bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hong Kong Poison Information Centre: Annual report 2017
Authors: Lau Kai Kee , Chow Tin Yat Anthony , Chan Chi Keung , Chan Yiu Cheung , Ng Chun Ho Vember , Ng Sze Hong , Tse Man Li 
Published: September 2018

Objectives:To report and analyse the poisoning data of Hong Kong Poison Information Centre in 2017.Methods:In 2017, all poisoning cases received by Hong Kong Poison Information Centre were retrieved from its database (Poison Information and Clinical Management System) for analysis.Results:A total of 3956 poisoned cases were analysed. There were 1789 male patients (45.2%), 2159 female patients (54.6%) and 8 sex‐unspecified patients (0.2%). The majority of cases (59.9%) were between 20 and 59 years old. The common causes of poisoning were suspected self‐harm/suicidal attempt (36.2%), unintentional exposure (18.6%) and abusive substance use (13.7%). Excluding the common co‐ingestant ethanol, the five commonest types of poison were benzodiazepines, paracetamol, zopiclone, Chinese herbal medicine and household products. Most patients were managed with supportive measures, while 17.4% and 13.2% of consultation cases were treated by decontamination and antidotes, respectively. The majority of the cases had uneventful recovery; 1.1% resulted in death and 4.3% had major outcomes. A total of 13 interesting cases and 1 poisoning outbreak were discussed.Conclusion:This 12th annual report provided the updated epidemiological information on poisoning pattern in Hong Kong and highlighted important changes in comparison with our previous reports.
Polymer Mechanical Recycling: Downcycling or Upcycling?
Authors: La Mantia Francesco Paolo 
Published: September 2018

Recycled plastics are considered as materials with physical, mechanical and aesthetic properties worse than the virgin ones. In fact, this is true because degradation during lifetime and during the recycling operations changes the structure and the morphology of the polymers and then the final properties of the secondary material. Several “strategies” are under investigation, and in some cases also applied, in order to avoid further degradation during recycling and, if possible, to repair the macromolecules broken during lifetime and then to restore or to improve the initial properties. In this paper the more important techniques, already used in industry or under investigation, according to this philosophy are shortly reviewed.
Regeneration of Carbon Black from Waste Automobile Tyres and its Use in Carcass Compound
Authors: Mandal Nilkanta , Gupta Saikat Das , Mukhopadhyaya R. 
Published: September 2018

Post-consumer tyre provide a real challenge for recovery and re-use, since they must be disposed of in an environmentally sound and sustainable manner. Pyrolysis has proved an attractive method. The authors have already established a process of pyrolysis to regenerate the carbon black from waste tyres; it was elaborated in an earlier paper. The regenerated blacks(RB) have now been characterized by various methods. They were mixed in a typical virgin carcass compound, the required properties of the mixed compounds were measured, and then the compounds were cured under standard conditions of time and temperature. The physico-mechanical properties of the cured specimens were measured and compared to those of samples made using virgin (VB) and heat-treated blacks (HTB). It was concluded that the regenerated black has a higher surface area, and gives a higher elongation at break, with a higher heat build up, lower cure rate and lower modulus than virgin blacks, but a comparable state of cure, dispersion, hardness, tensile strength, tear strength and high adhesion strength. It was also found that regenerated black had a slightly different structure and agglomerate size. Some polar groups were incorporated into the carbon black, either during pyrolysis or during heat treatment. The regenerated black gave better ageing properties than the virgin or heat-treated blacks.
Radiation-Cured Nanocomposites Based on Diene Rubber and Nanoclay
Authors: Cataldo Franco , Ursini Ornella , Angelini Giancarlo 
Published: September 2018

SBR/BR-based rubber nanocomposites filled with carbon black (65 phr) and nanoclay (1 and 3 phr) were radiation-cured at 100, 200, 389 and 800 kGy from a 60Co γ radiation source and tested against a reference compound without nanoclay. For reference the same compounds where also sulfur cured. The nanoclay consisted of a layered silicate, a montmorillonite, treated with an alkylammonium salt. The nanoclay was added on top to a conventional carbon black-filled rubber compound during the first masterbatch preparation. The spectacular reinforcement effect derived from the nanoclay addition to the composite has been observed both in the radiation-cured compounds and in the sulfur-cured compound. Although the sulfur-cured composite show a reduction in hysteresis after the nanoclay addition, the radiation-cured compounds show an opposite trend.
Establishing healthy pharmaceutical regulations on statutory exclusivity: Lessons from the experience in the European Union, Canada, South Korea, Australia, and the United States
Authors: Son Kyung-Bok 
Published: September 2018

Abstracts Objectives Recent international trade agreements require member countries a prolonged statutory exclusivity for biologics, and domestic legislation guarantees various forms of exclusivity for specific drugs, indications, or studies. This study notes prolonged exclusivity provisions for biologics in the United States and international trade agreements. We aim to review various exclusivity systems, including chemical entities, in selected high-income countries and to suggest implications for establishing the system specifically relevant for biologics in low- and middle-income countries. Methods We conducted a review of a comprehensive range of literature to develop the framework. Then, a comparative legal analysis was conducted to analyze the deviations among the systems in the European Union, Canada, South Korea, Australia, and the United States. Results There is constructive ambiguity in international trade agreements, specifically for provisions regarding biologics. Furthermore, the selected countries operate different statutory exclusivity systems in terms of eligibility for statutory exclusivity, specific measures for exclusivity, and other elements of exclusivity. In addition, market exclusivity, which is distinguished from data exclusivity, is not available in Korea and Australia. There are also various forms of statutory exclusivity for specific drugs, indications, or studies requested by the marketing authority. Conclusions Given constructive ambiguities in international agreements and variations in the manner of implementations of the systems in selected countries, statutory exclusivity for biologics could be established with cautions to mediate the harms. In this study, we suggest several solutions and alternatives for low- and middle-income countries.
Treatment of Odontoid Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU)
Authors: Gonschorek Oliver , Vordemvenne Thomas , Blattert Thomas , Katscher Sebastian , Schnake Klaus John ,   the Spine Section of the German Society for Orthopaedics and Trauma
Published: September 2018

Study Design: Narrative review. Objective: To establish recommendations for the treatment of odontoid fractures based on current literature and the knowledge of the experts of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU). Methods: Narrative review of the literature. Analyzing treatment algorithms of German trauma and spine centers as members of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU). Results: There are many influencing factors leading to appropriate treatment of odontoid fractures such as age, bone quality, arthrosis, classification, and type of the fracture. Conservative nonoperative treatment is appropriate for stable undislocated displaced odontoid fractures. Anterior osteosynthesis with 1 or 2 screws leads to good results in the classical unstable type II odontoid fracture in patients with good bone quality. However, modifiers have been identified by the working group leading to higher complication and failure rates. For these cases, more stable constructs and/or posterior approaches are indicated. Conclusions: Operation seems to be standard treatment for odontoid fractures. However, in the aged population, conservative treatment should be considered as morbidity and mortality rise significantly in the group of >75 years. Conservative treatment may also be started within stable nondislocated fractures, but then regular controls have to be performed. If operation is indicated, many influencing factors have to be considered for appropriate approach and technique. The classification of Anderson and D’Alonzo is still standard. To create an adequate treatment algorithm, dislocation displacement and instability have to be identified. Stable odontoid fractures are treated conservatively non-operatively, but if so regular controls have to be performed. Unstable and/or dislocated displaced odontoid fractures are treated by anterior osteosynthesis with 1 or 2 screws. The technique is demanding and leads to elevated complication and failure rates if modifiers are apparent. In these cases, posterior instrumentation or fusion of C1 and C2 is favorable. In the aged population (>80 years), operative therapy is critical as postoperative morbidity complication and mortality rates rise significantly. As there is still some bias in the treatment algorithms, the working group recommends establishment of a prospective study to result in more objective statements.
Complications and Risk Factors Using Structural Allograft Versus Synthetic Cage: Analysis 17 783 Anterior Cervical Discectomy and Fusions Using a National Registry
Authors: Goz Vadim , Buser Zorica , D’Oro Anthony , Wang Christopher , Yoon S. Tim , Park Jong-Beom , Youssef Jim A. , Meisel Hans-Joerg , Wang Jeffrey C. , Brodke Darrel S. 
Published: September 2018

Study Design: Retrospective cohort study. Objective: To determine the rates of perioperative complications in patients undergoing anterior cervical discectomy and fusion (ACDF) with allograft versus synthetic cage. Methods: A large national administrative health care database was queried for ACDF procedures performed between 2007 and 2014 using ICD-9 (International Statistical Classification of Diseases, 9th revision) and CPT (Current Procedural Terminology) codes. Cases that utilized structural allograft and synthetic cages were identified via CPT codes. Gender, age, frequency of obesity, cigarette use, diabetes, and number of levels fused were compared between the 2 cohorts using χ2 test. Complications within 90 days were identified via ICD-9 codes and compared between the 2 cohorts. Revision rates within 2 years were noted. Results: A total of 10 648 ACDF cases using synthetic cages and 7135 ACDFs using structural allograft were identified. The demographics between the 2 cohorts were similar. Overall complication rate was 8.71% in the synthetic cage group compared with 7.76% in the structural allograft group ( P < .01). Use of synthetic cage was associated with higher rate of respiratory complications, 0.57% compared with 0.31% in the structural allograft cohort ( P = .03), while use of structural allograft was associated with a higher rate of dysphagia, 0.64% compared with 0.33% ( P < .01). Revision rate at 2 years was 0.50% and 0.56% in the synthetic cage and allograft groups, respectively ( P = .03). Conclusions: This data suggests that synthetic cages are associated with a marginally higher overall rate of complications with similar revision rates.
Enhancing immunotherapy of STING agonist for lymphoma in preclinical models
Authors: Sallets Adrienne , Robinson Sophie , Kardosh Adel , Levy Ronald 
Published: September 2018

Key Points
The immunotherapeutic property of STING agonists is more potent to clear lymphoma than its cytotoxic property. In situ vaccination with STING agonist can be enhanced by agents that improve APC or T-cell function such as anti-GITR and anti-PD-1.
Liaison psychiatry services in Wales
Authors: Tahir Tayyeb A. , Watkins Adam , Slack Philip , Chick Phil , Lee William , Gray Andrea 
Published: September 2018

Aims and methodRecent funding from Welsh Government for mental health has helped to develop liaison psychiatry services in Wales. Systematic data collection was undertaken to map the liaison psychiatry services in Wales in collaboration with the Royal College of Psychiatrists in Wales and Public Health Wales 1000 Lives Improvement. A questionnaire was designed and circulated to all the health boards in Wales to gather information to map liaison psychiatry services in Wales. Up-to-date information was confirmed in January 2018, via email.ResultsOver the past 2 years, liaison psychiatry services have been set up in six out of seven health boards in Wales. Staffing levels have increased and the remit of services has broadened.Clinical implicationsMapping has highlighted that liaison psychiatry services in Wales continue to evolve. It will be important to continue to monitor these developments and their effects. Comparison with services in England will provide a useful comparison of service provision. A particular challenge will be to establish and monitor liaison psychiatry standards in Wales.Declaration of interestNone.
Temporal Trends and Geographic Patterns of Lung Cancer Incidence by Histology in Thailand, 1990 to 2014
Authors: Chang Joanne T. , Jeon Jihyoun , Sriplung Hutcha , Yeesoonsang Seesai , Bilheem Surichai , Rozek Laura , Chitapanarux Imjai , Pongnikorn Donsuk , Daoprasert Karnchana , Vatanasapt Patravoot , Suwanrungruang Krittika , Meza Rafael 
Published: September 2018

Purpose Lung cancer is one of the most common cancers worldwide and in Thailand. We characterize and forecast region-specific patterns of lung cancer incidence by histology and sex. Methods We analyzed lung cancer incidence trends in Thailand by histology (adenocarcinoma [AdC]; squamous cell carcinoma [SCC]; and large-cell, small-cell, and other carcinomas) from 1990 to 2014 in four cancer registries in three regions (north, Chiang Mai Province and Lampang Province; northeast: Khon Kaen Province; south: Songkhla Province). Annual percent change (APC) was calculated to quantify the incidence rate trends using joinpoint regression. Age-period-cohort models were used to examine the temporal trends of AdC and SCC by age, calendar year, and birth cohort. We projected the incidence of AdC and SCC up to 2030 using three independent approaches: joinpoint, age-period-cohort, and Nordpred models. Results AdC incidence significantly increased from 1990 to 2012 in Chiang Mai males (APC, 1.3%), Songkhla males from 2004 to 2014 (APC, 2.5%), Songkhla females from 1990 to 2014 (APC, 5.9%), and Khon Kaen females from 2005 to 2014 (APC, 3.1%). Conversely, SCC incidence significantly decreased from 1990 to 2012 in Chiang Mai males and females (APC, −1.2% and −4.8%, respectively), Lampang males and females from 1993 to 2014 (APC, −5.4% and −5.2%, respectively), and Songkhla females from 1990 to 2014 (APC, −2.1%). In general, trends of AdC and SCC correlated more with birth cohort than with calendar year. Three projection models suggested that incidence rates of AdC in Songkhla may continue to increase until 2030. Conclusion Temporal trends of lung cancer by histology varied among regions in Thailand. Reduction of lung cancer incidence in Thailand likely will require prevention strategies tailored to each specific region.
Pupillary Pain Index Changes After a Standardized Bolus of Alfentanil Under Sevoflurane Anesthesia: First Evaluation of a New Pupillometric Index to Assess the Level of Analgesia During General Anesthesia
Authors: Sabourdin Nada , Diarra Coumba , Wolk Risa , Piat Véronique , Louvet Nicolas , Constant Isabelle 
Published: September 2018

BACKGROUND:
The pupillary pain index (PPI) is a novel pupillometric index, designed to assess intraoperative analgesia. It is based on the evaluation of the pupillary response to electrical stimuli of increasing intensity. It ranges from 1 (low level of pupillary reactivity, high level of analgesia) to 10 (high level of pupillary reactivity, low level of analgesia). In this first evaluation of the PPI, our objective was to investigate the PPI changes after a bolus of 10 µg·kg−1 of alfentanil in children under sevoflurane general anesthesia.

METHODS:
After ethics committee approval and informed consent, 20 healthy children (9 ± 5 years) undergoing elective surgery under general anesthesia were included in this prospective, open, registered pilot study (NCT02646592). Anesthetic induction was standardized with sevoflurane 6% and propofol 1 mg·kg−1. After tracheal intubation, sevoflurane concentration was maintained at 2% for 10 minutes. A first PPI measurement was performed (PPI-1), and a bolus of 10 µg·kg−1 was administered. Two minutes after this bolus, a second PPI measurement was performed (PPI-2). Heart rate, blood pressure, and bispectral index were recorded before and after each PPI measurement. Resting pupillary diameter was recorded before each PPI measurement. PPI scores before and after the bolus of alfentanil were compared using a Wilcoxon signed rank test.

RESULTS:
PPI scores decreased after administration of a bolus of alfentanil (median difference: −3 [95% confidence interval, −4 to −2]). The median (quartiles) of PPI-1 (baseline, before alfentanil) was 6 (4, 7), and the median (quartiles) of PPI-2 (after alfentanil) was 2 (2, 3) (P < .001). No difference was found in resting pupillary diameter before PPI-1 and PPI-2 (2.2 ± 0.2 and 2.2 ± 0.3 mm, respectively; P = .86). There were no significant changes in heart rate or blood pressure after PPI measurements (P = .46 and .49, respectively). Bispectral index was slightly increased after PPI measurements (P = .01; mean bispectral index increase <5%). No withdrawal movements occurred during PPI measurements.

CONCLUSIONS:
There was a significant decrease in PPI after alfentanil administration. The results of this pilot study suggest that PPI score decreases when the level of analgesia increases. PPI measurement was not associated with a clinical or hemodynamic nociceptive response. This new index might provide useful information to individually adapt opioid administration before nociceptive stimuli under general anesthesia.
Pharmacokinetics of Dexmedetomidine in Infants and Children After Orthotopic Liver Transplantation
Authors: Damian Mihaela A. , Hammer Gregory B. , Elkomy Mohammed H. , Frymoyer Adam , Drover David R. , Su Felice 
Published: September 2018

BACKGROUND:
Dexmedetomidine (DEX) is a sedative and analgesic medication that is frequently used postoperatively in children after liver transplantation. Hepatic dysfunction, including alterations in drug clearance, is common immediately after liver transplantation. However, the pharmacokinetics (PK) of DEX in this population is unknown. The objective of this study was to determine the PK profile of DEX in children after liver transplantation.

METHODS:
This was a single-center, open-label PK study of DEX administered as an intravenous loading dose of 0.5 μg/kg followed by a continuous infusion of 0.5 μg/kg/h. Twenty subjects, 1 month to 18 years of age, who were admitted to the pediatric intensive care unit after liver transplantation were enrolled. Whole blood was collected and analyzed for DEX concentration using a dried blood spot method. Nonlinear mixed-effects modeling was used to characterize the population PK of DEX.

RESULTS:
DEX PK was best described by a 2-compartment model with first-order elimination. A typical child after liver transplantation with an international normalized ratio (INR) of 1.8 was found to have a whole blood DEX clearance of 52 L/h (95% confidence interval [CI], 31–73 L/h). In addition, intercompartmental clearance was 246 L/h (95% CI, 139–391 L/h), central volume of distribution was 186 L/70 kg (95% CI, 140–301 L/70 kg), and peripheral volume of distribution was 203 L (95% CI, 123–338 L). Interindividual variability ranged from 11% to 111% for all parameters. Clearance was not found to be associated with weight but was found to be inversely proportional to INR. An increase in INR to 3.2 resulted in a 50% decrease in DEX clearance. Weight was linearly correlated with central volume of distribution. All other covariates, including age, ischemic time, total bilirubin, and alanine aminotransferase, were not found to be significant predictors of DEX disposition.

CONCLUSIONS:
Children who received DEX after liver transplantation have large variability in clearance, which was not found to be associated with weight but is influenced by underlying liver function, as reflected by INR. In this population, titration of DEX dosing to clinical effect may be important because weight-based dosing is poorly associated with blood concentrations. More attention to quality of DEX sedation may be warranted when INR values are changing.
Using text messages to support recovering substance misusers
Authors: McClelland Gabrielle Tracy , Duffy Paul , Davda Priya 
Published: September 2018

Background: The use of digital technology in health and social care is developing rapidly. It is promoted in UK policy and research which suggests varied results surrounding its implementation and outcomes. Introduction: This article aimed to test the implementation and outcomes of a short messaging service sent to a dedicated phone. The target cohort were drug treatment clients in two sites in Northern England. Materials and methods: Through staff focus groups and interviews with a small cohort of clients, the implementation and perceptions of the system were examined. Results: A total of 19 participants were recruited to site 1 (15 male, 4 female, average age=37.7 years) and 12 participants were recruited to site 2 (9 male, 3 female, average age=40.3 years). One outcome that was of interest was wellbeing in treatment which, in this study, was described as an overall sense of feeling better rather than just focusing on the rehabilitation aspect of the programme. Other outcomes included: the successful completion of treatment and for clients to report and instance of a relapse/re-presentation. Discussion: The system shows some evidence of its ‘social actor’ role; however, its implementation was hindered by staff citing that it called for increased resources. For future implementation, the use of clients' own phones may be considered which may help to embed the system more fully in recovery planning and targeting clients at a different treatment stage. Conclusions: Despite some indications of positive results for clients and a perception that the system may have value as an addition to existing clinical interventions, more evaluation is required to determine whether this system can be implemented in a drug treatment setting.