bluuebunny/crossref_metadata_2025_split huggingface dataset:
Virtual non-contrast for evaluation of liver parenchyma and vessels: results from 25 patients using multi-phase spectral-detector CT
Authors: Laukamp Kai Roman , Ho Vivian , Obmann Verena Carola , Herrmann Karin , Gupta Amit , Borggrefe Jan , Lennartz Simon , Große Hokamp Nils , Ramaiya Nikhil 
Published: December 2019

Background In abdominal imaging, contrast-enhanced computed tomography (CT) examinations are most commonly applied; however, unenhanced examinations are still needed for several clinical questions but require additional scanning and radiation exposure. Purpose To evaluate accuracy of virtual non-contrast (VNC) from arterial and venous phase spectral-detector CT (SDCT) scans compared to true-unenhanced (TNC) images for the evaluation of liver parenchyma and vessels. Material and Methods A total of 25 patients undergoing triphasic SDCT examinations were included. VNC was reconstructed from arterial and venous phases and compared to TNC images. Quantitative image analysis was performed by region of interest (ROI)-based assessment of mean and SD of attenuation (HU) in each liver segment, spleen, portal vein, common hepatic artery, and abdominal aorta. Subjectively, iodine subtraction and diagnostic assessment were rated on 5-point Likert scales. Results Attenuation and image noise measured in the liver from VNC were not significantly different from TNC (TNC: 54.6 ± 10.8 HU, VNC arterial phase: 55.7 ± 10.8 HU; VNC venous phase: 58.3 ± 10.0 HU; P > 0.05). VNC also showed accurate results regarding attenuation and image noise for spleen, portal vein, and abdominal aorta. Only iodine subtraction in the common hepatic artery in the arterial phase was insufficient which was confirmed by the subjective reading. Apart from that, subjective reading showed accurate iodine subtraction and comparable diagnostic assessment. Conclusion VNC from the arterial and venous phases were very similar to TNC yielding mostly negligible differences in attenuation, image noise, and diagnostic utility. Inadequate iodine subtraction occurred in hepatic arteries in the arterial phase.
Functional characteristics of autophagy in pancreatic cancer induced by glutamate metabolism in pancreatic stellate cells
Authors: Wang Lei , Bi RongRong , Li Lei , Zhou Kun , Liu HaiLin 
Published: December 2019

Objective To observe the effects of glutaminase (GLS) inhibitors on autophagy and proliferation of pancreatic stellate cells, and to explore their functions in pancreatic cancer. Methods Pancreatic cancer cells were divided into two groups. Group A was the control untreated group, and group B cells were treated with GLS inhibitors. Western blotting was used to detect the expression of Atg5, Bcl-2, Bax, and Bid proteins. The bromodeoxyuridine assay and scratch test were employed to investigate cell proliferation and invasion, respectively. The expression of E-cadherin, vimentin, cell adhesion molecule 2 (CADM2), and Snail protein was investigated by immunofluorescence. Results The expression of Atg5, Bax, and Bid was higher in group A than in group B, while Bcl-2 expression was lower in group A than in group B. Group A cells demonstrated greater proliferation and invasion than group B cells. The expression of E-cadherin was lower in group A cells than group B cells, while vimentin, CADM2, and Snail were expressed at higher levels in group A than group B cells. Conclusion The inhibition of glutamine isozymes reduces autophagy and apoptosis in astrocytes, and inhibits pancreatic cancer cell proliferation and metastasis, while reducing their invasiveness.
Assessment of extravasation on ruptured uterine artery pseudoaneurysm using contrast-enhanced ultrasonography during uterine balloon tamponade
Authors: Takeda Jun , Makino Shintaro , Hirai Chihiro , Shimanuki Yota , Inagaki Tetsunori , Itakura Atsuo , Takeda Satoru 
Published: December 2019

Objective Contrast-enhanced ultrasonography (CEU) has been used in critical trauma situations to visualize extravasation; however, its use is limited in the field of obstetrics. Cases of ruptured uterine artery pseudoaneurysm (UAP) were analyzed to clarify the efficacy to CEU during uterine balloon tamponade. Methods Cases of ruptured UAP diagnosed at a teaching university hospital from January 2015 to December 2017 were retrospectively analyzed. UAP was diagnosed using color Doppler ultrasonography. Extravasation was identified using computed tomography and double checked using CEU with an intravenously administered contrast agent (Sonazoid; Daiichi Sankyo Company, Ltd., Tokyo, Japan) and an ultrasound instrument (HI VISION Preirus; Hitachi Aloka Medical, Ltd., Tokyo, Japan). A balloon was then inserted into the uterine cavity and inflated at the point of bleeding until extravasation ceased. Results Three patients exhibited ruptured UAP during the study period. Bleeding points were successfully identified using CEU in all cases, and hemostasis was achieved using uterine balloon tamponade. Obliteration of UAP was confirmed using magnetic resonance imaging, and no patients developed recurrent UAP or any complications. Conclusion CEU can be used at the bedside to promptly diagnose ruptured UAP. Moreover, it precisely facilitates balloon compression at the point of bleeding.
Maternal Prenatal Anxiety and Children’s Externalizing and Internalizing Behavioral Problems: The Moderating Roles of Maternal-Child Attachment Security and Child Sex
Authors: Ali Elena , Letourneau Nicole , Benzies Karen , Ntanda Henry , Dewey Deborah , Campbell Tavis , Giesbrecht Gerry 
Published: December 2019

Background Prenatal anxiety is associated with child behavioral problems. Prenatal anxiety is predictive of postnatal anxiety which can interfere with the security of maternal-child attachment and further raise the risk of child behavior problems. Secure maternal-child attachment is essential for optimal emotional health. Sex influences the type of behavior problem experienced. There is a gap in understanding whether attachment security and the sex of the child can moderate association between prenatal anxiety and children’s behavioral problems. Purpose To examine the association between prenatal anxiety and child behavioral problems and to test the moderating effects of attachment security and child sex on the association between prenatal anxiety and child behavioral problems. Methods Secondary analysis of data from 182 mothers and their children, enrolled in the Alberta Pregnancy Outcomes and Nutrition Study using Hayes' (2013) conditional process modeling. Results Prenatal anxiety was associated with both externalizing ( b = −0.53; standard error ( SE) = 0.20; p = 0.009) and internalizing ( b = −0.32; SE = 0.13; p = 0.01) behaviors only in children with an insecure style of attachment. Child sex did not moderate the association between prenatal anxiety and children's behavioral problems. Conclusions Attachment security moderated the association between prenatal anxiety and children’s externalizing and internalizing behavioral problems.
Physical Activity Support Predicts Safety-Net Patients’ Digital Health-Care Engagement: Implications for Patient Care Delivery
Authors: Laing Sharon S. , Sterling Ryan , Ocampo Carlota 
Published: December 2019

Purpose: Assess relationship among health services received and patients’ digital health-care engagement. Design: Quantitative cross-sectional survey study. Setting: Community health centers in Washington state and DC. Sample: N = 164 adult safety-net patients. Intervention: Not applicable Measures: Outcomes were knowledge and use of health apps. Predictors were health service access (access to specialists and health information); health service delivery (healthy eating and physical activity counsel); health service satisfaction; and perceived service value. Analysis: Descriptive and multivariate regression analyses. Odds ratios (OR) reported for 95% confidence interval (CI). Results: Response rate was 35%. Of all, 71% were knowledgeable of smartphone use for wellness and 48% used health apps. Physical activity (PA) counseling predicted knowledge and health apps use. Respondents receiving PA counseling were 2.61 times more likely to be knowledgeable about using smartphones for health promotion (OR = 2.61; P = .047; 95% CI: 1.01-6.73). Respondents receiving PA counseling were 2.89 times more likely to use health apps (OR = 2.89; P = .022; 95% CI: 1.17-7.17). Health information access predicted health apps use; respondents with easy access to general health information were 0.29 times as likely to use health apps (OR = 0.29; P = .043; 95% CI: 0.09-0.96). Conclusion: Targeted preventive care support encourages digital health-care engagement. mHealth may supplement health-care needs outside clinics.
Combined but not single treatment with ethinylestradiol/levonorgestrel and spironolactone reduces plasminogen activator inhibitor-1 in insulin-resistant ovariectomised rats
Authors: Aremu Adeyanju Oluwaseun , Lilian Dibia Chinaza , Olufemi Soladoye Ayodele , Aderemi Olatunji Lawrence 
Published: December 2019

Objective: Increased circulating level of plasminogen activator inhibitor-1 (PAI-1) is associated with menopausal oestrogen deficiency. We therefore hypothesised that the combined oral contraceptive (COC) with spironolactone (SPL) improves insulin resistance (IR) in ovariectomised (OVX) rats by reducing circulating PAI-1. Methods: Twelve-week-old female Wistar rats were divided into sham-operated (SHM), OVX, OVX+SPL (0.25 mg/kg), COC (1.0 µg ethinylestradiol and 5.0 µg levonorgestrel) and OVX+COC+SPL rats treated with COC and SPL daily for eight weeks. IR was assessed by homeostatic model assessment of IR (HOMA-IR). Results: Data showed that OVX rats had a higher HOMA-IR value that is associated with increased visceral adiposity, triglycerides (TG), total cholesterol/high-density lipoprotein cholesterol (HDL-C), TG/HDL-C, plasma insulin, GSK-3, corticosterone and decreased 17β-oestradiol. However, these effects were attenuated in OVX+COC, OVX+SPL and OVX+COC+SPL rats compared to OVX rats. OVX rats had lower PAI-1 than SHM rats, whereas the beneficial effect on IR and other parameters by COC or SPL was accompanied with increased PAI-1. Improvement of IR and other parameters with combined COC and SPL in OVX rats was accompanied with reduced PAI-1. Conclusion: Taken together, COC or SPL improves IR independent of PAI-1, whereas a combination of COC and SPL in OVX rats ameliorates IR in a PAI-1-dependent manner.
Sufferings in silence: Violence against female workers in the ready-made garment industry in Bangladesh: A qualitative exploration
Authors: Akhter Sadika , Rutherford Shannon , Chu Cordia 
Published: December 2019

Introduction: Despite the improved safety of the ready-made garment industry in Bangladesh since 2013, other workplace health and safety issues in the ready-made garment industry continue, especially violence towards female workers. This article examines this violence as well as the social norms and attitudes of key stakeholders underpinning it. Methods: Data were collected in four ready-made garment factories in Bangladesh through in-depth interviews, focus group discussions with female workers and key-informant interviews with different stakeholders, along with factory observations. Results: Findings were analysed thematically. Female workers described personal experience of violence in the workplace: physical and verbal abuse, constant pressure, other personal restrictions and withholding of pay. They did not make complaints for fear of losing their jobs. Supervisors characterized the women as ‘disobedient,’ ‘uncooperative’ and ‘unwilling’ to work and viewed their behaviour as acceptable. Other stakeholders ignored these problems. Conclusion: Finally, this study suggests how the findings encourage action to prevent violence in the workplace in order to address the emerging occupational health problems in Bangladesh.
Locating and Preserving the Sphenopalatine Ganglion in Endoscopic Endonasal Pterygopalatine Fossa Surgery: An Anatomical Study
Authors: Spielman Daniel B. , Kim Matthew , Overdevest Jonathan , Gudis David A. 
Published: December 2019

Background The pterygopalatine fossa (PPF) contains numerous important neurovascular structures; notably, the sphenopalatine ganglion (SPG), the maxillary branch of the trigeminal nerve (V2), and the internal maxillary artery. With the advent of extended endoscopic endonasal surgery, the surgical anatomy of the PPF warrants increased investigation. Intraoperative dissection and preservation of the SPG is essential to prevent postoperative xeropthalmia and facial hypoesthesia. Objective This study aims to (1) describe a novel dissection technique for identifying the SPG and (2) define the SPG location relative to the sphenopalatine foramen (SPF), which is a consistently identifiable landmark. Methods Eight cadaveric PPFs were dissected in step-wise fashion. An endoscopic medial maxillectomy was performed, the SPF was identified, and the posterior maxillary wall was resected. The maxillary branch of the trigeminal nerve (V2) was identified anterolaterally in its infraorbital canal and traced medially to identify the pterygopalatine nerve to the SPG. The lateral distance and superior/inferior distance from the SPG to the fixed SPF was measured. Results The surgical technique described allowed for reliable identification of the SPG. The SPG was located on average 4.5 ± 1.1 mm lateral and 1 ± 1.4 mm inferior to the SPF. Conclusion Identification and preservation of the SPG is necessary to prevent complications in endoscopic endonasal PPF surgery. The SPG can be reliably located near the SPF by following the pterygopalatine nerve branch of V2.
First steps towards combining faecal immunochemical testing with the gut microbiome in colorectal cancer screening
Authors: Grobbee Esmée J , Lam Suk Yee , Fuhler Gwenny M , Blakaj Blerdi , Konstantinov Sergey R , Bruno Marco J , Peppelenbosch Maikel P , Kuipers Ernst J , Spaander Manon CW 
Published: December 2019

ObjectivesMany countries use faecal immunochemical testing (FIT) to screen for colorectal cancer. There is increasing evidence that faecal microbiota play a crucial role in colorectal cancer carcinogenesis. We assessed the possibility of measuring faecal microbial features in FIT as potential future biomarkers in colorectal cancer screening.MethodsBacterial stability over time and the possibility of bacterial contamination were evaluated using quantitative polymerase chain reaction analysis. Positive FIT samples (n  = 200) of an average‐risk screening cohort were subsequently analysed for universal 16S, and bacteria. Escherichia coli (E. coli), Fusobacterium nucleatum (F. nucleatum), Bacteroidetes and Faecalibacterium prausnitzii (F. prausnitzii) by qPCR. The results were compared with colonoscopy findings.ResultsFaecal microbiota in FIT were stably measured up to six days for E. coli (p  = 0.53), F. nucleatum (p  = 0.30), Bacteroidetes (p = 0.05) and F. prausnitzii (p  = 0.62). Overall presence of bacterial contamination in FIT controls was low. Total bacterial load (i.e. 16S) was significantly higher in patients with colorectal cancer and high‐grade dysplasia (p  = 0.006). For the individual bacteria tested, no association was found with colonic lesions.ConclusionsThese results show that the faecal microbial content can be measured in FIT samples and remains stable for six days. Total bacterial load was higher in colorectal cancer and high‐grade dysplasia. These results pave the way for further research to determine the potential role of microbiota assessment in FIT screening.
Imaging of penetrating thoracic trauma in a large Nordic trauma center
Authors: Nummela Mari T , Thorisdottir Sigurveig , Oladottir Gudrun L , Koskinen Seppo K 
Published: December 2019

Background Penetrating trauma is rarely encountered in Nordic trauma centers, yet the incidence is increasing. Typical imaging findings in penetrating trauma should thus be familiar to all radiologists. Purpose To evaluate incidence and imaging findings of penetrating chest trauma, gunshot wound (GSW) and stab wound (SW) injury spectrum, imaging protocols, and outcome in a large trauma center. Material and Methods Trauma registry data from 2013–2016 was retrieved, and imaging accessed through hospital PACS. Retrieved variables included age, gender, injury severity scores, mechanism of injury, time to CT, and 30-day mortality. Depth of thoracic, pulmonary, abdominal and skeletal injury, active bleeding, and use of chest tubes were evaluated. Results Of 636 patients with penetrating injuries, 443 (69.7%) underwent imaging. Of these, 161 (36.3%) had penetrating thoracic injuries. Of 161 patients with penetrating chest trauma in imaging, 151 (93.8%) were men (mean age = 34.9 years) and 10 (6.2%) were women (mean age = 40.7 years). The majority of patients had SWs (138 SW vs. 15 GSW). Patients with GSWs were more severely injured (mean ISS 17.00 vs. 8.84 [ P=0.0014] and ISS≥16 in 53.3% vs. 16.7%) than SW patients. In CT, intrathoracic injuries were found in 49.4% (77/156) and active bleeding in 26.3% (41/156). Emergency surgery was performed in 6.2% (10/161) with postoperative CT imaging. Thirty-day mortality rate was 1.2% (2/161). Conclusion Penetrating thoracic trauma often violates intrathoracic structures and nearby compartments. Arterial phase whole-body CT is recommended as multiple injuries and active bleeding are common. CT after emergency surgery is warranted, especially to assess injuries outside the surgical field.
Epidemiology, Injury Patterns, and Treatment of Meniscal Tears in Pediatric Patients: A 16-Year Experience of a Single Center
Authors: Jackson Taylor , Fabricant Peter D. , Beck Nicholas , Storey Eileen , Patel Neeraj M. , Ganley Theodore J. 
Published: December 2019

Background: Meniscal injuries in children continue to increase, which may be attributable to increasing levels of athletic participation and may be associated with additional injuries or need for additional surgeries. Purpose: To better understand the patterns of pediatric meniscal injuries by analyzing tear location, morphologic features, and associated injury patterns over a 16-year period. Study Design: Case series; Level of evidence, 4. Methods: Pediatric patients were identified and were included in the study if age at the time of initial surgery for meniscal tear was between 5 and 14 years for female patients and 5 and 16 years for male patients. Patients were observed until age 18, and any subsequent surgeries were noted. Demographic factors, tear type and location, associated injuries, and treatment type were analyzed. Results: Mean patient age at surgery was 13.3 years, and 37% of patients were female. A total of 1040 arthroscopic meniscal surgeries in 880 pediatric patients were evaluated. There were 160 reoperations in 138 patients, representing a reoperation rate of 15%. These included 98 reoperations on the ipsilateral knee in 88 patients and 62 operations for injuries to the contralateral knee in 50 patients; 53% of surgeries were meniscal repair, as opposed to partial meniscectomy, and the most common technique was an all-inside repair (91%). Significant differences were identified between male and female patients. Male patients were more likely to have lateral meniscus (74% vs 65%), posterior horn (71% vs 60%), peripheral (45% vs 30%), and vertical tears (31% vs 21%); concomitant ACL injury (50% vs 40%); and an associated osteochondritis dissecans lesion (7% vs 4%). Female patients were more likely to have medial meniscus (24% vs 17%), anterior horn (25% vs 15%), and degenerative tears (34% vs 26%); discoid meniscus (33% vs 24%); and isolated meniscal tears (47% vs 33%). Conclusion: This evaluation of a large series of patients has helped characterize injury patterns associated with pediatric meniscal surgeries. Most meniscal tears were repaired (53%) and were associated with additional injuries (62%), especially anterior cruciate ligament injuries (48%). More than 25% of patients had a discoid meniscus. Injury patterns differed significantly between male and female patients.
DACA and the Supreme Court: How We Got to This Point, a Statistical Profile of Who Is Affected, and What the Future May Hold for DACA Beneficiaries
Authors: Alulema Daniela 
Published: December 2019

Executive Summary In June 2012, the Obama administration announced the establishment of the Deferred Action for Childhood Arrivals (DACA) program, which sought to provide work authorization and a temporary reprieve from deportation to eligible undocumented young immigrants who had arrived in the United States as minors. Hundreds of thousands of youth applied for the program, which required providing extensive evidence of identity, age, residence, education, and good moral character. The program allowed its recipients to pursue higher education, to access more and better job opportunities, and to deepen their social ties in the United States. This article provides a statistical portrait of DACA recipients based on administrative data from US Citizenship and Immigration Services (USCIS) and estimates drawn from the 2017 American Community Survey (ACS) Census data. It finds the following: As of September 30, 2019, there were 652,880 active DACA recipients. Sixty-six percent of recipients are between the ages of 21 and 30. The top five countries of birth for DACA recipients are Mexico (80 percent), El Salvador (4 percent), Guatemala (3 percent), Honduras (2 percent), and Peru (1 percent). DACA recipients reside in all 50 states and Washington, DC, and in US territories including Puerto Rico, Guam, and the Virgin Islands. The top five states with the highest number of DACA recipients are California (29 percent), Texas (17 percent), Illinois (5 percent), New York (4 percent), and Florida (4 percent). Eighty-one percent of DACA recipients has lived in the United States for more than 15 years. Six percent is married to US citizens, 4 percent to lawful permanent residents (LPRs), and 13 percent to undocumented immigrants. Among US-born children younger than 18 years, 346,455 have at least one DACA parent. Fifty-five percent of DACA recipients graduated from high school, 36 percent has some college education, and 7 percent a bachelor’s degree or higher. Ninety-five percent is employed. The Trump administration rescinded the DACA program in September 2017, leaving recipients and their families in a legal limbo. Federal litigation led to a nationwide preliminary injunction and DACA’s partial reinstatement for existing recipients. At this writing, the case is before the US Supreme Court, which will determine the program’s fate. Beyond its statistical portrait, the article provides testimonies from DACA recipients who recount how the program improved their lives and their concerns over its possible termination. It also provides recommendations for Congress, local and state governments, and immigration advocates. In particular, it recommends passage of legislation that would create a path to citizenship for DACA recipients and programs and policies to support and empower young immigrants.