bluuebunny/crossref_metadata_2025_split huggingface dataset:
Roxadustat on anti‐erythropoietin antibody‐related pure red cell aplasia in the patient with end‐stage renal disease
Authors: Wu Rui , Peng Yanqiang 
Published: June 2021

AbstractAnti‐erythropoietin antibody‐related pure red cell aplasia (anti‐EPO PRCA) is a severe complication in patients who receive erythropoiesis‐stimulating agents for nephrogenic anemia. The standard therapy is withdrawl of EPO and immunosuppression. Here, we present successful treatment of anti‐EPO PRCA with roxadustat, a hypoxia‐inducible factor prolyl hydroxylase inhibitor. A 39‐year‐old woman with end‐stage renal disease received recombinant human erythropoietin (rhEPO) subcutaneously. Unfortunately, she developed anti‐EPO PRCA and her hemoglobin dropped continuously, whereas she rejected immunosuppressive therapy. The patient failed to achieve spontaneous hematologic recovery with cessation of rhEPO alone, and she became transfusion dependent. Thus, she accepted our advice to try roxadustat for nephrogenic anemia. Surprisingly, after starting roxadustat treatment, her reticulocyte and hemoglobin improved gradually. Four months later, the bone marrow aspiration smear demonstrated a return to normal in erythroid cells. Besides, her anti‐erythropoietin antibody converted to negative. All in all, this case reveals the potential effect of roxadustat on anti‐EPO PRCA.
Similarities between Cognitive Models of Language Production and Everyday Functioning: Implications for Development of Interventions for Functional Difficulties
Authors: Mis Rachel , Giovannetti Tania 
Published: June 2021

AbstractThe loss of the ability to independently complete activities of daily living, such as meal preparation and household chores, is a defining characteristic of clinical dementia; however, minor difficulties in completing everyday activities emerge in the mild cognitive impairment stage, and even healthy older adults exhibit subtle functional difficulties compared to younger adults. These functional difficulties are associated with an array of negative outcomes, including decreased quality of life, higher costs of care, and increased frustration, depression, caregiver burden, and institutionalization. While cognitive models have been proposed to explain the functional deficits seen in dementia and subtler forms of cognitive decline, in contrast to other cognitive disorders such as aphasia, there are essentially no theoretically motivated interventions to address difficulties in everyday functioning. Proposed models of functional impairment share features with cognitive processing models of language, including hierarchical organization of representations and interactive, spreading activation; thus, an examination of aphasia interventions has the potential to inform the development of theoretically motivated interventions for everyday activities. This review first addresses the shared characteristics of cognitive models of everyday function and language, with a focus on linguistic production. Next, we will present aphasia interventions that target single‐word production, sentence production, short‐term memory, and semantics, and discuss their implications for everyday functioning interventions. We conclude with a discussion of limitations of the language‐everyday functioning comparison as well as areas of future research.
Suction and Injection Impacts on Casson Nanofluid With Gyrotactic Micro-organisms Over a Moving Wedge
Authors: Jabeen K. , Mushtaq M. , Akram Muntazir R. M. 
Published: June 2021

AbstractThis work deals with the effects of suction and injection on Casson nanofluid around a moving wedge under the influence of gyrotactic micro-organisms along with viscous and ohmic dissipation. The governing system of highly coupled nonlinear partial differential equations together with assisting boundary conditions is converted by applying suitable similarity transformations, into a set of nonlinear ordinary differential equations. The obtained flow model is solved numerically by bvp4c (matlab) procedure. The accuracy of the flow model under consideration is validated by employing another well-known mathematical technique Runge–Kutta-Fehlberg (RKF) having good agreement while comparing the numerical results obtained by bvp4c for both suction and injection cases. Impacts of various pertinent parameters active in the flow model such as thermophoresis and Brownian motion, moving wedge, magnetic field, viscous and ohmic dissipation are numerically calculated for both suction and injection flow situations and also presented graphically. It is observed that the increase in casson parameter enhances the velocity but declines the density of motile organism, concentration and temperature for suction as well as injection flow case. The impacts of mass transfer rate of gyrotactic micro-organisms, Nusselt and Sherwood numbers for various fluid parameters are numerically presented in tabular form, separately for both suction and injection. One of the important observations of this study is that the suction or injection plays a key role in controlling boundary layer flow and brings stability in the flow. Moreover, rate of heat and mass transfer get enhanced in the existence of gyrotactic micro-organisms. Further, it would be worth mentioning that physical behavior of this flow problem coincides very well with already published literature either graphically or in tabular representation.
Non-invasive wearables for remote monitoring of HbA1c and glucose variability: proof of concept
Authors: Bent Brinnae , Cho Peter J , Wittmann April , Thacker Connie , Muppidi Srikanth , Snyder Michael , Crowley Matthew J , Feinglos Mark , Dunn Jessilyn P 
Published: June 2021

IntroductionDiabetes prevalence continues to grow and there remains a significant diagnostic gap in one-third of the US population that has pre-diabetes. Innovative, practical strategies to improve monitoring of glycemic health are desperately needed. In this proof-of-concept study, we explore the relationship between non-invasive wearables and glycemic metrics and demonstrate the feasibility of using non-invasive wearables to estimate glycemic metrics, including hemoglobin A1c (HbA1c) and glucose variability metrics.Research design and methodsWe recorded over 25 000 measurements from a continuous glucose monitor (CGM) with simultaneous wrist-worn wearable (skin temperature, electrodermal activity, heart rate, and accelerometry sensors) data over 8–10 days in 16 participants with normal glycemic state and pre-diabetes (HbA1c 5.2–6.4). We used data from the wearable to develop machine learning models to predict HbA1c recorded on day 0 and glucose variability calculated from the CGM. We tested the accuracy of the HbA1c model on a retrospective, external validation cohort of 10 additional participants and compared results against CGM-based HbA1c estimation models.ResultsA total of 250 days of data from 26 participants were collected. Out of the 27 models of glucose variability metrics that we developed using non-invasive wearables, 11 of the models achieved high accuracy (<10% mean average per cent error, MAPE). Our HbA1c estimation model using non-invasive wearables data achieved MAPE of 5.1% on an external validation cohort. The ranking of wearable sensor’s importance in estimating HbA1c was skin temperature (33%), electrodermal activity (28%), accelerometry (25%), and heart rate (14%).ConclusionsThis study demonstrates the feasibility of using non-invasive wearables to estimate glucose variability metrics and HbA1c for glycemic monitoring and investigates the relationship between non-invasive wearables and the glycemic metrics of glucose variability and HbA1c. The methods used in this study can be used to inform future studies confirming the results of this proof-of-concept study.
Stock-specific variation in the probability of precocious male maturation in hatchery Chinook salmon (Oncorhynchus tshawytscha)
Authors: Larsen Donald A. , Fuhrman Abby E. , Harstad Deborah L. , Venditti David A. , Beckman Brian R. 
Published: June 2021

Age of maturation in many salmonid species is phenotypically plastic and dependent on exceeding a genetically set threshold in growth, often described as a probabilistic maturation reaction norm (PMRN). Hatchery supplementation programs for Chinook salmon (Oncorhynchus tshawytscha) in the Pacific Northwest US have been developed to minimize differences between hatchery and wild fish by integrating natural-origin adults into broodstock, potentially affecting PMRNs. We raised fish from 10 Chinook salmon stocks with variable levels of natural-origin integration in a common garden environment to explore potential genetic variation in PMRNs for precocious male maturation as age 2 minijacks. Proportion minijacks varied ≈10-fold (0.043 to 0.443) and the PMRN WP50 (predicted weight at 50% maturation) varied by ≈18 g (24.1 to 41.7 g). The propensity for minijack maturation was generally higher in stocks with higher levels of natural-origin integration. These findings demonstrate the effect of genotype by environment interactions on life history of salmonids and the need for stock-specific tailoring of rearing regimes to regulate differences between hatchery and wild fish, when wild fish are used in broodstocks.
Computed Tomography Angiography Spot Sign, Hematoma Expansion, and Functional Outcome in Spontaneous Cerebellar Intracerebral Hemorrhage
Authors: Singh Sanjula D. , Pasi Marco , Schreuder Floris H.B.M. , Morotti Andrea , Senff Jasper R. , Warren Andrew D. , McKaig Brenna N. , Schwab Kristin , Gurol M. Edip , Rosand Jonathan , Greenberg Steven M. , Viswanathan Anand , Klijn Catharina J.M. , Rinkel Gabriel J.E. , Goldstein Joshua N. , Brouwers H. Bart 
Published: June 2021

Background and Purpose:
The computed tomography angiography spot sign is associated with hematoma expansion, case fatality, and poor functional outcome in spontaneous supratentorial intracerebral hemorrhage (ICH). However, no data are available on the spot sign in spontaneous cerebellar ICH.

Methods:
We investigated consecutive patients with spontaneous cerebellar ICH at 3 academic hospitals between 2002 and 2017. We determined patient characteristics, hematoma expansion (>33% or 6 mL), rate of expansion, discharge and 90-day case fatality, and functional outcome. Poor functional outcome was defined as a modified Rankin Scale score of 4 to 6. Associations were tested using univariable and multivariable logistic regression.

Results:

Three hundred fifty-eight patients presented with cerebellar ICH, of whom 181 (51%) underwent a computed tomography angiography. Of these 181 patients, 121 (67%) were treated conservatively of which 15 (12%) had a spot sign. Patients with a spot sign treated conservatively presented with larger hematoma volumes (median [interquartile range]: 26 [7–41] versus 6 [2–13],
P
=0.001) and higher speed of expansion (median [interquartile range]: 15 [24–3] mL/h versus 1 [5–0] mL/h,
P
=0.034). In multivariable analysis, presence of the spot sign was independently associated with death at 90 days (odds ratio, 7.6 [95% CI, 1.6–88],
P
=0.037). With respect to surgically treated patients (n=60, [33%]), 14 (23%) patients who underwent hematoma evacuation had a spot sign. In these 60 patients, patients with a spot sign were older (73.5 [9.2] versus 66.6 [15.4],
P
=0.047) and more likely to be female (71% versus 37%,
P
=0.033). In a multivariable analysis, the spot sign was independently associated with death at 90 days (odds ratio, 2.1 [95% CI, 1.1–4.3],
P
=0.033).

Conclusions:
In patients with spontaneous cerebellar ICH treated conservatively, the spot sign is associated with speed of hematoma expansion, case fatality, and poor functional outcome. In surgically treated patients, the spot sign is associated with 90-day case fatality.
A Whole-of-Society Approach to the Rohingya Refugee Crisis: Strengthening Local Protection Capacity in South and South-East Asia
Authors: Barbour Brian , Fan Lilianne , Lewa Chris 
Published: June 2021

Abstract
In 2020, Rohingya men, women, and children continue to embark across the Bay of Bengal and Andaman Sea, and States continue to lack safe and predictable disembarkation protocols and standards. From a protection perspective, the situation in 2020 has played out as it did in 2015 showing a lack of progress. After decades of discriminatory policies, denial of basic human rights, and targeted violence, at least 1.5 million stateless Rohingya refugees have fled Myanmar’s Rakhine State to seek refuge in the region and scattered locations around the globe, often surviving horrendous journeys by sea in the hope of disembarking with even marginally better prospects. The reception of the Rohingya in each of their places of refuge has been mixed, but it has rarely if ever been one of unqualified welcome. How do we engage with challenges that seem so intractable? The academic literature looking at refugee protection in the Asian region has largely dealt with its absence or inadequacy. Yet if we look more closely at any specific context in Asia, we can see that States may have laws, policies, or practices that can be utilised to recognise or respond to protection needs; international institutions like the United Nations High Commissioner for Refugees (unhcr) are often recognised and permitted to conduct protection activities; civil society actors in every jurisdiction have developed substantial capacity for operationalising protection in practice; and refugees themselves are coping and contributing to their own protection in every case. It is at the national and local levels where protection capacity must be built towards implementation of a ‘whole-of-society’ approach.
Towards an asean Model of ‘Responsibility-Sharing’ for Refugees and Asylum-Seekers
Authors: McMillan Kate , Petcharamesree Sriprapha 
Published: June 2021

Abstract
The Andaman Sea crisis of 2015 focused global attention on asean’s response to mass refugee flows and generated calls for greater regional cooperation to protect the rights and safety of forced migrants. Such calls draw from the concept of ‘responsibility-sharing’; a concept that has long underpinned the international refugee regime. Scholars have responded to this challenge by identifying a range of ways in which asean countries might benefit from sharing responsibility for the refugees and asylum-seekers in their region. Based on interviews with 40 key asean-based actors working on migration and refugee issues across the governmental and non-governmental sectors, this article seeks to understand how the concept of responsibility-sharing for refugee protection is understood in four Southeast Asian countries: Thailand, Malaysia, Indonesia and Singapore. While it finds common agreement among the interviewees that the Andaman Sea crisis was a humanitarian disaster and that existing approaches to refugee issues in the region are ineffective, it also finds little to suggest that a regional approach to refugee issues is likely to develop in the short-to-medium term. On the other hand, interviewees identified a wide range of mechanisms through which bilateral, multilateral and global initiatives might assist the region to deal with refugee and asylum issues. Linking refugee issues with other issues that concern asean Member States and incremental progress towards embedding regional human rights norms via asean human rights institutions are identified as the most fruitful pathways towards regional cooperation to protect refugee rights and safety.
Robust worst-case scenarios from ensemble forecasts
Authors: Scher Sebastian , Jewson Stephen , Messori Gabriele 
Published: June 2021

AbstractTo extract the most information from an ensemble forecast, users would need to consider the possible impacts of every member in the ensemble. However, not all users have the resources to do this. Many may opt to consider only the ensemble mean and possibly some measure of spread around the mean. This provides little information about potential worst-case scenarios. We explore different methods to extract worst-case scenarios from an ensemble forecast, for a given definition of severity of impact: taking the worst member of the ensemble, calculating the mean of the N worst members, and two methods that use a statistical tool known as directional component analysis (DCA).We assess the advantages and disadvantages of the four methods in terms of whether they produce spatial worst-case scenarios that are not overly sensitive to the finite size and randomness of the ensemble or small changes in the chosen geographical domain. The methods are tested on synthetic data and on temperature forecasts from ECMWF. The mean of the N worst members is more robust than the worst member, while the DCA-based patterns are more robust than either. Furthermore, if the ensemble variability is well-described by the covariance matrix, the DCA patterns have the statistical property that they are just as severe as those from the other two methods, but more likely. We conclude that the DCA approach is a tool that could be routinely applied to extract worst-case scenarios from ensemble forecasts.
Method-dependent variation in TSH and FT4 reference intervals in pregnancy: A systematic review
Authors: Okosieme Onyebuchi E , Agrawal Medha , Usman Danyal , Evans Carol 
Published: June 2021

Background Gestational TSH and FT4 reference intervals may differ according to assay method, but the extent of variation is unclear and has not been systematically evaluated. We conducted a systematic review of published studies on TSH and FT4 reference intervals in pregnancy. Our aim was to quantify method-related differences in gestation reference intervals, across four commonly used assay methods, Abbott, Beckman, Roche and Siemens. Methods We searched the literature for relevant studies, published between January 2000 and December 2020, in healthy pregnant women without thyroid antibodies or disease. For each study, we extracted trimester-specific reference intervals (2.5–97.5 percentiles) for TSH and FT4 as well as the manufacturer-provided reference interval for the corresponding non-pregnant population. Results TSH reference intervals showed a wide range of study-to-study differences with upper limits ranging from 2.33 to 8.30 mU/L. FT4 lower limits ranged from 4.40 to 13.93 pmol/L, with consistently lower reference intervals observed with the Beckman method. Differences between non-pregnant and first trimester reference intervals were highly variable, and for most studies, the TSH upper limit in the first trimester could not be predicted or extrapolated from non-pregnant values. Conclusions Our study confirms significant intra- and intermethod disparities in gestational thyroid hormone reference intervals. The relationship between pregnant and non-pregnant values is inconsistent and does not support the existing practice in many laboratories of extrapolating gestation references from non-pregnant values. Laboratories should invest in deriving method-specific gestation reference intervals for their population.
Identifying Phenotypically Distinct Fibroblast Subsets in Type 2 Diabetes–Associated Iatrogenic Laryngotracheal Stenosis
Authors: Lina Ioan A. , Berges Alexandra , Ospino Rafael , Davis Ruth J. , Motz Kevin M. , Tsai Hsiu‐Wen , Collins Samuel , Hillel Alexander T. 
Published: June 2021

ObjectiveIatrogenic laryngotracheal stenosis (iLTS) is the pathologic narrowing of the glottis, subglottis, and/or trachea secondary to intubation or tracheostomy related injury. Patients with type 2 diabetes mellitus (T2DM) are more likely to develop iLTS. To date, the metabolomics and phenotypic expression of cell markers in fibroblasts derived from patients with T2DM and iLTS are largely unknown.Study DesignControlled in vitro cohort study.SettingTertiary referral center (2017‐2020).MethodsThis in vitro study assessed samples from 6 patients with iLTS who underwent surgery at a single institution. Fibroblasts were isolated from biopsy specimens of laryngotracheal scar and normal‐appearing trachea and compared with controls obtained from the trachea of rapid autopsy specimens. Patients with iLTS were subcategorized into those with and without T2DM. Metabolic substrates were identified by mass spectrometry, and cell protein expression was measured by flow cytometry.ResultsT2DM iLTS‐scar fibroblasts had a metabolically distinct profile and clustered tightly on a Pearson correlation heat map as compared with non‐T2DM iLTS‐scar fibroblasts. Levels of itaconate were elevated in T2DM iLTS‐scar fibroblasts. Flow cytometry demonstrated that T2DM iLTS‐scar fibroblasts were associated with higher CD90 expression (Thy‐1; mean, 95%) when compared with non‐T2DM iLTS‐scar (mean, 83.6%; P =. 0109) or normal tracheal fibroblasts (mean, 81.1%; P =. 0042).ConclusionsScar‐derived fibroblasts from patients with T2DM and iLTS have a metabolically distinct profile. These fibroblasts are characterized by an increase in itaconate, a metabolite related to immune‐induced scar remodeling, and can be identified by elevated expression of CD90 (Thy‐1) in vitro.
Epinephrine dosing interval and neurological outcome in out-of-hospital cardiac arrest
Authors: Fukuda Tatsuma , Kaneshima Hirotsugu , Matsudaira Aya , Chinen Takumi , Sekiguchi Hiroshi , Ohashi-Fukuda Naoko , Inokuchi Ryota , Kukita Ichiro 
Published: June 2021

Objective: Current guidelines for cardiopulmonary resuscitation (CPR) recommend that standard-dose epinephrine be administered every 3–5 minutes during cardiac arrest. However, there is a knowledge gap regarding the optimal epinephrine dosing interval. This study aimed to examine the association between epinephrine dosing intervals and outcomes after out-of-hospital cardiac arrest (OHCA). Methods: This was a nationwide population-based observational study using data from a Japanese government-led registry of OHCA, including patients who experienced OHCA in Japan from 2011 to 2017. We defined the epinephrine dosing interval as the time interval between the first epinephrine administration and return of spontaneous circulation in the prehospital setting, divided by the total number of epinephrine doses. The primary outcome was 1-month neurologically favorable survival. Results: A total of 10,965 patients (mean (SD) age, 75.8 (14.3) years; 59.8% male) were included. The median epinephrine dosing interval was 3.5 minutes (IQR, 2.5–4.5; mean (SD), 3.6 (1.8)). Only approximately half of the patients received epinephrine administration with a standard dosing interval, as recommended in the current CPR guidelines. After multivariable adjustment, compared with the standard dosing interval, neither shorter nor longer epinephrine dosing intervals were associated with neurologically favorable survival after OHCA (Short vs Standard: adjusted OR 0.87 [95%CI 0.66–1.15]; and Long vs Standard: adjusted OR 1.08 [95%CI 0.76–1.55]). Similar associations were observed in propensity score-matched analyses. Conclusions: The epinephrine dosing interval was not associated with 1-month neurologically favorable survival after OHCA. Our findings do not deny the recommended epinephrine dosing interval in the current CPR guidelines.