bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health Informatics in Developing Countries: A Review of Unintended Consequences of IT Implementations, as They Affect Patient Safety and Recommendations on How to Address Them
Authors: Almerares A. , Luna D. , Marcelo A. , Househ M. , Mandirola H. , Otero C. 
Published: March 2018

SummaryBackground: Patient safety concerns every healthcare organization. Adoption of Health information technology (HIT) appears to have the potential to address this issue, however unanticipated and undesirable consequences from implementing HIT could lead to new and more complex hazards. This could be particularly problematic in developing countries, where regulations, policies and implementations are few, less standandarized and in some cases almost non-existing.Methods: Based on the available information and our own experience, we conducted a review of unintended consequences of HIT implementations, as they affect patient safety in developing countries.Results: We found that user dependency on the system, alert fatigue, less communications among healthcare actors and workarounds topics should be prioritize. Institution should consider existing knowledge, learn from other experiences and model their implementations to avoid known consequences. We also recommend that they monitor and communicate their own efforts to expand knowledge in the region.
Worsening Cardiac Function in a Patient with Friedreich’s Ataxia Secondary to Profound Hypothyroidism
Authors: Thrasher Bradly , Whitham Jennifer , Law Jennifer 
Published: March 2018

AbstractWe present a case of declining cardiac function in a patient with Friedreich's Ataxia, however, her worsening cardiac function was not related to her chronic disease. Her declining cardiac function was associated with hypothyroidism that was initially overlooked. The purpose of this article is to remind physicians of the role that thyroid hormone has in cardiac function and overall health. Autoimmune hypothyroidism is a common condition, and physicians should consider screening thyroid function in any patient with poor or worsening cardiac function.
Association of Vitamin D Levels and type 2 Diabetes Mellitus in Asian Indians is Independent of Obesity
Authors: Gupta A. , Aslam M. , Rathi S. , Mishra B. , Bhardwaj S. , Jhamb R. , Madhu S. 
Published: March 2018

Abstract
Background A large proportion of subjects with type 2 diabetes mellitus (T2DM) in India are non-obese. Asian-Indian subjects with diabetes have been shown to have low vitamin D levels. Whether low vitamin D levels and T2DM in Asian-Indians is attributable to the associated obesity as in caucasians is unclear. Hence we studied the association of vitamin D levels and T2DM in Asian-Indians with or without obesity.
Methods Total of 213 subjects were recruited in four groups, group 1-Non-obese diabetic, group 2-Non-obese non-diabetic, group 3-Obese diabetic and group 4-Obese non-diabetic. Subjects recruited under various groups were matched for age and sex. Anthropometry, skin-fold thickness, fasting and postprandial plasma glucose, HbA1c, fasting insulin, lipids and vitamin D levels were measured in all study subjects and were compared between the groups.
Results Mean age of study population was 41.23±7.43 years. Mean BMI in groups 1,2,3 and 4 was 21.34±1.41, 20.53±2.27, 27.72±2.94 and 27.62±3.37 kg/m2 respectively. Overall 64.3% study subjects had vitamin D deficiency and 27.7% had insufficient vitamin D levels. Significantly lower vitamin D levels were found in diabetic groups 1 and 3 compared to non-diabetic groups 2 and 4. No significant difference was observed in vitamin D levels between groups 1 and 3. Similarly, no significant difference was observed in vitamin D levels between groups 2 and 4. Vitamin D levels did not show any significant correlation with BMI, waist or body fat.
Conclusion Vitamin D levels do not appear to be related to obesity in diabetic as well non-diabetic Asian-Indian individuals.
Bullöses Pemphigoid
Authors: Bündner Martin 
Published: March 2018

ZusammenfassungEs wird die homöopathische Behandlung eines bullösen Pemphigoids1 mit Phosphorus vorgestellt, die mehrfach aufgrund interkurrenter Erkrankungen unterbrochen werden muss. Diese akuten Therapien erfolgen teilweise durch andere, dem jeweiligen Zustand entsprechende Mittel, teilweise durch das dann jeweils passende Phosphorus, wobei das chronische Mittel dann gleichzeitig das akute Mittel ist.Die Behandlung des Pemphigoids ist erschwert durch eigenwillige Dosierung der Medikation durch den Patienten, sowohl bezüglich der homöopathischen Arznei als auch der noch bestehenden chemischen Präparate.Es wird postuliert, dass neben den Heringʼschen Regeln auch die Rückwärtsentwicklung des Schweregrades von Erkrankungen Hinweise auf einen regelrechten Heilungsverlauf gibt.
Weisheitszähne in der Kieferorthopädie
Authors: Neuner Hemma 
Published: March 2018

Zusammenfassung50% der Menschen mit dritten Molaren haben Probleme mit diesen. Das Vorhandensein von Weisheitszähnen muss in der kieferorthopädischen Planung berücksichtig werden. Es gibt viele unterschiedliche Aspekte zum Thema Weisheitszähne: Agenesie, Retention, Zahnverlagerung, Malokklusion, Autotransplantation, Klase-III- Entwicklung, um einige zu erwähnen. Für Patient und Behandler besonders interessant ist auch die Rolle der Weisheitszähne in Zusammenhang mit einer Frontengstand-Entwicklung. Leider gibt es eine sehr kontroverse Datenlage und weitere qualitativ hochwertige Studien zu diesem Thema sind notwendig.
Innate responses to gene knockouts impact overlapping gene networks and vary with respect to resistance to viral infection
Authors: Liu Yonghong , Liu Yuanyuan , Wu Jiaming , Roizman Bernard , Zhou Grace Guoying 
Published: March 2018

Significance
Analyses of 10 cell lines from which individual genes associated with innate immunity had been knocked out revealed the following: knockout of some genes is associated with increases in the expression of overlapping networks of genes and significant loss of ability to support the replication of HSV-1; knockout of other genes is associated with decreases in the expression of overlapping networks of genes and, overall, no effect on viral replication; the phenotype of cells from which a gene was deleted reflects the sum total of the effects of genes up- or down-regulated as a consequence of the deletion; and key functions associated with innate immunity are normally repressed and must be activated in response to infection.
Neuron numbers increase in the human amygdala from birth to adulthood, but not in autism
Authors: Avino Thomas A. , Barger Nicole , Vargas Martha V. , Carlson Erin L. , Amaral David G. , Bauman Melissa D. , Schumann Cynthia M. 
Published: March 2018

Significance
We demonstrate that the number of mature neurons in the human amygdala increases from childhood into adulthood. This trajectory may be due to the incorporation of immature neurons from the paralaminar nucleus in the ventral amygdala. In contrast, individuals with autism spectrum disorder (ASD) show an initial excess of mature neurons followed by a decline into adulthood. Our results suggest a degenerative component in ASD and highlight the need for a more comprehensive understanding of the protracted cellular development of the human amygdala for multiple psychiatric disorders.
The prevalence of human intestinal spirochetosis in Norway
Authors: Lindboe Christian F. 
Published: March 2018

AbstractThe prevalence of human intestinal spirochetosis (HIS) was determined histologically in 402 subjects from South Norway (Kristiansand) who had undergone colorectal resections during the period June 1991–June 1996. The figures were compared with those from a previous mid-Norwegian study (Trondheim)1comprising 1205 patients with large bowel resections as well as colonoscopic mucosal biopsies examined in 1990. The studies showed a prevalence of HIS of 2.5% in mid-Norway and 3.0% in South Norway, and in both regions there was a considerable male predominance of HIS (70% and 75%, respectively). Furthermore, HIS was more often diagnosed by the pathologists in South Norway (25%) than in mid-Norway (6.5%).
Human intestinal spirochetosis:Brachyspira aalborgiand/orBrachyspira pilosicoli?
Authors: Mikosza Andrew S. J. , Hampson David J. 
Published: March 2018

AbstractIntestinal spirochetosis in humans (HIS) is a condition defined by the presence of a layer of spirochetes attached by one cell end to the colorectal epithelium. The pathologic significance of HIS is uncertain, but it has been linked to chronic diarrhea and other abdominal complaints. Two anaerobic intestinal spirochete species have been associated with HIS, namelyBrachyspira pilosicoliandBrachyspira aalborgi.Brachyspira pilosicoli, which colonizes many animal species, is common (~30%) in the feces of people from developing countries, including Australian Aborigines, and in HIV+ patients and male homosexuals in Western societies. It is also commonly seen attached to the rectal mucosa of homosexual males. In other groups in Western societies both the presence of B.pilosicoliin feces and histologic HIS are uncommon (~1.5%).Brachyspira aalborgiis an extremely slow growing and fastidious spirochete, which previously had been isolated from an HIS patient in Denmark. Recent studies using polymerase chain reaction amplification of DNA from intestinal biopsies from a series of cases of HIS in the general Western population demonstrated thatB. aalborgi, rather thanB. pilosicoli, was the main spirochete species involved in these patients. This review outlines recent developments in the study of HIS and the two spirochete species, and identifies priorities for future research.
Susceptibility to pleuromutilins inBrachyspira(Serpulina)hyodysenteriae
Authors: Karlsson M. , Gunnarsson A. , Franklin A. 
Published: March 2018

AbstractThe pleuromutilins are the only antimicrobial agents with sufficient minimum inhibitory concentration (MIC) values left to treat swine dysentery in Sweden. Other antimicrobials are either not approved for use against swine dysentery or only partly active againstBrachyspira hyodysenteriae. To date, in Sweden two pleuromutilins, tiamulin and valnemulin, are authorized for use in pigs. This study includes a comparison between MICs of tiamulin and valnemulin for Swedish field isolates ofB. hyodysenteriae, as determined by broth dilution. For different isolates the MIC of tiamulin was between 0 and 8 times higher than that of valnemulin. No resistance to pleuromutilins was recorded (tiamulin MIC range 0.031–2 μg/ml, valnemulin MIC range ≤0.016–1 μg/ml).In vitrodevelopment of tiamulin resistance was also studied. TwoB. hyodysenteriaeand twoB. pilosicolistrains became resistant to tiamulin following reiterated passages on agar containing tiamulin in increasing concentrations. The resistance emerged slowly and three of the strains that went through more than 60 passages increased their tiamulin MICs from 0.031–0.25 to more than 128 μg/ml. The tiamulin MIC for oneB. hyodysenteriaestrain that went through 29 passages increased from 0.0125 to 4 μg/ml. OneB. pilosicolistrain developed cross-resistance to valnemulin; the MIC increased from 0.25 to more than 64 μg/ml. The valnemulin MIC for oneB. hyodysenteriaestrain increased from 0.031 μg/ml to 32 μg/ml. Valnemulin MIC was not determined for theB. hyodysenteriaestrain that only went through 29 passages. The valnemulin MIC of the otherB. pilosicolistrain increased from 0.031 to 4 μg/ml.
Thermoelectricity in single-molecule devices
Authors: Harzheim Achim 
Published: March 2018

Harvesting waste energy from heat sources such as electronic devices through exploiting the thermoelectric effect is becoming increasingly attractive as information technique associated devices are now making up over 10% of the worldwide electricity consumption [Mills MP. The cloud begins with coal – big data, big network, big infrastructures and big power; 2013. Available from: https://www.tech-pundit.com/wp-content/uploads/2013/07/CloudBeginsWithCoal.pdf ]. While solid-state thermogenerators have been developed and have shown promising results, their price in addition to other characteristics make them unattractive for a wide use [Zhang Q, Sun Y, Xu W, et al. Organic thermoelectric materials: emerging green energy materials converting heat to electricity directly and efficiently. Adv Mater. 2014;26(40):6829–6851]. Owing to those limitations, molecular structures have emerged as a possible alternative for fabricating cheap, efficient thermogenerators. Single-molecule devices are not prone to the mechanisms that limit the performance of bulk devices and could potentially be used to build ultra-high-efficiency thermoelectric power generators [Venkatasubramanian R, Siivola E, Colpitts T, et al. Thin-film thermoelectric devices with high room-temperature figures of merit. Nature. 2001;413(6856):597–602]. Since the pioneering work by Reddy et al. in measuring single molecules there has been a steady rise in interest in this field [Reddy P, Jang SY, Segalman RA, et al. Thermoelectricity in molecular junctions. Science. 2007;315(5818):1568–1571]. While a molecular device structure allowing for cheap and scalable fabrication as well as exhibiting high efficiency has not been identified yet, there have been intriguing results in theory and experiment, showing what would be necessary to make molecules a viable alternative. Furthermore, molecular electronics has been shown to permit sensing applications and give additional insight into molecular transport. This review was submitted as part of the 2018 Materials Literature Review Prize of the Institute of Materials, Minerals and Mining run by the Editorial Board of MST. Sponsorship of the prize by TWI Ltd is gratefully acknowledged.
Constituent Instruments of International Organizations as a Special Source of the Law of International Organizations
Authors: Shpakovych Olha M , Vladyka Svitlana A 
Published: March 2018

Abstract
The article deals with the study of constituent instruments of international organizations (IOs). The author analyzes constituent instruments of IOs and determines their peculiarities. The article defines charters of IOs as a more complex instrument than a multilateral agreement. Constituent instruments, charters, as a rule, firstly fix the will of sovereign states to establish an organization and to delegate certain rights and responsibilities. Charters are directly refer to relations between member states and organs. Except charters, the law of IOs also encompasses other international agreements governing various aspects of organizations. Significant number of international agreements together with charters of organizations results in complexity of the law of IOs.
Which orthopaedic trauma patients need psychiatry consultation? A single institution pilot survey study
Authors: Campbell Sean T. , Schultz Blake J. , Franciscus Amanda M. , Ravindranath Divy , Bishop Julius A. 
Published: March 2018

Background:
The burden of psychologic stressors among trauma patients is high, and these symptoms are often left untreated. The purpose of this study was to determine the threshold for psychiatric symptom severity for which the orthopaedic surgeon and psychiatrist believe a consultation is indicated, and to compare these thresholds between the two groups.

Methods:
A survey was created following multidisciplinary discussion, which consisted of ten clinical scenarios related to orthopaedic trauma patients with symptoms of common psychologic stressors. The survey was distributed to residents in the orthopaedic surgery and psychiatry programs at our institution. Participants were asked whether a psychiatry consultation was indicated. Nonparametric statistics were used to analyze differences. Qualitative data were obtained from participants to better understand trends.

Results:
The survey was completed by 32 trainees (82 possible, 39%). There was agreement between the groups regarding scenarios involving suicidality, drug use or withdrawal, and the capacity to consent. There was disagreement for clinical scenarios involving schizophrenia, with orthopaedic surgeons believing a psychiatry consultation was indicated significantly more often than psychiatrists, and delirium, in which orthopaedic surgeons thought that a psychiatry consultation was indicated significantly less often than psychiatrists.

Conclusions:
This study demonstrated disagreement between orthopaedic surgery and psychiatry trainees. Psychiatry residents may believe that some inpatient consults for psychotic patients are unnecessary, while orthopaedic residents may be under-utilizing resources for delirious patients. Further study is necessary to determine if these trends exist at the national level and if there are implications for patient outcomes.
Upper Instrumented Vertebrae (UIV) Tilt Angle Is an Important Postoperative Radiological Parameter That Correlates With Postoperative Neck and Medial Shoulder Imbalance
Authors: Chan Chris Yin Wei , Chiu Chee Kidd , Ler Xin Yi , Ng Yun Hui , Chian Xue Han , Tan Pheng Hian , Kwan Mun Keong 
Published: March 2018

Study Design.
Retrospective study.

Objective.
To investigate the association between postoperative upper instrumented vertebrae (UIV) tilt angle with postoperative medial shoulder and neck imbalance.

Summary of Background Data.
Studies had found that current recommendations for UIV selection were not predictive of good postoperative shoulder balance.

Methods.
A total of 98 patients with adolescent idiopathic scoliosis with Lenke 1/2 curves who underwent posterior spinal fusion between 2013 and 2014 with minimum follow-up of 2 years were recruited. Radiological parameters: UIV tilt angle, T1 tilt, cervical axis, and clavicle angle were measured preoperatively, postoperatively, and at final follow-up.

Results.
Mean age was 16.2 ± 6.2 years. Mean follow-up was 37.9 ± 6.5 months. There were 73.5% Lenke 1 and 26.5% Lenke 2 curves. Significant factors affecting postoperative T1 Tilt were postoperative UIV tilt angle, preoperative T1 tilt, and preoperative UIV tilt angle. Postoperative UIV tilt angle and preoperative cervical axis were significant factors affecting cervical axis at final follow-up. UIV level was not significant independent factor that affected postoperative T1 tilt and cervical axis. There was strong correlation between postoperative UIV tilt angle and T1 tilt for the whole cohort (P < 0.001), when UIV was at T2 (P < 0.001), T3 (P < 0.001), and T4 (P < 0.001). Postoperative UIV tilt angle also had significant correlation with cervical axis when UIV was at T2 (P = 0.021) and T3 (P = 0.009).

Conclusion.
Postoperative UIV tilt angle was an independent factor, which had significant correlation with postoperative T1 tilt and cervical axis measurement. There was strong correlation between postoperative UIV tilt angle and T1 tilt for the whole cohort, when UIV was at T3 and T4. There was very strong correlation between postoperative UIV tilt angle and T1 tilt when UIV was at T2. There was also moderate and significant correlation between postoperative UIV tilt angle and cervical axis for the whole cohort.

Level of Evidence: 2
Ketorolac May Increase Hematoma Risk in Reduction Mammaplasty: A Case-control Study
Authors: Barkho Jouseph O. , Li Yu Kit , Duku Eric , Thoma Achilleas 
Published: March 2018

Background:
Ketorolac is a potent nonsteroidal anti-inflammatory drug that has valuable analgesic properties but also a hypothetical risk of increased bleeding due to inhibition of platelet activation. The clinical significance of this risk, however, is unclear when it is used after reduction mammaplasty. Our study objective was to therefore examine the association between ketorolac exposure and hematoma occurrence after breast reduction surgery. We hypothesized that there was no association between ketorolac exposure and hematoma occurrence in breast reduction surgery.

Methods:
A case-control design was used. Data from charts of all reduction mammaplasties that developed hematomas requiring surgical evacuation (cases) at our university-based hospitals were retrieved and matched to data from charts of reduction mammaplasty patients who did not indicate this complication (controls). Matching occurred in a 1:1 ratio based on 4 criteria: age, body mass index, institution, and preexisting hypertension. Charts were reviewed for retrospective information on exposure to ketorolac. Odds ratio (OR) was calculated with an OR > 1 favoring an association.

Results:
From 2002 to 2016, 40 cases of hematoma met inclusion criteria and were matched with 40 controls (N = 80). Cases had a significantly lower body mass index than controls; however, the other baseline patient demographics were similar between the 2 groups. There was an association between hematoma formation and exposure to ketorolac (OR, 2.4; 95% confidence interval, 0.8–7.4; P = 0.114) and a trend for greater risk of hematoma formation, although this was not statistically significant.

Conclusions:
Based on this level 3 evidence, there appears to be an association between perioperative ketorolac exposure and hematoma after breast reduction surgery, but it was not statistically significant. Although this study was adequately powered, the OR of 2.4 was associated with a wide confidence interval. A larger sample size may increase the precision of the results and may also make the association definitive.
Anterior Chamber Angle Tissue as an Incidental Optical Coherence Tomography Finding in a Large Healthy Caucasian Child Population
Authors: Fernández-Vigo José I. , De-Pablo-Gómez-de-Liaño Lucía , Kudsieh Bachar , Fernández-Vigo Cristina , Fernández-Vigo José Á. , García-Feijóo Julián 
Published: March 2018

Purpose:
The aim of this study was to describe the presence of anterior chamber angle (ACA) tissue as an incidental optical coherence tomography (OCT) finding in healthy children.

Methods:
For this cross-sectional study, we reviewed Fourier-domain OCT images obtained in 422 children, who were chosen as candidates for inclusion in a prior study, and who visited our clinic for a routine vision test. The presence of angle tissue was assessed in the nasal and temporal quadrants. On tomographies showing angle tissue, several measurements were made, including ACA width and trabecular meshwork length and size.

Results:
Hyperreflective tissue was observed in the ACA recess in 14 eyes of 13 children subjected to OCT (3.3%). This tissue was only present in 1 quadrant. The mean age of the affected children was 10.1±2.5 years (range, 7 to 14); 69% were female patients. Spherical refractive error was −0.5 to +1.75 D. ACA width was 45.9±9.1 (24.8 to 57.9) in the nasal quadrant and 44.3±10.1 (23.9 to 60.1) in the temporal quadrant. Trabecular meshwork length and size were 494±94 μm (322 to 732) and 0.064±0.018 mm2 (0.03 to 0.11), respectively. In all 13 children, intraocular pressure was ≤18 mm Hg, the appearance of the optic nerve head was normal, and none had a family history of glaucoma.

Conclusions:
We, here, report the incidental observation of angle tissue in a small percentage of healthy Caucasian children. The follow-up of these children in future work could clarify the possible clinical implications of this observation.