bluuebunny/crossref_metadata_2025_split huggingface dataset:
Necrotizing fasciitis and the midterm outcomes after survival
Authors: Kruppa Christiane , Hutter Danial J , Königshausen Matthias , Gessmann Jan , Schildhauer Thomas A , Coulibaly Marlon O 
Published: April 2019

Background and Aims: Radical surgical intervention is necessary to save patients’ lives in cases of necrotizing fasciitis. This leads to persistent disabilities and most likely to a deteriorated quality of life. The purpose of this study was to evaluate the midterm outcomes after survival of necrotizing fasciitis. Materials and Methods: A retrospective analysis of 69 patients, treated for necrotizing fasciitis between 2003 and 2012. The patients were identified using the International Classification of Diseases (10th Revision) code M 72.6. Of the 50 survivors, 22 patients completed the Short Form 36 and Short Musculoskeletal Function Assessment questionnaires as a postal survey. The follow-up averaged 59 months (range: 6–128 months). Results: The average age at the time of necrotizing fasciitis was 60.0 years. The body mass index average was 29.7. The patients had a significantly decreased physical component summary score of 33.3 compared to a normative group (p < 0.001) (Short Form 36). They further showed a significantly decreased dysfunction and bother indices (Short Musculoskeletal Function Assessment) (p < 0.001). An increased age (⩾70 years) was associated with an inferior role emotional (p = 0.048) and physical functioning (p = 0.011) as well as social functioning (p = 0.038) (Short Form 36). The majority of patients (16, 72.7%) complained of pain at the final follow-up and 50% of patients required an assistive device on a regular basis. Conclusion: Patients who survived necrotizing fasciitis suffer from functional impairment and changed body appearance. Assistive devices or pain medication are often required, and the patients present with significantly decreased physical, social, and emotional functioning at the midterm follow-up. The patient’s age is a critical factor regarding functional or mental outcome parameters. Further research on the post-hospital course and long-term multidisciplinary care is required to improve the outcomes of these patients.
Presumed immune-mediated haemolytic anaemia associated with pregnancy in a cat
Authors: Kopke Matthew A , Pemberton Sarah , Ruaux Craig G 
Published: April 2019

Case summary A 7-year-old female entire Birman presented with acute-onset haemorrhagic vulvar discharge. Moderate, normocytic, normochromic, non-/pre-regenerative anaemia, along with a moderate mature neutrophilia, were seen on haematology. Saline test for agglutination was positive. No haemotropic mycoplasmas were identified. Serum biochemistry revealed severe hyperbilirubinaemia. Retroviral testing was negative. Serology for toxoplasmosis revealed a titre of 1:512. Abdominal ultrasound identified a large uterus, containing at least three advanced-stage fetuses, two of which failed to exhibit independent motion or cardiac activity. Ovariohysterectomy was performed. Histology demonstrated mild, multifocal suppurative placentitis, with Gram staining revealing no evidence of bacteria. Complete resolution of the anaemia was seen within 1.5 months of ovariohysterectomy. Relevance and novel information Immune-mediated haemolytic anaemia (IMHA) in association with pregnancy has not been previously reported in cats. This case represents a potential novel cause for IMHA in cats, which resolved following ovariohysterectomy.
Ceramic Fracture in Bilayered All-ceramic Indirect Restoration: A Review of the Literature
Authors: Alayad Abdullah Saeed 
Published: April 2019

Background:High incidence of fracture of all-ceramic crowns may compromise the clinical outcome and is a source of hassle for both patients and dentist.Objective:The objective of the present review was to identify reasons for high ceramic fracture or chipping and to minimize these incidents in dental settings.Methods:The final search strategy was executed on Medline via OvidSP, PubMed, and Web of Knowledge. Studies meeting the following inclusion criteria were included in the current review. (1) Literature in English language only, (2) in vitro studies, (3) studies providing evidence on ceramic fracture, and (4) studies only related to indirect restoration and ceramics. Moreover, the exclusion criteria were based on (1) articles other than English, (2) studies reporting direct restoration, (3) any non–peer-reviewed gray literature, and (4) studies discussing fracture other than ceramic material.Results:From the initial search strategy, 101 studies were retrieved from different databases. A total of 3 studies were scrutinized through other resources. Following duplicate removal (n = 24), 80 studies were screened for the title and abstract. Moreover (n = 49) studies were shortlisted for full text and review. Following review and discussion in the final result, only 26 studies were included.Conclusions:Many improvements in the material, its fabrication process, and surface treatments can reduce the incidence of fracture within the material.
Enhancing Accessibility of Physical Activity During Pregnancy: A Pilot Study on Women’s Experiences With Integrating Yoga Into Group Prenatal Care
Authors: Kinser Patricia , Jallo Nancy , Thacker Leroy , Aubry Christine , Masho Saba 
Published: April 2019

Introduction: Health guidelines suggest that pregnant women should participate in daily physical activity, yet rarely do they meet these guidelines. Means to enhance accessibility of physical activity for pregnant women are required, and yoga has been suggested as a possible method to enhance women’s sense of confidence and competence with physical activity. In this pilot study, our primary aim is to evaluate pregnant women’s perceptions about their lived experience of an intervention which integrates a low-intensity form of physical activity, yoga, into prenatal care; our secondary aim is to evaluate changes in participants’ self-efficacy for physical activity and time spent in physical activity over time. Methods: Held in an outpatient obstetrics department of an urban hospital system in the United States, this pilot study enrolled 16 pregnant women to participate in the intervention throughout their pregnancy. We explored participants’ lived experience of the intervention using qualitative methods (phenomenology). Means, variances, and covariances were calculated for the 2 measures (self-efficacy and time spent in physical activity) over the intervention period. Results: Qualitative findings from focus groups suggest that it is acceptable for prenatal yoga to be integrated into group prenatal care classes and women reported increased confidence with physical activity during pregnancy. Participants did not consider the intervention to fit within the traditional definition of exercise. Women reported increased amounts of time spent in physical activity from baseline to the end of pregnancy, but there were no statistically significant changes in self-efficacy over time. Discussion: The integration of gentle physical activity into the group prenatal care model warrants further attention for potential benefits with regard to maternal physical and mental wellness.
Health Extension Workers Involvement in the Utilization of Focused Antenatal Care Service in Rural Sidama Zone, Southern Ethiopia: A Cross-Sectional Study
Authors: Gebretsadik Achamyelesh , Teshome Million , Mekonnen Mekdes , Alemayehu Akalewold , Haji Yusuf 
Published: April 2019

Background: Health extension workers (HEWs) are primarily been assigned in rural areas of Ethiopia to provide maternal and child health services. Few studies have been done to investigate HEWs’ contributions towards maternal health services. This study describes HEWs involvement in the utilization of focused antenatal care (FANC). Methods: A population-based cross-sectional survey was conducted between January 21 and February 4, 2017. Mothers (2300) who gave birth in the last 6 months (0-6 months) in randomly selected 30 kebeles in the rural Sidama zone, participated in the study. A face-to-face interview was done using a structured questionnaire adapted from the Saving Newborn Lives Program. The main outcome variable was FANC utilization. Descriptive statistics and multivariate logistic regression analysis were used using SPSS statistical software. Results: The FANC was used by 525 (24.36%; 95% confidence interval [CI]: 22.5%-26.2%) women. Health extension workers accounted for 244 (46.47%; 95% CI: 43.5-47.7%) of mothers. The FANC utilization was less likely among those who were illiterate (adjusted odds ratio [AOR]: .32; 95% CI: .18-.57) and those who attended first cycle (AOR: .41; 95% CI: .23-.74), those who attended secondary cycle (AOR: .47; 95% CI: .27-.82), primipara (AOR: 0.53; 95% CI: .35-.83), and those who gave birth at home (AOR: .66; 95% CI: .51-.84). Mothers who had knowledge of pregnancy danger signs (AOR: 1.42; 95% CI: 1.2-1.7) and exposure to mass media (AOR: 1.35; 95% CI: 1.1-1.66) were more likely to utilize FANC. Conclusions: FANC utilization in this study was low compared to other studies. The HEWs had a major contribution to the services. However, it is low when compared to the plan set by the state ministry of health. The existing health extension program could be strengthened by increasing the number of HEWs. Empowering rural mothers through continuous education program to enhance the utilization of maternal health services.
One-step templated synthesis of chiral organometallic salicyloxazoline complexes
Authors: Luo Mei , Zhang Jing Cheng , Yin Hao , Wang Cheng Ming , Morris-Natschke Susan , Lee Kuo-Hsiung 
Published: April 2019

Abstract
Background
The general approach to the synthesis of metal complexes begins with ligand synthesis, followed by ligand reaction with metal salts to afford organometallic complexes. Our research group first reported a one-pot multicomponent synthesis of chiral oxazolinyl–zinc complexes, in the presence of a large amount of ZnCl2 (0.4–2.6 equiv.), with the yields of some products reaching 90%.

Results
Our prior strategy was extended to use copper, cobalt, nickel, manganese, palladium or platinum salts as the third component. The one-step method used 1.0 equivalent of a metal salt, such as M(OAc)2·nH2O or MCl2·nH2O (M: Cu, Co, Ni, Pd or Pt, n = 1, 2 or 4), as a reagent to generate chiral salicyloxazoline complexes 1–8 in the reaction of 2-cyanophenol with different d- and l-amino alcohols.

Conclusion
Complexes 1–8 were obtained using a one-pot method with a sequential strategy. The reaction outcome was demonstrated for three-component reactions between metal salts, amino alcohols and 2-hydroxybenzonitrile to afford organometallic complexes in good yields (65–95%).
Evaluation of a Multidisciplinary Team Approach for Generating Survivorship Care Plan Treatment Summaries in Patients With Breast Cancer
Authors: Ivanics Tommy , Proctor Erica , Chen Yalei , Ali Haythem , Severson Dawn , Nasser Hassan , Colbert Sonja , Susick Laura , Walker Eleanor , Petersen Lindsay , Bensenhaver Jessica , Loutfi Randa , Nathanson S. David , Newman Lisa A. 
Published: April 2019

INTRODUCTION: The optimal structure for survivorship care plan (SCP) programs and methodology for generating treatment summaries (TSs) has not yet been defined, but the Commission on Cancer and the National Accreditation Program for Breast Centers both mandate that participating oncology programs implement SCP-TS processes for patients that have completed treatment. METHODS: We used the Institute for Healthcare Improvement’s Plan-Do-Study-Act model for conducting a quality improvement project evaluating two different SCP-TS programs implemented at the Henry Ford Health System/Henry Ford Cancer Institute’s Breast Oncology Program in Detroit, Michigan. System I involved TSs drafted by nonspecialist breast clinic staff; System II involved TSs vetted through a multidisciplinary breast specialist conference approach. Accuracy of basic documentation entries related to dates and components of treatment were compared for the two approaches. RESULTS: Seventy-one System I and 93 System II documents were reviewed. Documentation was accurate in at least 90% of documents for both systems regarding delivery of chemotherapy and/or endocrine therapy and for documenting the identity of the various members of the cancer treatment team. Both systems had notable inaccuracies in documenting type of surgery performed, but System II had fewer inaccuracies than System I (33.78% v 51.67%, respectively; P = .05). System II, compared with System I, had fewer inaccuracies in documenting date of diagnosis (9.68% v 25.35%, respectively; P = .01) and had less missing information for dose of radiation delivered (9.33% v 33.9%, respectively; P < .01). CONCLUSION: A multidisciplinary team approach to drafting and reviewing SCP-TS documents improved content accuracy for our program, but ongoing education regarding documentation of various surgical procedures is warranted.
Distinct gene-selective roles for a network of core promoter factors inDrosophilaneural stem cell identity
Authors: Neves Alexandre , Eisenman Robert N. 
Published: April 2019

ABSTRACTThe transcriptional mechanisms that allow neural stem cells (NSC) to balance self-renewal with differentiation are not well understood. Employing an in vivo RNAi screen we identify here NSC-TAFs, a subset of nine TATA-binding protein associated factors (TAFs), as NSC identity genes in Drosophila. We found that depletion of NSC-TAFs results in decreased NSC clone size, reduced proliferation, defective cell polarity and increased hypersensitivity to cell cycle perturbation, without affecting NSC survival. Integrated gene expression and genomic binding analyses revealed that NSC-TAFs function with both TBP and TRF2, and that NSC-TAF-TBP and NSC-TAF-TRF2 shared target genes encode different subsets of transcription factors and RNA-binding proteins with established or emerging roles in NSC identity and brain development. Taken together, our results demonstrate that core promoter factors are selectively required for NSC identity in vivo by promoting cell cycle progression and NSC cell polarity. Because pathogenic variants in a subset of TAFs have all been linked to human neurological disorders, this work may stimulate and inform future animal models of TAF-linked neurological disorders.
History and Prospects of Proton Therapy
Authors: Хорошков В. , Khoroshkov V. 
Published: April 2019

Purpose: Presentation of the history, status and prospects for the development of proton therapy. Material and methods: The history of proton therapy (PT) is divided into two periods. The first one – the experimental period lasted since 1954 to 1990, when proton therapy was carried out at the ten facilities in physical institutes. The research accelerators and the horizontal proton beams with a fixed direction are used. The second period is from 1990, when the first clinical proton center was commissioned in a multi-field hospital in the city of Loma Linda, USA. In the first period, the necessary technical tools were developed and the advantages of using accelerated protons in remote radiation therapy formulated by R. Wilson in 1946 were confirmed on a limited (about 9,000) patient population: halving the radiation load on the healthy tissues surrounding the tumor and on the organism as a whole compared to γ- and electron irradiation and high dose gradients at the borders of the dose distributions and the tumors. This allows to increase the dose in the tumor (target), increase the probability of the tumor resorption and at last to irradiate tumors, including small sizes, located near critical organs and structures. By 1990, in three experimental centers in Russia (JINR, ITEP, PNPI) accumulated about 30 % of world clinical experience. Today, more than 70 multi-cabin and several single-cabin clinical based proton therapy centers operate in the world. Almost all centers are equipped with gantry installations for PT for 95 % of patients. Today proton therapy is indicated and is used for the treatment of 10–15 % of all malignancies of cancer incidence structure. Results: Healthcare in Russia needs 10–15 multi-cabin proton (and ion) centers. Currently, there are one experimental PT center in the JINR, where up to 100 patients are exposed pea year. The modern proton center was commissioned at the Medical Institute Sergei Berezin in St. Petersburg with two gantry of company Varian. The IBA proton center in Dimitrovgrad is expected. The single-cabin proton complex of domestic production has been operating in Obninsk since 2017. 20th-century technologies and the horizontal beam (without the possibility of its rotation) are used in this complex for treatment of patients with small head and neck tumors. Conclusion: Equipping the Russian health care facilities with proton therapy facilities is inevitable. Russia will buy them worldwide for decades, like almost all types of high-tech medical equipment, are bought today, or can produce them locally. All the prerequisites needed for production (rich physical – technical experience, scientific and industrial potential) are available.
Morphofunctional Indicators of the Effects of Protons on the Central Nervous System
Authors: Ляхова К. , Lyakhova K. , Колесникова И. , Kolesnikova I. , Утина Д. , Utina D. , Северюхин Ю. , Severyukhin Yu. , Буденная Н. , Budennaya N. , Абросимова А. , Abrosimova A. , Молока­нов А. , Molokanov A. 
Published: April 2019

Purpose: Investigation of the dose–time–effect dependency of the behavior of mice and rats after irradiation with accelerated protons and comparison of these data with the morphological changes in the hippocampus and the cerebellum of rodents.
Material and methods: Experiments were performed on outbred adult female ICR mice (CD-1), SPF categories, body weight 30–35 g, of the age of 10 weeks – total number 61 animals, and on 39 male Sprague Dawley outbred rats weighing 190–230 g, aged 6.5–7.5 weeks. The animals were irradiated with accelerated protons with energy of 70 MeV on the medical beam of the phasotron of the Joint Institute for Nuclear Research (Dubna). Mice were placed in individual containers and irradiated 4 ones at a time. Irradiation was performed in a modified Bragg peak at doses of 0.5; 1; 2.5 and 5 Gy in caudocranial and craniocaudal direction. Rats were divided into 2 groups: intact control and group irradiated with 170 MeV protons at a dose of 1 Gy, dose rate of 1 Gy / min in the craniocaudal direction. The behavioral responses of experimental animals were tested in the Open Field test on days 1, 7, 14, 30, 90 in rats and on days 8, 30, and 90 in mice. Quantitative analysis of the dilution of Purkinje cells in the rat cerebellum was made, as well as morphological changes in the rat hippocampal neurons. It was shown a development of structural changes after irradiation with protons in neurons of different severity at different times after exposure: after 30 and 90 days.
Results: In the period of 1–8 days after proton irradiation of mice and rats in non-lethal doses (0.5–5.0 Gy), there is a dose-independent decrease in the main indicators of the spontaneous locomotor activity of rodents.
By the 90th day after irradiation, there is a clear tendency to normalize the indicators of OIR in all groups of irradiated animals, while the ES remains elevated.
Disruption of motor activity of rodents irradiated with protons in the early period and its relative normalization in the late post-irradiation period occur on the background of an increased number of morphologically altered and dystrophic neurons in the hippocampus and rarefied of Purkinje cells in the cerebellum.
Conclusion: The complex hierarchical structure of the central nervous system, the dependence of its function on the state of the whole organism and its hormonal background, as well as on the state of the blood supply and other factors, along with its high plasticity, require complex physiological, morphological and neurochemical approaches in analyzing the radiobiological effect of corpuscular radiation, taking into consideration the unevenness in dose distribution during irradiation.
Training for Nuclear Medicine
Authors: Кузнецова О. , Kuznetsova O. , Самойлов А. , Samoylov A. , Волпянс­кая О. , Volpyanskaya O. 
Published: April 2019

Purpose: Due to the necessity of improving the education of medical workers it is vital to conduct a review of the current state of training for work associated with the use of high-tech equipment and the use of radiopharmaceuticals for nuclear medicine.
Results: To ensure the availability of modern, high-quality medical care, oriented to world standards, it should be considered that the necessary conditions are based not only on the development of medical science and technology, material and technical equipment, but also on the provision of highly qualified personnel with a certain set of competencies.
Currently, the training and professional development of personnel for this area is carried out at all levels of vocational education: secondary and higher in accordance with the Lists of specialties and areas of vocational education. At the same time, the issues of developing and approving relevant professional standards and Federal state educational standards (FSES) for the needs of nuclear medicine remain unsolved, which in turn is one of the factors that reduce the demand for specialists in this field in the labor market.
At the same time, the issues of developing and approving relevant professional standards and FSES for the needs of nuclear medicine remain unsolved, which in turn is one of the factors that reduce the demand for specialists in this field on the labor market.
The personnel crisis is overcome due to the implementation of additional professional programs and practical training at the bases of leading scientific, clinical and educational institutions that are leaders in the field of nuclear medicine and radiopharmaceuticals.
Conclusion: In order to address the shortage of personnel for such a booming industry, a clear coordinated plan is needed, which would include systematic measures to train personnel both at the undergraduate level and to improve already prepared specialists. In addition, it is necessary to prepare a pool of highly qualified faculty for training specialists of a new formation. It is necessary to create federal educational standards taking into account that the current state of medical science and on the basis of professional standards. Work in this direction can be successful only if all stakeholders are actively involved: educational organizations, the professional community and government structures.
At the same time, it is an obvious fact that, before the adoption of professional standards and the FSES, the available experience of leading scientific and educational organizations in the training of specialists should be adopted and they should receive support and development.