bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Polygamist (extract)
Authors: Sithole Ndabaningi 
Published: May 2019

The Revd. Ndabaningi Sithole is leader of the Zimbabwe African National Union and a minister in the American Congregational Church. He joined nationalist politics in Rhodesia in 1960 and in 1964 was sent to prison on a charge of subversion for calling on his supporters to resist UDI with any means at their disposal. After completing his sentence he was sent into detention, but in November 1968 he was re-arrested and in February 1969 sentenced to six years’ hard labour on a charge of plotting to assassinate cabinet ministers of the Rhodesian Front. The various laws under which the Revd. Sithole has been held prohibit, among other things, the publication in Rhodesia of ‘any information, pictorial or in writing’ about restricted or imprisoned individuals and also prevent any communication between them and members of the public. This means that two earlier books by Sithole, African Nationalism and the novel Obed, may not be circulated in Rhodesia and that this latest work, The Polygamist, will not be published there. The Polygamist deals with the clash between African and European culture among the Africans in Rhodesia and apparently contains autobiographical elements. It deals with the conflict between an African chieftain — ‘the polygamist’ — and his eldest son, who becomes a christian and shocks his elders by electing to marry only one wife. Interestingly enough, the novel comes down on the side of European culture, but not without a good deal of wry humour expressed at the expense of both sides, as the following extract shows.
Breastfeeding Before and After Spinal Cord Injury: A Case Report of a Mother With C6 Tetraplegia
Authors: Lee Amanda H. X. , Wen Betty , Hocaloski Shea , Sandholdt Nora , Hultling Claes , Elliott Stacy L. , Krassioukov Andrei V. 
Published: May 2019

Introduction: Although lactation dysfunction and breastfeeding difficulties after spinal cord injury have been previously reported, there is still a lack of research on the specific challenges and aspects that require more support. This unique case of a mother with C6 tetraplegia details her breastfeeding experience before and after spinal cord injury. Main Issue: A 23-year-old woman with a 20-month-old daughter sustained a motor and sensory complete traumatic spinal cord injury in a motor-vehicle crash while she was 6 months pregnant with her second child. This resulted in complete absence of sensory function below the level of injury (including the breast) and limited hand function. In comparison with her breastfeeding experience before injury, after injury she experienced decreased milk production, absence of the milk ejection reflex, and impaired ability to pick up, hold, and position her infant. Management: Care aides and family members assisted this mother with picking up, positioning, and latching her infant. She also utilized alternative breastfeeding positions, nursing pillows, and wedges. Domperidone was suggested by her physiatrist to increase milk production but ultimately was not used as there were no concerns with her infant’s growth or development. Conclusion: Breastfeeding as a recently injured mother while undergoing intensive post-injury rehabilitation was challenging. Her second child developed well and was breastfed for 3 months compared to her first child (9 months). Breastfeeding was possible for this mother after spinal cord injury, in part due to previous experience successfully breastfeeding her first child, assistance from care personnel, and nursing aids.
Caregivers’ perception of women’s dignity in the delivery room: A qualitative study
Authors: Mohammadi Fateme , Tabatabaei Hadise sadate , Mozafari Farzaneh , Gillespie Mark 
Published: May 2019

Introduction: Dignified care is one of the moral responsibilities of professional caregivers. However, in many cases the dignity of hospitalized patients, especially women in the delivery room, is not maintained. Dignity is an abstract concept and there has been no previous research exploring the dignity of pregnant women in the delivery room in Iran. Objectives: The objective of this study is to define and explain the concept of dignity for pregnant women in the delivery room from the perspectives of professional caregivers. Research design: This is qualitative research. The data were collected through in-depth semi-structured individual interviews. The conventional content analysis method was used to analyze the data. In qualitative content analysis, participant narrative is examined in-depth and sorted into categories and themes. Participants and research context: Potential participants who met the entrance criteria for this study were approached between July 2016 and February 2017. In all, 20 professional caregivers working in the delivery room setting within Iranian general hospitals were invited to participate in the study. The sampling was done through targeted sampling until saturation was achieved. Ethical considerations: The research ethics committee of the Shiraz University of Medical Sciences has approved the study’s protocol and all commonly recognized ethical principles were followed throughout the study. Findings: The findings of this study were presented in three main themes, including “privacy,” “respecting patients’ preferences,” and “comprehensive attention” and eight categories. Discussions and conclusion: Women in the delivery room need to be taken care of in an environment where healthcare staff promote the preservation of dignity through maintaining privacy, by providing attentive care and through ensuring that patient preferences regarding care and treatment are respected. In such an environment, the dignity of these women would be maintained and desirable outcomes achieved.
Association of central arterial stiffness with the presence and severity of diabetic retinopathy in Asians with type 2 diabetes
Authors: Zhang Xiao , Lim Su Chi , Tavintharan Subramaniam , Yeoh Lee Ying , Sum Chee Fang , Ang Keven , Yeo Darren , Low Serena , Kumari Neelam 
Published: May 2019

Objective: Arterial stiffness has been associated with diabetic retinopathy; however, the information is limited in Asians. We aim to examine the association of central arterial stiffness with the presence and severity of diabetic retinopathy in type 2 diabetes mellitus patients in Singapore. Methods: Arterial stiffness was estimated by carotid-femoral pulse wave velocity and augmentation index using applanation tonometry method. Digital colour fundus photographs from 1,203 patients were assessed for diabetic retinopathy. Diabetic retinopathy severity was categorized into non-proliferative diabetic retinopathy and proliferative diabetic retinopathy. Logistic regression model was used to evaluate the associations of diabetic retinopathy with pulse wave velocity and augmentation index. Results: Diabetic retinopathy was diagnosed in 391 (32.5%) patients, including 271 non-proliferative diabetic retinopathy and 108 proliferative diabetic retinopathy. Diabetic retinopathy have higher pulse wave velocity (11.2 ± 3.3 vs 9.5 ± 2.6 m/s, p < 0.001) and augmentation index (28.4 ± 9.4 vs 26.1 ± 10.6%, p < 0.001) than non-diabetic retinopathy. After multivariable adjustment, pulse wave velocity [odds ratio = 1.11 (95% confidence interval = 1.05–1.17), p < 0.001] and augmentation index [odds ratio = 1.03 (95% confidence interval = 1.01–1.04), p = 0.009] was associated with diabetic retinopathy. In severity analyses, pulse wave velocity was associated with non-proliferative diabetic retinopathy [odds ratio = 1.10 (95% confidence interval = 1.03–1.17), p = 0.002] and proliferative diabetic retinopathy [odds ratio = 1.15 (95% confidence interval = 1.06–1.25), p = 0.001] ( p-trend < 0.001). Augmentation index showed significant associations with non-proliferative diabetic retinopathy [odds ratio = 1.02 (95% confidence interval = 1.01–1.04), p = 0.008], but not with proliferative diabetic retinopathy [odds ratio = 1.01 (95% confidence interval = 0.98–1.04), p = 0.36] ( p-trend = 0.03). Conclusion: Central arterial stiffness was associated with the presence and severity of diabetic retinopathy in type 2 diabetes mellitus patients, suggesting its etiologic implication in diabetic retinopathy.
Developing a mouse model of acute encephalopathy using low-dose lipopolysaccharide injection and hyperthermia treatment
Authors: Kurata Hirofumi , Saito Kengo , Kawashima Fumiaki , Ikenari Takuya , Oguri Masayoshi , Saito Yoshiaki , Maegaki Yoshihiro , Mori Tetsuji 
Published: May 2019

Acute encephalopathy (AE) is mainly reported in East Asia and, in most cases, results from pediatric viral infections, leading to fever, seizure, and loss of consciousness. Cerebral edema is the most important pathological symptom of AE. At present, AE is classified into four categories based on clinical and pathophysiological features, and cytokine storm-induced AE is the severest among them. The pathogenesis of AE is currently unclear; this can be attributed to the lack of a simple and convenient animal model for research. Here, we hypothesized that the induction of systemic inflammation using lipopolysaccharide (LPS) injection followed by hyperthermia (HT) treatment can be used to develop an animal model of cytokine storm-induced AE. Postnatal eight-day-old mouse pups were intraperitoneally injected with low-dose LPS (50 or 100 µg/kg) followed by HT treatment (41.5°C, 30 min). Histological analysis of their brains was subsequently performed. Fluorescein isothiocyanate assay combined with immunohistochemistry was used to elucidate blood–brain barrier (BBB) disruption. LPS (100 µg/kg) injection followed by HT treatment increased BBB permeability in the cerebral cortex and induced microglial activation. Astrocytic clasmatodendrosis was also evident. The brains of some pups exhibited small ischemic lesions, particularly in the cerebral cortex. Our results indicate that a low-dose LPS injection followed by HT treatment can produce symptoms of cytokine storm-induced AE, which is observed in diseases, such as acute necrotizing encephalopathy and hemorrhagic shock and encephalopathy syndrome. Thus, this mouse model can help to elucidate the pathogenetic mechanisms underlying AE.Impact statementAcute encephalopathy (AE), mainly reported in East Asia, is classified into four categories based on clinical and neuropathological findings. Among them, AE caused by cytokine storm is known as the severest clinical entity that causes cerebral edema with poor prognosis. Because suitable and convenient model animal of AE had not been developed, the treatment of patients with AE is not established. In the present study, we established a simple and convenient protocol to mimic AE due to cytokine storm. Our model animal should be useful to elucidate the pathogenesis of AE.
The association between platelet/lymphocyte ratio, neutrophil/lymphocyte ratio, and carotid artery stenosis and stroke following carotid endarterectomy
Authors: Deşer Serkan Burç , Yucel Semih Murat , Demirag Mustafa Kemal , Guclu Muzaffer Murat , Kolbakir Fersat , Keceligil Hasan Tahsin 
Published: May 2019

Objectives Platelet/lymphocyte ratio is considered to be a recent biomarker which is not only related with inflammation but also associated with the atherosclerotic process. In this study, we aimed to investigate the relationship between carotid artery stenosis, platelet/lymphocyte ratio, neutrophil/lymphocyte ratio, and mean platelet volume in patients undergoing carotid endarterectomy. Methods A total of 160 patients (127 males, 33 females; mean age 69.98 ± 9.76 years; range 48–92 years), who were undergoing carotid endarterectomy due to severe carotid artery stenosis, were evaluated and compared with 201 patients (140 males, 61 females, mean age 66.30 ± 9.24 years, range 41–90 years) without severe carotid artery stenosis. The patients were divided into four groups with respect to the carotid artery stenosis as: Group I (<50% stenosis), Group II (50–70% stenosis), Group III (70–90% stenosis), and Group IV (90–99% stenosis). Results Platelet/lymphocyte ratio, neutrophil/lymphocyte ratio and mean platelet volume were found higher in Group IV (patients with severe carotid artery stenosis) (p < 0.01) and were positively correlated with the degree of stenosis (p < 0.01). Platelet/lymphocyte ratio is an independent predictor for post operative stroke (p = 0.047) at multivariate analysis. A threshold level of 145.304 of platelet/lymphocyte ratio combined with a sensitivity 83.3% and specificity 73.8% (95% CI, 0.802–0.921, area under the curve = 0.862 ± 0.03; p = 0.002) for the identification of post operative stroke. Conclusions This retrospective study suggests that platelet/lymphocyte ratio in the blood which was taken preoperatively could be considered as an additional, easy, and inexpensive method to predict a possible higher incidence of postoperative stroke after carotid endarterectomy.
The serum level of CC chemokine ligand 18 correlates with the prognosis of non-small cell lung cancer
Authors: Huang Hui , Li Jing , Hu Wen-jia , Chen Chen , Luo Hai-qing , Tang Xu-dong , Zhou Ke-yuan , Zhong Wang-tao , Li Xiang-yong 
Published: May 2019

Background: CC chemokine ligand 18 (CCL18) is a chemotactic cytokine involved in the pathogenesis and progression of various cancers. Our previous research showed that the expression of CCL18 is obviously higher in non-small cell lung cancer (NSCLC) than in the adjacent normal tissues, suggesting its role in NSCLC. Methods: We further examined the serum level of CCL18 in 80 NSCLC patients with enzyme-linked immunosorbent assay and simultaneously analyzed the survival curve of these patients by the Kaplan–Meier method, and then utilized a log-rank test to evaluate the correlation of CCL18 expression with the malignant progression of NSCLC. Results: Our results showed that the median serum concentration of CCL18 was significantly elevated to 436.11 ng/mL in NSCLC patients compared to 41.97 ng/ml in healthy people ( P<0.01), which was also positively related to the expression of lung cancer biomarkers carcinoma–embryonic antigen and cytokeratin fragment antigen 21-1. Moreover, correlation analysis showed that an increased level of serum CCL18 was associated with a worse survival time in NSCLC patients. Conclusion: Our findings suggest that the serum CCL18 level of NSCLC patients was negatively correlated with the prognosis, thus suggesting that CCL18 may serve as a potential circulating biomarker for NSCLC diagnosis.
Adjuvant therapy for pancreatic body or tail adenocarcinoma: a study of the National Cancer Database
Authors: Seaton Max , Hanna Andrew , Boutros Cherif , Hanna Nader 
Published: May 2019

Background: The optimal multimodality therapy for pancreatic ductal adenocarcinoma in the body or tail of the pancreas (PDAC-BT) is unclear. The purpose of this study was to compare overall 5-year survival between patients treated with adjuvant chemotherapy, adjuvant chemoradiation, and surgery alone. Methods: Patients from the National Cancer Database (1998–2012) with resected stage I or II PDAC-BT were included. Overall survival between the three treatment groups was compared using Cox proportional-hazards regression, propensity-score matching, and the Kaplan–Meier method. Results: Of the 700 patients included in the analysis, 189 (27%) were treated with chemotherapy, 226 (32%) were treated with chemoradiation, and 285 (41%) were treated with surgery alone. Chemoradiation was associated with higher survival than surgery alone [adjusted hazard ratio (HRadj): 0.67; 95% confidence interval (CI): 0.54, 0.84; p = 0.001], but there was no difference between chemotherapy and chemoradiation (HRadj: 0.82; 95% CI: 0.65, 1.05; p = 0.115). In propensity-score matched cohorts, median survival was 24.1 months (95% CI: 20.4, 28.4) with chemotherapy and 25.4 months (95% CI: 22.1, 31.7) with chemoradiation (log-rank p = 0.122). Among patients with positive resection margins, chemoradiation was associated with higher survival compared with chemotherapy (HRadj: 0.54; 95% CI: 0.32, 0.92; p = 0.022). In this subgroup of the propensity-score matched cohorts, median survival was 9.5 months (95% CI: 8.4, 16.0) with chemotherapy and 18.3 months (95% CI: 11.6, 26.3) with chemoradiation (log-rank p = 0.011). Conclusion: In patients with resected pancreatic body or tail adenocarcinoma, adjuvant chemoradiation was associated with higher survival compared with surgery alone. Among patients with positive resection margins, adjuvant chemoradiation was associated with higher survival compared with adjuvant chemotherapy.
Analysis of Histopathological Endotyping for Chronic Rhinosinusitis Phenotypes Based on Comorbid Asthma and Allergic Rhinitis
Authors: Radabaugh Jeffrey P. , Han Joseph K. , Moebus Rachel G. , Somers Evan , Lam Kent 
Published: May 2019

Background An emerging trend in clinical research has centered on improving the characteristics of chronic rhinosinusitis (CRS) according to phenotypes and endotypes. The objective of this study is to utilize histopathological markers to better characterize CRS phenotypes that are defined by the presence or absence of comorbid bronchial asthma (BA) and allergic rhinitis (AR). Methods A prospective case-controlled study of CRS patients was conducted. For the CRS cohort, mucosal biopsies were obtained during endoscopic sinus surgery, while samples of ethmoid mucosa were collected in control patients undergoing endoscopic skull base surgery. Histopathological analysis of tissue samples determined the relative frequency of inflammatory cell types, including eosinophils, lymphocytes, neutrophils, mast cells, and plasma cells. The presence and absence of comorbid BA and AR were used to further divide CRS, allowing for further subgroup analysis. Results Of 82 recruited patients, there were 67 CRS patients and 15 controls. Significantly increased eosinophil ratios were found in CRS patients with AR, BA, or both, when compared with controls ( P < .001). Conversely, CRS patients with neither comorbid diagnosis failed to demonstrate statistically significant elevations in eosinophil ratios ( P > .05). Lymphocyte ratios showed a significantly inverse correlation with trends demonstrated by eosinophil ratios in all patient subgroups ( P < .001). Neutrophil, mast cell, and plasma cell ratios did not show significant differences across the evaluated subgroups. Conclusions The clinical diagnosis of comorbid BA and AR may aid in better characterizing CRS endotypes without invasive testing and better direct management of the disease.
Epidemiology and Impact of Prior Musculoskeletal Injury and Orthopaedic Surgery on Draft Rank, Availability, and Short-term Performance in Major League Baseball: A Summary Analysis and Matched Cohort of 1890 Predraft Players
Authors: Ramkumar Prem N. , Navarro Sergio M. , Luu Bryan C. , Haeberle Heather S. , Karnuta Jaret M. , Stearns Kim L. , Soloff Lonnie , Frangiamore Salvatore J. , Schickendantz Mark S. 
Published: May 2019

Background: Despite the many reports of injury rates in Major League Baseball (MLB), little is known about the epidemiology or impact of prior musculoskeletal injuries and surgical procedures among players entering the MLB draft. Purpose: To determine the (1) epidemiology of all musculoskeletal injuries and surgical procedures among players entering the MLB draft, (2) impact of injury or surgery on draft rank, (3) impact of injury or surgery on availability within the first 2 years of play in the MLB, and (4) impact of injury or surgery on performance. Study Design: Cohort study; Level of evidence, 3. Methods: We retrospectively reviewed 1890 medical records that were completed by MLB team physicians as preparticipation physical assessment prior to the draft from 2014 to 2018. Players were divided into 3 groups: noninjured, nonoperative, and operative. Draft status, overall draft rank, missed games, batting average, and earned run average for the first 2 seasons of MLB play were obtained for all available players. Players across all 3 groups were compared with linear, logistic, and beta regression models, controlling for age, position, injury status, and draft rank. Unadjusted differences among groups were assessed with 1-way analysis of variance. Results: Overall, 750 position players and 1140 pitchers were included, of whom 22.8% had no reported injury history; 48.8% reported injury treated nonoperatively; and 28.5% were treated operatively. The most common predraft injuries were elbow tendinitis (n = 312), ulnar collateral ligament injury (n = 212), and shoulder labral tear (n = 76). The most common predraft treatments were physical therapy (n = 922), ulnar collateral ligament reconstruction (n = 115), and fracture fixation (n = 69). Of the 1890 players, 719 were drafted and played for at least 2 years. No difference was found among noninjured, nonoperative, and operative groups in terms of draft rank, games missed, or performance. Players with a nonoperative injury had a decreased odds ratio of being drafted (0.738; P = .017). Conclusion: More than half of the players entering the MLB reported a history of musculoskeletal injury requiring treatment, and the most commonly affected joints were the shoulder and elbow. Musculoskeletal history did not affect draft rank, short-term availability, or performance for MLB prospects.
Immunogenicity and safety of 4 vs. 3 standard doses of HBV vaccination in HIV-infected adults with isolated anti-HBc antibody
Authors: Laksananun Nattinee , Praparattanapan Jutarat , Kotarathititum Wilai , Supparatpinyo Khuanchai , Chaiwarith Romanee 
Published: May 2019

Abstract
Background
Presence of isolated anti-HBc antibody is common in HIV-infected patients in endemic areas and could be caused by prior HBV infection with loss of anti-HBs antibody. The role of vaccination in these patients remains controversial and is based largely on limited and low quality data. We, therefore, conducted this study to determine immunogenicity and safety of 4 vs. 3 standard doses of HBV vaccination in HIV-infected adults with isolated anti-HBc antibody.

Methods
An open-label, randomized controlled trial was conducted among HIV-infected patients visiting HIV clinic of the Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand between July and September 2017. Inclusion criteria included ≥ 18 years of age, currently on a stable antiretroviral regimen, CD4+ cell count ≥ 200 cells/mm3, plasma HIV-1 RNA < 20 copies/mL, and isolated anti-HBc antibody. The participants were randomized to receive either 3 standard doses (20 µg at month 0, 1, 6) or 4 standard-doses (20 µg at month 0, 1, 2, 6) of IM HBV vaccination, and were evaluated for anamnestic response at week 4 and vaccine response at week 28.

Results
Of the 97 patients screened, 54 (32 male, mean age of 46 years) were enrolled and 27 were allocated to each of the vaccination groups. Anamnestic response occurred in 25.9% vs. 33.3% in 3-dose group vs. 4-dose group, respectively (p = 0.551). The vaccine response rates at week 28 were 85.2% in 3-dose group vs. 88.9% in 4-dose group (p = 1.000); geometric mean titer of anti-HBs antibody at week 28 was 63.8 and 209.8 mIU/mL in 3-dose group and 4-dose group, respectively (p = 0.030). No adverse events were reported.

Conclusions
An anamnestic response occurred in one-third of Thai HIV-infected patients with isolated anti-HBc antibody who received one dose of HBV vaccination; however, the majority were still unprotected. The use of either 3 or 4 standard-doses of vaccination was highly effective and should be recommended in all HIV-infected individuals with isolated anti-HBc antibody.
Trial registration ClinicalTrials.gov; NCT03212911. Registered 11 July 2019, https://clinicaltrials.gov/ct2/show/NCT03212911