bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spinal Serotonin and 5HT6 Receptor Levels During Development of Neuropathy and Influence of Blockade of these Receptors on Thermal Hyperalgesia in Diabetic Mice
Authors: Sari Cagda Celik , Gunduz Ozgur , Ulugol Ahmet 
Published: January 2019

AbstractLittle is known about the role of 5-HT6 receptors in the pathophysiology of neuropathic pain. The aim of this study is firstly, to investigate the influence of spinal and systemic 5-HT6 receptors on thermal hyperalgesia, one of the most significant symptoms of neuropathy occurring in diabetes; and secondly to determine spinal lumbar serotonin and 5-HT6 receptor levels during development of diabetic neuropathy in mice. Diabetes was produced in Balb/c mice with a single injection of streptozocin (150 mg/kg, i.p.). Using the hot plate test, the 5-HT6 antagonist SB-258585 was given systemically (3, 10, 30 mg/kg) and intrathecally (0.01, 0.1, 1 nmol/mouse) to determine its effect on thermal hyperalgesia. Furthermore, on days 7 and 15 of diabetes, development of thermal hyperalgesia was evaluated in relation to changes in spinal serotonin and 5-HT6 receptor levels by using LC/MS/MS and Western blot analyses, respectively. Two-way analysis of variance and unpaired t-tests were used to evaluate data from hot-plate tests and 5-HT levels/ 5-HT6 receptor expression, respectively. Thermal hyperalgesia was observed in neuropathic mice, starting from day 5 after streptozocin administration. On day 15, systemic, but not intrathecal, SB-258585 attenuated thermal hyperalgesia in neuropathic mice. Spinal serotonin levels did not change during development of hyperalgesia after induction of diabetes, whereas spinal 5-HT6 receptor levels were significantly reduced on days 7 and 15. Our findings show that systemic, but not spinal, blockade of 5-HT6 receptors may exert antihyperalgesic effects in neuropathic mice and suggest that systemic 5-HT6 receptors contribute to the pathophysiology of diabetic neuropathy.
Cochlear Implantation for Single-Sided Deafness: Observations in Poor Performers
Authors: Mittmann Philipp , Ernst A. , Scholz S. , Battmer R. , Todt I. 
Published: January 2019

Abstract
Objectives Patients with single-sided deafness can nowadays receive a cochlear implant. A majority of these patients are well adapted and benefit from the implant. The aim of this study was to evaluate the reasons for poor performance in a group of patients with single-sided deafness, who received a cochlear implant.
Design A total of 65 patients were enrolled into a retrospective case series. Seven poor performers were present in the group. Freiburger monosyllabics, localization testing, and radiologic images were evaluated.
Results Localization testing showed the absence of lateralization ability in three patients, whereas the Freiburger monosyllabic word scores improved in three patients. One patient had no speech perception after 1 year of rehabilitation. Findings of magnetic resonance imaging (MRI) revealed cerebral involvement in five patients.
Conclusion Various factors influence the outcome in unilateral cochlear implantation in patients with single-sided deafness. These reasons may be preoperative, operative, or postoperative. Nevertheless, the majority of patients benefit from these implants.
Practical Synthesis of Precursors of Cyclohexyne and 1,2-Cyclohexadiene
Authors: Okano Kentaro , Nakura Ryo , Inoue Kazuki , Mori Atsunori 
Published: January 2019

This study investigated a practical method for regiocontrolled synthesis of precursors of strained cyclohexynes and 1,2-cyclohexadienes, which is a one-pot procedure consisting of a rearrangement of silyl enol ether and subsequent formation of the enol triflates. Triethylsilyl enol ether, derived from cyclohexanone, was treated with a combination of LDA and t-BuOK in n-hexane/THF to encourage the migration of the silyl group to generate an α-silyl enolate. Subsequently, the α-silyl enolate was reacted with Comins’ reagent to yield the corresponding enol triflate. Finally, the α-silylated trisubstituted lithium enolate for the synthesis of 1,2-cyclohexadiene precursor was isomerized in the presence of a stoichiometric amount of water for one hour at room temperature to exclusively provide tetrasubstituted lithium enolate for the synthesis of cyclohexyne precursor in one pot.
Conformational Dynamics in Asymmetric Catalysis: Is Catalyst Flexibility a Design Element?
Authors: Crawford Jennifer , Sigman Matthew 
Published: January 2019

Traditionally, highly selective low molecular weight catalysts have been designed to contain rigidifying structural elements. As a result, many proposed stereochemical models rely on steric repulsion for explaining the observed selectivity. Recently, as is the case for enzymatic systems, it has become apparent that some flexibility can be beneficial for imparting selectivity. Dynamic catalysts can reorganize to maximize attractive non-covalent interactions that stabilize the favored diastereomeric transition state, while minimizing repulsive non-covalent interactions for enhanced selectivity. This short review discusses catalyst conformational dynamics and how these effects have proven beneficial for a variety of catalyst classes, including tropos ligands, cinchona alkaloids, hydrogen-bond donating catalysts, and peptides.1	Introduction2	Tropos Ligands3	Cinchona Alkaloids4	Hydrogen-Bond Donating Catalysts5	Peptide Catalysts6	Conclusion
Gold Vinylidenes as Useful Intermediates in Synthetic Organic Chemistry
Authors: Gagosz Fabien 
Published: January 2019

Gold vinylidenes have recently emerged as useful intermediates in synthetic organic chemistry. These species, which can principally be accessed by a 1,2-migration process from a gold-activated alkyne or by dual gold catalysis on a diyne substrate, can react with nucleophilic partners or by C–H insertion to produce a variety of functionalized (poly)cyclic compounds. This short review covers the synthetic approaches developed so far to access gold vinylidenes and the different reactivities these species can exhibit.1	Introduction2	1,2-Migration Processes3	Dual Gold Catalysis4	Other Processes5	Conclusion
Predisposing Sinonasal Disease Foci: Do They Really Affect Mucosal Chronic Otitis Media?
Authors: Bhat Vikram Kemmannu , Paramu Aroosh Thevaruparambil , Nagachar Shwetha 
Published: January 2019

Abstract
Background This study aimed to find the relationship between sinonasal predisposing foci in chronic otitis media mucosal disease (COMMD) and risk from these predisposing disease foci, and to identify the correlation of bacterial flora of the ear and nose in chronic otitis media.
Materials and Methods This was a prospective case–control study with 100 cases and 100 controls. All patients underwent a detailed clinical ear-nose-throat (ENT) examination and diagnostic nasal endoscopy to look for sinonasal and pharyngeal pathology. In all patients, ear and nasal swabs were taken at the first visit. The relationship between these factors and COMMD was studied by appropriate statistical tests.
Observations and Results Extremely significant association between tubal tonsil hypertrophy and COMMD, very significant association between adenoid hypertrophy and COMMD, and just significant association between deviated nasal septum, inferior turbinate hypertrophy, concha bullosa, and COMMD were found. No significant association was found between sinusitis and COMMD. In this study Staphylococcus aureus (51%) was the predominant organism isolated from ear swab, followed by Pseudomonas (27%). The same organism in nasal and ear swabs was demonstrated only in eight (13%) cases.
Conclusion Sinonasal predisposing foci play a substantial role in the development of COMMD and observed in 97% of the cases with bilateral disease and 91% with unilateral disease in this study. Hence, every case of COMMD must undergo investigations such as diagnostic nasal endoscopy to discover these foci. Because sinonasal disease is one of the important factors contributing to otitis media, timely detection and management of symptomatic sinonasal disease must precede surgical management of COMMD.
Enhanced Recovery After Surgery Interactive Audit System: 10 Years' Experience with an International Web-Based Clinical and Research Perioperative Care Database
Authors: Currie Andrew , Demartines Nicolas , Fearon Kenneth , Kennedy Robin , Ljungqvist Olle , Soop Mattias 
Published: January 2019

AbstractThe Enhanced Recovery After Surgery (ERAS) is a managed care program that has shown the ability to reduce complications following elective colorectal surgery. In 2006, the ERAS® Society developed the ERAS® Interactive Audit System (EIAS), which has allowed centers in over 20 countries to enter perioperative patient data to benchmark against international practice within the audit system and act as a stimulus for quality improvement. The de-identified patient data are coded in SQL (a relational database), stored on secure servers, and data governance aspects have been secured in all involved countries. A collaborative approach is undertaken within involved units toward research questions with published cohort data from the audit system having demonstrated the importance of overall compliance on improving patient outcomes and less cost of care. The EIAS has shown that collaborative clinical effort can drive quality improvement in a short time frame in an international context.
Japanese Encephalitis Virus-Induced Anti-N-Methyl-D-Aspartate Receptor Encephalitis: A Case Report and Review of Literature
Authors: Tian Maoqiang , Li Juan , Lei Wenting , Shu Xiaomei 
Published: January 2019

AbstractAnti-N-methyl-D-aspartate receptor encephalitis (anti-NMDARe) was originally described as a paraneoplastic disease with more than 50% cases involving a tumor. However, tumor incidence in anti-NMDARe in children is much lower. Herpes simplex virus-induced anti-NMDARe has been well-described; however, findings on Japanese encephalitis virus (JEV)-induced anti-NMDARe are scarce. Here, we describe a 7-year-old boy who presented with fever and headache that progressed to seizures and disturbance of consciousness. Brain magnetic resonance imaging (MRI) revealed abnormalities in the bilateral globus pallidus. The diagnosis of JE was made based on a positive JE antibody test results in serum and cerebrospinal fluid. Antiviral and symptomatic therapies led to rapid recovery. Four weeks after the onset of JE, the patient presented with emotional and behavioral disturbances, sleep difficulty, and extrapyramidal symptoms. MRI showed symmetrical lesions in the bilateral thalami and basal ganglia which were expanded than those on the original scan. Antibodies against NMDAR were detected and immunotherapy led to significant recovery. This case and our literature review suggest that JEV may be a clinically important cause of anti-NMDARe in children. Patients with JE-induced anti-NMDARe present with symptoms similar to those of patients with primary anti-NMDARe. Most patients with JE-induced anti-NMDARe showed a good response to first-line immunotherapies.
Otolaryngologic Lesions among Human Immunodeficiency Virus-infected Children
Authors: Babatunde Oluwabusayo , Adeyemo Adebolajo , Oladokun Regina 
Published: January 2019

Abstract
Background Otolaryngologic (ORL) lesions are common in children. ORL lesions occur even more commonly and more severely in HIV-infected children. The few available literature has reported a high prevalence in human immunodeficiency virus (HIV)–infected children; however, there are inadequate data on the impact of HIV infection on hearing and the pattern of manifestations of ORL lesions among African children.
Objectives This study was conducted to describe the prevalence and manifestations of ORL lesions among HIV-infected children and controls in Nigeria.
Materials and Methods A prospective comparative cross-sectional study design was adopted. Clinical evaluation was done, and hearing assessment was done using otoacoustic emission for all participants and pure tone audiometry for participants aged ≥ 5 years. Hearing thresholds were defined according to the World Health Organization classification.
Results One hundred children were studied: 50 HIV-infected and 50 HIV-negative children. The prevalence of ORL lesions among HIV-infected children was 66%, whereas it was 46% (p = 0.044) among HIV-negative children. ORL lesions were more prevalent among children between the 18-month and 5-year age group (p = 0.003) irrespective of HIV status. The lesions that were associated with HIV infection were cervical adenopathy (44%, p = 0.010) and hearing loss (36%, p = 0.023).
Conclusion The frequency of ORL lesions is high in HIV-infected children, but improved outcomes following use of medications may be responsible for the slight disparity in prevalence when compared with HIV-negative children.
Problems Faced by Married Women with Epilepsy in Indian Scenario: A Hospital-Based Study
Authors: Sharma Sunil Kumar , Sardana Vijay , Maheshwari Dilip , Bhushan Bharat , Jain Nishtha , Shringi Prashant , Bhattiprolu Rahi Kiran 
Published: January 2019

Abstract
Background Epilepsy is still being considered as a social stigma especially in developing countries such as India. This study was conducted to analyze the problems faced by married women with epilepsy in various aspects of personal and social life.
Objectives The main purpose of this article is to study the psychosocial problems, drug compliance, clinical course, attitude of in-laws, and effect of epilepsy on pregnancy and its outcome in married women with epilepsy in Indian scenario.
Design, Materials, and Methods This is a prospective observational study including 100 patients. Questionnaire-based face-to-face interview of all the patients was conducted. Patients were divided into informed and concealed groups and various attributes and their significance were compared. Statistical analysis was performed using SPSS-20.0 and Microsoft Office Excel software.
Results Out of 100 patients, a total of 58 (58%) patients had informed prior to marriage, while 42 (42%) concealed it. Attitude of husband was negative in 33% (14 out of 42) of concealed group and was statistically significant (p = 0.03). Statistically significant adverse marital outcome was observed in concealed group and Muslim community (p = 0.0001). Majority of the patients in both groups (86%) opined that it should be disclosed prior to marriage.
Conclusion In a developing country such as India, epilepsy is still considered a social stigma that can manifest as felt or enacted stigma. Previous studies clearly indicate increasing awareness. Social stigma associated with epilepsy can only be eliminated with collaborative efforts of healthcare professional, government, and general public.
Isthmocele: From Risk Factors to Management
Authors: Iannone Piergiorgio , Nencini Giulia , Bonaccorsi Gloria , Martinello Ruby , Pontrelli Giovanni , Scioscia Marco , Nappi Luigi , Greco Pantaleo , Scutiero Gennaro 
Published: January 2019

Objective The aim of the present study was to perform a comprehensive review of the literature to provide a complete and clear picture of isthmocele—a hypoechoic area within the myometrium at the site of the uterine scar of a previous cesarean section—by exploring in depth every aspect of this condition.
Methods A comprehensive review of the literature was performed to identify the most relevant studies about this topic.
Results Every aspect of isthmocele has been studied and described: pathophysiology, clinical symptoms, classification, and diagnosis. Its treatment, both medical and surgical, has also been reported according to the actual literature data.
Conclusion Cesarean section is the most common surgical procedure performed worldwide, and one of the consequences of this technique is isthmocele. A single and systematic classification of isthmocele is needed to improve its diagnosis and management. Further studies should be performed to better understand its pathogenesis.
The Role of Speech-Language Pathology in an Interdisciplinary Care Model for Persistent Symptomatology of Mild Traumatic Brain Injury
Authors: Kelly James , Hardin Kathryn 
Published: January 2019

AbstractThe Marcus Institute for Brain Health (MIBH) provides interdisciplinary care for adults struggling with persistent effects of mild traumatic brain injury and accompanying changes in behavioral health, with specific emphases on Veterans and retired elite athletes. The cognitive, physical, and behavioral symptoms associated with mild traumatic brain injury are interrelated, with neurobiopsychosocial modeling encompassing the factors related to recovery from a traumatic brain injury. The diffuse impacts of chronic concussive injuries require multiple clinical providers to address the breadth of symptoms, facilitating both interdisciplinary and transdisciplinary care models. By implementing integrated practice units, patients receive advanced medical care, imaging, speech-language pathology, physical therapy, behavioral health, neuropsychology, and clinical pharmacy for a cohesive diagnostic and intervention plan. Nationally, speech-language pathologists report challenges with best-practice options for concussion, particularly in the domain of assessment practices. At the MIBH, speech-language pathologists begin their assessment with a structured clinical interview that focuses on patients' needs and concerns. Evaluation modalities focus on hearing, communication, and functional cognition to guide therapeutic treatment planning. The intensive outpatient care program at MIBH incorporates both individual sessions targeting patient-centered goals and group care, where speech-language pathologists work transdisciplinarily to generalize care from all disciplines out into the community. Care practices for concussive injuries continue to evolve rapidly; speech-language pathology at the MIBH offers one such vision for excellence in clinical care.
Benign Bone Tumors When They Coexist with Common Orthopaedic Conditions
Authors: Hasan Khalid , Nguyen Duc , Conway Sheila 
Published: January 2019

AbstractBenign and malignant bone tumors around the knee can be encountered with concomitant orthopaedic disease. As such, it is important to recognize these oncologic processes that may impact or alter the routine treatment of more common orthopaedic processes. Frequently, these rare oncologic conditions are discovered only through the evaluation of acute injuries as in the setting of fractures or sports injuries. Other times, they are encountered when evaluating chronic entities, such as arthroplasty. This article aims to provide general guidelines and management strategies for benign bone tumors when they coincide with common orthopaedic conditions around the knee.
Percutaneous Tracheostomy
Authors: Al-Shathri Ziyad , Susanto Irawan 
Published: January 2019

AbstractTracheostomy is a commonly performed surgical procedure in intensive care units (ICUs). Over the past three decades, there has been a substantial body of evidence to suggest percutaneous tracheostomy (PT) is at least as safe as surgical tracheostomy (ST) in the hands of trained clinicians. In most institutions, PT is more readily performed at bedside than ST in the ICU; hence, PT is an attractive alternative to ST in the ICU. Bedside PT generates significant cost savings by eliminating operating room and anesthesia charges. Bronchoscopy is commonly used as a visual aid during PT. Ultrasound (US)-guided PT is gaining popularity. It can be used as an adjunct or alternative to bronchoscopic-guided PT, especially in hospitals where access to bronchoscopy remains fairly limited and US is more widely available. There are many benefits in converting translaryngeal intubation to tracheostomy. It is widely accepted that tracheostomy is preferred if there is an anticipation of prolonged need for an artificial airway. The timing of this conversion from translaryngeal intubation to tracheostomy remains a subject of controversy. Limited data are available regarding the safety of PT on patients who are on dual antiplatelet therapy or active anticoagulation. Given the heterogeneity of PT techniques, adequate training and experience with the technique, coupled with careful planning are essential in minimizing any potential complication.
CDS in a Learning Health Care System: Identifying Physicians' Reasons for Rejection of Best-Practice Recommendations in Pneumonia through Computerized Clinical Decision Support
Authors: Jones Barbara , Collingridge Dave , Vines Caroline , Post Herman , Holmen John , Allen Todd , Haug Peter , Weir Charlene , Dean Nathan 
Published: January 2019

Background Local implementation of guidelines for pneumonia care is strongly recommended, but the context of care that affects implementation is poorly understood. In a learning health care system, computerized clinical decision support (CDS) provides an opportunity to both improve and track practice, providing insights into the implementation process.
Objectives This article examines physician interactions with a CDS to identify reasons for rejection of guideline recommendations.
Methods We implemented a multicenter bedside CDS for the emergency department management of pneumonia that integrated patient data with guideline-based recommendations. We examined the frequency of adoption versus rejection of recommendations for site-of-care and antibiotic selection. We analyzed free-text responses provided by physicians explaining their clinical reasoning for rejection, using concept mapping and thematic analysis.
Results Among 1,722 patient episodes, physicians rejected recommendations to send a patient home in 24%, leaving text in 53%; reasons for rejection of the recommendations included additional or alternative diagnoses beyond pneumonia, and comorbidities or signs of physiologic derangement contributing to risk of outpatient failure that were not processed by the CDS. Physicians rejected broad-spectrum antibiotic recommendations in 10%, leaving text in 76%; differences in pathogen risk assessment, additional patient information, concern about antibiotic properties, and admitting physician preferences were given as reasons for rejection.
Conclusion While adoption of CDS recommendations for pneumonia was high, physicians rejecting recommendations frequently provided feedback, reporting alternative diagnoses, additional individual patient characteristics, and provider preferences as major reasons for rejection. CDS that collects user feedback is feasible and can contribute to a learning health system.