bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased Intracranial Pressure in Acute Disseminated Encephalomyelitis
Authors: Orbach Rotem , Schneebaum Sender Nira , Lubetzky Ronit , Fattal-Valevski Aviva 
Published: November 2018

Objective: To assess the intracranial pressure in pediatric acute disseminated encephalomyelitis using spinal tap opening pressure on lumbar puncture, which is routinely performed as part of suspected acute disseminated encephalomyelitis workup. Compared to other cerebrospinal fluid parameters such as cell count, protein concentration, and presence of oligoclonal bands, cerebrospinal fluid opening pressure is infrequently recorded. Methods: A retrospective chart review of demographic, clinical, and laboratory data of children diagnosed with acute disseminated encephalomyelitis admitted to a tertiary referral hospital between 2005 and 2016. Results: Of the 36 children diagnosed with acute disseminated encephalomyelitis, 24 had the cerebrospinal fluid opening pressure documented in their records. The mean cerebrospinal fluid opening pressure was 27.6±12.6 cmH2O, range 9-55 cmH2O (95% confidence interval 21.9-33.6). Cerebrospinal fluid opening pressure in the acute disseminated encephalomyelitis group was statistically significantly higher ( P = .0013, 95% confidence interval 4.2-15.0) than the accepted upper limit in this age group (18 cmH2O). In 10 of 24 patients (42%), the opening pressure was above 28 cmH2O. Conclusions: Increased opening pressure was the most frequent cerebrospinal fluid abnormal finding in our cohort, which suggests a potential role of increased intracranial pressure in the acute disseminated encephalomyelitis pathophysiological disease mechanism. In certain cases, the opening pressure value could have monitoring and therapeutic implications, and therefore its measurement is highlighted by this study.
Clinical Predictors for Unsafe Direct Discharge Home Patients From Intensive Care Units
Authors: Lau Vincent Issac , Priestap Fran , Lam Joyce N. H. , Basmaji John , Ball Ian M. 
Published: November 2018

Purpose: To describe factors (demographics and clinical characteristics) that predict patients who are at an increased risk of adverse events or unplanned return visits to a health-care facility following discharge direct to home (DDH) from intensive care units (ICUs). Methods: Prospective cohort study of all adult patients who survived their stay in our medical–surgical–trauma ICU between February 2016 and 2017 and were discharged directly home. Patients were followed for 8 weeks postdischarge. Univariable and multivariable logistic regression analyses were performed to identify factors associated with adverse events or unplanned return visits to a health-care facility following DDH from ICU. Results: A total of 129 DDH patients were enrolled and completed the 8-week follow-up. We identified 39 unplanned return visits (URVs). There was 0% mortality at 8 weeks postdischarge. Eight potential predictors of hospital URVs ( P < .2) were identified in the univariable analysis: prior substance abuse (odds ratio [OR] of URV of 2.50 [95% confidence interval: 1.08-5.80], hepatitis (OR: 6.92 [1.68-28.48]), sepsis (OR: 11.03 [1.19-102.29]), admission nine equivalents of nursing manpower score (NEMS) <24 (OR: 2.28 [1.03-5.04], no fixed address (OR: 22.9 [1.2-437.3]), ICU length of stay (LOS) <2 days (OR: 2.95 [1.28-6.78]), home discharge within London, Ontario (OR: 2.44 [1.00-5.92]), and left against medical advice (AMA; OR: 6.06 [2.04-17.98]). Conclusions: Our study identified 8 covariates that were potential predictors of URV: prior substance abuse, hepatitis, sepsis, admission NEMS <24, no fixed address, ICU LOS <2 days, home discharge within London, Ontario, and left AMA. The practice of direct discharges home from the ICU would benefit from adequately powered multicenter study in order to construct a clinical prediction model (that would require further testing and validation).
The silliness of magical realism
Authors: Clermont Kevin M 
Published: November 2018

Relative plausibility, even after countless explanatory articles, remains an underdeveloped model bereft of underlying theory. Multivalent logic, a fully developed and accepted system of logic, comes to the same endpoint as relative plausibility. Multivalent logic would thus provide the missing theory, while it would resolve all the old problems of using traditional probability theory to explain the standards of proof as well as the new problems raised by the relative plausibility model. For example, multivalent logic resolves the infamous ‘conjunction paradox’ that traditional probability creates for itself, and which relative plausibility tries to sweep under the rug. Yet Professors Allen and Pardo dismiss multivalent logic as magical realism when applied to legal factfinding. They reject this ring buoy because they misunderstand nonclassical logic, as this response explains.
Potential liabilities: Social investment policy as biopolitics in New Zealand – An examination of the National Coalition government’s welfare policies
Authors: Stuart Margaret 
Published: November 2018

Using Michel Foucault’s theories of biopolitics, about risk and security, I examine the welfare policies of the National Coalition Government in New Zealand (2008–2017). This government attempted to mitigate risk by projecting possible challenges and solutions to ‘vulnerable populations’. Welfare was re-defined in monetarist economic terms, as ways to ensure ‘small government’. Over the three terms of government they brought in changes across the education, and social services, with the intent of implementing new economic facets to reduce the cost to the state of beneficiaries and their dependent children.  Using cross-ministry data collection, they planned to identify the ‘job-shy’ parents and children deemed ‘vulnerable’. Social Investment aimed to change the behaviours of such populations, whom the National Coalition government deemed future potential liabilities for the state. Projecting costs over 20 or 30 years and modelling the costs of dysfunction would give the social agencies improved information. Early intervention would save the state welfare budget, and responsibilize the young children at risk of themselves becoming beneficiaries later in life.
Medical complications in pregnancy at Mulago Hospital, Uganda’s national referral hospital
Authors: Milln JM , Nakimuli A 
Published: November 2018

Introduction Medical complications in pregnancy contribute significantly to maternal morbidity in sub-Saharan Africa. Anecdotally, obstetricians in Uganda do not feel equipped to treat complex medical cases, and receive little support from physicians. Methods The aim of the study was to quantify the burden of complex medical conditions on the obstetric high dependency unit at Mulago National Referral Hospital, and potential deficiencies in the referral of cases and training in obstetric medicine. A prospective audit was taken on the obstetric high dependency unit from April to May 2014. In addition, 50 trainees in obstetrics and gynaecology filled a nine-point questionnaire regarding their experiences. Results Complex medical disorders of pregnancy accounted for 22/106 (21%) admissions to the high dependency unit, and these cases were responsible for 51% of total bed occupancy, and had a case fatality rate of 6/22 (27.2%). Only 6/14 (43%) of referrals to medical specialties were fulfilled within 48 h. Of the six women who died due to medical conditions, three specialty referrals were made, none of which were fulfilled. Trainees reported deficiencies in obstetric medicine training and in referral of complex conditions. They were least confident addressing non-communicable conditions in pregnancy. Discussion Deficiencies exist in the care of women with complex medical conditions in pregnancy in Uganda. Frameworks of obstetric medicine training and referral of complex cases should be explored and adapted to the sub-Saharan African setting.
Feasibility of ureteroscopy as a pure day-case procedure
Authors: Grice PT , Phillips OP , Khan MA 
Published: November 2018

Objective: Ureteroscopy (URS) is a procedure that is commonly performed by endourologists for stone surgery and other diagnostic and therapeutic indications. With stone disease becoming an increasing burden on the health economy, there is a clear incentive to perform URS as a day-case procedure. Patients and methods: This single-centre, single-surgeon study prospectively considered all patients for day-case rigid or flexible URS over a 12-month period, with the only exclusion criteria being an American Society of Anesthesiologists score greater than 3 or a lack of aftercare. Results: Sixty-six patients were included with 61 being discharged the same day of surgery, meaning a pure day-case rate of 92% and 30-day postoperative readmission rate of 6%. Conclusion: This study suggests that URS should primarily be considered a day-case procedure whenever feasible. Level of evidence: 2c
Arthroscopic Superior Capsular Reconstruction With a Minimally Invasive Harvested Fascia Lata Autograft Produces Good Clinical Results
Authors: de Campos Azevedo Clara Isabel , Ângelo Ana Catarina Leiria Pires Gago , Vinga Susana 
Published: November 2018

Background: Painful dysfunctional shoulders with irreparable rotator cuff tears (IRCTs) in active patients are a challenge. Arthroscopic superior capsular reconstruction (ASCR) is a new treatment option originally described using a fascia lata autograft harvested through an open approach. However, concerns about donor site morbidity have discouraged surgeons from using this type of graft. Hypothesis: ASCR using a minimally invasive harvested fascia lata autograft produces good 6-month and 2-year shoulder outcomes in IRCTs, with low-impact thigh morbidity at 2 years. Study Design: Case series; Level of evidence, 4. Methods: From 2015 to 2016, a total of 22 consecutive patients (mean age, 64.8 ± 8.6 years) with chronic IRCTs (Hamada grade 1-2; Goutallier cumulative grade ≥3; Patte stage 1: 2 patients; Patte stage 2: 6 patients; Patte stage 3: 14 patients) underwent ASCR using a minimally invasive harvested fascia lata autograft. All patients completed preoperative and 6-month evaluations consisting of the Simple Shoulder Test (SST), subjective shoulder value (SSV), Constant score (CS), range of motion (ROM), acromiohumeral interval (AHI), and magnetic resonance imaging. Twenty-one patients completed the 2-year shoulder and donor site morbidity assessments. Results: The mean active ROMs improved significantly ( P < .001): elevation, from 74.8° ± 55.5° to 104.5° ± 41.9° (6 months) and 143.8° ± 31.7° (2 years); abduction, from 53.2° ± 43.3° to 86.6° ± 32.9° (6 months) and 120.7° ± 37.7° (2 years); external rotation, from 13.2° ± 18.4° to 27.0° ± 16.1° (6 months) and 35.6° ± 17.3° (2 years); and internal rotation, from 1.2 ± 1.5 points to 2.6 ± 1.5 points (6 months) and 3.8 ± 1.2 points (2 years). The mean functional shoulder scores improved significantly ( P < .001): SST, from 2.1 ± 2.9 to 6.8 ± 3.5 (6 months) and 8.6 ± 3.5 (2 years); SSV, from 33.0% ± 17.4% to 55.7% ± 25.6% (6 months) and 70.0% ± 23.0% (2 years); CS, from 17.5 ± 13.4 to 42.5 ± 14.9 (6 months) and 64.9 ± 18.0 (2 years). The mean shoulder abduction strength improved significantly ( P < .001) from 0.0 to 1.1 ± 1.4 kg (6 months) and 2.8 ± 2.6 kg (2 years). The mean AHI improved from 6.4 ± 3.3 mm to 8.0 ± 2.5 mm (6 months) and decreased to 7.1 ± 2.5 mm (2 years). This 0.7 ± 1.5–mm overall decrease was statistically significant ( P = .042). At 6 months, 20 of 22 patients (90.9%) had no graft tears. At 2 years, 12 of 21 patients (57.1%) were bothered by their harvested thigh, 16 (76.2%) noticed donor site changes, 16 (76.2%) considered that the shoulder surgery’s end result compensated for the thigh’s changes, and 18 (85.7%) would undergo the same surgery again. Conclusion: ASCR using a minimally invasive harvested fascia lata autograft produced good 6-month and 2-year shoulder outcomes in IRCTs, with low-impact thigh morbidity at 2 years.
Availability of secondary prevention services after stroke in Europe: An ESO/SAFE survey of national scientific societies and stroke experts
Authors: Webb A , Heldner MR , Aguiar de Sousa D , Sandset EC , Randall G , Bejot Y , van der Worp B , Caso V , Fischer U ,   On behalf of the ESO-SAFE Secondary Prevention Survey Steering Group
Published: November 2018

Background Recurrent stroke is associated with increased disability and cognitive impairment, but the availability of secondary prevention measures after transient ischaemic attack (TIA) or stroke in Europe is uncertain. This limits prioritisation of investment and development of national stroke strategies. Methods National stroke representatives throughout Europe were surveyed. Consensus panels reported national data if available, or else expert opinion, estimating the availability of each intervention by quintiles of patients, dichotomised for analysis at 60%. Countries were classified into tertiles of gross domestic product per capita. Results Of 50 countries, 46 responded; 14/45 (31%) had national stroke registries and 25/46 (54.3%) had national stroke strategies incorporating secondary prevention. Respondents reported that the majority of TIA patients were assessed by specialist services within 48 hours in 74.4% of countries, but in nine countries more than 20% of patients were seen after more than seven days and usually assessed by non-specialists (7/46 countries). Eighty percent of countries deferred blood pressure assessment to primary care, whilst lifestyle management programmes were commonly available in only 46% of countries. Although basic interventions were widely available, interventions frequently not available to more than 60% of patients included: ambulatory cardiac monitoring (40% countries); prescription (26%) and continuation (46%) of statins; blood pressure control at follow-up (44%); carotid endarterectomy within one month (15%); face-to-face follow-up in hospital (33%); direct oral anticoagulants (21%). Gross domestic product per capita and reimbursement of interventions were the commonest predictors of availability of interventions. Conclusions Provision of secondary prevention varied, with gaps in care prevalent throughout Europe, particularly in lower income countries.
Advanced Birdshot Chorioretinopathy Presenting as Chronic Cystoid Macular Edema and Vitritis Following Cataract Surgery
Authors: Powers Matthew A. , Wood Edward H. , Sanislo Steven R. , Nguyen Quan Dong , Hassan Tarek S. 
Published: November 2018

Purpose: The purpose of this case report is to present a case of birdshot chorioretinopathy in an elderly woman who presented with postoperative macular edema and vitritis following cataract surgery. Methods: A retrospective case report was compiled of the use of optical coherence tomography, scanning laser ophthalmoscopy, fluorescein angiography, and wide-angle fundus photography to document exam findings. Results: An 81-year old woman presented with steroid-resistant bilateral cystoid macular edema and vitritis following cataract surgery. Clinical testing, including serum HLA-A29, was suggestive of birdshot chorioretinopathy. Pars plana vitrectomy with membrane peeling was performed, and the patient was started on both steroid-sparing immunomodulatory therapy and systemic corticosteroids. Her macular edema improved and her disease progression stabilized. Conclusions: To the best of the authors’ knowledge, this is the oldest patient diagnosed with birdshot chorioretinopathy to be reported in the literature. The unusual initial presentation following cataract extraction highlights the importance of diagnostic vigilance when facing an unusual case of posterior uveitis.
Ceramic properties of Uşak clay in comparison with Ukrainian clay
Authors: Aghayev Tural , Küçükuysal Ceren 
Published: November 2018

ABSTRACTIn this contribution, a new raw material, Uşak clay (Usc), was investigated in order to assess its potential for the ceramic industry by comparing it with a world reference ceramic material, a Ukrainian clay (Ukc). Mineralogical characterization (X-ray diffraction [XRD], scanning electron microscopy [SEM] and Fourier-transform infrared [FTIR] spectroscopy), quantitative chemical analysis (X-ray fluorescence [XRF]) and the thermal properties of Ukc and Usc samples were investigated. Additionally, Atterberg limits, particle-size distribution and cation exchange capacity of both samples were determined. Various technological properties of Ukc and Usc were determined in the temperature range 800–1430°C. The bending and compressive strengths, total linear shrinkage, colour, water absorption and unit-volume mass values were measured. The findings from these analyses show that kaolinite-dominated Ukc and quartz-dominated Usc samples differ from each other not only mineralogically, but also in terms of their chemical, physical and technological properties. The firing colour of Usc was determined as 84% white, and so this can be considered as a light firing clay. In addition, due to its low plasticity, Usc may be utilized to reduce both the plasticity of the ceramic materials and the viscosity in slip-casting applied ceramics. Furthermore, the melting temperature of 1300°C suggests that Usc cannot be classified as refractory. However, this property does suggest an economic value for Usc in terms of developing technological characteristics at lower firing temperatures.
Modification and characterization of an Iranian montmorillonite as a corrosion/mechanical promoter for epoxy coatings
Authors: Ghodrati S. , Mahmoodi A. , Mohseni M. 
Published: November 2018

ABSTRACTIranian montmorillonite (MMT) was modified with hexadecyltrimethylammonium bromide (HDTB) and used as a nano-additive for the enhancement of the mechanical and anticorrosion properties of an epoxy coating. Infrared (IR) spectroscopy, thermo-gravimetric analysis (TGA), transmission electron microscopy (TEM) and X-ray diffraction (XRD) analysis indicated that HDTB reacted with MMT (with 97% yield) and increased the d001 spacing of MMT from 1.27 to 3.92 nm. Some 1, 3 and 5 wt.% of organically modified montmorillonite (OMMT) were added to the epoxy coating formulation. XRD and TEM/image processing analysis showed that the extent of intercalation/exfoliation of OMMT was substantially greater than that of MMT. Dynamic mechanical analysis showed that the glass transition temperature and storage modulus increased significantly with the addition of OMMT. Electrochemical impedance spectroscopy (EIS) and salt spray/image processing results revealed that addition of OMMT to the epoxy coating significantly increased the corrosion resistance of the coating compared to neat and MMT-containing epoxy coatings. The optimum concentration of OMMT was 3 wt.%. At this concentration, the mechanical and anticorrosion properties were greatly superior to those of neat and MMT-containing epoxy coatings.
BCAS2 is essential for hematopoietic stem and progenitor cell maintenance during zebrafish embryogenesis
Authors: Yu Shanshan , Jiang Tao , Jia Danna , Han Yunqiao , Liu Fei , Huang Yuwen , Qu Zhen , Zhao Yuntong , Tu Jiayi , Lv Yuexia , Li Jingzhen , Hu Xuebin , Lu Zhaojing , Han Shanshan , Qin Yayun , Liu Xiliang , Xie Shanglun , Wang Qing K. , Tang Zhaohui , Luo Daji , Liu Mugen 
Published: November 2018

Abstract
Hematopoietic stem and progenitor cells (HSPCs) originate from the hemogenic endothelium via the endothelial-to-hematopoietic transition, are self-renewing, and replenish all lineages of blood cells throughout life. BCAS2 (breast carcinoma amplified sequence 2) is a component of the spliceosome and is involved in multiple biological processes. However, its role in hematopoiesis remains unknown. We established a bcas2 knockout zebrafish model by using transcription activator–like effector nucleases. The bcas2−/− zebrafish showed severe impairment of HSPCs and their derivatives during definitive hematopoiesis. We also observed significant signs of HSPC apoptosis in the caudal hematopoietic tissue of bcas2−/− zebrafish, which may be rescued by suppression of p53. Furthermore, we show that the bcas2 deletion induces an abnormal alternative splicing of Mdm4 that predisposes cells to undergo p53-mediated apoptosis, which provides a mechanistic explanation of the deficiency observed in HSPCs. Our findings revealed a novel and vital role for BCAS2 during HSPC maintenance in zebrafish.
American Society of Hematology 2018 guidelines for management of venous thromboembolism: diagnosis of venous thromboembolism
Authors: Lim Wendy , Le Gal Grégoire , Bates Shannon M. , Righini Marc , Haramati Linda B. , Lang Eddy , Kline Jeffrey A. , Chasteen Sonja , Snyder Marcia , Patel Payal , Bhatt Meha , Patel Parth , Braun Cody , Begum Housne , Wiercioch Wojtek , Schünemann Holger J. , Mustafa Reem A. 
Published: November 2018

AbstractIn February 2022, these guidelines were reviewed by an expert work group convened by ASH. Review included limited searches for new evidence and discussion of the search results. Following this review, the ASH Committee on Quality agreed to continue monitoring the supporting evidence rather than revise or retire these guidelines at this time. Limited searches and expert review will be repeated annually going forward until these guidelines are revised or retired.
Prevalence and in-hospital outcomes of diabetes among patients with acute coronary syndrome in China: findings from the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome Project
Authors: Zhou Mengge , Liu Jing , Hao Yongchen , Liu Jun , Huo Yong , Smith Sidney C. , Ge Junbo , Ma Changsheng , Han Yaling , Fonarow Gregg C. , Taubert Kathryn A. , Morgan Louise , Yang Na , Xing Yueyan , Zhao Dong ,   the CCC-ACS Investigators
Published: November 2018

Abstract
Background
Guidelines have classified patients with acute coronary syndrome (ACS) and diabetes as a special population, with specific sections presented for the management of these patients considering their extremely high risk. However, in China up-to-date information is lacking regarding the burden of diabetes in patients with ACS and the potential impact of diabetes status on the in-hospital outcomes of these patients. This study aims to provide updated estimation for the burden of diabetes in patients with ACS in China and to evaluate whether diabetes is still associated with excess risks of early mortality and major adverse cardiovascular and cerebrovascular events (MACCE) for ACS patients.

Methods
The Improving Care for Cardiovascular Disease in China-ACS Project was a collaborative study of the American Heart Association and the Chinese Society of Cardiology. A total of 63,450 inpatients with a definitive diagnosis of ACS were included. Prevalence of diabetes was evaluated in the overall study population and subgroups. Multivariate logistic regression was performed to examine the association between diabetes and in-hospital outcomes, and a propensity-score-matched analysis was further conducted.

Results
Among these ACS patients, 23,880 (37.6%) had diabetes/possible diabetes. Both STEMI and NSTE-ACS patients had a high prevalence of diabetes/possible diabetes (36.8% versus 39.0%). The prevalence of diabetes/possible diabetes was higher in women (45.0% versus 35.2%, p < 0.001). Even in patients younger than 45 years, 26.9% had diabetes/possible diabetes. While receiving comparable treatments for ACS, diabetes/possible diabetes was associated with a twofold higher risk of all-cause death (adjusted odds ratio 2.04 [95% confidence interval 1.78–2.33]) and a 1.5-fold higher risk of MACCE (adjusted odds ratio 1.54 [95% confidence interval 1.39–1.72]).

Conclusions
Diabetes was highly prevalent in patients with ACS in China. Considerable excess risks for early mortality and major adverse cardiovascular events were found in these patients.
Trial registration NCT02306616. Registered December 3, 2014