bluuebunny/crossref_metadata_2025_split huggingface dataset:
Next endoscopic approach for acute lower gastrointestinal bleeding without an identified source on colonoscopy: upper or capsule endoscopy?
Authors: Aoki Tomonori , Nagata Naoyoshi , Yamada Atsuo , Shimbo Takuro , Matsushita Yuuki , Shimomura Akira , Kobayashi Sakurako , Moriyasu Shiori , Niikura Ryota , Sakurai Toshiyuki , Hirata Yoshihiro , Akiyama Junichi , Uemura Naomi , Koike Kazuhiko 
Published: February 2019

Abstract
Background and study aims We evaluated the utility of esophagogastroduodenoscopy (EGD) or capsule endoscopy (CE) as the next diagnostic approach after negative colonoscopy (CS) results in acute-onset hematochezia.
Patients and methods We retrospectively analyzed 401 patients emergently hospitalized for acute hematochezia who underwent CS within 48 hours of arriving at two large emergency hospitals and in whom a definitive bleeding source was not identified. The positive endoscopic findings, requirement for additional therapeutic procedures, and 30-day rebleeding rates were compared among three strategies: EGD following CS (CS-EGD), CE following CS (CS-CE), and CS alone. Predictors of positive endoscopic findings in the CS-EGD strategy were determined.
Results The rates of positive endoscopic findings and requirement for additional therapeutic procedures were 22 % and 16 %, respectively, in CS-EGD and 50 % and 28 % in CS-CE. The 30-day rebleeding rate did not significantly decrease in CS-EGD (8 %) or CS-CE (11 %) compared with CS alone (12 %). The rate of additional endoscopic therapies was lower in patients with a colonic diverticulum than in those without (CS-EGD: 3 % vs. 33 %, P = 0.007; CS-CE: 11 % vs. 44 %, P = 0.147). A history of syncope, low blood pressure, blood urea nitrogen/creatinine ratio of ≥ 30, and low albumin level significantly predicted EGD findings after negative CS results (P < 0.05).
Conclusions When the definitive bleeding source is not identified by colonoscopy in patients with acute hematochezia, adjunctive endoscopy helps to identify the etiology and enables subsequent therapy, especially for patients without a colonic diverticulum. Upper gastrointestinal endoscopy is indicated for severe bleeding; other patients may be candidates for capsule endoscopy.
Jung bleiben mit Omega-3-Fettsäuren
Authors: Schmiedel Volker 
Published: February 2019

ZusammenfassungStille Entzündung ist ein Risikofaktor für das Altern. Alle Faktoren, die dazu
beitragen, Entzündungen zu reduzieren, sollten daher auch den Alterungsprozess
verlangsamen können. Medikamente wie Kortison oder NSAR kommen wegen zahlreicher
Nebenwirkungen allerdings nicht in Frage. Die antiinflammatorische Wirkung von
Omega-3-Fettsäuren ist seit langer Zeit bekannt. Gibt es auch Nachweise, dass
Altersbeschwerden wie Demenz, Sarkopenie oder Hautalterung durch
Omega-3-Fettsäuren aufgehalten werden können? Der Artikel gibt eine Übersicht
über die wichtigsten Studien.
Rasayana – Ayurvedisches Anti-Aging
Authors: Chopra Ananda Samir 
Published: February 2019

ZusammenfassungDie Āyurveda-Medizin kennt schon seit 2000 Jahren differenzierte Konzepte zur
Erhaltung von Jugendlichkeit und Kraft auch im hohen Alter. Rasāyana bezeichnet
den Fachbereich der Āyurveda-Medizin, der speziell diesem Ziel gewidmet ist. Zu
Rasāyana gehören sowohl der Einsatz spezifischer pflanzlicher Arzneien, als auch
die Durchführung besonderer Therapieverfahren und eine gesundheitsförderliche
Lebensweise. Die verschiedenen Behandlungsmöglichkeiten müssen aber stets auf
der Grundlage einer individuellen Betrachtungsweise des Menschen eingesetzt und
kombiniert werden. Dabei ist die Grundkonstitution des Menschen zu
berücksichtigen ebenso wie Lebensalter und andere individuelle Determinanten.
Behandlungsansätze und Vorgehensweisen des Rasāyana werden hier übersichtsartig
vorgestellt.
Outcomes of endoscopic submucosal dissection for superficial esophageal cancer in an elderly population: a retrospective single center cohort study
Authors: Iizuka Toshiro , Kikuchi Daisuke , Hoteya Shu 
Published: February 2019

Abstract
Background and study aims Endoscopic submucosal dissection (ESD) is increasingly being used to treat superficial esophageal cancer in the elderly. However, data on clinical outcomes in this age group are limited. The aim of this study was to evaluate the safety and efficacy of ESD in treatment of superficial esophageal cancer and its effect on long-term outcome in the elderly.
Patients and methods In total, 664 consecutive patients with a histological diagnosis of squamous cell carcinoma or high-grade intraepithelial neoplasia who underwent ESD between April 2008 and March 2016 at our institution were enrolled. Clinical outcomes and prognostic factors were compared retrospectively between those aged 75 years or older (n = 162) and those aged younger than 75 years (n = 502).
Results There was no significant difference in post-ESD bleeding (0 vs. 0.8 %, P = 0.27) and perforation rates (1.8 vs. 1.2 %, P = 0.47) between the two age groups; however, stricture rate was higher in younger patients than in elderly patients (20.8 % vs 11 %; P = 0.036). There was no significant difference in the rate of locoregional recurrence between the two groups. Overall survival was significantly different between the two groups, but cause-specific survival was similar.
Conclusion These findings confirm the efficacy of ESD for superficial esophageal cancer in selected elderly patients (75 years or older) who were fit for the treatment because they can achieve similar long-term survival to younger patients.
Miasmatic Rubric: Concept and Applications
Authors: Soulis Dimitrios 
Published: February 2019

Background The aim of this study is to distinguish repertory rubrics where at least one miasm has a significantly higher prevalence amongst the remedies included.
Methods Sankaran's 10 miasm classification has been used where each remedy belongs only to one miasm. In this study, 14,486 rubrics from Schroyens ‘synthesis’ repertory were included; each one has 11 remedies at least. Pearson's chi-square test was applied to each rubric comparing the observed distribution of remedies amongst miasms to the expected one (based on the distribution of remedies amongst the whole population of rubrics).
Results Total 536 rubrics were identified to be significantly different regarding the observed count of remedies in each miasm compared with the expected one.
Conclusions Some of the ‘miasmatic rubrics’ identified refer to symptoms closely related to the miasm definitions and some of them do not. The latter category can give us more insight into the concept of each miasm by associating it with symptoms not currently included in miasmatic theory.
Impact of Multilayer Vascularized Reconstruction after Skull Base Endoscopic Endonasal Approaches
Authors: Simal-Julián Juan Antonio , Miranda-Lloret Pablo , Pérez de San Román Mena Laila , Sanromán-Álvarez Pablo , García-Piñero Alfonso , Sanchis-Martín Rosa , Botella-Asunción Carlos , Kassam Amin 
Published: February 2019

Abstract
Background The use of vascularized flap to reconstruct the skull base defects has dramatically changed the postoperative cerebrospinal fluid (CSF) leak rates allowing the expansion of endoscopic skull base procedures. At present, there is insufficient scientific evidence to permit identification of the optimal reconstruction technique after the endoscopic endonasal approach (EEA).
Objective The main purpose of this article is to establish the risk factors for failure in the reconstruction after EEA and whether the use of a surgical reconstruction protocol can improve the surgical results.
Material and Methods A retrospective cohort study was conducted in our institution, selecting patients that underwent EEA with intraoperative CSF leak. Two reconstructive protocols were defined based on different reconstructive techniques; both were vascularized but one monolayer and the other multilayer. A multivariate analysis was performed with outcome variable presentation of postoperative leak.
Results One hundred one patients were included in the study. Patients reconstructed with protocol 1, with the diagnosis different to the pituitary adenoma and older than 45 years old had higher risk of presenting postoperative leak, and with statistically significant differences when we adjusted for the remaining variables.
Conclusion The vascularized reconstructions after endoscopic endonasal skull base approaches have demonstrated to be able to obtain a low rate of postoperative CSF leak. The multilayer vascularized technique may provide a more evolved technique, even reducing the postoperative leak rates comparing with the monolayer vascularized one. The reconstructive protocol employed in each case, as well as age and histological diagnosis, is independent risk factor for presenting postoperative leak.
Transcanal Microscopic Transpromontorial Approach for Vestibular Schwannoma
Authors: Isaacson Brandon , Tolisano Anthony M. , Patel Ankur Ramanlal , Barnett Samuel L. 
Published: February 2019

Objectives This video demonstrates the transcanal transpromontorial approach for resection of vestibular schwannoma.
Design/Setting/Participants Present study is based on a video of a single patient undergoing the above approach at a tertiary care skull base surgery program.
Results This video demonstrates a transcanal microscopic transpromontorial approach for resection of an enlarging intracanalicular vestibular schwannoma in a young patient with nonserviceable hearing. The video highlights the pertinent surgical anatomy and outlines, in a step-by-step fashion, the approach to the internal auditory canal via this minimally invasive approach. The surgical indications and reconstructive techniques are also discussed (Fig. 1).
Conclusions A transcanal microscopic transpromontorial approach for vestibular schwannoma is feasible and offers a minimally invasive option for patients electing for microsurgical resection.The link to the video can be found at: https://youtu.be/-oKkRooytws.
The Use of Mobile Educational Tools to Improve Antimicrobial Prescription for the Treatment of Acute Pyelonephritis in Pregnancy: A Retrospective Cross-sectional Study
Authors: Antonello Vicente Sperb , Cunegatto Marjane Caroline , Rosin Elisa Tasca , Castilhos Júlia Xavier , Beduschi Fabrícia Gamba , Bumaguin Daniela Benzano , Antonello Ivan Carlos Ferreira , Jimenez Mirela Foresti 
Published: February 2019

Objective To analyze the prescription of antimicrobial agents for pregnant women admitted into the obstetrics service who presented with acute pyelonephritis.
Methods Three cross-sectional studies were performed comparing the prescription of antimicrobials for pyelonephritis in pregnant women in the time periods evaluated (2010–2011: 99 patients evaluated; 2013: 116 patients evaluated; 2015: 107 patients evaluated), at the Hospital Fêmina, Porto Alegre, in the state of Rio Grande do Sul, Brazil. The analysis was performed before and after the promotion of an institutional protocol for the treatment of pyelonephritis during pregnancy, and on a third occasion after the introduction of a smartphone-based mobile educational tool.
Results The evaluation of the prescribing physicians and the adequacy of the prescriptions between the different periods studied revealed a significant increase in appropriate conduct for the choice of antimicrobial (2010: 83.8%; 2013: 95.7%; and 2015: 100%), route of administration (2010: 97%; 2013: 100%; and 2015: 100%), and interval (2010: 91.9%; 2013: 95.7%; and 2015: 100%), following the introduction of the protocol, and again after the implementation of the software application with orientations on the antimicrobial treatment.
Conclusion The use of specific mobile applications should be encouraged to attain a better quality and accuracy in prescriptions and to include strategies that not only reduce the risk of negative outcomes, but also improve the quality of care and treatment for maintaining the health both of the mother and of the baby.
Comparison of Continuation of Low-Molecular-Weight Heparin versus Switching to Unfractionated Heparin in the Peripartum
Authors: Enakpene Christopher A. , Pontarelli Kristina N. , Della Torre Micaela 
Published: February 2019

Objective This study aimed to determine whether switching from low-molecular-weight heparin (LMWH) to unfractionated heparin (UFH) or its continuation in the peripartum affected anesthesia choice or bleeding complications.
Study Design A retrospective cohort study of 189 anticoagulated pregnant women who delivered at the University of Illinois at Chicago Hospital and Health Science System from 2005 to 2016. Demography, anesthesia choice, and bleeding complications were compared between the two groups.
Results There were 138 (73%) women on LMWH versus 51 (27%) who switched from LMWH to UFH during the peripartum. The demographics were similar, 123 women were on prophylactic: 81 (66%) were on LMWH and 42 (34%) switched to UFH. Of the 66 women on therapeutic anticoagulation, 57 (86%) continued on LMWH, while 9 (14%) switched to UFH. No difference in neuraxial anesthesia type received: 42 (82.4%) versus 108 (79.7%) women (odds ratio: 1.20, 95% confidence interval [CI]: 0.52–2.73, p = 0.837). Bleeding complications more than 1,000 mL, 6 versus 10% (relative risk [RR]: 0.58, 95% CI: 0.17–1.94, p = 0.380) and relaparotomy due to hemoperitoneum, 2% in either group (RR: 0.9, 95% CI: 0.10–8.48, p = 0.930) were similar in the two groups regardless of time of last injection.
Conclusion Anesthesia type and rate of bleeding complications were similar between women on LMWH and UFH during the peripartum.
The intersection of language ideologies and language awareness among in-service teachers of emergent
bilinguals
Authors: Lindahl Kristen , Henderson Kathryn I. 
Published: February 2019

Abstract
Important components of the teacher knowledge base are how aware a teacher is of language (including how it is
acquired and best taught), as well as their language ideologies. Because a combination of ideologies and awareness may guide many
pedagogical decisions, this mixed-methods sequential explanatory study explored prevalent language ideological orientations of
educators in a dual language immersion (DLI) context, their degrees of Teacher Language Awareness (TLA), and the relationship
between the two. Findings revealed that participants with high degrees of TLA oriented significantly more positively towards
additive language ideologies, while educators with low degrees of TLA were significantly more likely to orient toward deficit
ideologies. Data from cases representing high and low degrees of TLA provide an in-depth view of the relationship between
teachers’ TLA and ideologies in practice. This study extends an understanding of how language awareness and ideologies interact,
along with implications for pre- and in-service teacher professional development.
The large genome size variation in the Hesperis clade was shaped by the prevalent proliferation of DNA repeats and rarer genome downsizing
Authors: Hloušková Petra , Mandáková Terezie , Pouch Milan , Trávníček Pavel , Lysak Martin A 
Published: February 2019

Abstract

Background and Aims
Most crucifer species (Brassicaceae) have small nuclear genomes (mean 1C-value 617 Mb). The species with the largest genomes occur within the monophyletic Hesperis clade (Mandáková et al., Plant Physiology174: 2062–2071; also known as Clade E or Lineage III). Whereas most chromosome numbers in the clade are 6 or 7, monoploid genome sizes vary 16-fold (256–4264 Mb). To get an insight into genome size evolution in the Hesperis clade (~350 species in ~48 genera), we aimed to identify, quantify and localize in situ the repeats from which these genomes are built. We analysed nuclear repeatomes in seven species, covering the phylogenetic and genome size breadth of the clade, by low-pass whole-genome sequencing.

Methods
Genome size was estimated by flow cytometry. Genomic DNA was sequenced on an Illumina sequencer and DNA repeats were identified and quantified using RepeatExplorer; the most abundant repeats were localized on chromosomes by fluorescence in situ hybridization. To evaluate the feasibility of bacterial artificial chromosome (BAC)-based comparative chromosome painting in Hesperis-clade species, BACs of arabidopsis were used as painting probes.

Key Results
Most biennial and perennial species of the Hesperis clade possess unusually large nuclear genomes due to the proliferation of long terminal repeat retrotransposons. The prevalent genome expansion was rarely, but repeatedly, counteracted by purging of transposable elements in ephemeral and annual species.

Conclusions
The most common ancestor of the Hesperis clade has experienced genome upsizing due to transposable element amplification. Further genome size increases, dominating diversification of all Hesperis-clade tribes, contrast with the overall stability of chromosome numbers. In some subclades and species genome downsizing occurred, presumably as an adaptive transition to an annual life cycle. The amplification versus purging of transposable elements and tandem repeats impacted the chromosomal architecture of the Hesperis-clade species.
Altered Cortical Brain Structure and Increased Risk for Disease Seen Decades After Perinatal Exposure to Maternal Smoking: A Study of 9000 Adults in the UK Biobank
Authors: Salminen Lauren E , Wilcox Rand R , Zhu Alyssa H , Riedel Brandalyn C , Ching Christopher R K , Rashid Faisal , Thomopoulos Sophia I , Saremi Arvin , Harrison Marc B , Ragothaman Anjanibhargavi , Knight Victoria , Boyle Christina P , Medland Sarah E , Thompson Paul M , Jahanshad Neda 
Published: February 2019

AbstractSecondhand smoke exposure is a major public health risk that is especially harmful to the developing brain, but it is unclear if early exposure affects brain structure during middle age and older adulthood. Here we analyzed brain MRI data from the UK Biobank in a population-based sample of individuals (ages 44–80) who were exposed (n = 2510) or unexposed (n = 6079) to smoking around birth. We used robust statistical models, including quantile regressions, to test the effect of perinatal smoke exposure (PSE) on cortical surface area (SA), thickness, and subcortical volumes. We hypothesized that PSE would be associated with cortical disruption in primary sensory areas compared to unexposed (PSE−) adults. After adjusting for multiple comparisons, SA was significantly lower in the pericalcarine (PCAL), inferior parietal (IPL), and regions of the temporal and frontal cortex of PSE+ adults; these abnormalities were associated with increased risk for several diseases, including circulatory and endocrine conditions. Sensitivity analyses conducted in a hold-out group of healthy participants (exposed, n = 109, unexposed, n = 315) replicated the effect of PSE on SA in the PCAL and IPL. Collectively our results show a negative, long term effect of PSE on sensory cortices that may increase risk for disease later in life.
Emergence of Drug Resistance in the Swiss HIV Cohort Study Under Potent Antiretroviral Therapy Is Observed in Socially Disadvantaged Patients
Authors: Abela Irene A , Scherrer Alexandra U , Böni Jürg , Yerly Sabine , Klimkait Thomas , Perreau Matthieu , Hirsch Hans H , Furrer Hansjakob , Calmy Alexandra , Schmid Patrick , Cavassini Matthias , Bernasconi Enos , Günthard Huldrych F ,   Swiss HIV Cohort Study, Anagnostopoulos A , Battegay M , Bernasconi E , Böni J , Braun D L , Bucher H C , Calmy A , Cavassini M , Ciuffi A , Dollenmaier G , Egger M , Elzi L , Fehr J , Fellay J , Furrer H , Fux C A , Günthard H F , Haerry D , Hasse B , Hirsch H H , Hoffmann M , Hösli I , Huber M , Kahlert C , Kaiser L , Keiser O , Klimkait T , Kouyos R D , Kovari H , Ledergerber B , Martinetti G , Martinez de Tejada B , Marzolini C , Metzner K J , Müller N , Nicca D , Paioni P , Pantaleo G , Perreau M , Rauch A , Rudin C , Scherrer A U , Schmid P , Speck R , Stöckle M , Tarr P , Trkola A , Vernazza P , Wandeler G , Weber R , Yerly S 
Published: February 2019

AbstractBackgroundThe rate of acquired human immunodeficiency virus type 1 (HIV-1) drug resistance (ADR) has fallen dramatically since introduction of combined antiretroviral therapy (cART) in Switzerland. However, clinical experience indicates that there are still patients at risk of newly acquiring drug resistance despite having access to cART. Here, we characterized risk factors for ADR, to improve patient care and prevent emergence of drug resistance and treatment failure.MethodsWe performed a case-control study to identify risk factors for ADR in all patients starting their first cART in the Swiss HIV Cohort Study (SHCS) since 1996. The SHCS is highly representative and includes &gt;75% of patients receiving ART in Switzerland. To this end, we implemented a systematic medical chart review to obtain more detailed information on additional parameters, which are not routinely collected in the SHCS. The collected data were analyzed using univariable and multivariable conditional logistic regression.ResultsWe included in our study 115 cases and 115 matched controls. Unemployment (multivariable odds ratio [mOR], 2.9 [95% confidence interval {CI}, 1.3–6.4]; P = .008), African origin (mOR, 3.0 [95% CI, 1.0–9.2]; P = .047), comedication with anti-infectives (mOR, 3.7 [95% CI, 1.0–12.6]; P = .045), and symptoms of mental illness (mOR, 2.6 [95% CI, 1.2–5.5]; P = .012) were associated with ADR in the multivariable model.ConclusionsAlthough ADR has become very rare with cART due to new potent therapies, patients in socially challenging life situations or presenting with mental health issues are at higher risk for drug resistance. Prompt identification and adequate support of these patients before ADR will prevent treatment failure and HIV-1 transmission.
T-lymphocyte in ANCA-associated vasculitis: what do we know? A pathophysiological and therapeutic approach
Authors: Martinez Valenzuela Laura , Bordignon Draibe Juliana , Fulladosa Oliveras Xavier , Bestard Matamoros Oriol , Cruzado Garrit Josep Maria , Torras Ambrós Juan 
Published: February 2019

Abstract
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is an autoimmune condition that commonly causes kidney impairment and can be fatal. The key participation of B-lymphocytes as ANCA producers and neutrophils as target of these antibodies is widely described as the mechanism of endothelial damage in this disease. There has been a rising interest in the role of T-lymphocytes in AAV in recent years. Evidence is strong from animal models, and T-lymphocytes can be found infiltrating kidney tissue and other tissue sites in AAV patients. Furthermore, the different subsets of T-lymphocytes are also key players in the aberrant immune response observed in AAV. Polarization towards a predominant Th1 and Th17 response in the acute phase of the disease has been described, along with a decline in the number of T-regulatory lymphocytes, which, in turn, show functional impairment. Interactions between different T-cell subsets, and between T-cells and neutrophils and B-cells, also enhance the inflammatory response, constituting a complex network. Novel therapies targeting T-cell immunity are emerging in this scenario and may constitute an interesting alternative to conventional therapy in selected patients. This review aims to summarize the available evidence regarding T-cell imbalances and functional impairment, especially focusing on renal involvement of AAV.