bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reintroduction failure after negative food challenges in adults is common and mainly due to atypical symptoms
Authors: Versluis Astrid , Knulst André C. , van Erp Francine C. , Blankestijn Mark A. , Meijer Yolanda , Le Thuy‐My , van Os‐Medendorp Harmieke 
Published: January 2020

AbstractBackgroundReintroduction of a food after negative food challenge (FC) faces many obstacles. There are no studies available about this subject in adults.ObjectiveTo investigate the frequency, reasons and risk factors of reintroduction failure in adults.MethodsIn this prospective study, adult patients received standardized follow‐up care after negative FCs including a reintroduction scheme and supportive telephone consultations. Data were collected by telephone interview (2 weeks after FC) and questionnaires (at baseline and 6 months after FC(s)): food habits questionnaire, State‐Trait Anxiety Inventory, Food Allergy Quality of Life Questionnaire‐Adult Form and Food Allergy Independent Measure. Frequency and reasons of reintroduction failure were analysed using descriptive statistics and risk factors with univariate analyses.ResultsEighty patients were included with, in total, 113 negative FCs. Reintroduction failed on short‐term (2 weeks after FC) in 20% (95% CI: 13%‐28%). Common reasons were symptoms upon ingestion during the reintroduction scheme (50%) and no need to eat the food (23%). On the long‐term (5‐12 months after FC(s)), reintroduction failure increased to 40% (95% CI: 28%‐53%). Common reasons were atypical symptoms after eating the food (59%) and fear for an allergic reaction (24%). Five risk factors for long‐term reintroduction failure were found: if culprit food was not one of the 13 EU regulated allergens, reintroduction failure at short‐term, atypical symptoms during FC, a lower quality of life and a higher state anxiety.Conclusions and clinical relevanceReintroduction failure after negative FCs in adults is common, increases over time, and is primarily due to atypical symptoms. This stresses the need for more patient‐tailored care before and after negative food challenges.
Emergent laparoscopic sigmoid resection for perforated diverticulitis: can it be safely performed by residents?
Authors: Dreifuss N. H. , Schlottmann F. , Bun M. E. , Rotholtz N. A. 
Published: January 2020

AbstractAimOutcomes after resident involvement in emergent colectomies have rarely been studied. The aim of this study was to analyse the outcomes of laparoscopic sigmoidectomy for Hinchey III diverticulitis performed by residents.MethodThis study was a retrospective analysis of patients undergoing laparoscopic sigmoidectomy for diverticulitis. The sample was divided into two groups: patients operated on by a supervised resident (SR) or a senior surgeon (SS). Supervising surgeons and SSs could be general surgeons (GSs) or colorectal surgeons (CSs). A SR was considered the first surgeon if he/she completed at least three of five defined steps of the procedure. The primary end‐points included length of hospital stay (LOS), morbidity and 30‐day mortality. A sub‐analysis of patients operated on by a SR assisted by either a CS or GS was performed.ResultsSupervised residents and SSs operated on 59 and 42 patients, respectively. The presence of a CS was more frequent in the SS group (SR 41% vs SS 81%, P < 0.001). LOS (SR 9.4 days vs SS 6.4 days, P = 0.04) was higher in the SR group. Overall morbidity (SR 39% vs SS 43%, P = 0.69) and 30‐day mortality (SR 5% vs SS 5%, P = 0.94) were also comparable among the groups. Procedures performed by SRs and supervised by a CS were associated with lower morbidity (GS 48% vs CS 25%, P = 0.06) and mortality (GS 8% vs CS 0%, P = 0.26).ConclusionLaparoscopic sigmoidectomy for Hinchey III diverticulitis has comparable outcomes when performed by a supervised SR or a SS. Procedures performed by residents assisted by a CS seem to have better outcomes than those assisted by a GS.
The role of gamut, intuition and engagement in colour management in a design context
Authors: Henry Phil , Westland Stephen 
Published: January 2020

AbstractColour management is ubiquitous in the digital world. However, despite the many advances in colour management over the last couple of decades, it remains an imperfect process. In the art and design community there is often a level of dissatisfaction and deep cynicism about colour management that can lead to lac of engagement with the process. This research explores colour management in a design context though three issues: the gamut issue, the intuitive issue and the engagement issue; each relates to areas where colour management could better connect with tacit design knowhow. The work focusses on the selection of colour in a digital context since for many users this is the first touch point that they have with colour management. Psychophysical studies have been carried out in both laboratory and design‐studio settings. It is shown that users can better predict the results from subtractive colour mixing than from additive colour mixing. The performance of various types of colour picker are explored and consequences for the design of user interfaces are discussed.
Immunohistochemistry utilization in the diagnosis of melanoma
Authors: Dinehart Matthew S. , Dinehart Scott M. , Sukpraprut‐Braaten Suporn , High Whitney A. 
Published: January 2020

AbstractBackgroundThe use of immunohistochemical (IHC) stains in dermatopathology is commonplace; however, little is known regarding utilization trends in melanoma diagnosis. Current Medicare local coverage determinations (LCDs) state that most pigmented lesions, including melanoma, can be diagnosed using H&E alone.MethodsHistopathology reports for all biopsy‐proven melanomas excised between January 1, 2017 and June 30, 2018, at a single dermatology clinic, were identified with the following parameters abstracted: laboratory/dermatopathologist rendering the diagnosis, whether IHC was performed, type/number of stains utilized, presence/depth of invasion, and melanoma subtype. The association of characteristics with IHC utilization was evaluated using χ2 test for categorical variables.ResultsThree hundred and fifty six eligible melanomas were identified. IHC was employed in 228 (64%) of the diagnoses. Invasive melanoma was diagnosed in 199 cases (55.9%) while 157 (44.1%) were identified as melanoma in situ (MIS). Of the 228 that utilized IHC, 117 were performed on invasive melanoma (58.8%) and 111 were performed on MIS (70.7%).ConclusionOur findings suggest a higher IHC usage for the diagnosis of melanoma than previously reported. Existing LCDs regarding IHC utilization in melanoma do not reflect the current state of practice. Further investigation regarding IHC utilization and the development of appropriate‐use criteria for melanoma IHC is necessary.
Investigating the histopathological findings and immunolocalization of rickettsialpox infection in skin biopsies: A case series and review of the literature
Authors: Vyas Nikki S. , Shieh Wun‐Ju , Phelps Robert G. 
Published: January 2020

AbstractBackgroundRecognition of rickettsialpox infection on skin biopsy can be challenging. The histopathology is non‐specific and inconsistently described. We assess classic histopathologic features in confirmed cases and review the literature.MethodsWe searched for cases of “rickettsialpox” diagnosed between 2006 and 2018 with positive immunostaining for Spotted Fever Group Rickettsia species. Original slides were evaluated for vacuolar alterations, granulomatous inflammation, vasculitis, necrosis, fibrin thrombi, microvesiculation, papillary dermal edema, and extravasated red blood cells. All biopsies were stained for CD3, CD20, CD68, and myeloperoxidase.ResultsSix biopsy specimens were compiled, three of which were sampled from vesiculopapules, one from a maculopapule, and two from eschars. Vacuolar alterations and vasculitis were present in all specimens (6/6; 100%). Granulomatous inflammation was present in five specimens (5/6; 83.3%). Fibrin thrombi and red blood cells were seen in 3/6 (50%) of specimens. The eschars showed necrosis of the epidermis and superficial dermis (2/6, 33.3%). Only one specimen showed intraepidermal vesiculation and papillary dermal edema (1/6; 16.7%). All six specimens showed perivascular infiltration with CD3+ T‐cells, and low amounts of CD20+ B‐cells and neutrophils. Five of the six specimens (83.3%) showed significant levels of CD68+ histiocytes.ConclusionThe histopathology of rickettsialpox infection is septic lymphocytic and granulomatous vasculitis.
Seasonal variations in incidence and maternal–fetal outcomes of gestational diabetes
Authors: Meek C. L. , Devoy B. , Simmons D. , Patient C. J. , Aiken A. R. , Murphy H. R. , Aiken C. E. 
Published: January 2020

AbstractAimsTo determine whether the neonatal and delivery outcomes of gestational diabetes vary seasonally in the context of a relatively cool temperate climate.MethodsA retrospect cohort of 23 735 women consecutively delivering singleton, live‐born term infants in a single tertiary obstetrics centre in the UK (2004–2008) was identified. A total of 985 (4.1%) met the diagnostic criteria for gestational diabetes. Additive dynamic regression models, adjusted for maternal age, BMI, parity and ethnicity, were used to compare gestational diabetes incidence and outcomes over annual cycles. Outcomes included: random plasma glucose at booking; gestational diabetes diagnosis; birth weight centile; and delivery mode.ResultsThe incidence of gestational diabetes varied by 30% from peak incidence (October births) to lowest incidence (March births; P=0.031). Ambient temperature at time of testing (28 weeks) was strongly positively associated with diagnosis (P<0.001). Significant seasonal variation was evident in birth weight in gestational diabetes‐affected pregnancies (average 54th centile June to September; average 60th centile December to March; P=0.027). Emergency Caesarean rates also showed significant seasonal variation of up to 50% (P=0.038), which was closely temporally correlated with increased birth weights.ConclusionsThere is substantial seasonal variation in gestational diabetes incidence and maternal–fetal outcomes, even in a relatively cool temperate climate. The highest average birth weight and greatest risk of emergency Caesarean delivery occurs in women delivering during the spring months. Recognizing seasonal variation in neonatal and delivery outcomes provides new opportunity for individualizing approaches to managing gestational diabetes.
A prominent brachiocephalic vein masquerading as an aortic dissection flap on transthoracic echocardiogram: A case for multimodality imaging
Authors: Gajjar Kushani , Biederman Robert 
Published: January 2020

AbstractA 30‐year‐old female patient with past medical history of supraventricular tachycardia presented with shortness of breath and underwent a transthoracic echocardiogram (TTE). The TTE noted a concerning partially mobile linear echo density, with positive Doppler color flow across it along the aortic arch, which was concerning for a dissection flap. The patient accordingly underwent a cardiac MRI which revealed that the anomaly seen on echocardiogram was in the setting of a prominent left brachiocephalic (innominate) vein and without evidence of aortic dissection. While this is a relatively common phenomenon, there is no literature on prominent brachiocephalic vein masquerading as an aortic dissection flap on TTE.
Observational study of left ventricular global longitudinal strain in ST‐segment elevation myocardial infarction patients with extended pharmaco‐invasive strategy: A six months follow‐up study
Authors: Manjunath Satvic C. , Doddaiah Balaraju , Ananthakrishna Rajiv , Sastry Sridhar Lakshmana , Patil Vikram S. , Devegowda Lachikrathman , Veervhadraiah Sumangala B. , bhat Prabhavathi , Nanjappa Manjunath Cholenahally 
Published: January 2020

AbstractAims and ObjectivesTo evaluate left ventricular (LV) function by assessment of LV global longitudinal strain (GLS) in ST‐segment elevation myocardial infarction (STEMI) patients who underwent delayed fibrinolysis and coronary intervention (extended pharmaco‐invasive strategy), since LV function is one of the determinants of both immediate and long‐term outcomes.MethodsProspective study of consecutive STEMI patients who underwent extended pharmaco‐invasive strategy. The LV function was estimated using LV GLS at baseline and at 6 months.ResultsThe study included eighty‐seven STEMI patients who received delayed pharmaco‐invasive therapy and coronary intervention. The primary aim of the study was to evaluate a change in LV function by assessment of GLS at 6 months as compared to baseline. Prior to PCI, LV ejection fraction was 48.08 ± 6.23% and GLS was −11.11 ± 2.99%. Procedural success was achieved in all patients. LV ejection fraction after 6 months of follow‐up increased to 53.12 ± 5.61% and the GLS improved to −13.03 ± 3.06% In comparison to baseline, there was a significant improvement in both LV ejection fraction and GLS at 6 months of follow‐up (P < .001).The cardiac mortality was 1.1% at 6 months.ConclusionThere is a significant improvement of LV function as assessed by GLS and ejection fraction at short‐term follow‐up. In a stable cohort of STEMI patients, extended pharmaco‐invasive strategy is also a reasonable option if PCI cannot be performed within the first 24 hours, due to logistic and infrastructural constraints.
Diagnosis of double‐chambered left ventricle by echocardiogram and cardiac magnetic resonance imaging: A rare case in an adult
Authors: Li Tianjing , Han Jiancheng , Li Yu , Gao Shuang , Hao Xiuxiu , He Yihua 
Published: January 2020

AbstractDouble‐chambered left ventricle (DCLV) is a very rare malformation which is congenital. In most cases, the left ventricle (LV) is divided into two parallel chambers by a septum or aberrant muscular structure, with fewer superior–inferior arrangement. Here, we present the case of an asymptomatic 25‐year‐old man who was diagnosed with superior–inferior arrangement DCLV on transthoracic echocardiography and cardiac magnetic resonance (CMR). DCLV generally does not cause serious outcomes. Owing to absence of any symptoms, no treatment was provided, and the patient was regularly followed up.
Right Ventricular Early Inflow‐Outflow Index—A new method for echocardiographic evaluation of right ventricle dysfunction in acute pulmonary embolism
Authors: Acar Emrah , İzci Servet , Inanir Mehmet , Yılmaz Mehmet Fatih , Izgi Ibrahim Akin , Kirma Cevat 
Published: January 2020

AbstractIntroductionAcute pulmonary embolism (APE) is a cardiothoracic thromboembolic emergency at risk of life‐threatening. Several risk graduation algorithms may be applied to delineate short‐term mortality in patients with APE. In this study, we aim to depict the relationship between the right ventricular early inflow‐outflow (RVEIO) index, which is a Doppler‐based parameter, and the pulmonary embolism severity index(PESI) in acute pulmonary embolism.MethodsIn the presented study, a total of 160 patients who were diagnosed with APE using pulmonary computed tomography angiography or ventilation/perfusion scintigraphy were comprised. Patients were separated to 2 groups based on the simplified PESI (sPESI): sPESI < 1 (n = 88) and sPESI ≥ 1 (n = 72). Echocardiographic parameters, including the RVEIO index, were measured.ResultsThere were no significant differences between the groups in age and gender distribution, or the presence of diabetes mellitus, hypertension, smoking, and history of coronary artery disease. There was a positive correlation with the mortality rate and RVEIO index; the mortality was higher in patients with a higher RVEIO index(<0.001). In receiver operating characteristic (ROC) curve analysis using a cutoff level of 14.39, RVEIO index predicted mortality with a sensitivity of 80.4% and specificity of 57.6%(ROC area under curve:0.694; 95%CI, 0.581‐0.814; P < .001). RVEIO index was higher in the sPESI ≥ 1(n:72) than in the patients with sPESI < 1(14.27 ± 2.13 vs 10.63 ± 2.09; P < .001). There was a positive correlation between RVEIO index and sPESI score(+0.428; P < .001).ConclusionAs well as predicting the degree of tricuspid regurgitation (TR), the RVEIO index is well‐correlated with sPESI score and is associated with mortality in patients with APE. This easily measurable parameter may be used to predict short‐term mortality in APE patients.
Mechanical dispersion in Fabry disease assessed with speckle tracking echocardiography
Authors: Cianciulli Tomas F. , Saccheri María C. , Rísolo Mario A. , Lax Jorge A. , Méndez Ricardo J. , Morita Luis A. , Beck Martin A. , Kazelián Lucia R. 
Published: January 2020

AbstractBackgroundFabry disease (FD) is a rare X‐linked storage disorder caused by deficiency of the lysosomal enzyme α‐galactosidase A, and it typically causes multiorgan dysfunction. The main cause of death is heart disease resulting from left ventricular (LV) diastolic dysfunction, LV systolic dysfunction, severe LV hypertrophy (LVH), and sudden death. In several cardiac disorders, LV systolic dysfunction and ventricular arrhythmias are associated with mechanical dispersion (MD). MD has until now not been studied in patients with FD.ObjectiveTo investigate the prevalence of MD in patients with FD.MethodsComplete echocardiographic data and speckle tracking echocardiographic data were collected. MD is an index of inter‐segmental discoordination of contraction and is defined as the standard deviation (SD) of the time‐to‐peak longitudinal negative strain in 17 LV segments with a value >49 milliseconds. Patients with FD were divided into the following 2 groups: group I (patients with FD but no LVH, n = 64) and group II (patients with FD and LVH, n = 25). These groups were compared with a group of healthy subjects (group III, n = 50). Parametric variables were expressed as mean ± SD, and nonparametric variables were expressed as median and inter‐quartile range. A P value <.05 was considered significant.ResultsA total of 113 patients with FD were included in this study. Of these, 24 (21%) were excluded because of poor imaging quality or presence of comorbidities, and the final study population consisted of 89 patients (mean age of 33.5 ± 14.5 years, 64% female). Group II patients were older than group I patients (46 ± 13 years vs 27 ± 11 years, P < .0001). There was no difference in LV ejection fraction between the 3 groups. There was also no difference in MD between groups I and III (32.4 ms [26‐39] vs 32 ms [26‐39]). In group II, the MD in 19 patients (76%) was 56 ms (39‐80).ConclusionsTo the best of our knowledge, this is the first study to assess the prevalence of MD in patients with FD. MD was observed in 76% of patients with FD and LVH. The use of MD in strain echocardiography may be beneficial in the assessment of patients with FD who develop heart failure.
Increase in interventricular septum thickness may be the first sign of cardiovascular change in kidney donors
Authors: Gokalp Cenk , Guner Oytun Merve , Gunay Emrah , Dogdus Mustafa , Sezis Demirci Meltem , Sen Sait , Tamsel Sadik , Sezer Taylan Ozgur , Toz Huseyin 
Published: January 2020

AbstractBackgroundBecause of the inadequate number of deceased kidney donors, living kidney donation remains an important issue for kidney transplantation. Previous studies have shown that living donation does not differ life expectancy and progression to end‐stage renal disease compared with the normal population. In this study, we investigated short‐term cardiovascular changes after donor nephrectomy.MethodsThirty‐four patients who underwent donor nephrectomy between January 2015 and July 2015 at Ege University Renal Transplantation Unit were included in the study. Arterial stiffness, multifrequency bioimpedance analysis, renal ARFI elastography, and echocardiography performed prior to the donor nephrectomy and 6 months after nephrectomy.ResultsA total of 34 kidney donors were enrolled in this study. Twenty donors were female (59%) and 14 donors were male (41%). The pathological evaluation of donor kidneys using implantation renal biopsy sample revealed mean Karpinski Renal Score of 1.5 and the mean glomerulosclerosis ratio was 5% for all donated kidneys. Arterial stiffness, systolic and diastolic blood pressure measures, body fluid composition, and left atrial size did not change significantly during the follow‐up. However, interventricular septum thickness of donors increased by 1 mm during a 6‐month period (9.6 mm vs 10.6 mm, P = .002).ConclusionWe observed an increase in interventricular septum thickness in kidney donors during a 6‐month follow‐up. In order to evaluate the net effect of this change on donor morbidity, prospective studies investigating an increased number of donors with long‐term follow‐up should be needed.
Fertility and the puzzle of female employment in the Middle East and North Africa
Authors: Majbouri Mahdi 
Published: January 2020

AbstractFemale labour force participation rates across the Middle East and North Africa (MENA) region have remained low for over four decades even though, in the same period, women's education rapidly increased and fertility rates substantially decreased. This study provides a better understanding of this surprising phenomenon by testing whether the number of children affects the mother's labour supply (using twins at first birth as an instrumental variable.) Despite a strong first stage, it does not find statistically significant effects in the second stage, even in the combined sample of over 100,000 observations. This non‐result, however, does not rule out that fertility affects women's employment in these countries. But it rejects impacts larger than 0.09. Similar twin‐studies in the United States found effects between 0.12 and 0.31. The paper discusses the implications of this result in understanding the puzzle of female participation in MENA and in designing policies to increase women's employment.