bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transforming Rebellion into Affirmation
Authors: Ringel Paul 
Published: October 2021

Abstract
Youth cultures grounded in commercial youth literature became national and international phenomena during the late eighteenth century. For generations, these cultures were at the forefront of efforts to legitimize young people’s emergence as consumers, as readers’ desire for entertainment and representations of youthful independence in their stories compelled producers to mitigate their instructional impulses. Yet as other industries like fashion, television, and music increasingly eschewed obligations to instruct young consumers, youth literature has retained its conservative values. Most of its successful narrative models follow a period of adolescent rebellion with a conclusion that affirms the value of existing institutions, values, and hierarchies. This pattern has caused books and magazines to recede from the vanguard of shaping youth cultures.
The Colosseum
Authors: Dodge Hazel 
Published: October 2021

Abstract
This chapter provides an overview of the uses and structural history of the Colosseum, the largest amphitheatre constructed in the Roman world. Romans knew it as the ‘Amphitheatrum Flavium’, after the dynasty of emperors responsible for its construction. It continued in use even after the fall of Rome, with games still popular into the sixth century. The chapter examines the evidence for naumachiae during the inaugural games and concludes that it is most unlikely that the Colosseum area was flooded to a practical depth. It also reviews the evidence for the accommodation of spectators and its reflection of Roman society.
Measurement of specific organ domains in lupus randomized controlled trials: a scoping review
Authors: Connelly Kathryn , Vettivel Jeevan , Golder Vera , Kandane-Rathnayake Rangi , Morand Eric F 
Published: October 2021

Abstract

Objective
Randomized controlled trials (RCTs) in SLE (lupus) typically adopt composite responder definitions as primary efficacy endpoints; however, outcomes within individual organ domains are also important to understand. The aim of this scoping review was to evaluate how organ-specific disease activity and therapeutic responses have been measured and reported in lupus RCTs.

Methods
We searched MEDLINE, EMBASE, Cochrane registry and clinicaltrials.gov. Eligible studies were RCTs investigating efficacy of an immune-directed drug therapy in active SLE, published January 2000–March 2021, excluding studies limited to lupus nephritis. Data were extracted independently in duplicate into a template and summarized descriptively.

Results
Thirty-four RCTs were included, of which 32 (94%) reported activity and/or responses in at least one organ domain. Study populations had a high, although variable, frequency of baseline musculoskeletal and mucocutaneous activity and low, but also variable, representation of other domains. Definitions of organ-specific responses were inconsistent, even within individual instruments. Response in most organ domains were evaluated using BILAG and SLEDAI components but meaningful comparison between treatment arms was limited by small subgroups analysed in a post hoc fashion. Specific mucocutaneous and arthritis instruments were also used, including within pre-specified organ-specific endpoints, which discriminated between treatment arms in some studies.

Conclusion
Mucocutaneous and musculoskeletal manifestations predominate in SLE RCTs. Organ-specific outcome measures are commonly reported, but definitions of involvement and response are inconsistent. Research into the development of new outcome measures for key organ domains, and validation and comparison of response definitions using existing instruments, is needed.
Relative Time Constraints Improve Molecular Dating
Authors: Szöllõsi Gergely J , Höhna Sebastian , Williams Tom A , Schrempf Dominik , Daubin Vincent , Boussau Bastien 
Published: October 2021

AbstractDating the tree of life is central to understanding the evolution of life on Earth. Molecular clocks calibrated with fossils represent the state of the art for inferring the ages of major groups. Yet, other information on the timing of species diversification can be used to date the tree of life. For example, horizontal gene transfer events and ancient coevolutionary interactions such as (endo)symbioses occur between contemporaneous species and thus can imply temporal relationships between two nodes in a phylogeny. Temporal constraints from these alternative sources can be particularly helpful when the geological record is sparse, for example, for microorganisms, which represent the majority of extant and extinct biodiversity. Here, we present a new method to combine fossil calibrations and relative age constraints to estimate chronograms. We provide an implementation of relative age constraints in RevBayes that can be combined in a modular manner with the wide range of molecular dating methods available in the software. We use both realistic simulations and empirical datasets of 40 Cyanobacteria and 62 Archaea to evaluate our method. We show that the combination of relative age constraints with fossil calibrations significantly improves the estimation of node ages. [Archaea, Bayesian analysis, cyanobacteria, dating, endosymbiosis, lateral gene transfer, MCMC, molecular clock, phylogenetic dating, relaxed molecular clock, revbayes, tree of life.]
The combined use of thermography and ultrasound to evaluate the development of pressure injury in a critically ill patient
Authors: Baron Miriam Viviane , Santos Amanda Corrêa dos , Martins Paulo Ricardo Hernandes , Dominguez Luis Manuel Ley , Ott Joice Nedel , Brandenburg Cristine , Pinto Marcus Vinicius de Mello , Sampaio Aline Ronis , Koepp Janine , Pinheiro Carolina Gonçalves , Iketani Nathália Ken Pereira , Florentino Danielle de Mello , Sancho Alexandre Gomes , Pacheco Esteban Fortuny , Costa Bartira Ercília Pinheiro da 
Published: October 2021

Abstract

Introduction:
Pressure injury is 1 of the most common pressure related injuries in patients admitted to the intensive care unit. In individuals with darker skin tones, skin assessment protocols appear to be less effective, resulting in early damage from pressure. Bedside assessment measures using ultrasound and infrared thermography (IRT) have been studied to identify pressure injuries.

Patient concerns:
A 58-year-old dark-skinned male was admitted to the intensive care unit due to an ischemic stroke.

Diagnosis:
The visual evaluation of the skin took place on the second day after admission to the intensive care unit (before 48 hours). The patient had a whitish erythema on the left heel (LH) and a large bloody blister on the right heel. There were no signs of color change on the sacrum skin.

Interventions:
We performed 3 skin evaluations of the sacrum and calcaneus using ultrasound and IRT.

Outcomes:
Changes in the temperature of the target regions (sacrum, right heel and LH) were observed. The right heel showed higher mean temperatures than the LH in all evaluations. In the first evaluation of the sacrum region, the average temperature was lower (-1.3°C) than in the second and third evaluation (1°C). In the calcaneus, the mean temperature range (right heel - LH) showed a difference of (3.5°C) in the first evaluation, a difference of (1.4°C) in the second evaluation, and a difference of (1.7°C) in the third evaluation. Ultrasound images of the selected regions showed abnormal tissue patterns - edema - since the first evaluation.

Conclusion:
These findings indicate that the regions with deep tissue injury on ultrasound evaluation were compatible with the regions of abnormal temperatures in the IRT. IRT could identify regions of pathological process, which could be confirmed by abnormal ultrasound findings. Well-designed, randomized research with a larger sample could verify if the combination of these assessment techniques could be used as a potential method for early detection and evaluation of pressure injuries.
A protocol for DUAL pathway inhibition (low-dose rivaroxaban and aspirin) as compared to aspirin only to improve endothelial function in peripheral artery disease
Authors: Willems LH , Thijssen DHJ , Donders ART , van der Vijver-Coppen RJ , Groh LA , Reijnen MMPJ , Warlé MC 
Published: October 2021

Abstract

Background:
Peripheral artery disease (PAD) patients are at high risk of major adverse cardiovascular events and major adverse limb events. Recent trials demonstrate that rivaroxaban, a factor Xa inhibitor, in addition to single antiplatelet therapy results in lower mortality. A potential explanation is that Factor Xa improves endothelial function through crosstalk between coagulation and inflammatory pathways, subsequently attenuating the occurrence of major adverse cardiovascular and major adverse limb events. In this study, we hypothesize that combined treatment of low-dose rivaroxaban and acetylsalicylic acid improves endothelial function in PAD patients.

Methods:
DUAL-PAD is a multicenter, two-arm, phase IV clinical trial. Two cohorts of patients with symptomatic lower extremity PAD are enrolled: a:) moderate PAD (intermittent claudication), b) severe PAD (critical limb ischemia). Participants are treated with acetylsalicylic acid for a 1-month run-in period, followed by 3-months of dual pathway inhibition with acetylsalicylic acid and low-dose rivaroxaban. The primary outcome is the change in proportion of patients with endothelial dysfunction, measured as carotid artery vasoconstriction upon sympathetic stimulation. The secondary endpoint is the change in level of endothelial dysfunction, as reflected by plasma endothelin-1 levels.

Discussion:
the aim of the study is to examine if dual pathway inhibition improves endothelial function in patients with moderate or severe PAD.

Trial registration:
This study is registered at ClinicalTrials.gov on January 6, 2020 (URL https://clinicaltrials.gov/ct2/show/NCT04218656?term=NCT04218656&draw=2&rank=1).
Lifetime Trauma and Cardiovascular Health in Latinas
Authors: Caceres Billy A. , Doan Danny , Barcelona Veronica , Suero-Tejeda Niurka 
Published: October 2021

Background
Potentially traumatic experiences throughout the life course are associated with poor cardiovascular health among women. However, research on the associations of trauma with cardiovascular health among Latino populations is limited. Understanding the impact of trauma on cardiovascular health within marginalized populations may provide guidance on developing interventions with a particular focus on preventative care.

Objective
The purpose of this descriptive cross-sectional study was to examine the associations of lifetime trauma with cardiovascular health among middle-aged and older Latina women.

Methods
Participants were recruited from an existing study in New York City. All participants completed a structured questionnaire to assess lifetime trauma, demographic characteristics (such as age and education), financial resource strain, and emotional support. The Trauma History Questionnaire was used to assess lifetime exposure to potentially traumatic experiences (range 0–24). Cardiovascular health was measured with a validated measure of cardiovascular health from the American Heart Association (Life’s Simple 7). We used self-reported and objective data to calculate cardiovascular health scores (range 0–14). Multiple linear regression was used to examine the associations of lifetime trauma with cardiovascular health, adjusted for age, education, financial resource strain, and emotional support.

Results
The sample included 50 Latina women with a mean age of 63.1 years, 88% were Dominican, and only 6% had completed a college degree. Women reported an average of 4.8 traumatic experiences. Mean cardiovascular health score was 6.5 (SD = 1.6, range 3–10). Linear regression models found that, after adjusting for age, education, financial resource strain, and emotional support, a higher count of lifetime trauma was associated with worse cardiovascular health. However, this association did not reach statistical significance.

Discussion
Women with a higher count of lifetime trauma had worse cardiovascular health scores; this association was not statistically significant. Future studies should investigate associations of lifetime trauma and cardiovascular health in larger and more diverse samples of Latinas. Nurses and other clinicians should incorporate trauma-informed approaches to cardiovascular disease risk reduction to improve the cardiovascular health of Latina women who are survivors of trauma.
Review of Fever Management Advice on Government and Hospital Websites in Australia
Authors: Hook Jody , Smith Sheree M. 
Published: October 2021

Background
The public often searches the Internet for information about managing symptoms of various diseases, with government and major hospital websites often providing valid and freely available information.

Objectives
Fever is a common symptom of viral illness, and this review sought to identify information related to fever self-management on government and major hospital websites.

Methods
Two distinct search strategies were used. The first was an Internet-based search reviewing fever management advice published on Australian government websites (state, territory, and federal). The second search strategy pertained to fever management advice posted by major Australian tertiary adult and children’s hospitals.

Results
A total of 4,797 results were identified during the two searches, with a total of 12 websites on fever self-management identified for inclusion; four were from either federal or state government, with the remaining eight from tertiary hospital websites. The information identified showed a discordant definition of fever and lack of consistency in self-management advice.

Discussion
This review identified a lack of consistent online government and hospital information. The information discrepancy across multiple websites was not underpinned by clinical evidence to support the self-management of fever.
Comparison of Autologous Breast Reconstruction Complications by Type of Neoadjuvant Chemotherapy Regimen
Authors: Olawoyin Olamide M. , Mehta Sumarth , Chouairi Fouad , Gabrick Kyle S. , Avraham Tomer , Pusztai Lajos , Alperovich Michael 
Published: October 2021

Background:
Neoadjuvant chemotherapy before mastectomy helps reduce tumor burden and pathologic response in breast cancer. Limited evidence exists regarding how neoadjuvant chemotherapy impacts outcomes following microvascular breast reconstruction. This study examines the effects of neoadjuvant chemotherapy regimens and schedules on microvascular breast reconstruction complication rates and also assesses the effects of neoadjuvant chemotherapy on circulating immune cells related to wound healing.

Methods:
Patients who underwent neoadjuvant chemotherapy and microvascular breast reconstruction at Yale New Haven Hospital between 2013 and 2018 were identified. Demographic variables, oncologic history, chemotherapy regimens, and complication profiles were collected. Chemotherapy regimens were stratified by inclusion of anthracycline and order of taxane administration. Chi-square, Fisher’s exact, and t tests were used for univariate analysis. Multivariate binary logistic regression was used to control for covariates.

Results:
One hundred patients met inclusion criteria. On multivariate analysis, the administration of taxane first in an anthracycline-containing chemotherapy sequence was associated with increased complications (OR, 3.521; p = 0.012), particularly fat necrosis (OR, 2.481; p = 0.040). In the logistic regression model evaluating the effect of the taxane-first regimen on complication rates, the area under the curve was estimated to be 0.760 (p < 0.0001), particularly fat necrosis 0.635 (p < 0.05). The dosage of chemotherapy, number of days between neoadjuvant chemotherapy completion and surgery, and number of circulating immune cells did not significantly differ among patients who experienced complications.

Conclusions:
Taxane-first, anthracycline-containing neoadjuvant chemotherapy regimens were associated with increased complications, particularly fat necrosis. The increased postreconstruction complication risk must be weighed against the benefits of taxane-first regimens in improving tumor outcome.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
TULUA Lipoabdominoplasty: Transversal Aponeurotic Plication, No Undermining, and Unrestricted Liposuction. A Multicenter Study of 845 Cases
Authors: Villegas-Alzate Francisco J. , Blugerman Guillermo , Vera-Cucchiaro Javier , Cárdenas-Camarena Lázaro , Uebel Carlos O. , Schavelzon Diego , Moretti Ernesto , Elena Esteban , Elmeligy Ayman , Danilla Stefan 
Published: October 2021

Background:
TULUA (transverse plication, no undermining, full liposuction, neoumbilicoplasty, and low transverse abdominal scar) is the acronym for a radically different lipoabdominoplasty, intended to add simplicity, improve vascular safety, and attain good results. Modifications are unrestricted liposuction, no flap detachment, massive transverse infraumbilical plication, umbilicus amputation, neoumbilicoplasty, diminished tension wound closure, and low transverse scar settlement. The objectives of this article are to describe the technique and analyze a multicenter experience.

Methods:
Sixty-eight plastic surgeons from 10 countries provided data for a retrospective review of 845 patients. Aesthetic results were scored by each surgeon using the Salles scale and analyzed in combination with complications to identify associations between patient and surgery characteristics.

Results:
Of the patients, 95.5 percent were female, 19.7 percent were obese, 35.6 percent had prior scars, 10.4 percent had undergone previous abdominoplasty, 6.5 percent were postbariatric, and 6.6 percent were smokers. One patient had a kidney transplant, and 16.5 percent had comorbidities. Surgery characteristics varied widely, being on average as follows: lipoaspirate, 2967 ml; resection, 1388 g; and surgical time, 3.9 hours; 46.5 percent were not hospitalized. Averaged results were 8.68 of 10 points, besides adequate positioning and proportion of scar and umbilicus, without epigastric compensatory bulging (4.97 of 6 points). Overall complications were 16.2 percent, mostly seroma (8.8 percent); vascular-related complications (i.e., necrosis, wound dehiscence, and infection) constituted 2.7 percent. There were no fatalities. The logistic regression model demonstrated that smoking and obesity duplicate the risk of complications; if age older than 60 years is added, the risk of complication increases seven to nine times. Reported indications were multiple; however, pathologic diastasis was excluded.

Conclusion:
TULUA lipoabdominoplasty is a new reproducible procedure with good quantified results and an acceptable complication rate.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Increased Akkermansia abundance is associated with increased colonic mucosal ω-3 fatty acids and decreased colonic mucosal PGE2 concentrations following healthy dietary pattern interventions
Authors: Rifkin S.B. , Sen A. , Turgeon D.K. , Chan R. , Ruffin M.T. , Brenner D.E. , Schloss P.D. , Djuric Z. 
Published: October 2021

ABSTRACTBoth increased dietary intake of ω-3 polyunsaturated fatty acids (PUFA) and subsequent increases in colonic mucosal ω-3 PUFA concentrations have been linked to improved gut barrier function and decreased risks of metabolic diseases and cancer. In addition, increased dietary ω-3 PUFA has been linked to eubiosis in mouse studies. Increased ω-3 PUFA function in part to reduce cyclooxygenase-(COX) mediated prostaglandin E2 (PGE2) production, a biomarker of cancer risk linked to compromised gut barrier function. We analyzed data from a dietary intervention study in individuals at increased risk of colon cancer to determine whether changes in the mucosal microbiome composition were associated with changes in colonic mucosal ω-3/ ω-6 PUFA ratio. Microbiome analyses of colonic biopsies before and after the dietary intervention from 86 participants were done by sequencing the V4 region of the 16S rRNA gene. Multivariable linear regression models were used to evaluate further whether changes in Akkermansia was associated with changes in each colonic tissue variable: ω-3/ω-6 PUFA ratios, PGE2 concentrations, and expression of COX-1 and COX-2. The median dietary intake and mucosal ω-3/ω-6 PUFA ratio increased after intervention. Greater increases in mucosal ω-3/ω-6 PUFA ratios after intervention were significantly associated with several changes in taxon abundance, including increased Akkermansia muciniphilia relative abundance. An increased abundance of Akkermansia muciniphilia also was associated significantly with decreased PGE2 concentrations but not with changes in COX expression. Further studies are warranted to elucidate mechanisms by which Akkermansia may affect or is affected by these pathways and the relative importance of individual dietary components.
Public acceptability of non-pharmaceutical interventions to control a pandemic in the United Kingdom: a discrete choice experiment
Authors: Loria-Rebolledo Luis Enrique , Ryan Mandy , Watson Verity , Genie Mesfin G , Sakowsky Ruben Andreas , Powell Daniel , Paranjothy Shantini 
Published: October 2021

AbstractObjectiveTo understand how individuals make trade-offs between features of lockdown interventions to control a pandemic across the four nations of the United Kingdom.DesignSurvey that included a Discrete Choice Experiment (DCE). The survey design was informed using policy documents, social media analysis and with input from remote think aloud interviews with members of the public (n=23).SettingNation-wide survey across the four nations of the United Kingdom. Representative sample in terms of age and sex for each of the nations recruited using an online panel between 29th October and 12th December 2020.ParticipantsIndividuals who are over 18 years old. A total of 4120 adults completed the survey (1112 in England, 848 in Northern Ireland, 1143 in Scotland and 1098 in Wales).Primary outcome measureAdult’s preferences for, and trade-offs between, type of lockdown restrictions, length of lockdown, postponement of routine healthcare, excess deaths, impact on ability to buy things and unemployment.ResultsIn all four countries, one out of five respondents were willing to reduce excess deaths at all costs. The majority of adults are willing to accept higher excess deaths if this means lockdowns that are less strict, shorter and do not postpone routine healthcare. On average, respondents in England were willing to accept a higher increase in excess deaths to have less strict lockdown restrictions introduced compared to Scotland, Northern Ireland, and Wales, respectively.ConclusionsThe majority of the UK population is willing to accept the increase in excess deaths associated with introducing less strict lockdown restrictions. The acceptability of different restriction scenarios varies according to the features of the lockdown and across countries. Authorities can use information about trade-off preferences to inform the introduction of different lockdown restriction levels, and design compensation policies that maximise societal welfare.Strengths and limitations of this studyThis study offers empirical evidence that, unlike existing data from opinion polls and citizens’ panels, offers a clear understanding of the trade-offs between restrictions and impacts of lockdown on society.Estimating preferences for each nation, and quantifying them in terms of a common denominator, allows a comparison that takes into account the heterogeneity of UK nations and can be used to inform the introduction of different levels of lockdown restrictions in each.A limitation of our study is that we are not able to estimate the effect of on-going lockdowns in preferences. Furthermore, our results are not necessarily transferable to other nations.