bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gravity flow test comparisons for mildly thick consistency
Authors: Garcia Jane Mertz , Chambers Edgar , Noll Krista S. 
Published: October 2019

AbstractSimple measurement tools that provide objective information about the consistency of thickened liquids have received increasing attention given possible application to clinical practice for dysphagia. The International Dysphagia Diet Standardization Initiative (IDDSI) advocates the use of the IDDSI Flow Test for measuring thickness and verifying a prescribed level of consistency. This study compares gravity flow test measurements taken with two 10‐ml syringes of starch and gum‐thickened samples prepared to a mildly thick consistency using product label information. One of the 10‐ml syringes met IDDSI specification and the other 10‐ml syringe did not. Thickened samples also were measured using the line spread apparatus. The results showed that two syringes yielded significantly different gravity flow test measurements, often resulting in changes to the classification level of thickness. There was no effect of thickening agent. Line spread measurements did not vary from one another. Study findings indicate the importance of continued testing with the IDDSI Flow Test and education/awareness about the use of the IDDSI reference syringe. An essential aspect about the use of thickened liquids in dysphagia management is that beverage preparations represent their prescribed level of modification. The findings of this study indicate the importance of following syringe specifications when conducting gravity flow testing using the IDDSI methodology. The implication is that the wrong 10‐ml syringe could result in errant clinical decisions in determining the accuracy of texture modifications, resulting in care providers who are more likely to over or under thicken modifications to achieve a targeted level of thickness.
Goal Identification Before Spinal Cord Stimulation: A Qualitative Exploration in Potential Candidates
Authors: Goudman Lisa , Bruzzo Alessandra , van de Sande Jasper , Moens Maarten 
Published: October 2019

AbstractIntroductionDue to the difficulties encountered in the treatment process of patients with chronic pain, it is of utmost importance to involve patients themselves in their rehabilitation trajectory. Patient engagement can be obtained by motivating patients to select their own treatment goals. We hypothesize that applying goal setting, as a form of patient empowerment, in potential candidates for spinal cord stimulation (SCS) may further improve the outcome of SCS. As a first step in creating patient empowerment, patients' goals that they aim to achieve with SCS will be explored.MethodsFifteen patients suffering from failed back/neck surgery syndrome and scheduled for SCS were interviewed in depth. All interviews were audio recorded and analyzed using in vivo coding. Afterwards, the International Classification of Functioning, Disability and Health framework was used to structure the responses of patients.ResultsIn the domain of bodily functions, all patients mentioned pain reduction, and 1 patient wanted to regain his previous sleep pattern. In the domain of activities, walking, sitting, driving a car, bending down, and picking up were the highest ranked goals. Regaining a social life was the highest ranked goal for participation. Eleven patients wanted to regain a feeling of happiness, and 5 patients wanted to focus on avoiding depression.ConclusionThe interviews revealed a broad spectrum of individual patients' goals, highlighting the need of individually targeted rehabilitation trajectories in the field of neuromodulation. Goal identification could entail the first step towards individualized medicine in the SCS trajectory.
Differential Recovery Migration across the Rural–Urban Gradient: Minimal and Short‐Term Population Gains for Rural Disaster‐Affected Gulf Coast Counties
Authors: Curtis Katherine J. , DeWaard Jack , Fussell Elizabeth , Rosenfeld Rachel A. 
Published: October 2019

AbstractPlaces affected or threatened by extreme environmental disturbances confront a number of significant issues, including whether their populations will stay the same or change through migration. Research on Hurricanes Katrina and Rita shows some displaced residents returned to their disaster‐affected communities once the built environment was restored, new migrants settled in affected places as part of the rebuilding effort, and the regional migration system grew more urbanized and spatially concentrated during post‐disaster years. Research also shows that not all disaster‐affected places recovered their populations. Our study examines whether differential recovery is systematically patterned along the rural–urban gradient. Using U.S. Census Bureau estimates and IRS county‐to‐county migration data, we investigate whether the 2005 hurricane season differentially exacerbated or altered previous migration trends across a rural–urban gradient that incorporates proximity to metropolitan areas and disaster‐related housing loss. We find a rural–urban differential in Gulf Coast recovery migration: The disaster boosted migration among non‐metropolitan counties, yet these increases were smaller and short‐lived compared to the patterns found for metropolitan counties, most especially high loss metropolitan counties. Our findings encourage theories of environmental migration to incorporate spatial differentiation and scenarios of environmental changes to account for differential impacts on settlement patterns across the rural–urban continuum.
A modified technique to fabricate a complete hollow obturator for bilateral maxillectomy in a patient with mucormycosis—A technical case report
Authors: Mani Uma Maheswari , Mohamed Kasim , Krishna Kumar Arjun , Inbarajan Athiban 
Published: October 2019

AbstractMaxillectomy performed in acquired lesions is often very extensive or bilateral, sparing very less hard and soft tissue in the oral cavity. These defects need both surgical and prosthetic rehabilitation. A definitive prosthesis is inserted after complete healing, when the patient is accustomed to the interim prosthesis. Definitive obturator warrants better retention and stability and needs a meticulous planning in design for long‐term use. Conventional design has a few disadvantages; it needs modification many times to improve retention and psychological comfort of the patient. The article explains an easy technique in fabrication of an obturator. The conventional obturator design has a hollow antral part but usually a solid oral part, which adds to the weight of the prosthesis pressurizing the soft tissues in a maxillectomy, which affects the function and esthetics. This article demonstrates the hollowing of oral part, which bears the artificial teeth, and modifying the antral bulb, which covers the defect. It was designed considering the potential difficulties shared by the patient in wearing the single piece conventional hollow bulb design. This technique when followed was beneficial in reducing the weight of the prosthesis and enhancing retention, and allowed the patient to perform normal functional movements.
Health status, health behaviours and healthcare access of lesbian, gay, bisexual and transgender populations in Turkey
Authors: Ercan Sahin Nilay , Aslan Funda , Emiroglu Oya Nuran 
Published: October 2019

BackgroundLesbian, gay, bisexual and transgender (LGBT) individuals experience many barriers to healthcare access and health disparities because of societal stigma, discrimination and homophobia by the community and healthcare providers. Therefore, this sexual minority group poses a risk for poor health status.AimsTo determine the health status, health behaviours and healthcare access among LGBT individuals in Turkey.MethodsThe study was conducted on 140 self‐identified LGBT individuals in Turkey between 11 April and 15 July 2016 as a descriptive, electronical survey design. Data were collected by questionnaire form, developed based on the researchers’ review of the literature.ResultsThe results of this study revealed that 65% of LGBT participants self‐reported that their mental health status was ‘poor/fair’ while 69% of participants reported that their physical health was ‘good/excellent’. Most of them had smoking (60%), using alcohol (76.3%) and did unprotected sex (55.3%) and reported disclosing their LGBT status to the healthcare provider (90.6%); 48.6% of participants thought that disclosing their LGBT status would affect their treatment. Barriers to healthcare access included disclosing LGBT status, societal stigma, negative attitude of healthcare provider, dissatisfaction with healthcare, and lack of health insurance and financial resources.ConclusionsThese results can assist healthcare providers, especially nurses as critical members of this group, to serve LGBT individuals satisfactorily. Besides, it is expected that these results will shed light on new research.
Free trade agreements in a small, open country: The case of Norway
Authors: Medin Hege 
Published: October 2019

AbstractNegotiating free trade agreements (FTAs) has been a high political priority for Norway. Today, it has agreements with 41 countries outside the European Union (EU)/the European Free Trade Association (EFTA), resulting in one of the world's most extensive FTA networks. FTAs cover about 10% of Norway's trade—a share likely to increase in the future. These agreements eliminate tariffs on a substantial number of traded products and have gradually become more comprehensive, covering an expanding range of non‐tariff areas. Hence, they may have trade‐promoting effects beyond tariff reductions as such. On the other hand, the non‐tariff provisions often do not go further than what has already been dealt with in other international agreements or practised domestically, so their overall effect may be limited.
Demand shifts and willingness to pay in applied trade models
Authors: Walmsley Terrie , Minor Peter 
Published: October 2019

AbstractEmerging issues facing open economies, including global value chains and non‐tariff measures, have important implications for demand that are often not well suited for analysis with the supply‐side mechanisms commonly found in economic models – namely taxes and productivity. The aim of this paper is to provide a methodological approach for implementing demand‐side changes. Specifically, the approach adapts the Armington equation to model a change in consumers' willingness to pay for imports. To illustrate, we estimate the impacts of the World Trade Organization's Trade Facilitation Agreement (TFA). Estimated ad valorem equivalents of the TFA are applied as demand‐side shocks to consumers' willingness to pay in a global applied general equilibrium model and the results compared to those obtained using Samuelson's iceberg approach. We find that the iceberg approach results in a technical change which increases the productivity of imports, raising real GDP, while the willingness‐to‐pay approach causes a smaller rise in real GDP, although trade increases further. The impact on the terms of trade differs significantly between the two mechanisms, with prices falling as costs fall, under the iceberg method, and rising with increased willingness to pay. Our results clearly show that the choice of mechanism matters.
Nicotinic receptors modulate skin perfusion during normothermia, and have a limited role in skin vasodilatation and sweating during hyperthermia
Authors: Fujii Naoto , Amano Tatsuro , Kenny Glen P. , Honda Yasushi , Kondo Narihiko , Nishiyasu Takeshi 
Published: October 2019

New Findings
What is the central question of this study?
What is the role of nicotinic receptors in the regulation of normothermic cutaneous blood flow and cutaneous vasodilatation and sweating during whole‐body heating induced following resting in a non‐heat‐stress condition?

What is the main finding and its importance?
Nicotinic receptors modulated cutaneous vascular tone during rest in a non‐heat‐stress condition and in the early stage of heating, but they had a limited role in mediating cutaneous vasodilatation when core temperature increased >0.4°C. Further, the contribution of nicotinic receptors to sweating was negligible during whole‐body heating. Our findings provide new insights into the role of nicotinic receptors in end‐organ function of skin vasculature and sweat glands in humans.

AbstractNicotinic receptors are present in human skin including cutaneous vessels and eccrine sweat glands as well as peripheral nerves. We tested the hypothesis that nicotinic receptors do not contribute to the control of cutaneous vascular tone in the normothermic state, but are involved in mediating cutaneous vasodilatation and sweating during a whole‐body passive heat stress in humans. We first performed a nicotinic receptor blocker verification protocol in six young adults (one female) wherein increases in cutaneous vascular conductance and sweating elicited by 10 mm nicotine were blocked by administration of 500 µm hexamethonium to confirm effective blockade. Thereafter, 12 young males participated in a passive heating protocol. After an instrumentation period in a non‐heat‐stress condition, participants rested for a 10 min baseline period. Thereafter, oesophageal temperature was increased by 1.0°C using water‐perfusion suits. Cutaneous vascular conductance, sweat rate, active sweat gland density and sweat output per individual gland were assessed with and without 500 µm hexamethonium administered via intradermal microdialysis. Hexamethonium reduced cutaneous vascular conductance by 22–34% during normothermia and the early stage of heating. However, this effect was diminished as oesophageal temperature increased >0.4°C. Active sweat gland density was reduced by hexamethonium when oesophageal temperature was elevated by 0.4–0.6°C above baseline resting. However, this was paralleled by a marginal increase in sweat gland output. Consequently, sweat rate remained unchanged. We showed that nicotinic receptors modulate cutaneous perfusion during normothermia and the early stage of heating, but not when core temperature increases >0.4°C. Additionally, they play a limited role in mediating sweating during heating.
Canada-Denmark MRI scoring system of the spine in patients with axial spondyloarthritis: updated definitions, scoring rules and inter-reader reliability in a multiple reader setting
Authors: Krabbe Simon , Østergaard Mikkel , Pedersen Susanne J , Weber Ulrich , Kröber Georg , Makysmowych Walter , Lambert Robert G W 
Published: October 2019

ObjectiveTo validate the Canada-Denmark (CANDEN) MRI scoring system for the spine in axial spondyloarthritis with updated lesion definitions.MethodsLesion definitions in the CANDEN system were updated and illustrated by a consensus set of reference images. Sagittal spine MRIs of 40 patients with axial spondyloarthritis obtained at baseline and at week 52 after initiation of treatment with the tumour necrosis factor inhibitor golimumab were evaluated in unknown chronology by seven readers blinded to all other data.ResultsCANDEN MRI spine inflammation score had very good reliability for status scores (single-measure intraclass correlation coefficient (ICC) of 21 reader pairs median of 0.91 (IQR 0.88–0.92)) and change scores (ICC 0.88 (0.86–0.92)). CANDEN MRI spine fat score had good to very good reliability for status scores (ICC 0.79 (0.75–0.86)) and moderate to good reliability for detecting change (ICC 0.59 (0.46–0.73)). CANDEN MRI spine bone erosion score and CANDEN MRI spine new bone formation score had slight to moderate reliability for status scores (ICC 0.38 (0.32–0.52) and 0.39 (0.27–0.49), respectively).ConclusionThe CANDEN MRI spine scoring system allows a comprehensive evaluation of inflammation, fat, bone erosion and new bone formation of the spine in patients with axial spondyloarthritis. It demonstrated very good reliability for detecting change in inflammation, moderate to good reliability for detecting change in fat, and slight to moderate reliability for detecting bone erosions and new bone formation. Studies with longer follow-up or patients with more advanced spinal involvement may be needed to reliably detect change in bone erosion and new bone formation scores.Trial registration numberNCT02011386.
Adiposity and asthma in adults: a bidirectional Mendelian randomisation analysis of The HUNT Study
Authors: Sun Yi-Qian , Brumpton Ben Michael , Langhammer Arnulf , Chen Yue , Kvaløy Kirsti , Mai Xiao-Mei 
Published: October 2019

BackgroundWe aimed to investigate the potential causal associations of adiposity with asthma overall, asthma by atopic status or by levels of symptom control in a large adult population and stratified by sex. We also investigated the potential for reverse causation between asthma and risk of adiposity.MethodsWe performed a bidirectional one-sample Mendelian randomisation (MR) study using the Norwegian Nord-Trøndelag Health Study population including 56 105 adults. 73 and 47 genetic variants were included as instrumental variables for body mass index (BMI) and waist-to-hip ratio (WHR), respectively. Asthma was defined as ever asthma, doctor-diagnosed asthma and doctor-diagnosed active asthma, and was further classified by atopic status or levels of symptom control. Causal OR was calculated with the Wald method.ResultsThe ORs per 1 SD (4.1 kg/m2) increase in genetically determined BMI were ranged from 1.36 to 1.49 for the three asthma definitions and similar for women and men. The corresponding ORs for non-atopic asthma (range 1.42–1.72) appeared stronger than those for the atopic asthma (range 1.18–1.26), but they were similar for controlled versus partly controlled doctor-diagnosed active asthma (1.43 vs 1.44). There was no clear association between genetically predicted WHR and asthma risk or between genetically predicted asthma and the adiposity markers.ConclusionsOur MR study provided evidence of a causal association of BMI with asthma in adults, particularly with non-atopic asthma. There was no clear evidence of a causal link between WHR and asthma or of reverse causation.
Symmetry properties of complex contact space form
Authors: Belkhelfa Mohamed , Kadi Fatima Zohra 
Published: October 2019

It is well known that a Sasakian space form is pseudo-symmetric [M. Belkhelfa, R. Deszcz and L. Verstraelen, Symmetry properties of Sasakian space-forms, Soochow J. Math. 31(4) (2005) 611–616], therefore it is Ricci-pseudo-symmetric. In this paper, we proved that a normal complex contact manifold is Ricci-semi-symmetric if and only if it is an Einstein manifold; moreover, we showed that a complex contact space form [Formula: see text] with constant [Formula: see text]-sectional curvature [Formula: see text] is properly Ricci-pseudo-symmetric [Formula: see text] if and only if [Formula: see text]; in this case [Formula: see text]. We gave an example of properly Ricci-pseudo-symmetric complex contact space form. On the other hand, we proved the non-existence of proper pseudo-symmetric ([Formula: see text]) complex contact space form [Formula: see text]
Interactions between Sedentary and Physical Activity Patterns, Lean Mass, and Bone Density in Arab Men
Authors: Alkahtani Shaea , Aljaloud Khalid , Yakout Sobhy , Al-Daghri Nasser M. 
Published: October 2019

The study examined the associations between physical activity and appendicular lean mass (ALM), fat mass, and bone mineral density (BMD) and examined the role of physical activity on these variables. The participants included 497 men (age: 32.2±10.4 years and body mass index: 28.2±5.4 kg/m2). The study was cross-sectional, and measurements included body composition measured on dual-energy X-ray absorptiometry and self-reported physical activity assessed using the International Physical Activity Questionnaire. Physical activity, including light physical activity, was associated with increased ALM (P≤0.05). Fat indicators, including waist circumference, were positively associated with ALM (P≤0.05), but not with BMD. Physical activity, including moderate-to-vigorous physical activity, was not associated with BMD, whereas ALM and handgrip strength were significantly associated with BMD (P≤0.05). Physical activity independent of exercise intensity was directly associated with ALM and indirectly associated with BMD through increased muscle mass and strength.
Comprehensive Profiling of Poor-Risk Paired Primary and Recurrent Triple-Negative Breast Cancers Reveals Immune Phenotype Shifts
Authors: Hutchinson Katherine E. , Yost Susan E. , Chang Ching-Wei , Johnson Radia Marie , Carr Adrian R. , McAdam Paul R. , Halligan Daniel L. , Chang Chun-Chieh , Schmolze Daniel , Liang Jackson , Yuan Yuan 
Published: October 2019

Abstract

Purpose:
Emerging data suggest immune checkpoint inhibitors have reduced efficacy in heavily pretreated triple-negative breast cancers (TNBC), but underlying mechanisms are poorly understood. To better understand the phenotypic evolution of TNBCs, we studied the genomic and transcriptomic profiles of paired tumors from patients with TNBC.

Experimental Design:
We collected paired primary and metastatic TNBC specimens from 43 patients and performed targeted exome sequencing and whole-transcriptome sequencing. From these efforts, we ascertained somatic mutation profiles, tumor mutational burden (TMB), TNBC molecular subtypes, and immune-related gene expression patterns. Stromal tumor-infiltrating lymphocytes (stromal TIL), recurrence-free survival, and overall survival were also analyzed.

Results:
We observed a typical TNBC mutational landscape with minimal shifts in copy number or TMB over time. However, there were notable TNBC molecular subtype shifts, including increases in the Lehmann/Pietenpol-defined basal-like 1 (BL1, 11.4%–22.6%) and mesenchymal (M, 11.4%–22.6%) phenotypes, and a decrease in the immunomodulatory phenotype (IM, 31.4%–3.2%). The Burstein-defined basal-like immune-activated phenotype was also decreased (BLIA, 42.2%–17.2%). Among downregulated genes from metastases, we saw enrichment of immune-related Kyoto Encyclopedia of Genes and Genomes pathways and gene ontology (GO) terms, and decreased expression of immunomodulatory gene signatures (P &lt; 0.03) and percent stromal TILs (P = 0.03). There was no clear association between stromal TILs and survival.

Conclusions:
We observed few mutational shifts, but largely consistent transcriptomic shifts in longitudinally paired TNBCs. Transcriptomic and IHC analyses revealed significantly reduced immune-activating gene expression signatures and TILs in recurrent TNBCs. These data may explain the observed lack of efficacy of immunotherapeutic agents in heavily pretreated TNBCs. Further studies are ongoing to better understand these initial observations.
See related commentary by Savas and Loi, p. 526