bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evolution of features of chronic pancreatitis during endoscopic ultrasound-based surveillance of individuals at high risk for pancreatic cancer
Authors: Konings Ingrid , Cahen Djuna , Harinck Femme , Fockens Paul , van Hooft Jeanin , Poley Jan-Werner , Bruno Marco 
Published: April 2018

Abstract
Background and study aims During endoscopic ultrasound (EUS)-based pancreatic ductal adenocarcinoma (PDAC)-surveillance in asymptomatic individuals, features of chronic pancreatitis (CP) are often detected. Little is known about the prevalence and progression of these features. The aim of this study was to quantify these features, assess the interobserver agreement, assess possible associated factors, and assess the natural course during 3 years of follow-up.
Patients and methods Two experienced endosonographers reviewed anonymized sequential EUS videos of participants in PDAC surveillance that were obtained in 2012 and 2015 for features of CP. Descriptives, agreement analyses, univariate and multivariate analyses for possible risk factors, and repeated measures analyses to assess intra-individual changes over time were performed.
Results A total of 42 EUS videos of 21 participants were reviewed. Any feature of CP was present in 86 % (2012) and 81 % (2015) of participants, with a mean of 2.5 features per individual. The overall interobserver agreement was almost perfect at 83 %. No baseline factors were significantly associated with features of CP. Features did not change over time, except for hyperechoic foci without shadowing, which decreased intra-individually (β = – 1.6, P = 0.005).
Conclusions This blinded study shows features of CP to be highly prevalent in individuals at high risk of developing pancreatic cancer. No baseline factors were associated with presence of these features. CP features did not increase intra-individually over a 3-year period. Longer follow-up and pathological examination of pancreatic resection specimens will be essential to learn whether EUS detection and follow-up of these CP features bear clinical relevance.
Adipositas in der Revisionsendoprothetik des Kniegelenks – eine systematische Literaturübersicht und rechtliche Bewertung
Authors: Ploeger Milena , Müller Norbert , Wirtz Dieter , Kohlhof Hendrik 
Published: April 2018

Zusammenfassung
Hintergrund Über die letzten Jahre zeigt sich ein deutlicher Trend hin zum Übergewicht innerhalb der deutschen Bevölkerung. Folglich wurde auch eine deutliche Zunahme der Anzahl adipöser Patienten in der Primärendoprothetik beschrieben. Als Folge der hohen Anzahl von primärendoprothetischen Gelenkersätzen steigt aktuell auch die Zahl der revisionsendoprothetischen Eingriffe, sodass auch hier mit einer Zunahme der Anzahl übergewichtiger Patienten zu rechnen ist. Trotz dieser Tatsachen beschreiben viele Prothesenhersteller Adipositas als eine relative, teilweise sogar absolute Kontraindikation, und auch die Datenlage in der Revisionsendoprothetik bez. Adipositas und deren Auswirkungen ist gering. Ziel dieses systematischen Reviews ist es daher, Fragen bez. der Re-Revisionsoperation, der Infektionsrate, des postoperativen Outcomes, der Implantatüberlebensrate und der rechtlichen Konsequenzen bei adipösen Patienten in der Revisionsendoprothetik des Kniegelenks zu erörtern.
Patienten/Material und Methoden Basierend auf einem systematischen Review der Datenbank PubMed identifizierten wir Studien, die sich mit der Thematik Adipositas und Übergewicht in der Wechselendoprothetik des Kniegelenks befassten. Die Bewertung der Studienqualität erfolgte anhand des Evidenzgrades sowie des modifizierten Jadad-Scores. Zusätzlich wurden die Studien nach Fallzahl, Alter, Größe, Gewicht, Geschlecht und Follow-up-Zeit analysiert. Zusätzlich erfolgte eine Analyse des aktuellen rechtlichen Aspekts.
Ergebnisse und Schlussfolgerung Insgesamt wurden aus n = 118 Suchergebnissen 5 Studien eingeschlossen. Der durchschnittliche Jadad-Score lag bei 1, das durchschnittliche Level of Evidence bei 3. Bezüglich der Infektionsrate und Revisionsoperationsrate zeigten 2 Studien deutlich schlechtere Werte für adipöse Patienten in der Wechselendoprothetik. Patienten mit einer morbiden Adipositas hatten in der Literatur ein deutlich erhöhtes Risiko für Wundheilungsstörungen und periprothetische Gelenkinfekte. Drei Studien gaben schlechtere Werte für adipöse Patienten an bez. des postoperativen Outcomes bei Funktion und Schmerz. Der rechtliche Aspekt wurde in keiner der 5 Studien genauer erörtert. Insgesamt ist die Datenlage bez. der Fragestellung gering und sehr heterogen, sodass die Gruppenbildung der 5 Studien nur bedingt vergleichbar ist. Insgesamt weisen jedoch die Ergebnisse des Reviews darauf hin, dass Adipositas auch in der Revisionsendoprothetik des Kniegelenks eine prognostisch ungünstige Einflussgröße ist. Rechtlich gesehen muss der Faktor Adipositas/Übergewicht in der Aufklärung der Wechselendoprothetik zwingend berücksichtigt werden, da sonst die Möglichkeit besteht, dass die Aufklärung nicht dem zu fordernden Fachstandard entsprechend erfolgt.
Quantification and Brain Targeting of Eugenol-Loaded Surface Modified Nanoparticles Through Intranasal Route in the Treatment of Cerebral Ischemia
Authors: Ahmad Niyaz , Ahmad Rizwan , Alam Md , Ahmad Farhan 
Published: April 2018

Abstract
Objective To enhance brain bioavailability for intranasally administered Eugenol-encapsulated-chitosan-coated-PCL-Nanoparticles (CS-EUG-PCL-NPs).
Methods Chitosan-coated-PCL-Nanoparticles (CS-PCL-NPs) were developed through double emulsification-solvent evaporation technique and further characterized for particle size, zeta potential, size distribution, encapsulation efficiency as well as in vitro drug release. UPLC-PDA method was developed to evaluate brain-drug uptake for optimized CS-EUG-PCL-NPs and to determine it’s pharmacokinetic in rat’s brain as well as plasma.
Results Mean particles size (224.5±5.31), polydispersity index (PDI) i. e. (0.216±0.020) and entrapment efficiency (68.13±5.03) was determined for developed NPs. UPLC-PDA-eλ study showed a significantly high mucoadhesive potential of CS-EUG-PCL-NPs and least for conventional and homogenized nanoformulation; elution time for EUG and internal standard (IS) thymoquinone as 3.50 and 3.61 min were observed respectively. Furthermore, intra and inter-assay (%CV) of 0.25–1.57, %accuracy (97.11-99.00%) as well as a linear dynamic range (100.00 ng/mL–2500.0 ng/mL), was observed. Pharmacokinetic studies in Wistar rat brain and plasma exhibited a high AUC0-24 alongwith an amplified Cmax (p**<0.01) as compared to i. v. treated group.
Conclusions Intranasal administration of developed CS-coated-EUG-loaded-PCL-NPs enhanced the drug bioavailability in rat brain and thus preparation of Eugenol-NPs may help treat cerebral ischemia effectively. The toxicity studies performed at the end revealed safe nature of optimized nanoformulation.
Controlled/Living Radical Polymerization of Semifluorinated (Meth)acrylates
Authors: Chen Mao , Gong Honghong , Gu Yu 
Published: April 2018

Fluorinated polymers are important materials for applications in many areas. This article summarizes the development of controlled/living radical polymerization (CRP) of semifluorinated (meth)acrylates, and briefly introduces their reaction mechanisms. While the classical CRP such as atom transfer radical polymerization (ATRP), reversible addition-fragmentation chain transfer (RAFT) polymerization and nitroxide-mediated radical polymerization (NMP) have promoted the preparation of semifluorinated polymers with tailor-designed architectures, recent development of photo-CRP has led to unprecedented accuracy and monomer scope. We expect that synthetic advances will facilitate the engineering of advanced fluorinated materials with unique properties.1	Introduction2	Atom Transfer Radical Polymerization3	Reversible Addition-Fragmentation Chain Transfer Polymerization4	Nitroxide-Mediated Radical Polymerization5	Photo-CRP Mediated with Metal Complexes6	Metal-free Photo-CRP7	Conclusion
Comprehensive Algorithm for Nasal Ala Reconstruction: Utility of the Auricular Composite Graft
Authors: Chen Collin , Patel Ruchin , Chi John 
Published: April 2018

AbstractDefects of the nasal ala are challenging to reconstruct, given its complex three-dimensional structure. Successful repair of these defects needs to provide aesthetic symmetry and preserve nasal function. A wide variety of reconstructive options have been described for nasal ala defects, ranging from skin grafts to locoregional flaps, and also includes the auricular composite graft. However, there are currently no comprehensive guidelines for nasal ala repair, and the versatile role of the auricular composite graft has not been well defined. In this review, we aim to provide a comprehensive algorithm to guide repair of nasal ala defects. Additionally, we compare our experience using the auricular composite graft with the available literature to better define its utility in nasal ala repair.
Total Knee Arthroplasty versus Osteochondral Allograft: Prevalence and Risk Factors following Tibial Plateau Fractures
Authors: Oladeji Lasun , Dreger Tina , Pratte Eli , Baumann Charles , Stannard James , Volgas David , Rocca Gregory , Crist Brett 
Published: April 2018

AbstractOrthopaedic surgeons commonly have the misconception that patients with tibial plateau fractures will likely go on to posttraumatic knee arthritis requiring total knee arthroplasty (TKA). In younger patients, osteochondral allograft (OCA) transplantation is an alternative method to address posttraumatic knee arthritis. The purpose of this study was (1) to identify our institutional failure rate following tibial plateau open reduction and internal fixation (ORIF) (failure was defined as conversion to TKA or OCA); (2) to determine if there are patient- or injury-related risk factors predictive of failure; and (3) to characterize differences between patients treated with TKA versus those treated with OCA transplantation. A 10-year retrospective review was conducted to identify patients treated at our institution with a tibial plateau fracture. Patients included in the final analysis were at least 18 years of age with an articular fracture (AO/OTA 41 B/C). The primary outcome was subsequent ipsilateral OCA or TKA. There were 350 patients (359 tibial plateau fractures) with a mean follow-up of 22.3 months (range, 6–133 months) who met inclusion criteria. Twenty-seven fractures (7.5%) were subsequently converted to a TKA or OCA at an average of 3.75 ± 3.1 years following their initial surgery. Patients who consumed tobacco were 2.3 times more likely to require a joint replacement (confidence interval [CI], 1.0–5.2; p = 0.04). Those patients who received an OCAs were significantly younger as compared with their TKA peers, both at time of initial injury (37 vs. 51 years, p = 0.02) and at time of surgery (41 vs. 55 years, p = 0.009). The joint replacement rate in this study is similar to those studies in the published literature that focused solely on the prevalence of conventional TKA. Tobacco is a risk factor for failure following tibial plateau ORIF. Patients who were treated with an OCA were younger at time of injury and failure.
A Model for Clinical Informatics Education for Residents: Addressing an Unmet Need
Authors: Mai Mark , Luo Brooke , Orenstein Evan , Luberti Anthony 
Published: April 2018

AbstractOpportunities for education in clinical informatics exist throughout the spectrum of formal education extending from high school to postgraduate training. However, physicians in residency represent an underdeveloped source of potential informaticians. Despite the rapid growth of accredited fellowship programs since clinical informatics became a board-eligible subspecialty in 2011, few resident physicians are aware of their role at the intersection of clinical medicine and health information technology or associated opportunities. In an effort to educate and engage residents in clinical informatics, Children's Hospital of Philadelphia has developed a three-pronged model: (1) an elective rotation with hands-on project experience; (2) a longitudinal experience that offers increased exposure and mentorship; and (3) a resident founded and led working group in clinical informatics. We describe resident participation in these initiatives and lessons learned, as well as resident perceptions of how these components have positively influenced informatics knowledge and career choices. Since inception of this model, five residents have pursued the clinical informatics fellowship. This educational model supports resident involvement in hospital-wide informatics efforts with tangible projects and promotes wider engagement through educational opportunities commensurate with the resident's level of interest.
Thromboembolic Reaction Following Wall Puncture in Arterioles and Venules of the Rabbit Mesentery
Authors: oude Egbrink Mirjam G A , Tangelder Geert Jan , Slaaf Dick W , Reneman Robert S 
Published: April 2018

SummaryThe walls of rabbit mesenteric arterioles and venules (diameter 20 to 40 pm) were punctured with glass micropipets (tip diameter 6 to 8 pm). Thromboembolic reactions resulting from this standardized, small mechanical vessel wall injury could be quantified in vivo with the use of intravital video-microscopy. Following induction of the injury thrombus growth started immediately (<0.1 s). Bleeding times were short, on the average less than 2 s, and did not differ between arterioles and venules. The duration of the embolization process was significantly longer in arterioles than in venules (median 101 and 17 s, respectively), and more emboli were produced in arterioles than in venules (median 6 and 1, respectively). Arteriolar thrombi were more effective in plugging the punctured holes than venular thrombi. The differences in thromboembolic reaction between arterioles and venules, as found in the present study, can probably not be explained by fluid dynamic factors.
Fibrinolytic and Haemostatic Responses to Desamino-D-Arginine Vasopressin (DDAVP) Administered by Intravenous and Subcutaneous Routes in Healthy Subjects
Authors: MacGregor I R , Roberts E M , Prowse C V , Broomhead A F , Ozolins M , Litka P 
Published: April 2018

SummaryDDAVP was administered at 0.4 ug kg−1 by intravenous (i. v.) and subcutaneous (s.c.) routes to 6 healthy subjects in a double blind crossover study. Both study treatments were well tolerated. Flushing occurred after both treatments but was more prominent after i.v. than after s.c. DDAVP. Mild transient local discomfort at the s.c. injection site occurred in 5 of 6 subjects. The mean peak factor VIII (FVIII) response was 369% and 247% of baseline after i.v. and s.c. DDAVP respectively and the maximum increase in FVIII occurred earlier with the i.v. route. Changes in FVIII antigen (FVIII: Ag) and von Willebrand factor antigen (vWF: Ag) were also monitored. Tissue-type plasminogen activator (t-PA) activity measured by a chromogenic assay employing soluble fibrin had a median peak value of 2.9 IU ml−1 at 20 min after i.v. and of 1.9 IU ml−1 at 60 min after s.c. DDAVP. t-PA antigen was a Iso incasiued so that die specific activity uf ciiculaliiig t-PA could be determined. Preinjection median values of 14,650 and 13,700 IU mg−1 increased to peak median values of 236,200 IU mg−1 at 20 min after i.v. and 202,400 IU mg−1 at 60 min after s.c. DDAVP. Plasminogen activator inhibitor (PAI) activity fell following DDAVP and became undetectable in some subjects during the sampling period. The ratio of maximum fibrinolytic response was similar to the ratio of maximum haemostatic responses obtained by two routes of injection. Our results indicate that s.c. DDAVP might successfully replace i.v. DDAVP in several applications such as confirmation of haemostatic or fibrinolytic responsiveness in patient groups; for obtaining FVIII enriched plasma; as well as its obvious potential usefulness in home treatment of haemophilia A and von Willebrand’s disease.
Plasminogen San Antonio: An Abnormal Plasminogen with a More Cathodic Migration, Decreased Activation and Associated Thrombosis
Authors: Liu Ying , Lyons Roger M , McDonagh Jan 
Published: April 2018

SummaryAn abnormal plasminogen (San Antonio) has been isolated from a patient with axillary vein thrombosis. A decreased level of fibrinolytic activity was detected in both plasma and a purified system. The molecular abnormalities were investigated with both functional and immunological tests. Slightly decreased antigen concentration was noted in plasma. By crossed immunoelec-trophoresis, the patient and his two children had a second small arc and the primary arc migrated more eathodically. A distinct isozyme was detected in the abnormal plasminogen. Functionally, this abnormal plasminogen is characterized by failure to enhance maximal conversion to plasmin, especially by plasminogen activators, which are enhanced by fibrin or fibrin degradation products. The proband and his children are heterozygous for this abnormal plasminogen.
An Enzyme-Linked Immunosorbent Assay (ELISA) Used to Study the Cellular Secretion of Endothelial Plasminogen Activator Inhibitor (PAI-1)
Authors: MacGregor I R , Booth N A 
Published: April 2018

SummaryA two-site sandwich ELISA was developed to measure PAI-1 antigen and utilised a polyclonal antiserum produced against PAI-1 purified from human endothelial cell secretory products. The assay was calibrated against a preparation of pure PAI-1 whose protein concentration had been determined by amino acid analysis and the detection limit was 30 pg PAI-1 ml“3 sample. PAI-1 was detected in primate sera but not in a wide range of nonprimate sera and no cross-reactivity with α2-antiplasmin or antithrombin III was observed.The ELISA was used to study cellular secretion of PAI-1 which was confirmed as a major secretory protein in human umbilical vein endothelial cells (HUVEC). PAI-1 antigen accumulated in the medium in a linear fashion with time and accounted for ≃10% of total secreted protein. Specific activity of intracellular PAI1 was typically 20-fold greater than that of PAI-1 in 24 h conditioned medium and a t½ for inactivation of secreted PAI-1 of 0.53 h was calculated. Purified endotoxin stimulated the secretion of PAI-1 antigen and raised the intracellular levels in HUVEC cultures showing that the anti-fibrinolytic actions of endotoxin are effected by increasing the rate of synthesis and secretion of PAI-1.
Kongenitales einfaches Hamartom des retinalen Pigmentepithels
Authors: Sturm Veit , Guber Josef , Silva Marcio , Heckmann Jan , Zawinka Claudia 
Published: April 2018

Zusammenfassung
Hintergrund Das kongenitale einfache Hamartom des retinalen Pigmentepithels (CSHRPE) ist ein seltener gutartiger Tumor mit charakteristischen klinischen Eigenschaften. Das typische ophthalmoskopische Bild zeigt eine kleine, gut umschriebene, stark pigmentierte Läsion in Foveanähe. Im Unterschied zur viel häufigeren flachen kongenitalen Pigmentepithelhypertrophie ist das CSHRPE erhaben.
Patienten und Methoden Retrospektive Fallserie von 3 Patienten mit CSHRPE. Die klinisch-morphologischen Merkmale werden unter Berücksichtigung verschiedener bildgebender Verfahren demonstriert.
Ergebnisse Bei 2 Patienten zeigte sich als Zufallsbefund eine typische dunkle Läsion im Bereich der Makula. In der optischen Kohärenztomografie (OCT) war diese als noduläre präretinale Hyperreflektivität mit Verschattung der tieferen Strukturen darstellbar. Die Fluoreszenzangiografie zeigte in einem Fall eine charakteristische persistierende Hypofluoreszenz. Der 3. Patient mit einer Visusminderung auf 0,3 zeigte eine charakteristische Veränderung in der Fovea. Die OCT-Untersuchung demonstrierte hier neben der präretinalen Hyperreflektivität auch eine mäßige Störung der Foveaarchitektur. Die eingeleitete Amblyopietherapie führte im Verlauf zu einem geringen Visusanstieg. Die Läsionen blieben bei 2 Patienten im Verlauf stabil (Nachbeobachtungszeitraum 8 – 14 Monate).
Schlussfolgerung CSHRPE werden häufig als Zufallsbefunde entdeckt. Infolge ihres benignen Charakters und der zumeist asymptomatischen Präsentation sind in der Regel nur Verlaufskontrollen angezeigt. Die Läsionen bleiben gewöhnlich unverändert und wachsen nicht. Bei Visusminderung infolge Foveabeteiligung sollte eine Amblyopiebehandlung versucht werden.
Off-Label Use in Rare Diseases: Myasthenia Gravis, Lambert-Eaton Myasthenic Syndrome and Congenital Myasthenic Syndromes
Authors: Janzen Rudolf 
Published: April 2018

AbstractThe off-label use of licensed drugs is widespread, and the risk of adverse events is elevated, especially if the scientific evidence is low. The treatment of rare diseases (<5/10,000) therefore may increase the risk of off-label use. The optimized standard treatment is primarily based on the regulatory decisions of the German Federal Joint Committee. The valid guidelines and the regulations of the German health system are discussed in this article. The criteria for indication and monitoring of off-label use are shown, especially focused on the problem of refractory myasthenia gravis. Escalation of treatment results regularly in off-label use. The arguments within the applicable guidelines should be followed. Some new aspects of the European regulations are likewise discussed.
Inter-Rater Reliability of Cyclotorsion Measurements Using Fundus Photography
Authors: Dysli Muriel , Kanku Madeleine , Traber Ghislaine 
Published: April 2018

Abstract
Background The foveo-papillary angle (FPA) on fundus photographs is the accepted standard for the measurement of ocular cyclotorsion. We assessed the inter-rater reliability of this method in healthy subjects and in patients with trochlear nerve palsies.
Patients and Methods In this methodological study, fundus photographs of healthy subjects and of patients with trochlear nerve palsies were made with a fundus camera (Zeiss Fundus Camera FF 450 plus, Jena, Germany). Three independent observers measured the FPA on the fundus photographs of all subjects in synedra View (synedra View 16, Version 16.0.0.11, Innsbruck, Austria).
Results One hundred and four eyes of 52 subjects (26 healthy controls and 26 patients) were assessed. The mean FPA of the healthy controls was 5.80 degrees (°) [± 0.44 standard error of the mean (SEM)] compared to 11.55° (± 0.80 SEM) for patients with trochlear nerve palsies. The inter-rater reliability of all measured FPAs showed an intraclass correlation coefficient (ICC) of 0.98 (95% CI 0.97 – 0.98).
Conclusions The inter-rater reliability of objective cyclotorsion measurements using fundus photographs was very high.
The Use of Optical Coherence Tomography for the Detection of Early Diabetic Retinopathy
Authors: Somfai Gabor Mark , Gerding Heinrich , DeBuc Delia 
Published: April 2018

AbstractDiabetic retinopathy (DR) is one of the leading causes of vision loss globally with a severe burden on all societies due to its high treatment and rehabilitation costs. The early diagnosis of DR may provide preventive steps (including retinal laser therapy and tight carbohydrate, blood pressure, and cholesterol control) that could in turn help to avoid progression of the pathology with the resultant vision loss. Optical coherence tomography (OCT) enables the in vivo structural imaging of the retina, providing both qualitative (structure) and quantitative (thickness) information. In the past decades, extensive OCT research has been done in the field of DR. In the present review, we are focusing on those that were aiming at detection of the earliest retinal changes before DR could be diagnosed funduscopically. The latest, widely available technology of spectral-domain (SD-)OCT comes with a fast and reliable retinal imaging, which, together with the most recent developments in image processing and artificial intelligence, holds the promise of developing a quick and efficient, state-of-the-art screening tool for DR.