bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endovascular Repair of Three Concurrent Mycotic Pseudoaneurysms
Authors: Asai Megumi , Van Houtte Olivier , Sullivan Terry R. , Garrido Mauricio , Pineda Danielle M. 
Published: May 2018

Introduction: Mycotic pseudoaneurysm has traditionally been repaired surgically with excision of the infected artery and revascularization via extra-anatomical or in situ bypass. There have been reports of endovascular repair for high-risk patients for formal surgical repair. We present a case of a patient with 3 large pseudoaneurysms arising from the right subclavian artery, descending thoracic aorta, and right popliteal artery treated with endovascular and hybrid intervention. Case: A 74-year-old male with remote history of coronary artery bypass graft and recent sternoclavicular joint abscess developed 3 concurrent pseudoaneurysms arising from the right subclavian artery, distal descending thoracic aorta, and right popliteal artery. He underwent right axillary to common carotid bypass with endovascular stent graft placement in the distal innominate and proximal subclavian artery, and subsequently had thoracic endovascular aortic repair and right popliteal stent graft. Four months later, he presented with hemoptysis due to compression of the lung secondary to the pseudoaneurysm. He underwent right anterior thoracotomy and debridement of the pseudoaneurysm. Patient recovered from the procedure and discharged. Conclusion: Endovascular repair of mycotic pseudoaneurysm is an acceptable alternative for high-risk patients. Even when open approach became necessarily, endovascular stent graft decreased blood loss and morbidity.
Rare variants in RNF213, a susceptibility gene for moyamoya disease, are found in patients with pulmonary hypertension and aggravate hypoxia‐induced pulmonary hypertension in mice
Authors: Kobayashi Hatasu , Kabata Risako , Kinoshita Hideyuki , Morimoto Takaaki , Ono Koh , Takeda Midori , Choi Jungmi , Okuda Hiroko , Liu Wanyang , Harada Kouji H. , Kimura Takeshi , Youssefian Shohab , Koizumi Akio 
Published: May 2018

Ring finger 213 (RNF213) is a susceptibility gene for moyamoya disease (MMD), a progressive cerebrovascular disease. Recent studies suggest that RNF213 plays an important role not only in MMD, but also in extracranial vascular diseases, such as pulmonary hypertension (PH). In this study, we undertook genetic screening of RNF213 in patients with PH and performed functional analysis of an RNF213 variant using mouse models. Direct sequencing of the exons in the C‐terminal region of RNF213, where MMD‐associated mutations are highly clustered, and of the entire coding exons of BMPR2 and CAV1, the causative genes for PH, was performed in 27 Japanese patients with PH. Two MMD‐associated rare variants (p.R4810K and p.A4399T) in RNF213 were identified in two patients, three BMPR2 mutations (p.Q92H, p.L198Rfs*4, and p.S930X) were found in three patients, whereas no CAV1 mutations were identified. To test the effect of the RNF213 variants on PH, vascular endothelial cell (EC)‐specific Rnf213 mutant transgenic mice were exposed to hypoxia. Overexpression of the EC‐specific Rnf213 mutant, but neither Rnf213 ablation nor EC‐specific wild‐type Rnf213 overexpression, aggravated the hypoxia‐induced PH phenotype (high right ventricular pressure, right ventricular hypertrophy, and muscularization of pulmonary vessels). Under hypoxia, electron microscopy showed unique EC detachment in pulmonary vessels, and western blots demonstrated a significant reduction in caveolin‐1 (encoded by CAV1), a key molecule involved in EC functions, in lungs of EC‐specific Rnf213 mutant transgenic mice, suggestive of EC dysfunction. RNF213 appears to be a genetic risk factor for PH and could play a role in systemic vasculopathy.
Safety profile of a special butterbur extract from Petasites hybridus in migraine prevention with emphasis on the liver
Authors: Diener HC , Freitag FG , Danesch U 
Published: May 2018

Background: Butterbur supplements are available in the USA and Canada and are commonly used for treating migraines. Petadolex, a special butterbur extract from Petasites hybridus, is a natural herbal product and the only butterbur extract with proven clinical efficacy in migraine prevention. The Complimentary Migraine Guidelines of the AAN mention butterbur as level A recommendation for the prevention of chronic episodic migraine. However, these guidelines have been retired. Methods: We review suspected serious liver cases, pyrrolizidine alkaloids, regulatory issues, preclinical and clinical data of the special butterbur extract Petadolex. Results: The RUCAM (Roussel Uclaf Causality Assessment Method) test found no probable relationship between the butterbur root extract Petadolex® and cases of serious liver injury. Two cases of non-serious reversible liver enzyme elevations were rated as probably related to Petadolex®. The safety is supported by preclinical data in animals as well as in-vitro toxicology experiments. In addition, Petadolexis free of detectable levels of pyrrolizidine alkaloids. Conclusion: There is no evidence that the special butterbur root extract Petadolex poses a substantial risk of liver injury for patients.
Triazolite, NaCu2(N3C2H2)2(NH3)2Cl3·4H2O, a new mineral species containing 1,2,4-triazolate anion, from a guano deposit at Pabellón de Pica, Iquique Province, Chile
Authors: Chukanov Nikita V. , Zubkova Natalia V. , Möhn Gerhard , Pekov Igor V. , Belakovskiy Dmitriy I. , Van Konstantin V. , Britvin Sergey N. , Pushcharovsky Dmitry Y. 
Published: May 2018

ABSTRACTThe new mineral triazolite is found in a guano deposit located on the Pabellón de Pica Mountain, Iquique Province, Tarapacá Region, Chile. Associated minerals are salammoniac, halite, dittmarite, joanneumite, chanabayaite, nitratine, natroxalate and möhnite. Triazolite occurs as deep blue prismatic crystals up to 0.1 mm × 0.15 mm × 0.75 mm and their radial aggregates up to 1.5 mm across. The mineral is brittle. Its Mohs hardness is 2.Dcalc= 2.028 g cm–3. The infrared spectrum shows the presence of 1,2,4-triazolate anion and ammonia and water molecules. Triazolite is optically biaxial (–), α = 1.582(4), β = 1.625(3), γ = 1.625(3) and 2Vmeas= 5(3)°. The chemical composition (electron-microprobe data for Cl, Na, Fe and Cu; H, C, N and S contents were measured by gas chromatography of products of ignition at 1200°C; wt.%) is: Na 4.91, Fe 1.51, Cu 22.06, Cl 19.80, S 1.4, C 7.7, H 4.4, N 24.2, O (calc.) 12.83, total 98.81. The empirical formula is Na1.14(Cu1.86Fe0.14)(Cl2.99S0.23)N9.23C3.43H23.34O4.29. The idealized formula is NaCu2(N3C2H2)2(NH3)2Cl3·4H2O. Triazolite is a metalorganic ammine complex in which 1,2,4-triazolate anion and ammonia molecule are ligands coordinating Cu2+. The crystal structure was solved by direct methods and refined toR= 0.0242 based on 4210 unique reflections withI> 2σ(I). Triazolite is orthorhombic, space groupP212121,a= 19.3575(5),b= 7.15718(19),c= 12.5020(4) Å,V= 1732.09(8) Å3andZ= 4. The eight strongest reflections of the powder X-ray diffraction pattern [d, Å (I,%) (hkl)] are: 10.22 (97) (101), 6.135 (40) (011), 5.696 (17) (301), 5.182 (59) (202), 5.119 (100) (211), 4.854 (19) (400), 3.752 (16) (312, 501), 3.294 (18) (221). Triazolite is named for the presence of 1,2,4-triazolate anion.
Recommendations for managing PD-1 blockade in the context of allogeneic HCT in Hodgkin lymphoma: taming a necessary evil
Authors: Herbaux Charles , Merryman Reid , Devine Steven , Armand Philippe , Houot Roch , Morschhauser Franck , Haverkos Bradley 
Published: May 2018

AbstractPD-1 blockade is an effective therapy in relapsed/refractory (R/R) classical Hodgkin Lymphoma (cHL) who have relapsed after or are ineligible for autologous hematopoietic cell transplantation (HCT). Although single-agent anti-PD-1 monoclonal antibodies (mAb’s) are associated with high response rates and durable remissions, available results to date suggest that a large majority of patients will eventually progress on therapy. Many of these patients are potential candidates for allogeneic HCT (allo-HCT) after receiving anti-PD-1 mAb’s, and allo-HCT remains for now the only treatment with demonstrated curative potential in this setting. However, initial reports suggested that allo-HCT in this setting may be associated with increased risk of early transplant-related toxicity, likely driven by lingering effects of PD-1 blockade. Furthermore, many patients with R/R cHL who undergo allo-HCT will relapse after transplantation, most often with limited treatment options. Here again, PD-1 blockade appears to yield high response rates, but with an increased risk of attendant immune toxicity. Many questions remain regarding the use of PD-1 blockade before or after allo-HCT, especially in relation to the feasibility, outcome, optimal timing, and method of allo-HCT after PD-1 blockade. Despite the scarcity of prospective data, these questions are unavoidable and must be tackled by clinicians in the routine care of patients with advanced cHL. We provide consensus recommendations of a working group based on available data and experience, in an effort to help guide treatment decisions until more definitive data are obtained.
“Availability of healthcare providers for rural veterans eligible for purchased care under the veterans choice act”
Authors: Ohl Michael E. , Carrell Margaret , Thurman Andrew , Weg Mark Vander , Hudson Teresa , Mengeling Michelle , Vaughan-Sarrazin Mary 
Published: May 2018

Abstract
Background
Military Veterans in the United States are more likely than the general population to live in rural areas, and often have limited geographic access to Veterans Health Administration (VHA) facilities. In an effort to improve access for Veterans living far from VHA facilities, the recently-enacted Veterans Choice Act directed VHA to purchase care from non-VHA providers for Veterans who live more than 40 miles from the nearest VHA facility. To explore potential impacts of these reforms on Veterans and healthcare providers, we identified VHA-users who were eligible for purchased care based on distance to VHA facilities, and quantified the availability of various types of non-VHA healthcare providers in counties where these Veterans lived.

Methods
We combined 2013 administrative data on VHA-users with county-level data on rurality, non-VHA provider availability, population, household income, and population health status.

Results
Most (77.9%) of the 416,338 VHA-users who were eligible for purchased care based on distance lived in rural counties. Approximately 16% of these Veterans lived in primary care shortage areas, while the majority (70.2%) lived in mental health care shortage areas. Most lived in counties that lacked specialized health care providers (e.g. cardiologists, pulmonologists, and neurologists). Counterintuitively, VHA played a greater role in delivering healthcare for the overall adult population in counties that were farther from VHA facilities (30.7 VHA-users / 1000 adults in counties over 40 miles from VHA facilities, vs. 22.4 VHA-users / 1000 adults in counties within 20 miles of VHA facilities, p < 0.01).

Conclusions
Initiatives to purchase care for Veterans living more than 40 miles from VHA facilities may not significantly improve their access to care, as these areas are underserved by non-VHA providers. Non-VHA providers in the predominantly rural areas more than 40 miles from VHA facilities may be asked to assume care for relatively large numbers of Veterans, because VHA has recently cared for a greater proportion of the population in these areas, and these Veterans are now eligible for purchased care.
Enhancing pharmacists’ role in developing countries to overcome the challenge of antimicrobial resistance: a narrative review
Authors: Sakeena M. H. F. , Bennett Alexandra A. , McLachlan Andrew J. 
Published: May 2018

Abstract
Background
Antimicrobial resistance (AMR) is a global health challenge and developing countries are more vulnerable to the adverse health impacts of AMR. Health care workers including pharmacists can play a key role to support the appropriate use of antimicrobials in developing countries and reduce AMR.

Objective
The aim of this review is to investigate the role of pharmacists in the appropriate use of antibiotics and to identify how the pharmacists’ role can be enhanced to combat AMR in developing countries.

Method
The databases MEDLINE, EMBASE, Web of Science and Google Scholar were searched for articles published between 2000 and the end of August 2017 that involved studies on the role of pharmacists in developing countries, the expanded services of pharmacists in patient care in developed countries and pharmacists’ contributions in antimicrobial use in both developed and developing nations.

Key findings
In developing countries pharmacists role in patient care are relatively limited. However, in developed nations, the pharmacists’ role has expanded to provide multifaceted services in patient care resulting in improved health outcomes from clinical services and reduced health care costs. Success stories of pharmacist-led programs in combating AMR demonstrates that appropriately trained pharmacists can be part of the solution to overcome the global challenge of AMR. Pharmacists can provide education to patients enabling them to use antibiotics appropriately. They can also provide guidance to their healthcare colleagues on appropriate antibiotic prescribing.

Conclusions
This review highlights that appropriately trained pharmacists integrated into the health care system can make a significant impact in minimising inappropriate antibiotic use in developing countries. Strengthening and enhancing the pharmacists’ role in developing countries has the potential to positively impact the global issue of AMR.
Genome-based analysis of Carbapenemase-producing Klebsiella pneumoniae isolates from German hospital patients, 2008-2014
Authors: Becker Laura , Kaase Martin , Pfeifer Yvonne , Fuchs Stephan , Reuss Annicka , von Laer Anja , Sin Muna Abu , Korte-Berwanger Miriam , Gatermann Sören , Werner Guido 
Published: May 2018

Abstract
Background
By using whole genome sequence data we aimed at describing a population snapshot of carbapenemase-producing K. pneumoniae isolated from hospitalized patients in Germany between 2008 and 2014.

Methods
We selected a representative subset of 107 carbapenemase-producing K. pneumoniae clinical isolates possessing the four most prevalent carbapenemase types in Germany (KPC-2, KPC-3, OXA-48, NDM-1). Isolates were processed via illumina NGS. Data were analysed using different SNP-based mapping and de-novo assembly approaches. Relevant information was extracted from NGS data (antibiotic resistance determinants, wzi gene/cps type, virulence genes). NGS data from the present study were also compared with 238 genome data from two previous international studies on K. pneumoniae.

Results
NGS-based analyses revealed a preferred prevalence of KPC-2-producing ST258 and KPC-3-producing ST512 isolates. OXA-48, being the most prevalent carbapenemase type in Germany, was associated with various K. pneumoniae strain types; most of them possessing IncL/M plasmid replicons suggesting a preferred dissemination of blaOXA-48 via this well-known plasmid type. Clusters ST15, ST147, ST258, and ST512 demonstrated an intermingled subset structure consisting of German and other European K. pneumoniae isolates. ST23 being the most frequent MLST type in Asia was found only once in Germany. This latter isolate contained an almost complete set of virulence genes and a K1 capsule suggesting occurrence of a hypervirulent ST23 strain producing OXA-48 in Germany.

Conclusions
Our study results suggest prevalence of “classical” K. pneumonaie strain types associated with widely distributed carbapenemase genes such as ST258/KPC-2 or ST512/KPC-3 also in Germany. The finding of a supposed hypervirulent and OXA-48-producing ST23 K. pneumoniae isolates outside Asia is highly worrisome and requires intense molecular surveillance.
Body image in paediatric burns: a review
Authors: King Ian C. C. 
Published: May 2018

Abstract
Burn injuries in children can result in life-long disfigurement. As medical and surgical techniques of burn management improve survival prospects more than ever before, body image adjustment is increasingly a central consideration in the care of burn-injured individuals. An appreciation that both physiological and psychosocial processes underpin such injuries is key to understanding wound healing. Perceptions of idealized body images in Western society challenge children and their families as they grow up with and adapt to disfigurement from burns. Whilst many studies have examined the psychosocial recovery of adults with burn injuries, few have considered the impact on burn-injured children. This paper explores the models of body image and discusses the relevance of these to research and practice in understanding how to manage burns in children.
Case Article—Converting Zip Code Data into Distances: A Case Study for Teaching Business Analytics
Authors: Huggins Eric 
Published: May 2018

In this case study, we demonstrate how to convert a column of zip code data into approximate distances from a default zip code using only standard Microsoft (MS) Excel functions and a free zip code database available online. We illustrate one example of analytics that may be applied to these distances with real data. The Case Article discusses our experiences in teaching the case and highlights the positive aspects of it. In the Case Study, we develop a hypothetical scenario in order to convey the value of being able to convert standard zip code data into distances to the students reading the case. Finally, the Case Teaching Note provides guidance regarding classroom discussion as well as specific instructions for developing the MS Excel spreadsheet. The Case Teaching Note and final product example are available at https://www.informs.org/Publications/Subscribe/Access-Restricted-Materials .
Are women empowered to make decisions about the use of antidepressants in pregnancy?
Authors: Randall Lorna , Briscoe Lesley 
Published: May 2018

Background Untreated depression is related to maternal mortality and morbidity. The most frequent treatment is antidepressant medication, but studies have shown that women find decisions about the use of antidepressants in pregnancy difficult and confusing. Aim To explain if women are empowered to make decisions around the use of antidepressants in pregnancy. Methods A literature review was conducted using CINAHL Complete, Intermid, Proquest and Discover More. Findings Information provision was inadequate and women experienced decisional conflict. Women wanted to be involved in a collaborative decision-making process. Conclusions Women want to be provided with clear and accurate information and prefer to collaborate when making decisions about antidepressants in pregnancy. More research is needed to explore demographic gaps within population samples, and women's experiences of decision-making about antidepressant usage. Undergraduate and postgraduate health education should include conversation skills training, associated with collaborative discussion and informed choice.
Physiotherapists' experiences of respiratory compromise in patients with Parkinson's disease: A qualitative study
Authors: Walker Nikki , Cross Jane 
Published: May 2018

Background/Aims: To explore the experiences and perceptions of physiotherapists involved in the care of people with Parkinson's disease and respiratory compromise. Methods: This exploratory qualitative study recruited four physiotherapists who participated in a focus group and completed reflective diaries over a 3-month period. Experiences were explored using Interpretative Phenomenological Analysis. Findings: The study highlights three key themes: application of professional knowledge, application of clinical decision making and challenges to application of care. Conclusions: The results demonstrate sensitive awareness in caring for a dependent and vulnerable population whose key motor signs, compounded by ageing are perceived as influencing the presentation of respiratory compromise. There are descriptions of a reactive response to illness, alongside reflections on the challenges faced when asserting autonomy and recognising where the role of physiotherapy fits within the multidisciplinary team. Sputum clearance is perceived as being a key aspect of this role, although there is uncertainty with regard to the effectiveness and appropriateness of treatment options. Multiple perceived challenges to care provision are highlighted, with key concerns surrounding clinician and patient knowledge levels, maintenance of patient mobility, person-centred care and clarity in the direction of care.
Travelling with children: What the practice nurse needs to know
Authors: Brewer Catherine 
Published: May 2018

Travelling with children can require careful planning. Catherine Brewer covers the practical considerations when providing travel advice to families Travelling with children needs careful planning and consideration. Practice nurses need to ensure that they carry out effective risk assessments to highlight potential health issues for different age categories. Risks will generally differ from adults and some vaccines are not licensed for young infants or children. This needs to be understood by the parents or carers. Areas of particular risk are malaria, food- and water-borne illnesses, rabies, sunburn and the potential for accident. If children become unwell the consequences can be more serious, so understanding when and how to access medical facilities is vital. There is also other practical advice about travelling with children that can be imparted to the parents to try to ensure a healthy and happy experience for all.
Invasive meningococcal disease: Which vaccines protect against it?
Authors: Ford Karen J 
Published: May 2018

Invasive meningococcal disease is a rare, but life-threatening cause of meningitis and septicaemia. Karen Ford describes the disease and causative bacteria, and provides a summary of the vaccines used to prevent it Invasive meningococcal disease is a rare, but life-threatening cause of meningitis and septicaemia. The highest disease rates are seen in infants and in late adolescence. Several vaccines have been licensed to protect against some types of this devastating disease. This article describes invasive meningococcal disease and the causative bacteria, then provides a summary of the UK meningococcal vaccination programme.
Differences between the use of PGDs and PSDs in primary care
Authors: Adsley Rosemary 
Published: May 2018

Rosemary Adsley provides an overview of Patient Specific Directions (PSDs) and Patient Group Directions (PGDs) and highlights their similarities and differences The use of both Patient Specific Directions (PSDs) and Patient Group Directions (PGDs) is commonplace in primary care. This article will provide a brief overview of the two directions and highlight some similarities and differences between them. It will also provide examples of the situations where each type of direction is currently used and discuss some of the benefits that one type of direction may have over another in certain situations.