bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimation of nares-to-epiglottis distance for selecting an appropriate nasopharyngeal airway
Authors: Tseng Wei-Cheng , Lin Wei-Lin , Cherng Chen-Hwan 
Published: March 2019

Abstract
The nasopharyngeal airway is an important equipment in airway management, a correct placement is crucial for its effectiveness. We measured the nares-to-epiglottis distance (NED) and examined the correlations of the optimal insertion length (NED-1) with patient characteristics and various external facial measurements. We aimed to develop a simple method for estimating the optimal insertion length and to help select an appropriate nasopharyngeal airway.
Two hundred patients of ASA grade I & II aged >20 years undergoing elective surgery under general anesthesia were enrolled. We measured nares-to-ear tragus distance (NTD), nares-to-mandibular angle distance (NMD), philtrum-to-ear tragus distance (PTD), and philtrum-to-mandibular angle distance (PMD). The NED was measured by fiber-optic bronchoscope. All measurements were obtained in centimeters. NED-1 (cm) was defined as the optimal insertion length. The patient's sex, age, body weight, body height, and body mass index were recorded.
The NED-1 significantly correlated with body weight, body height, NTD, NMD, PTD, and PMD. Backward stepwise multiple linear regression analysis yielded the formula for predicting NED-1: 0.331 − 0.018 × BW + 0.061 × BH + 1.080 × NMD – 1.256 × PMD + 0.697 × PTD (r = 0.640, P < .001). The regression lines of the optimal insertion length versus PTD showed the best fit to the equality line. The measurements of PTD showed the minimal differences from NED-1 and with the most patients showing <1 cm differences from NED-1.
The optimal insertion depth of nasopharyngeal airway can easily be predicted by the distance from philtrum-to-ear tragus, and a nasopharyngeal airway of an appropriate size can be selected accordingly.
Comparative effectiveness of antitumour necrosis factor agents and vedolizumab in ulcerative colitis
Authors: Davis Rebecca , McParland Paula , Dodd Susanna , Storey Daniel , Probert Chris , Collins Paul , Skouras Thomas , Steel Alan , Derbyshire Edmund , Dibb Martyn , Subramanian Sreedhar 
Published: March 2019

Introduction
Antitumour necrosis factor (TNF) agents and vedolizumab are used to treat ulcerative colitis (UC) but the response is variable and there is little data on comparative effectiveness. Apart from previous exposure to anti-TNF agents, predictors of response have not been identified. We aimed to (i) compare the efficacy of anti-TNF agents and vedolizumab in UC and (ii) investigate the utility of clinical and biochemical parameters in predicting response.

Patients and methods
Patients commencing any biological therapy for ambulant UC were included. Disease activity was monitored serially with the Simple Clinical Colitis Activity Index for up to 12 months. We compared the efficacy of anti-TNF agents and vedolizumab for induction and maintenance of response and remission on an intention-to-treat basis. We examined the utility of faecal calprotectin (FC) and early normalization of FC to predict response.

Results
Ninety-seven patients commencing anti-TNF and 42 commencing vedolizumab therapy were included. Vedolizumab-treated patients had significantly greater previous anti-TNF therapy exposure and a lower baseline FC. Response, remission and steroid-free remission rates were comparable between both groups at 6 weeks, 6 and 12 months. Clinical remission but not steroid-free remission at 12 months was higher in the vedolizumab group. There was a significant reduction in the Simple Clinical Colitis Activity Index and FC at 6 weeks, 6 and 12 months compared with baseline in both groups. Baseline FC and early normalization did not predict response at 6 and 12 months.

Conclusion
The efficacy of anti-TNF and vedolizumab in UC appear comparable. We could not identify any predictors of response and remission.
Bone morphogenetic protein and blood vessels: new insights into endothelial cell junction regulation
Authors: Bautch Victoria L. 
Published: March 2019

Purpose of review
BMP signaling is an important regulator of vascular development and homeostasis, and perturbations of BMP pathway components are linked to vascular disease. However, until recently BMP's broad requirements in many developmental programs delayed cause-and-effect and mechanistic studies of its vascular role in vivo. This review covers recent findings that illuminate the role of BMP signaling in endothelial cells of blood vessels, and highlights effects of BMP signaling on endothelial cell junctions and vascular barrier function.

Recent findings
BMP signaling in endothelial cells of blood vessels is context-dependent, and can either be pro-angiogenic and promote vascular sprouting, or antiangiogenic and promote vascular homeostasis. I discuss how distinct BMP signaling inputs impact blood vessel formation and function, with emphasis on new studies that investigate how BMP signaling affects endothelial cell junctions and vascular permeability.

Summary
BMP signaling is important but complex in endothelial cells of blood vessels, with multiple distinct inputs leading to opposing cellular behaviors and phenotypic outputs in ways that are poorly understood. Endothelial cell–cell junctions are a target of BMP signaling, and junction stability can be tuned in either direction by BMP inputs. Several human diseases have perturbed junctions linked to BMP signaling changes.
New insights into the links between hypoxia and iron homeostasis
Authors: Renassia Cyril , Peyssonnaux Carole 
Published: March 2019

Purpose of review
This review outlines recent discoveries on the crosstalk between oxygen metabolism and iron homeostasis, focusing on the role of HIF-2 (hypoxia inducible factor-2) in the regulation of iron metabolism under physiopathological conditions.

Recent findings
The importance of the hepcidin/ferroportin axis in the modulation of intestinal HIF-2 to regulate iron absorption has been recently highlighted. Latest advances also reveal a direct titration of the bone morphogenetic proteins by the erythroferrone contributing to liver hepcidin suppression to increase iron availability. Iron is recycled thanks to erythrophagocytosis of senescent erythrocytes by macrophages. Hemolysis is frequent in sickle cell anemia, leading to increased erythrophagocytosis responsible of the macrophage polarization shift. New findings assessed the effects of hemolysis on macrophage polarization in the tumor microenvironment.

Summary
Hypoxia signaling links erythropoiesis with iron homeostasis. The use of HIF stabilizing or inhibiting drugs are promising therapeutic approaches in iron-associated diseases.
CADASIL: new advances in basic science and clinical perspectives
Authors: Ferrante Elisa A. , Cudrici Cornelia D. , Boehm Manfred 
Published: March 2019

Purpose of review
Recent advances in genetic evaluation improved the identification of several variants in the NOTCH3 gene causing Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL). Despite improved diagnosis, the disease mechanism remains an elusive target and an increasing number of scientific/clinical groups are investigating CADASIL to better understand it. The purpose of this review is to summarize the current knowledge in CADASIL.

Recent findings
CADASIL is a genotypically and phenotypically diverse condition involving multiple molecular systems affecting small blood vessels. Cerebral white matter changes observed by MRI are a key CADASIL characteristic in young adult patients often before severe symptoms and trigger NOTCH3 genetic testing. NOTCH3 mutation locations are highly variable, correlate to disease severity and consistently affect the cysteine balance within extracellular Notch3. Granular osmiophilic material deposits around blood vessels are also a unique CADASIL feature and appear to have a role in sequestering proteins that are essential for blood vessel homeostasis. As potential biomarkers and therapeutic targets are being actively investigated, neurofilament light chain can be detected in patient serum and may be a promising circulating biomarker.

Summary
CADASIL is a complex, devastating disease with unknown mechanism and no treatment options. As we increase our understanding of CADASIL, translational research bridging basic science and clinical findings needs to drive biomarker and therapeutic target discovery.
Rapamycin and treatment of venous malformations
Authors: Seront Emmanuel , Van Damme An , Boon Laurence M. , Vikkula Miikka 
Published: March 2019

Purpose of review
The field of vascular anomalies has seen a fundamental change during the past 10 years. The identification of somatic genetic mutations as the explanation of sporadic vascular anomalies opened the doors to study prospectively and a posteriori the causes of various vascular malformations. This was helped by the rapidly evolving genetic techniques including the highly sensitive next generation sequencing. In parallel, knowledge on signaling alterations occurring in vascular endothelial cells because of the various mutations, development of in-vitro and especially the first in-vivo models, gave the possibility to test preclinically molecular therapies for vascular malformations.

Recent findings
One of the first molecules, rapamycin, showed clear evidence of interrupting lesion growth. As its safety profile had been established in other conditions, it was quickly accepted for clinical trials on vascular anomalies. Now, with a few trials published and others ongoing, it is establishing itself as a gold standard for molecular therapy for recalcitrant lesions.

Summary
Targeted molecular therapies are becoming interesting new additions to the management of vascular anomalies, and rapamycin is establishing itself as a gold standard for venous malformations.
Strategies for managing transfusional iron overload: conventional treatments and novel strategies
Authors: Sheth Sujit 
Published: March 2019

Purpose of review
For individuals who have transfusion-dependent anemia, iron overload is the long-term complication, which results in significant morbidity. Ameliorating this is now the biggest unmet need. This review specifically addresses this issue.

Recent findings
Over the last decade or so, major advances in the treatment of these individuals, has resulted from novel strategies aimed at reducing transfusion requirement as well as optimizing chelation therapy. This review will summarize these advances and provide insights into some of the therapies in the pipeline. Strategies aimed at reducing transfusion requirement include modulation of erythropoietic regulation by reducing ineffective red cell production through activin trapping, as well as stem cell gene modification approaches, which aim for a cure, and transfusion independence. Refined means of assessing tissue iron and the introduction of oral chelators have facilitated tailoring chelation regimens with closer monitoring and improved compliance. Newer approaches to ameliorate iron toxicity have focused on the hepcidin pathway, all of which would result in increased hepcidin levels and reduction of iron absorption from the intestine, sequestration of iron in normal storage sites and reduced exposure of more susceptible organs, such as the heart and endocrine organs, to the toxic effects of increased iron.

Summary
These advances offer the promise of improved management of transfusion-dependent individuals.
Overcoming developing world challenges of cochlear implantation: Chinese perspective
Authors: van Hasselt Andrew , Sung John K.K. , Tong Michael C.F. 
Published: March 2019

Purpose of review
Over a short period, China has adopted cochlear implants and emerged as a burgeoning market. This represents a valuable case study for emerging countries in terms of planning, initiating, and growing cochlear implant programs.

Recent findings
Although many challenges such as funding, establishing infrastructure, and recipient community support have been addressed, many more remain. Consistent rapid escalation in numbers has been driven by push-and-pull factors. Federal, state, and private funding have all played a role.

Summary
The review highlights the massive need for hearing rehabilitation that currently exists in China. The shortfall can only be addressed by a purposeful and coordinated approach involving government policy, The China Disabled Persons Federation, the industry partnering with hearing and medical professionals and the deaf community.
Paternal Preferences, Perspectives, and Involvement in Perinatal Decision Making
Authors: Cheng Erika R. , McGough Haley , Tucker Edmonds Brownsyne 
Published: March 2019

Importance
Despite increasing attention to the importance of father involvement during pregnancy, the literature on fathers' roles in perinatal decision making is scant.

Objective
The aim of this study was to conduct a narrative review of the literature exploring fathers' preferences, perspectives, and involvement in perinatal decision making.

Evidence Acquisition
We searched PubMed, Ovid, EMBASE, Cochrane Library, and CINAHL databases using the terms father, spouse(s), husband, and paternal separately with the combined terms of attitude, preference, involvement, influence, informed consent, decision making, pregnancy, labor induction, genetic testing, prenatal diagnosis, amniocentesis, fetal surgery, genetic abnormalities, congenital anomalies, birth defects, perinatal, and antenatal. The search was limited to English-language studies that were published anytime and conducted between July and September 2018.

Results
The initial search identified 616 articles; 13 articles met criteria for inclusion. Fathers view themselves as serving distinct roles in perinatal decision making and have specific informational needs that would support their involvement in decision making. Although fathers want to support their partners and learn about fetal health, they often feel excluded from perinatal screening decisions. Mothers and fathers also have different needs, concerns, and preferences regarding key perinatal decisions that, if unresolved, can impact the couples' relationship and perinatal outcomes.

Conclusions
Findings provide import insights into the distinct experiences, roles, needs, and perspectives of fathers facing perinatal decision making.

Relevance
Advancing research and policy on fathers' involvement in perinatal decision making could lead to a paradigm shift in how maternity care is structured, how obstetric services are delivered, and how perinatal interventions are designed and implemented.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, the learner should be better able to describe why fathers are important to perinatal health; assess gaps in care practices that limit father involvement in perinatal decision making; evaluate situations where fathers wish to be involved in perinatal decision making; and list opportunities for future research in this area.
Too Many Women Are Dying From Cervix Cancer: Problems and Solutions
Authors: Gaffney David K. , Hashibe Mia , Kepka Deanna , Maurer Kathryn A. , Werner Theresa L. 
Published: March 2019

(Abstracted from Gynecol Oncol 2018;151:547–554)
Nearly all cases of cervical cancer are due to infection with the human papillomavirus (HPV) virus. Globally, more than 270,000 women per year die of this cancer.
The Management of Nausea and Vomiting of Pregnancy: Synthesis of National Guidelines
Authors: Tsakiridis Ioannis , Mamopoulos Apostolos , Athanasiadis Apostolos , Dagklis Themistoklis 
Published: March 2019

Importance
Nausea and vomiting of pregnancy (NVP) affects a high proportion of the pregnant population.

Objective
The aim of this study was to compare and synthesize recommendations from national guidelines regarding the management of NVP.

Evidence Acquisition
A descriptive review of 3 recently published national guidelines on NVP was conducted: Royal College of Obstetricians and Gynaecologists on “The Management of Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum,” American College of Obstetricians and Gynecologists on “Nausea and Vomiting of Pregnancy,” and Society of Obstetricians and Gynaecologists of Canada on “The Management of Nausea and Vomiting of Pregnancy.” These guidelines were summarized and compared in terms of the recommended management of pregnant women. The quality of evidence was also reviewed based on the method of reporting.

Results
Several differences were identified on the different guidelines regarding the management of NVP. Frequent small meals and avoidance of iron supplements are recommended for prevention. The consumption of ginger, acustimulations, antihistamines, phenothiazines, dopamine, and serotonin 5-hydroxytryptamine type 3 receptor antagonists is routinely recommended for use in the community as treatment.

Conclusions
Evidence-based medicine may lead to the adoption of an international guideline for the management of NVP, which may lead to a more effective management of that entity.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After participating in this activity, the learner should be better able to synthesize management recommendations in cases of NVP; assess the preventive and nonpharmacologic regimens in cases of NVP; and propose the necessary pharmacologic treatment in cases of NVP.
Effects of Exercise During Pregnancy in Women With Short Cervix: Secondary Analysis From the Italian Pessary Trial in Singletons
Authors: Saccone Gabriele , Berghella Vincenzo , Venturella Roberta , D'Alessandro Pietro , Arduino Bruno , Raffone Antonio , Giudicepietro Antonia , Visentin Silvia , Vitagliano Amerigo , Martinelli Pasquale , Zullo Fulvio 
Published: March 2019

(Abstracted from Eur J Obstet Gynecol Reprod Biol 2018;229:132–136)
Preterm birth (PTB) is a leading cause of perinatal morbidity and mortality. Over the last few years, cervical assessment has moved from digital examination to ultrasound evaluation, and ultrasound of the cervix has been the focus of much research.
The overview of the Australian trauma system
Authors: Warren Kirrily-Rae J. , Morrey Chris , Oppy Andrew , Pirpiris Marinis , Balogh Zsolt J. 
Published: March 2019

Abstract
Trauma management in Australia is predominantly that of blunt mechanism trauma spread across a geographically large and sparsely populated country. A complex network of patient care has evolved to manage major trauma. Over recent decades, focus has been given to improving and co-ordinating transfer of patients into major trauma centers and improved data collection with the corresponding improved patient outcomes. This article provides an overview of the nature and structure of the Australian trauma system and its regulation.
Late Occurrence of Raccoon Eyes
Authors: Bogdanović Milenko , Popović Vesna , Savić Slobodan , Durmić Tijana , Radnić Bojana 
Published: March 2019

Abstract
This case represents a planned complex suicide in which the victim combined gunshot to the head and hanging. The most interesting finding in the presented case was pale face, but without any visible injury to it at the time the body was found (more than 24 hours after death), whereas at autopsy (20 hours later), black eyes were prominent. The removal of the ligature led to the decompression of the neck and its blood vessels with consequential blood redistribution, which, alongside the liquid state of blood, resulted in the aforementioned finding. Considering the described postponed appearance of periorbital ecchymosis, this kind of finding suggests that great caution is necessary when interpreting hematomas in terms of their vitality.
Congenital Adrenal Hyperplasia—When Clinical Symptoms Are Missing
Authors: Ferraz Liz Catarina , Rocha Alberto 
Published: March 2019

Background
Congenital adrenal hyperplasia is an autossomic recessive condition. The most common mutation is in the CYP21A2 gene situated in chromosome 6, leading to a 21-hydroxylase deficiency. Clinical presentation ranges from light hyperandrogenism to potentially fatal adrenal salt-losing crisis. In this study, we describe a case of congenital adrenal hyperplasia in a male newborn.

Case
A male newborn was brought to the emergency department owing to an episode of regurgitation after feeding, followed by pallor of the skin and decreased activity. In physical examination, he was hypotonic with irregular respiratory pattern. Heart rate was 180 beats per minute, blood pressure levels were 93/63 mm Hg, and peripheral oxygen saturation was 80% to 84% associated with a sine wave pattern in the electrocardiogram. No scrotal hyperpigmentation was present. The venous blood gas analysis showed a metabolic acidosis (pH, 7.28; pCO2, 41 mmHg; sodium bicarbonate, 18.2 mmol/L; and base excess of −7), hyperkalemia (9.3 mmol/L), and hyponatremia (112 mmol/L). Based on these findings, the most probable diagnosis was a salt wasting form of congenital adrenal hyperplasia. Treatment of hyperkalemia and sodium deficit correction were initiated, as well as glycorticoid therapy. The concentration of 17-hydroxyprogesterone in dried blood spot confirmed the diagnosis.

Conclusions
Because of the severity of this disease and the risk for rapid hemodynamical collapse, clinicians should be aware of this condition. In this specific case, we highlight the absence of testicular hyperpigmentation, which is a hallmark of this condition.
Pediatric Trauma Experience After Transition to a Freestanding Children's Hospital
Authors: Mills David , Segura Bradley , Zaremba Jen , Louie Jeffrey P. 
Published: March 2019

Introduction
Transition of pediatrics services to freestanding children's hospitals is a common trend over the past 3 decades, yet there is no published information on the effect of these moves on the pediatric emergency department (ED). We looked at the effect on trauma volume and severity presenting to the ED after transitioning to a freestanding children's hospital at a location previously without dedicated pediatrics services.

Methods
We analyzed data using a retrospective chart review of pediatric trauma visits (age, <15 years) from our pediatric trauma registry. Data analyzed included trauma volume per year, injury severity score, method of trauma, and method of arrival to hospital. Patients were differentiated into groups based on premove years (2008–2010) and postmove years (2012–2014).

Results
A total of 833 trauma patients were admitted to the ED between 2008 and 2014. Trauma volume per year almost doubled in years after the move. Difference in injury severity score and methods of trauma were not statistically significant. In postmove years, there was an increase in emergency medical service and private vehicle visits.

Conclusions
New characteristics and location of the freestanding children's hospital may suggest that easy access to the new location, parental preferences for specialized pediatrics services, and emergency medical service preferences may have positively impacted trauma volume without affecting the severity of trauma seen in our department. This study provides a unique single-center experience in understanding ED patient flow after a major department transition.