bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case report of a patient with wide complex tachycardia due to Wolff–Parkinson–White syndrome mimicking ventricular tachycardia
Authors: Preisendörfer Stefan , Hessling Gabriele , Deisenhofer Isabel , Bourier Felix 
Published: September 2021

Abstract

Background
Wide complex tachycardia (WCT) associated with syncope as manifestation of an underlying, life-threatening arrhythmia might potentially be the harbinger of sudden cardiac death. Identifying the aetiology of a WCT is imperative to provide appropriate treatment and prevent recurrence.

Case summary
We report the case of a 22-year-old male who had been experiencing haemodynamically significant WCT leading to syncope at the age of 13 years. As the patient and the family rejected an electrophysiological (EP) study, he had received an implantable cardioverter-defibrillator (ICD) for secondary prevention. After 7 years of experiencing multiple shocks, the patient finally gave consent to an EP study, which identified a left-sided accessory atrioventricular pathway that was successfully ablated during the same procedure.

Discussion
The differential diagnosis of WCT might be challenging and includes both ventricular and supraventricular tachycardias. In young patients without structural heart disease experiencing WCT, an EP study should be offered before ICD implantation to make a final diagnosis with the potential to provide definitive treatment.
Associations between health indicators and sleep duration of American adults: NHANES 2011–16
Authors: You Yueyue , Luo Jie , Elstgeest L E M , Zhang Yujian , Tan Siok Swan , Raat Hein 
Published: September 2021

Abstract

Background
This study aimed to investigate associations between health indicators and sleep duration in the general population.

Methods
This cross-sectional data from the National Health and Nutrition Examination Survey. Self-reported sleep duration was classified into short sleep (&lt;7 h/day), regular sleep (7–8 h/day) and long sleep duration (&gt;8 h/day). Health indicators included lifestyle indicators (smoking, alcohol use and physical inactivity), general health indicators (waist circumference and self-reported health condition) and chronic conditions [overweight/obesity, hypertension, diabetes, high cholesterol, chronic low back pain (CLBP) and oral health problems]. A series of multinomial logistic regression analysis were performed, controlling for confounders (age, sex, marital status, ethnic background, education level and poverty-to-income ratio).

Results
Data of 12 835 participants were analyzed. The mean (SD) age of participants was 50.0 (±17.4) years, and 50.6% were women. After adjusting for all health indicators, current smoking (OR: 1.37; 95% CI: 1.17–1.61), a poor (OR: 1.52; 95% CI: 1.23–1.88) health condition, CLBP (OR: 1.40; 95% CI: 1.16–1.69) and oral health problems (OR: 1.28; 95% CI: 1.10–1.49) were associated with short sleep duration. No independent association with long sleep duration was observed in this study.

Conclusions
The results confirm that lifestyle indicators (current smoking and physical inactivity), general health indicators (self-reported health condition) and presence of some chronic conditions (CLBP and oral health problems) are associated with short sleep duration. The results did not confirm that any health indicator was associated with long sleep duration.
Mechanisms and clinical importance of bacteriophage resistance
Authors: Egido Julia E , Costa Ana Rita , Aparicio-Maldonado Cristian , Haas Pieter-Jan , Brouns Stan J J 
Published: September 2021

Abstract
We are in the midst of a golden age of uncovering defense systems against bacteriophages. Apart from the fundamental interest in these defense systems, and revolutionary applications that have been derived from them (e.g. CRISPR-Cas9 and restriction endonucleases), it is unknown how defense systems contribute to resistance formation against bacteriophages in clinical settings. Bacteriophages are now being reconsidered as therapeutic agents against bacterial infections due the emergence of multidrug resistance. However, bacteriophage resistance through defense systems and other means could hinder the development of successful phage-based therapies. Here, we review the current state of the field of bacteriophage defense, highlight the relevance of bacteriophage defense for potential clinical use of bacteriophages as therapeutic agents and suggest new directions of research.
Free French francs? Wartime monetary sovereignty (1940–1944)
Authors: Foulk David A 
Published: September 2021

Abstract
This article asks whether the concept of ‘monetary sovereignty’ can be applied to General Charles de Gaulle’s Free French movement during the Second World War. It explains the creation of the Caisse centrale de la France libre, the Free French semi-central bank, and the role of its personnel, alongside those of the Bank of England and HM Treasury. Using social network analysis, the role of important intermediaries, including John Lithiby and Allen Bartholomew of the Bank of England, comes to the fore. The article demonstrates the importance of international relations to the economic situation of the territories rallied to the Free French. The part played by the Free French delegations in helping to fund the movement is also underlined. Ultimately, the Free French were far from being monetarily sovereign during this period, but retained limited aspects of economic independence, nonetheless.
Jesting culture and religious politics in seventeenth-century England
Authors: Somers Tim 
Published: September 2021

Abstract
This article argues that jestbooks performed important functions within seventeenth-century religious politics. These functions were distinct from the ‘biting’ polemic and satire that more often catches the eyes of scholars. The article identifies ubiquitous ‘popular jests’ and discusses how jesting opened up space to engage playfully with controversial topics. In doing so, it challenges the historiographical dominance of the ‘superiority theory’ of laughter and the othering of dissenters and Catholics. The second section discusses jesting in relation to tension in the 1630s, while the final section discusses royalism, humorous manuscript chronicling and the way jesting shaped the memory of the civil wars.
On desingularization of steady vortex for the lake equations
Authors: Cao Daomin , Zhan Weicheng , Zou Changjun 
Published: September 2021

Abstract
In this paper, we constructed a family of steady vortex solutions for the lake equations with a general vorticity function, which constitutes a desingularization of a singular vortex. The precise localization of the asymptotic singular vortex is shown to be the deepest position of the lake. We also study global nonlinear stability for these solutions. Some qualitative and asymptotic properties are also established.
The Role of Phage Therapy in Burn Wound Infections Management: Advantages and Pitfalls
Authors: Azevedo Maria Manuel , Pina-Vaz Cidália , Rodrigues Acácio G 
Published: September 2021

Abstract
Burn wound infections are often the source of bacteria responsible for systemic infections, including bloodstream infections and pneumonia that ultimately can result in multisystem organ failure and death. Any rapid change in the burn wound appearance or the clinical condition of the burn patient may herald burn wound infection or sepsis. The revival of phage therapy, either in single mode or in combination with conventional antibiotics may represent a valuable alternative, to treat specific bacterial infections such as burn wound infections, including those caused by multidrug-resistant organisms. This systematic review addresses the: 1) general characteristics of bacteriophages; 2) activity of bacteriophages vs conventional antibiotics; 3) activity of bacteriophages against biofilms; 4) bacteriophage administration; and 5) use of bacteriophages in burn wound infections. Although several scientific organizations/societies recognized that phage therapy could be of key value in modern wound care, specific aspects are critical for a burn surgeon and might represent pitfalls discouraging phage therapy adoption in burn wound management; in particular, the unavailability of consensual therapeutic guidelines/regulatory policies and the lack of laboratorial support that might be predictive of its efficacy. The availability of a product/formulation convenient to use, with adequate stability and shelf half-life is also a key condition.
Patterns and Outcomes of High-Voltage vs Low-Voltage Pediatric Electrical Injuries: An 8-Year Retrospective Analysis of a Tertiary-Level Burn Center
Authors: Gurbuz Kayhan , Demir Mete 
Published: September 2021

Abstract
Although electrical injuries (EIs) are rare traumas in the pediatric age group, they are considered one of the most devastating injuries. We aimed to evaluate the patterns and outcomes of pediatric high-voltage injuries (HVIs) vs low-voltage injuries (LVIs), admitted to the burn center within the efforts of determining evidence-based data for contributing to burn prevention strategies. A retrospective study was conducted on children with EIs hospitalized in the Burn Center of Adana City Training and Research Hospital for 8 years (2013–2020). Data including the patients’ clinical and demographic characteristics, the percentage of total body surface area with burns (%TBSA), length of hospital stay, exposure place, electrical current type, and treatment results were collected and analyzed. EIs were detected in 57 (2.5%) of 2243 acute pediatric burn injury admissions. EIs were most frequently observed in the form of HVIs, among children within the age range of 13 to 18 years, mostly in residential outdoor environments, where the high-power lines still passing close to the home roofs and balconies, resulting from contact with them. Besides, to a lesser extent in LVIs, in the home environment among children younger than 5 years, which was caused by connection with substandard electrical cords/poor-quality electrical devices and inserting an object into the electric sockets. Concerning the mean of %TBSA, HVIs suffered more extensive burns than LVIs. The most frequently affected anatomical regions among HVIs and LVIs were the upper limb, followed by the lower limb. While superficial partial- and deep partial-thickness burns were significantly more common among the LVIs, full-thickness burns were more prevalent among the HVIs. The amputation rate was 12% of which only one of them was major amputation (forearm above the elbow joint). HVIs had more elevated creatine kinase (CK) and CK-myocardial band (CK-MB) levels than LVIs but were not correlated with electrocardiography findings. Only one death (caused by HVI) was observed, with a mortality rate of 1.8%. Pediatric EIs are less common than scald or fire flame-related burns in this age group but can cause significant morbidity and even mortality, especially in severe burns. It is possible to prevent possible morbidity and mortality by strengthening compliance with safety precautions, especially with parental education and raising social awareness. In this context, taking necessary precautions for passing high-voltage power lines under the ground, the standardization of electrical cables by the relevant legal regulations, the use of socket covers in homes, promoting the widespread use of residual current relays, and arrangements to be taken against the use of illegal electricity are among measures for the prevention strategy.
Refiguring the Poetic Elegy in Music: The Rhetoric of Mourning in Parry’s Elegy for Brahms
Authors: Allis Michael 
Published: September 2021

ABSTRACT
Of Hubert Parry’s relatively neglected works, his Elegy for Brahms for orchestra (1897) is particularly intriguing. Written to mark Brahms’s death, it was not premiered until Parry’s own memorial concert in 1918. After contextualizing the work in terms of Parry’s clear admiration for Brahms and highlighting significant British orchestral elegies at the turn of the twentieth century, this article suggests how studies of the poetic elegy can be used as a hermeneutic tool to identify a musico-rhetorical structure at the heart of Parry’s composition. Specifically, elegiac conventions and devices identified by Peter Sacks as significant features of poetic models (including the use of repetition, elegiac questioning, processional, the division of mourning voices, and the issue of fame and inheritance) can be identified in Parry’s musical design. This interdisciplinary approach not only creates a distinctive new reading of Parry’s Elegy, but has wider implications for elegiac music in general.
Tissue Engineering and Regenerative Medicine Cranioplasty Using Polycaprolactone-Tricalcium Phosphate: Management and Treatment Outcomes
Authors: Hwang Kihwan , Villavicencio Jay B , Agdamag Anna May P 
Published: September 2021

ABSTRACT

BACKGROUND
Cranioplasty is a procedure commonly performed as the next step in management for patients with decompressive craniectomy. It is commonly associated with complications that might result in implant failure and reoperation. Tissue engineering and regenerative medicine (TERM) involve the development of biological substitutes that restore tissue function and regrow and replace damaged tissues. TERM is a potential solution that might allow for improved long-term outcomes in cranioplasty.

OBJECTIVE
To present a case series that describes the management and treatment outcomes of using TERM in cranioplasty, using polycaprolactone-tricalcium phosphate (PCL-TCP) implants in 2 patients.

METHODS
In 2 young adults, large bone defects of the skull following decompressive craniectomy were reconstructed using patient-specific implants manufactured from PCL-TCP. Bone marrow aspirate was used as autologous biologic that incorporates stem cell and growth factors into the implant.

RESULTS
Both patients recovered without any complications following surgery. Physical examination shows favorable healing outcomes with the defect area having a hard texture upon palpation. Postoperative imaging performed at 8 and 20 months for each patient, respectively, demonstrated ossification over the defect area.

CONCLUSION
Satisfactory bone growth is seen with TERM cranioplasty. The PCL-TCP implant is a novel and recommendable alternative to currently available patient-specific implants used in cranioplasty. TERM cranioplasty is the potential solution to the quest of finding the ideal cranioplasty implant.
A Pragmatic Approach to Adverse Outcome Pathway Development and Evaluation
Authors: Svingen Terje , Villeneuve Daniel L , Knapen Dries , Panagiotou Eleftheria Maria , Draskau Monica Kam , Damdimopoulou Pauliina , O’Brien Jason M 
Published: September 2021

Abstract
The adverse outcome pathway (AOP) framework provides a practical means for organizing scientific knowledge that can be used to infer cause-effect relationships between stressor events and toxicity outcomes in intact organisms. It has reached wide acceptance as a tool to aid chemical safety assessment and regulatory toxicology by supporting a systematic way of predicting adverse health outcomes based on accumulated mechanistic knowledge. A major challenge for broader application of the AOP concept in regulatory toxicology, however, has been developing robust AOPs to a level where they are peer reviewed and accepted. This is because the amount of work required to substantiate the modular units of a complete AOP is considerable, to the point where it can take years from start to finish. To help alleviate this bottleneck, we propose a more pragmatic approach to AOP development whereby the focus becomes on smaller blocks. First, we argue that the key event relationship (KER) should be formally recognized as the core building block of knowledge assembly within the AOP knowledge base (AOP-KB), albeit framing them within full AOPs to ensure regulatory utility. Second, we argue that KERs should be developed using systematic review approaches, but only in cases where the underlying concept does not build on what is considered canonical knowledge. In cases where knowledge is considered canonical, rigorous systematic review approaches should not be required. It is our hope that these approaches will contribute to increasing the pace at which the AOP-KB is populated with AOPs with utility for chemical safety assessors and regulators.
International Medical Graduate Resident Wellness: Examining Qualitative Data From J-1 Visa Physician Recipients
Authors: Symes Hilary A. , Boulet John , Yaghmour Nicholas A. , Wallowicz Tracy , McKinley Danette Waller 
Published: September 2021

Purpose
International medical graduates (IMGs), approximately 25% of the U.S. physician workforce, have unique needs as they enter residency programs. This study identified wellness barriers and challenges that IMGs encounter as they transition to the United States.

Method
The authors analyzed results from 3 open-ended questions in a 21-item survey. This survey was administered in December 2019 to 11,504 IMG resident physicians sponsored by the Educational Commission for Foreign Medical Graduates’ J-1 visa program. These questions asked respondents to describe challenges to their wellness, how they maintain wellness, and resources that would have aided their transition. Data were analyzed using a mixed-methods approach, including both qualitative descriptions and category frequencies.

Results
Of the surveys administered, 7,817 responses (68% response rate) were received. Respondents identified challenges navigating cultural differences (1,314, 17%), health care system (1,108, 14%), distance from family and friends (890, 11%), bureaucratic barriers (724, 9%), and language/communication and finances (575, 7%; 565, 7%, respectively). They also specified that friendships/relationships (2,800, 36%) followed by exercise (2,318, 30%), family (1,822, 23%), socialization (1,001, 13%), and healthy eating (775, 10%) were factors important to their wellness. Respondents requested more information about socialization (741, 9%), bureaucratic support (456, 6%), IMG support networks (427, 5%), financial support (404, 5%), and greater online resources (240, 3%).

Conclusions
IMGs have needs and concerns specific to their demographic group. Participants’ responses suggested that they wanted additional support in the workplace and their personal lives. Answers also indicated that IMGs experienced a unique set of stressors such as fluctuating immigration laws that U.S. medical graduates do not face. Finally, this study supports a body of research that connects social and physical wellness. By identifying and describing these challenges, the authors seek to inform the development of specific programs and resources to improve IMG resident wellness.
Latina Women in the U.S. Physician Workforce: Opportunities in the Pursuit of Health Equity
Authors: Balderas-Medina Anaya Yohualli , Hsu Paul , Martínez Laura E. , Hernandez Stephanie , Hayes-Bautista David E. 
Published: September 2021

Purpose
Some progress has been made in gender diversity in undergraduate medical education and the physician workforce, but much remains to be done to improve workforce disparities for women, particularly women from underrepresented populations, such as Latinas. This study examines the current level of representation and demographic characteristics of Latina physicians, including age, language use, nativity, and citizenship status.

Method
The authors used data from the 2014–2018 U.S. Census Bureau’s American Community Survey (ACS) 5-year estimates for their analyses. During the time period covered by this analysis, ACS response rates ranged from 92.0% to 96.7%. The authors included in this study individuals who self-reported their occupation as physician and who self-identified their race/ethnicity as either non-Hispanic White (NHW) or Hispanic/Latino, regardless of race. The authors used person-level sampling weights provided by the ACS to convert the original 1% sample to a 100% enumeration of the population.

Results
According to the ACS 2014–2018 5-year estimates, NHW physicians make up 65.8% (660,031/1,002,527) of physicians in the United States. Women comprise 36.1% (361,442) of the total U.S. physician population; however, Hispanic/Latina women comprise only 2.4% (24,411). The female physician population is younger than the male physician population, and Hispanic female physicians are the youngest. Latina physicians are far more likely to speak Spanish at home than NHW physicians. Immigrants make up 40.1% (9,782/24,411) of the Hispanic female physician population, and 12.3% (3,012/24,411) of Hispanic female physicians are not U.S. citizens.

Conclusions
This study suggests that Latina physicians in the United States are younger, more likely to be bilingual and speak Spanish at home, and very underrepresented, compared with NHW female and male physicians. Increasing their share of the U.S. physician workforce would benefit the pursuit of health equity for an ever more diverse population.
Examining Employment and Employment Barriers Among a Sample of Patients in Medication-Assisted Treatment in the United States
Authors: Ware Orrin D. , Frey Jodi J. , Cloeren Marianne , Mosby Amanda , Imboden Rachel , Bazell Alicia T. , Huffman Margo , Hochheimer Martin , Greenblatt Aaron D. , Sherman Stephan A. 
Published: September 2021

Background:
Barriers to employment are a considerable problem for individuals recovering from an opioid use disorder (OUD). Being unemployed while receiving OUD treatment is associated with poorer treatment outcomes.

Objectives:
Apply the biopsychosocial model to examine employment status and the association of barriers to employment among a sample of adults receiving Methadone for OUD.

Materials and Methods:
Administrative data from an east coast midsized urban medication-assisted treatment provider in the United States were obtained from a state database. Univariate analyses were used to describe the sample, and bivariate analyses were used to examine the relationship between employment status and select variables. A logistic regression model was used to predict employment status.

Results:
Sample characteristics include 80.8% unemployed, 63.1% male, 49.6% White, and 65.3% never married. Employment status was significantly associated with past 30-day depression/sadness (χ2
(1)=11.361, P<0.01), past 30-day anxiety/tension (χ2
(1)=8.799, P<0.01), receiving financial support (χ2
(1)=6.550, P<0.05), having a driver’s license (χ2
(1)=12.984, P<0.001) and having a vehicle (χ2
(1)=43.208, P<0.001). The logistic regression model found those with a vehicle were less likely to be unemployed (odds ratio=0.248, P<0.01), while those awaiting a trial/charge were more likely to be unemployed (odds ratio=9.253, P<0.001).

Conclusions:
This study identified potential barriers (ie, psychological, transportation, criminal justice system involvement) from a biopsychosocial framework, associated with employment status among a sample of individuals in Methadone treatment. Identifying employment barriers in this population will help with treatment based clinical interventions.