bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radionuklidtherapie mit 223Ra-Dichlorid – Strahlenschutz und Dosimetrie
Authors: Wanke Carsten , Szermerski Bastian , Geworski Lilli 
Published: March 2018

ZusammenfassungFür die Behandlung von Patienten mit symptomatischen Knochenmetastasen bei kastrationsresistentem Prostatakarzinom (mCPRC) ohne bekannte viszerale Metastasen wird ein Medikament mit dem Wirkstoff 223Ra-Dichlorid eingesetzt. Diese Therapie stellt den derzeit einzigen Einsatz eines Alphastrahlers in der klinischen Routinetherapie dar. Dieser Artikel geht auf die Durchführung der 223Ra-Dichlorid-Therapie nebst Dosimetrie ein und beschreibt Anforderungen an den Strahlenschutz, die sich bei der Anwendung von 223Ra-Dichlorid ergeben.
Was ist neu in der 2017 ESC/EACTS-Leitlinie zum Management von Klappenerkrankungen?
Authors: Baumgartner Helmut 
Published: February 2018

ZusammenfassungDie neue gemeinsame Leitlinie der European Society of Cardiology (ESC) und European Association for Cardio-Thoracic Surgery (EACTS) für das Management von Klappenerkrankungen löst die letzte Version von 2012 ab. Neuerungen haben sich insbesondere im Bereich der katheterinterventionellen Klappenbehandlung, bei den Indikationen zur Intervention bei asymptomatischen Patienten, bei der antithrombotischen Therapie von Patienten mit Vorhofflimmern und nach Klappenintervention sowie für die Versorgungsstruktur ergeben. Der Beitrag listet im Vergleich zur Version von 2012 die 2017 veränderten und neu hinzugefügten Empfehlungen.
Ernährung und Sarkopenie
Authors: Kiesswetter Eva 
Published: February 2018

ZusammenfassungAufgrund zahlreicher Aufgaben verschiedener Ernährungsfaktoren im Muskelstoffwechsel spielt die Ernährung eine wesentliche Rolle bei der Entstehung der Sarkopenie, einem geriatrischen Syndrom, welches durch eine niedrige Muskelmasse in Kombination mit Funktionseinschränkungen gekennzeichnet ist. Eine bedarfsdeckende Energiezufuhr bildet die Grundlage für den Erhalt von Muskelmasse. Hinsichtlich der Optimierung der Muskelproteinsynthese ist besonders die Proteinzufuhr (Menge, Verteilung, Qualität) relevant. In Interaktion mit körperlichem Training ergeben sich weitere Ansatzpunkte, die anabole Resistenz des gealterten Muskels zu minimieren und Supplementationseffekte zu optimieren. Für weitere Ernährungsfaktoren wie β-Hydroxy-β-Methylbutyrat, Omega-3-Fettsäuren, Vitamin D und Antioxidanzien, die ebenfalls im Muskelstoffwechsel involviert sind, deuten Studien ein präventives und therapeutisches Potenzial bei Sarkopenie an. Die Komplexität der Ernährung und der damit verbundene Untersuchungsaufwand bedingen allerdings, dass es in vielen Bereichen noch an hochwertigen, randomisiert kontrollierten Studien fehlt und daher häufig keine spezifischen Empfehlungen für die Zufuhr der einzelnen Stoffe abgeleitet werden können.
Theaflavin-3-gallate specifically interacts with phosphatidylcholine, forming a precipitate resistant against the detergent action of bile salt
Authors: Narai-Kanayama Asako , Saruwatari Kosuke , Mori Natsumi , Nakayama Tsutomu 
Published: February 2018

Abstract
Black tea is a highly popular beverage, and its pigments, polymerized catechins such as theaflavins (TFs), are attracting attention due to their beneficial health effects. In this study, to test the inhibitory activities of TFs on the intestinal absorption of cholesterol, we investigated their effects on phosphatidylcholine (PC) vesicles in the absence or presence of a bile salt. (−)-Epicatechin gallate, (−)-epigallocatechin gallate, and TFs formed insoluble complexes with PC vesicles. Galloylated TFs such as TF2A, TF2B, and TF3 precipitated far more than other polyphenols. The subsequent addition of taurocholate redispersed the polyphenol-PC complexes, except that a large amount of TF2A remained insoluble. After incubation with taurocholate-PC micelles, TF2A elevated the turbidity of the micelle solution, providing red sediments. The TF2A-specific effect was dependent on the PC concentration. These results suggest that TF2A interacts with PC and aggregates in a specific manner different from catechins and other TFs.
Working Memory Load Modulates Neuronal Coupling
Authors: Pinotsis Dimitris A , Buschman Timothy J , Miller Earl K 
Published: February 2018

AbstractThere is a severe limitation in the number of items that can be held in working memory. However, the neurophysiological limits remain unknown. We asked whether the capacity limit might be explained by differences in neuronal coupling. We developed a theoretical model based on Predictive Coding and used it to analyze Cross Spectral Density data from the prefrontal cortex (PFC), frontal eye fields (FEF), and lateral intraparietal area (LIP). Monkeys performed a change detection task. The number of objects that had to be remembered (memory load) was varied (1–3 objects in the same visual hemifield). Changes in memory load changed the connectivity in the PFC–FEF–LIP network. Feedback (top-down) coupling broke down when the number of objects exceeded cognitive capacity. Thus, impaired behavioral performance coincided with a break-down of Prediction signals. This provides new insights into the neuronal underpinnings of cognitive capacity and how coupling in a distributed working memory network is affected by memory load.
A Lack of Continuity in Education, Training, and Practice Violates the “Do No Harm” Principle
Authors: Englander Robert , Carraccio Carol 
Published: February 2018

The paradigm shift to competency-based medical education (CBME) is under way, but incomplete implementation is blunting the potential impact on learning and patient outcomes. The fundamental principles of CBME call for standardizing outcomes addressing population health needs, then allowing time-variable progression to achieving them. Operationalizing CBME principles requires continuity within and across phases of the education, training, and practice continuum. However, the piecemeal origin of the phases of the “continuum” has resulted in a sequence of undergraduate to graduate medical education to practice that may be continuous temporally but bears none of the integration of a true continuum.
With these timed interruptions during phase transitions, learning is not reinforced because of a failure to integrate experiences. Brief block rotations for learners and ever-shorter supervisory assignments for faculty preclude the development of relationships. Without these relationships, feedback falls on deaf ears. Block rotations also disrupt learners’ relationships with patients. The harms resulting from such a system include decreases in patient satisfaction with their care and learner satisfaction with their work. Learners in this block system also demonstrate an erosion of empathy compared with those in innovative longitudinal training models. In addition, higher patient mortality during intern transitions has been demonstrated.
The current medical education system is violating the first principle of medicine: “Do no harm.” Full implementation of competency-based, time-variable education and training, with fixed outcomes aligned with population health needs, continuity in learning and relationships, and support from a developmental program of assessment, holds great potential to stop this harm.
First Case of Lymphaticovenular Anastomosis for Treatment of Secondary Lymphedema in Costa Rica: Japanese Contribution to Microsurgery Development
Authors: Centeno-Rodriguez Madelein , Koshima Isao 
Published: February 2018

Summary:
Although a large number of treatments have been developed for lymphedema, definitive management still remains a challenge for plastic surgery, because not all surgical techniques have a positive effect on every patient, and good results are difficult to reproduce. However, it is important to recognize the efforts that Professor Isao Koshima and his colleagues together with the Government of Japan are carrying out to spread information to the different countries on the newest surgical techniques available in current plastic surgery and to motivate young doctors in developing countries to create a microsurgery unit in their home country, providing them with the necessary knowledge and skills to deliver real solutions to complex problems that were previously unanswered. As a result of this program, the authors present the first case of secondary lymphedema successfully treated with lymphaticovenular anastomosis in Costa Rica, Central America.
Single‐Cell Sequencing in Normal and Malignant Hematopoiesis
Authors: Wilson Nicola K. , Göttgens Berthold 
Published: March 2018

AbstractHematopoiesis is one of the best studied adult stem‐cell systems, with a differentiation hierarchy progressing from immature hematopoietic stem cells to over 10 distinct mature cell types. Recent technological breakthroughs now make it possible to define transcriptional profiles in thousands of individual cells. Facilitated by the wealth of prior data on cell purification and analysis strategies, hematopoiesis has been one of the earliest experimental systems to which many of these new single‐cell sequencing technologies have been applied. In this review, the authors focus on recent studies, which have shed light on heterogeneity within individual populations as well as the relationships between populations, and also attempt to characterize the differences between normal and disease/perturbed states.
BILATERAL ENTEROCOCCUS FAECALIS ENDOPHTHALMITIS WITH MULTIPLE RECURRENCES
Authors: Aderman Christopher M. , Chao Daniel L. , Obeid Anthony , Schwartz Daniel M. , Bhisitkul Robert B. , Chiu Cynthia S. 
Published: February 2018

Purpose:
To describe the first case report of a bilateral recurrent Enterococcus faecalis endophthalmitis postcataract surgery.

Methods:
Case report with a description of the timeline, diagnosis, and management of a patient with bilateral recurrent E. faecalis endophthalmitis.

Results:
An 89-year-old man presented 6 weeks' postcataract surgery with pain, tearing, and blurred vision in the left eye. B-scan ultrasonography revealed vitritis and cultures postvitrectomy grew E. faecalis. There was gradual improvement in vision postintravitreal vancomycin administration. Four years later, the patient experienced another episode of E. faecalis endophthalmitis in the right eye postcataract extraction, followed by several additional episodes in both eyes posttreatment.

Conclusion:

Enterococcus faecalis is a rare but highly virulent cause of endophthalmitis that may remain sequestered in the capsular bag, despite aggressive treatment. Even after recurrent episodes, early vitrectomy and aggressive antibiotic therapy may prove to be effective in preventing vision loss.
In Vivo Confocal Microscopic Study of Hard Contact Lens–Induced Lipid Keratopathy Secondary to Corneal Neovascularization in a Rabbit Hypercholesterolemic Model
Authors: Sun Yi-Chen , Yang Li-Chuan , Hu Fung-Rong , Lin Chung-Tien , Chen Yan-Ming , Chen Wei-Li 
Published: February 2018

Objectives:
In vivo confocal microscopy was used to observe the morphological presentations and anatomical correlations between corneal neovascularization (NV) and intracorneal lipid deposition in a rabbit model of contact lens (CL)–induced lipid keratopathy secondary to corneal NV.

Methods:
Rabbits were divided into 3 groups: (1) 8-week normal diet, (2) 8-week high-cholesterol diet, and (3) 4-week normal diet followed by 4-week high-cholesterol diet. Corneal NV was induced by closed-eye CL. The formation and maturation of corneal NV were shown by immunohistochemical staining against CD31 and high-molecular-weight melanoma-associated antigen. In vivo confocal microscopy identified corneal NV and lipid deposition. Acquired images for each eye were arranged and mapped into subconfluent montages.

Results:
In group 1, corneal NV sprouting formed from the peripheral to the central cornea by the end of week 4. Pericytes around vessels were shown after 2 weeks of CL wear. In group 2, lipid deposition started from the peripheral cornea and progressively covered the whole cornea. In group 3, lipid deposition was found first in the central cornea after 2 weeks of high-cholesterol diet and progressed to cover the peripheral cornea. In vivo confocal microscopy demonstrated four different patterns of intracorneal lipid deposition: spindle shapes arranged randomly or in parallel, amorphous shapes, multiangular shapes, and mixed types. Intracorneal lipid deposition was distributed from basal corneal epithelium to deep stroma.

Conclusions:
Intracorneal lipids tend to accumulate around newly formed corneal NV but can extend to the area covered with mature NV. In vivo confocal microscopy can demonstrate various shapes and depths of intracorneal lipid deposition.
Tablet-based Screening for Hearing Loss: Feasibility of Testing in Nonspecialty Locations
Authors: Kelly Elizabeth A. , Stadler Michael E. , Nelson Steven , Runge Christina L. , Friedland David R. 
Published: February 2018

Objective:
To determine the feasibility of audiometric screening with tablet-based applications in typical clinic locations: examination room and clinic waiting area.

Study Design:
A randomized prospective study.

Setting:
Tertiary referral center.

Patients:
Participants included 107 adult patients referred for audiometric testing to assess hearing loss.

Intervention:
Each patient completed standard audiometry testing and one of three tablet-based audiometric applications that included pure-tone air conduction testing. The tablet-based audiometric testing was completed in a quiet examination room and a clinic waiting area using noise-cancellation headphones. A 5-question patient satisfaction survey was completed at the end of the testing.

Main Outcome Measure:
Thresholds at each frequency were compared with those obtained from tablet-based audiometric applications in a quiet examination room and clinic waiting area. Sensitivity and specificity of each tablet-based audiogram in detecting a hearing loss at each frequency was determined.

Results:
All three tablet-based audiometric applications were user-friendly for hearing screening. However, one application was shown to be feasible and the most accurate of the three tested with 92% of thresholds within 10 dB of conventional audiometry across all test conditions. This application had a sensitivity of 96 to 100% and specificity of 72 to 85% for identifying a hearing loss in each frequency tested. Variability was noted among applications between testing in a quiet clinic room and testing in the clinic waiting area. Patients showed no preference for either conventional audiometry or the tablet-based device.

Conclusion:
Tablet-based audiometric applications can be used to screen for hearing loss in typical clinic locations. This tool does not replace standard audiometry testing but allows for screening for hearing disorders when appropriate and in settings without access to audiometric equipment.
Frequency of and Factors Associated With Obstructive Sleep Apnea and Periodic Limb Movements in Stroke and TIA Patients
Authors: Gadodia Gaurav , Rangaraju Srikant , Raza Syed A. , Razzak Ammar , Marmarchi Labib , Davis Brittaine , Henriquez Laura , Trotti Lynn M. , Rye David , Nahab Fadi 
Published: February 2018

Introduction:
Obstructive sleep apnea (OSA) and periodic limb movements (PLMs) have been associated with an increased risk of cardiovascular disease. There is limited data on the relationship between OSA and PLMs with atrial fibrillation and resistant hypertension in stroke and transient ischemic attack (TIA) patients.

Methods:
Consecutive stroke and TIA patients referred by a vascular neurologist for diagnostic polysomnography (PSG) from September 1, 2012 to August 31, 2015 were included in a retrospective analysis. Baseline clinical characteristics, PSG results and outcomes were collected to identify the frequency of and factors associated with PLMs (mild 5 to 10/h; severe ≥15/h), PLM arousals (≥5/h) and moderate-severe OSA (apna-hypopnea Index ≥15) including atrial fibrillation and resistant hypertension.

Results:
Among 103 patients (mean age, 60±15 y; 50% female; 61% nonwhites; 77% ischemic stroke; 23% resistant hypertension) who underwent PSG, 20% had mild PLMs, 28% had severe PLMs, 14% had PLM arousals, and 22% had moderate-severe OSA. Factors associated with moderate-severe OSA included older age (odds ratio, 1.06; 95% confidence interval, 1.02-1.11) and presence of atrial fibrillation (odds ratio, 4.26; 95% confidence interval, 1.17-15.44). Nonwhite race was associated with lower likelihood of mild and severe PLMs, whereas female sex was associated with lower likelihood of PLM arousals. OSA and PLMs were not associated with resistant hypertension.

Conclusions:
A significant number of stroke and TIA patients who underwent PSG have PLMs and moderate-severe OSA. Stroke and TIA patients with atrial fibrillation are more likely to have moderate-severe OSA and may benefit from PSG evaluation.
Intravenous Paracetamol Overdose
Authors: Aslan Nagehan , Yildizdas Dincer , Arslan Didar , Horoz Ozden Ozgur , Yilmaz Hayri Levent , Bilen Sevcan 
Published: February 2018

Abstract
Paracetamol is a common antipyretic often used to treat children with fever and pain. With the increasing administration of intravenous (IV) paracetamol, there will be the associated risk of medication dosing errors. We report a case of IV paracetamol overdose in a child with fever during hospital admission. A IV paracetamol dosing error occurred, with delayed recognition resulting in transient hepatotoxicity, with a peak alanine transaminase of 1946 IU/L and aspartate transaminase of 1633 IU/L.
The Not-So-Soft Spot
Authors: Cristoforo Thomas , Le Nicole K. , Rye-Buckingham Summer , Hudson William B. , Carroll Leslie F. 
Published: February 2018

Abstract
Roseola infantum is a clinical syndrome characterized by high fever followed by the emergence of a rash. Case reports have documented an association between bulging fontanelles and roseola. We propose a novel mechanism for the development of intracranial hypertension caused by human herpesvirus 6–induced cytokine elevation leading to increased cerebrospinal fluid production.
Removal of Maxillary Sinus Antrolith and Concomitant Intrasinus Augmentation
Authors: Rahpeyma Amin , Khajehahmadi Saeedeh 
Published: March 2018

Abstract
Maxillary sinus antrolithisis is a rare finding. Conservative surgical removal recommended. In the patients that need to maxillary intrasinus augmentation and antrolith is observed in preoperative radiography, 2 options remain. First, doing Caldwell-luc surgery to remove antrolith and delayed open sinus lift. Second way is removing antrolith and concomitant intrasinus augmentation.
The first way has 2 disadvantages: prolonged waiting period and difficulty of open sinus lift in sinuses with scar and fibrosis. Coupling these 2 surgeries and using corticocancellous bone block as grafting material are recommended by us. Buccal fat pad is a good option to isolate this graft from maxillary sinus.
Evaluation of Smartphone Pelvic Floor Exercise Applications Using Standardized Scoring System
Authors: Barnes Kara Lauren , Dunivan Gena , Jaramillo-Huff Ashley , Krantz Tessa , Thompson Jennifer , Jeppson Peter 
Published: February 2018

Objective
The aim of this study was to identify smartphone Kegel and pelvic floor exercise applications (apps) and identify those with superior functionality, features, and accuracy.

Methods
We identified a complete list of Kegel and pelvic floor exercise applications by searching iTunes and Google Play stores for “pelvic floor,” “pelvic floor exercises,” “Kegel,” and “Kegel exercises.” We used a modified APPLICATIONS scoring system to evaluate all identified apps.

Results
We identified 120 apps related to Kegel exercises. Apps unrelated to the pelvic floor, unavailable in English, or duplicated on a separate platform were excluded from the analysis, leaving 90 unique apps. After a preliminary review, we excluded an additional 58 apps that were nonfunctional, required a biofeedback device, or intended for pregnant women. The final 32 apps included 15 paid and 17 free apps. Paid apps had higher rates of privacy features than free apps (80% vs 53%), used more images and figures (53% vs 41%), and were more likely to cite primary literature in their descriptions (33% vs 29%). Paid apps were also more likely to have tech support available (73% vs 53%). Overall score, however, was almost identical between the groups, with paid apps averaging 9.93 and free apps 9.41. The highest rated free and paid app both received a score of 12, consisting of Kegel Trainer and Kegel Trainer Pro, respectively.

Conclusion
The quality of the apps is markedly variable in both the paid and unpaid applications. Using the APPLICATIONS scoring system, the apps were very similar in overall quality and value.
Human axial progenitors generate trunk neural crest cells
Authors: Frith Thomas J. R. , Granata Ilaria , Stout Erin , Wind Matthew , Thompson Oliver , Neumann Katrin , Stavish Dylan , Heath Paul R. , Hackland James O.S. , Anastassiadis Konstantinos , Gouti Mina , Briscoe James , Wilson Val , Guarracino Mario R. , Andrews Peter W. , Tsakiridis Anestis 
Published: February 2018

AbstractThe neural crest (NC) is a multipotent embryonic cell population generating distinct cell types in an axial position-dependent manner. The production of NC cells from human pluripotent stem cells (hPSCs) is a valuable approach to study human NC biology. However, the origin of human trunk NC remains undefined and therefore current in vitro differentiation strategies induce only a modest yield of trunk NC cells. Here we show that hPSC-derived axial progenitors, the posteriorly-located drivers of embryonic axis elongation, give rise to trunk NC cells and their derivatives. Moreover, we define the molecular signatures associated with the emergence of human NC cells of distinct axial identities in vitro. Collectively, our findings indicate that there are two routes toward a human post-cranial NC state: the birth of cardiac and vagal NC is facilitated by retinoic acid-induced posteriorisation of an anterior precursor whereas trunk NC arises within a pool of posterior axial progenitors.