bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonepileptic Episodic Events
Authors: Hopp Jennifer L. 
Published: March 2019

ABSTRACT

PURPOSE OF REVIEW
This review addresses the scope, evaluation, treatments, and outcomes of patients with nonepileptic episodic events with a focus on psychogenic nonepileptic seizures. Differentiation of the types of events, including a review of terminology, is included, as well as a brief review of special patient populations with these disorders.

RECENT FINDINGS
There are continued efforts to develop tools to improve the diagnosis of these disorders. A thorough evaluation with trained personnel and physicians knowledgeable in the assessment and treatment of these disorders is important. Although inpatient video-EEG monitoring in an epilepsy monitoring unit remains the gold standard for diagnosis, the assessment of clinical and historical factors is critical and can be useful in expediting the process and improving diagnostic certainty. International efforts have recently assisted in providing guidelines for the evaluation of the psychogenic disorders and may help target educational and other resources to underserved areas.

SUMMARY
The prompt and accurate diagnosis of nonepileptic episodic events and psychogenic nonepileptic seizures is possible with current technology, and the appropriate and targeted use of evidence-based treatments may help improve patient quality of life and avoid unnecessary disability in patients with these disorders.
Update on Antiepileptic Drugs 2019
Authors: Abou-Khalil Bassel W. 
Published: March 2019

ABSTRACT

PURPOSE OF REVIEW
This article is an update from the article on antiepileptic drug (AED) therapy published in the last Continuum issue on epilepsy and is intended to cover the vast majority of agents currently available to the neurologist in the management of patients with epilepsy. Treatment of epilepsy starts with AED monotherapy. Knowledge of the spectrum of efficacy, clinical pharmacology, and modes of use for individual AEDs is essential for optimal treatment for epilepsy. This article addresses AEDs individually, focusing on key pharmacokinetic characteristics, indications, and modes of use.

RECENT FINDINGS
Since the previous version of this article was published, three new AEDs, brivaracetam, cannabidiol, and stiripentol, have been approved by the US Food and Drug Administration (FDA), and ezogabine was removed from the market because of decreased use as a result of bluish skin pigmentation and concern over potential retinal toxicity.
Older AEDs are effective but have tolerability and pharmacokinetic disadvantages. Several newer AEDs have undergone comparative trials demonstrating efficacy equal to and tolerability at least equal to or better than older AEDs as first-line therapy. The list includes lamotrigine, oxcarbazepine, levetiracetam, topiramate, zonisamide, and lacosamide. Pregabalin was found to be less effective than lamotrigine. Lacosamide, pregabalin, and eslicarbazepine have undergone successful trials of conversion to monotherapy. Other newer AEDs with a variety of mechanisms of action are suitable for adjunctive therapy. Most recently, the FDA adopted a policy that a drug’s efficacy as adjunctive therapy in adults can be extrapolated to efficacy in monotherapy. In addition, efficacy in adults can be extrapolated for efficacy in children 4 years of age and older. Both extrapolations require data demonstrating that an AED has equivalent pharmacokinetics between its original approved use and its extrapolated use. In addition, the safety of the drug in pediatric patients has to be demonstrated in clinical studies that can be open label. Rational AED combinations should avoid AEDs with unfavorable pharmacokinetic interactions or pharmacodynamic interactions related to mechanism of action.

SUMMARY
Knowledge of AED pharmacokinetics, efficacy, and tolerability profiles facilitates the choice of appropriate AED therapy for patients with epilepsy.
A gene expression atlas of embryonic neurogenesis in Drosophila reveals complex spatiotemporal regulation of lncRNAs
Authors: McCorkindale Alexandra L. , Wahle Philipp , Werner Sascha , Jungreis Irwin , Menzel Peter , Shukla Chinmay J. , Abreu Rúben Lopes Pereira , Irizarry Rafael A. , Meyer Irmtraud M. , Kellis Manolis , Zinzen Robert P. 
Published: March 2019

ABSTRACT
Cell type specification during early nervous system development in Drosophila melanogaster requires precise regulation of gene expression in time and space. Resolving the programs driving neurogenesis has been a major challenge owing to the complexity and rapidity with which distinct cell populations arise. To resolve the cell type-specific gene expression dynamics in early nervous system development, we have sequenced the transcriptomes of purified neurogenic cell types across consecutive time points covering crucial events in neurogenesis. The resulting gene expression atlas comprises a detailed resource of global transcriptome dynamics that permits systematic analysis of how cells in the nervous system acquire distinct fates. We resolve known gene expression dynamics and uncover novel expression signatures for hundreds of genes among diverse neurogenic cell types, most of which remain unstudied. We also identified a set of conserved long noncoding RNAs (lncRNAs) that are regulated in a tissue-specific manner and exhibit spatiotemporal expression during neurogenesis with exquisite specificity. lncRNA expression is highly dynamic and demarcates specific subpopulations within neurogenic cell types. Our spatiotemporal transcriptome atlas provides a comprehensive resource for investigating the function of coding genes and noncoding RNAs during crucial stages of early neurogenesis.
Effect of Creatine Supplementation on the Airways of Youth Elite Soccer Players
Authors: SIMPSON ANDREW J. , HORNE SARA , SHARP PETER , SHARPS ROBERT , KIPPELEN PASCALE 
Published: March 2019

ABSTRACT

Introduction
Owing to its well-established ergogenic potential, creatine is a highly popular food supplement in sports. As an oral supplement, creatine is considered safe and ethical. However, no data exist on the safety of creatine on lung function in athletes. The aim of this project was to evaluate the effects of a standard course of creatine on the airways of youth elite athletes.

Methods
Nineteen elite soccer players, 16–21 yr old, completed a stratified, randomized, double-blind, placebo-controlled, parallel-group trial. The creatine group (n = 9) ingested 0.3 g·kg−1⋅d−1 of creatine monohydrate (CM) for 1 wk (loading phase) and 5 g·d−1 for 7 wk (maintenance phase), and the placebo group (n = 10) received the same dosages of maltodextrin. Airway inflammation (assessed by exhaled nitric oxide, FENO) and airway responsiveness (to dry air hyperpnoea) were measured pre- and postsupplementation.

Results
Mild, unfavorable changes in FENO were noticed by trend over the supplementation period in the CM group only (P = 0.056 for interaction, η
2 = 0.199), with a mean group change of 9 ± 13 ppb in the CM group versus −5 ± 16 ppb in the placebo group (P = 0.056, d = 0.695). Further, the maximum fall in forced expiratory volume in 1 s after dry air hyperpnoea was larger by trend postsupplementation in the CM group compared with the placebo group: 9.7% ± 7.5% vs 4.4% ± 1.4%, respectively (P = 0.070, d = 0.975). These adverse effects were more pronounced when atopic players only (n = 15) were considered.

Conclusion
On the basis of the observed trends and medium to large effect sizes, we cannot exclude that creatine supplementation has an adverse effect on the airways of elite athletes, particularly in those with allergic sensitization. Further safety profiling of the ergogenic food supplement is warranted.
Improved inference of chromosome conformation from images of labeled loci
Authors: Ross Brian C. , Costello James C. 
Published: March 2019

We previously published a method that infers chromosome conformation from images of fluorescently-tagged genomic loci, for the case when there are many loci labeled with each distinguishable color. Here we build on our previous work and improve the reconstruction algorithm to address previous limitations. We show that these improvements 1) increase the reconstruction accuracy and 2) allow the method to be used on large-scale problems involving several hundred labeled loci. Simulations indicate that full-chromosome reconstructions at 1/2 Mb resolution are possible using existing labeling and imaging technologies. The updated reconstruction code and the script files used for this paper are available at: https://github.com/heltilda/align3d.
Non-restorative cavity treatment: should this be the treatment of choice? reflections of a teacher in paediatric dentistry
Authors: Gruythuysen René JM 
Published: March 2019

Non-Restorative Cavity Treatment (NRCT) is not favoured by many paediatric dentists. However, perhaps it should be the treatment of choice rather than confronting child and parents with a restorative, symptomatic, often less child-friendly approach. Does the child have a right to a viable biological treatment option, because solving a biological problem, basically caused by neglect, with technical solutions is ethically not defensible in all cases? Restorations simply mask the caries activity. What matters is the oral health and the well-being of the child. How can this best be served? CPD/Clinical Relevance: This paper might serve as a discussion document for a group of oral health providers deciding practice policy with regard to the management of caries in primary teeth.
A review of additive manufacturing in conservative dentistry and endodontics part 2: applications in restorative dentistry and endodontics
Authors: Srinivas Peddi Shanmukh , Ashwini TS , Paras MG 
Published: March 2019

The field of science and research is dynamic and the scientific disciplines of restorative dentistry and endodontics is no exception. The practice of dentistry and the technology involved has evolved hugely from the traditional to the contemporary. As a result of continual developments in technology, newer cutting edge methods in production and treatment have evolved. This paper explores the scope of additive manufacturing technology in restorative dentistry and endodontics, progress achieved in this field, practicality hurdles, and a promising future that this technology might provide if harnessed to its full potential. CPD/Clinical Relevance: This paper gives an update on current concepts of additive manufacturing being employed in the field of restorative dentistry and endodontics for clinical practice, academic progress and translational research.
Management of intrabony defects in periodontal disease
Authors: Anderson William , Pye Andrew 
Published: March 2019

Intrabony periodontal defects present a clinical challenge in the treatment of periodontal disease and maintenance of compromised teeth. The management of such defects ranges from non-surgical mechanical debridement to modern minimally invasive regenerative surgery. The incidence of intrabony defects is discussed along with prognosis and likely outcomes of various treatment options. CPD/Clinical Relevance: Vertical or intrabony (IB) defects are a common occurrence in patients suffering from advanced periodontal disease. Primary care practitioners must be aware of possible treatment options in order to make suitable referrals when initial phases of treatment prove unsuccessful.
Amlodipine-induced gingival overgrowth in the peri-implant region: a review and case report
Authors: MacBeth Neil , Sterlitz Stephen , Bryce Graeme 
Published: March 2019

Gingival overgrowth is a known side-effect of the antihypertensive drug amlodipine, but the risk of mucosal overgrowth around dental implants has been less well documented. This article discusses the role of calcium channel blockers in drug-induced mucosal overgrowth around dental implants and describes the preventive and surgical management of the case. CPD/Clinical Relevance: The report describes the management of a patient with an implant-supported restoration who presented with peri-implantitis and drug-induced mucosal overgrowth. The review discusses how amlodipine and other medications, commonly associated with drug-induced gingival overgrowth, impact on the management of implant patients.
The bigger picture: a gorlin-goltz case report
Authors: Nimaa Zahra , Dubb Sukhpreet , Sharma Valmiki 
Published: March 2019

Gorlin-Goltz is a multisystemic inherited disorder characterized by multiple oral and systemic manifestations. Although rare, it is important for the general dentist to be aware of this condition due to the presentation of multiple odontogenic keratocysts, and to understand the differential diagnoses of jaw radiolucencies. This case describes a 53-year-old Afro-Caribbean patient who was referred by his dentist to the Maxillofacial team at Queen's Hospital regarding a ‘strange sensation’ in the mouth. Upon further investigation it was found that he had Gorlin-Goltz syndrome. CPD/Clinical Relevance: This article highlights the importance of looking at ‘the bigger picture’ clinically and radiographically and provides a reminder of the oral manifestations of Gorlin-Goltz syndrome and differential diagnoses of jaw radiolucencies.
Understanding the Systems, Contexts, Behaviors, and Strategies of Parents Advocating for Their Children With Down Syndrome
Authors: Krueger Kristen , Cless Jessica D. , Dyster Meghan , Reves Mollie , Steele Robert , Nelson Goff Briana S. 
Published: March 2019

AbstractIn the current qualitative research study, we focused on understanding the ecological systems, contexts, behaviors, and strategies of parents (N = 435) advocating for their children with an intellectual and developmental disability diagnosis, specifically Down syndrome (DS). Based on the data analysis, parents of children with DS advocate for their children frequently, in a variety of settings, with different actions, attitudes, motivations, and outcomes. The most common settings where advocacy occurred were primarily school and healthcare systems. The goals of parents often included inclusiveness, equality, and acceptance, whereas a few parents reported advocating due to discrimination and judgment. Implications for further research and professional practice also are described.
Fiscal Stewardship, Choice, and Control: The Context of Self-Directed Services for People With Intellectual and Developmental Disabilities (IDD) in the United States
Authors: Bogenschutz Matthew D. , DeCarlo Matthew , Hall-Lande Jennifer , Hewitt Amy 
Published: March 2019

Abstract
Self-directed home and community based services (HCBS) waiver services and supports for people with intellectual and developmental disabilities (IDD) have become a viable and widely used method of service provision in the United States. Grounded in theories of self-determination, previous literature on self-direction has suggested high satisfaction and positive outcomes for people who use self-directed programs as well as cost savings for state IDD service systems. This study explored the ways in which state IDD service administrators think about how self-direction may be used as a method of achieving cost savings while providing opportunities for people with IDD and their families to exercise choice and control. Informed by 54 high-level IDD service administrators in 34 states, and guided by a thematic analysis approach to data interpretation, the study found evidence that administrators typically see strong potential for self-direction to have cost-savings benefits, while also fostering choice. In the current political climate, the need for cautious fiscal stewardship may become a stronger driving force behind self-direction for people with IDD in the United States.
Development and Validation of a Model to Predict Regression of Large Size Hepatocellular Adenoma
Authors: Klompenhouwer Anne Julia , Alblas Maaike , van Rosmalen Belle Vivica , Haring Martinus Petrus Daniel , Venema Esmee , Doukas Michail , Thomeer Maarten Guillaume Josephus , Takkenberg Robert Bart , Verheij Joanne , de Meijer Vincent Erwin , van Gulik Thomas Matthijs , Lingsma Hester Floor , de Man Robert Auke , Ijzermans Jan Nicolaas Maria 
Published: March 2019

INTRODUCTION:
Surgery is advocated in hepatocellular adenomas (HCA) >5 cm that do not regress to <5 cm after 6–12 months. The aim of this study was to develop a model for these patients, estimating the probability of HCA regression to <5 cm at 1 and 2 years follow-up.

METHODS:
Data were derived from a multicenter retrospective cohort of female patients diagnosed with HCA >5 cm at first follow-up. Potential predictors included age, body mass index, and HCA diameter at diagnosis (T0), HCA-subtype (hepatocyte nuclear factor 1α inactivated HCA, inflammatory-HCA, unclassified HCA) and “T0-T1 regression-over-time” (percentage of regression between T0 and first follow-up (T1) divided by weeks between T0 and T1). Cox proportional hazards regression was used to develop a multivariable model with time to regression of HCA < 5 cm as outcome. Probabilities at 1 and 2 years follow-up were calculated.

RESULTS:
In total, 180 female patients were included. Median HCA diameter at T0 was 82.0 mm and at T1 65.0 mm. Eighty-one patients (45%) reached the clinical endpoint of regression to <5 cm after a median of 34 months. No complications occurred during follow-up. In multivariable analysis, the strongest predictors for regression to <5 cm were HCA diameter at T0 (logtransformed, hazard ratio (HR) 0.05), T0-T1 regression-over-time (HR 2.15) and HCA subtype inflammatory-HCA (HR 2.93) and unclassified HCA (HR 2.40), compared to hepatocyte nuclear factor 1α inactivated HCA (reference). The model yielded an internally validated c-index of 0.79.

DISCUSSION:
In patients diagnosed with HCA > 5 cm that still exceed 5 cm at first follow-up, regression to <5 cm can be predicted at 1 and 2 years follow-up using this model. Although external validation in an independent population is required, this model may aid in decision-making and potentially avoid unnecessary surgery.
Endoscopic Papillectomy for Major and Minor Papillary Adenoma in Familial Adenomatous Polyposis
Authors: Ahmed Moiz , Philipose Jobin , Hunton Andrew , Andrawes Sherif 
Published: March 2019

ABSTRACT
Ampullary adenomas can occur sporadically or in the patients with adenomatous polyposis syndrome, including familial adenomatous polyposis (FAP) and MUTYH-associated polyposis. The potential for malignant transformation is high in the setting of FAP. Although endoscopic resection of major papillary adenoma has been well described, minor papilla adenomas are exceptionally rare. This is the second documented case of an endoscopic papillectomy in a patient with FAP with simultaneous ampullary adenoma of the major and minor papilla.
A Successful Steroid-Sparing Approach in Cronkhite-Canada Syndrome
Authors: Mao Eric J. , Hyder Sarah M. , DeNucci Thomas D. , Fine Sean 
Published: March 2019

ABSTRACT
Cronkhite-Canada Syndrome (CCS) is a rare, sporadic polyposis condition. The literature on CCS consists mostly of case reports. Although disease presentation has been well-described, there is no consensus on the management of CCS. We present a severe case of CCS that demonstrated clinical and endoscopic response to corticosteroids. This response was maintained with azathioprine. This case provides additional experience on a therapeutic strategy to induce and maintain a durable corticosteroid-free remission.
Evaluación de la eficiencia de biodepuración para aguas de pozos profundos en la sabana de Bogotá
Authors: Quintana Germán Melo , Sánchez Leal Ligia Consuelo , Agudelo López Edgar 
Published: March 2019

En este artículo se evaluó el proceso de biodepuración de agua a ser utilizada en riegos de hortalizas en Chía, Cundinamarca; el proyecto tuvo como objetivo evaluar el tiempo y acción fitodepuradora con la presencia de tres especies de macrófitas —Eichornnia crassipes, Scirpus californicus y Lemna minor— que por tener características de fácil adaptación fueron seleccionadas. Para realizar la verificación de la acción del biosistema se generó un proceso de evaluación por medios físicos, químicos y microbiológicos, además de utilizar grupos control de Spinacia oleracea, cultivada en la zona de estudio. Se logró concluir que el biosistema posee un alto rendimiento de biodepuración, alcanzando un porcentaje de remoción óptimo para uso agrícola; adicionalmente, el sistema es funcional frente a su construcción, utilización y mantenimiento, dando respuesta a la crítica situación de las aguas empleadas para riego en esta zona colombiana.
Perbedaan Pemberian Deksametason Antara Teknik Premedikasi dan Priming Terhadap Jumlah Neutrofil Pasien Bedah Jantung yang Menggunakan Mesin
Authors: Sumantomo Boy , Nugroho Widya Istanto , Satoto Hari Hendriarto 
Published: March 2019

Latar belakang: Bedah jantung terbuka merupakan salah satu jenis operasi dengan trauma yang cukup besar, dalam pelaksanaannya menggunakan mesin jantung paru. Penggunaan mesin jantung paru menyebabkan respon inflamasi yang besar dan ditandai dengan leukositosis (neutrophil). Salah satu cara untuk mengurangi produksi neutrophil ini dengan menggunakan dexamethason, ada beberapa teknik pemberian deksametason diantaranya cara premedikasi dan priming.Tujuan: Membandingkan dexamethason 1 mg/kgBB sebagai premedikasi dan dexamethason 1 mg/kgBB saat priming terhadap jumlah neutrofil post CPB pada operasi jantung.Metode: Penelitian ini merupakan percobaan klinik secara acak yang mengikut sertakan 18 pasien bedah jantung ganti katup dengan general anestesi dan menggunakan mesin jantung paru. Sampel dibagi 2, antara pemberian deksametason teknik premedikasi dan teknik priming. Kelompok premedikasi mendapatkan deksametason 1 mg/kgbb setelah induksi, kelompok priming mendapatkan deksametason 1 mg/kgbb pada mesin jantung paru. Dengan membandingkan jumlah neutrophil pada masing-masing teknik antara preoperasi dan postoperasi.Hasil: pada penelitian ini didapatkan penurunan produksi neutrophil batang untuk teknik premedikasi dengan (p = 0,048) dan terjadi peningkatan neutrophil batang pada teknik priming (p = 0,012). Namun pada pemeriksaan neutrophil segmen terjadi peningkatan yang tidak bermakna untuk teknik premedikasi (p = 0,086) dan peningkatan yang bermakna untuk neutrophil segmen untung teknik priming (p = 0,012).Simpulan: Pemberian dexamethasone 1 mg/kgbb dengan teknik premedikasi terbukti menurunkan jumlah neutrophil batang pada pemeriksaan paska operasi bila dibandingkan pemberian dengan teknik priming. Namun tidak terbukti pada jumlah neutrophil segmen.
Study on Methyl Esterification of Salicylic Acid Using an Intensified Fixed Bed Reactor
Authors: Yang Gaodong , Chen Si , Li Xiabing , Liu Chengzhi , He Jian , Ding Weiping , Zhou Zheng , Zhang Zhibing 
Published: March 2019

Abstract
Methyl esterification of salicylic acid catalyzed by strong acidic cation exchange resin NKC-9 was carried out on an intensified fixed bed reactor (IFBR) to investigate the effects of different parameters and the results showed that the optimal conditions were as follows: circulation speed is 1.5 L· h−1, catalyst loading is 20 %, initial mole ratio of salicylic acid and methanol is 1:6 and reaction temperature is 343.15 K. The thermodynamics for the methyl esterification of salicylic acid have been studied to obtain the equilibrium constant from the experimental data at different temperature. PH, E-R and LHHW models were used to correlate the kinetic data in the temperature range from 328.15 to 348.15 K. The calculated value is in good agreement with experimental value, indicating that all the models can be used to accurately describe the process of the methyl esterification of salicylic acid.