bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of an e‑portfolio mapping tool: connecting experiences, analysis and action by learners
Authors: Heeneman Sylvia , Driessen Erik , Durning Steven J. , Torre Dario 
Published: May 2019

Reflective practice is an important characteristic of a knowledgeable health professional. Reflection is needed to maintain professional competence, practice-based learning, and an improvement focused attitude. Yet, learners struggle with reflective practice activities as they are perceived as challenging and time consuming. We used the idea of concept mapping to design an e‑portfolio tool that supports learners with their reflective practice activities. The purpose of this article is to demonstrate the design and rationale of e‑portfolio mapping and how this tool could be used to support reflective practice activities.
Following the stepwise approach typical for the reflective cycle, two types of maps were designed, a trigger map and a competency map. In a trigger map, the learner reflects on a concrete learning or feedback experience. In a competency map the learner interprets and synthesizes several previous trigger maps which ultimately leads to the formulation of new learning objectives. The e‑portfolio mapping tool can be a useful and supportive tool to foster learners’ reflective skills and provide mentors with in-depth insight into the students’ learning and reflection processes.
Being a scalpel holder might make you its victim; a series of 4 cases
Authors: Yaldo Fitoon F. , Baram Aram , Kakamad Fahmi , Allaf Rebwar A. , Kareem Shokha S. , Aziz Luqman M. , Kareem Awrin R. 
Published: May 2019

ABSTRACT

Introduction:
Scalpel blades and suture needles are the two most perilous nonhollow-bore gadgets causing percutaneous injuries in hospitals. The prevalence of these injuries and type of injuries in the Kurdistan federal region is not known.

Patients and methods:
a retrospective, multicenter study, enrolling four medical personnel suffering from significant blade injuries necessitating surgical intervention.

Results:
This study reports a series of four cases who had critical injuries caused by surgical blades. These injuries occurred in the femoral artery, radial artery, index figure and thumb. Surgical intervention was performed under general anesthesia in three cases and under local anesthesia in one case. The injuries left long term sequelae in two cases.

Conclusion:
Accidental scalpel injury is a continuous and neglected threat to health care staffs especially surgeons and could be tragic and both time consuming and financially exhausting. Elucidating the circumstances and risk factors resulting in such injuries is important in order to develop preventive guidelines and to increase awareness about this relatively hidden yet tragic event.

Highlights:
Erectile Dysfunction Predicts Cardiovascular Events as an Independent Risk Factor: A Systematic Review and Meta-Analysis
Authors: Zhao Binghao , Hong Zhengdong , Wei Yiping , Yu Dongliang , Xu Jianjun , Zhang Wenxiong 
Published: May 2019

AbstractIntroductionPrevious studies demonstrating that erectile dysfunction (ED) predicts the risk of further cardiovascular events (CV) events are insufficient to make recommendations for cardiologists, diabetologists, urologists, and more, and the association between CV events and ED degree is unclear.AimTo assess whether ED was a risk factor for CV events in a comprehensive literature review and meta-analysis.MethodsPubMed, EMBASE, the Cochrane Library, Medline, and the Web of Science were searched for eligible studies. The protocol for this meta-analysis is available from PROSPERO (CRD42018086138).Main Outcome MeasuresThe main outcomes included cardiovascular disease (CVD), coronary heart disease (CHD), stroke, and all-cause mortality. Subgroup and sensitivity analyses were conducted to detect potential bias.Results25 eligible studies involving 154,794 individuals were included in our meta-analysis. Compared with those of men without ED, the CVD risk of ED patients was significantly increased by 43% (relative risk [RR] =1.43; P &lt; .001), CHD was increased by 59% (RR = 1.59; P &lt; .001), stroke was increased by 34% (RR = 1.34; P &lt; .001), and all-cause mortality was increased by 33% (RR = 1.33; P &lt; .001). Older individuals with ED (≥55 years), those with ED of a shorter duration (&lt;7 years), and those with higher rates of diabetes (≥20%) and smoking (≥40%) were more prone to develop CVD. Additionally, severe ED was proven to predict higher CVD and all-cause mortality risk. The standardized model proposed here can be properly applied for screening early CV events.Clinical ImplicationsThe evidence prompts the diligent observation of at-risk men and reinforces the importance of early treatment to prevent CV events.Strengths & LimitationsLarger sample sizes from recent prospective cohort studies were included to provide more up-to-date, reliable, and comprehensive results. Moreover, the results were robust regarding consistency across sensitivity and subgroup analyses and remained consistent; even pre-excluded retrospective or cross-sectional studies were included. We constructed a standardized model that addresses the study’s innovations and implications for the first time. However, not all included studies were randomized controlled trials, which might downgrade this evidence.ConclusionsRisk of total CVD, CHD, stroke, and all-cause mortality was significantly increased in populations with ED, and severe ED is of particular concern. The evidence suggests the need for diligent observation of at-risk men and reinforces the importance of early treatment to prevent CV events.
Mare Nostrum: A New International Law of the Sea
Authors: Allott Philip 
Published: May 2019

That Princes may have an exclusive property in the Soveraigntie of the severall parts of the Sea, and in the passage, fishing and shores thereof, is so evidently true by way of fact, as no man that is not desperately impudent can deny it.Sir John BoroughsUsing the United Nations Convention on the Law of the Sea of 1982 as a root stock, it is possible to generate a fundamentally new international law of the sea. This regeneration will not be the product of yet another diplomatic negotiation among the representatives of the governments of states. It will be brought about by a much more direct and efficient method. It requires nothing more nor less than a reconceiving of the theoretical basis of the law of the sea.
I MONDI DEL BENESSERE: UNA NUOVA CLASSIFICAZIONE DEI WELFARE STATES
Authors: Ferrera Maurizio 
Published: May 2019

IntroduzioneNel corso dell'ultimo decennio la ricerca comparata sul welfare state ha progressivamente abbandonato l'approccio quantitativo, imperniato sul trattamento statistico di dati aggregati, per indirizzarsi con sempre maggiore convinzione verso l'analisi qualitativa, volta all'esplorazione ravvicinata di singole (o gruppi di) esperienze nazionali concrete, osservate nella loro evoluzione storica. La letteratura metodologica ha parlato in proposito di un ri-orientamento da una strategia «a intensità di variabili» (ovariable-centred) a una strategia «a intensità di casi» (ocase-centred), ovvero da una logica di spiegazione basata sulle «generalizzazioni trans-storiche», di matrice durkheimiana ad una basata sulle «generalizzazioni storiche», di matrice weberiana. Anche se ancora agli inizi, il nuovo filone qualitativo ha già apportato nuovi e importanti contributi conoscitivi sull'evoluzione del welfare state occidentale e sulle principali diversità di percorso osservabili tra paesi. Tuttavia il potenziale euristico di questi contributi è rimasto spesso limitato da un'insufficiente messa a punto degli strumenti concettuali e classificatori da essi utilizzati.
L'IDENTITÀ DELLA SINISTRA: LE POLITICHE SOCIALDEMOCRATICHE NELL'EUROPA DEL SUD
Authors: Maravall José Maria 
Published: May 2019

IntroduzioneQuesto articolo intende discutere i programmi e le politiche realizzate dai partiti socialisti dell'Europa del Sud giunti al potere negli anni ottanta. Vi sono considerati i partiti socialisti spagnolo (PSOE), greco (PASOK), portoghese (PSP), italiano (PSI) e francese (PS). Per i primi tre, la democrazia costituiva un'esperienza recente, esito delle transizioni dall'autoritarismo della metà degli anni settanta; negli altri due casi, era stata invece ristabilita al termine del secondo conflitto mondiale. Tre dei partiti socialisti considerati – PSOE, PS e PASOK – giungevano al potere forti di maggioranze assolute al Parlamento e dopo una lunga esclusione dal potere. Al contrario, i partiti socialisti portoghese e italiano facevano parte di coalizioni, con l'eccezione, in Portogallo, di un breve periodo di governo monopartitico socialista, dalle elezioni del 1976 fino alla fine del 1977. Il PSI, inoltre, figura al governo come partner minore, sebbene Craxi sia stato primo ministro dal 1983 al 1987. L'analisi comparata delle politiche sarà quindi agéométrie variable: poiché la presenza di coalizioni rende difficile assumere il bilancio dell'azione del governo come indicativo di specifiche politiche socialiste, il lavoro discuterà i casi di Spagna, Francia e Grecia con maggior dovizia.
A Rationale for Dopamine Agonists as Primary Therapy for Parkinson’s Disease
Authors: Olanow C.W. 
Published: May 2019

ABSTRACT:Levodopa is the most potent symptomatic treatment for Parkinson’s disease but adverse reactions are common and the initial response is not maintained. Further there is recent evidence that suggests that free radicals generated from the oxidative metabolism of dopamine may contribute to the pathogenesis of Parkinson’s disease. This raises the possibility that levodopa therapy by way of its conversion to dopamine may promote free radical formation and accelerate the rate of neuronal damage. Levodopa sparing strategies designed to minimize the cumulative levodopa dosage employed over the course of the disease seem a rational way to treat Parkinson patients in face of current information. Such a strategy would include the use of dopamine agonists as primary symptomatic therapy, the introduction of levodopa as an adjunct when dopamine agonists can no longer sufficiently provide satisfactory clinical control and the use of the lowest dose of levodopa that will provide satisfactory clinical control. In this way symptomatic control is not compromised on theoretical grounds, but the cumulative levodopa dose is minimized in an effort to reduce the likelihood of free radical formation with their potential adverse consequences on disease progression.
Suppression of Spreading Depression of Leão in Neocortex by an N-Methyl-D-Aspartate Receptor Antagonist
Authors: McLachlan Richard S. 
Published: May 2019

ABSTRACT:Spreading depression has been implicated in the pathophysiology of a number of diseases such as migraine, stroke and epilepsy. The characteristics of this phenomenon were explored in neocortex of anesthetized rats. Spreading depression was produced in 10 of 15 animals using mechanical, electrical and chemical stimulation. Mean amplitude of the DC shift was -9.3 mV, mean duration at any one electrode 65 sec and rate of spread 2-5 mm/min. Spreading depression was facilitated by focal interictal spike activity induced by penicillin and completely blocked by the N-methyl-D-aspartate (NMDA) receptor antagonist, DL-2-aminophosphonovaleric acid (APV), providing further evidence that excitatory amino acid neurotransmission is a critical element in the development or propagation of the phenomenon.
Malignant Astrocytoma of the Optic Nerve in a Child
Authors: Safneck Janice R. , Napier Lee B. , Halliday William C. 
Published: May 2019

ABSTRACT:Malignant gliomas of optic nerve and chiasm are rare, rapidly fatal neoplasms of adulthood. This report documents the occurrence of a malignant astrocytoma of the optic nerve in an 11-year-old boy who 9 years previously had a cerebellar medulloblastoma treated with surgery and irradiation. This malignant optic nerve glioma followed the same aggressive clinical course as that seen in adults, with death 9 months after diagnosis despite surgery and chemotherapy: Radiation may have been an important factor in the development of this malignant tumor which is almost never seen in the pediatric age group.
Amyotrophic Lateral Sclerosis: Interleukin-6 Levels in Cerebrospinal Fluid
Authors: Krieger Charles , Perry Thomas L. , Ziltener Hermann J. 
Published: May 2019

ABSTRACT:Recent observations indicate that antibodies to gangliosides are found in many patients with amyotrophic lateral sclerosis (ALS). If antigen-antibody complexes occur in ALS, elevations of cytokine levels might be expected, among them the cytokine interleukin-6 (IL-6). IL-6 is secreted by activated monocytes and other cell types and is an important mediator of the inflammatory response. We have measured cerebrospinal fluid (CSF) IL-6 levels in patients with ALS and compared them with those in psychiatric and neurodegenerative disorders not believed to be due to immune disorders of the central nervous system. We found no significant differences in CSF IL-6 levels between these groups.
Treatment of Acquired Autoimmune Myasthenia Gravis: a Topic Review
Authors: Verma Pradeep , Oger Joël 
Published: May 2019

ABSTRACT:We propose a new approach to staging the disease based on clinical and immunological response to treatment. We oppose clinical remission to immunological remission and define total clinical remission as the goal of therapy. We describe the use, side effects and indications of established therapies. Acetycholine esterase inhibitors are only a symptomatic treatment as is plasma exchange. Usefulness and limits of thymectomy, corticosteroids and immunosuppressants are described here. Their goal is to reduce the auto-immune process. Long-term hazards from these medications are described and methods to reduce their potential risks are suggested. We suggest the number of patients having life threatening complications while undergoing aggressive immunosuppression can be reduced by a systematic approach to follow-up. In the second part of this review article, adapting management to specific situations is emphasized in refractory disease, respiratory failure, neonatal and juvenile forms of the disease. The special situation of seronegative myasthenia is discussed.
MRI Diagnosis of Brainstem Cavernous Angiomas Presenting as Tumours
Authors: Preul Mark C. , Villemure Jean-Guy , Leblanc Richard , del Carpio-O’Donovan Raquel 
Published: May 2019

ABSTRACT:We report experience with 11 patients misdiagnosed for years, on the basis of computed tomography (CT) and angiography, as harbouring brainstem tumours in whom magnetic resonance imaging (MRI) demonstrated cavernous angiomas. Seven had undergone external irradiation, 2 had a ventriculo-peritoneal shunt, 2 developed aseptic femur necrosis following corticosteroid treatment, 1 had undergone a biopsy with a pathological diagnosis of glioma. CT had depicted ill-defined, hyperdense, faintly enhancing lesions. Angiography was normal, or showed an avascular mass or subtle venous pooling. MRI delineated discrete lesions, typical of cavernous angiomas, with a mixed hyperintense, reticulated, central core surrounded by a hypointense rim. Six patients subsequently underwent stereotactic radiosurgery without changes in clinical status or lesion. Although hemorrhagic neoplasms may mimic the clinical course and MRI appearance of cavernous angiomas, MRI is useful in the diagnosis of brainstem cavernous angiomas and should be performed in patients with suspected brainstem tumours.
Spontaneous Disappearance of an Intracranial Aneurysm After Subarachnoid Hemorrhage
Authors: Hamilton Mark G. , Dold Oliver N.R. 
Published: May 2019

ABSTRACT:Spontaneous disappearance of an intracranial aneurysm after subarachnoid hemorrhage is an uncommon event and usually associated with severe cerebral vasospasm, giant aneurysms or the use of antifibrinolytics. We present a young woman who suffered a grade 5 subarachnoid hemorrhage with severe vasospasm caused by a small anterior communicating artery aneurysm. The patient underwent a slow recovery and two years later requested surgery. Angiography demonstrated complete disappearance of the aneurysm. The neurosurgeon should be aware that spontaneous thrombosis of cerebral aneurysms can occur and ensure that angiography is repeated when surgery is significantly delayed.
The Anticonvulsant Effects of Vitamin E: A Further Evaluation
Authors: Levy Sheldon L. , Burnham W.M. , Bishai A. , Hwang Paul A. 
Published: May 2019

ABSTRACT:Vitamin E (d-α-tocopherol) has proven to be a useful adjunct to anticonvulsant drugs in clinical studies. Improvement has occurred even in patients with complex partial seizures, which are often resistant to drug therapy. In animals, vitamin E is effective against ferrous chloride seizures, hyperbaric oxygen seizures and penicillin-induced seizures. It has failed, however, to show anticonvulsant effects in the standard animal models used for drug screening – the maximal electroshock and threshold pentylenetetrazol tests. The present experiments were designed to further explore the anti-epileptic actions of vitamin E in animals. Three models related to complex partial epilepsy were used: 1) the development of amygdala-kindled seizures; 2) the development of electrically-induced status in kindled animals; and 3) the development of kainic-acid seizures. Vitamin E failed to produce significant effects in any of the models.
Neuroblastoma and Fetal Exposure to Phenytoin in a Child Without Dysmorphic Features
Authors: Al-Shammri S. , Guberman A. , Hsu E. 
Published: May 2019

ABSTRACT:Despite the fact that the teratogenic effects of phenytoin have been suggested in several case reports, the evidence for a possible oncogenic potential of phenytoin has not been widely recognized. Recently, neuroblastoma as well as other neuroectodermal and non-ectodermal tumors has been seen in several children exposed to phenytoin prenatally. Previous cases have been almost uniformly associated with the features of “fetal hydantoin syndrome” and none have been developmentally normal. We report a developmentally-normal boy of 2½ years with an abdominal neuroblastoma whose mother had been on phenytoin (as well as carbamazepine) throughout gestation. We review the various neoplasms which have been reported in the offspring of mothers receiving phenytoin.
Standard v. baby-led complementary feeding: a comparison of food and nutrient intakes in 6–12-month-old infants in the UK
Authors: Alpers Brigid , Blackwell Victoria , Clegg Miriam E 
Published: May 2019

AbstractObjective:To compare food and nutrient intakes of infants aged 6–12 months following a baby-led complementary feeding (BLCF) approach and a standard weaning (SW) approach.Design:Participants completed an online questionnaire consisting of sociodemographic questions, a 28 d FFQ and a 24 h dietary recall.Setting:UK.Participants:Infants (n 134) aged 6–12 months (n 88, BLCF; n 46, SW).Results:There was no difference between weaning methods for the food groups ‘fruits’, ‘vegetables’, ‘all fish’, ‘meat and fish’, ‘sugary’ or ‘starchy’ foods. The SW group was offered ‘fortified infant cereals’ (P < 0·001), ‘salty snacks’ at 6–8 months (P = 0·03), ‘dairy and dairy-based desserts’ at 9–12 months (P = 0·04) and ‘pre-prepared baby foods’ at all ages (P < 0·001) more often than the BLCF group. The SW group was offered ‘oily fish’ at all ages (P < 0·001) and 6–8 months (P = 0·01) and ‘processed meats’ at all ages (P < 0·001), 6–8 months (P = 0·003) and 9–12 months (P < 0·001) less often than the BLCF group. The BLCF group had significantly greater intakes of Na (P = 0·028) and fat from food (P = 0·035), and significantly lower intakes of Fe from milk (P = 0·012) and free sugar in the 6–8 months subgroup (P = 0·03) v. the SW group. Fe intake was below the Reference Nutrient Intake (RNI) for both groups and Na was above the RNI in the BLCF group.Conclusion:Compared with the SW group, the BLCF group was offered foods higher in Na and lower in Fe; however, the foods offered contained less free sugar.
Combination of 5-fluorouracil and thymoquinone targets stem cell gene signature in colorectal cancer cells
Authors: Ndreshkjana Benardina , Çapci Aysun , Klein Volker , Chanvorachote Pithi , Muenzner Julienne K. , Huebner Kerstin , Steinmann Sara , Erlenbach-Wuensch Katharina , Geppert Carol I. , Agaimy Abbas , Ballout Farah , El-Baba Chirine , Gali-Muhtasib Hala , Roehe Adriana Vial , Hartmann Arndt , Tsogoeva Svetlana B. , Schneider-Stock Regine 
Published: May 2019

AbstractCancer stem cells (CSCs) residing in colorectal cancer tissues have tumorigenic capacity and contribute to chemotherapeutic resistance and disease relapse. It is well known that the survival of colorectal CSCs after 5-fluorouracil (5-FU)-based therapy leads to cancer recurrence. Thus CSCs represent a promising drug target. Here, we designed and synthesized novel hybrid molecules linking 5-FU with the plant-derived compound thymoquinone (TQ) and tested the potential of individual compounds and their combination to eliminate colorectal CSCs. Both, Combi and SARB hybrid showed augmented cytotoxicity against colorectal cancer cells, but were non-toxic to organoids prepared from healthy murine small intestine. NanoString analysis revealed a unique signature of deregulated gene expression in response to the combination of TQ and 5-FU (Combi) and SARB treatment. Importantly, two principle stem cell regulatory pathways WNT/ß-Catenin and PI3K/AKT were found to be downregulated after Combi and hybrid treatment. Furthermore, both treatments strikingly eliminated CD133+ CSC population, accompanying the depleted self-renewal capacity by eradicating long-term propagated 3D tumor cell spheres at sub-toxic doses. In vivo xenografts on chicken eggs of SARB-treated HCT116 cells showed a prominent nuclear ß-Catenin and E-cadherin staining. This was in line with the reduced transcriptional activity of ß-Catenin and diminished cell adhesion under SARB exposure. In contrast to 5-FU, both, Combi and SARB treatment effectively reduced the angiogenic capacity of the remaining resistant tumor cells. Taken together, combination or hybridization of single compounds target simultaneously a broader spectrum of oncogenic pathways leading to an effective eradication of colorectal cancer cells.
Coulombic self-ordering upon charging a large-capacity layered cathode material for rechargeable batteries
Authors: Mortemard de Boisse Benoit , Reynaud Marine , Ma Jiangtao , Kikkawa Jun , Nishimura Shin-ichi , Casas-Cabanas Montse , Delmas Claude , Okubo Masashi , Yamada Atsuo 
Published: May 2019

AbstractLithium- and sodium-rich layered transition-metal oxides have recently been attracting significant interest because of their large capacity achieved by additional oxygen-redox reactions. However, layered transition-metal oxides exhibit structural degradation such as cation migration, layer exfoliation or cracks upon deep charge, which is a major obstacle to achieve higher energy-density batteries. Here we demonstrate a self-repairing phenomenon of stacking faults upon desodiation from an oxygen-redox layered oxide Na2RuO3, realizing much better reversibility of the electrode reaction. The phase transformations upon charging A2MO3 (A: alkali metal) can be dominated by three-dimensional Coulombic attractive interactions driven by the existence of ordered alkali-metal vacancies, leading to counterintuitive self-repairing of stacking faults and progressive ordering upon charging. The cooperatively ordered vacancy in lithium-/sodium-rich layered transition-metal oxides is shown to play an essential role, not only in generating the electro-active nonbonding 2p orbital of neighbouring oxygen but also in stabilizing the phase transformation for highly reversible oxygen-redox reactions.