bluuebunny/crossref_metadata_2025_split huggingface dataset:
COT-01 SYMPTOMATIC EPILEPSY INDUCED BY MALIGNANT BRAIN TUMOR
Authors: Oyama Hirofumi 
Published: December 2019

Abstract

CASES
We report about 41 cases of malignant brain tumor which were treated with operation, irradiation, chemotherapy during past 62 months. 34 cases of glioblastoma, 2 cases of malignant glioma(WHO grade III), 2 cases of medulloblastoma, 1 case of germ cell tumor, 1 case of malignant neurocytoma, and 1 case of malignant ependymoma were included in 41 cases. Two cases of glioblastoma survived over than 25 years, but the median survival of dead 11 glioblastoma cases was 22 months. 4 cases were expired among another 7 cases.

RESULTS
6 cases showed mutation in ATRX and one case had mutation of IDH-1 among 34 cases of glioblastoma. One case showed mutation in ATRX and IDH-1 among 2 cases of malignant glioma. But the mutation in ATRX and IDH-1 had no correlation with convulsion. The initial symptom was epilepsy in 3 cases of glioblastoma and another 3 cases of glioblastoma showed convulsive seizure thereafter. One case of glioblastoma showed rapid aggravation of symptom after convulsion. The initial symptom was epilepsy in 1 case of malignant glioma. One case of malignant ependymoma and one case of medulloblastoma showed rapid aggravation of symptom after convulsion.

DISCUSSION
Nine cases showed convulsion among our 41 cases. Convulsion happened as initial symptom in 4 cases but it happened during treatment in 5 cases. Three cases among these 5 cases showed rapid aggravation of symptom after convulsion. So pre- and post-operative anti-epileptic treatment seems to be necessary.
COT-03 EVALUATING FUNCTIONING AND DISABILITY OF A PATIENT WITH BRAIN TUMOR BY WHODAS
Authors: Ishita Kohei , Ikeda Mitsuyo , Yamada Shin , Okajima Yasutomo , Saito Kuniaki , Kobayashi Keiichi , Shiokawa Yoshiaki , Nagane Motoo 
Published: December 2019

Abstract

BACKGROUND
The WHO Disability Assessment Schedule (WHODAS) is a practical assessment instrument which measures level of functioning in the following six domains of life. Here we report a case of brain tumor who was evaluated with the 36-item full version of WHODAS 2.0 (self-administered mode), and discuss usefulness of the WHODAS.

CASE PRESENTATION
A 69-year-old man was referred to our hospital with cognitive problems because of which he needed assistance for his ADLs at home. He was diagnosed as having primary central nervous system lymphoma (PCNSL) following open brain biopsy, and was transferred to our hospital for chemotherapy at 23 days after the biopsy. He showed no sign of motor or sensory impairments, but initial evaluation revealed that he had troubles in judgment in his ADLs mainly because of marked memory deficits. Motor, cognitive and total FIM score was 65/91, 22/35, and 87/126, respectively and MMSE score was 24/30. After 48 days of chemotherapy (3 courses of initial DeVIC and following R-MPV regimens), he was temporally discharged home before readmission for another chemotherapy. According to him and his family, he was then basically independent in ADLs at home. We implemented WHODAS 2.0 to demonstrate minute ADL problems of this patient at home so that we might focus on rehabilitation for specific problems at home. Sub-scores of the WHODAS were 15/30 for Cognition, 10/25 for Mobility, 4/20 for Self-care, 14/25 for Getting along, 12/20 for Life activities, and 27/40 for participation. In fact, he felt difficulty in the areas of “activity and participation”.

DISCUSSION
The WHODAS is useful to identify various problems in their daily livings even though patients were independent in ADLs. Patients with brain tumors often repeat hospitalization for medical treatment. We have to be alert to not only objective but subjective changes in ADLs at home.
Quantification of rhBMP2 in bioactive bone materials
Authors: Lian Huan , Wang Han , Han Qianqian , Wang Chunren 
Published: December 2019

Abstract
Bone morphogenetic protein (BMP), belongs to transforming growth factor-β (TGF-β) superfamily except BMP-1. Implanting BMP into muscular tissues induces ectopic bone formation at the site of implantation, which provides opportunity for the treatment of bone defects. Recombinant human BMP-2 (rhBMP-2) has been used clinically, but the lack of standard methods for quantifying rhBMP-2 biological activity greatly hindered the progress of commercialization. In this article, we describe an in vitro rhBMP-2 quantification method, as well as the data analyzation pipeline through logistic regression in RStudio. Previous studies indicated that alkaline phosphatase (ALP) activity of C2C12 cells was significantly increased when exposed to rhBMP-2, and showed dose-dependent effects in a certain concentration range of rhBMP-2. Thus, we chose to quantify ALP activity as an indicator of rhBMP-2 bioactivity in vitro. A sigmoid relationship between the ALP activity and concentration of rhBMP-2 was discovered. However, there are tons of regression models for such a non-linear relationship. It has always been a major concern for researchers to choose a proper model that not only fit data accurately, but also have parameters representing practical meanings. Therefore, to fit our rhBMP-2 quantification data, we applied two logistic regression models, three-parameter log-logistic model and four-parameter log-logistic model. The four-parameter log-logistic model (adj-R2 &gt; 0.98) fits better than three-parameter log-logistic model (adj-R2 &gt; 0.75) for the sigmoid curves. Overall, our results indicate rhBMP-2 quantification in vitro can be accomplished by detecting ALP activity and fitting four-parameter log-logistic model. Furthermore, we also provide a highly adaptable R script for any additional logistic models.
Actavis Group PTC EHF v ICOS Corporation
Authors:   Supreme Court
Published: December 2019

Abstract
H1 Patents – European Patents – Pharmaceuticals – Tadalafil – Dosing regimens – Revocation – Obviousness – Obvious to try – Fair expectation of success – Relevant factors – Dose ranging studies – Routine tests – Whether permissible to take into account information not available at priority date – The “patent bargain” – The “problem-and-solution” approach – Role of the appellate court – Appeal to Supreme Court
The development of a noninvasive behavioral test for assessment of goat–human interactions
Authors: Markland M L , Goering M J , Mumm J M , Jones C K , Crane A R , Hulbert L E 
Published: December 2019

Abstract
The objective was to develop a protocol for a noninvasive behavioral test to assess goat–human interactions. Boer goats (n = 45) were housed in groups of 3 at the K-State Sheep and Meat Goat Unit. A 3-min human approach test (HAT) was conducted after their first- and seventh-handling experience (i.e., moved by group through the chute and scale). Video footage was analyzed using specialized software (Observer 11.5 XT, Leesburg, VA, USA). The ethogram included three main categories (mutually exclusive within category): 1) spatial (close, middle, far); 2) orientation (facing vs. turned-away); and 3) structural (lie, stand, and nutritive and nonnutritive oral behaviors). The durations of these behavior outcomes were converted to percent, and then applied to a weighted formula to create an approach index (AI). This index placed behaviors on a 0 to 100% scale (0 = lying in back of the pen; 100 = closest to the human, performing oral behaviors). The Proc Univariate (SAS v.9.3, SAS Inst. Inc., Cary, NC, USA) was used to evaluate descriptive statistics and calculate sample size for future projects from all behavior outcomes. In addition, each goat AI categorized as great approach (GA; ≥75% quartile), moderate approach (MA; 25% to 75% quartiles), or least approach (LA; ≤ 25%) and the 1st vs. 7th handling experience was evaluated using Chi-square (χ 2) analysis. The CV% was low for the AI outcome; therefore, less animals are needed if the AI is used rather than other behavior outcomes used. After the first-handling experience, there were less GA-goats than what was expected from the χ 2 analysis (χ 2 = 17.6; P ≤ 0.01; residual = 0.26; expected = 24.5). After the seventh-handling experience, there were more MA-goats than expected (χ 2 = 17.6; P ≤ 0.01; residual = 1.92; expected = 52.0). Repeated handling appeared to moderately improve goat approach to humans, which indicates that this protocol is a promising behavioral test to assess welfare of goats.
Assessing Swallowing of the Breastfeeding NICU Infant Using Fiberoptic Endoscopic Evaluation of Swallowing
Authors: Armstrong Erika S. , Reynolds Jenny , Sturdivant Chrysty , Carroll Sandra , Suterwala Mustafa S. 
Published: December 2019

Background:
Premature infants may demonstrate feeding difficulties requiring an instrumental swallowing assessment. Fiberoptic endoscopic evaluation of swallowing (FEES) is one assessment that can evaluate bottle feeding and breastfeeding.

Purpose:
This pilot study investigated the safety and feasibility of FEES for neonatal intensive care unit (NICU) infants during breastfeeding.

Methods:
The setting for this prospective, descriptive study was an urban level III NICU that provided care for premature and critically ill infants. Participants were 5 infants recruited from a convenience sample who were at least 37 weeks postmenstrual age, demonstrated feeding difficulties during a bedside feeding and swallowing examination, and were breastfeeding. Each participant received a FEES assessment while breastfeeding (FEES-B). Adverse events and vital signs including prefeeding and postfeeding respiratory rate, heart rate, and oxygen saturation level were recorded to assess safety. Visualization of milk, laryngeal penetration, and tracheal aspiration assessed feasibility.

Results:
Participants had a mean postmenstrual age of 39.8 weeks. No adverse events, including epistaxis or laryngospasm, were reported; there were no instances of autonomic instability; and there were no statistically significant differences between prefeeding and postfeeding respiratory rate, heart rate, or oxygen saturation level. Two infants successfully breastfed during FEES-B. Human milk was observable, and laryngeal penetration was noted with 1 infant.

Implication for Practice:
FEES-B was found to be safe, with limited data supporting feasibility. Infants demonstrated no physiologic instability during FEES-B, and milk was visualized in the pharynx during breastfeeding with 2 infants.

Implication for Research:
Further studies are warranted to assess effectiveness of FEES-B in infants.
Safe Zone for Anterior Retractor Placement in Total Hip Arthroplasty: A Cadaveric Study
Authors: Mathew John K. , Nithyananth Manasseh , Kumar Govindaraju Santhosh 
Published: December 2019

Aim:
Femoral nerve entrapment during placement of anterior retractors for total hip replacement results in considerable morbidity, although it is uncommon. The aim of this study is to describe a safe zone for placement of anterior retractors during total hip arthroplasty by studying anatomy in cadavers.

Materials and Methods:
Ten hips from 6 cadavers were dissected and studied. The clock face anatomy of the acetabulum was used as pins were placed at various clock positions before proceeding with the sectioning of the surrounding muscles. For the left hip 6, 5, 3, 1, and 12’o clock positions and for the right hip 6, 7, 9, 11, and 12’o clock positions were pinned along the anterior acetabular wall. The limbs were dissected axially, beginning from the inferior aspect of the acetabulum and proceeding in a proximal sequence with an interval of 1 cm. The plane of the first section passed through the distal end of the acetabulum and was named plane A. The subsequent proximal planes were named planes B, C, and D, respectively. The distance between the femoral nerve and the anterior acetabular wall was measured.

Results:
The distance from the anterior acetabular rim to the femoral nerve was closest at plane C, measuring 10.76±2.58 mm (which coincides with the 3’o clock position in the left hip and the 9’o clock position in the right hip). The anteroposterior diameter of Iliacus muscle was maximum at plane A, measuring 17.56±3.90 mm (which coincides with the 6’o clock position in both the right and left hips), and mediolateral diameter of iliopsoas was maximum at plane D, measuring 28.50±3.74 mm (which coincides with the 11’o clock position in the right hip and the 1’o clock position in the left hip).

Conclusions:
The femoral nerve is closest to the anterior acetabular rim at plane C (9’o clock position of the right hip/3’o clock position of the left hip). Hence, the Hohmann retractor should not be placed on this plane. Anterior retractors can be safely placed adjacent the acetabular rim at planes A, B, and D.
Effectiveness of a Faculty Mentor Development Program for Scholarship at an Academic Health Center
Authors: Sood Akshay , Qualls Clifford , Tigges Beth , Wilson Bronwyn , Helitzer Deborah 
Published: December 2019

Introduction:Mentors are in short supply at academic health centers (AHCs). The effectiveness of training mentors (without preselection for their research skills) to support faculty mentees in scholarly activities at AHCs is not well known.Methods:The University of New Mexico Health Sciences Center has a two-component program to develop effective mentors for scholarship for faculty mentees. It has an online component supplemented by an optional face-to-face (F2F) component. Study outcomes included changes in self-reported knowledge scores for online users and Mentoring Competency Assessment scores for F2F users.Results:One hundred five mentors, mostly women associate professors, used the online program. Online users demonstrated improvement in self-reported knowledge scores. Thirty-eight users additionally completed the F2F program—63% on a clinician–educator track and none with a National Institutes of Health–funded K-award mentee. The self-reported Mentoring Competency Assessment composite score rose from 4.3 ± 1.0 to 5.5 ± 0.8 (pairedt= 7.37, df = 37,P< .001) for the F2F participants, with similar improvement noted in the clinician–educator subgroup.Discussion:Users of the online and F2F components of the program improved their self-assessed knowledge and mentoring skill, respectively, demonstrating the effectiveness of the program. Such programs may help AHCs enhance the scholarship and the diversity of their scientific and clinician–educator workforce.
Real-World Adherence to Guideline-Recommended Treatment for Small Cell Lung Cancer
Authors: Elegbede Anifat A. , Gibson Amanda J. , Fu Hao , Dean Michelle L. , Ezeife Doreen A. , Lau Harold , Cheung Winson Y. , Bebb Dafydd G. 
Published: December 2019

Objectives:
The authors sought to quantify the treatment patterns and outcomes for limited-stage (LS) and extensive-stage (ES) small cell lung cancer (SCLC) in a real-world setting.

Methods:
A review was conducted using the Glans-Look Research Database of patients with SCLC managed at a tertiary cancer center in Canada from 2010 to 2016. Adherence was defined as the commencement of planned SCLC treatment. Rate of compliance with the Alberta Health Services, American Society of Clinical Oncology, and National Comprehensive Cancer Network SCLC treatment guidelines was evaluated. Outcomes were analyzed using the Kaplan-Meier method and the Cox proportional hazards model.

Results:
A total of 404 patients met our inclusion criteria, 31% were LS. The median age at first treatment receipt was 67 years. LS treatment consisted mostly of chemoradiation (62%). Chemoradiation and surgery±adjuvant predicted better survival (median, 32 and 40 mo, respectively) compared with no treatment. ES treatment consisted mostly of chemotherapy (90%). Chemotherapy and thoracic radiotherapy correlated with longer overall survival (13 vs. 9 mo, respectively) compared with chemotherapy alone. Prophylactic cranial irradiation receipt in LS (50%) and ES (20%) predicted favorable survivals than none (LS: hazard ratio, 0.48; 95% CI, 0.29-0.79; ES: hazard ratio, 0.48; 95% CI, 0.33-0.70). Approximately a quarter of relapsed LS and ES had second-line chemotherapy; improved survival with second line was observed only in ES (P<0.01).

Conclusions:
This study highlights high rates of guideline-recommended first treatment among the real-world LS and ES patients but it also revealed important outcome differences in relapsed LS and ES patients treated with second-line chemotherapy.
Evaluation of Skyshine from an Accelerator Facility: Dependence on Distance and Angle
Authors: Liang Taiee Ted , Liu James C. , Rokni Sayed H. 
Published: December 2019

Abstract
Neutron skyshine from Linac Coherent Light Source II 4 GeV electron beam operation at SLAC National Accelerator Laboratory can contribute to prompt radiation exposure to the public at distances far beyond the accelerator tunnel housing. One of the shielding design requirements at SLAC is that the annual dose to a member of the public is no more than 0.05 mSv y−1. This study uses Monte Carlo code FLUKA to simulate the generation of neutrons from 4 GeV electron beam losses on a thick copper target inside a generalized geometry of the Linac Coherent Light Source II Beam Transport Hall accelerator tunnel section. The effective dose from neutron skyshine was characterized as a function of both distance from the tunnel wall (up to 1 km away) and angle relative to the beam direction (between 0° and 180°). This new methodology for evaluating neutron skyshine dose is applicable to high-energy GeV-range electron accelerator facilities both at SLAC and elsewhere.
Long-Term Outcomes of Descemet Membrane Endothelial Keratoplasty in Postvitrectomized Eyes With the Use of Pars Plana Infusion
Authors: Mednick Zale , Sorkin Nir , Einan-Lifshitz Adi , Santaella Gisella , Trinh Tanya , Chan Clara C. , Rootman David S. 
Published: December 2019

Purpose:
To evaluate the use of pars plana infusion as part of Descemet membrane endothelial keratoplasty (DMEK) in eyes of patients who underwent vitrectomy.

Methods:
A retrospective chart review was conducted of patients at Toronto Western Hospital (Toronto, Canada) who had undergone DMEK with pars plana infusion, with a minimum follow-up of at least 12 months. Collected data included postoperative best-corrected visual acuity (BCVA), intraoperative complications, and postoperative complications such as graft detachment, rejection and failure, and rate of endothelial cell loss.

Results:
Fifteen eyes of 14 patients were included in this study. The mean follow-up time was 23.9 ± 5.7 months. Four grafts required rebubbling within the first month of surgery, and one graft required repeat DMEK right away. Two grafts failed secondarily at 24 months, and there was one episode of graft rejection. Five eyes had retinal complications including retinal detachment, retinoschisis, and cystoid macular edema. BCVA improved significantly from 1.7 ± 0.77 logarthim of the minimum angle of resolution (LogMAR) (mean Snellen 20/1000) preoperatively when compared with postoperative BCVA at 6 months (0.95 ± 0.74 LogMar, mean Snellen 20/180, P = 0.02, n = 10), 12 months (0.93 ± 0.6,P = 0.01, mean Snellen 20/170, n = 11), and 24 months (1.01 ± 0.68, mean Snellen 20/200 P = 0.046, n = 7).

Conclusions:
Although pars plana infusion is a helpful technique for DMEK in vitrectomized eyes, such cases are still quite difficult to perform compared with standard DMEK and use of an infusion may increase the risk of retinal complications. Descemet Stripping Automated Endothelial Keratoplasty may be the preferred technique in these challenging vitrectomized eyes.
Postoperative Symptoms and Quality of Life in Pituitary Macroadenomas Patients
Authors: Jang Min Kyeong , Oh Eui Geum , Lee HyangKyu , Kim Eui Hyun , Kim Sanghee 
Published: December 2019

ABSTRACT

BACKGROUND
Patients with pituitary macroadenoma commonly experience symptoms such as headache, visual disturbance, and olfactory dysfunction due to tumor effects. Even after undergoing surgery for tumor removal, patients continue to experience these symptoms and have difficulty resuming their general activities, decreasing their quality of life (QOL). Although some studies have focused on QOL in pituitary macroadenoma, few studies have examined the relationship between postoperative symptoms and patient QOL in the period after surgery. This study aimed to identify the relationships between postoperative symptoms and QOL among pituitary macroadenoma patients.

METHODS
This study used a descriptive cross-sectional design to identify relationships between postoperative symptoms and QOL in pituitary macroadenoma patients. Medical records of 62 patients with pituitary macroadenomas who had undergone surgery were retrieved and reviewed 3 months after surgery; at that time, all participants completed a self-report survey addressing their current symptoms and QOL. The researchers then evaluated patient QOL and 3 common symptoms—headache, objectively measured visual disturbance, and olfactory dysfunction—using correlation analysis and multiple linear regression.

RESULTS
Three months after surgery, patients still experienced headache and lack of olfactory function. Headache showed a strong negative correlation with physical (r = −0.501, P < .001, R
2 = 36%) and mental (r = −0.448, P < .001, R
2 = 26%) QOL. Headache was a significant factor influencing QOL.

CONCLUSION
Study findings show that continuous assessment and intervention for headache are essential for improving QOL in pituitary macroadenoma patients after surgery. Nurses should prioritize assessment and management of postoperative headache in long-term care for such patients. The study findings support development of a clinical guideline for managing headache in such patients and thus improving their QOL.
Using Esophageal Temperature Management to Treat Severe Heat Stroke: A Case Report
Authors: Martin Katherine Riley , Naiman Melissa , Espinoza Maurice 
Published: December 2019

ABSTRACT

BACKGROUND: Exertional heat stroke (EHS) is defined by a core body temperature that exceeds 40°C with associated central nervous system dysfunction, skeletal muscle injury, and multiple organ damage. The most important initial focus of treatment involves reduction of patient temperature. First approaches to achieve temperature reduction often include ice packs, water blankets, and cold intravenous fluid administration. When these measures fail, more advanced temperature management methods may be deployed but often require surgical expertise. Esophageal temperature management (ETM) has recently emerged as a new temperature management modality in which an esophageal heat transfer device replaces the standard orogastric tube routinely placed after endotracheal intubation and adds a temperature modulation capability. The objective of this case study is to report the first known use of ETM driven by bedside nursing staff in the treatment of EHS. METHOD: An ETM device was placed after endotracheal intubation in a 28-year-old man experiencing EHS over a 5-day course of treatment. RESULTS: Because the ETM device was left in place, when the patient experienced episodes of increasing temperature as high as 39.1°C, which required active cooling, nursing staff were able to immediately adjust the external heat exchange unit settings to achieve aggressive cooling at bedside. CONCLUSION: This nurse-driven technology offers a new means to rapidly deploy cooling to critically ill patients without needing to implement advanced surgical approaches or obstruct access to the patient, freeing the provider to continue optimal care in high-morbidity conditions.