bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiological and Clinical Profiles of Patients with Acute Respiratory Distress Syndrome Admitted to Medical Intensive Care in Qatar: A Retrospective Analysis of the Data Registry for the Year 2015
Authors: Ibrahim Abdulsalam Saif , Akkari Abdel-Rauof Mahmud , Raza Tasleem , Hassan Ibrahim Fawzy , Akbar Anzila , Alatoum Ibrahim 
Published: July 2019

Background: Although acute respiratory distress syndrome (ARDS) is a common reason for admission to intensive care units, limited information is available about the epidemiological and clinical characteristics of these patients in Middle Eastern countries. Qatar is a high per capita income country with a large multinational expatriate population. Hamad General Hospital is our main tertiary referral center with the largest medical intensive care unit (MICU). Method: A retrospective cross-sectional study was conducted to extract data from the MICU registry for 101 patients aged >14 years who were admitted with ARDS from January 2015 to December 2015. Results: In 2015, a total of 101 (14.8%) of 682 patients admitted to MICU were diagnosed with ARDS. Males comprised 71.3% and females 28.7%. The mean age of the study population was 44.96 ± 17.97 years. Community-acquired bacterial and viral pneumonia were the most common reasons for ARDS. Crude mortality rate was 35%. The mean age of survivors was 42.09 ± 13.58 years compared with 50.36 ± 16.84 years of non-survivors (p = 0.008). Mortality was associated with increasing age, the Acute Physiologic Assessment and Chronic Health Evaluation II severity score, lower P/F ratio, higher Murray's score, higher PCO2, lower pH, and circulatory support with vasopressors. Preexisting comorbidities did not contribute to high mortality. No difference in mortality was noted with higher versus lower positive end expiratory pressure. The prone position was used in 8% of the cases. Twenty-seven (27%) patients had undergone salvage therapy with extracorporeal membrane oxygenation (ECMO) that resulted in a survival rate of 44%. ARDS was associated with acute renal failure requiring dialysis in 28.7% of the cases, pneumothoraces in 4%, ventilator-associated pneumonia in 7.9%, and central line-associated bloodstream infection in 2%. ARDS led to a prolonged length of stay compared with the average length of stay in MICU. Conclusion: Community-acquired bacterial and viral pneumonia were the most common causes of ARDS at our center. Critical care outcome correlated with the severity of the disease. ECMO was used as salvage therapy in our center.
Access to Elective Orthopaedic Surgery After the Affordable Care Act Medicaid Expansion: The New York State Experience
Authors: Williamson Tyler R. , Paoli Albit R. , Hutzler Lorraine , Zuckerman Joseph , Bosco Joseph 
Published: July 2019

Background:
As part of the Patient Protection and Affordable Care Act, states were given the option of expanding Medicaid coverage to include adults younger than age 65 years with income at or below 138% of the federal poverty level. Although this expansion was intended to provide health care coverage to an estimated 20 million Americans, several studies have shown increased coverage does not equate to increased access to care by specialty providers.

Methods:
We queried the New York Statewide Planning and Research Cooperative System database and identified all patients who underwent the 10 most common elective orthopaedic surgeries from January 1, 2012, through March 31, 2016. Medicaid monthly enrollment for the 4-year study period was obtained from NY Department of Health Medicaid Managed Care Enrollment Reports.

Results:
Our query identified 700,159 patients who underwent the investigated orthopaedic surgeries. Of these, 60,786 were Medicaid recipients. During the 4-year study period, Medicaid enrollment and the number of procedures reimbursed by Medicaid increased significantly (P < 0.001 for both).

Conclusions:
Affordable Care Act–supported Medicaid expansion was associated with an increase in Medicaid enrollment and a concomitant increase in the utilization of orthopaedic surgery by Medicaid beneficiaries in New York State.
Fellow Versus Resident: Graduate Medical Education and Patient Outcomes After Anterior Cervical Diskectomy and Fusion Surgery
Authors: Galetta Matthew S. , Fang Taolin , Goyal Dhruv K.C. , Divi Srikanth N. , Schroeder Gregory D. , Kepler Christopher K. , Vaccaro Alexander R. 
Published: July 2019

Introduction:
The effect of spine fellow versus orthopaedic surgery resident assistance on outcomes in anterior cervical diskectomy and fusion (ACDF) has not been well studied. The objective of this study was to determine differences in patient health-related outcomes based on the level of surgical trainees.

Methods:
Consecutive cases of ACDF (n = 407) were reviewed at a single high-volume institution between 2015 and 2017 and were separated into two groups based on whether they were fellow-assisted or resident-assisted. Demographic and clinical variables were recorded, and health-related quality of life was evaluated using the Short Form-12 (SF-12) survey. The SF-12, visual analog scale pain score, and neck disability index were compared between the two groups. Surgery level, surgical time, preoperative Charlson Comorbidity Index, estimated blood loss, equivalent morphine use, perioperative complications, and 30-day readmission were also recorded. Patient outcomes were compared using an unpaired t-test as well as multivariate linear regression, controlling for age, sex, body mass index, Charlson Comorbidity Index, presurgical visual analog scale, SF-12, and neck disability index. Results were reported with the 95% confidence interval.

Results:
Spine surgery fellows and orthopaedic surgery residents participated in 228 and 179 ACDF cases, respectively. No notable demographic differences between the two groups were found. A higher proportion of three or more level ACDF surgeries assisted by fellows versus residents was found. Estimated blood loss was greater in fellow-assisted ACDF cases. Both surgery time and total time in the room were also longer in the fellow-assisted ACDF group. No 30-day readmissions were found in either groups, and only one case of acute hemorrhagic anemia was found in the fellow-assisted group. Overall, postoperative complications were higher in the resident group; however, no difference with regard to intraoperative complications between groups was found.

Discussion:
This study shows that patient health-related outcomes are similar in ACDF cases that were fellow-assisted versus resident-assisted. However, fellow-assisted ACDF cases were associated with more blood loss and longer surgery time.
Sustainable Development Goals Synergies/Trade-offs: Exploring Long- and Short-Run Impacts of Economic Growth, Income Inequality, Energy Consumption and Unemployment on Carbon Dioxide Emissions in South Africa
Authors: Ngankam Bertrand Tessa 
Published: July 2019

This study examines the short- and long-run impacts of economic growth and unemployment (SDG 8), energy consumption (SDG 7) and income inequality (SDG 10) on CO2 emissions in South Africa over the period 1980-2012 to establish potential synergy/trade-off to achieve these goals. We use the autoregressive distributed lag (ARDL) approach to cointegration technique. Our results show that the promotion of economic growth (SDG 8) as well as the reduction in energy consumption/increase in energy efficiency (SDG 7) can be achieved in synergy with the reduction of CO2 emissions (SDG 13). On the other hand, our results suggest a trade-off between reducing unemployment rate or achieving productive employment and decent work (SGD 8) and mitigating CO2 emissions (SDG 13). Neither a synergy nor trade-off (neutral relationship) is found between the reduction of income inequality (SDG 10) and the reduction of CO2 emissions (SDG 13). Our findings highlight the importance of mainstreaming SDG&rsquo;s policy interactions to achieve sustainable development goals, while also stressing the potential for South Africa to achieve low-carbon development should economic growth be decoupled from carbon-intensive energy use through policies that promote access and effective use of clean energy. The transition to clean energy is therefore emphasized and relevant factors underpinning such as transition should be explored further.

Highlights

This study examines the short- and long-run impacts of economic growth and unemployment (SDG 8), energy consumption (SDG 7) and income inequality (SDG 10) on CO2 emissions in South Africa
The autoregressive distributed lag approach to cointegration is employed
A synergy is established between the promotion of economic growth (SDG 8) and the reduction of CO2 emissions (SDG 13), and between the reduction in energy consumption/increase in energy efficiency (SDG 7) and the reduction of CO2 emissions (SDG 13)
A trade-off is confirmed between reducing unemployment rate or achieving productive employment and decent work (SDG 8) and mitigating CO2 emissions (SDG 13)
A neutral relationship is found between the reduction of income inequality (SDG 10) and the reduction of CO2 emissions (SDG 13)
Policymakers need to mainstream SDG&rsquo;s policy interactions to achieve sustainable development goals

South Africa can achieve low-carbon development should economic growth be decoupled from carbon-intensive energy use through policies that promote access and effective use of clean energy
Identidad territorial, agro y políticas públicas. Reflexiones históricas sobre las desigualdades regionales en la Argentina hasta mediados del siglo XX
Authors: Girbal-Blacha Noemí María 
Published: July 2019

Este estudio histórico se propone abordar -en el escenario de la Argentina Moderna y hasta mediados del siglo XX- las característi-cas de la organización del territorio en tanto parte de la identidad nacional, la acción del Estado y su burocracia técnica, así como el alcance de las políticas públicas agrarias, conceptualmente defi-nidas. El objetivo es dar cuenta de los desequilibrios regionales, en un país que concentra alrededor de las tres cuartas partes de su población, su infraestructura y su producción agraria y agroin-dustrial en una cuarta parte del territorio. Una situación que logra trascender los cambios políticos y gubernamentales ocurridos. Conocer sus causas y consecuencias es parte del desafío que se emprende en estas páginas.
This historical research intends to tackle – in Modern Argentina and until the mid-twentieth century - the characteristics of the territorial organization as part of the national identity, the State action and its technical bureaucracy together with the scope of the agrarian public policies, conceptually identified. The aim is to show the regional inequalities in a country that concentrates about three-quarters of its population, its infrastructure and its agrarian production and agro-industrial in one quarter of the territory. A situtation that moves beyond political and governmental changes. One of the challenges of these pages is to know the causes and consequences.
Evolución histórica de la protección ambiental en la minería en España
Authors: Ramírez Sánchez-Maroto Carlos 
Published: July 2019

En este trabajo se analiza la gestación de la normativa de protección ambiental relacionada con las actividades mineras, así como disposiciones específicas mineras que se fueron aprobando y tuvieron incidencia para reducir los efectos negativos al medio natural. Las normativas mineras que se aprobaron en la Edad Moderna preveían algunas medidas a fin de evitar perjuicios a la agricultura, ganado y a pueblos en el entorno de actividades mineras. En el siglo XIX, con un Estado liberal, se fueron aprobando lentamente a partir de mitad de siglo diversas leyes y reglamentos mineros, debido a conflictos sociales, que introdujeron medidas con efectos de protección a la salud y al medio natural. Con un mayor grado de intervencionismo estatal en el siglo XX se fueron aprobando, en un contexto de presión de grupos sociales afectados, diversas normas sectoriales de protección a ríos y arroyos. La Ley de Minas vigente introdujo que se aprobase por decreto el fijar las condiciones imperativas de protección del ambiente, siendo el origen del primer Real Decreto de restauración de actividades mineras de 1982.
This paper analyzes the gestation of environmental protec-tion regulations related to mining activities, as well as specific mining provisions that were approved and had an impact to reduce the negative effects to the natural environment. The mining regulations that were approved in the Modern Age envisaged some measures in order to avoid damage to agri-culture, livestock and to villages in the environment of mining activities. In the XIX century, with a liberal State, several laws and mining regulations were slowly being adopted from the middle of the century, due to social conflicts, which introduced measures with health and natural protection effects. With a greater de-gree of state interventionism in the XX century, in a context of pressure from affected social groups, various sectoral rules for the protection of rivers and streams were approved. The Law of Mines in force introduced that it was approved by decree to fix the imperative conditions of protection of the environ-ment, being the origin of the first Royal Decree of restoration of mining activities of 1982.
Percepción competencial del emprendimiento en personas con discapacidad. Un estudio comparativo
Authors: Olaz Capitán Angel José , Ortiz García Pilar 
Published: July 2019

El propósito de este trabajo es identificar a través de la comparativa entre dos colectivos: personas con discapacidad que desarrollan actividades de emprendimiento y el de técnicos de la Administración Regional relacionados con este ámbito qué dimensiones y aspectos competenciales favorecen y / o limitan la actividad emprendedora de las personas con algún tipo de discapacidad física y/o sensorial. Desde una perspectiva metodológica cualitativa y en base a muestras estructurales, el análisis se desarrolló a través de dos herramientas: la Técnica Nominal de Grupo para identificar dimensiones de análisis y el test Emotional Competence Intelligence para ponderar qué competencias psicosociales eran claves en la comprensión del fenómeno. Tras el análisis en cada uno de estos colectivos este trabajo concluye estableciendo las oportunas conclusiones comparativas.
The aim of this work is to identify through the comparison between two groups: people with disabilities who develop entrepreneurship activities and technicians of the Regional Administration related to this area which dimensions and competencies favour and / or limit the entrepreneurial activity of people with some kind of physical and / or sensory disability. From a qualitative methodological perspective and based on structural samples, the analysis was developed through two tools: the Nominal Group Technique to identify dimensions of analysis and the Emotional Competence Intelligence test to assess which psychosocial competences were key in understanding the phenomenon. After the analysis in each of these groups this work concludes establishing the appropriate comparative conclusions.
A cidade educadora, uma estratégia para a inclusão das pessoas com deficiência - Um futuro desejável e um processo de mudança em curso
Authors: Rasteiro Domingos 
Published: July 2019

[PT] Sabemos hoje as potencialidades que a educação tem nos processos de mudança das pessoas, das organizações e das sociedades e, nesse pressuposto, o principal objetivo deste artigo é explorar a temática da educação nas cidades, ligando esse domínio à problemática das pessoas com deficiência. Nesse quadro apresentam-se os resultados de um trabalho de investigação que foi realizado entre 2015 e 2017 e teve como foco as cidades portuguesas associadas da Associação Internacional das Cidades Educadoras (AICE). As cidades que participaram no estudo foram 31, de um universo de 57, sendo possível, através do estudo das perceções dos dirigentes políticos e dos técnicos dos municípios, construir um «ranking» do potencial inclusivo das cidades. A realização de dois estudos de caso nas cidades com melhor potencial inclusivo permitiu determinar quais os fatores que influenciam as políticas de inclusão que desenvolvem, tendo como preocupação a melhoria da qualidade de vida das pessoas com deficiência, servindo de indicação para boas práticas inclusivas. [ES] Sabemos hoy las potencialidades que la educación tiene en los procesos de cambio de las personas, de las organizaciones y de las sociedades y, en ese supuesto, el principal objetivo de este artículo es explorar la temática de la educación en las ciudades, vinculando ese dominio a la problemática de las personas con discapacidad. Esta tabla presenta los resultados de un trabajo de investigación que se llevó a cabo, centrándose en las ciudades portuguesas asociados con la Asociación Internacional de Ciudades Educadoras (AICE), que tuvo lugar entre 2015 y 2017. Las ciudades que participaron en el estudio fueron 31 de un universo de 57, siendo posible a través del estudio de las percepciones de los dirigentes políticos y de los técnicos de los municipios, construir un "ranking" del potencial inclusivo de las ciudades. La realización de dos estudios de caso en las ciudades con mejor potencial inclusivo permitió determinar cuáles son los factores que influencian las políticas de inclusión que desarrollan, teniendo como preocupación la mejora de la calidad de vida de las personas con discapacidad, sirviendo de indicación para buenas prácticas inclusivas.
A 3-mRNA-based prognostic signature of survival in oral squamous cell carcinoma
Authors: Cao Ruoyan , Wu Qiqi , Li Qiulan , Yao Mianfeng , Zhou Hongbo 
Published: July 2019

Background
Oral squamous cell carcinoma (OSCC) is the most common type of head and neck squamous cell carcinoma with an unsatisfactory prognosis. The aim of this study was to identify potential prognostic mRNA biomarkers of OSCC based on analysis of The Cancer Genome Atlas (TCGA).

Methods
Expression profiles and clinical data of OSCC patients were collected from TCGA database. Univariate Cox analysis and the least absolute shrinkage and selection operator Cox (LASSO Cox) regression were used to primarily screen prognostic biomarkers. Then multivariate Cox analysis was performed to build a prognostic model based on the selected prognostic mRNAs. Nomograms were generated to predict the individual’s overall survival at 3 and 5 years. The model performance was assessed by the time-dependent receiver operating characteristic (ROC) curve and calibration plot in both training cohort and validation cohort (GSE41613 from NCBI GEO databases). In addition, machine learning was used to assess the importance of risk factors of OSCC. Finally, in order to explore the potential mechanisms of OSCC, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis was completed.

Results
Three mRNAs (CLEC3B, C6 and CLCN1) were finally identified as a prognostic biomarker pattern. The risk score was imputed as: (−0.38602 × expression level of CLEC3B) + (−0.20632 × expression level of CLCN1) + (0.31541 × expression level of C6). In the TCGA training cohort, the area under the curve (AUC) was 0.705 and 0.711 for 3- and 5-year survival, respectively. In the validation cohort, AUC was 0.718 and 0.717 for 3- and 5-year survival. A satisfactory agreement between predictive values and observation values was demonstrated by the calibration curve in the probabilities of 3- and 5- year survival in both cohorts. Furthermore, machine learning identified the 3-mRNA signature as the most important risk factor to survival of OSCC. Neuroactive ligand-receptor interaction was most enriched mostly in KEGG pathway analysis.

Conclusion
A 3-mRNA signature (CLEC3B, C6 and CLCN1) successfully predicted the survival of OSCC patients in both training and test cohort. In addition, this signature was an independent and the most important risk factor of OSCC.
Hyperemesis Gravidarum, Wernicke’s Encephalopathy and Korsakoff Syndrome Looked through the Lens of Three Cases, Paper II
Authors: Salahuddin Nasreen Khawer , Dutta Arindam , Qureshi Naseem Akhtar 
Published: July 2019

Objective: Pregnancy a normal physiological condition is worsened by morning sickness, nausea and vomiting of pregnancy, hyperemesis gravidarum, Wernicke’s encephalopathy and Korsakoff syndrome in vulnerable women with gestation. This report of three cases described hyperemesis gravidarum, Wernicke’s encephalopathy and Korsakoff syndrome in the worsening pregnancies.
Methods: Prospective collection of data concerning three pregnant patients seen in Dubai Health Care City, Dubai, United Arab Emirates.
Results: All three patients were admitted to the hospital with manifestations of HG and WE and one of them showed additional features of Korsakoff syndrome. One patient developed intractable hyponatremia and central pontine myelinolysis. Two patients developed abortion while one patient's pregnancy ended with successful delivery with living infant. All patients were managed with thiamine, antiemetics, parenteral fluids and electrolytes and one patients required steroid therapy.
Conclusion: The findings of these cases are compatible with international literature on HG and its sequential syndromes. This study may enhance awareness of HG, WE and KS and also fill the knowledge gap of professionals providing services to women with worsening health during pregnancy in Arabian Gulf countries.
Artificial Sensory Memory
Authors: Wan Changjin , Cai Pingqiang , Wang Ming , Qian Yan , Huang Wei , Chen Xiaodong 
Published: July 2019

AbstractSensory memory, formed at the beginning while perceiving and interacting with the environment, is considered a primary source of intelligence. Transferring such biological concepts into electronic implementation aims at achieving perceptual intelligence, which would profoundly advance a broad spectrum of applications, such as prosthetics, robotics, and cyborg systems. Here, the recent developments in the design and fabrication of artificial sensory memory devices are summarized and their applications in recognition, manipulation, and learning are highlighted. The emergence of such devices benefits from recent progress in both bioinspired sensing and neuromorphic engineering technologies and derives from abundant inspiration and benchmarks from an improved understanding of biological sensory processing. Increasing attention to this area would offer unprecedented opportunities toward new hardware architecture of artificial intelligence, which could extend the capabilities of digital systems with emotional/psychological attributes. Pending challenges are also addressed to aspects such as integration level, energy efficiency, and functionality, which would undoubtedly shed light on the future development of translational implementations.
Engineering Optical Absorption in Graphene and Other 2D Materials: Advances and Applications
Authors: Li Qiang , Lu Jun , Gupta Prince , Qiu Min 
Published: July 2019

Abstract2D materials are promising but remain to be further explored, with respect to their usage in various optoelectronic devices. Generally, 2D materials exhibit far less than ideal absorption due to their thickness, limiting their deployment in practical optoelectronic applications. To address this challenge, extensive research has been performed utilizing different designs, such as distributed Bragg reflector microcavities, metallic reflectors, photonic crystal nanocavities, and plasmonic nanostructures, to confine light within 2D materials and increase light absorption. Recent progresses in enhancing light absorption in graphene and other 2D materials such as transition metal dichalcogenides and phosphorene are reviewed. Some physical mechanisms that realize enhanced absorption in 2D materials, as well as their potential applications are also discussed.