bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transoral approach using a tubular retractor system in the treatment of atlantoaxial Pott’s disease: a novel method of surgical decompression
Authors: Araneta Karla Teresa Saldaña , Bundoc Rafael 
Published: March 2021

The use of tubular retractors in minimally invasive spine surgery has been described extensively in the literature. However, there are only select reports discussing their use specifically in a transoral approach for upper cervical pathologies such as an epidural abscess and a dystrophic os odontoideum.We report the first use of a transtubular transoral approach in a rare case of an adult presenting with severe neck pain with progressing neurologic signs secondary to atlantoaxial Pott’s disease. Debridement and partial odontoidectomy performed using this approach allowed less trauma to surrounding soft tissues without sacrificing an excellent visualisation of the operative field. A halo vest was applied to provide temporary stability. The patient transitioned out of his halo vest after 6 months while completing medical therapy after a year without need for further intervention. The transtubular transoral approach is a suitable alternative to the conventional approach in patients with atlantoaxial Pott’s disease.
Angioedema as a predominant symptom ofBordetella pertussisinfection
Authors: Bal Christina , Baumgartner Ruth , Gompelmann Daniela , Idzko Marco 
Published: March 2021

A 41-year-old woman was referred to our hospital with a 6-week history of severe angioedema, dyspnoea and coughing. Initial investigations focused on common causes of angioedema. Clinical presentation and resistance to treatment with antihistamines and steroids made histamine-mediated angioedema unlikely. Bradykinin-mediated angioedema, such as hereditary or drug-induced angioedema, was excluded by a thorough history investigation and laboratory testing for C1-esterase and C4.In rare cases, exogen pathogens cause angioedema. After profound testing for respiratory pathogens,Bordetella pertussistoxins IgA and IgG were found to be positive, indicating recentB. pertussisinfection. Pertussis toxin may be responsible for increased vascular permeability causing angioedema. With adequate antibiotic treatment, the symptoms resolved quickly.This case is an example of an atypical presentation ofB. pertussisinfection in an unvaccinated adult. The recent resurgence of pertussis makes early diagnosis and disease prevention by vaccination crucial.
Birth weight modifies the relation between adulthood levels of insulin-like growth factor-1 and type 2 diabetes: a prospective cohort study
Authors: Geng Tingting , Wang Mengying , Li Xiang , Zhou Tao , Ma Hao , Fonseca Vivian A , Koh Woon-Puay , Huang Tao , Heianza Yoriko , Qi Lu 
Published: March 2021

IntroductionInsulin-like growth factor-1 (IGF-1) has been implicated in fetal and early-life growth and development of type 2 diabetes (T2D). We aimed to examine the interaction between circulating IGF-1 and birth weight in relation to risk of T2D.Research design and methodsWe included 181 090 adults, aged 39–70 years in the UK Biobank Study, who were free of diabetes or major cardiovascular diseases at baseline. Serum IGF-1 levels were determined using chemiluminescent immunoassay method. Birth weight was self-reported; a Genetic Risk Score (GRS) was calculated to define the genetically determined birth weight. The outcome was the incidence of T2D.ResultsWe identified 3299 incident T2D cases over an average of 9.9 years of follow-up. Among the participants with birth weight of ≥2.5 kg, IGF-1 levels were inversely associated with T2D risk in a dose-dependent manner (p-trend<0.001). In contrast, the association was not significant among those with birth weight of <2.5 kg (p-interaction=0.001). The GRS of birth weight did not interact with IGF-1 levels on T2D risk.ConclusionsOur results indicate that birth weight significantly modifies the relation between adulthood levels of circulating IGF-1 and the risk of T2D. Our findings highlight the importance of early-life risk factors in the development of the lifecourse prevention strategies targeting IGF-1 and T2D.
Patterns of heavy drinking behaviour over age and birth cohorts among Chinese men: a Markov model
Authors: Lee Kyueun , Salomon Joshua , Goldhaber-Fiebert Jeremy 
Published: March 2021

ObjectivesTo estimate the age patterns and cohort trends in heavy drinking among Chinese men from 1993 to 2011 and to project the future burden of heavy drinking through 2027.DesignWe constructed a Markov cohort model that simulates age-specific heavy drinking behaviours for a series of cohorts of Chinese men born between 1922 and 1993 and fitted the model to longitudinal data on drinking patterns (1993–2015). We projected male prevalence of heavy drinking from 2015 through 2027 with and without modification of heavy drinking behaviours.ParticipantsA cohort of Chinese men who were born between 1922 and 1993.Main outcome measuresOutcomes included age-specific and birth cohort-specific rates of initiating, quitting and reinitiating heavy drinking from 1993 through 2011, projected prevalence of heavy drinking from 2015 to 2027, and total reduction in prevalence and total averted deaths with hypothetical elimination of heavy drinking behaviours.ResultsAcross multiple birth cohorts, middle-aged Chinese men have consistently higher risks of starting and resuming heavy drinking and lower probabilities of quitting their current heavy drinking than men in other age groups. From 1993 to 2011, the risk of starting or resuming heavy drinking continued to decrease over generations. Our model projected that the prevalence of heavy drinking among Chinese men will decrease by 33% (95% CI 11.5% to 54.6%) between 2015 and the end of 2027. Complete elimination of or acceptance of a change in heavy drinking behaviours among Chinese men could accelerate this decrease by 12 percentage points (95% CI 7.8 to 18.2) and avert 377 000 deaths (95% CI 228 000 to 577 000) in total from 2015 to 2027.ConclusionHeavy drinking prevalence will continue to decrease through 2027 if current age-specific and birth cohort-specific patterns of starting, quitting and resuming heavy drinking continue. Effective mitigation policy should consider age-specific patterns in heavy drinking behaviours to further reduce the burden of heavy drinking.
Effect of vibration therapy on physical function in critically ill adults (VTICIA trial): protocol for a single-blinded randomised controlled trial
Authors: Nakanishi Nobuto , Doi Satoshi , Kawahara Yoshimi , Shiraishi Mie , Oto Jun 
Published: March 2021

IntroductionVibration therapy has been used as an additional approach in passive rehabilitation. Recently, it has been demonstrated to be feasible and safe for critically ill patients, whose muscle weakness and intensive care unit (ICU)-acquired weakness are serious problems. However, the effectiveness of vibration therapy in this population is unclear.Methods and analysisThis study will enrol 188 adult critically ill patients who require further ICU stay after they can achieve sitting at the edge of the bed or wheelchair. The sample size calculation is based on a 15% improvement of Functional Status Score for the ICU. They will be randomised to vibration therapy coupled with protocolised mobilisation or to protocolised mobilisation alone; outcomes will be compared between the two groups. Therapy will be administered using a low-frequency vibration device (5.6–13 Hz) for 15 min/day from when the patient first achieves a sitting position and onward until discharge from the ICU. Outcome assessments will be blinded to the intervention. Primary outcome will be measured using the Functional Status Score for the ICU during discharge. Secondary outcomes will be identified as follows: delirium, Medical Research Council Score, ICU-acquired weakness, the change of biceps brachii and rectus femoris muscle mass measured by ultrasound, ICU mobility scale and ventilator-free and ICU-free days (number of free days during 28 days after admission). For safety assessment, vital signs will be monitored during the intervention.Ethics and disseminationThis study has been approved by the Clinical Research Ethics Committee of Tokushima University Hospital. Results will be disseminated through publication in a peer-reviewed journal and presented at conferences.Trial registration numberUMIN000039616.
Utilisation of follow-up rehabilitation services for stroke survivors: a scoping review protocol
Authors: Madombwe Jacqueline , Dlungwane Thembelihle 
Published: March 2021

IntroductionStroke is a leading cause of death and disability and has been identified as a significant public health problem. Residual functional deficits negatively affect the stroke survivor’s functional independence and quality of life. Rehabilitation is necessary for them to regain lost skills, relearn tasks and be independent again.Methodology and analysisA scoping review will be conducted to map available literature on factors influencing utilisation of follow-up rehabilitation services for stroke survivors. Databases including PubMed, LISTA(EBSCO), Web of Science (Clarivate), Google Scholar, Scopus and Science Direct will be searched using keyword searches for articles. The review will include studies presenting evidence on outpatient stroke rehabilitation services, studies undertaken and published in English, including grey literature. Title and abstract screening will be done simultaneously. Two reviewers will independently conduct the abstract and full-text article screening as well as pilot the data extraction form. Thematic analysis will be used to analyse the findings.Ethics and disseminationThis scoping review is part of a larger study approved by the University of KwaZulu Natal Biomedical Research Ethics Committee (Reference no. BREC/00000660/2019). The results will be disseminated through publication.
On the development of effective field theory
Authors: Weinberg Steven 
Published: March 2021

AbstractEditor’s note: One of the most important developments in theoretical particle physics at the end of the 20th century and beginning of the twenty-first century has been the development of effective field theories (EFTs). Pursuing an effective field theory approach is a methodology for constructing theories, where a set of core principles is agreed upon, such as Lorentz symmetry and unitarity, and all possible interactions consistent with them are then compulsory in the theory. The utility of this approach to particle physics (and beyond) is wide ranging and undisputed, as evidenced by the recent formation of the international seminar series All Things EFT (Talks in the series can be viewed at https://www.youtube.com/channel/UC1_KF6kdJFoDEcLgpcegwCQ (accessed 21 December 2020).) which brings together each week the worldwide community of EFT practitioners. The text below is a lightly edited version of the talk given by Prof. Weinberg on September 30, 2020, which inaugurated the series. The talk reviews some of the early history of EFTs from the perspective of its pioneer and concludes with a discussion of EFT implications for future discovery.
How Moist and Dry Intrusions Control the Local Hydrologic Cycle in Present and Future Climates
Authors: Smith Samuel , Staten Paul W. , Lu Jian 
Published: March 2021

AbstractModels disagree on how much the hydrologic cycle could intensify under climate change. These changes are expected to scale with the Clausius–Clapeyron relation but may locally diverge due in part to the uncertain response of the general circulation, causing the hydrologic cycle to inherit this uncertainty. To identify how the circulation contributes, we link circulation changes to changes in the higher moments of the hydrologic cycle using the novel dynamical framework of the local hydrologic cycle, the portion of the hydrologic cycle driven by moist or dry intrusions. We expand this dynamical framework, developing a closed budget that diagnoses thermodynamic, advective, and overturning contributions to future hydrologic cycle changes. In analyzing these changes for the Community Earth System Model Large Ensemble, we show that overturning is the main dynamic contributor to the tropical and subtropical annual response, consistent with a weakening of this circulation. In the extratropics, we show that advective contributions, likely from storm track changes, dominate the response. We achieve a cleaner separation between dynamic and thermodynamic contributions through a semiempirical scaling, which reveals the robustness of the Clausius–Clapeyron scaling for the local hydrologic cycle. This scaling also demonstrates the slowing of the local hydrologic cycle and how changing subtropical dynamics asymmetrically impact wave breaking and suppress meridional moisture transport. We conclude that dynamic changes in the subtropics are predominantly responsible for the annual, dynamic response in the extratropics and thus a significant contributor to uncertainty in future projections.
Sublesional Bevacizumab Injection for Recurrent Respiratory Papillomatosis: Evaluation of Utility in a Typical Clinical Practice
Authors: Hall Scott Ryan , Thiriveedi Mrudula , Yandrapalli Usha , Zhang Nan , Lott David G. 
Published: March 2021

Objectives: The goal of this study was to evaluate the benefit of sublesional bevacizumab injection for recurrent respiratory papillomatosis (RRP) as used in a typical clinical practice. Methods: A retrospective review of patients with RRP treated between 2011 and 2016 was undertaken. All patients were treated with in-office potassium titanyl phosphate (KTP) laser photoablation. Sublesional bevacizumab injection was used based on joint patient-physician decision making. Papilloma burden was objectively measured on prior recordings by 2 blinded reviewers and described as vocal fold segments affected (VFSA) by papilloma. Each patient served as their own control by comparing times when bevacizumab was or was not used. Mixed model for longitudinal data was used to determine if the previous use of bevacizumab decreased the disease burden. Results: A total of 19 patients met inclusion criteria and all prior laryngoscopic exams were reviewed for VFSA as described above. The mean (SD) number of VFSA when bevacizumab was not used at the prior procedure was 15 (14) as compared to 8 (11) when bevacizumab was used. When adjusted for age, time from initial presentation and baseline disease burden, mixed model showed a decrease of 11 VFSA (95% CI 6.5, 15.5, P < .0001) when bevacizumab was used as compared to when bevacizumab was not used at the prior procedure. In mixed model analysis, there was not a significant association between bevacizumab dose used and VFSA at the subsequent visit ( P = .8). Conclusion: Using sublesional bevacizumab intermittently based on clinical findings appears to be effective in improving disease control. Papilloma burden is significantly decreased at the subsequent clinical follow-up following injection of sublesional bevacizumab. The beneficial effect of sublesional bevacizumab may be not be dose-dependent.
Regenerative Agriculture: An agronomic perspective
Authors: Giller Ken E , Hijbeek Renske , Andersson Jens A , Sumberg James 
Published: March 2021

Agriculture is in crisis. Soil health is collapsing. Biodiversity faces the sixth mass extinction. Crop yields are plateauing. Against this crisis narrative swells a clarion call for Regenerative Agriculture. But what is Regenerative Agriculture, and why is it gaining such prominence? Which problems does it solve, and how? Here we address these questions from an agronomic perspective. The term Regenerative Agriculture has actually been in use for some time, but there has been a resurgence of interest over the past 5 years. It is supported from what are often considered opposite poles of the debate on agriculture and food. Regenerative Agriculture has been promoted strongly by civil society and NGOs as well as by many of the major multi-national food companies. Many practices promoted as regenerative, including crop residue retention, cover cropping and reduced tillage are central to the canon of ‘good agricultural practices’, while others are contested and at best niche (e.g. permaculture, holistic grazing). Worryingly, these practices are generally promoted with little regard to context. Practices most often encouraged (such as no tillage, no pesticides or no external nutrient inputs) are unlikely to lead to the benefits claimed in all places. We argue that the resurgence of interest in Regenerative Agriculture represents a re-framing of what have been considered to be two contrasting approaches to agricultural futures, namely agroecology and sustainable intensification, under the same banner. This is more likely to confuse than to clarify the public debate. More importantly, it draws attention away from more fundamental challenges. We conclude by providing guidance for research agronomists who want to engage with Regenerative Agriculture.
Opioid Prescribing Patterns After Head and Neck Surgery
Authors: Patel Punam A. , Nagappan Lavanya , Yu Daohai , Liu Xiaoning , Schmalbach Cecelia E. 
Published: March 2021

ObjectivePostoperative prescription narcotics increase access to opioids and associated abuse among patients, family, and acquaintances. Judicious opioid stewardship is required. Best practice questions remain for larger head and neck surgeries. We aim to review opioid utilization patterns in an urban patient population to identify patients at risk for poor postoperative pain control.Study DesignCase series with planned chart review for patients undergoing head and neck surgery (2015‐2018).SettingSingle urban hospital.MethodsOutcome measures included postoperative phone calls and emergency room visits as markers for inadequate pain control. Age, sex, race, body mass index (BMI), smoking status, comorbidities, prior narcotic filling behavior, surgery type, and duration were evaluated as potential risk factors for pain control. Chi‐square and Wilcoxon tests were used for group comparisons.ResultsIn total, 215 patients met inclusion criteria: male (22%), white/Hispanic (47%), and African American (44%). Median BMI was 31.6 kg/m2; median age was 52 years. Surgeries included total thyroidectomy (41%), hemithyroidectomy (27%), and parathyroidectomy (15%). The 23‐hour observation patients (n = 175, 81%) had a median of 20 morphine milligram equivalents (MMEs). Sixteen patients experienced inadequate pain control. Female sex (P =. 03), younger age (P =. 02), current smoker (P =. 03), and higher inpatient MME (P =. 006) were associated with inadequate pain control.ConclusionFemale sex, younger age, smokers, and high inpatient opioid dose requirements are associated with inadequately controlled pain. These patients may benefit from additional education, earlier postoperative visits, and a more comprehensive nonopioid regimen.
Rural Barriers to Surgical Care for Children With Sleep‐Disordered Breathing
Authors: Yan Flora , Levy Dylan A. , Wen Chun‐Che , Melvin Cathy L. , Ford Marvella E. , Nietert Paul J. , Pecha Phayvanh P. 
Published: March 2021

ObjectiveTo assess the impact of rural‐urban residence on children with obstructive sleep‐disordered breathing (SDB) who were candidates for tonsillectomy with or without adenoidectomy (TA).Study DesignRetrospective cohort study.SettingTertiary children’s hospital.MethodsA cohort of otherwise healthy children aged 2 to 18 years with a diagnosis of obstructive SDB between April 2016 and December 2018 who were recommended TA were included. Rural‐urban designation was defined by ZIP code approximation of rural‐urban commuting area codes. The main outcome was association of rurality with time to TA and loss to follow‐up using Cox and logistic regression analyses.ResultsIn total, 213 patients were included (mean age 6 ± 2.9 years, 117 [55%] male, 69 [32%] rural dwelling). Rural‐dwelling children were more often insured by Medicaid than private insurance (P <. 001) and had a median driving distance of 74.8 vs 16.8 miles (P <. 001) compared to urban‐dwelling patients. The majority (94.9%) eventually underwent recommended TA once evaluated by an otolaryngologist. Multivariable logistic regression analysis did not reveal any significant predictors for loss to follow‐up in receiving TA. Cox regression analysis that adjusted for age, sex, insurance, and race showed that rural‐dwelling patients had a 30% reduction in receipt of TA over time as compared to urban‐dwelling patients (hazard ratio, 0.7; 95% CI, 0.50‐0.99).ConclusionRural‐dwelling patients experienced longer wait times and driving distance to TA. This study suggests that rurality should be considered a potential barrier to surgical intervention and highlights the need to further investigate geographic access as an important determinant of care in pediatric SDB.
Economic legacy effects of armed conflict: Insights from the civil war in Aceh, Indonesia
Authors: Heger Martin Philipp , Neumayer Eric 
Published: March 2021

The province of Aceh in Indonesia provides a promising case for studying the economic legacy effects of conflict given subnational district-level data on violence and gross domestic product. We demonstrate specific negative economic legacy effects of armed conflict despite a general peace dividend: whilst all districts in Aceh grow faster after conflict ends in 2005 than during the conflict, the districts that suffered relatively more from violence during the war grow relatively more slowly during peacetime than districts that experienced relatively little violence. These negative legacy effects are relatively short-lived, however, and are no longer statistically significant from 2009 onwards. JEL classification: O40, O47, Q54