bluuebunny/crossref_metadata_2025_split huggingface dataset:
T2-Weighted Whole-Brain Intracranial Vessel Wall Imaging at 3 Tesla With Cerebrospinal Fluid Suppression
Authors: Zhang Lei , Zhu Yanjie , Qi Yulong , Wan Liwen , Ren Lijie , Zhu Yi , Zhang Na , Liang Dong , Li Ye , Zheng Hairong , Liu Xin 
Published: June 2021

BackgroundT2-weighted (T2w) intracranial vessel wall imaging (IVWI) provides good contrast to differentiate intracranial vasculopathies and discriminate various important plaque components. However, the strong cerebrospinal fluid (CSF) signal in T2w images interferes with depicting the intracranial vessel wall. In this study, we propose a T2-prepared sequence for whole-brain IVWI at 3T with CSF suppression.MethodsA preparation module that combines T2 preparation and inversion recovery (T2IR) was used to suppress the CSF signal and was incorporated into the commercial three-dimensional (3D) turbo spin echo sequence-Sampling Perfection with Application optimized Contrast using different flip angle Evolution (SPACE). This new technique (hereafter called T2IR-SPACE) was evaluated on nine healthy volunteers and compared with two other commonly used 3D T2-weighted sequences: T2w-SPACE and FLAIR-SPACE (FLAIR: fluid-attenuated inversion recovery). The signal-to-noise ratios (SNRs) of the vessel wall (VW) and CSF and contrast-to-noise ratios (CNRs) between them were measured and compared among these three T2-weighted sequences. Subjective wall visualization of the three T2-weighted sequences was scored blindly and independently by two radiologists using a four-point scale followed by inter-rater reproducibility analysis. A pilot study of four stroke patients was performed to preliminarily evaluate the diagnostic value of this new sequence, which was compared with two conventional T2-weighted sequences.ResultsT2IR-SPACE had the highest CNR (11.01 ± 6.75) compared with FLAIR-SPACE (4.49 ± 3.15; p &lt; 0.001) and T2w-SPACE (−56.16 ± 18.58; p &lt; 0.001). The subjective wall visualization score of T2IR-SPACE was higher than those of FLAIR-SPACE and T2w-SPACE (T2IR-SPACE: 2.35 ± 0.59; FLAIR-SPACE: 0.52 ± 0.54; T2w-SPACE: 1.67 ± 0.58); the two radiologists’ scores showed excellent agreement (ICC = 0.883).ConclusionThe T2IR preparation module markedly suppressed the CSF signal without much SNR loss of the other tissues (i.e., vessel wall, white matter, and gray matter) compared with the IR pulse. Our results suggest that T2IR-SPACE is a potential alternative T2-weighted sequence for assessing intracranial vascular diseases.
Gluten-Free Labeling Is Misused Frequently in Foods Marketed in Northwestern Mexico
Authors: Calderón de la Barca Ana M. , Luna-Alcocer Valeria , Valenzuela-Miranda José R. , Mejía-León Maria E. 
Published: June 2021

Background: Patients with celiac disease (CD) require a gluten-free (GF) diet, including industrialized products containing ≤ 20 mg gluten/kg. The market status of GF food products is almost unknown in Mexico. Therefore, we studied the GF-labeled products on the northwestern Mexican market and analyzed their gluten content.Methods: We searched for GF type of foods in three different supermarkets of each chain in Mexicali Baja California and Hermosillo Sonora and corroborated the price, origin, and GF certification of each item using internet sites. We quantified the gluten in the foods using the sandwich R5-enzyme-linked immunosorbent assay (ELISA) and detected their immune-reactivity for IgA from patients with CD.Results: The study included &gt;263 different GF-labeled foodstuffs, and 55% of them were made in Mexico. The Mexican items were principally flours, sausages, bread and bakery, milk-type products, and tortillas, while pasta, snacks, and breakfast cereals were mainly imported. The cost ratio of GF products to the conventional mean was 3.5, ranging principally from 1 to 13. The most common GF-labeled foods were flours and pasta (34), cookies and snacks (32), breakfast cereals, sausages, and milk-type products (18–20). Although 36% of the products were certified, 17.4% of the analyzed samples contained &gt;20 mg gluten/kg, mainly the non-certified ones and those made in Mexico. IgA from patients with CD reacted in vitro against gluten proteins from the contaminated GF-labeled products.Conclusion: The accessibility of GF products in the northwestern Mexican market is wide; however, such products are expensive, and some could be risky for patients with CD because they contain gluten, which is recognized by the immune systems of these patients.
Surgical Treatment of Sacral Metastatic Tumors
Authors: Sun Mengxiong , Zuo Dongqing , Wang Hongsheng , Sheng Jiakang , Ma Xiaojun , Wang Chongren , Zan Pengfei , Hua Yingqi , Sun Wei , Cai Zhengdong 
Published: June 2021

ObjectiveThis study intends to retrospectively analyze the data of patients with sacral metastases in our center, and analyze the treatment methods and therapeutic effects of sacral metastases.Methods73 patients with sacral metastases treated in our hospital from June 2013 to June 2019 were retrospectively analyzed. There were 54 cases of neurological symptoms, 42 cases of sacroiliac joint instability, 24 cases of lower limb muscle weakness and 19 cases of abnormal urination and defecation. Four patients with tumors below S3 underwent complete tumor resection, 23 patients with tumors above S3 and without sacroiliac joint instability underwent tumor curettage and nerve root lysis, 34 patients with tumors above S3 and sacroiliac joint instability underwent tumor curettage, nerve root release and screw rod reconstruction. 12 patients with multiple metastases underwent percutaneous radiofrequency ablation and sacroplasty. VAS was used to evaluate the preoperative and postoperative pain scores, and the postoperative pain relief, neurological function, bowel function, wound healing and complications were evaluated.ResultsThere were no perioperative death, 8 cases of poor wound healing, 5 cases of nerve injury, postoperative sensory and motor loss of lower limbs. Cerebrospinal fluid (CSF) leak in 7 cases. The patients were followed up for 6-25 months (mean 12 months). The VAS scores of patients with pain symptoms were 7 points before operation and 1.44 points after operation, In 19 patients with abnormal urination and defecation function, 12 patients recovered to normal 3-6 months after operation, 5 cases had no significant change compared with preoperative, and 2 cases had aggravated symptoms; 17 cases of patients with lower limb muscle strength were significantly recovered after operation, and the average muscle strength was increased by 2 grades; 30 cases of patients with unstable sacroiliac joint got internal fixation had significantly pain relief. Pain symptoms of 9 patients were significantly relieved after percutaneous radiofrequency ablation.Conclusionthe operation of sacral metastases mainly adopts a relatively conservative surgical method, which can effectively improve the quality of life of patients with sacral metastases by retaining the nerve function and relieving the pain of patients, combining with radiofrequency ablation, sacroplasty and targeted drugs.
The Case Selection for Vaginal Cuff Brachytherapy in Cervical Cancer Patients After Radical Hysterectomy and External Beam Radiation Therapy
Authors: Lai Ying-Lu , Jin Ye-Ning , Wang Xi , Qi Wei-Xiang , Cai Rong , Xu Hao-Ping 
Published: June 2021

ObjectiveTo explore the suitable cases for vaginal cuff brachytherapy (VCB) combined with external beam radiation therapy (EBRT) in the postoperative treatment of cervical cancer.MethodsWe retrospectively analyzed the clinical data of 214 postoperative cervical cancer patients who received radiotherapy from January 2008 to December 2015. Among them, 146 patients received postoperative EBRT, 68 received EBRT plus VCB. There was no statistical difference in clinical and pathological characteristics between these two groups. Those who with negative vaginal cuff underwent supplemented 12–18 Gy/2–3 Fx VCB. Survival analyses were performed using Kaplan–Meier method, and Cox model was used to analyze prognostic factors.ResultsThe median follow-up was 52 months (9–136 months), and 4-year RFS (recurrence-free survival) was 77%. Among them, 58 patients (27.10%) had local or distant recurrences, 29 (13.55%) in pelvis, six (2.80%) with metastases to para-aortic, 19 (8.88%) with distant metastases (including inguinal lymph nodes) and four (1.87%) with both local and distant recurrences. The postoperative brachytherapy boost did not improve RFS or OS (overall survival) among the investigated subjects, P = 0.77, P = 0.99, respectively. Neither it decreased the local relapse in the pelvis or vaginal cuff, P = 0.56, P = 0.59. Subgroup analyses showed that brachytherapy boost improved RFS in patients who had bulky mass (&gt;4 cm) as well as 1) with deep stromal invasion (&gt;50% stromal invasion), P = 0.012 or 2) received low EBRT dose (≤45 Gy), P = 0.033, and in patients with deep stromal invasion as well as received low EBRT dose (P = 0.018).ConclusionsWe first proposed the case selection model for postoperative EBRT plus VCB. Brachytherapy boost were considered in the setting of postoperative radiotherapy if the patients had at least two out of these following factors: bulky mass, deep stromal invasion and low EBRT dose.
Predictive Value of Skeletal Muscle Mass in Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma Patients Treated With Immune Checkpoint Inhibitors
Authors: Arribas Lorena , Plana Maria , Taberna Miren , Sospedra Maria , Vilariño Noelia , Oliva Marc , Pallarés Natalia , González Tampán Ana Regina , Del Rio Luis Miguel , Mesia Ricard , Baracos Vickie 
Published: June 2021

BackgroundReduced muscle mass has been associated with increased treatment complications in several tumor types. We evaluated the impact of skeletal muscle index (SMI) on prognosis and immune-related adverse events (IrAEs) in a cohort of recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) treated with immune checkpoints inhibitors (ICI).MethodsA single-institutional, retrospective study was performed including 61 consecutive patients of R/M HNSCC diagnosed between July 2015 and December 2018. SMI was quantified using a CT scan at L3 to evaluate body composition. Median baseline SMI was used to dichotomize patients in low and high SMI. Kaplan-Meier estimations were used to detect overall survival (OS) and progression-free survival (PFS). Toxicity was recorded using Common Terminology Criteria for Adverse Event v4.3.ResultsPatients were 52 men (85.2%) with mean of age 57.7 years (SD 9.62), mainly oral cavity (n = 21; 34.4%). Low SMI was an independent factor for OS in the univariate (HR, 2.06; 95% CI, 1.14–3.73, p = 0.017) and multivariate Cox analyses (HR, 2.99; 95% CI, 1.29–6.94; p = 0.011). PFS was also reduced in patients with low SMI (PFS HR, 1.84; 95% CI, 1.08–3.12; p = 0.025). IrAEs occurred in 29 (47.5%) patients. There was no association between low SMI and IrAEs at any grade (OR, 0.56; 95% CI, 0.20–1.54; p = 0.261). However, grades 3 to 4 IrAEs were developed in seven patients of whom three had low SMI.ConclusionsLow SMI before ICI treatment in R/M HNSCC patients had a negative impact on OS and PFS. Further prospective research is needed to confirm the role of body composition as a predictive biomarker in ICI treatment.
Hepatic Branch Vagotomy Modulates the Gut-Liver-Brain Axis in Murine Cirrhosis
Authors: Zhang Yuan , Kang Jason D. , Zhao Derrick , Ghosh Siddartha S. , Wang Yanyan , Tai Yunling , Gonzalez-Maeso Javier , Sikaroodi Masoumeh , Gillevet Patrick M. , Lippman H. Robert , Hylemon Phillip B. , Zhou Huiping , Bajaj Jasmohan S. 
Published: June 2021

BackgroundCirrhosis and hepatic encephalopathy (HE) are linked with an altered gut-liver-brain axis, however, the relative contribution of hepatic vagal innervation is unclear. We aimed to determine the impact of hepatic vagotomy on the gut microbiome, brain, and liver in murine cirrhosis.Methods10–15-week-old male C57BL/6 mice with and without hepatic vagotomy underwent carbon tetrachloride (CCl4) gavage for 8 weeks. Frontal cortex [inflammation, glial/microglial activation, BDNF (brain-derived neurotrophic factor)], liver [histology including inflammation and steatosis, fatty acid synthesis (sterol-responsive binding protein-1) SREBP-1, insulin-induced gene-2 (Insig2) and BDNF], and colonic mucosal microbiota (16srRNA microbial sequencing) were evaluated on sacrifice. Conventional mice with and without cirrhosis were compared to vagotomized counterparts.ResultsConventional control vs. cirrhosis: Cirrhosis resulted in dysbiosis, hepatic/neuro-inflammation with glial/microglial activation, and low brain BDNF vs. controls. Conventional control vs. vagotomy controls: Vagotomized control mice had a lower colonic dysbiosis than conventional mice but the rest of the hepatic/brain parameters were similar. Conventional cirrhosis vs. vagotomized cirrhosis: After vagotomy + cirrhosis, we found lower dysbiosis but continuing neuroinflammation in the absence of glial/microglial activation vs. conventional cirrhosis. Vagotomy + Cirrhosis groups showed higher hepatic steatosis due to higher SREBP1 and low Insig2 protein and altered activation of key genes involved in hepatic lipid metabolism and inflammation. BDNF levels in the brain were higher but low in the liver in vagotomy + cirrhosis, likely a protective mechanism.ConclusionsHepatic vagal innervation affects the gut microbial composition, hepatic inflammation and steatosis, and cortical inflammation and BDNF expression and could be a critical modulator of the gut-liver-brain axis with consequences for HE development.
Psychological and Demographic Determinants of Substance Use and Mental Health During the COVID-19 Pandemic
Authors: Mougharbel Fatima , Sampasa-Kanyinga Hugues , Heidinger Brandon , Corace Kim , Hamilton Hayley A. , Goldfield Gary S. 
Published: June 2021

Background:Alcohol consumption and distress have increased among Canadians since the start of the COVID-19 pandemic.Methods:We examined whether sociodemographic and COVID-19-related worries are associated with various combinations of alcohol consumption and comorbid psychological distress variables among a Canadian sample of adults. Data were derived from a sample of Canadian adults (N= 1,005, 49.6% female) who participated in an online survey in May 2020. Four multivariate ordinal logistic regression models were used to estimate the odds of binge drinking, increased alcohol consumption during the pandemic, and psychological distress. Predictor variables used in the analyses included self-reported sociodemographic characteristics, financial worries, COVID-19 impact on work, and worrying about getting ill.Results:Women were found to have higher odds of increased drinking and anxiety. Also being divorced, separated, or widowed was associated with higher odds of binge drinking and anxiety, and binge drinking and depression. Furthermore, being 60 or older was associated with lower odds of binge drinking and depression and increased drinking and depression, as well as lower odds of increased drinking and depression and increased drinking and anxiety. High income groups were associated with higher odds of binge drinking, increased drinking, and mental distress. Compared to those less worried, being very worried about finances were associated with higher odds of binge drinking and anxiety, increased drinking and anxiety, and increased drinking and depression. Also, being very worried about getting ill with COVID was associated with higher odds of binge drinking and anxiety and increased drinking and anxiety.Conclusion:Our findings identify several demographic and COVID-related worries for increased odds of alcohol intake and co-morbid psychological distress during the COVID-19 pandemic, including identifying as a woman, high income groups, being divorced, separated or widowed, and experiencing financial worries and COVID illness worries. These characteristics should be considered when developing prevention and treatment programs for adults with problematic alcohol use and comorbid anxiety and depression.
Knowledge, Attitudes, and Practices of Military Personnel Regarding Heat-Related Illness Risk Factors: Results of a Chinese Cross-Sectional Study
Authors: Wang Xuren , Xia Demeng , Long Xisha , Wang Yixin , Wu Kaiwen , Xu Shuogui , Gui Li 
Published: June 2021

Background:Military personnel are widely exposed to risk factors for heat-related illnesses. Knowledge, attitudes, and practices (KAP) are three of the most important means by which to prevent such illnesses, but there has been a lack of investigations into and correlation analyses of KAP. This study aimed to explore the heat-related KAP of military personnel in China.Methods:We conducted a cross-sectional study (June 1-25, 2019). A total of 646 military personnel were recruited from two Chinese Navy troops in the tropical zone and one troop in the temperate zone. We collected data on demographic characteristics and KAP scores using questionnaires. Univariate analysis and Scheffe's method were used for data analyses.Results:The mean KAP scores were 10.37 (range = 3–13, standard deviation = 1.63) for knowledge (K-score), 7.76 (range = 0–16, SD = 2.65) for attitudes (A-score), and 3.80 (range = 1–6, SD = 1.12) for practices (P-score). There were noticeable differences in mean K-score according to age, military rank, and educational level (P&lt; 0.05). Participants from the tropical zone had higher A-scores (P&lt; 0.05) and higher P-scores (P&lt; 0.001) than those from the temperate zone. Additionally, participants with relevant experience also had higher A-scores (P&lt; 0.05) than those without such experience.Conclusions:Military personnel's awareness of preventive and first-aid measures against heat-related illnesses need to be strengthened. It will be very important to develop educational programmes and enrich systematic educational resources to raise this awareness.
Oral ondansetron for paediatric gastroenteritis in primary care: a randomised controlled trial
Authors: Bonvanie Irma J , Weghorst Anouk AH , Holtman Gea A , Russchen Heleen A , Fickweiler Freek , Verkade Henkjan J , Kollen Boudewijn J , Berger Marjolein Y 
Published: June 2021

BackgroundAcute gastroenteritis (AGE) affects almost all children aged ≤5 years. In secondary care, ondansetron was found to be effective at reducing vomiting.AimTo determine the effectiveness of adding oral ondansetron to care as usual (CAU) to treat vomiting in children with AGE attending out-ofhours primary care (OOH-PC).Design and settingA pragmatic randomised controlled trial at three OOH-PC centres in the north of the Netherlands (Groningen, Zwolle, and Assen), with a follow-up of 7 days.MethodChildren were included if they were: aged 6 months–6 years; AGE diagnosed by a GP; ≥4 reported episodes of vomiting in the 24 hours before presentation; ≥1 reported episode of vomiting in the 4 hours before presentation; and written informed consent from both parents. Children were randomly allocated to either the control group or the intervention group. The control group received CAU, namely oral rehydration therapy. The intervention group received CAU plus one dose of oral ondansetron (0.1 mg/kg).ResultsIn total, 194 children were included for randomisation. One dose of oral ondansetron decreased the proportion of children who continued vomiting within 4 hours from 42.9% to 19.5%, with an odds ratio of 0.37 (95% confidence interval [CI] = 0.20 to 0.72, number needed to treat: four). Ondansetron also decreased the number of vomiting episodes within 4 hours (incidence rate ratio 0.51 [95% CI = 0.29 to 0.88]) and improved overall parental satisfaction with treatment (P = 0.027).ConclusionChildren with AGE and increased risk of dehydration due to vomiting could be treated with ondansetron in primary care to stop vomiting more quickly and increase parental satisfaction with treatment. These results could be used to improve the quality and efficacy of general practice medicine.
Tombes d’enfants du Bronze Récent en Haute-Mésopotamie. Étude de cas
Authors: Sauvage M. 
Published: June 2021

The study of the funeral practices can give us interesting information about the child and his status in ancient societies. Two different Upper Mesoptamian examples of Late Bronze Age date illustrate this observation : the middle-Assyrian burials of Tell Mohammed Diyab and the Mitannian infant burials of Nuzi.
The first example shows us a great variability in funeral practices but a great homogeneity of the associated funeral material, which seems to indicate a strong social integration even of very young children.
In Nuzi, where burials of newly bom infants were found in private dwellings, often as secondary inhumations, we are probably dealing with a ritual practice.
Actores clave de Turismo Sostenible. Estudio de caso: San Telmo, Ciudad Autónoma de Buenos Aires
Authors: Dunjó Jorgelina Alicia , Servalli Natalia 
Published: June 2021

El presente trabajo identifica y analiza el rol de los actores intervinientes en el desarrollo de la actividad turística dentro de la Ciudad Autónoma de Buenos Aires (Argentina), específicamente en la Comuna 1 en el barrio de San Telmo.[1] En dicho desarrollo intervienen organizaciones internacionales, el sector privado, el tercer sector, la sociedad civil y el Estado.
Se diseña un mapa de actores claves donde se identifican a las personas o áreas relevantes en los procesos de planeación, diseño, implementación y evaluación de políticas públicas y su vinculación con el turismo y la sostenibilidad. Se observa que el Estado en todos sus niveles tiene una alta influencia e impacto en las problemáticas observadas como también en las posibles resoluciones.

[1] Se seleccionó al barrio porteño de San Telmo como área de estudio enmarcado en los objetivos planteados en el PICT - 2015-3118 “Los impactos del turismo en la Ciudad Autónoma de Buenos Aires: Valoración del desarrollo turístico a través de indicadores de sustentabilidad”. Aprobado por la Agencia Nacional de Promoción Científica y Tecnológica, Resolución ANPCyT Nº 240-16 (mayo 2016). Ejecución: 2017-2019.
Turismo e historiografía del saber: entre la historia del progreso y la emergencia de los olvidados
Authors: Comparato Gabriel Joaquín 
Published: June 2021

El presente escrito se propone problematizar y analizar, en clave metahistórica, el tratamiento que han tenido los estudios turísticos como objeto de estudio enfatizando en algunas particularidades latinoamericanas en el escenario de posguerra. Lejos de ser exhaustivo y excluyente, toma como punto de partida un área de vacancia de la literatura con una impronta reflexiva, en el que se combinan debates historiográficos generales y, a posteriori, discusiones más específicas del campo. En este sentido, se propone desarticular un tipo de hacer historia, cargada de continuidad y coherencia, para dar lugar, propedéuticamente, a sesgos, déficits y relaciones de poder. Específicamente, a partir de una revisión de la literatura, se identificó que dentro de los estudios turísticos históricos prevalece una tendencia a ser racionalista, gradualista y consensual, marcada por una narrativa con hegemonía occidentalizada y angloparlante, recurriendo a holgadas y estrechas fuentes historiográficas. Pero lejos de dar un cierre y pretender realizar una propuesta totalizadora, el trabajo apunta a la necesidad de profundizar los ejercicios de reflexividad disciplinar en lo relativo a la construcción, reconstrucción y deconstrucción de las narrativas históricas. Es una invitación más que un cierre y, en particular, a reflexionar no solo cognoscitivamente, sino también, y simultáneamente, en clave política.