bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Colonic Anastomotic Strictures with ‘Through the Scope’ Balloon Dilators
Authors: Dinneen M D , Motson R W 
Published: February 2018

Stricture occurs in 1.2–4.2% of colonic anastomoses. Symptomatic strictures have previously been treated by resection and re-anastomosis and more recently by radiographically guided dilatation by a modified Seldinger technique. This paper describes the endoscopic balloon dilatation of five symptomatic cases and three asymptomatic cases. Eight patients underwent balloon dilatation of colonic anastomotic strictures. Four patients had no symptoms post dilatation and the strictures remained patient on follow-up endoscopy. All the remaining patients required re-dilatation at approximately 2 months. One of these patients underwent dilatation but remained symptomatic, the dilatation was repeated and a colonic perforation occurred at this time. Of the other three, two continue to be followed up, and are well and one patient died of disseminated malignancy. Balloon dilatation with ‘through the scope’ dilators is a simpler technique than radiologically guided dilatation. These early results suggest that endoscopic dilatation may avoid further surgery in some patients with anastomotic stricture.
Treatment of Basal Cell Carcinoma with Intralesional Interferon Alpha-2b
Authors: Healsmith M F , Berth-Jones J , Fletcher A , Graham-Brown R A C 
Published: February 2018

We report a series of 11 basal cell carcinomas of various types treated with nine intra-lesional injections of 1.5 million units of interferon alpha-2b. The diagnosis was confirmed histologically in each case. After 3 months' follow-up six tumours had resolved both clinically and histologically. In three cases the tumour size was reduced. One tumour grew larger. Side effects were well tolerated except by one subject who was withdrawn. Those cases which responded have now been followed-up for between 12 and 26 months with no clinical or histological evidence of tumour recurrence. This is the longest period of follow-up so far reported for this novel treatment. The results are encouraging and, if maintained in future series, may indicate a useful role for interferon alpha in the management of this common cutaneous malignancy.
Evaluating the use of appropriate anticoagulation with lenalidomide and pomalidomide in patients with multiple myeloma
Authors: Anderson Sarah M , Beck Bradley , Sterud Susan , Lockhorst Robin , Ngorsuraches Surachat 
Published: February 2018

Background Lenalidomide and pomalidomide are two immunomodulatory medications with the potential to improve outcomes for patients with multiple myeloma; however, a black box warning for venous thromboembolism exists. Purpose The purpose of this study was to assess overall adherence to guideline recommendations for anticoagulation therapy with lenalidomide and pomalidomide in multiple myeloma patients. Methods This retrospective study at an ambulatory oncology clinic utilized chart reviews from the calendar years 2013–2016. The primary endpoint was prescription of appropriate anticoagulation upon initiation of therapy based on a list of predetermined risk factors. Secondary endpoints included incidence of deep venous thromboembolism, pulmonary embolism, myocardial infarction, stroke, and major bleed; initial anticoagulant prescribed; and whether or not anticoagulation was prescribed for another disease state. Results A total of 130 patients met inclusion criteria: 70.8% (n = 92) and 29.2% (n = 38) were prescribed lenalidomide and pomalidomide, respectively. A total risk score of two was most common (n = 54, 41.5%). Aspirin 81 mg oral tablet was prescribed most often (n = 53, 40.8%), followed by no anticoagulation (n = 30, 23.1%). Overall, 27 patients (20.8%) were prescribed anticoagulation in accordance with National Comprehensive Cancer Network guidelines. Incidence of deep venous thromboembolism was the most common adverse event (n = 4, 3.1%), followed by major bleed (n = 1, 0.8%). No reports of pulmonary embolism, myocardial infarction, or stroke were documented. Conclusions Overall, a disparity exists between appropriate prescribing of prophylactic anticoagulation and current practice guidelines. However, documentation of thromboembolic events was lower than recorded in previously published literature.
Australian social work students: Balancing tertiary studies, paid work and poverty
Authors: Baglow Len , Gair Susan 
Published: February 2018

Summary It is commonly understood that enrolment in higher education means inevitable financial strain. In an online national survey in 2015, a sample of 2320 current students from 29 Australian social work programs reported on their experiences of juggling life, study and work. Findings This article details preliminary findings regarding the impact of low levels of income on the lives and study success of an Australian student cohort, and offers a considered comparison to relevant available data. Students in this study reported regularly going without necessities, and identified that a lack of finances and long hours in employment were adversely affecting their study experience. These problems became acute during compulsory field placements. Applications The purpose of this study was to illuminate social work students’ complex study realities in order to inform future education, policy and practice. The findings identify that for these students adverse outcomes including poverty and disruption to studies may be increasingly difficult to avoid. This situation may not be confined to this cohort or the Australian experience. There appears to be an urgent need for national bodies, universities and students to join together in advocating for increased support for tertiary social work students.
Vascular ultrasound, the potential of integration of multiparametric ultrasound into routine clinical practice
Authors: Rafailidis Vasileios , Sidhu Paul S 
Published: February 2018

Introduction Ultrasound has traditionally been regarded as the first-line imaging modality for screening, diagnostic evaluation and monitoring treatment and disease progression of vascular pathology, including both the arterial and the venous branch of the vascular system. Albeit of its well-tolerated nature, wide availability and low cost, ultrasound above all, has the advantage of providing the clinician with clinically significant information related to both intraluminal irregularities and extravascular disease. Ultrasound has the potential not only to anatomically describe tissues but also to assess physiology by evaluating blood flow characteristics in real time. Discussion The already fundamental role of ultrasound has been even more expanded with the introduction of newer techniques like contrast-enhanced ultrasound, tissue-elastography and 3D ultrasound and the incorporation of research advances into clinical practice. The purpose of this review is to present and discuss some of the latest advances in the field of vascular ultrasound in attempt to illustrate how the adoption of multiparametric ultrasound into everyday clinical practice could address the patient's needs. Pathology and applications discussed include carotid and aortic disease, portal and peripheral venous abnormalities. Conclusion Widespread availability of modern technology in ultrasound devices has made the application of contrast-enhanced ultrasound, tissue elastography and 3D ultrasound feasible options, ready to contribute to the diagnostic performance of the ultrasonographic technique.
Clinical course and outcome in patients with severe dysphagia after lateral medullary syndrome
Authors: Kim Hyojun , Lee Ho Jun , Park Jin-Woo 
Published: February 2018

Background The objective of this study was to investigate the clinical course and final outcome in patients afflicted with severe dysphagia following a diagnosis of lateral medullary syndrome (LMS). Methods The patients with severe dysphagia after LMS admitted to a rehabilitation unit were included and their respective clinical data were prospectively collected. The criteria of ‘severe dysphagia’ was defined as the condition that showed decreased pharyngeal constriction with no esophageal passage in a videofluoroscopic swallowing study (VFSS) and initially required enteral tube feeding. The data included VFSS findings, types of diet and postural modification, penetration-aspiration scale (PAS) and functional oral intake scale (FOIS). Results A total of 11 patients were included and VFSS was performed every 2 weeks after stroke onset. Esophageal passage began to show at an average 34.7 ± 18.3 days, and the patients were able to begin consuming a partial oral diet with postural modification. It was 52.2 ± 21.8 days till they were advanced to a full oral diet. PAS and FOIS were significantly improved over time. Conclusions Patients with severe dysphagia after LMS were able to tolerate a partial oral diet at about 5 weeks following onset, and they were advanced to a normal diet after 10 weeks. This clinical course might help in predicting the prognosis, as well as assist in making practical decisions regarding a rehabilitation program.
Microseismic monitoring of a tight light oil reservoir: A case history in the Cardium Halo Play, Alberta
Authors: Duhault John L. J. , Eaton David W. , Kent Pedersen Per 
Published: February 2018

The effectiveness of hydraulic-fracturing completions in a tight-oil play is investigated by detailed interpretation of microseismicity. The microseismic programs were acquired in the Cretaceous Cardium light oil sandstone reservoirs in Alberta, Canada. Events with magnitudes between [Formula: see text] and [Formula: see text] are located by downhole monitor wells to a maximum distance of 525 m, enabling inference of the fracture wing length, height, and azimuth based on event distribution. The fracture ports, one per stage, were located in an open-hole configuration that used external packers for zonal isolation. During completions, the ports were opened with ball-actuated frac sleeves. Event distributions indicated that, in some cases, fractures grew preferentially away from the Rocky Mountain deformation front. This inferred that fracture asymmetry is independent of the position of the monitoring array, indicating that it cannot be ascribed to observation bias and suggesting that the direction of fracture growth was dominantly influenced by the preexisting stress conditions in the reservoir. The distribution of microseismicity further indicates that isolated event clusters occur 30–50 m above the reservoir. These out-of-zone events are interpreted to have occurred on unpropped fractures. In comparison with gelled oil or foamed water, slickwater fracturing fluids are shown to produce more diffuse and scattered microseismic expression accompanied by better cumulative oil production. Taken together, the results of these studies indicate that the use of slickwater fracturing fluid, along with the reduced stage spacing and tighter interwell spacing, is expected to lead to higher initial production as well as higher estimated ultimate recovery.
I. American Psychological Literature
Authors: Nicol Patrick 
Published: February 2018

American Journal of Insanity, vol. xxv. July, 1868, to April, 1869.October, 1868. No. 11.—“ Insanity and its Relations to Medicine by John Gray, M.D., &c. “History and Philosophy of Medical Jurisprudence,” by John Ordronaux, Professor of Medical Jurisprudence in Columbia College. “Last Wills-Unsound Mind and Memory.” “A Lecture on Gastric Epilepsy,” by G. E. Paget, M.D. “Case of Compound Fracture of the Skull, with Recovery,” by Edwin Hutchinson, M.D. BIBLIOGRAPHICAL: English Psychological Literature. Sltmma1'y: Obituary; “ Epileptiform Convulsions, following a Blow on the Head;” “Case of Epilepsy connected with Vesical Calculus, cured by Lithotomy.”., Thinking, Doing, Feeling.”
Feigned Insanity; with Cases
Authors: Nicolson David 
Published: February 2018

When we find, as recorded in the book of Samuel, that the great Psalmist resorted to imposture and “feigned himself mad and scrabbled on the doors of the gate, and let his spittle fall down upon his beard;” we cannot be surprised if minds less gifted should, for whatever purpose, assume the character of a madman. The beautiful conceptions of Shakespeare unfold to us in its highest fulness the rôle to be sustained by the player who is “but mad in craft.” We are told how Hamlet:—Repulsed,Fell into a sadness; then into a fast;Thence to a watch; thence into a weakness;Thence to a lightness, and by this declension,Into the madness wherein now he raves,And all we mourn for,and how Edgar, amid all his witless jabbering, himself exclaims aside :—
My tears begin to take his part so much, they'll mar my counterfeiting.
Breast Cancer Diagnosis and Treatment After High-Deductible Insurance Enrollment
Authors: Wharam J. Frank , Zhang Fang , Lu Christine Y. , Wagner Anita K. , Nekhlyudov Larissa , Earle Craig C. , Soumerai Stephen B. , Ross-Degnan Dennis 
Published: February 2018

PurposeHigh-deductible health plans (HDHPs) require substantial out-of-pocket spending and might delay crucial health services. Breast cancer treatment delays of as little as 2 months are associated with adverse outcomes.MethodsWe used a controlled prepost design with survival analysis to assess timing of breast cancer care events among 273,499 women age 25 to 64 years without evidence of breast cancer before inclusion. Women were included if continuously enrolled for 1 year in a low-deductible ($0 to $500) plan followed by up to 4 years in a HDHP (at least $1,000 deductible) after an employer-mandated switch. Study inclusion was on a rolling basis, and members were followed between 2003 and 2012. The comparison group comprised 2.4 million contemporaneously matched women whose employers offered only low-deductible plans. Measures were times to first diagnostic breast imaging (diagnostic mammogram, breast ultrasound, or breast magnetic resonance imaging), breast biopsy, incident early-stage breast cancer diagnosis, and breast cancer chemotherapy. Outcomes were analyzed by using Cox models and adjusted for age-group, morbidity score, poverty level, US region, index date, and employer size.ResultsAfter the index date, HDHP members experienced delays in receipt of diagnostic imaging (adjusted hazard ratio [aHR], 0.95; 95% CI, 0.94 to 0.96), biopsy (aHR, 0.92; 95% CI, 0.89 to 0.95), early-stage breast cancer diagnosis (aHR, 0.83; 0.78 to 0.90), and chemotherapy initiation (aHR, 0.79; 95% CI, 0.72 to 0.86) compared with the control group.ConclusionWomen switched to HDHPs experienced delays in diagnostic breast imaging, breast biopsy, early-stage breast cancer diagnosis, and chemotherapy initiation. Additional research should determine whether such delays cause adverse health outcomes, and policymakers should consider selectively reducing out-of-pocket costs for key breast cancer services.
The first 3D printed multiple sclerosis brain: Towards a 3D era in medicine
Authors: Avasarala Jagannadha , Pietila Todd 
Published: February 2018

Conventional magnetic resonance imaging (MRI) studies depict disease of the human brain in 2D but the reconstruction of a patient’s brain stricken with multiple sclerosis (MS) in 3D using 2D images has not been attempted. Using 3D reconstruction algorithms, we built a 3D printed patient-specific brain model to scale. It is a first of its kind model that depicts the total white matter lesion (WML) load using T2 FLAIR images in an MS patient. The patient’s images in Digital Imaging and Communications in Medicine (DICOM) format were imported into Mimics inPrint 2.0 (Materialise NV, Leuven, Belgium) a dedicated medical image processing software designed for the purposes of image segmentation and 3D modeling. The imported axial images were automatically formatted to display coronal and sagittal slices within the software. The imaging data were then segmented into regions and surface rendering was done to achieve 3D virtual printable files of the desired structures of interest. Rendering brain tumor(s) in 3D has been attempted with the specific intent of extending the options available to a surgeon but no study to our knowledge has attempted to quantify brain disease in MS that has, for all practical purposes, no surgical options. The purpose of our study was to demonstrate that 3D depiction of chronic neurological diseases is possible in a printable model while serving a fundamental need for patient education. Medical teaching is moored in 2D graphics and it is time to evolve into 3D models that can be life-like and deliver instant impact.
Successful CRISPR/Cas9 mediated homologous recombination in a chicken cell line
Authors: Antonova Ekaterina , Glazova Olga , Gaponova Anna , Eremyan Aykaz , Zvereva Svetlana , Grebenkina Natalya , Volkova Natalya , Volchkov Pavel 
Published: February 2018

Background: CRISPR/Cas9 system is becoming the dominant genome editing tool in a variety of organisms. CRISPR/Cas9 mediated knock out has been demonstrated both in chicken cell lines and in chicken germ cells that served to generate genetically modified birds. However, there is limited data about CRISPR/Cas9 dependent homology directed repair (HDR) for avian, even in cell culture. Few attempts have been made with integrations in safe harbor loci of chicken genome that induces constitutive expression of the inserted gene. Gene expression under an endogenous promoter would be more valuable than under a constitutive exogenous promoter, as it allows the gene expression to be tissue-specific. Methods: Three gRNAs were chosen to target chicken 3’-untranslated region of GAPDH gene. Cas9-mediated activity in the targeted locus for the gRNAs in DF-1 cells was estimated by T7E1 assay. To edit the locus, the HDR cassette was added along with CRISPR/Cas9. The inserted sequence contained eGFP in frame with a GAPDH coding sequence via P2A and Neomycin resistance gene (neoR) under cytomegalovirus promoter. Correct integration of the cassette was confirmed with fluorescent microscopy, PCR analysis and sequencing. Enrichment of modified cells was done by G418 selection. Efficiency of integration was assessed with fluorescence activated cell sorting (FACS). Results: We have established a CRISPR/Cas9 system to target an endogenous locus and precisely insert a gene under endogenous control. In our system, we used positive and negative selection to enrich modified cells and remove cells with undesirable insertions. The efficiency of CRISPR/Cas9-mediated HDR was increased up to 90% via G418 enrichment. We have successfully inserted eGFP under control of the chicken GAPDH promoter. Conclusions: The approach can be used further to insert genes of interest under control of tissue-specific promoters in primordial germ cells in order to produce genetically modified birds with useful for biotechnological purposes features.
Revised World Health Organization (WHO)’s causality assessment of adverse events following immunization—a critique
Authors: Puliyel Jacob , Naik Pathik 
Published: February 2018

The World Health Organisation (WHO) has recently revised how adverse events after immunization (AEFI) are classified. Only reactions that have previously been acknowledged in epidemiological studies to be caused by the vaccine, are classified as a vaccine-product–related-reaction. Deaths observed during post-marketing surveillance are not considered as “consistent with causal association with vaccine”, if there was no statistically significant increase in deaths recorded during the small Phase 3 trials that preceded it. Of course, vaccines that caused deaths in the control-trials stage would not be licensed. After licensure, deaths and all new serious adverse reactions are labelled as ‘coincidental deaths’ or ‘unclassifiable’, and the association with vaccine is not acknowledged. The resulting paradox is evident. The definition of causal association has also been changed. It is now used only if there is “no other factor intervening in the processes.” Therefore, if a child with an underlying congenital heart disease (other factor), develops fever and cardiac decompensation after vaccination, the cardiac failure would not be considered causally related to the vaccine. The Global Advisory Committee on Vaccine Safety has documented many deaths in children with pre-existing heart disease after they were administered the Pentavalent vaccine. The WHO now advises precautions when vaccinating such children and this has reduced the risk of death. Using the new definition of causal association, this relationship would not be acknowledged and lives would be put at risk. In view of the above, it is necessary that the AEFI manual be revaluated and revised urgently. AEFI reporting is said to be for vaccine safety. Child safety (safety of children) rather than vaccine safety (safety for vaccines) needs to be the emphasis.
Sutureless versus Conventional Aortic Valve Replacement: Outcomes in 70 High-Risk Patients Undergoing Concomitant Cardiac Procedures
Authors: Hanedan Muhammet Onur , Yuruk Mehmet Ali , Parlar Ali Ihsan , Ziyrek Ugur , Arslan Ali Kemal , Sayar Ufuk , Mataraci Ilker 
Published: February 2018

In elderly, high-risk surgical patients, sutureless aortic valve replacement (AVR) can often be an alternative to conventional AVR; shorter aortic cross-clamp and cardiopulmonary bypass times are the chief advantages. We compared the outcomes of sutureless AVR with those of conventional AVR in 70 elderly patients who underwent concomitant cardiac surgical procedures.
We retrospectively analyzed the cases of 42 men and 28 women (mean age, 70.4 ± 10.3 yr; range, 34–93 yr) who underwent cardiac operations plus AVR with either a sutureless valve (group 1, n=38) or a conventional bioprosthetic or mechanical valve (group 2, n=32). Baseline patient characteristics were similar except for worse New York Heart Association functional status and the prevalence of diabetes mellitus in group 1.
In group 1, the operative, cross-clamp, and cardiopulmonary bypass times were shorter (all P=0.001), postoperative drainage amounts were lower (P=0.009), hospital stays were shorter (P=0.004), and less red blood cell transfusion was needed (P=0.037). Echocardiograms before patients' discharge from the hospital showed lower peak and mean aortic gradients in group 1 (mean transvalvular gradient, 8.4 ± 2.8 vs 12.2 ± 5.2 mmHg; P=0.012).
We found that elderly, high-risk patients who underwent multiple cardiac surgical procedures and sutureless AVR had better hemodynamic outcomes and shorter ischemic times than did patients who underwent conventional AVR.