bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trocar umbilical hernia repair by open suture repair and open suture–mesh repair in an ambulatory setting in comparison to recurrent and primary umbilical hernia repair
Authors: Holzheimer René G , Gaschütz Nikolai 
Published: June 2020

AbstractReports on the ambulatory open repair of umbilical trocal hernias are missing. Patients with trocar, primary and recurrent umbilical hernia open suture and open suture–mesh repair with prospective follow-up were retrospectively evaluated. Patients received perioperative antibiotic prophylaxis, preemptive analgesia and modified anesthesia. In total, 171 patients with umbilical hernia (51 years, female 14%; male 86%) were treated with open suture (n = 29; 17%) and suture–mesh (n = 142; 83%) repair. In total, 10% of patients were treated for trocar hernia (late onset), 5% for recurrent hernia and 85% for a primary umbilical hernia. In total, 29% of trocar hernia repairs had minor complications associated with obesity (40%) and comorbidity (80%). Age, suture and suture–mesh repair were not associated with complications. According to guidelines for umbilical hernia repair open flat mesh may be useful in the treatment of trocar hernia.
Renal medicine and urology
Authors: Simon Chantal , Everitt Hazel , van Dorp Françoise , Hussain Nazia , Nash Emma , Peet Danielle 
Published: June 2020

Abstract
This chapter in the Oxford Handbook of General Practice explores renal medicine and urology in general practice. It covers laboratory tests, how to estimate renal function, presentation of renal disease, chronic kidney disease, specific kidney diseases, renal stones, and haematuria, bladder, and renal cancer. It explores urinary tract infection, incontinence of urine, aids and appliances, and urinary tract obstruction. It examines benign prostatic hypertrophy, prostate-specific antigen testing, and prostate cancer. It also reviews conditions of the penis and testicular disease.
Neurology
Authors: Simon Chantal , Everitt Hazel , van Dorp Françoise , Hussain Nazia , Nash Emma , Peet Danielle 
Published: June 2020

Abstract
This chapter in the Oxford Handbook of General Practice explores neurology in general practice. It covers reflexes and muscle power, cranial nerve lesions, neuropathy, polyneuropathy, walking problems, and speech problems. It explores transient loss of consciousness, migraine, headache, facial pain, raised intracranial pressure, intracranial bleeds, acute stroke, and prevention of stroke. It discusses Parkinson’s disease, multiple sclerosis, motor neurone disease, and Creutzfeldt–Jakob disease. It also examines spinal cord conditions, epilepsy, muscle disorders, neurological rehabilitation problems, and neurological assessment scales.
Haematology and immunology
Authors: Simon Chantal , Everitt Hazel , van Dorp Françoise , Hussain Nazia , Nash Emma , Peet Danielle 
Published: June 2020

Abstract
This chapter in the Oxford Handbook of General Practice explores haematology in general practice. It covers full blood count and erythrocyte sedimentation rate. It explores diagnosis and initial investigation of anaemia, iron deficiency anaemia, haemoglobinopathies, bleeding and clotting disorders, and anticoagulation. It examines haematological malignancy, acute leukaemia, chronic leukaemia and myeloproliferation, lymphoma, immune deficiency, and allergy.
Gynaecology
Authors: Simon Chantal , Everitt Hazel , van Dorp Françoise , Hussain Nazia , Nash Emma , Peet Danielle 
Published: June 2020

Abstract
This chapter in the Oxford Handbook of General Practice explores gynaecology in general practice. It covers the menstrual cycle, premenstrual syndrome, amenorrhoea, menorrhagia, the menopause, and hormone replacement therapy. It discusses pelvic pain, endometriosis and adenomyosis, prolapse, and uterine problems. It also explores ovarian disease, conditions of the cervix, cervical cancer screening, and vaginal and vulval problems.
Child health
Authors: Simon Chantal , Everitt Hazel , van Dorp Françoise , Hussain Nazia , Nash Emma , Peet Danielle 
Published: June 2020

Abstract
This chapter in the Oxford Handbook of General Practice explores child health in general practice. It covers child health promotion from birth, including the neonatal and 6-week check, neonatal bloodspot screening, screening for hip dysplasia, vision and hearing screening tests, birth trauma, genetic disorders, common problems of small babies, prematurity, and neonatal jaundice. It examines feeding babies, weaning, and developmental milestones. It discusses fever and acute illness in the under 5s, childhood infection, urinary tract infection, congenital heart disease, asthma, constipation, malabsorption, gut atresia, hernias, and intussusception. It explores growth disorders, endocrine problems, funny turns, febrile convulsions, epilepsy, hydrocephalus, neural tube defect, arthritis, dermatology, and cancer. It also discusses behaviour problems, sleep problems, toilet training, poor progress at school, autism, learning disability, adolescence, chronic illness, disability, safeguarding children, and child death.
Ear, nose, and throat
Authors: Simon Chantal , Everitt Hazel , van Dorp Françoise , Hussain Nazia , Nash Emma , Peet Danielle 
Published: June 2020

Abstract
This chapter in the Oxford Handbook of General Practice explores ear, nose, and throat (ENT) medicine in general practice. It covers dental and jaw problems, sore throat and tonsillitis, hoarseness and stridor, neck lumps, and salivary gland problems. It examines nasal problems, sinusitis, and rhinitis. It discusses ear pain and external ear problems, otitis media, deafness, tinnitus, and vertigo.
Ophthalmology
Authors: Simon Chantal , Everitt Hazel , van Dorp Françoise , Hussain Nazia , Nash Emma , Peet Danielle 
Published: June 2020

Abstract
This chapter in the Oxford Handbook of General Practice explores ophthalmology in general practice. It covers assessment of the eye, eye trauma, eye pain, papilloedema, and orbital disease. It examines lid disease, blepharitis, tear duct problems, red eye, conjunctivitis, and corneal, scleral and uveal disease. It discusses visual field loss and blindness, sudden loss of vision in one eye, gradual loss of vision, glaucoma, and cataract. It also explores refraction errors, squint, contact lenses, and drugs for the eye.
The SkyMapper-Gaia RVS view of the Gaia–Enceladus–Sausage  – an investigation of the metallicity and mass of the Milky Way’s last major merger
Authors: Feuillet Diane K , Feltzing Sofia , Sahlholdt Christian L , Casagrande Luca 
Published: June 2020

ABSTRACT
We characterize the Gaia–Enceladus–Sausage kinematic structure recently discovered in the Galactic halo using photometric metallicities from the SkyMapper survey, and kinematics from Gaia  radial velocities measurements. By examining the metallicity distribution functions (MDFs) of stars binned in kinematic/action spaces, we find that the $\sqrt{J_R}$ versus Lz space allows for the cleanest selection of Gaia–Enceladus–Sausage stars with minimal contamination from disc or halo stars formed in situ or in other past mergers. Stars with $30 \le \sqrt{J_R} \le 50$ (kpc km s−1)1/2 and −500 ≤ Lz ≤ 500 kpc km s−1 have a narrow MDF centred at [Fe/H] = −1.17 dex with a dispersion of 0.34 dex. This [Fe/H] estimate is more metal-rich than literature estimates by 0.1−0.3 dex. Based on the MDFs, we find that selection of Gaia–Enceladus–Sausage stars in other kinematic/action spaces without additional population information leads to contaminated samples. The clean Gaia–Enceladus–Sausage sample selected according to our criteria is slightly retrograde and lies along the blue sequence of the high VT halo colour magnitude diagram dual sequence. Using a galaxy mass–metallicity relation derived from cosmological simulations and assuming a mean stellar age of 10 Gyr, we estimate the mass of the Gaia–Enceladus–Sausage progenitor satellite to be 108.85–9.85 M⊙, which is consistent with literature estimates based on disc dynamic and simulations. Additional information on detailed abundances and ages would be needed for a more sophisticated selection of purely Gaia–Enceladus–Sausage stars.
Chromatin remodeler Ino80C acts independently of H2A.Z to evict promoter nucleosomes and stimulate transcription of highly expressed genes in yeast
Authors: Qiu Hongfang , Biernat Emily , Govind Chhabi K , Rawal Yashpal , Chereji Răzvan V , Clark David J , Hinnebusch Alan G 
Published: June 2020

Abstract
The chromatin remodelers SWI/SNF and RSC function in evicting promoter nucleosomes at highly expressed yeast genes, particularly those activated by transcription factor Gcn4. Ino80 remodeling complex (Ino80C) can establish nucleosome-depleted regions (NDRs) in reconstituted chromatin, and was implicated in removing histone variant H2A.Z from the −1 and +1 nucleosomes flanking NDRs; however, Ino80C’s function in transcriptional activation in vivo is not well understood. Analyzing the cohort of Gcn4-induced genes in ino80Δ mutants has uncovered a role for Ino80C on par with SWI/SNF in evicting promoter nucleosomes and transcriptional activation. Compared to SWI/SNF, Ino80C generally functions over a wider region, spanning the −1 and +1 nucleosomes, NDR and proximal genic nucleosomes, at genes highly dependent on its function. Defects in nucleosome eviction in ino80Δ cells are frequently accompanied by reduced promoter occupancies of TBP, and diminished transcription; and Ino80 is enriched at genes requiring its remodeler activity. Importantly, nuclear depletion of Ino80 impairs promoter nucleosome eviction even in a mutant lacking H2A.Z. Thus, Ino80C acts widely in the yeast genome together with RSC and SWI/SNF in evicting promoter nucleosomes and enhancing transcription, all in a manner at least partly independent of H2A.Z editing.
Forecasting Seizure Freedom After Epilepsy Surgery Assessing Concordance Between Noninvasive and StereoEEG Findings
Authors: Uribe San Martin Reinaldo , Di Giacomo Roberta , Mai Roberto , Gozzo Francesca , Pelliccia Veronica , Mariani Valeria , Cardinale Francesco , Ciampi Ethel , Onofrj Marco , Tassi Laura 
Published: June 2020

Abstract

BACKGROUND
Accurate localization of the probable Epileptogenic Zone (EZ) from presurgical studies is crucial for achieving good prognosis in epilepsy surgery.

OBJECTIVE
To evaluate the degree of concordance at a sublobar localization derived from noninvasive studies (video electroencephalography, EEG; magnetic resonance imaging, MRI; 18-fluorodeoxyglucose positron emission tomography FDG-PET, FDG-PET) and EZ estimated by stereoEEG, in forecasting seizure recurrence in a long-term cohort of patients with focal drug-resistant epilepsy.

METHODS
We selected patients with a full presurgical evaluation and with postsurgical outcome at least 1 yr after surgery. Multivariate Cox regression analysis for seizure freedom (Engel Ia) was performed.

RESULTS
A total of 74 patients were included, 62.2% were in Engel class Ia with a mean follow-up of 2.8 + 2.4 yr after surgery. In the multivariate analysis for Engel Ia vs >Ib, complete resection of the EZ found in stereoEEG (hazard ratio, HR: 0.24, 95%CI: 0.09-0.63, P = .004) and full concordance between FDG-PET and stereoEEG (HR: 0.11, 95%CI: 0.02-0.65, P = .015) portended a more favorable outcome. Most of our results were maintained when analyzing subgroups of patients.

CONCLUSION
The degree of concordance between noninvasive studies and stereoEEG may help to forecast the likelihood of cure before performing resective surgery, particularly using a sublobar classification and comparing the affected areas in the FDG-PET with EZ identified with stereoEEG.
Strategic environmental policy and international market share rivalry under differentiated Bertrand oligopoly
Authors: Lapan Harvey E , Sikdar Shiva 
Published: June 2020

AbstractWe analyse strategic environmental policies under international Bertrand oligopoly when firms in different industries, located in different countries, produce differentiated products. Under cooperation, emission prices always exceed the joint marginal damage from pollution. Under non-cooperation, internationally nontradable and tradable emission permit prices are always higher than the domestic marginal damage from emissions (the Pigovian tax); emission taxes can also exceed the Pigovian tax. The non-cooperative emission prices under all instruments can exceed the joint pollution damage. Internationally tradable permits generate outcomes closest to cooperation — they result in the lowest pollution and the highest welfare among all instruments under non-cooperation. Pollution is the highest and welfare the lowest with taxes. Our results provide support for allowing international trade in emission permits even when governments choose their permit levels non-cooperatively.
Possible Diagnostic Delays and Missed Prevention Opportunities in Pneumocystis Pneumonia Patients Without HIV: Analysis of Commercial Insurance Claims Data—United States, 2011–2015
Authors: Gold Jeremy A W , Jackson Brendan R , Benedict Kaitlin 
Published: June 2020

Abstract

Background
Pneumocystis pneumonia (PCP) is a life-threatening but treatable and preventable fungal infection in immunocompromised persons. Previous studies suggest that persons without HIV who develop PCP (PCPHIV-) experience more acute, severe illness than persons with HIV who develop PCP (PCPHIV+). We analyzed health insurance claims data to compare demographics, underlying conditions, symptoms, and prescriptions for PCPHIV+ and PCPHIV-.

Methods
We used the IBM MarketScan Research Databases to identify patients diagnosed with PCP during 2011–2015. We analyzed claims 1 year before to 3 months after diagnosis to compare PCPHIV+ and PCPHIV-.

Results
Among 3938 patients, 70.4% were PCPHIV-. Compared with PCPHIV+, PCPHIV- were more likely to be older (median, 60 vs 45 years; P &lt; .0001), female (51.5% vs 20.2%; P &lt; .0001), hypoxemic (13.5% vs 7.1%; P &lt; .0001), and to die within 90 days (6.6% vs 4.2%; P &lt; .0001). The most common underlying conditions among PCPHIV- included chronic pulmonary diseases (54.6%), solid tumors (35.1%), hematologic malignancies (20.1%), and rheumatologic conditions (14.0%). The median time between the first visit for PCP-related symptoms and PCP diagnosis was longer for PCPHIV- than PCPHIV+ (25 vs 16 days; P &lt; .0001). In the 3 months before PCP diagnosis, PCPHIV- were less likely to have an outpatient prescription for PCP prophylaxis than PCPHIV+ (6.9% vs 10.6%; P = .0001).

Conclusions
PCPHIV- may experience a prolonged illness course and diagnostic delays compared with PCPHIV+. Clinicians should maintain a high index of suspicion for PCP in immunocompromised patients with compatible symptoms, regardless of HIV status.
The United Kingdom’s Statutory Constitution
Authors: Psygkas Athanasios 
Published: June 2020

Abstract
The emergence of the UK’s statutory constitution has challenged the old Diceyan adage that ‘neither the Act of Union with Scotland nor the Dentists Act 1878 has more claim than the other to be considered supreme law’. This article reconceptualises constitutional statutes, offering a three-pronged approach to identifying such legislation. This new model examines the content of the statute, the history of enacting the constitutional statute (the ‘life of the Bill’), and the post-enactment history (the ‘life of the statute’). The proposed framework reflects a historical approach to constitutionalism and gives weight not only to judicial practice, but also to the interactions between other constitutional actors and to popular endorsement. Four case studies of statutes demonstrate how the new model adds layers to, and diverges from, the current judicial approach. Finally, the article describes the implications of taking constitutional statutes seriously under the proposed approach.
Syncope in a hypertrophic heart at a wedding party: can happiness break a thick heart? Takotsubo cardiomyopathy complicated with left ventricular outflow tract obstruction in a hypertrophic heart
Authors: Orphanou Nicoletta , Eftychiou Christos , Papasavvas Elias , Ioannides Marios , Avraamides Panayiotis 
Published: June 2020

Abstract
A 70-year-old woman with known history of hypertension presented because of a syncopal episode during dinner at a wedding party, followed by chest pain. On physical examination a systolic murmur was noted, and her electrocardiogram showed ST segment elevation in anterior leads. She had elevated troponin levels while echocardiography showed a hypertrophic interventricular septum with dyskinetic apex and left ventricular outflow (LVOT) obstruction. Emergency coronary angiography excluded obstructive coronary artery disease and confirmed the presence of LVOT obstruction with a gradient of 90 mm Hg. A left ventriculography showed hypercontractility of the basal and mid segments with apical wall dyskinesia indicating Takotsubo cardiomyopathy. Patient was discharged after 6 days of hospitalization with normalization of left ventricular function and regression of the LVOT obstruction. This is an interesting case of Takotsubo cardiomyopathy complicated with severe LVOT obstruction in a patient with hypertensive heart disease and a sigmoid septum hypertrophy.
Conformational selection of allergen-antibody complexes—surface plasticity of paratopes and epitopes
Authors: Fernández-Quintero Monica L , Loeffler Johannes R , Waibl Franz , Kamenik Anna S , Hofer Florian , Liedl Klaus R 
Published: June 2020

Abstract
Antibodies have the ability to bind various types of antigens and to recognize different antibody-binding sites (epitopes) of the same antigen with different binding affinities. Due to the conserved structural framework of antibodies, their specificity to antigens is mainly determined by their antigen-binding site (paratope). Therefore, characterization of epitopes in combination with describing the involved conformational changes of the paratope upon binding is crucial in understanding and predicting antibody-antigen binding. Using molecular dynamics simulations complemented with strong experimental structural information, we investigated the underlying binding mechanism and the resulting local and global surface plasticity in the binding interfaces of distinct antibody-antigen complexes. In all studied allergen-antibody complexes, we clearly observe that experimentally suggested epitopes reveal less plasticity, while non-epitope regions show high surface plasticity. Surprisingly, the paratope shows higher conformational diversity reflected in substantially higher surface plasticity, compared to the epitope. This work allows a visualization and characterization of antibody-antigen interfaces and might have strong implications for antibody-antigen docking and in the area of epitope prediction.
Mitogenomics of the endangered Mediterranean monk seal (Monachus monachus) reveals dramatic loss of diversity and supports historical gene-flow between Atlantic and eastern Mediterranean populations
Authors: Rey-Iglesia Alba , Gaubert Philippe , Espregueira Themudo Gonçalo , Pires Rosa , de la Fuente Constanza , Freitas Luís , Aguilar Alex , Borrell Asunción , Krakhmalnaya Tatiana , Vasconcelos Raquel , Campos Paula F 
Published: June 2020

AbstractThe Mediterranean monk seal Monachus monachus is one of the most threatened marine mammals, with only 600–700 individuals restricted to three populations off the coast of Western Sahara and Madeira (North Atlantic) and between Greece and Turkey (eastern Mediterranean). Its original range was from the Black Sea (eastern Mediterranean) to Gambia (western African coast), but was drastically reduced by commercial hunting and human persecution since the early stages of marine exploitation.We here analyse 42 mitogenomes of Mediterranean monk seals, from across their present and historical geographic ranges to assess the species population dynamics over time. Our data show a decrease in genetic diversity in the last 200 years. Extant individuals presented an almost four-fold reduction in genetic diversity when compared to historical specimens. We also detect, for the first time, a clear segregation between the two North Atlantic populations, Madeira and Cabo Blanco, regardless of their geographical proximity. Moreover, we show the presence of historical gene-flow between the two water basins, the Atlantic Ocean and the Mediterranean Sea, and the presence of at least one extinct maternal lineage in the Mediterranean. Our work demonstrates the advantages of using full mitogenomes in phylogeographic and conservation genomic studies of threatened species.
Sepsis secondary to multifocal Enterococcus faecium infection
Authors: Huang Xiao-qing , Qiu Jun-ke , Wang Cai-hong , Pan Lei , Xu Jie-kun , Pan Xiao-hong , Ji Xiao-bo , Mao Min-jie 
Published: June 2020

Abstract

Introduction:
Nosocomial Enterococcus faecium (E faecium) infections are common among immunocompromised patients; however, sepsis caused by E faecium is rarely encountered in the clinical setting.

Patient concerns:
A 69-year-old woman with a previous history of tuberculosis (TB), developed symptoms of recurrent fever, paroxysmal cough, and exertional dyspnea for over 2 months before she presented to the hospital.

Diagnosis:
The patient was initially misdiagnosed with recurrent TB, and did not respond to anti-TB therapy. Culture results of blood, endotracheal necrotic tissue, and urine confirmed a diagnosis of multifocal E faecium infection.

Interventions:
On definitive diagnosis, the patient received intensive antimicrobial combination treatment with linezolid, teicoplanin, caspofungin, and voriconazole on the basis of antimicrobial susceptibility results.

Outcomes:
After transient improvement, the patient's condition deteriorated due to secondary infections, and the patient died after discharge against medical advice.

Conclusion:

E faecium bacteremia may cause sepsis in immunocompromised patients, and has a high mortality rate. Careful pathogen detection and early initiation of treatment is crucial to good patient outcome.
Effectiveness of a primary care clinical ultrasound classroom for family physicians as a formative intervention system, a quasi-experimental trial
Authors: Diego-Domínguez Fernando , Torrecilla-García Miguel , Casado-Huerga Jesús , Paule-Sánchez Maria Ángeles , Soria-López Clara Isabel , Iglesias-Clemente José Manuel , de Dios-Hernández José María , Diego-Mangas Natalia , Cubillo-Jiménez María , Pérez-Escanilla Fernando 
Published: June 2020

Abstract

Introduction:
Clinical ultrasound is a technique that increases diagnostic capacity and facilitates clinical decision making. The objective is to develop and validate an ultrasound training methodology oriented to the clinical practice of the family physician.

Methods:
Quasi-experimental study, with a before/after design, a control group, and 1 year of follow-up. Twenty family physicians working in primary care health centers with a list of over 800 patients will be included, as well as a control group of family physicians with similar characteristics in terms of age, sex, and patient list. A structured training process oriented to the clinical practice of the family physician, primary care clinical ultrasound classroom (AECAP), will be carried out, and the improvement of knowledge and skills of the participants will be evaluated, as well as the improvement of the quality of care based on clinical indicators.

Discussion:
The family physician is in a privileged situation allows increasing the performance of ultrasound in frequent clinical situations and reducing care hours. We hope that the results obtained in this study demonstrate the effectiveness of the structured training method (AECAP) and support the generalization of ultrasound in primary health care.

Ethics and dissemination:
The study was approved by the Medical Research Ethics Committee of Salamanca on December 17, 2018 (cod 2018 11 134). The trial was registered in ClinicalTrials.gov provided by the US National Library of Medicine-number: NCT04283383.