bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fragmentation Trade and Vertical Specialisation: How Does South Asia Compare with China
Authors: Veeramani C. 
Published: April 2019

This article analyses the trends and patterns of export and fragmentation trade by South Asian countries—Bangladesh, India, Pakistan and Sri Lanka. To place the discussion in a comparative perspective, the analysis also covers China. Experience of China and other East Asian countries shows that export-led industrialisation and a high degree of participation in global production networks/value chains, based initially on specialisation in labor-intensive activities, are crucial for sustained employment generation and poverty reduction. However, exports have not become a major engine of growth in South Asian countries. An important reason for this is that South Asia has been locked out of the global production networks/value chains in several industries, except Bangladesh and Sri Lanka in readymade garments and India in automobiles. India’s export basket is biased towards capital- and skill-intensive products, which is an anomaly as the country’s true comparative advantage lies in unskilled labor-intensive activities. We argue that India’s labor laws have had the unintended consequence of discouraging specialisation in labor-intensive stages of the production process in manufacturing industries. Greater integration of domestic industries with global production networks/value chains will accelerate the process of shifting the surplus labor from agriculture to manufacturing. JEL Codes: F10, F15, F40
The effect of gefapixant, a P2X3 antagonist, on cough reflex sensitivity: a randomised placebo-controlled study
Authors: Morice Alyn H. , Kitt Michael M. , Ford Anthony P. , Tershakovec Andrew M. , Wu Wen-Chi , Brindle Kayleigh , Thompson Rachel , Thackray-Nocera Susannah , Wright Caroline 
Published: April 2019

We evaluated the effect of gefapixant on cough reflex sensitivity to evoked tussive challenge.In this phase 2, double-blind, two-period study, patients with chronic cough (CC) and healthy volunteers (HV) were randomised to single-dose gefapixant 100 mg or placebo in a crossover fashion. Sequential inhalational challenges with ATP, citric acid, capsaicin and distilled water were performed 1, 3 and 5 h after dosing. Mean concentrations evoking ≥2 coughs (C2) and ≥5 coughs (C5) post doseversusbaseline were co-primary endpoints. Objective cough frequency (coughs·h−1) over 24 h and a cough severity visual analogue scale (VAS) were assessed in CC patients. Adverse events were monitored.24 CC patients and 12 HV were randomised (mean age 61 and 38 years, respectively). The cough challenge threshold increased for ATP by 4.7-fold (C2, p≤0.001) and 3.7-fold (C5, p=0.007) for gefapixantversusplacebo in CC patients; in HV, C2 and C5 increased 2.4-fold (C2, p=0.113; C5, p=0.003). The distilled water C2 and C5 thresholds increased significantly (p<0.001) by a factor of 1.4 and 1.3, respectively, in CC patients. Gefapixant had no effect on capsaicin or citric acid challenge. Median cough frequency was reduced by 42% and the least squares mean cough severity VAS was 18.0 mm lower for gefapixantversusplacebo in CC patients. Dysgeusia was the most frequent adverse event (75% of HV and 67% of CC patients).ATP-evoked cough was significantly inhibited by gefapixant 100 mg, demonstrating peripheral target engagement. Cough count and severity were reduced in CC patients. Distilled water may also evoke cough through a purinergic pathway.
Needle-based confocal laser endomicroscopy for real-time diagnosing and staging of lung cancer
Authors: Wijmans Lizzy , Yared Joey , de Bruin Daniel M. , Meijer Sybren L. , Baas Paul , Bonta Peter I. , Annema Jouke T. 
Published: April 2019

Diagnosing lung cancer in the absence of endobronchial abnormalities is challenging. Needle-based confocal laser endomicroscopy (nCLE) enables real-time microscopic imaging of cells. We assessed the feasibility and safety of using nCLE for real-time identification of lung cancer.In patients with suspected or proven lung cancer scheduled for endoscopic ultrasound (EUS), lung tumours and mediastinal lymph nodes were imaged with nCLE before fine-needle aspiration (FNA) was performed. nCLE lung cancer characteristics were identified by comparison with pathology. Multiple blinded raters validated CLE videos of lung tumours and mediastinal nodes twice.EUS-nCLE-FNA was performed in 22 patients with suspected or proven lung cancer in whom 27 lesions (six tumours, 21 mediastinal nodes) were evaluated without complications. Three nCLE lung cancer criteria (dark enlarged pleomorphic cells, dark clumps and directional streaming) were identified. The accuracy of nCLE imaging for detecting malignancy was 90% in tumours and 89% in metastatic lymph nodes. Both inter-observer agreement (mean κ=0.68, 95% CI 0.66–0.70) and intra-observer agreement (mean±sdκ=0.70±0.15) were substantial.Real-time lung cancer detection by endosonography-guided nCLE was feasible and safe. Lung cancer characteristics were accurately recognised.
French experience of balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension
Authors: Brenot Philippe , Jaïs Xavier , Taniguchi Yu , Garcia Alonso Carlos , Gerardin Benoit , Mussot Sacha , Mercier Olaf , Fabre Dominique , Parent Florence , Jevnikar Mitja , Montani David , Savale Laurent , Sitbon Olivier , Fadel Elie , Humbert Marc , Simonneau Gérald 
Published: April 2019

AimsTo evaluate safety and efficacy of balloon pulmonary angioplasty (BPA) in a large cohort of patients with chronic thromboembolic pulmonary hypertension (CTEPH).MethodsFrom 2014 to 2017, 184 inoperable CTEPH patients underwent 1006 BPA sessions. Safety and efficacy during the first 21 months (initial period) were compared with those of the last 21 months (recent period). A total of 154 patients had a full evaluation after a median duration of 6.1 months.ResultsOverall, there was a significant improvement in New York Heart Association functional class, 6-min walk distance (mean change +45 m), and a significant decrease in mean pulmonary artery pressure (PAP) and in pulmonary vascular resistance (PVR) by 26% and 43%, respectively. The percentage decreases of mean PAP and PVR were 22% and 37% in the initial periodversus30% and 49% in the recent period, respectively (p<0.05). The main complications included lung injury, which occurred in 9.1% of 1006 sessions (13.3% in the initial periodversus5.9% in the recent period; p<0.001). Per-patient multivariate analysis revealed that baseline mean PAP and the period during which BPA procedure was performed (recentversusinitial period) were the strongest factors related to the occurrence of lung injury. 3-year survival was 95.1%.ConclusionThis study confirms that a refined BPA strategy improves short-term symptoms, exercise capacity and haemodynamics in inoperable CTEPH patients with an acceptable risk–benefit ratio. Safety and efficacy improve over time, underscoring the unavoidable learning curve for this procedure.
CCSP counterbalances airway epithelial-driven neutrophilic chemotaxis
Authors: Knabe Lucie , Petit Aurélie , Vernisse Charlotte , Charriot Jérémy , Pugnière Martine , Henriquet Corinne , Sasorith Souphatta , Molinari Nicolas , Chanez Pascal , Berthet Jean-Philippe , Suehs Carey , Vachier Isabelle , Ahmed Engi , Bourdin Arnaud 
Published: April 2019

Club cell secretory protein (CCSP) knockout mice exhibit increased airway neutrophilia, as found in chronic obstructive pulmonary disease (COPD). We therefore investigated whether treating COPD airway epithelia with recombinant human CCSP (rhCCSP) could dampen exaggerated airway neutrophilia.Control, smoker and COPD air–liquid interface (ALI) cultures exposed to cigarette smoke extract (CSE) were treated with and without rhCCSP. The chemotactic properties of the supernatants were assessed using Dunn chambers. Neutrophil chemotaxis along recombinant human interleukin 8 (rhIL8) gradients (with and without rhCCSP) was also determined. rhCCSP–rhIL8 interactions were tested through co-immunoprecipitation, Biacore surface plasmon resonance (SPR) andin silicomodelling. The relationship between CCSP/IL8 concentration ratios in the supernatant of induced sputum from COPD patientsversusneutrophilic airway infiltration assessed in lung biopsies was assessed.Increased neutrophilic chemotactic activity of CSE-treated ALI cultures followed IL8 concentrations and returned to normal when supplemented with rhCCSP. rhIL8-induced chemotaxis of neutrophils was reduced by rhCCSP. rhCCSP and rhIL8 co-immunoprecipitated. SPR confirmed thisin vitrointeraction (equilibrium dissociation constant=8 µM).In silicomodelling indicated that this interaction was highly likely. CCSP/IL8 ratios in induced sputum correlated well with the level of small airway neutrophilic infiltration (r2=0.746, p<0.001).CCSP is a biologically relevant counter-balancer of neutrophil chemotactic activity. These different approaches used in this study suggest that, among the possible mechanisms involved, CCSP may directly neutralise IL8.
Hypocoagulation induced by broad-spectrum antibiotics in extensive burn patients
Authors: Liu Jian , Liu Yiqing , Liu Shengjun , Zhang Qin , Zheng Jiexin , Niu Yiwen , Wang Xuefeng 
Published: April 2019

Abstract

Background
Patients with extensive burns usually develop pro-coagulation soon after the injury if there is no sepsis occurred. We describe the case of an extensive burn adult suffering from hypocoagulation not related to sepsis, but secondary to antibiotic treatment.

Case presentation
Here, we report a case of an adult male patient suffering from flame burns of 45% total body surface area (40% full thickness) combined with inhalation injury. Hypocoagulopathy with soaring prolonged activated partial thromboplastin time value occurred on third week post-burn while systemic infection had been under control by application of broad-spectrum antibiotics. Investigations showed that not the infection but vitamin K-related coagulation factor deficiency were responsible for unexpected bleeding. However, supplemental vitamin K was not the key as we expected, which prompted us trying to decode the underlying cause of coagulation disturbance in this patient and pick out the most effective treatment for live-saving. After the withdrawal of highly suspected broad-spectrum antibiotic, Meropenem®, disturbed vitamin K related coagulation factors gradually restored to their optimal levels so as to maintain normal coagulation status. Therefore, surgical procedures without further risk of bleeding could be carried out in time for wound recovery. The patient was discharged on post-burn day 67 and transferred to a secondary hospital for his rehabilitation.

Conclusion
Hypocoagulopathy may be devoted to different reasons other than sepsis in extensive burns. Early recognition of the cause for coagulation disturbance is critical to make appropriate treatment and save patients’ lives. This case illustrated the importance of unveiling the mist cause for coagulation disturbance occurred in extensive burn patient, which paved the way for optimal life-saving treatments. And we also recommend burn surgeons to be alerted to antibiotic-induced vitamin K deficiency-related coagulopathy among critical burn patients.
Role of Treatment Deintensification in the Management of p16+ Oropharyngeal Cancer: ASCO Provisional Clinical Opinion
Authors: Adelstein David J. , Ismaila Nofisat , Ku Jamie A. , Burtness Barbara , Swiecicki Paul L. , Mell Loren , Beitler Jonathan J. , Gross Neil , Jones Christopher U. , Kaufman Marnie , Le Quynh-Thu , Semrad Thomas J. , Siu Lillian L. , Ridge John A. 
Published: April 2019

PURPOSE An ASCO provisional clinical opinion offers timely clinical direction to ASCO’s membership after publication or presentation of potentially practice-changing data from major studies. This provisional clinical opinion addresses the role of treatment deintensification in the management of p16+ oropharyngeal cancer (OPC). CLINICAL CONTEXT For patients with p16+ OPC, current treatment approaches are well established. In the good-prognosis subset of nonsmoking p16+ patients with early-stage disease, these treatments have been highly successful, albeit with significant associated acute and late toxicity. Deintensification of surgical, radiation, and medical treatment in an effort to reduce toxicity while preserving high survival rates is an appropriate therapeutic objective currently being explored in patients who are experiencing the best treatment results. However, careful delineation of this good-risk subset is essential. While the current eighth edition of the American Joint Committee on Cancer staging system is prognostically robust, it should not be interpreted as reason to alter therapeutic decisions or justify treatment deintensification. The development of transoral surgical techniques and the adoption of intensity-modulated radiation therapy planning have been transformative in disease management and suggest potentially beneficial approaches. Recent advances in systemic treatments have been notable. The optimal integration and modification of these modalities to ameliorate toxicity has not been defined and remains an important focus of current investigation. PROVISIONAL CLINICAL OPINION The hypothesis that de-escalation of treatment intensity for patients with p16+ OPC can reduce long-term toxicity without compromising survival is compelling and necessitates careful study and the analysis of well-designed clinical trials before changing current treatment standards. Treatment deintensification for these patients should only be undertaken in a clinical trial. Additional information is available at www.asco.org/head-neck-cancer-guidelines .
Understanding Inherited Risk in Unselected Newly Diagnosed Patients With Endometrial Cancer
Authors: Cadoo Karen A. , Mandelker Diana L. , Mukherjee Semanti , Stewart Carolyn , DeLair Deborah , Ravichandran Vignesh , Srinivasan Preethi , Hurley Daire , Kemel Yelena , Arnold Angela G. , Sheehan Margaret , Pradhan Nisha , Joseph Vijai , Chi Dennis S. , Gardner Ginger J. , Jewell Elizabeth L. , Leitao Mario M. , Long Roche Kara , Mueller Jennifer J. , Sonoda Yukio , Zivanovic Oliver , Walsh Michael , Carlo Maria I. , Berger Michael F. , Hyman David M. , Zhang Liying , Robson Mark E. , Offit Kenneth , Aghajanian Carol , Abu-Rustum Nadeem R. , Stadler Zsofia 
Published: April 2019

PURPOSEMutations in DNA mismatch repair genes and PTEN, diagnostic of Lynch and Cowden syndromes, respectively, represent the only established inherited predisposition genes in endometrial cancer to date. The prevalence of other cancer predisposition genes remains unclear. We determined the prevalence of pathogenic germline variants in unselected patients with endometrial cancer scheduled for surgical consultation.PATIENTS AND METHODSPatients prospectively consented (April 2016 to May 2017) to an institutional review board–approved protocol of tumor-normal sequencing via a custom next-generation sequencing panel—the Memorial Sloan Kettering–Integrated Mutation Profiling of Actionable Cancer Targets—that yielded germline results for more than 75 cancer predisposition genes. Tumors were assessed for microsatellite instability. Per institutional standards, all tumors underwent Lynch syndrome screening via immunohistochemistry (IHC) for mismatch repair proteins.RESULTSOf 156 patients who consented to germline genetic testing, 118 (76%) had stage I disease. In 104 patients (67%), tumors were endometrioid, and 60 (58%) of those tumors were grade 1. Twenty-four pathogenic germline variants were identified in 22 patients (14%): seven (4.5%) had highly penetrant cancer syndromes and 15 (9.6%) had variants in low-penetrance, moderate-penetrance, or recessive genes. Of these, five (21%) were in Lynch syndrome genes (two MSH6, two PMS2, and one MLH1). All five tumors had concordant IHC staining; two (40%) were definitively microsatellite instability–high by next-generation sequencing. One patient had a known BRCA1 mutation, and one had an SMARCA4 deletion. The remaining 17 variants (71%) were incremental findings in low- and moderate-penetrance variants or genes associated with recessive disease.CONCLUSIONIn unselected patients with predominantly low-risk, early-stage endometrial cancer, germline multigene panel testing identified cancer predisposition gene variants in 14%. This finding may have implications for future cancer screening and risk-reduction recommendations. Universal IHC screening for Lynch syndrome successfully identifies the majority (71%) of high-penetrance germline mutations.
Effect of a Ketogenic Diet on Submaximal Exercise Capacity and Efficiency in Runners
Authors: SHAW DAVID M. , MERIEN FABRICE , BRAAKHUIS ANDREA , MAUNDER ED , DULSON DEBORAH K. 
Published: April 2019

ABSTRACT

Purpose
We investigated the effect of a 31-d ketogenic diet (KD) on submaximal exercise capacity and efficiency.

Methods
A randomized, repeated-measures, crossover study was conducted in eight trained male endurance athletes (V˙O2max, 59.4 ± 5.2 mL⋅kg−1⋅min−1). Participants ingested their habitual diet (HD) (13.1 MJ, 43% [4.6 g⋅kg−1⋅d−1] carbohydrate and 38% [1.8 g⋅kg−1⋅d−1] fat) or an isoenergetic KD (13.7 MJ, 4% [0.5 g·kg−1⋅d−1] carbohydrate and 78% [4 g⋅kg−1⋅d−1] fat) from days 0 to 31 (P < 0.001). Participants performed a fasted metabolic test on days −2 and 29 (~25 min) and a run-to-exhaustion trial at 70% V˙O2max on days 0 and 31 following the ingestion of a high-carbohydrate meal (2 g⋅kg−1) or an isoenergetic low-carbohydrate, high-fat meal (<10 g CHO), with carbohydrate (~55 g⋅h−1) or isoenergetic fat (0 g CHO⋅h−1) supplementation during exercise.

Results
Training loads were similar between trials and V˙O2max was unchanged (all, P > 0.05). The KD impaired exercise efficiency, particularly at >70% V˙O2max, as evidenced by increased energy expenditure and oxygen uptake that could not be explained by shifts in respiratory exchange ratio (RER) (all, P < 0.05). However, exercise efficiency was maintained on a KD when exercising at <60% V˙O2max (all, P > 0.05). Time-to-exhaustion (TTE) was similar for each dietary adaptation (pre-HD, 237 ± 44 vs post-HD, 231 ± 35 min; P = 0.44 and pre-KD, 239 ± 27 vs post-KD, 219 ± 53 min; P = 0.36). Following keto-adaptation, RER >1.0 vs <1.0 at V˙O2max coincided with the preservation and reduction in TTE, respectively.

Conclusion
A 31-d KD preserved mean submaximal exercise capacity in trained endurance athletes without necessitating acute carbohydrate fuelling strategies. However, there was a greater risk of an endurance decrement at an individual level.
Effectiveness of a mobile health intervention on infant and young child feeding among children ≤ 24 months of age in rural Islamabad over six months duration
Authors: Akber Subhana , Mahmood Hana , Fatima Razia , Wali Ahmed , Alam Ashraful , Sheraz Syed Yahya , Yaqoob Aashifa , Najmi Hina , Abbasi Saleem , Mahmood Humaira , Dibley Michael J. , Hazir Tabish 
Published: April 2019

Background: Childhood development is highly influenced by feeding practices at the infancy and young age of children. Unfortunately, according to the National Nutrition Survey (2011), the prevalence of exclusive breastfeeding in Pakistan was 21% at four months, and 13% at six months of age with 51.3% of mothers initiating semisolid foods to their children at the recommended 6-8 months of age. The latest Pakistan Demographic & Health Survey (PDHS 2018) however; indicates that only 48% of infants are exclusively breastfed which has been improved from 38% as reported in the past five years but still more improvement is anticipated. Methods: A quasi-experimental study design was employed for this post-intervention survey assessing effectiveness of mobile health (mhealth) regarding infant & young child feeding (IYCF) among pregnant and lactating mothers in Tarlai, Islamabad from May to June 2018. A total of 135 mothers who were earlier included in the intervention phase were recruited after obtaining verbal & written consent. The data was entered in EpiData (3.1) and analyzed in SPSS version 21. Results: The mean age of these pregnant and lactating mothers was 30.5 years ± 4.5 SD with the majority of mothers in the age group of 25 to 29 years. After the intervention, the overall knowledge of mothers regarding IYCF nutrition was raised to 69.6% among 94 mothers as compared to 74 (54.8%). Overall attitude regarding IYCF was found to be positive among 86 (63.7%) of the mothers, whereas 88 (65.2%) of the mothers had good IYCF related practices. Conclusion: Our post-intervention survey signifies the effectiveness of mhealth in raising knowledge, attitude, and practices of mothers regarding IYCF in rural Islamabad. However, implementation of mhealth in masses requires future research specifically to address the cost-effectiveness of such interventions in maternal & child health programmes.
Anorexia e bulimia: uma reflexão psicanalítica
Authors: Lima Gerusa Marcondes Pimentel de Abreu 
Published: April 2019

Objetivou-se neste artigo refletir sobre a teoria psicanalítica dos transtornos alimentares e os seus efeitos no campo psíquico e subjetivo dos indivíduos doentes, evidenciando a anorexia e bulimia. Freud observou que as cobranças da realidade levam as crianças a entrarem em contato com a falta e com a perda, partindo desta perspectiva, o que se sobressai é a falta desse objeto. Nesse caso, a falta está relacionada Ã castração da mãe que levará a criança a prosseguir para o desenvolvimento de sua subjetividade e consequentemente, ao seu psiquismo. A angústia de perda é destruidora, pois se perde algo de que ela depende integralmente. Estes são um dos mecanismos apresentados as pacientes com transtornos alimentares.
Internet of things (IoT) based health monitoring system and challenges
Authors: Sathya M , Madhan S , Jayanthi K 
Published: April 2019

Among the applications that Internet of Things (IoT) facilitated to the world, Healthcare applications are most important. In general, IoT has been widely used to interconnect the advanced medical resources and to offer smart and effective healthcare services to the people. The advanced sensors can be either worn or be embedded into the body of the patients, so as to continously monitor their health. The information collected in such manner, can be analzed, aggregated and mined to do the early prediction of diseases. The processing algorithms assist the physicians for the personalization of treatment and it helps to make the health care economical, at the same time, with improved outcomes. Also, in this paper, we highlight the challenges in the implementation of IoT health monitoring system in real world.