bluuebunny/crossref_metadata_2025_split huggingface dataset:
Partial Cutting and Suture Technique for Caudal Septoplasty
Authors: Cheon Tae-Uk , Song Young Jun , Kang Byung Chul , Nam Jung-Gwon , Lee Tae-Hoon 
Published: June 2019

Background The partial cutting and suture technique is a modification of the cutting and suture technique that overcomes the limitations and simplifies the procedure of the cutting and suture technique. Objective We describe the partial cutting and suture technique and evaluate its effectiveness of correcting caudal septal deviation. Methods We retrospectively reviewed the medical records of patients who underwent anterior septoplasty using the partial cutting and suture technique. The patients were evaluated with the Nasal Obstructive Symptoms Evaluation (NOSE) scale scores and the acoustic rhinometry preoperatively and 3 months postoperatively. Results Thirty-one patients underwent caudal septoplasty by our novel technique. The NOSE scale score changed from 43.5 to 11.0 ( P = .000). The minimal cross-sectional area (MCA) on the convex side changed from 0.49 cm2 to 0.65 cm2 ( P = .006). Conclusion The partial cutting and suture technique is relatively easy and is very effective in correcting caudal septal deviation without any complications.
Metoclopramide as a prokinetic agent for diabetic gastroparesis: revisiting the risk of Parkinsonism
Authors: Lai Chien-Hsu , Yeh Yi-Chun , Chen Yen-Yu 
Published: June 2019

Background: Metoclopramide is used to relieve gastrointestinal symptoms, however, it could cause adverse reactions of motor disorders. The aim of this study was to investigate whether metoclopramide treatment has a duration–response or dose–response effect and to estimate the risk of developing Parkinsonism following different and specific durations of treatment. Methods: A cohort study of newly diagnosed type 2 diabetes mellitus in 45- to 79-year-old patients, between 1999 and 2008, was selected using the Longitudinal Health Insurance Database 2005. A nested case–control study was conducted in the diabetes cohort in which all incident cases of Parkinsonism were identified. We randomly matched each case with up to 10 controls from the risk set. Conditional logistic regression was utilized to estimate odds ratio of Parkinsonism associated with metoclopramide use. Results: A total of 34,685 patients with diabetes were assembled as the cohort, and 541 incident Parkinsonism cases were identified. There were duration–response and dose–response effects on the risk of developing Parkinsonism. Compared with never-use patients, the adjusted odds ratios (ORs) of continuing therapy for 0–1 month, 1–2 months, 2–3 months, 3–5 months, and more than 5 months were 1.17 [95% confidence interval (CI) 0.93–1.45], 1.44 (95% CI 1.04–2.00), 1.74 (95% CI 1.14–2.65), 1.90 (95% CI 1.23–2.93), and 2.17 (95% CI 1.50–3.12), respectively. Conclusions: With metoclopramide treatment, regardless of less or more than 3 months of use, the risk of developing Parkinsonism in patients with newly diagnosed diabetes escalated with the duration of therapy. Therefore, we recommend close monitoring for the development of Parkinsonism in patients treated with metoclopramide, particularly (but not limited to) those with prolonged exposure.
Completion and adherence rates to exercise interventions in intermittent claudication: Traditional exercise versus alternative exercise – a systematic review
Authors: Lin Edward , Nguyen Cindy H , Thomas Scott G 
Published: June 2019

Background Intermittent claudication, defined as fatigue or pain in the legs while walking, is a common symptom in peripheral arterial disease. Although exercise effectively improves function and manages symptoms, adherence rates are not ideal. The high levels of pain experienced in traditional exercise programmes may explain the suboptimal adherence. Alternative modalities of exercise can elicit similar benefits to traditional walking exercise. The purpose of this systematic review was to compare completion and adherence rates of exercise programmes in traditional exercise interventions versus alternative exercise interventions among patients with intermittent claudication. Design Systematic review. Methods The electronic databases of Medline, SPORTDiscus and CINAHL were searched from the earliest records to March 2018. Search terms were based on ‘peripheral artery disease’ and ‘exercise’. Studies were included if they involved structured exercise and explicitly reported the number of participants that commenced and completed the programme. Results The search identified 6814 records based on inclusion criteria. Eighty-four full-text records were reviewed in further detail. Out of the 84 studies, there was a total of 122 separate exercise groups, with 64 groups of ‘traditional walking exercise’ and 58 groups of ‘alternative exercise’. Completion and adherence rates for traditional exercise were 80.8% and 77.6%, respectively. Completion and adherence rates for alternative exercise were 86.6% and 85.5%, respectively. Conclusions The use of alternative modalities of exercise, which have been proved to be as effective as traditional exercise, may offer a solution to the poor participation and adherence rates to exercise in this population.
Role of Food Allergy Education: Measuring Teacher Knowledge, Attitudes, and Beliefs
Authors: Canon Nicole , Gharfeh Maya , Guffey Danielle , Anvari Sara , Davis Carla M. 
Published: June 2019

Introduction Almost 6 million children suffer from food allergies with roughly 2 affected per classroom. Deficiencies in knowledge and discrepancies in attitudes within school staff when addressing food allergies are associated with barriers to care. In this study, school teacher knowledge, beliefs, and attitudes were measured before and after a food allergy educational session. Methods Three hundred seventy-five personnel of similar age, socioeconomic status, ethnicity, and educational level completed the Chicago Food Allergy Research survey before and after a 1-hour educational session in 6 private schools in Houston randomly assigned into an intervention (n = 4) and control group (n = 2). Responses were measured using frequencies and percentages. The group score differences and survey question comparisons were evaluated with a linear mixed-effects model. Results Posttest, the intervention group had knowledge scores 19.58% points higher than control (95% confidence interval = 16.62–22.53; P < .001) with no differences pretest. Odds of agreeing that injectable epinephrine is important was higher in the intervention schools posteducation. Within the intervention group, personnel were more likely to agree to injectable epinephrine use for children posteducation. Conclusion A 1-hour educational session improved knowledge and attitudes in personnel in the intervention schools. Given the growing prevalence of food allergy, the emphasis on food allergy education is crucial to allow for familiarization of the condition, early recognition of anaphylaxis, and promotion of injectable epinephrine use.
Professional and Amateur Pitchers’ Perspective on the Ulnar Collateral Ligament Injury Risk
Authors: Vance Danica D. , Alexander Frank J. , Kunkle Brian W. , Littlefield Mark , Ahmad Christopher S. 
Published: June 2019

Background: Medial ulnar collateral ligament (UCL) injury is increasingly prevalent in professional baseball pitchers, and significant research has been devoted to understanding the risk factors and prevention strategies associated with it. To date, no study has investigated what the players themselves believe causes and prevents the injury. Purpose: To evaluate the opinions of UCL injuries among pitchers, including professional athletes. Study Design: Cross-sectional study. Methods: A total of 214 baseball pitchers (45 high school/college, 169 Major League Baseball [MLB]/Minor League Baseball) completed a 52-item questionnaire designed to evaluate their opinions on the cause of UCL injuries, injury prevention, and Tommy John surgery. Overall, 51 of the 214 pitchers had previously experienced a UCL injury. The frequency of the selection of each answer option was measured. Additionally, chi-square tests were used to compare (1) responses between professional and nonprofessional pitchers and (2) responses between pitchers with and without a previous UCL injury. Results: Only 45% of pitchers thought that UCL injuries are avoidable in MLB. Additionally, 55% of pitchers with a UCL injury had a history of elbow injuries as an adolescent/child, compared with 18% in the uninjured group ( P < .0001). Also, 72% of all surveyed pitchers agreed that fatigue over the course of a season increases the risk of UCL injuries, and the majority of pitchers agreed that inadequate rest from throwing both during the off-season (61%) and the season (59%) increases the risk of UCL injuries. Moreover, 59% of pitchers believed that a 6-man starting rotation would decrease the incidence of UCL injuries. Professional and nonprofessional pitchers significantly differed ( P = .005) in the type of pitch most prone to causing UCL injuries. Conclusion: Pitchers with a previous childhood elbow injury had a significantly higher incidence of UCL injuries during their adult career, suggesting possible predisposition to UCL injury and warranting further research. Fatigue and inadequate rest were of greatest concern among all pitchers for an increased risk of UCL injuries. Understanding and acknowledging the opinions that players have regarding UCL injuries are important to improve UCL education, prevention, and treatment.
Tumor microenvironment and clonal monocytes from chronic myelomonocytic leukemia induce a procoagulant climate
Authors: Zannoni Johanna , Mauz Natacha , Seyve Landry , Meunier Mathieu , Pernet-Gallay Karin , Brault Julie , Jouzier Claire , Laurin David , Pezet Mylène , Pernollet Martine , Cahn Jean-Yves , Cognasse Fabrice , Polack Benoît , Park Sophie 
Published: June 2019

Abstract
Chronic myelomonocytic leukemia (CMML) is a myeloid hematological malignancy with overlapping features of myelodysplastic syndromes (MDSs) and myeloproliferative neoplasms (MPNs). The knowledge of the role of the tumor microenvironment (TME), particularly mesenchymal stromal cells (MSCs), in MDS pathogenesis is increasing. Generally, cancer is associated with a procoagulant state participating in tumor development. Monocytes release procoagulant, tissue factor (TF)–bearing microparticles. We hypothesized that MSCs and clonal monocytes release procoagulant extracellular vesicles (EVs) within the CMML TME, inducing a procoagulant state that could modify hematopoietic stem cell (HSC) homeostasis. We isolated and cultured MSCs and monocytes from CMML patients and MSCs from healthy donors (HDs). Their medium EVs and small EVs (sEVs) were collected after iterative ultracentrifugations and characterized by nanoparticle tracking analysis. Their impact on hemostasis was studied with a thrombin generation assay and fibrinography. CMML or HD HSCs were exposed to sEVs from either CMML or HD MSCs. CMML MSC sEVs increased HD HSC procoagulant activity, suggesting a transfer of TF from the CMML TME to HD HSCs. The presence of TF on sEVs was shown by electron microscopy and western blot. Moreover, CMML monocyte EVs conferred a procoagulant activity to HD MSCs, which was reversed by an anti-TF antibody, suggesting the presence of TF on the EVs. Our findings revealed a procoagulant “climate” within the CMML environment related to TF-bearing sEVs secreted by CMML MSCs and monocytes.
Non-tuberculous mycobacterial pulmonary disease
Authors: Cowman Steven , van Ingen Jakko , Griffith David E. , Loebinger Michael R. 
Published: June 2019

Nontuberculous mycobacterial pulmonary disease (NTM-PD) is a challenging infection which is becoming increasingly prevalent, particularly in the elderly, for reasons which are unknown. While underlying lung disease is a well-established risk factor for NTM-PD, it may also occur in apparently healthy individuals. No single common genetic or immunological defect has been identified in this group, and it is likely that multiple pathways contribute towards host susceptibility to NTM-PD which further interact with environmental and microbiological factors leading to the development of disease.The diagnosis of NTM-PD relies on the integration of clinical, radiological and microbiological results. The clinical course of NTM-PD is heterogeneous, with some patients remaining stable without the need for treatment and others developing refractory disease associated with considerable mortality and morbidity. Treatment regimens are based on the identity of the isolated species, drug sensitivity testing (for some agents) and the severity of disease. Multiple antibiotics are typically required for prolonged periods of time and treatment is frequently poorly tolerated. Surgery may be beneficial in selected cases. In some circumstances cure may not be attainable and there is a pressing need for better regimens to treat refractory and drug-resistant NTM-PD.This review summarises current knowledge on the epidemiology, aetiology and diagnosis of NTM-PD and discusses the treatment of two of the most clinically significant species, theM. aviumandM. abscessuscomplexes, with a focus on refractory disease and novel therapies.
Bronchodilator reversibility in asthma and COPD: findings from three large population studies
Authors: Janson Christer , Malinovschi Andrei , Amaral Andre F.S. , Accordini Simone , Bousquet Jean , Buist A. Sonia , Canonica Giorgio Walter , Dahlén Barbro , Garcia-Aymerich Judith , Gnatiuc Louisa , Kowalski Marek L , Patel Jaymini , Tan Wan , Torén Kjell , Zuberbier Torsten , Burney Peter , Jarvis Deborah 
Published: June 2019

Bronchodilator response (BDR) testing is used as a diagnostic method in obstructive airway diseases. The aim of this investigation was to compare different methods for measuring BDR in participants with asthma and chronic obstructive pulmonary disease (COPD) and to study to the extent to which BDR was related to symptom burden and phenotypic characteristics.Forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were measured before and 15 min after 200 μg of salbutamol in 35 628 subjects aged ≥16 years from three large international population studies. The subjects were categorised in three groups: current asthma (n=2833), COPD (n=1146) and no airway disease (n=31 649). Three definitions for flow-related reversibility (increase in FEV1) and three for volume-related reversibility (increase in FVC) were used.The prevalence of bronchodilator reversibility expressed as increase FEV1≥12% and 200 mL was 17.3% and 18.4% in participants with asthma and COPD, respectively, while the corresponding prevalence was 5.1% in those with no airway disease. In asthma, bronchodilator reversibility was associated with wheeze (OR 1.36, 95% CI 1.04–1.79), atopy (OR 1.36, 95% CI 1.04–1.79) and higher exhaled nitric oxide fraction, while in COPD neither flow- nor volume-related bronchodilator reversibility was associated with symptom burden, exacerbations or health status after adjusting for pre-bronchodilator FEV1.Bronchodilator reversibility was at least as common in participants with COPD as those with asthma. This indicates that measures of reversibility are of limited value for distinguishing asthma from COPD in population studies. However, in asthma, bronchodilator reversibility may be a phenotypic marker.
Are smokers “hardening” or rather “softening”? An ecological and multilevel analysis across 28 European Union countries
Authors: Feliu Ariadna , Fernandez Esteve , Martinez Cristina , Filippidis Filippos T. 
Published: June 2019

BackgroundTobacco control policies can reduce smoking prevalence. These measures may be less effective where smoking prevalence has significantly declined, as the remaining smokers have “hardened”. Our aim was to empirically evaluate the “hardening hypothesis” at the population level in the European Union (EU) and explore factors associated with hardcore smoking.MethodsWe conducted two separate analyses in the EU using data on smoking from the Eurobarometer surveys (2009–2017, n=112 745). 1) A panel-data fixed-effects linear regression to investigate changes over time in the percentage of hardcore smokers in relation to standardised smoking prevalence at the country level. 2) A multilevel logistic regression analysis with hardcore (daily smokers, ≥15 cigarettes per day who have not attempted to quit in the last 12 months) or light (<5 cigarettes per day) smoking as the dependent variable and time as the main independent variable, controlling for individual and ecological variables.ResultsWe studied 29 010 current smokers (43.8% hardcore smokers and 14.7% light smokers). The prevalence of hardcore smoking among adult smokers increased by 0.55 (95% CI 0.14–0.96) percentage points per each additional percentage point in the overall smoking prevalence. The odds of being a hardcore smoker increased over time and were higher in middle-aged males and people with financial difficulties, while the odds of being a light smoker significantly declined among females.ConclusionThis study does not support the “hardening hypothesis” in the EU between 2009 and 2017, but suggests a softening of the smoking population. Existing tobacco control policies are likely to be suitable to further decrease smoking prevalence in Europe.
Proliferating SPP1/MERTK-expressing macrophages in idiopathic pulmonary fibrosis
Authors: Morse Christina , Tabib Tracy , Sembrat John , Buschur Kristina L. , Bittar Humberto Trejo , Valenzi Eleanor , Jiang Yale , Kass Daniel J. , Gibson Kevin , Chen Wei , Mora Ana , Benos Panayiotis V. , Rojas Mauricio , Lafyatis Robert 
Published: June 2019

A comprehensive understanding of the changes in gene expression in cell types involved in idiopathic pulmonary fibrosis (IPF) will shed light on the mechanisms underlying the loss of alveolar epithelial cells and development of honeycomb cysts and fibroblastic foci. We sought to understand changes in IPF lung cell transcriptomes and gain insight into innate immune aspects of pathogenesis.We investigated IPF pathogenesis using single-cell RNA-sequencing of fresh lung explants, comparing human IPF fibrotic lower lobes reflecting late disease, upper lobes reflecting early disease and normal lungs.IPF lower lobes showed increased fibroblasts, and basal, ciliated, goblet and club cells, but decreased alveolar epithelial cells, and marked alterations in inflammatory cells. We found three discrete macrophage subpopulations in normal and fibrotic lungs, one expressing monocyte markers, one highly expressingFABP4andINHBA(FABP4hi), and one highly expressingSPP1andMERTK(SPP1hi). SPP1himacrophages in fibrotic lower lobes showed highly upregulatedSPP1andMERTKexpression. Low-level local proliferation of SPP1himacrophages in normal lungs was strikingly increased in IPF lungs.Co-localisation and causal modelling supported the role for these highly proliferative SPP1himacrophages in activation of IPF myofibroblasts in lung fibrosis. These data suggest that SPP1himacrophages contribute importantly to lung fibrosis in IPF, and that therapeutic strategies targeting MERTK and macrophage proliferation may show promise for treatment of this disease.
Studies on wall painting materials and techniques at two historic buildings in Gyantse, Tibet
Authors: Yang Xinhui , Ji Xinyan , Cao Yongkang , Yu Taoyi 
Published: June 2019

Abstract
This paper presents a scientific examination of wall paintings at two nonmonastic sites in Gyantse, Tibet: Gazhi Lhakang, which is a family temple built in the mid-eighteenth century by local aristocrats, and the Lotso Residence, which was occupied by Nepalese merchants in the early twentieth century. Samples were analyzed with optical microscopy, scanning electron microscopy with energy-dispersive X-ray spectroscopy, Raman spectroscopy, and X-ray diffraction. Two phases of painting—an early phase and a late phase—were identified in Gazhi Lhakang, including three distinct types of mural stratigraphy. The earlier phase features an unusual technique known as “paperhanging”, wherein the pigments were applied on a layer of Tibetan paper glued to the wall. The later phase at Gazhi Lhakang and the painting of the Lotso Residence feature a relatively simple wall treatment with fewer coating layers and no ground layer. A typical mixture of clay and sand was used for the coating layers, while the structure slightly varied from what has been described in the literature. The techniques of powder embossing, gilding, and gold outlining were adopted in both buildings. The metallic material found at Gazhi Lhakang is a gold-silver alloy, while copper was used as imitation gold at the Lotso Residence. Mineral pigments, such as azurite, malachite, orpiment, cinnabar, and iron oxide, were used for both phases of Gazhi Lhakang. Modern synthetic pigments, such as chrome yellow, emerald green, and synthetic ultramarine, were used for the Lotso Residence, indicating that it was painted after the mid-nineteenth century.
Coagulation Factor Levels and Underlying Thrombin Generation Patterns in Adult Extracorporeal Membrane Oxygenation Patients
Authors: Mazzeffi Michael , Strauss Erik , Meyer Michael , Hasan Shaheer , Judd Miranda , Abuelkasem Ezeldeen , Chow Jonathan , Nandwani Veena , McCarthy Paul , Tanaka Kenichi 
Published: June 2019

BACKGROUND:
There is a paucity of data on the underlying procoagulant–anticoagulant balance during extracorporeal membrane oxygenation (ECMO). We hypothesized that adult ECMO patients would have an imbalance between procoagulant and anticoagulant factors, leading to an abnormal underlying thrombin generation (TG) pattern.

METHODS:
Twenty adult venoarterial (VA) ECMO patients had procoagulant and anticoagulant factor levels measured temporally on ECMO day 1 or 2, day 3, and day 5. In heparin-neutralized plasma, underlying TG patterns, and sensitivity to activated protein C were assessed using calibrated automated thrombogram. TG parameters including lag time, peak TG, and endogenous thrombin potential (ETP) were compared against 5 normal plasma controls (3 males and 2 females) obtained from a commercial supplier. Thrombomodulin (TM) was added to some samples to evaluate for activated protein C resistance.

RESULTS:
Procoagulant factors (factor [F] II, FV, and FX) were mostly in normal reference ranges and gradually increased during the first 5 ECMO days (P = .022, <.001, <.001). FVIII levels were elevated at all time points and did not change (P = .766). In contrast, FXI was in the low-normal range but did not increase during ECMO (P = .093). Antithrombin (AT) and protein C levels were below normal but increased during the first 5 ECMO days (P = .002 and P = .014). Heparinase-treated samples showed prolonged lag time, increased peak TG, and increased ETP compared to controls; mean difference in lag time on ECMO day 1 or 2 = 6.0 minutes (99% confidence interval [CI], 2.8–9.2), peak TG = 193.4 (99% CI, 122.5–264.3), and ETP = 1170.4 (99% CI, 723.2–1617.6). After in vitro TM treatment, differences in TG parameters were accentuated and ECMO samples appeared insensitive to TM treatment; mean difference in lag time on ECMO day 1 or 2 = 9.3 minutes (99% CI, 6.2–12.4), peak TG = 233.0 (99% CI, 140.9–325.1), and ETP = 1322.5 (99% CI, 764.8–1880.2). Similar differences in TG parameters were observed on ECMO days 3 and 5.

CONCLUSIONS:
Contact activation occurs during ECMO, but procoagulant factor levels are generally preserved. Although heparin-neutralized TG is delayed, peak TG and ETP are supranormal in the setting of high FVIII and low AT and protein C levels. Resistance to TM is also apparent. These changes demonstrate a possible mechanism for hypercoagulability during adult VA ECMO.