bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful EUS-guided antegrade stenting for malignant severe biliary obstruction combined with a newly developed plastic stent
Authors: Minami Kazuhiro , Iwasaki Eisuke , Itoi Takao , Fukuhara Seiichiro , Horibe Masayasu , Seino Takashi , Kawasaki Shintaro , Katayama Tadashi , Takimoto Yoichi , Tamagawa Hiroki , Machida Yujiro , Hamamoto Yasuo , Ogata Haruhiko , Kanai Takanori 
Published: November 2018

Abstract
Background and study aims We report the effectiveness of a newly developed plastic stent for preventing bile leakage after endoscopic ultrasonography (EUS)-guided antegrade stenting. This treatment was performed on a 59-year-old woman with malignant obstructive jaundice caused by peritoneal metastasis. First, we attempted transpapillary drainage using short-type single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography, but we could not achieve it. We then attempted EUS-guided antegrade stenting through the intrahepatic bile duct from the esophagojejunal anastomosis. We successfully inserted uncovered metallic stents for common bile duct and a newly plastic stent for hepaticojejunostomy from the antegrade approach. There were no adverse events after the treatment.
Endoscopic submucosal dissection of 301 large colorectal neoplasias: outcome and learning curve from a specialized center in Europe
Authors: Rönnow Carl-Fredrik , Uedo Noriya , Toth Ervin , Thorlacius Henrik 
Published: November 2018

Abstract
Background and study aims Endoscopic submucosal dissection (ESD) allows en bloc resection of large colorectal lesions but ESD experience is limited outside Asia. This study evaluated implementation of ESD in the treatment of colorectal neoplasia in a Western center.
Patients and methods Three hundred and one cases of colorectal ESD (173 rectal and 128 colonic lesions) were retrospectively evaluated in terms of outcome, learning curve and complications.
Results Median size was 4 cm (range 1 – 12.5). En bloc resection was achieved in 241 cases amounting to an en bloc resection rate of 80 %. R0 resection was accomplished in 207 cases (69 %), RX and R1 were attained in 83 (27 %) and 11 (4 %) cases, respectively. Median time was 98 min (range 10 – 588) and median proficiency was 7.2 cm2/h. Complications occurred in 24 patients (8 %) divided into 12 immediate perforations, five delayed perforations, one immediate bleeding and six delayed bleedings. Six patients (2 %), all with proximal lesions, had emergency surgery. Two hundred and four patients were followed up endoscopically and median follow-up time was 13 months (range 3 – 53) revealing seven recurrences (3 %). En bloc rate improved gradually from 60 % during the first period to 98 % during the last period. ESD proficiency significantly improved between the first study period (3.6 cm2/h) and the last study period (10.8 cm2/h).
Conclusions This study represents the largest material on colorectal ESD in the west and shows that colorectal ESD can be implemented in clinical routine in western countries after appropriate training and achieve a high rate of en bloc and R0 resection with a concomitant low incidence of complications. ESD of proximal colonic lesions should be attempted with caution during the learning curve because of higher risk of complications.
First-line endoscopic treatment with over-the-scope clips in patients with either upper or lower gastrointestinal bleeding: a multicenter study
Authors: Manta Raffaele , Mangiafico Santi , Zullo Angelo , Bertani Helga , Caruso Angelo , Grande Giuseppe , Zito Francesco Paolo , Mangiavillano Benedetto , Pasquale Luigi , Parodi Andrea , Germanà Bastianello , Bassotti Gabrio , Monica Fabio , Zilli Maurizio , Pisani Antonio , Mutignani Massimiliano , Conigliaro Rita , Galloro Giuseppe 
Published: November 2018

Abstract
Background and study aims Endoscopic treatment is the mainstay approach for gastrointestinal bleeding, in either upper (UGIB) or lower (LGIB) tract. The over-the-scope clip (OTSC) may overcome limitations of standard clips or thermocoagulation in high-risk bleeding lesions. We evaluate the main clinically relevant outcomes following endoscopic hemostasis with OTSC in high-risk lesions and/or patients.
Patients and methods This was a retrospective analysis of prospectively collected databases including all patients with UGIB and LGIB who underwent OTCS placement as first-line treatment in eleven tertiary endoscopic referral centers. Technical success, primary hemostasis, rebleeding, blood transfusion, hospital stay, and hemorrhage-related mortality rates were evaluated.
Results Data from 286 patients, with either UGIB (N = 214) or LGIB (N = 72) were available. Overall, 112 patients (39.2 %) were receiving antithrombotic therapy. Technical success and primary hemostasis rates were 97.9 % and 96.4 %, respectively. Early rebleeding occurred in 4.4 %, more frequently in those on antithrombotic therapy, and no late rebleeding was observed. Following a successful primary haemostasis, only 5.2 % patients needed blood transfusions, and the median hospital stay was 4 days (range: 3 – 11). Eighteen patients with either technical failure (N = 6) or rebleeding (N = 12) underwent radiological or surgical approaches. Overall, bleeding-related deaths occurred in 5 (1.7 %) patients, including 3 patients with technical procedural failure, and 2 in the rebleeding group.
Conclusions Data from our large, multicenter study show that OTSC placement is an effective first-line treatment for hemostasis in high-risk patients and/or lesions both in upper and lower gastrointestinal tract.
Treatment of neglected, severely displaced, open malunion
of the distal radius and ulna in an elderly person with Alzheimer’s disease – a
case report
Authors: Zyluk Andrzej , Puchalski Piotr 
Published: November 2018

AbstractThe case of a patient suffering from Alzheimer’s disease who sustained
epiphyseal, severely dislocated fractures of the distal radius and ulna is
reported. As the patient was incapacitated and attempts to contact her curator
failed, the decision was made on a conservative treatment of the fractures. This
treatment eventually failed and resulted in malunion with exposure of bone
fragments above the skin. After obtaining informed consent from her curator, a
corrective osteotomy was performed using an original method, followed by
fixation of bone fragments in almost anatomical position by intramedullary K
wires. At a 6-month follow-up, the patient was using her hand in daily life and
did not complain of any pain. An X-ray showed consolidation of the bones in the
distal forearm in an acceptable position.
Metabolic Syndrome as a Predictor of Adrenal Functional Status: A Discriminant Multivariate Analysis Versus Logistic Regression Analysis
Authors: Tsentidis Charalampos , Bampilis Andreas , Ntova Vasiliki , Fragkos Dimitrios , Panos Christos , Limniati Christina , Kassi Georgia 
Published: November 2018

AbstractPatients harboring adrenal tumors are characterized by higher prevalence of metabolic syndrome (MetS) components and a higher incidence of cardiovascular complications, especially in cases of subclinical or overt hormonal hypersecretion. Early detection and referral of those patients in tertiary centers could prevent unfavorable outcomes. In this cross-sectional, retrospective study, we evaluated 111 consecutive patients with adrenal incidentalomas and 14 patients with known hypersecretory adrenal lesions (autonomous cortisol secretion, primary aldosteronism, and pheochromocytoma), who were investigated in our clinic. Based on the different distribution of MetS components in patients with non-functional and functional adrenal lesions we introduced a predictive model of hormonal hypersecretion using those components. We performed multivariate discriminant analysis and compared predictive results with conventional multiple logistic regression analysis. Diabetes, impaired glucose tolerance, impaired fasting glucose, hypertension, body mass index, HDL-cholesterol levels, triglyceride levels, drug treatment for lipid disorder (statins, fenofibrate, and fish oils, alone or in combination), and maximal adrenal lesion diameter were used as discriminating covariates. Multivariate discriminant function exhibited a sensitivity of 77.27% and specificity of 73.08% in predicting adrenal hormonal hypersecretion. Receiver operating characteristic curve of discriminant predictive function had an area under the curve value of 0.785, S.E. 0.04. Logistic function delivered comparable results. MetS components exhibit a good predictive feature of hormonal hypersecretion in patients with adrenal tumors. Predictive functions may help in the search for an easy and generally available algorithm to validly predict the functional activity of adrenal masses.
Granulomatosis with Polyangiitis (Wegener's Granulomatosis): Evolving Concepts in Treatment
Authors: Derhovanessian Ariis , Tazelaar Henry , Belperio John , Lynch Joseph 
Published: November 2018

AbstractGranulomatosis with polyangiitis (GPA), formerly termed Wegener's granulomatosis, is the most common of the pulmonary vasculitides. GPA typically involves the upper respiratory tract, lower respiratory tract (bronchi and lung), and kidney, with varying degrees of disseminated vasculitis. Cardinal histologic features include a necrotizing vasculitis involving small vessels, extensive “geographic” necrosis, and granulomatous inflammation. The spectrum and severity of the disease is heterogeneous, ranging from indolent disease involving only one site to fulminant, multiorgan vasculitis. Circulating antibodies against cytoplasmic components of neutrophils (ANCAs) play a role in the pathogenesis, and often correlate with activity of the disease. Treatment strategies are evolving. Cyclophosphamide (CYC) plus corticosteroids was the mainstay of therapy for generalized, multisystemic GPA since the 1970s. However, within the past decade, rituximab (RTX), a monoclonal antibody directed against B cells, has been shown to be at least as effective (and possibly more effective) as CYC. Furthermore, the use of RTX may reduce the need for maintenance immunosuppression. Optimal therapy for GPA remains controversial, and additional studies are required to determine the role and duration of maintenance therapy following successful induction therapy.
Artificial Intelligence in Radiology: Current Technology and Future Directions
Authors: Zoga Adam , Syed Ali 
Published: November 2018

AbstractArtificial intelligence (AI) has been heralded as the next big wave in the computing revolution and touted as a transformative technology for many industries including health care. In radiology, considerable excitement and anxiety are associated with the promise of AI and its potential to disrupt the practice of the radiologist. Radiology has often served as the gateway for medical technological advancements, and AI will likely be no different. We present a brief overview of AI advancements that have driven recent interest, offer a review of the current literature, and examine the most likely ways that AI will change radiology in the coming years.
Evaluation of Preeclampsia Results after Use of Metformin in Gestation: Systematic Review and Meta-analysis
Authors: Nascimento Iramar Baptistella do , Dienstmann Guilherme , de Souza Matheus Leite Ramos , Fleig Raquel , Hoffmann Carla Beatriz Pimentel Cesar , Silva Jean Carl 
Published: November 2018

Objective Does the use of metformin have an influence on the outcomes of preeclampsia (PE)?
Sources of Data The descriptors pregnancy, metformin, treatment, and preeclampsia associated with the Boolean operators AND and OR were found in the MEDLINE, LILACS, Embase and Cochrane databases. A flowchart with exclusion criteria and inclusion strategy using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, and eligibility criteria was used. Data were extracted regarding the type of study, the applied dosage, treatment time, segment, bias risks, and the Patient, Intervention, Comparison and Outcome (PICO) strategy to identify the quality of the study.
Selection of Studies Total number of journals in the initial search (n = 824); exclusions from repeated articles on different search engines (n = 253); exclusions after reading the titles, when the title had no correlations with the proposed theme (n = 164); exclusions due to incompatibility with the criteria established in the methodological analysis (n = 185), exclusion of articles with lower correlation with the objective of the present study (n = 187); and final bibliographic selection (n = 35).
Data Collection At first, a systematic review of the literature was performed. Subsequently, from the main selection, randomized and non-randomized trials with metformin that presented their results in absolute and relative numbers of PE outcomes were selected. The variables were treated statistically in the meta-analysis with the Review Manager software (RevMan), version 5.3. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration. Denmark in the Hovedistaden region.
Synthesis of Data The study showed that metmorfin presented greater preventive effects for pregnancy-induced hypertension and was less effective for PE.
Conclusion Metformin may gain place in preventive treatments for PE, once the dosages, the gestational age, and treatment time are particularly evaluated. A methodological strategy with an improved perspective of innovative and/or carefully progressive dosages during pregnancy to avoid side effects and the possibility of maternal-fetal risks is suggested.
Prognostic Impact of Intracranial Pressure Monitoring in Patients with Severe Traumatic Brain Injury
Authors: Borchardt Bárbara , Freitas Luanna , Filho Ademar , da Rosa Áurea , Gabe Milena , Madeira Kristian , Moreira Carlos 
Published: November 2018

Objectives The aim of the present study was to analyze the prognostic impact of intracranial pressure (ICP) monitoring in patients with severe traumatic brain injury (TBI).
Methods An observational, retrospective and quantitative study was performed. The sample consisted of 246 patients diagnosed with severe TBI, from January 2009 to August 2017.
Results Out of the total sample, 43.56% of the patients were submitted to ICP monitoring. The mean time of use of the catheter was 1.7 days. In both groups, males were the most affected, and the majority of the patients were < 50 years old. Automobile accident was the main etiology of TBI. In the initial clinical evaluation, mydriatic pupils were related to death and normal pupil reaction at hospital discharge. The monitored group performed a larger number of computed tomography (CT) scans, with a mean of 2.6 examinations, with cerebral edema being the most common finding. Regarding the prognosis, those who used a catheter for ICP monitoring had a 47% reduction in the chance of death when compared with those who did not use the catheter. The stay duration both in the hospital and in the intensive care units was higher in patients who underwent ICP monitoring; periods > 30 days were related to meningitis, especially in those who used the catheter.
Conclusion Patients who used a catheter for ICP monitoring had a significant improvement in survival.
Is the Tubular Nervous System Related with the Development of Skeletal Muscle in Chordates? – A Review
Authors: Singh Rajani 
Published: November 2018

AbstractMany theories and arguments have been proposed regarding the ancestors of the vertebrates and the factors that lead to the evolution of the tubular nervous system. Invertebrates had simpler smooth muscles. Vertebrates acquired additional skeletal muscles. The skeletal muscles were found to be associated with a new type of tubular nervous system. There were three stages in the evolution of the nervous system. The most primitive was the network type, in which there was neither a polarization nor a centralization of neurons. The second stage was characterized by the evolution of a ganglionic nervous system. Then, the tubular type of nervous system appeared for the first time in chordates. Therefore, the author hypothesizes that the skeletal muscle developed simultaneously with the tubular nervous system. The chorda mesoderm and, thereby, the skeletal muscle, induced the formation of a tubular nervous system in chordates. In the present article, the author aims to analyze the nervous system, starting from invertebrates and moving on to chordates.
Criticality in tumor evolution and clinical outcome
Authors: Persi Erez , Wolf Yuri I. , Leiserson Mark D. M. , Koonin Eugene V. , Ruppin Eytan 
Published: November 2018

SignificanceHow mutation and selection co-determine the course of cancer evolution remains an open, fundamental question. We construct a mutation-selection phase diagram, using tumor mutation load (ML) and selection strength (dN/dS) as key variables, and assess their association with clinical outcome. The results reveal a biphasic evolutionary regime whereby beyond a critical ML, tumor fitness decreases with the number of mutations, although the proteome evolves near neutrality—that is, without strong selection. Deviations from neutrality at extreme ML show how positive selection (at low ML) and purifying selection (at high ML) may act to maintain tumor fitness. These results corroborate the existence of a critical state in cancer evolution predicted by theory and have fundamental and likely clinical implications.
The Russian-Chinese Pidgin
Authors: Fedorova Kapitolina 
Published: November 2018

Abstract
For a long period in history, the border between Russian Empire and China was a place of constant and intensive cultural and
language contacts, which resulted in the emergence of the Russian-Chinese Pidgin. In the 19th century it was used by no less than
one million people around the border with China, in an area of more than 3,000 kilometers long. The grammatical analysis of
Russian-Chinese Pidgin reveals several features (e.g. using the imperative as a basic verb form), which can be interpreted not
only linguistically but sociologically as well, because they are intertwined with the social positions of the contact groups and
their attitudes towards each other. Interestingly, features found in the pidgin’s grammar have certain parallels in
foreigner-directed talk used nowadays by Russian speakers when communicating with Chinese speakers in the border area, which may
indicate there are rather stable linguistic stereotypes associated with these contact situations.
Settler colonialism speaks
Authors: Deumert Ana 
Published: November 2018

AbstractIn this article I explore a particular set of contact varieties that emerged in Namibia, a former German colony. Historical evidence comes from the genre of autobiographic narratives that were written by German settler women. These texts provide – ideologically filtered – descriptions of domestic life in the colony and contain observations about everyday communication practices. In interpreting the data I draw on the idea of ‘jargon’ as developed within creolistics as well as onChabani Manganyi’s (1970)comments on the ‘master-servant communication complex’, and BeatrizLorente’s (2017)work on ‘scripts of servitude’. I suggest that to interpret the historical record is a complex hermeneutic endeavour: on the one hand, the examples given are likely to tell us ‘something’ about communication in the colony; on the other hand, the very description of communicative interactions is rooted in what I call a ‘script of supremacy’, which is quite unlike the ‘atonement politics’ (McIntosh 2014) of postcolonial language learning.
Français tirailleur
Authors: Parkvall Mikael 
Published: November 2018

AbstractFrançais-Tirailleur is the conventional name for the French-lexicon pidgin used in France’s African army during the 19th and 20th centuries.Tirailleurliterally translates as ‘rifleman’ or ‘sharpshooter’, but in time, and in practice, it came to refer specifically to indigenous colonial soldiers. The literature on the variety is anything but vast, but some publications are partly or entirely devoted it, almost invariably drawing on one and the same source (an anonymously authored phrasebook intended for use by French officers commanding African soldiers;Anon. 1916). Another thing most of them have in common is that they see the language as an instrument of oppression, and as we shall see, quite a few claim that the pidgin was even invented for this specific purpose.
Religious tourism and sacred sites in Asia.
Authors: Griffin K. , Raj R. , Yasuda S. 
Published: November 2018

Abstract

This chapter offers an introduction to religion, religious tourism and pilgrimage in Asia and outlines eight themes in relation to the changing face of religion in the world as identified by geographer Stanley Brunn. These are presented and considered here to illustrate the challenges facing religion, religious tourism and pilgrimage, and society in general in modern times. The layout of the book's chapters is then described.
Nankana Sahib as 'A symbol of religious coexistence'.
Authors: Abbasi A. S. 
Published: November 2018

Abstract

This chapter outlines the origins and development of Sikhism, and its integration with other religious practices in modern Pakistan. As the birthplace of this belief, Nankana Sahib possesses enormous potential for the development of religious tourism. The chapter identifies the main religious sites related to Sikhism in Nankana Sahib and other parts of Punjab, illustrating the wealth of their architecture and their importance for followers of Sikhism. The chapter then points out, using Islamic writings, how Sikhism and Islam can coexist without conflict, and thus, in the future, there is a major possibility for the expansion of Sikh tourism in Pakistan.
The destination marketing development of religious tourism in Uzbekistan: a case study.
Authors: Navruz-zoda B. , Navruz-zoda Z. 
Published: November 2018

Abstract

Following an in-depth discussion of Sufism and its development in Uzbekistan, this chapter presents a model which outlines how the Sufi tourism 'product' in Uzbekistan could be positioned and marketed to a broad range of religious tourists and pilgrims. Recommendations regarding visitor segmentation and marketing implementation are presented.
Changes in mechanical properties of sprinting during repeated sprint in elite rugby sevens athletes
Authors: Jiménez‐Reyes Pedro , Cross Matt , Ross Alex , Samozino Pierre , Brughelli Matt , Gill Nicholas , Morin Jean‐Benoît 
Published: November 2018

AbstractThis study aimed to analyse fatigue‐induced changes in mechanical sprinting properties during a specific repeated‐sprint test in elite rugby sevens athletes. Twenty elite rugby sevens players performed ten 40 m sprints on a 30 s cycle with participant's running back and forth in a marked lane. Radar was used to assess maximal overground sprint performance over each 40 m. Macroscopic mechanical properties (maximal horizontal force (F0), maximal horizontal power (Pmax), maximal ratio of horizontal force (RFpeak), decrease in the ratio of horizontal‐to‐total force (DRF), total force and maximal sprinting velocity (v0)) were drawn from horizontal force velocity relationships, using a validated method applied to the speed–time data. Fatigue‐induced changes were analysed comparing the first sprint to an average of 2nd‐4th, 5th‐7th and 8th‐10th. Repeated‐sprint ability (RSA) testing induced substantial changes in the maximal velocity component, with a decrease (–15%) in v0 (effect size (ES) = –2.46 to –4.98), and to a lower extent (–5.9%) in the maximal force component F0 (ES = –0.59). DRF moderately decreased (14%; ES=–0.76–1.11), and RFpeak largely decreased in the later sprints (ES = –0.32 to –1.27). Fatigue observed in this RSA test appeared to have a greater effect on the technical ability to produce horizontal force at high velocities, likely due to an alteration in the ability to maintain horizontally oriented force application when velocity increases rather than during the initial acceleration phase, but also the overall force production capacity. The ability to maintain forward‐oriented force at high velocities is of central importance for identifying fatigue and monitoring load.