bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dissatisfaction with Nasal Tip Shape: Secondary Tip Maneuvers
Authors: Moyer Jeffrey 
Published: June 2018

AbstractDissatisfaction with the appearance of the nasal tip is a common compliant in patients seeking revision surgery after rhinoplasty. Revision rhinoplasty is more technically difficult and unpredictable given the frequent presence of scar contracture, impaired skin envelope quality, and missing alar cartilage. This article describes some of the more common causes for tip revision surgery and techniques to address these abnormalities.
Outcomes After PCI in Patients with LV Dysfunction
Authors: Ravikiran M , Indrani G. 
Published: June 2018

AbstractBackground: Coronary artery disease (CAD) is the most common cause of left ventricular dysfunction. Percutaneous coronary intervention (PCI) in patient with LV dysfunction is a high risk procedure and may be associated with adverse outcomes. We observed for outcomes after PCI in the elective and acute coronary syndrome setting in patient with LV dysfunction.Methods: A prospective single center study was performed in 836 patients with and without LV dysfunction who underwent PCI with a follow up period of 1 year for MACCE.Results: A total of 836 patients were studied. 329 (39.4%) patients have LV dysfunction (LVD) and 507 (60.6%) patients have good LV function (GLV). Among the patients with LVD, 160 (48.6%) has mild, 89 (27.1%) has moderate, 80 (24.3%) has severe LVD. Mean age was 56.5±12.5 years in patients with GLV and 58.8±10 years in LVD patients (p=0.003). Number of males were 259 (78.7%) in LVD and 364 (71.7%) in GLV group. Hypertension and diabetes were present in 237(72%) vs 368(72.5%), 168 (51%) vs 286 (56.4%) in LVD and GLV groups respectively (p=0.8, 0.1). There was no difference in the previous history of CABG (5.2% vs 3.4%, p=0.2) and PCI (19.5% vs 16.4%, p=0.3) in both groups. 174 (52.9%) patients with LVD and 409 (80.7%) patients with GLV has chronic stable angina. Multivessel PCI was done in 79 (24%) patients with LVD and 110 (21.7%) patients with GLV (p=0.4). Major adverse cardiovascular and cerebrovascular events (MACCE) occurred in 3 patients with mild, 5 patients with moderate, 6 patients with severe LVD during the follow up of 1 year. There was no difference in outcomes between the LVD and GLV group at one year (p=0.2), but when a subgroup analysis was made among patients with LV dysfunction there was a significant occurrence of MACCE in patients with severe LV dysfunction when compared with mild LVD (p=0.05).Conclusion: There was no significant difference between the occurrence of MACCE in patients with LV dysfunction and without LV dysfunction who underwent PCI. But when a subgroup analysis was done there was a significant occurrence of MACCE in patients with severe LV dysfunction (p=0.05) when compared to mild LVD.
Application of Genetic Testing for CYP 450 Polymorphism to Predict Response to Clopidogrel Inpatient Undergoing PCI
Authors: Ram V , Lalita N , Jyotsna Maddury 
Published: June 2018

AbstractIntroduction: The anti-platelet agent clopidogrel is a commonly prescribed medication in patients in patients who are undergoing percutaneous coronary intervention. Response to clopidogrel varies substantially due to genetic and acquired factors. Patients who experience recurrent cardiovascular ischemic or thrombotic events while taking clopidogrel are typically described as non-responsive or resistant. In our study was planned to assess the utility of pharmaco-genetic testing (CYP2C19) for clopidogrel response and application of the data for modification of anti-platelet regimen accordingly. Methods: This is a prospective nonrandomized ethical committee approved study from our institute. We included the post PCI patients presented with chronic stable angina and acute coronary syndrome (who has less bleeding risk score) with good left ventricular function. Along with the demographic and clinical features, we collected the data of platelet aggregation test (light transmission of aggregometry), CYP2C19 genetic analysis test and clinical outcome at the time of discharge, at 15days of discharge and end of 3 months. CYP2C19 genetic analysis is done by method of DNA based clopidogrel resistance genotyping test. We grouped the cases as extensive metabolizers (EM) and intermediate metabolizers (IM) depending on CYP2C19genetic analysis into two groups.Results: A total of 33 patients are included in this study. Among 33 cases, 25(75.7%) cases are male patients and 8(24.2%) cases are female patient, 18 (54.5%) patients are diabetic Mellitus, 20(60.6%) patient are hypertensives, 7(21.2%) cases are smokers and 5 (15.1%) case are alcoholic. We have diagnosed 20(60.6%) cases of unstable angina and 13(39.4%) cases of chronic stable angina. The average Meheran bleeding risk score is 9.8. Age, risk factors are comparable between the the EM and IM group. But presentation of ACS is more in IM (p=0.001).Follow up at 3 months, one died suddenly (probable stent thrombosis) in EM group. No other MACE occurred in both the groups. Multivariate analysis with binary logistic regression showed that only presentation as ACS is statistically significant in IM (p=0.001). Platelet aggregation showed tendency towards statistical significance (p=0.08) in EM patient. With all other parameters including MACE (p=0.3), there is no statistical significance by multivariate analysis.Conclusion: In our small prospective clinical and genetic analysis of clopidogrel metabolizer status has shown that intermediate metabolizer status of the patient is statistically more in unstable angina (p=0.003). There is tendency for statistically significance between the platelet aggregation test (p=0.08) and extensive metabolizer status of the patient. Whatever may be the status of the clopidogrel metabolizing condition, there is no difference in MACE.
Pilot Study of Coronary Artery Calcification by Computerized Tomography as Non-Invasive Predictor of Coronary Artery Disease in Asymptomatic Elderly Diabetics
Authors: Maheshwari Monika 
Published: June 2018

Abstract75-80% mortality in diabetics result from coronary artery disease. Helical computed tomography is a noninvasive technology for evaluating the extent of coronary artery atherosclerosis by detecting coronary artery calcium. In our study, we analyzed the data of CT scans in 25 diabetic and 25 nondiabetic population, who are > 70 years. We found calcium density > 400 HU is more in elderly asymptomatic diabetics (75%) when compared to nondiabetic elderly patients (20%), which is statistically significant (p=0.03). Therefore, screening such high risk population is warranted, so as to take early preventive steps and decrease morbidity and mortality.
Applicability of Appropriate Use Criteria for Myocardial Perfusion Scan in Indian Scenario
Authors: Kenchi Gopi , Kavitha N. , Srivastava Madhur 
Published: June 2018

AbstractBackground: Appropriate usage Criteria (AUC) for nuclear imaging exams were created by American College of Cardiology (ACC) e American Society of Nuclear Cardiology (ASNC) to allow the rational use of tests. Little is known whether these criteria have been followed in clinical practice. Objective: To evaluate whether the medical applications of myocardial perfusion scintigraphy (MPS) in a tertiary cardiology hospital were suitable to the criteria of indications proposed by the American medical societies in 2009.Methods: We included records of patients who undergone MPS, from April 2016 up to August 2016. Demographic characteristics, patient's origin, coronary risk factors, clinical presentation, ECG, 2d echocardiogram, TMT and AUC of medical applications were studied. The criteria were evaluated by two independent cardiologists and, in doubtful cases, defined by a medical expert in MPS.Results: Total no of cases included in the study were 334 patients. Mean age was 62 ± 10 years. Of the 334 records reviewed, 201 (60.17%) studies were performed in men and 133 (39.8%) were performed in women. With ACC 2009, 168 (50.29%) were considered appropriate indications and 166 (49.70%) were considered inappropriate and uncertain indications. The AUC Sensitivity is 78.8, Specificity of 58.7%, Positive Predictive Value of 37.5% and Negative Predictive Value of 89.8%.Conclusions: In 63(18.8%) of patients MPS investigation is used appropriately to detect the CAD according to ACC & ASNC guidelines of 2009.
A Case of Complete Heart Block Due to Intentional Ingestion of Plant Extracts
Authors: Prasad K. , Lavanya K. 
Published: June 2018

AbstractCardiac glycosides are widely available in botanic products and other naturally occurring substances worldwide. Accidental consumption of it leads to digitalis toxicity with varied systemic manifestations. We describe a case of consumption of extract of leaves of the Indian rubber vine plant (Crytostegia grandi flora) which led to gastrointestinal, cardiac, electrolyte, and hematological disturbances.
Clinical and Electroencephalographic Correlates in Pediatric Cardiac Arrest: Experience at a Tertiary Care Center
Authors: Park Jun , Brooks Garrett 
Published: June 2018

AbstractPediatric cardiac arrest is a significant cause of death and neurologic disability; however, there is a paucity of literature specifically evaluating the utility of prognostic factors in the pediatric population. This retrospective chart review examines clinical, laboratory, and electroencephalographic (EEG) data in children following cardiopulmonary arrest to better characterize findings that may inform prognosis. Pre-arrest clinical characteristics, resuscitation details, and post-arrest hospital course variables were analyzed and neurologic outcome was determined using the Pediatric Cerebral Performance Category scale. Forty-one patients were identified who had cardiac arrest from March, 2011 to January, 2015. Duration of cardiopulmonary resuscitation (p = 0.013), out-of-hospital arrest (p = 0.005), arterial pH (0.014), arterial lactate (0.004), lack of pupil reactivity to light (p < 0.001), absent motor response to noxious stimuli (p < 0.001), and absent brainstem reflexes (p < 0.001) were all predictors of poor neurologic outcome. EEG background suppression (p = 0.005) was associated with poor outcome. Nine patients had electrographically recorded seizures, which began up to 1 week following cardiac arrest. Two patients (4.9%) experienced post-anoxic myoclonic status epilepticus and both had a poor outcome.
Evidence and morality in harm-reduction debates: can we use value-neutral arguments to achieve value-driven goals?
Authors: Zampini Giulia Federica 
Published: June 2018

AbstractIt is common to argue that politicians make selective use of evidence to tacitly reinforce their moral positions, but all stakeholders combine facts and values to produce and use research for policy. The drug policy debate has largely been characterised in terms of an opposition between evidence and politics. Focusing on harm reduction provides useful ground to discuss a further opposition proposed by evidence advocates, that between evidence and morality. Can evidence sway individuals from their existing moral positions, so as to “neutralise” morality? And if not, then should evidence advocates change the way in which they frame their arguments? To address these questions, analysis of N = 27 interviews with stakeholders actively involved in drug policy and harm reduction debates in England, UK and New South Wales, Australia, was conducted. Participants’ accounts suggest that although evidence can help focus discussions away from values and principles, exposure to evidence does not necessarily change deeply held views. Whether stakeholders decide to go with the evidence or not seems contingent on whether they embrace a view of evidence as secular faith; a view that is shaped by experience, politics, training, and role. And yet, morality, values, and emotions underpin all stakeholders’ views, motivating their commitment to drug policy and harm reduction. Evidence advocates might thus benefit from devising strategies to morally and emotionally engage audiences. This paper aims to develop better tools for analysing the role of morality in decision-making. Using tools from disciplines such as moral psychology is relevant to the study of the politics of evidence-based policymaking.
Casting methods for the production of rotationally symmetric copper bimetals
Authors: Greß Thomas , Mittler T. , Volk W. 
Published: June 2018

Multiple-material products are characterised by a complex property profile which is achieved by combining the particular advantages of at least two different materials. Bimetal casting is an energy- and material-efficient technology for the production of multi-metallic objects. This paper describes the development of a semi-continuous casting process for the formation of a rotationally symmetric bimetal with a cohesive bonding character at the interface of a copper–tin alloy (CuSn6) and pure copper (Cu99.5). Initial experiments are conducted by static casting to evaluate the thermal process window. Based on the results of the initial experiments, a vertical semi-continuous compound casting process is developed. A stable cohesive bond between the joining partners is accomplished by forming a solid solution at the interface. This paper is part of a Thematic Issue on Copper and its Alloys.
Microsatellite and SNAP markers used for evaluating pollen dispersal on Pati tall coconuts and Xenia effect on the production of ‘Kopyor’ fruits
Authors: Larekeng S H , Purwito A , Mattjik N A , Sudarsono S 
Published: June 2018

Abstract
Kopyor coconut is one of the many unique coconut types existed in Indonesia. To overcome the problem of low kopyor fruit yield, it is necessary to study xenia effect on the fruit yield of this coconut. The combination of kopyor coconut and normal coconut population selected at infarmers’ coconut plantations consisted of 33 normal coconut trees, and 9 kopyor coconut trees. All adult trees surrounding the 9 kopyor heterozygous (Kk) palms were evaluated as potential male candidate parents (pollen donors). All samples genotypes were determined using four SNAP markers and six microsatellite marker loci, parentage analysis using CERVUS software version 2.0. Results of the analysis indicate that xenia effect reduced kopyor fruit yields. Kopyor heterozygous (Kk) female parents produced low number of kopyor fruits when they were surrounded by many normal homozygous (KK) pollen donors. Out of 99 harvested progeny arrays from the kopyor heterozygous (Kk) female parents, none exhibited kopyor phenotype. The results also indicate that the pollen dispersal from normal homozygous (KK) donor palms range from 0 m (self pollination) to 54 m (outcrossing). The occurence of outcrossing frequency was at least 95% and the selfing frequency is 5%.
Improving agricultural commodity supply-chain to promote economic activities in rural area
Authors: Padjung R 
Published: June 2018

Abstract
Long supply chain of agricultural commodities has become concern to governments particularly in large countries such as Indonesia as it causes high price disparity between farm-gate and retailer. Policies to overcome such problem are usually by shortening the chain, by which farmers sell the products directly to retailers. Using an action research in AEDEF (Aceh Economic Development Financing Facilities) Program, conducted in the province of Nangro Aceh Darussalam (NAD) Indonesia, the paper shows that shortening the commodity supply chain is not the best solution to such problem, as it causes loss of jobs in the villages. High price disparity between farm-gate and retailer is not necessary brought about by long supply-chain but by the efficiency of the chain instead. Efficiency of the chain can be improved by creating enabling business environment such that every actors and players work in a fair manner. This can be achieved by transparency in price and quality grade. With development achieved in Information and Communication Technology (ICT), having a good and reliable flow of such information is not difficult. In addition to information flow, the availability and quality of infrastructure to support flow of goods from farm-gate to end-user is of reasonably important.
Clinical applications of retinal gene therapies
Authors: Fu Xin , Huu Viet Anh Nguyen , Duan Yaou , Kermany Daniel S , Valentim Carolina C S , Zhang Runze , Zhu Jie , Zhang Charlotte L , Sun Xiaodong , Zhang Kang 
Published: June 2018

Abstract
Retinal degenerative diseases are a major cause of blindness. Retinal gene therapy is a trail-blazer in the human gene therapy field, leading to the first FDA approved gene therapy product for a human genetic disease. The application of Clustered Regularly Interspaced Short Palindromic Repeat/Cas9 (CRISPR/Cas9)-mediated gene editing technology is transforming the delivery of gene therapy. We review the history, present, and future prospects of retinal gene therapy.
Strategies for Successful Nurse-Student Preceptorships
Authors: Thomas Cynthia M. , Allen Roberta , Edwards Jane 
Published: June 2018

ABSTRACT:
Being a preceptor for a new nurse or a student is a great way to promote the future of nursing. However, most nurses have not been taught how to be an effective preceptor. Eight strategies for effective precepting are presented. Servant leadership is discussed as a theoretical basis for serving as a preceptor.
Basal-Cell Carcinoma With Matrical Differentiation: Report of a New Case in a Renal-Transplant Recipient and Literature Review
Authors: Kanitakis Jean , Ducroux Emilie , Hoelt Pauline , Cahen Rémi , Jullien Denis 
Published: June 2018

Abstract:
Basal-cell carcinoma with matrical differentiation (BCC-MD) is one of the rarest pathologic variants of basal-cell carcinoma, of which 41 cases have been so far reported in detail. One of them developed in a heart-transplant recipient. We report a new case of BCC-MD occurring in a renal-transplant recipient and review the relevant literature. A 75-year-old white man who had received a renal allograft 7 years ago developed a tumor on the left temple clinically suggestive of basal-cell carcinoma. Microscopically, the tumor associated features typical of basal-cell carcinoma (basaloid lobules with peripheral palisading and clefting) and pilomatricoma (presence of shadow/ghost cells). The 2 tumor components expressed variably beta-catenin, HEA/Ber-EP4, CD10, PHLDA-1, MIB-1/Ki67, calretinin, and bcl-2. BCC-MD has no distinctive clinical features. It affects predominantly male patients with a mean age of 69 years. More than half of cases appear on the head/neck area. Some cases harbor CTNNB1 mutations. Differential diagnosis includes tumors with matrical differentiation, namely pilomatrix carcinoma. The outcome is usually favorable after surgical excision, although regional lymph node metastases developed in 2 patients.
Case Report of Myeloid Sarcoma Masquerading as In-Transit Metastasis at a Previous Melanoma Site: Avoiding a Diagnostic Pitfall
Authors: Curry Jonathan L. , Tetzlaff Michael T. , Wang Sa A. , Landon Gene , Alouch Nail , Patel Sapna P. , Nagarajan Priyadharsini , Gupta Shiva , Aung Phyu P. , Devine Catherine E. , Khoury Joseph D. , Loghavi Sanam , Prieto Victor G. , DiNardo Courtney D. , Gershenwald Jeffrey E. 
Published: June 2018

Abstract:
Myeloid sarcoma is a rare extramedullary hematologic malignancy. Accurate and timely diagnosis may be challenging because myeloid sarcoma is known to mimic solid tumors, including hepatobiliary, nasopharyngeal, and breast carcinomas. We report a case of myeloid sarcoma that developed in the primary tumor lymphatic drainage field of a previously treated intermediate-thickness cutaneous melanoma, clinically and radiographically mimicking an in-transit metastasis, in a patient with myelodysplastic syndrome. The diagnosis of myeloid sarcoma was achieved after surgical excision of the mass and pathological examination that included extensive immunohistochemical studies. Awareness of such an unusual clinical presentation can help reduce diagnostic delay and ensure that adequate tissue is obtained for pathological examination and ancillary studies that are critical for accurate diagnosis and appropriate patient management.
Predictors of Discharge Destination From Acute Care in Patients With Traumatic Brain Injury: A Systematic Review
Authors: Zarshenas Sareh , Colantonio Angela , Alavinia Seyed Mohammad , Jaglal Susan , Tam Laetitia , Cullen Nora 
Published: June 2018

Objective:
To systematically review studies on clinical and nonclinical predictors of discharge destination from acute care in patients with traumatic brain injury.

Methods:
The search was conducted using 7 databases up to December 2016. A systematic review and in-depth quality synthesis were conducted on eligible articles that met the inclusion criteria.

Results:
The search yielded 8503 articles of which 18 studies met the inclusion criteria. This study demonstrated that a larger proportion of patients with traumatic brain injury were discharged home. The main predictors of discharge to a setting with rehabilitation services versus home included increasing age, white and non-Hispanic race/ethnicity, having insurance coverage, greater severity of the injury, and longer acute care length of stay. Age was the only consistent factor that was negatively associated with discharge to inpatient rehabilitation facilities versus other institutions.

Conclusion:
Results of this study support healthcare providers in providing consultation to patients about the expected next level of cares while considering barriers that may helpful in effective discharge planning, decreasing length of stay and saving resources. These findings also suggest the need for further studies with a stronger methodology on the contribution of patients and families/caregivers to distinguish the predictors of discharge to dedicated rehabilitation facilities.
Reduced Resting and Increased Elevation of Heart Rate Variability With Cognitive Task Performance in Concussed Athletes
Authors: Huang Mu , Frantz Justin , Moralez Gilbert , Sabo Tonia , Davis Peter F. , Davis Scott L. , Bell Kathleen R. , Purkayastha Sushmita 
Published: June 2018

Objective:
To examine heart rate variability (HRV) at rest and with a 2-Back cognitive task involving executive function and sustained attention in athletes during the acute phase following concussion and compare them with the controls.

Participants:
Twenty-three male and female collegiate athletes (20 ± 1 years) following (4 ± 1 days) a sports-related concussion and 23 sports- and sex-matched noninjured controls.

Procedure:
Continuous R-R interval was acquired using 3-lead electrocardiogram for 3 minutes each at rest and during the 2-Back task. HRV was quantified as percent high-frequency (HF) power.

Results:
At rest, lower percent HF power was observed in the concussed athletes (23 ± 11) compared with the controls (38 ± 14; P = .0027). However, with the 2-Back task, an increase in HF power was observed in the concussed group (39 ± 12; P = .0008) from rest and was comparable with the controls (36 ± 15). No difference in HF power between rest and 2-Back task was observed in the controls.

Conclusion:
Lower HRV was observed at rest following concussion. An increase in HRV, suggestive of enhanced prefrontal cortex (PFC) functioning, was observed during a cognitive task in the concussed athletes. Therefore, cognitive tasks as early as 4 days after injury may increase PFC functioning from rest and expedite return to learn in collegiate athletes.