bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aspiration risk in relation to Glasgow Coma Scale score and clinical parameters in patients with severe acute alcohol intoxication: a single-centre, retrospective study
Authors: Conzelmann Michael , Hoidis Anne , Bruckner Thomas , Popp Erik , Koschny Ronald 
Published: October 2021

ObjectivesIn alcohol intoxicated patients, the decision for or against airway protection can be challenging and is often based on the Glasgow Coma Scale (GCS). Primary aim of this study was to analyse the aspiration risk in relation to the GCS score and clinical parameters in patients with severe acute alcohol monointoxication. Secondary aim was the association between the blood alcohol level and the GCS score.SettingSingle-centre, retrospective study of alcoholised patients admitted to a German intensive care unit between 2006 and 2020.ParticipantsA total of n=411 admissions were eligible for our analysis.Clinical measures and analysisThe following data were extracted: age, gender, admission time, blood alcohol level, blood glucose level, initial GCS score, GCS score at admission, vital signs, clinical signs of aspiration and airway management measures. The empirical distribution of continuous and categorical data was calculated. Binary multivariable logistic regression analysis was used to identify possible risk factors for aspiration.ResultsThe mean age was 35 years. 72% (n=294) of the admissions were male. The blood alcohol level (mean 2.7 g/L±1.0, maximum 5.9 g/L) did not correlate with the GCS score but with the age of the patient. In univariate analysis, the aspiration risk correlated with blood alcohol level, age, GCS score, oxygen saturation, respiratory rate and blood glucose level and was significantly higher in male patients, on vomiting, and in patients requiring airway measures. Aspiration rate was 45% (n=10) in patients without vs 6% (n=3) in patients with preserved protective reflexes (p=0.0001). In the multivariate analysis, only age and GCS score were significantly associated with the risk of aspiration.ConclusionAlthough in this single-centre, retrospective study the aspiration rate in severe acute alcohol monointoxicated patients correlates with GCS and protective reflexes, the decision for endotracheal intubation might rather be based on the presence of different risk factors for aspiration.
Qualitative study of the acceptability and feasibility of acceptance and commitment therapy for adolescents with chronic fatigue syndrome
Authors: Clery Philippa , Starbuck Jennifer , Laffan Amanda , Parslow Roxanne Morin , Linney Catherine , Leveret Jamie , Crawley Esther 
Published: October 2021

BackgroundPaediatric chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is disabling and relatively common. Although evidenced-based treatments are available, at least 15% of children remain symptomatic after one year of treatment. Acceptance and commitment therapy (ACT) is an alternative therapy option; however, little is known about whether it is an acceptable treatment approach. Our aim was to find out if adolescents who remain symptomatic with CFS/ME after 12 months of treatment would find ACT acceptable, to inform a randomised controlled trial (RCT) of ACT.MethodsWe recruited adolescents (diagnosed with CFS/ME; not recovered after one year of treatment; aged 11–17 years), their parent/carer and healthcare professionals (HCPs) from one specialist UK paediatric CFS/ME service. We conducted semi-structured interviews to explore barriers to recovery; views on current treatments; acceptability of ACT; and feasibility of an effectiveness RCT. Thematic analysis was used to identify patterns in data.ResultsTwelve adolescents, eleven parents and seven HCPs were interviewed. All participants thought ACT was acceptable. Participants identified reasons why ACT might be efficacious: pragmatism, acceptance and compassion are valued in chronic illness; values-focussed treatment provides motivation and direction; psychological and physical needs are addressed; normalising difficulties is a useful life-skill. Some adolescents preferred ACT to cognitive behavioural therapy as it encouraged accepting (rather than challenging) thoughts. Most adolescents would consent to an RCT of ACT but a barrier to recruitment was reluctance to randomisation. All HCPs deemed ACT feasible to deliver. Some were concerned patients might confuse ‘acceptance’ with ‘giving up’ and called for clear explanations. All participants thought the timing of ACT should be individualised.ConclusionsAll adolescents with CFS/ME, parents and HCPs thought ACT was acceptable, and most adolescents were willing to try ACT. An RCT needs to solve issues around randomisation and timing of the intervention.
Injury epidemiology in professional football in South America compared with Europe
Authors: Bengtsson Håkan , Ortega Gallo Pablo Alfredo , Ekstrand Jan 
Published: October 2021

ObjectiveTo describe the injury epidemiology in professional football in South America and compare it with European professional football.MethodsData about football exposures and injury occurrences were registered in Six teams participating in Copa Libertadores in 2016. These teams’ exposure and injury data were compared with teams participating in the UEFA Elite Club Injury Study during the 2015/2016 and 2016/2017 seasons.ResultsA total of 271 injuries were reported in the South American cohort representing a training injury incidence of 3.2 (95% CI=2.7 to 3.7) injuries/1000 hours of training exposure and 20.9 (95% CI=17.3 to 25.1) injuries/1000 hours of match exposure. While no differences in muscle injury incidence were observed between South American and European teams, the ligament injury incidence in training among South American teams was significantly higher than European teams (0.6 vs 0.3, RR 1.87, 95% CI 1.21 to 2.87). In addition, a significantly higher proportion of all reported injuries among South American teams than European teams occurred in training.ConclusionsA larger proportion of injuries occur in training in South American compared with European professional football. Specifically, ligament injuries in training were more frequent among South American teams.
PET/CT scan and biopsy-driven approach for safe anti-PD-1 therapy discontinuation in patients with advanced melanoma
Authors: Gibney Geoffrey T. , Zaemes Jacob , Shand Shelly , Shah Neil J. , Swoboda David , Gardner Kellie , Radfar Arash , Petronic-Rosic Vesna , Reilly Michael J. , Al-Refaie Waddah B. , Rapisuwon Suthee , Atkins Michael B. 
Published: October 2021

BackgroundLimited data exist on safe discontinuation of antiprogrammed cell death protein 1 (PD-1) therapy in responding patients with advanced melanoma. The use of 18fluorodeoxyglucose (18FDG)-PET/CT scan and tumor biopsy for assessment of active disease may be an effective predictive biomarker to guide such treatment decisions.MethodsA retrospective study of 122 patients with advanced melanoma treated with anti-PD-1 monotherapy or anti-PD-1/anticytotoxic T-lymphocyte-associated protein 4 combination therapy at Georgetown Lombardi Comprehensive Cancer Center was conducted. Uveal melanoma patients and those receiving concurrent experimental therapy were excluded. Baseline characteristics, treatment outcomes, and survival were analyzed. Patients who decided to come off treatment typically after 12 months using CT scan radiographic complete response (CR),18FDG-PET/CT scan complete metabolic response (CMR) or tumor biopsy of a non-CR/CMR tumor site negative for active disease (possible pathological CR) were identified and compared with patients who discontinued treatment due to toxicity while their disease was in control. Event-free survival (EFS) was assessed from the last dose of anti-PD-1 therapy to progression requiring subsequent treatment (surgery, radiation, and/or systemic therapy) or referral to hospice/death due to melanoma.Results24 (20%) patients discontinued treatment by choice with no active disease and 28 (23%) patients discontinued treatment due to toxicity with disease control after 12-month and 4-month median treatment durations, respectively. Similar baseline characteristics were observed between cohorts except higher prior receipt of ipilimumab (29% vs 7%; p=0.036) and fewer BRAF mutant positive disease (17% vs 41%; p=0.064) in patients off treatment by choice. Three-year EFS rates were 95% and 71%, respectively. No significant associations between EFS and sex, disease stage, lactate dehydrogenase elevation, BRAF status, prior systemic therapy, ECOG performance status, presence of brain metastases, or combination versus monotherapy were observed. Tumor biopsies led to alternative management in 3/10 patients due to active metastatic melanoma or second malignancy.ConclusionsAnti-PD-1 therapy discontinuation after 12 months when no active disease is observed on CT scan, PET/CT scan or tumor biopsy may have low rates of disease relapse in patients with advanced melanoma. Biopsy of residual disease may frequently lead to a change in management. These findings are undergoing validation in the EA6192 trial.
Multicenter, double-blind, placebo-controlled trial of seviprotimut-L polyvalent melanoma vaccine in patients with post-resection melanoma at high risk of recurrence
Authors: Slingluff Craig L , Lewis Karl D , Andtbacka Robert , Hyngstrom John , Milhem Mohammed , Markovic Svetomir N , Bowles Tawnya , Hamid Omid , Hernandez-Aya Leonel , Claveau Joel , Jang Sekwon , Philips Prejesh , Holtan Shernan G , Shaheen Montaser F , Curti Brendan , Schmidt William , Butler Marcus O , Paramo Juan , Lutzky Jose , Padmanabhan Arvinda , Thomas Sajeve , Milton Daniel , Pecora Andrew , Sato Takami , Hsueh Eddy , Badarinath Suprith , Keech John , Kalmadi Sujith , Kumar Pallavi , Weber Robert , Levine Edward , Berger Adam , Bar Anna , Beck J Thaddeus , Travers Jeffrey B , Mihalcioiu Catalin , Gastman Brian , Beitsch Peter , Rapisuwon Suthee , Glaspy John , McCarron Edward C , Gupta Vinay , Behl Deepti , Blumenstein Brent , Peterkin Joanna J 
Published: October 2021

BackgroundMost patients with advanced melanomas relapse after checkpoint blockade therapy. Thus, immunotherapies are needed that can be applied safely early, in the adjuvant setting. Seviprotimut-L is a vaccine containing human melanoma antigens, plus alum. To assess the efficacy of seviprotimut-L, the Melanoma Antigen Vaccine Immunotherapy Study (MAVIS) was initiated as a three-part multicenter, double-blind, placebo-controlled phase III trial. Results from part B1 are reported here.MethodsPatients with AJCC V.7 stage IIB-III cutaneous melanoma after resection were randomized 2:1, with stage stratification (IIB/C, IIIA, IIIB/C), to seviprotimut-L 40 mcg or placebo. Recurrence-free survival (RFS) was the primary endpoint. For an hypothesized HR of 0.625, one-sided alpha of 0.10, and power 80%, target enrollment was 325 patients.ResultsFor randomized patients (n=347), arms were well-balanced, and treatment-emergent adverse events were similar for seviprotimut-L and placebo. For the primary intent-to-treat endpoint of RFS, the estimated HR was 0.881 (95% CI: 0.629 to 1.233), with stratified logrank p=0.46. However, estimated HRs were not uniform over the stage randomized strata, with HRs (95% CIs) for stages IIB/IIC, IIIA, IIIB/IIIC of 0.67 (95% CI: 0.37 to 1.19), 0.72 (95% CI: 0.35 to 1.50), and 1.19 (95% CI: 0.72 to 1.97), respectively. In the stage IIB/IIC stratum, the effect on RFS was greatest for patients <60 years old (HR=0.324 (95% CI: 0.121 to 0.864)) and those with ulcerated primary melanomas (HR=0.493 (95% CI: 0.255 to 0.952)).ConclusionsSeviprotimut-L is very well tolerated. Exploratory efficacy model estimation supports further study in stage IIB/IIC patients, especially younger patients and those with ulcerated melanomas.Trial registration numberNCT01546571.
The First Fatal Case of Capnocytophaga Canimorsus Sepsis Caused by a Cat Scratch
Authors: McLean C. R. , Hargrove R. , Behn E. 
Published: October 2021

AbstractA case is presented of fatal capnocytophaga canimorsus sepsis caused by a neglected cat scratch. Although fatalities are known to occur as a result of sepsis caused by this organism, death following cat scratch transmission has not previously been reported. The case is important as it demonstrates how a seemingly innocuous injury can have devastating consequences that may have been prevented by simple first aid measures.
Receiving Mass Casualties at Sea: The Capabilities of the Primary Casualty Receiving Facility
Authors: Evans G. W. L. 
Published: October 2021

AbstractExercise Aurora (May-June 2004) off the eastern Seaboard of the United States provided an opportunity, on several occasions, to test the ability of the PCRF to cope with large numbers of “casualties” arriving simultaneously. This article reviews the role of the PCRF, its facilities and capabilities, and how these are currently utilised to handle mass casualties. Some of the valuable lessons identified from Exercise Aurora are briefly discussed.
The Use of Patient Group Directions in the Royal Naval Medical Services
Authors: Taylor M. 
Published: October 2021

AbstractAs the first primary care nurse practitioner, the author wished to explore the future use of Patient Group Directions (PGD’s) within the Royal Naval Medical Services (RNMS). Extensive investigations carried out within the National Health Service (NHS) have resulted in changes in legislation allowing registered nurses to supply medications using PGD’s. The design and implementation of PGD’s require a cohesive approach of a doctor or dentist, a pharmacist and the lead health care professional. In order that they are implemented in a safe and effective manner all concerned parties must undertake a robust education and training programme. The RNMS will need to address a number of change management issues in order that registered nurses are supported in continuing professional development and PGD’s are adopted as practice
Measurement of Carbon Dioxide Levels during use of ELSA and the Effect of Venting on these Levels
Authors: Dekker B. J. , Heames R. M. , Hughes D. J. , Hett D. A. , Johnston C. G. 
Published: October 2021

AbstractTitleMeasurement of carbon dioxide levels during use of ELSA and the effect of venting on these levels.DesignA prospective, objective assessment of ELSA use, in order to determine whether venting of the ELSA influences carbon dioxide (CO2) levels.Primary EndpointInspired and expired CO2 levels.SettingOn board RFA ARGUS during Operation TELIC.Methods10 volunteers had a baseline of inspired and expired CO2 levels taken. These levels were measured at one minute intervals during use of an ELSA in 3 conditions - sitting, jogging and jogging with venting.ResultsThere was no difference in expired CO2 levels between baseline and use of ELSA whilst sitting. Periodic venting of the ELSA made no difference to inspired and expired CO2 levels.ConclusionsVenting of the ELSA during use makes no difference to CO2 levels whether inspired or expired. Therefore, venting is unnecessary and potentially wastes vital time during escape from a smoke-filled compartment and adds additional stress to the escapee.
Mental Health Referrals to the Falkland Islands British Military Mental Health Team, 1986-96
Authors: Micheal G L , Fear N. T. , Hughes J. Hacker 
Published: October 2021

AbstractObjectivesTo examine the pattern of out-patient mental health care referrals for military personnel deployed to the Falklands Islands, 1986-96.MethodsData from referral books of British Military Community Mental Health Nurses based in the Falkland Islands were abstracted, entered into an electronic database and analysed.ResultsOver the period 1986-96, 538 Service personnel were referred to the mental health out-patient facility on the Falkland Islands. The majority were male (96%) and junior ranks (81%). Approximately a third of patients were referred for reasons relating to alcohol (31%) and for over two-thirds of patients no follow-up was required (68%). Differences were observed by Service with the Army having more referrals due to alcohol than the other two Services, whilst the Navy had more deliberate self-harm referrals and the RAF more referrals for anxiety.ConclusionsThe lack of information on the total population deployed to the Falkland Islands over this period limit the interpretation of the results.
Effects of phytocannabinoids on heart rate variability and blood pressure variability in female post-concussion syndrome patients: case series
Authors: Singh Jyotpal , Bhagaloo Lanishen , Piskorski Jaroslaw , Neary J. Patrick 
Published: October 2021

Cannabidiol (CBD) can exert neuroprotective effects without being intoxicating, and in combination with Δ9-tetrahydrocannabinol (THC) CBD has shown to protect against THC psychosis. Acute concussion and post-concussion syndrome (PCS) can result in autonomic dysfunction in heart rate variability (HRV), but less information is available on blood pressure variability (BPV). Furthermore, the effects of phytocannabinoids on HRV and BPV in PCS are unknown. The purpose of this study was to observe the influence of daily administration of CBD or a combination of CBD and THC on HRV and BPV parameters in four female PCS participants. Participants completed a seated 5-min rest followed by six breaths-per-minute paced breathing protocol. Data was collected prior to phytocannabinoid intake and continued over 54 to 70 days. High frequency systolic BPV parameter increased every assessment period, unless altered due to external circumstances and symptoms. HRV parameters showed less consistent and varying responses. These results suggest that CBD can help to improve the altered autonomic dysfunction in those with PCS, and that responses to the drug administration was individualized. Double blinded, randomized controlled trials with greater sample sizes are required to better understand the influences of the varying dosages on human physiology and in PCS.
Confirming $$U(1)_{L_\mu -L_{\tau }}$$ as a solution for $$(g-2)_\mu $$ with neutrinos
Authors: Amaral D. W. P. , Cerdeño D. G. , Cheek A. , Foldenauer P. 
Published: October 2021

AbstractThe recent measurement of the muon anomalous magnetic moment by the Fermilab E989 experiment, when combined with the previous result at BNL, has confirmed the tension with the SM prediction at $$4.2\,\sigma $$

4.2

σ

CL, strengthening the motivation for new physics in the leptonic sector. Among the different particle physics models that could account for such an excess, a gauged $$U(1)_{L_\mu -L_{\tau }}$$

U

(
1
)

L
μ

-

L
τ

stands out for its simplicity. In this article, we explore how the combination of data from different future probes can help identify the nature of the new physics behind the muon anomalous magnetic moment. In particular, we contrast $$U(1)_{L_\mu -L_{\tau }}$$

U

(
1
)

L
μ

-

L
τ

with an effective $$U(1)_{L_\mu }$$

U

(
1
)

L
μ

-type model. We first show that muon fixed target experiments (such as NA64$$\mu $$
μ
) will be able to measure the coupling of the hidden photon to the muon sector in the region compatible with $$(g-2)_\mu $$

(
g
-
2
)

μ

, and will have some sensitivity to the hidden photon’s mass. We then study how experiments looking for coherent elastic neutrino-nucleus scattering (CE$$\nu $$
ν
NS) at spallation sources will provide crucial additional information on the kinetic mixing of the hidden photon. When combined with NA64$$\mu $$
μ
results, the exclusion limits (or reconstructed regions) of future CE$$\nu $$
ν
NS detectors will also allow for a better measurement of the mediator mass. Finally, the observation of nuclear recoils from solar neutrinos in dark matter direct detection experiments will provide unique information about the coupling of the hidden photon to the tau sector. The signal expected for $$U(1)_{L_\mu -L_{\tau }}$$

U

(
1
)

L
μ

-

L
τ

is larger than for $$U(1)_{L_\mu }$$

U

(
1
)

L
μ

with the same kinetic mixing, and future multi-ton liquid xenon proposals (such as DARWIN) have the potential to confirm the former over the latter. We determine the necessary exposure and energy threshold for a potential $$5\,\sigma $$

5

σ

discovery of a $$U(1)_{L_\mu -L_{\tau }}$$

U

(
1
)

L
μ

-

L
τ

boson, and we conclude that the future DARWIN observatory will be able to carry out this measurement if the experimental threshold is lowered to $$1\,{\mathrm {keV}}_{\mathrm {nr}} $$

1

keV
nr

.
Rare, Damaging DNA Variants in
CORIN
and Risk of Coronary Artery Disease: Insights From Functional Genomics and Large-Scale Sequencing Analyses
Authors: Wang Minxian , Lee-Kim Vivian S. , Atri Deepak S. , Elowe Nadine H. , Yu John , Garvie Colin W. , Won Hong-Hee , Hadaya Joseph E. , MacDonald Bryan T. , Trindade Kevin , Melander Olle , Rader Daniel J. , Natarajan Pradeep , Kathiresan Sekar , Kaushik Virendar K. , Khera Amit V. , Gupta Rajat M. 
Published: October 2021

Background:
Corin is a protease expressed in cardiomyocytes that plays a key role in salt handling and intravascular volume homeostasis via activation of natriuretic peptides. It is unknown if Corin loss-of-function (LOF) is causally associated with risk of coronary artery disease (CAD).

Methods:

We analyzed all coding
CORIN
variants in an Italian case-control study of CAD. We functionally tested all 64 rare missense mutations in Western Blot and Mass Spectroscopy assays for proatrial natriuretic peptide cleavage. An expanded rare variant association analysis for Corin LOF mutations was conducted in whole exome sequencing data from 37 799 CAD cases and 212 184 controls.

Results:

We observed LOF variants in
CORIN
in 8 of 1803 (0.4%) CAD cases versus 0 of 1725 controls (
P
, 0.007). Of 64 rare missense variants profiled, 21 (33%) demonstrated <30% of wild-type activity and were deemed damaging in the 2 functional assays for Corin activity. In a rare variant association study that aggregated rare LOF and functionally validated damaging missense variants from the Italian study, we observed no association with CAD—21 of 1803 CAD cases versus 12 of 1725 controls with adjusted odds ratio of 1.61 ([95% CI, 0.79–3.29];
P
=0.17). In the expanded sequencing dataset, there was no relationship between rare LOF variants with CAD was also observed (odds ratio, 1.15 [95% CI, 0.89–1.49];
P
=0.30). Consistent with the genetic analysis, we observed no relationship between circulating Corin concentrations with incident CAD events among 4744 participants of a prospective cohort study—sex-stratified hazard ratio per SD increment of 0.96 ([95% CI, 0.87–1.07],
P
=0.48).

Conclusions:

Functional testing of missense mutations improved the accuracy of rare variant association analysis. Despite compelling pathophysiology and a preliminary observation suggesting association, we observed no relationship between rare damaging variants in
CORIN
or circulating Corin concentrations with risk of CAD.
Dualities of Form: Considerations of Functional and Narrative Aspects of Design for Data Visualization
Authors: Samara Timothy 
Published: October 2021

Abstract
Design expertise's true value is its capacity to render complex information understandable and compelling. To make informed decisions, lay audiences depend on the clarity and resonance of data displays. But these, as created by scientists, journalists, and policy researchers, often contradict principles understood by designers to effectively and convincingly communicate data through visual means. Design education and practice insist that visual form conveys the nature of content, or data, on both objectively functional and narrative levels. This article addresses established best practices for creating clear, functional data displays, using form to clarify data's relevance and reveal its intricacy without distortion. It further advocates exploiting form's narrative potential—to qualify and contextualize information, thus enhancing how viewers internalize data, accept its veracity, and invest interest in its meaning. The author posits balancing this formal duality within data visualizations to best engage and resonate with lay audiences, and so catalyze their participation in the world around them.