bluuebunny/crossref_metadata_2025_split huggingface dataset:
Numerical modeling of the geothermal hydrology of the Volcanic Island of Basse-Terre, Guadeloupe
Authors: Raguenel Margaux , Driesner Thomas , Bonneau François 
Published: September 2019

Abstract
This study investigates the thermo-hydraulic implications of three geologic scenarios for characterizing the geothermal hydrology of Basse-Terre Island, Guadeloupe. Despite newly acquired magnetotelluric, petrophysical, and geologic data, flow patterns and heat sources have remained elusive. Our simulations were performed in 2D, on a cross section going from La Soufrière volcano in the south to the operating Bouillante geothermal field near the west coast. Simulation results are compared to geologic constraints such as the temperature profile measured at Bouillante and the timing of volcanic activity in the area, which may be indicative of new heat sources at depth. The simulations indicate that during lateral flow from La Soufrière, geothermal fluids would cool too much to explain the temperature at Bouillante. Two other scenarios were found to explain the current thermal structure of the Bouillante geothermal system: a young (ca. 5000 years) and more local magmatic intrusion at depth, or vertical corridors of enhanced permeability that tap hot and porous formations at a few km depth. Without further geologic evidence, neither of these two scenarios can be preferred. The second magma chamber scenario would indicate a more complex magmatic history of the island than previously established. The study shows that geologically constrained scenarios of regional geothermal hydrology can be meaningfully tested with current numerical simulation techniques, providing further insights for geothermal exploration.
Using scaffold innovation-thinking frameworks to integrate food science and technology into the transdisciplinary engineering design classroom
Authors: Bosman Lisa , Eom Sangjun 
Published: September 2019

Abstract
Technology and innovation are essential for students to not only learn and understand the technical skills, but also identify a problem, discover a solution, and communicate the value proposition. In this study, innovation-thinking frameworks were integrated into undergraduate transdisciplinary engineering and technology classrooms with a topic of food science and technology, exploring design within the area of new product development. The qualitative analysis, conducted using NVivo, indicated that the food science and technology focused educational experiences had the potential of transforming student self-reported perspectives related to metacognitive reflection, connecting the topics to the real-world and communicating. The findings offer exciting insights into the benefit of integrating self-regulated learning, visualization, and communication technology into future food-related education programs.
Atypical RAS Mutations in Metastatic Colorectal Cancer
Authors: Pietrantonio Filippo , Yaeger Rona , Schrock Alexa B. , Randon Giovanni , Romero-Cordoba Sandra , Rossini Daniele , Fucà Giovanni , Ross Jeffrey S. , Kotani Daisuke , Madison Russell , Kim Seung Tae , Salvatore Lisa , Raimondi Alessandra , Pagani Filippo , Borelli Beatrice , Perrone Federica , Di Bartolomeo Maria , Miller Vincent A. , Ali Siraj M. , Lee Jeeyun , Yoshino Takayuki , de Braud Filippo , Falcone Alfredo , Hechtman Jaclyn F. , Cremolini Chiara 
Published: September 2019

PURPOSE To describe the clinical and molecular features of metastatic colorectal cancers (mCRCs) bearing uncommon atypical RAS (At- RAS) mutations at codons other than 12, 13, 59, 61, 117, and 146. MATERIALS AND METHODS By exploiting five next-generation sequencing sources (Italian collaboration, Memorial Sloan Kettering Cancer Center, Samsung Medical Center, the Biomarker Research for Anti-EGFR Monoclonal Antibodies by Comprehensive Cancer Genomics (BREAC) study, and the Foundation Medicine database), we retrieved 175 At- RAS mutated cases. Molecular data were obtained from 163 samples from Memorial Sloan Kettering Cancer Center and the Foundation Medicine database. Clinical data were available for 27 At- RAS–positive and 467 negative cases from the Italian collaboration, Memorial Sloan Kettering Cancer Center, Samsung Medical Center, and the BREAC study. RESULTS At- RAS mutations were identified in 163 (0.9%) of 18,270 mCRCs. Among 133 with evaluable microsatellite instability status, 11 (8%) were microsatellite instability high. POLE exonuclease domain mutations had higher frequency (7%) than expected and were found only in microsatellite-stable tumors with high tumor mutational burden (TMB). Overall, 17% (28 of 163) of At- RAS cases had TMB greater than 20 mutations/Mb. Co-occurring typical RAS/BRAF V600E mutations and NF1 mutations, presumed to cause RAS activation, were found in 30% and 12% of samples, respectively (up to 43% and 50%, respectively, in TMB-high samples). Patients with RAS/BRAF wild-type mCRC achieved a median overall survival (OS) of 42.1 months, whereas those harboring isolated At- RAS, typical RAS, or BRAF V600E mutations showed a median OS of 32.3, 30.0, and 17.9 months, respectively ( P < .001). No significant OS difference ( P = .240) was found between patients with At- RAS versus typical RAS-mutated mCRC. Only one of six patients evaluable for primary resistance to anti–epidermal growth factor receptors achieved tumor response. CONCLUSION At- RAS mutations may be a marker for RAS pathway activation and can be associated with high co-occurrence of POLE exonuclease domain mutations.
Pediatric Parathyroid Carcinoma: A Case Report and Review of the Literature
Authors: Dutta Aditya , Pal Rimesh , Jain Nimisha , Dutta Pinaki , Rai Ashutosh , Bhansali Anil , Behera Arunanshu , Saikia Uma Nahar , Vishwajeet Vikarn , Collier David , Boon Hannah , Korbonits Márta , Bhadada Sanjay Kumar 
Published: September 2019

Abstract
Primary hyperparathyroidism (PHPT) is a rare endocrine disease in the pediatric population. Sporadic parathyroid adenomas remain the most common cause of pediatric PHPT. Parathyroid carcinoma (PC) is an extremely rare cause of pediatric PHPT. We report a 16-year-old boy presenting with a nonhealing fragility fracture of the right leg along with florid features of rickets. Examination revealed a neck mass, mimicking a goiter. Biochemical findings were consistent with PHPT. Imaging was suggestive of a right inferior parathyroid mass infiltrating the right lobe of thyroid. The patient underwent en bloc surgical excision of the parathyroid mass along with the right lobe of thyroid. Histopathology was suggestive of a PC. He achieved biochemical remission with normalization of serum calcium and parathyroid hormone levels. At follow-up, there was no biochemical or imaging evidence of recurrence or metastasis. Genetic analysis revealed heterozygous germline deletion of CDC73. An extensive literature search on PC was conducted, with an emphasis on the pediatric population. Thirteen cases of pediatric PC were identified. The median age of presentation was 13 years; there was no sex predilection. All cases were symptomatic; 31% had a visible neck mass. The median serum calcium and intact parathyroid hormone levels were 14.3 mg/dL and 2000 pg/mL, respectively. All patients underwent surgical excision, with 27% showing metastatic relapse. Our findings indicate that the preoperative features that could point toward a diagnosis of PC in a child with PHPT are a tumor size of >3 cm, thyroid infiltration on imaging, and severe hypercalcemia at presentation.
Efficacy and Safety of Once-Weekly Thyroxine for Thyroxine-Resistant Hypothyroidism
Authors: Jayakumari Chellama , Nair Abilash , Puthiyaveettil Khadar Jabbar , Das Darvin V , Prasad Nandini , Jessy S J , Gopi Anjana , Guruprasad Padmanabhan 
Published: September 2019

Abstract

Context
Noncompliance with thyroxine therapy is the most common cause of poor control of hypothyroidism. An open-label prospective study to compare once-weekly thyroxine (OWT) with standard daily thyroxine (SDT) was undertaken.

Design
Patients taking thyroxine doses of >3 μg/kg/d, with or without normalization of TSH, were included and administered directly observed OWT or nonobserved SDT according to patient preference based on their weight for 6 weeks. Furthermore, patients on OWT were advised to continue the same at home without supervision.

Results
Twenty six of 34 patients on OWT and 7 of 18 patients on SDT achieved a TSH <10 μIU/mL (P < 0.05), and 2 patients from the SDT arm were lost to follow-up. During home treatment, 15 of 25 at 12 weeks and 19 of 23 contactable patients at a median follow-up of 25 months maintained TSH below target. Thyroxine absorption test was unable to predict normalization of TSH at 6 weeks of OWT therapy. No adverse events were seen with OWT-treated patients over the 12-week follow-up period. OWT has significantly higher efficacy (OR = 5.1) than SDT for patients with thyroxine-resistant hypothyroidism and is not associated with side effects.

Conclusion
OWT benefits a majority of patients in the long-term treatment of thyroxine-resistant hypothyroidism, in the real-world setting.
Referrals for Elevated Thyroid Stimulating Hormone to Pediatric Endocrinologists
Authors: Gammons Sarah , Presley Brent K , White Perrin C 
Published: September 2019

AbstractObjectiveWe aimed to determine the reproducibility of TSH testing in pediatric patients referred to pediatric endocrinologists and to identify the threshold TSH levels that would predict the presence of antithyroid autoantibodies and inform decisions by pediatric endocrinologists to initiate or continue treatment with levothyroxine.Study DesignWe analyzed a retrospective case series of 325 children aged 1 to 18 years referred for hypothyroidism to the endocrinology clinic at a tertiary care children’s hospital. The receiver operating characteristic area under curve (AUC) determined the ability of the initial TSH level to predict pediatric endocrinologists’ treatment decisions, presence of thyroid autoantibodies, and reproducibility of elevated TSH on repeat testing.ResultsOf 325 patients, 191 were treated. The treated patients were more likely to have had a higher referral TSH, positive autoantibodies, and abnormal thyroid gland examination findings. An initial TSH of 5 had a specificity of only 14% for a repeat TSH of ≥5. An initial TSH level of 11 had a specificity of 90% for a repeat TSH of ≥11, with sensitivity of 90%. TSH was a relatively poor predictor (AUC, 0.711) of the presence of autoantibodies with optimal classification at TSH >8.8 mIU/L. It was better (AUC, 0.878) at predicting whether endocrinologists started or continued treatment with levothyroxine, with optimal classification at 8.2 mIU/L. TSH levels combined with antibody status and thyroid examination findings had the best ability to predict treatment (AUC, 0.930).ConclusionsTSH levels slightly above the reference range should not prompt referral to pediatric endocrinologists unless another basis for clinical concern is present.
Metreleptin Supplementation for Improving Lipid and Glycemic Profiles in Acquired Diabetes Lipodystrophy: A Case Report
Authors: Nagayama Ayako , Ashida Kenji , Moritaka Kanoko , Hidaka Mami , Gobaru Mizuki , Tanaka Seiji , Hasuzawa Nao , Akasu Shoko , Goto Yuka , Motomura Seiichi , Hara Kento , Tsuruta Munehisa , Wada Nobuhiko , Nakayama Hitomi , Tajiri Yuji , Nomura Masatoshi 
Published: September 2019

Abstract
Most childhood cancer survivors who undergo hematopoietic stem cell transplantation subsequently develop impaired glucose tolerance and hypertriglyceridemia. These conditions are presumably associated with total-body irradiation–related acquired lipodystrophy and may lead to cardiovascular disease. Metreleptin (recombinant leptin) may help improve the lipoprotein profile, insulin sensitivity, and quality of life of patients with total-body irradiation-related lipodystrophy. This report describes the safe and effective use of metreleptin supplementation for insulin resistance and dyslipidemia in acquired incomplete lipodystrophy.
A 24-year-old Japanese woman with diabetes mellitus and hypertriglyceridemia was admitted to our hospital. She was diagnosed with acute lymphocytic leukemia at 3 years of age and had undergone systemic chemotherapy and total-body irradiation before allogeneic stem cell transplantation. She was also diagnosed with hypertriglyceridemia and diabetes mellitus at 11 years of age. She had a low adiponectin level, low-normal leptin level, and diabetes mellitus with marked insulin resistance. Thus, acquired incomplete lipodystrophy was diagnosed. Her serum triglyceride and lipoprotein profiles improved within 1 month of treatment initiation. Glycemic metabolism and insulin sensitivity in the skeletal muscles improved after 6 months.
As previously reported, metreleptin therapy is effective in improving lipid and glycemic profiles in generalized lipodystrophy. In the present case, we considered that metreleptin supplementation could reduce the remnant VLDL cholesterol fraction and improve diabetes mellitus. We conclude that it may be an effective alternative therapy for improving the expected prognosis of patients with acquired incomplete lipodystrophy, including childhood cancer survivors.
Morphine on Trial
Authors: Black Sara 
Published: September 2019

AbstractThis article examines medical-legal debates over the criminal responsibility of morphine addicts in the fin de siècle, at a time when the use of psychotropic drugs was not yet illegal. Addicted defendants argued that morphine had produced a temporary state of insanity at the time of the crime. However, medical-legal experts emphasized the regulatory influence of morphine over the addicted body, navigating between moralistic arguments about the primacy of free will and deterministic arguments about the role of physiology in establishing criminal responsibility. Withdrawal, rather that morphine, served as the primary condition for criminal irresponsibility in most cases of addiction. Therefore morphine became a fundamental element of the addicted individual, required for these defendants to be considered sane and morally responsible.Cet article examine les débats médico-légaux sur la responsabilité pénale des morphinomanes de la fin du dix-neuvième siècle, une époque où l'usage des psychotropes n'était pas encore illégal. Les inculpés morphinomanes ont soutenu qu'au moment du crime, la morphine les avait rendus fous. Par contre, les experts ont cherché un terrain d'entente entre les arguments moralisateurs sur le libre arbitre et les arguments déterministes qui privilégiaient le rôle de la physiologie dans la responsabilité pénale. C'était le sevrage, la privation de la morphine plutôt que la drogue elle-même, qui était la condition principale de l'irresponsabilité criminelle du morphinomane. Par conséquent, la morphine est devenue un élément fondamental de l'individu morphinomane, et sans morphine l'individu n'était ni sain d'esprit, ni moralement responsable.
As parcerias público-privadas e a infraestrutura no Brasil
Authors: Nakamura Andre Luiz dos Santos 
Published: September 2019

The public-private partnerships and the infrastructure in Brazil As parcerias público-privadas foram apresentadas como a solução para a falta de investimento público em infraestrutura no Brasil. Entretanto, trata-se de um modelo de contratação complexo que merece todo o planejamento necessário para que se mostre adequado ao interesse público. A opção pelo modelo de parcerias público-privadas nem sempre é a opção mais barata, se comparada ao investimento público. Somente em casos de comprovada maior eficiência do agente privado deverá o Estado optar pelo modelo contratual de parcerias público-privadas, sob pena de grandes prejuízos aos cofres públicos e da consequente responsabilização de agentes estatais. Public-private partnerships were presented as the solution to the lack of fund for investment in infrastructure in Brazil. However, it is a complex contracting model that deserves all the necessary planning to be adequate to the public interest. The option of public-private partnerships is not always a cheaper option compared to public investment. Only in cases of proven greater efficiency of the private agent should the State opt for the contractual model of public-private partnerships, under penalty of great losses to the public coffers and the consequent accountability of state agents.
Case Report: Kikuchi-Fujimoto Disease: A case of supraclavicular lymphadenopathy
Authors: Sarfraz Shiza , Rafique Hamza , Ali Hassam , Hassan Syed Zawahir 
Published: September 2019

Kikuchi-Fujimoto Disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare cause of cervical lymphadenopathy. Patients usually present with localized lymphadenopathy, fever and fatigue. Because of the poorly understood etiology, it can be mistaken for an infectious disease or even malignance. Here we discuss a case of KFD that initially presented with left sided cervical lymphadenopathy that later progressed to left supraclavicular lymph nodes. Due to its characteristic overlap with other disorders like tuberculous lymphadenitis and lymphoma, KFD remains an arduous diagnosis for physicians. Therefore, one should be made aware of symptoms that can lead to misdiagnosis in patients.
Could EAISI-trained providers provide better quality of IUD services? Results of a secondary data analysis of complications as a proxy indicator
Authors: Gehani Manish , Pal Manoj , Arya Anupama , Singh Shobhana , S. Kaushik , O’Connell Kathryn A. , Cagatay Levent , Sengupta Sumon , Singal Sunita 
Published: September 2019

Background: For accelerating its progress towards FP2020 goals, the Government of India has focused on improving the quality of intrauterine device (IUD) services. EngenderHealth has supported the Governments of Rajasthan and Gujarat since 2014 through its Expanding Access to IUD Services in India (EAISI) project by building the capacity of service providers, monitoring their compliance with standard practices, and strengthening health systems. This study sought to assess whether EAISI trained providers provide a better quality of IUD services as compared to non-EAISI trained providers, as indicated by a reduction in confirmed IUD complications? Methods: This study was an analytical cross-sectional study of secondary data collected from the follow-up registers of 176 intervention facilities (138 in Rajasthan and 38 in Gujarat) during Phase I of EAISI project. The analysis included clients who returned between April 2018 and March 2019 to the same facility for a follow-up visit. Multivariate logistic regression was performed to determine factors associated with IUD complications. Results: A total of 56,733 IUD insertions were conducted, and 10,747 (18.9%) client follow-ups were documented. Of these, 49.4% (N=5,305) clients received IUDs from EAISI-trained providers, while 50.6% (N=5,442) received IUDs from non-EAISI trained providers. A total of 4.0% (N=432) of clients experienced complications (Expulsion: 1.3%, Missing Strings: 1.7%, Infection: 1.1%). Clients who received IUDs from non-EAISI-trained providers were 55.5% more likely [95% CI (26.2%, 91.5%), p<0.0005] to have complications compared to clients who received insertions from EAISI-trained providers. Other significant factors include the type of IUD, timing of the follow-up visit and timing of the insertion. Conclusion: The findings demonstrate that intensive, hands-on training of providers to improve clinical skills for IUD insertions can have a positive impact on the reduction of post-insertion complications.
Metabolic tracing reveals novel adaptations to skeletal muscle cell energy production pathways in response to NAD+ depletion
Authors: Oakey Lucy A. , Fletcher Rachel S. , Elhassan Yasir S. , Cartwright David M. , Doig Craig L. , Garten Antje , Thakker Alpesh , Maddocks Oliver D. K. , Zhang Tong , Tennant Daniel A. , Ludwig Christian , Lavery Gareth G. 
Published: September 2019

Background: Skeletal muscle is central to whole body metabolic homeostasis, with age and disease impairing its ability to function appropriately to maintain health. Inadequate NAD+ availability is proposed to contribute to pathophysiology by impairing metabolic energy pathway use. Despite the importance of NAD+ as a vital redox cofactor in energy production pathways being well-established, the wider impact of disrupted NAD+ homeostasis on these pathways is unknown. Methods: We utilised skeletal muscle myotube models to induce NAD+ depletion, repletion and excess and conducted metabolic tracing to provide comprehensive and detailed analysis of the consequences of altered NAD+ metabolism on central carbon metabolic pathways. We used stable isotope tracers, [1,2-13C] D-glucose and [U-13C] glutamine, and conducted combined 2D-1H,13C-heteronuclear single quantum coherence (HSQC) NMR spectroscopy and GC-MS analysis. Results: NAD+ excess driven by nicotinamide riboside (NR) supplementation within skeletal muscle cells resulted in enhanced nicotinamide clearance, but had no effect on energy homeostasis or central carbon metabolism. Nicotinamide phosphoribosyltransferase (NAMPT) inhibition induced NAD+ depletion and resulted in equilibration of metabolites upstream of glyceraldehyde phosphate dehydrogenase (GAPDH). Aspartate production through glycolysis and TCA cycle activity was increased in response to low NAD+, which was rapidly reversed with repletion of the NAD+ pool using NR. NAD+ depletion reversibly inhibits cytosolic GAPDH activity, but retains mitochondrial oxidative metabolism, suggesting differential effects of this treatment on sub-cellular pyridine pools. When supplemented, NR efficiently reversed these metabolic consequences. However, the functional relevance of increased aspartate levels after NAD+ depletion remains unclear, and requires further investigation. Conclusions: These data highlight the need to consider carbon metabolism and clearance pathways when investigating NAD+ precursor usage in models of skeletal muscle physiology.
Quality and Safety of Pediatric Inpatient Care in Community Hospitals: A Scoping Review
Authors: Leary Jana C , Walsh Kathleen E , Morin Rebecca A , Schainker Elisabeth G , Leyenaar JoAnna K 
Published: September 2019

BACKGROUNDAlthough the majority of children are hospitalized in nonchildren's hospitals, little is known about the quality and safety of pediatric care in community hospitals.OBJECTIVEThe aim of this study was to conduct a scoping review and synthesize literature on the quality and safety of pediatric inpatient care in United States community hospitals.METHODSWe performed a systematic literature search in October 2016 to identify pediatric studies that reported on safety, effectiveness, efficiency, timeliness, patient‐centeredness, or equity set in general, nonuniversity, or nonchildren's hospitals. We extracted data on study design, patient descriptors, and quality outcomes and assessed the risk of bias using modified Newcastle‐Ottawa Scales.RESULTSA total of 44 articles met the inclusion criteria. Study designs, patient populations, and quality outcome measures were heterogeneous; only three clinical domains, (1) perinatal regionalization, (2) telemedicine, and (3) imaging radiation, were explored in multiple studies with consistent directionality of results. A total of 30 studies were observational, and 22 studies compared community hospital quality outcomes with other hospital types. The remaining 14 studies reported testing of interventions; 12 showed improved quality of care postintervention. All studies reported an outcome addressing safety, effectiveness, or efficiency, whereas timeliness, patient‐centeredness, and equity were infrequently addressed. Risk of bias was moderate or high for 72% of studies.CONCLUSIONSLiterature on the inpatient care of children in community hospitals is limited, making it difficult to evaluate healthcare quality. Measures of timeliness, patient‐centeredness, and equity are underrepresented. The field would benefit from more multicenter collaborations to facilitate the application of robust study designs and to enable a systematic assessment of individual interventions and community hospital quality outcomes.