bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arbitration clauses in trusts: a human rights issue?
Authors: Briggs Aidan 
Published: December 2019

Abstract
Can settlors require beneficiaries and trustees to submit their trust disputes to arbitration? This article examines three of the key arguments favour of enforcement, and the major difficulties posed by the caselaw emanating from the European Court of Human Rights in Strasbourg. It also puts the English law position in an international context.
Much has been written, both in previous editions of this journal and elsewhere, on the vexed question of whether a clause in a trust instrument which requires any dispute between trustees and beneficiaries to be submitted to arbitration is enforceable. Practitioners and academics remain divided on this central issue, and unfortunately we still await a decision of the English courts to put an end to the debate.
Clinical Aspects of Aging Skin: Considerations for the Wound Care Practitioner
Authors: Levine Jeffrey M. 
Published: December 2019

ABSTRACT
Aging is a complex phenomenon manifested by macromolecular damage, adverse changes to the genome, blunted immunologic function, alterations in body composition, and decreased adaptation to stress. Understanding the changes that skin undergoes with age is essential for wound care practitioners. Accordingly, this article will introduce the reader to theories of aging, the biologic changes associated with aging skin, and clinical considerations for the wound care practitioner, including the concepts of skin failure, Skin Changes At Life’s End, and frailty.

GENERAL PURPOSE
To provide information about changes associated with aging skin and the implications for wound care practitioners.

TARGET AUDIENCE
This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES
After participating in this educational activity, the participant should be better able to:
1. Describe proposed biologic theories of aging and the biology of aging skin.
2. Discuss the clinical consequences of aging skin and the implications for wound care practitioners.
Using Wireless Near-Infrared Spectroscopy to Predict Wound Prognosis in Diabetic Foot Ulcers
Authors: Lin Bor-Shyh , Chang Chang-Cheng , Tseng Yuan-Hsi , Li Jhe-Ruei , Peng Yun-Shing , Huang Yao-Kuang 
Published: December 2019

ABSTRACT

OBJECTIVE
To use wearable near-infrared spectroscopy (NIRS) to determine the effect of Buerger exercises on diabetic foot ulcer (DFU) healing.

METHODS
Study authors enrolled 50 consecutive patients in a 1-year prospective observational study of DFUs. The patients were divided into groups by their arterial statuses: group A (no peripheral arterial disease [PAD]), group B (PAD without angioplasty), and group C (PAD with angioplasty). Tissue perfusion was assessed through wireless wearable NIRS to determine the effects of Buerger exercises on wound healing.

MAIN RESULTS
The patients in group C were older, were more likely to have had an amputation, and had more severe wounds than did the patients in other groups. The requirements of insulin injection for diabetes mellitus control differed significantly (P = .024) among the three groups. At the end of the survey, 19 patients (38%) had unhealed DFUs. The NIRS revealed that most nonhealed patients in groups B and C shared higher resting hemoglobin levels and tissue blood volume and lower tissue oxygen concentration, which indicated inflammation accompanied by higher blood flow and oxygen consumption. Notably, the nonhealed patients in group C showed paradoxically reduced hemoglobin and tissue blood volume after the exercises.

CONCLUSIONS
Although DFUs remain a challenge to treat, NIRS may prove valuable in predicting wound healing by identifying risk factors for poor wound prognosis, such as reduced hemoglobin and tissue blood volume after exercise.
Overactive Bladder
Authors: Al Hussein Al Awamlh Bashir , Al Hussein Alawamlh Omar , Lee Richard , Lee Una J. 
Published: December 2019

Abstract:
Overactive bladder (OAB) syndrome is a condition that involves urinary urgency, usually accompanied by increased daytime frequency and nocturia, with or without urgency urinary incontinence, in the absence of urinary tract infection or other obvious pathology. This condition is multifactorial, and several theories exist that explain the pathophysiologic process underlying the condition. Because the prevalence of the condition is high among women across all age groups, obstetrician–gynecologists will encounter women with OAB syndrome and should be able to evaluate and treat this condition. The appropriate management often is based on the degree of bother and severity of symptoms in an individual patient. This monograph will delineate the general characteristics of OAB syndrome from its epidemiology to potential causes and provide a detailed discussion of the evaluation of the patient with various diagnostic modalities and the range of available treatment options.
Assessing the association of appropriateness of coronary revascularization and 1-year clinical outcomes for patients with stable coronary artery disease in China
Authors: Lin Shen , Zhang Heng , Rao Chen-Fei , Chen Si-Peng , Qiao Shu-Bin , Yan Hong-Bing , Dou Ke-Fei , Wu Yong-Jian , Tang Yi-Da , Yang Xin-Chun , Shen Zhu-Jun , Liu Jian , Zheng Zhe 
Published: December 2019

AbstractBackground:The Chinese appropriate use criteria (AUC) for coronary revascularization was released in 2016 to improve the use of coronary revascularization. This study aimed to evaluate the association between the appropriateness of coronary revascularization based on the Chinese AUC and 1-year outcomes in stable coronary artery disease (CAD) patients.Methods: We conducted a prospective, multi-center cohort study of stable CAD patients with coronary lesion stenosis ≥50%. After the classification of appropriateness based on Chinese AUC, patients were categorized into the coronary revascularization group or the medical therapy group based on treatment received. The primary outcome was a composite of death, myocardial infarction, stroke, repeated revascularization, and ischemic symptoms with hospital admission.Results:From August 2016 to August 2017, 6085 patients were consecutively enrolled. Coronary revascularization was associated with a lower adjusted hazard of 1-year major adverse cardiovascular and cerebrovascular events (MACCEs; hazard ratio [HR]: 0.62; 95% confidence interval [CI]: 0.45–0.86;P = 0.004) than medical therapy in patients with appropriate indications (n = 1617). No significant benefit in 1-year MACCEs was found after revascularization compared to after medical therapy in patients with uncertain indications (n = 2658, HR: 0.81; 95% CI: 0.52–1.25;P = 0.338) and inappropriate indications (n = 1810, HR: 0.80; 95% CI: 0.51–1.23;P = 0.308).Conclusions:In patients with appropriate indications according to Chinese AUC, coronary revascularization was associated with significantly lower risk of MACCEs at 1 year. No benefit was found in coronary revascularization in patients with inappropriate indications. Our findings provide evidence for using Chinese AUC to guide clinical decision-making.Clinical trial registration:NCT02880605. https://www.clinicaltrials.gov.
Spiradenoma With Adenoid Cystic Carcinoma–Like Features
Authors: Hopkins Christina , Moyer Amanda , Huttenbach Yve Thaller 
Published: December 2019

Abstract:
Spiradenoma is a benign cutaneous adnexal neoplasm that characteristically presents as a painful dermal nodule, often on the head or trunk. It has a distinct histologic phenotype and management involves surgical excision with low risk of recurrence. In comparison, adenoid cystic carcinoma (ACC) is a low-grade malignancy manifesting as an often painless subcutaneous mass with potential for local invasion, perineural extension, and high rates of recurrence after excision. We report the case of a 63-year-old male patient with a recurrent, painful hematoma-like cyst overlying the left lower extremity tibial tuberosity. A firm nodule was located at the base of the cyst, which was histologically consistent with spiradenoma. Interestingly, the lesion contained multifocal ACC-like components composed of epithelial basaloid cells surrounding pseudocystic structures filled with mucinous material. The ACC-like components did not demonstrate infiltration or perineural invasion. To the best of our knowledge, this is the second publication in the English literature regarding spiradenoma with an ACC-like pattern. Although a benign entity, knowledge of this morphological variant of spiradenoma is essential for diagnostic accuracy in these cases. If a limited biopsy captures only the ACC-like component of a spiradenoma, the lesion may be incorrectly diagnosed as ACC.
Subtotal Nasal Reconstruction Using a Custom 3-Dimensional Porous Polyethylene Construct
Authors: Walton Robert L. , Seelaus Rosemary , Robinson Brent R. 
Published: December 2019

Summary:
Subtotal loss of the nose is a devastating occurrence. Traditional approaches to reconstruction have employed techniques that sequentially restore the nasal lining, support and external cover using autologous tissues. The results can be quite variable and are heavily weighted on surgical experience and expertise. We report a case of subtotal nasal reconstruction using a computer generated, 3-D printed porous polyethylene (PPE) scaffold. The patient is a 64-year-old man who presented with a sub-total nasal defect following excision of recurrent basal cell carcinoma. The missing parts comprised the distal half of the composite nose including the nasal floor and lining. The replacement nose was constructed on the patient’s right radial forearm. A computer generated PPE nasal scaffold was prelaminated with a forearm flap for lining and a free temporal fascial flap and skin graft for external cover. Following healing, nostrils were created and the nasal construct was then microsurgically transferred to the face. At 18 months post-op, the reconstructed nose has remained stable and functional with excellent aesthetic appearance. The implications for use of 3-D scaffolds for composite nasal reconstruction are enormous.
Photopeak Efficiency and Coincidence Summing Factors for HPGe Detectors Using Bulk Sources
Authors: Alharshan Gharam A. 
Published: December 2019

Abstract
In the field of gamma-ray spectroscopy with high-purity germanium detectors, used to measure the activity when the sample to be measured has low radioactivity, volumetric sources are widely used. To determine the sample activity, the full-energy peak efficiency is needed. Bulk sources are very common for low-level radioactivity measurements in activation analysis and environmental samples. The main problem with these measurements is that coincidence effects are large for close source-detector geometries. Ignoring these effects can lead to an error typically of a factor of 2 in the determination of 60Co and 88Y activity, which was used in this work in the calibration process. Extensive experimental readings have been carried out, and bulk gamma aqueous sources containing several radionuclides covering the energy range from 60 to 1,840 keV were used. By comparison, the experimental (present work) and theoretical (published) full-energy peak efficiency values are in good agreement; the overall percentage error is less than 6%.
Reduction of Occupational Exposure Using a Novel Tungsten-Containing Rubber Shield in Interventional Radiology
Authors: Kijima Kenta , Krisanachinda Anchali , Tamura Mikoto , Monzen Hajime , Nishimura Yasumasa 
Published: December 2019

Abstract
This study investigates whether a novel tungsten-containing rubber shield could be used as substitute shielding material in interventional radiology to reduce the occupational exposure of operators to scattered radiation from a patient. The tungsten-containing rubber is a lead-free radiation-shielding material that contains as much as 90% tungsten powder by weight. Air kerma rates of scattered radiation from solid-plate phantoms, simulating a patient, were measured with a semiconductor dosimeter at the height of the operator’s eye (1,600 mm from the floor), chest (1,300 mm), waist (1,000 mm), and knee (600 mm) with and without tungsten-containing rubber shielding (1–5 mm thickness). The tungsten-containing rubber and a commercial shielding material (RADPAD) were affixed onto the phantom on the operator’s side, and reductions in air kerma rates were compared. Reduction rates for tungsten-containing rubber shielding with thicknesses of 1, 2, 3, 4, and 5 mm at each height level were as follows: 70.37 ± 0.40%, 72.17 ± 0.29%, 72.95 ± 0.31%, 72.58 ± 0.35%, and 73.63 ± 0.63% at eye level; 76.36 ± 0.19%, 77.13 ± 0.10%, 77.36 ± 0.14%, 77.62 ± 0.25%, and 77.66 ± 0.14% at chest level; 67.78 ± 0.31%, 68.12 ± 0.19%, 68.88 ± 0.28%, 68.97 ± 0.14%, and 68.85 ± 0.45% at waist level; and 0.14 ± 0.94%, 0.72 ± 0.56%, 1.08 ± 0.74%, 1.77 ± 0.80%, and 1.79 ± 1.82% at knee level, respectively. Reduction rates with RADPAD were 61.80 ± 0.67%, 60.33 ± 0.61%, 64.70 ± 0.25%, and 0.14 ± 0.66% at eye, chest, waist, and knee levels, respectively. The shielding ability of the 1 mm tungsten-containing rubber was superior to that of RADPAD. The tungsten-containing rubber could be employed to minimize an operator’s radiation exposure instead of the commercial shielding material in interventional radiology.
Brain Abscess Caused by Resistant Streptococcus pneumoniae
Authors: Jain Hanish , Gada Kunal , Fazili Tasaduq , Eranki Ambika 
Published: December 2019

Abstract
Brain abscess can have multiple sources such as traumatic brain injury, prior neurosurgical procedure, contiguous spread from a local source, or hematogenous spread of a systemic infection. Streptococcus pneumoniae has been isolated from brain abscesses with hematogenous spread from paranasal sinusitis. This case encompasses an unusual presentation of a resistant S. pneumoniae isolate causing brain abscess in a patient with a history of neurosurgical procedure highlighting challenges in empiric therapy, further management, and outcomes.
Aspirin use and pancreatic cancer risk
Authors: Sun Jinjin , Li Yanxun , Liu Lili , Jiang Zhijia , Liu Geng 
Published: December 2019

AbstractObjectives:Although there is evidence that aspirin might be able to prevent pancreatic cancer, the findings have been inconsistent. In this paper, we conducted a meta-analysis of observational studies to examine the relationship between aspirin use and the risk of pancreatic cancer.Methods:We identified potential studies by searching the MEDLINE, EMBASE, and Wangfang (Chinese database) database (from 1967 to March 2017) and by reviewing the bibliography of relevant publications. Random effects model was used to calculate odds ratio (OR) and 95% confidence interval. The Cochran Q statistic (significance level atP < .1) was used to assess heterogeneity in this study. The author adopted weighted regression method of Egger to assessed publication bias.Results:A total of 12 studies involving 4748 pancreatic cancer cases, were included in the meta-analysis. The study reflected that there was no signification association between aspirin use and mortality risk of pancreatic cancer. Aspirin use might reduce the incidence of pancreatic cancer. Specifically, there was a high signification association between frequent aspirin use and reduced pancreatic cancer incidence, without heterogeneity. In addition, there was a high signification association between duration of aspirin use more than 5 years and reduced pancreatic cancer incidence, without obvious heterogeneity among the original studies.Conclusions:In summary, this meta-analysis suggested that the aspirin use might be negatively related to the incidence risk of pancreatic cancer. Specifically, the frequency and duration of aspirin use might play an important role in decreasing the incidence of pancreatic cancer.
Acupuncture for reduction of opioid consumption in chronic pain
Authors: Lee Seunghoon , Jo Dae-Hyun 
Published: December 2019

AbstractBackground:This review aims to evaluate the effectiveness and safety of acupuncture treatment for reducing opioid consumption in patients with chronic pain.Methods:We will search the following electronic databases from their inception to November 2019: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health Literature, the Allied and Complementary Medicine Database, the China National Knowledge Infrastructure (a Chinese database), the Japan Science and Technology Information Aggregator (a Japanese database), and five Korean databases (KoreaMed, Research Information Service System, Korean Studies Information Service System, Database Periodical Information Academic, and Oriental Medicine Advanced Searching Integrated System). Randomized controlled trials comparing acupuncture to no treatment, sham acupuncture, and other active interventions for the reduction of opioid consumption in chronic pain patients will be included. The risk of bias will be assessed using the Cochrane risk of bias tool. The primary outcomes will include the prescribed or consumed dose of opioids and withdrawal symptoms related to opioid reduction. A meta-analysis will be performed to estimate a pooled effect, if possible.Conclusion:This study may provide important practical guidance for patients, practitioners, and health-policy makers regarding the use of acupuncture in opioid taper support programs.Dissemination:The results will be disseminated through a peer-reviewed journal or conference presentations.Trial registration number: PROSPERO 2019: CRD42019143486
Contribution of MTR A2756G polymorphism and MTRR A66G polymorphism to the risk of idiopathic male infertility
Authors: Ren Zheng-Ju , Zhang Yan-Ping , Ren Peng-Wei , Yang Bo , Deng Shi , Peng Zhu-Feng , Liu Liang-Ren , Wei WuRan , Dong Qiang 
Published: December 2019

Abstract

Background:
Methionine synthase reductase gene (MTRR A66G) polymorphism and methionine synthase gene (MTR A2756G) polymorphism have shown an association with idiopathic male infertility risk in several ethnic populations. However, their small sample sizes and inconsistent outcomes have prevented strong conclusions. We performed a meta-analysis with published studies to evaluate the associations of the 2 single nucleotide polymorphisms (SNPs) and idiopathic male infertility risk.

Methods:
A thorough literature search was performed up to Jun 21, 2019 with Medline, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), China Biology Medical literature (CBM), China Science and Technology Journal Database (VIP), and Chinese literature (Wan Fang) databases. Odds ratio (OR) and 95% confidence interval (95% CI) were used to assess the strength of associations.

Results:
Seventeen studies including 3269 cases and 3192 controls met the inclusion criteria. Our meta-analysis showed that the MTR A2756G mutation may contribute to genetic susceptibility to the risk of idiopathic male infertility in Non-Asians, but not to Asian population, whereas the MTRR A66G polymorphism may be unrelated to idiopathic male infertility in both Non-Asian and Asian populations. In the stratified analysis by infertility type, the MTR A2756G polymorphism was a risk factor for both non-obstructive azoospermia (NOA) and oligoasthenoteratozoospermia (OAT) patients. However, the MTRR A66G polymorphism is associated with risk for OAT in Asian, but not in Non-Asian population.

Conclusion:
This meta-analysis suggested that the MTR A2756G and MTRR A66G polymorphisms were risk factors for idiopathic male infertility. Studies with larger sample sizes and representative population-based cases and well-matched controls are needed to validate our results.
Surgical treatment of spontaneous brainstem hemorrhage
Authors: Hao Guangshan , Xu Zhentao , Zhu Jianxin 
Published: December 2019

Abstract

Rationale
The improvement of microneurosurgery and neuroimaging, as well as neuronavigation and neurophysiological monitoring, enables neurosurgeons to safely and accurately resect lesions on the brainstem.

Patient concerns
A 54-year-old man, with 2-year history of hypertension, presented with sudden loss of consciousness for 1.5 hours.

Diagnoses
Spontaneous brainstem hemorrhage.

Interventions
We performed posterior fossa decompression together with hematoma evacuation in the super early stage for the patient.

Outcomes
The patient regained normal spontaneous breathing function after surgery. And he needed help for daily activities with hemiplegia of right limb at three-month follow-up.

Lessons
The hematoma evacuation together with posterior fossa decompression in the super early stage maybe a good treatment for patients in a deep coma with a large hematoma at the dorsal side.
Comparative effectiveness of simultaneous integrated boost vs sequential intensity-modulated radiotherapy for oropharyngeal or hypopharyngeal cancer patients
Authors: Kuo Yao-Hung , Liang Ji-An , Wang Tang-Chuan , Juan Chun-Jung , Li Chia-Chin , Chien Chun-Ru 
Published: December 2019

Abstract
There were 2 common radiotherapy dose fractionation strategies in head-and-neck cancer patients (such as oropharyngeal cancer [OPC] or hypopharyngeal cancer [HPC]) treated with radiotherapy: intensity-modulated radiotherapy using simultaneous integrated boost (IMRT-SIB) and sequential IMRT (IMRT-SEQ). There is a lack of high-level clinical evidence to compare IMRT-SIB vs IMRT-SEQ specifically for OPC or HPC patients. The present study investigated the survival outcomes of OPC or HPC patients receiving definite concurrent chemoradiotherapy (CCRT) with either IMRT-SIB or IMRT-SEQ via a population-based propensity score (PS)-based analysis.
The localized stage OPC or HPC patients diagnosed between 2011 and 2015 were identified based on the Health and Welfare Data Science Center database in Taiwan. These patients received definitive CCRT with either IMRT-SIB or IMRT-SEQ. We constructed a PS-matched cohort (1:1 for IMRT-SIB vs IMRT-SEQ) to balance observable potential confounders. We compared the hazard ratio (HR) of death between IMRT-SIB and IMRT-SEQ during the entire follow-up period. We also evaluated other disease outcome or subgroups.
Our study population constituted 200 patients with well balance in observed covariables. The HR of death when IMRT-SIB was compared to IMRT-SEQ was 1.23 (95% confidence interval 0.84–1.80, P = .29). The results were similar for other disease outcome or subgroups.
We found the survival outcome might be comparable for those treated with IMRT-SIB vs those treated with IMRT-SEQ.