bluuebunny/crossref_metadata_2025_split huggingface dataset:
A contemporary description of patients’ estimated blood losses from diagnostic phlebotomy in a census of hospital episodes from a Canadian tertiary care center
Authors: Quinn Jason G. , Levy Adrian R. , Cheng Calvino K. , Doucette Steve , Theriault Chris , Doiron Don , Kiberd Bryce A. , Tennankore Karthik K. 
Published: July 2019

BACKGROUNDPhlebotomy for diagnostic testing is among the commonest hospital procedures, but hospital‐wide surveys of all inpatients characterizing blood draw volumes have not been published. The objectives were to characterize the daily blood volumes drawn for diagnostic testing from patients discharged from a Canadian tertiary care center, describe the daily distributions of phlebotomy volumes across service locations, and describe changes in hemoglobin (Hb) and transfusion across service locations.STUDY DESIGN AND METHODSData were obtained on all patients discharged between 2012 and 2014 using linked discharge abstract and laboratory data. Cumulative daily blood volume and draw frequency were reported by service and days since admission. Changes in Hb and red blood cell (RBC) transfusion rates were reported for nontransfused and transfused patients.RESULTSData were included on 59,715 subjects. Mean daily estimated blood loss varied from 8.5 ± 6.5 mL/day onward to 27.2 ± 20.0 mL/day in the intensive care unit (ICU; p < 0.001). Phlebotomy volumes were highest on the first day of admission and declined thereafter (p < 0.001). For nontransfused individuals in the first week of admission, Hb levels decreased by the highest percentage in the ICU. The rate of RBC unit transfusion was highest in the ICU (232.4 units/1000 patient‐days; 95% confidence interval, 225.8‐239.2; p < 0.0001 compared with all other locations).CONCLUSIONConsiderable variation was observed in estimated blood loss due to diagnostic phlebotomy across different services within one teaching hospital. Thi information is foundational for planning interventions to minimize estimated blood loss from phlebotomy.
Emerging roles of adjunct therapies in acquired thrombotic thrombocytopenia purpura
Authors: Racine‐Brzostek Sabrina E. , Shi Patricia A. 
Published: July 2019

KEY IDEAS

Acquired thrombotic thrombocytopenia purpura (aTTP) is caused by autoantibody‐mediated severe deficiency of the von Willebrand factor (vWF) cleaving protease ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 repeats, member 13), with subsequent accumulation of ultra‐large vWF‐multimers that spontaneously form platelet‐VWF complexes and microthrombi within the microcirculation.
Therapeutic plasma exchange (TPE), by removing autoantibodies and excess ultra‐large vWF multimers and replenishing ADAMTS13 activity, remains the urgent primary initial treatment. Although heterogeneity in treatment exists, most centers add upfront immunosuppression with steroids, and many also add upfront rituximab. Refractoriness, exacerbation and relapse are commonly treated with adjunct rituximab.
Despite adjunct steroids and rituximab, TTP refractoriness, exacerbation, relapse, morbidity, and mortality remain problematic. Newer adjunct therapies include suppression of ADAMTS13 autoantibody production via plasma cell depletion, inhibition of vWF‐platelet interaction, and replenishment of ADAMTS13 function with recombinant ADAMTS13 protein.
Recent Advances in Shock Vibration Isolation: An Overview and Future Possibilities
Authors: Ledezma-Ramírez Diego Francisco , Tapia-González Pablo Ernesto , Ferguson Neil , Brennan Michael , Tang Bin 
Published: July 2019

Abstract
Mechanical shock is a common problem that is present in many situations, such as ground motion, blast, explosions, crash, and impact. The development of passive, active, or adaptive control and isolation strategies for shock-induced vibration has experienced recent interest, typically due to the increasing demand in improved isolation requirements for sensitive equipment subjected to harsh environments. This paper presents a review of some of the significant recent works developed in the field, focusing on novel developments that contribute to the shock isolation. The article explores several isolation approaches considering passive, active, and nonlinear systems discussing both theoretical and experimental results. In addition, important outcomes of the work are reviewed. The paper concludes with suggestions for potential developments, applications, and recommendations for future research.
Metabolic Model of thePhytophthora infestans-Tomato Interaction Reveals Metabolic Switches during Host Colonization
Authors: Rodenburg Sander Y. A. , Seidl Michael F. , Judelson Howard S. , Vu Andrea L. , Govers Francine , de Ridder Dick 
Published: July 2019

Late blight disease caused by the oomycete pathogenPhytophthora infestansleads to extensive yield losses in tomato and potato cultivation worldwide. To effectively control this pathogen, a thorough understanding of the mechanisms shaping the interaction with its hosts is paramount. While considerable work has focused on exploring host defense mechanisms and identifyingP. infestansproteins contributing to virulence and pathogenicity, the nutritional strategies of the pathogen are mostly unresolved. Genome-scale metabolic models (GEMs) can be used to simulate metabolic fluxes and help in unravelling the complex nature of metabolism. We integrated a GEM of tomato with a GEM ofP. infestansto simulate the metabolic fluxes that occur during infection. This yields insights into the nutrients thatP. infestansobtains during different phases of the infection cycle and helps in generating hypotheses about nutritionin planta.
Implantation of Scharioth macula lens in patients with age-related macular degeneration: results of a prospective European multicentre clinical trial
Authors: Srinivasan Sathish , Scharioth Gabor , Riehl Anneliese , Tanev Ivan V , Rozsival Pavel , Acker Emmanuel Van , Nagy Zoltan Z , Balta Florian , Nekolova Jana 
Published: July 2019

ObjectiveTo report the visual and refractive outcomes following monocular implantation of a supplementary (piggyback) Scharioth macula lens (SML) in previously pseudophakic eyes with age-related macular degeneration (AMD).Methods and analysisProspective European multicentre clinical trial. 50 eyes of 50 pseudophakic patients with either dry or previously treated and stable neovascular AMD for at least 6 months were included. The inclusion criteria were age over 55, corrected distance visual acuity (CDVA) of 0.4–0.1 (decimal), improvement of at least three lines of corrected near visual acuity (CNVA) when tested with a +6.0 dioptre (D) reading addition at 15 cm, compared with a +2.5 D reading addition at 40 cm using a standardised, self-illuminated Early Treatment Diabetic Retinopathy Study near vision chart. The SML intraocular lens (IOL) was implanted as an add-on/piggyback IOL in the ciliary sulcus, monocularly in the better seeing eye of each subject meeting the inclusion criteria.ResultsThere were no intraoperative complications. One subject had the SML explanted in the postoperative period due to postoperative glare/halos. The mean CNVA improved from 0.23±0.12 (decimal) preoperatively to 0.57±0.33 at 1 year. The mean CDVA remained unchanged measuring 0.19±0.13 preoperatively and 0.19±0.09 at 1 year postoperatively.ConclusionThe SML appears to be safe and effective in improving the CNVA in patients with AMD. Data suggest that the CDVA remains unaffected following implantation. Further data are needed to assess the long-term safety and efficacy.
Time of day and endovascular treatment decision in acute stroke with relative endovascular treatment indication: insights from UNMASK EVT international survey
Authors: Ospel Johanna Maria , Kashani Nima , Goyal Mayank , Menon Bijoy K , Campbell Bruce C V , Fischer Urs , Turjman Francis , Mitchell Peter , Yoshimura Shinichi , Podlasek Anna , Rabinstein Alejandro A , Wilson Alexis T , Kim Byung Moon , Baxter Blaise W , Cherian Mathew P , Heo Ji Hoe , Foss Mona , Demchuk Andrew M , Sylaja Pillai N , Hill Michael D , Saposnik Gustavo , Almekhlafi Mohammed A 
Published: July 2019

Background and purposeThe decision to proceed with endovascular thrombectomy should ideally be made independent of inconvenience factors, such as daytime. We assessed the influence of patient presentation time on endovascular therapy decision making under current local resources and assumed ideal conditions in acute ischemic stroke with level 2B evidence for endovascular treatment.Methods and materialsIn an international cross sectional survey, 607 stroke physicians from 38 countries were asked to give their treatment decisions to 10 out of 22 randomly assigned case scenarios. Eleven scenarios had level 2B evidence for endovascular treatment: 7 daytime scenarios (7:00 am–5:00 pm) and four night time cases (5:01 pm– 6:59 am). Participants provided their treatment approach assuming (A) there were no practice constraints and (B) under their current local resources. Endovascular treatment decisions in the 11 scenarios were analyzed according to presentation time with adjustment for patient and physician characteristics.ResultsParticipants selected endovascular therapy in 74.2% under assumed ideal conditions, and 70.7% under their current local resources of night time scenarios, and in 67.2% and 63.8% of daytime scenarios. Night time presentation did not increase the probability of a treatment decision against endovascular therapy under current local resources or assumed ideal conditions.ConclusionPresentation time did not influence endovascular treatment decision making in stroke patients in this international survey.
Early versus delayed stenting for intracranial atherosclerotic artery stenosis with ischemic stroke
Authors: Zhang Yong , Sun Yujie , Li Xin , Liu Tonghui , Liu Peng , Wang Hongxia , Ding Jian , Miao Zhong-Rong , Li Guangwen 
Published: July 2019

ObjectiveTo evaluate the clinical outcomes of early stenting (≤14 days) or late stenting (>14 days) in patients who underwent intracranial stent placement.MethodsPatients with ischemic stroke caused by 70–99% intracranial atherosclerotic stenosis combined with poor collaterals were enrolled. The early stenting group, who underwent stenting within 14 days of last ischemic symptoms, were compared with the late stenting group who underwent stenting >14 days from last ischemic symptom. The patients were treated either with a balloon-mounted stent or a self-expanding stent as determined by the operators following a guideline. The baseline characteristics and clinical outcomes were evaluated and compared.ResultsOne hundred and fifteen stroke patients were recruited into the study. Four patients (4/41) in the early stenting group and two patients (2/74) in the late stenting group were diagnosed with a cerebral vascular event associated with stenting within 3 days (p=0.184). In the long-term follow-up, eight patients in the early stenting group had restenosis ≥50%, which was higher than patients in the late stenting group (8/41 vs 4/74, p=0.018). The total rates of any ischemic stroke, transient ischemic attack, hemorrhagic stroke, and death in the early stenting group were higher than in the late stenting group (9/41 vs 6/74, p=0.035). The recurrence rate of ischemic stroke in the early stenting group was higher than in the late stenting group (5/41 vs 2/74, p=0.041).ConclusionsStent placement in the setting of ischemic stroke caused by intracranial artery stenosis within 14 days may confer a higher risk of long-time cerebral vascular events and lead to a higher risk of restenosis.Clinical trial registrationNCT01968122.
Altered Nuclear Export Signal Recognition as a Driver of Oncogenesis
Authors: Taylor Justin , Sendino Maria , Gorelick Alexander N. , Pastore Alessandro , Chang Matthew T. , Penson Alexander V. , Gavrila Elena I. , Stewart Connor , Melnik Ella M. , Herrejon Chavez Florisela , Bitner Lillian , Yoshimi Akihide , Lee Stanley Chun-Wei , Inoue Daichi , Liu Bo , Zhang Xiao J. , Mato Anthony R. , Dogan Ahmet , Kharas Michael G. , Chen Yuhong , Wang Demin , Soni Rajesh K. , Hendrickson Ronald C. , Prieto Gorka , Rodriguez Jose A. , Taylor Barry S. , Abdel-Wahab Omar 
Published: July 2019

Abstract

Altered expression of XPO1, the main nuclear export receptor in eukaryotic cells, has been observed in cancer, and XPO1 has been a focus of anticancer drug development. However, mechanistic evidence for cancer-specific alterations in XPO1 function is lacking. Here, genomic analysis of 42,793 cancers identified recurrent and previously unrecognized mutational hotspots in XPO1. XPO1 mutations exhibited striking lineage specificity, with enrichment in a variety of B-cell malignancies, and introduction of single amino acid substitutions in XPO1 initiated clonal, B-cell malignancy in vivo. Proteomic characterization identified that mutant XPO1 altered the nucleocytoplasmic distribution of hundreds of proteins in a sequence-specific manner that promoted oncogenesis. XPO1 mutations preferentially sensitized cells to inhibitors of nuclear export, providing a biomarker of response to this family of drugs. These data reveal a new class of oncogenic alteration based on change-of-function mutations in nuclear export signal recognition and identify therapeutic targets based on altered nucleocytoplasmic trafficking.

Significance:
Here, we identify that heterozygous mutations in the main nuclear exporter in eukaryotic cells, XPO1, are positively selected in cancer and promote the initiation of clonal B-cell malignancies. XPO1 mutations alter nuclear export signal recognition in a sequence-specific manner and sensitize cells to compounds in clinical development inhibiting XPO1 function.
This article is highlighted in the In This Issue feature, p. 1325
Premature Atherosclerotic Cardiovascular Disease: Trends in Incidence, Risk Factors, and Sex‐Related Differences, 2000 to 2016
Authors: Vikulova Diana N. , Grubisic Maja , Zhao Yinshan , Lynch Kelsey , Humphries Karin H. , Pimstone Simon N. , Brunham Liam R. 
Published: July 2019

Background

The incidence of atherosclerotic cardiovascular disease has declined in the past 2 decades. However, these benefits may not extend to young patients. The objective of this work was to assess temporal trends in the incidence, risk profiles, sex‐related differences, and outcomes in a contemporary population of young patients presenting with coronary artery disease (
CAD
) in British Columbia, Canada.

Methods and Results

We used a provincial cardiac registry to identify young patients (men aged <50 years, women aged <55 years), with a first presentation of
CAD
between 2000 and 2016, who had either ≥50% stenosis of ≥1 coronary arteries on angiography or underwent coronary revascularization. A total of 12 519 patients (30% women) met our inclusion criteria. The incidence of
CAD
remained stable and was higher for men than women (46–53 versus 18–23 per 100 000). Of patients, 92% had at least one traditional cardiovascular risk factor and 67% had multiple risk factors. The prevalence of diabetes mellitus, obesity, and hypertension increased during the study period and was higher for women. Women had fewer emergent procedures and revascularizations. Mortality rates decreased by 31% between 2000 and 2007, then were stable for the remaining 9 years. Mortality was significantly higher for women aged <45 years compared with men.

Conclusions

The incidence of premature
CAD
has not declined, and the prevalence of 3 major cardiovascular risk factors increased between 2000 and 2016. The risk burden and mortality rates were worse for women. These data have important implications for the design of strategies to prevent
CAD
in young adults.
Extubation Readiness in Critically Ill Stroke Patients
Authors: Suntrup-Krueger Sonja , Schmidt Sarah , Warnecke Tobias , Steidl Corinna , Muhle Paul , Schroeder Jens B. , Labeit Bendix , Minnerup Jens , Dziewas Rainer 
Published: July 2019

Background and Purpose—
Predicting safe extubation represents a clinical challenge in acute stroke patients. Classical respiratory weaning criteria have not proven reliable. Concerning the paramount relevance of postextubation dysphagia in this population, criteria related to airway safety seem to perform better, but diagnostic standards are lacking. We compare clinical and instrumental swallowing examination tools to assess extubation readiness and propose a simple Determine Extubation Failure in Severe Stroke score for decision making.

Methods—
Data of 133 orally intubated acute stroke patients were prospectively collected in this observational study. Classical extubation criteria, a modified semiquantitative airway score, and an oral motor function score were assessed before extubation. A 3-ounce water swallow test and validated 6-point fiberoptic endoscopic dysphagia severity scoring were performed thereafter. Association of demographic and clinical parameters with extubation failure (EF) was investigated. Independent predictors of EF were translated into a point scoring system. Ideal cutoff values were determined by receiver operator characteristics analyses.

Results—

Patients with EF (24.1% after 24±43 hours) performed worse in all swallowing assessments (
P
<0.001). Fiberoptic endoscopic dysphagia severity scoring was the only independent predictor of EF (adjusted odds ratio, 4.2;
P
<0.007) with optimal cutoff ≥5 (sensitivity 84.6% and specificity 76.5%). Restricting regression analysis to parameters collected before extubation, a 4-item Determine Extubation Failure in Severe Stroke score (duration of ventilation, the examination of oral motor function, infratentorial lesion, and stroke severity) was derived. The score demonstrated excellent discrimination (area under the curve 0.89; 95% CI, 0.83–0.95) and calibration (Nagelkerkes R
2
=0.54) with an ideal cutoff ≥4 (sensitivity: 81.3% and specificity: 78.2%).

Conclusions—
Risk of EF is strongly correlated with postextubation dysphagia severity in stroke. Fiberoptic endoscopic examination of swallowing best predicts necessity of reintubation but requires a trial of extubation. The Determine Extubation Failure In Severe Stroke score is based on easy to collect clinical data and may guide extubation decision making in critically ill stroke patients.
Jesuit History, Theatre, and Spirituality
Authors: Muneroni Stefano 
Published: July 2019

Abstract
The 2014 staging and publication of Jonathan Moore’s play Inigo offers a unique commentary on the relationship between acting and spirituality within the Society of Jesus, the official name of the Jesuit Order. Through a close analysis of Moore’s play, this article contends that Jesuit spirituality draws on performative skills to inspire exemplary behavior and foster an embodied and long-lasting response to devotional narratives. In probing post-secular readings of hagiographical drama, the author considers the reasons for the ongoing fascination exerted by saints as stage characters in contemporary plays and argues that the success of Inigo is due to its humanistic reconfiguration of the notions of sanctity, faith, and redemption, as well as to its understanding of sainthood as the result of answering a religious and artistic vocation.
Two Overlooked Greek Manuscripts of 1 Clement
Authors: Lincicum David 
Published: July 2019

Abstract
This short article presents two late Greek manuscripts that partially preserve the text of 1 Clement. The first, BNF Suppl. gr. 64, fols. 105-112v (‘P’) is a 15th century manuscript containing 1 Clem. 40.5-60.4a, in a textual form affiliated with Codex Hierosolymitanus (Taphou 54). The second, EBE 1896, fols. 205-223 (‘E’), contains 1 Clement from the incipit through 31.3, and appears to be an apograph of Codex Alexandrinus.
Quranic Messages on Environmental Sustainability: an Expository Study of Its Relevance
Authors: Muhamad Asmawati , Syihab Abdul Halim , Achour Meguellati 
Published: July 2019

Abstract
The contemporary discourse of environmental sustainability has many values embedded in the teachings of the Quran and Sunna. The general outlook of the Quranic paradigm on utilizing the natural environment is based on the prohibition of aggression and misuse, as well as being founded on ideas of construction and sustainability. Unfortunately, in the contemporary world the Muslim community fails to pay sufficient attention to the relevant instructions in the Quran and Sunna. Thus, this article attempts to expand on key concepts within the Quran and Sunna which reveal the most important values for environmental sustainability. The research methodology employed in this paper is an analytical study of a number of Quranic verses with a particular focus on tafsīr bi al-maʾṯūr (explanation based on hadith), tafsīr bi al-raʾyi (explanation based on reason), and historical narrative. In short, this paper brings to light the importance of relevant classical and contemporary Quran and Sunna studies for improving human-nature relations and coexistence.
Democratization and budget openness: evidence from Hong Kong, Macao and Taiwan
Authors: Fong Brian C.H. 
Published: July 2019

The existing literature postulates that budget openness often improves at critical moments of democratization. Hong Kong, Macao and Taiwan, which are transitional regimes currently experiencing different regime trajectories, should be ideal places to test the validity of this theory. By examining whether and how open budget reforms in Hong Kong, Macao and Taiwan are related to their regime trajectories through historical-comparative case studies, this article aims to make an original contribution to the comparative budgeting literature by providing a new and unique set of Open Budget Survey-based case studies in the context of East Asian transitional regimes. Points for practitioners This article uses comparative studies of Hong Kong, Macao and Taiwan to illustrate the politics of budget openness facing policymakers in the process of democratization. For policymakers, the lesson from the comparative studies is that the rise of competitive electoral and legislative politics will bring about pressures for open budget reforms. More policy learning is necessary for policymakers from different types of political regimes to share the experiences of handling the politics of budget openness.