic drops. Furthermore, although all children with PCD had chronic rhinosinusitis, only 36% of them were using topical nasal treatment. The most common bacteria cultured from the middle meatus wereStaphylococcus aureusin 11 of 47 (23%), followed byStreptococcus pneumoniaein 10 of 47 (21%).ConclusionThis multisite cohort highlights the importance of otolaryngology involvement in the management of children with PCD. More rigorous otolaryngological management may lead to reductions in overall morbidity and improve quality of life for children with PCD.
Clinical features and outcomes of metastatic bone tumors of the pelvis
Authors: Yang Qing , Chen Nong , Fu Wenqin 
Published: June 2021

Objective The number of patients with metastatic bone tumors of the pelvis (MBTP) has increased, and the risk of metastasis and recurrence in the pelvic bones is difficult to assess. Therefore, we investigated the clinical features and oncological outcomes of patients with MBTP. Methods We analyzed the clinical features and oncological outcomes of MBTP in 72 patients (42 men, 30 women; mean age, 50.5 years) from 2008 to 2017. Recurrence in the pelvic bones and survival rates were analyzed with regard to patients’ potential contributing factors. Results Enneking region I was the area most commonly containing MBTP (47.3%). Low- and high-grade tumors were identified in 40 and 32 patients, respectively. The most common pathological type was adenomatous carcinoma (34.7%), and the most common primary lesion was lung cancer (20.8%). The 3-year overall recurrence rate within the pelvic bones was 34.7%, and the 5-year overall survival rate was 29.2%. Conclusion Patients with MBTP have a high risk of recurrence in the pelvic bones and poor survival after multimodal treatment. Pelvic recurrence might be affected by the metastatic involvement, tumor grade, surgical margins, and type of surgery, whereas the survival rate tends to be associated with the tumor grade.