bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dietetic Treatment of Diabetes Mellitus with Special Reference to High Blood-Pressure
Authors: Embleton Dennis 
Published: July 2019

The error in a diabetic is essentially a carbohydrate intolerance, and correction of this defect should be aimed at in treatment. Dietetic treatment of diabetes is more readily studied in early cases or cases in the pre-diabetic state, before arterial degeneration and other catastrophes have become manifest. It is suggested that such a condition exists in obese subjects with a carbohydrate intolerance. A high protein diet based on a study of these cases is brought forward. This diet has been shown to operate favourably in diabetic states. Many cases of reasonable severity can be brought to develop a normal or nearly normal glucose tolerance curve and retain this state over a period of years. Cases in this state are better able to resist concomitant infections without deterioration of their tolerance than cases imperfectly balanced with insulin. The high protein diet can be used in cases of hyperpiesia in the absence of gross kidney damage. These cases show a steady and lasting drop in blood-pressure without the necessity of employing rest. The value of the pure fruit diet in increasing tolerance of certain diabetics to carbohydrate is demonstrated. The indiscriminate use of insulin in hyperglycæmic states is deprecated on the grounds that it is frequently unnecessary, and though it may balance it does not necessarily rectify the main deficiency of carbohydrate intolerance. By the use of this simple high protein diet, where no weighing, &c., is required, a large number of diabetics at present on insulin could be readily dealt with, a return to a normal or nearly normal glucose tolerance curve being obtained and maintained.
The Significance of Anoxæmia in Modern Psychiatric Treatment
Authors: Quastel J. H. 
Published: July 2019

Blood in its passage through the brain loses oxygen and glucose at relatively high rates, the amount of oxygen disappearing being approximately equivalent to the amount of glucose consumed, calculating on the basis that the sugar is completely oxidized. The respiratory quotient of brain in vivo is unity. These facts point to the dominance of carbohydrate oxidation in brain respiration in vivo and are similar to those found in studies of brain in vitro. Various factors influence glucose oxidation in brain, e.g. changes in the ionic environment of the cells, vitamin B1, or the presence of narcotics. The latter bring about inhibitions of glucose oxidation in brain tissue which may in most cases be shown to be reversible in vitro. Glucose is not only important for the maintenance of respiration of brain but for enabling certain synthetic processes to occur. One of these is the formation of acetylcholine whose physiological significance is now well known and whose synthesis seems to be confined to the nervous system. This synthesis depends not only on the presence of glucose but on that of oxygen. The influence of glucose has been observed also in investigations on cortical potentials. An important feature of the nerve cell is its vulnerability to the lack of oxygen. Reversibility depends on the degree and duration of the anoxæmia. During insulin shock treatment studies of brain in vivo show lowered oxygen consumption and glucose utilization, these depending on the degree of hypoglycæmia. In cardiazol treatment, in vivo studies show that the oxygen content of the blood may fall to 42%. During the convulsion there is a greatly lowered arterial and venous blood-flow through the brain and cerebral anæmia becomes a marked feature. In narcosis treatment both in vitro and in vivo studies show a diminished ability of the brain to consume oxygen. It is suggested that the most significant facts to be taken into account are (1) the importance of glucose and oxygen for the metabolism and function of the nervous system, (2) the vulnerability and varying sensitivities of nerve cells to lack of oxygen and glucose, (3) the occurrence of varying degrees of cerebral anoxæmia in narcosis, insulin and cardiazol treatments.
Family Limitation
Authors: Smith Robert 
Published: July 2019

Dr Robert Smith surveys the history of birth control and sounds a warning for the future of mankind, if the population explosion is allowed to continue unchecked. He stresses the importance of the role of the general practitioner in the limitation of births. Sir Theodore Fox describes the work of the Family Planning Association and stresses that, increasingly, this is a specialist service covering all aspects of fertility. He also feels that the general practitioner has a role in family planning.
Should Routine Methicillin-Resistant Staphylococcus aureus (S. aureus), or MRSA, Screening Be in Place Prior to Total Ankle Arthroplasty (TAA)?
Authors: Kaplan Jonathan R. M. , Slullitel Gaston , Lopez Valeria 
Published: July 2019

Recommendation: Unknown. The role of screening for methicillin-resistant Staphylococcus aureus (MRSA) and decolonization prior to total ankle arthroplasty (TAA) remains unclear. Further data are needed to support this practice in TAA, which can be costly and logistically difficult to implement. Level of Evidence: Consensus. Delegate Vote: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)
Predicting outcomes in patients with cancer and atrial fibrillation
Authors: Gutierrez Alejandra , Patell Rushad , Rybicki Lisa , Khorana Alok A. 
Published: July 2019

Background: The role of cancer-specific factors for ischemic stroke and mortality in patients with cancer and atrial fibrillation (AF) is unknown. We evaluated the utility of a previously validated risk tool for venous thromboembolism (VTE) in cancer outpatients [Khorana score (KS)] in predicting stroke and mortality in cancer patients with AF. Methods: We conducted a retrospective cohort study of patients with cancer and AF at the Cleveland Clinic from 2008 to 2014. Outcomes, CHADS2, CHA2DS2-VASc, and KS scores were calculated from date of cancer diagnosis. Prognostic factors were identified with Fine and Gray regression (for stroke) or Cox proportional hazards analysis (for mortality). Results: The study population comprised 1181 patients. Genitourinary (19%), lung (18%), and gastrointestinal (13%) were the most frequent cancers. Overall, 67% had CHADS2 ⩾ 2, 57% had an intermediate KS (1–2), and 7% high KS (⩾3). Median follow up was 26.5 months (range 0.03–76). At a median of 8.2 months (range 0–61), 45 patients (3.8%) developed a stroke and 418 (35%) died. In multivariable analysis a high KS (HR 4.5, 95% CI 3.2–6.3, p < 0.001) was associated with a quadruple risk of death and every point increase in CHADS2 score had a 20% increased risk of death (HR 1.19, 95% CI 1.1–1.2, p < 0.001). The addition of KS did not improve risk stratification for ischemic stroke to CHADS2. Conclusion: In patients with cancer and AF, CHADS2 and CHA2DS2-VASc but not KS were predictive of ischemic stroke. A high KS represented a unique predictor of mortality beyond traditional risk scores.
Purine nucleoside use as surrogate markers of cerebral ischaemia during local and general anaesthetic carotid endarterectomy
Authors: Fisher Owain , Benson Ruth A , Tian Faming , Dale Nicholas E , Imray Christopher HE 
Published: July 2019

Objectives: In periods of cerebral ischaemia, adenosine triphosphate is metabolised, leading to accumulation of adenosine inosine and hypoxanthine. These can be measured in real time using peripheral blood samples intraoperatively. The primary aim of this study was to describe changes in purine concentrations in a cohort of patients undergoing carotid endarterectomy under general anaesthetic, and to evaluate correlation between changes in values with major perioperative steps. The secondary aim was to compare changes in concentrations with a previous cohort of patients who had undergone carotid endarterectomy under local anaesthetic. Methods: This was a prospective observational study. Purine concentrations were determined from arterial line samples and measured via an amperometric biosensor at specific time points during carotid endarterectomy. Mean arterial pressure was manipulated to maintain steady cerebral perfusion pressure throughout the procedure. These results were analysed against data from a cohort of patients who underwent carotid endarterectomy under local anaesthetic in previously published work. Results: Valid results were obtained for 37 patients. Purine concentrations at baseline were 3.02 ± 1.11 µM and 3.16 ± 1.85 µM for the unshunted and shunted cohorts, respectively. There was no significant change after 30 min of carotid clamping at 2.07 ± 0.89 and 2.4 ± 3.09 µM, respectively (both p > 0.05). Peak purine during the clamp phase in the loco-regional anaesthetic cohort was 6.70 ± 3.4 µM, which was significantly raised compared to both general anaesthetic cohorts (p = 0.004). There were no perioperative neurological events in either cohort. Conclusion: This small study does not demonstrate conclusive evidence that purine nucleosides can be used as a marker of cerebral ischaemia; the comparisons to the loco-regional anaesthetic data offer information about differences in the cerebral adenosine triphosphate metabolism between general anaesthetic and loco-regional anaesthetic. We hypothesise that the lack of a rise in purine nucleosides under general anaesthetic may be caused by a decrease in the cerebral metabolic rate and loss of metabolic rate-blood flow coupling caused by general anaesthetic agents.
Mental Health Comorbidities and Elevated Risk of Opioid Use in Elderly Breast Cancer Survivors Using Adjuvant Endocrine Treatments
Authors: Desai Raj , Camacho Fabian , Tan Xi , LeBaron Virginia , Blackhall Leslie , Balkrishnan Rajesh 
Published: July 2019

PURPOSE: Prolonged opioid use is common and associated with lower survival rates in breast cancer survivors. We explored whether opioid use in elderly breast cancer survivors using adjuvant endocrine therapy (AET) regimens was affected by the prevalence of mental health comorbidity and, in turn, how this affected survival in this population. METHODS: This retrospective study analyzed 2006 to 2012 SEER-Medicare data sets and followed patients for at least 2 years from the index date, defined as the first date they filled an AET prescription. The study included adult women with incident, primary, hormone receptor–positive, stage I to III breast cancer. They were also first-time AET users and fee-for-service Medicare enrollees continuously enrolled in Medicare Parts A, B, and D. We measured whether patients with a clinical diagnosis of a mental health comorbid condition used opioids after the initiation of AET and their survival at the end of the study period. RESULTS: A total of 10,452 breast cancer survivors who began AET treatments were identified, among whom the most commonly diagnosed mental health comorbidities were depression (n = 554) and anxiety (n = 246). Using a propensity score risk adjustment model, we found that opioid use was significantly higher in women with a mental health comorbidity (odds ratio,1.33; 95% CI, 1.06 to 1.68). In addition, mental health comorbidity was associated with a significantly increased hazard of mortality in this population (hazard ratio, 1.49; 95% CI, 1.02 to 2.18). CONCLUSION: The presence of mental health comorbidity in breast cancer survivors significantly increases the risk of opioid use and mortality, which highlights the need for better management of comorbid mental health conditions.
Comparison of 3T diffusion-weighted MRI and 18F-FDG PET/CT in musculoskeletal tumours: quantitative analysis of apparent diffusion coefficients and standardized uptake values
Authors: Lee So-Yeon , Jee Won-Hee , Yoo Ie Ryung , Jung Joon-Yong , Im Soo-A , Chung Yang-Guk , Kang Jin Hyoung 
Published: July 2019

Objective:
To determine whether the apparent diffusion coefficient (ADC) on 3T MR imaging including diffusion-weighted MR imaging (DWI) correlate with the standardized uptake value (SUV) on 18F-FDG PET/CT in musculoskeletal tumours.

Methods:
This retrospective cohort study included 57 patients (36 males, 21 females, mean age 54 years, range 12–90 years) with pathologically confirmed soft tissue (n = 32) and bone (n = 25) tumours who underwent 3T MR imaging including DWI and whole-body 18F-FDG PET/CT before treatment. 14 patients had follow-up MR imaging and 18F-FDG PET/CT after treatment. The minimum (ADCmin) and mean (ADCmean) ADCs of musculoskeletal tumour, ADC of normal skeletal muscle (ADCmus), SUVmax and SUVmean of musculoskeletal tumour were obtained. Correlation between ADCs and SUVs was assessed using Pearson correlation coefficients (r). ADCmin and SUVmax were compared between pretreatment and posttreatment by t-test.

Results:
There was inverse correlation between SUVmax and the ratio ADCmin/ADCmus (r = - 0.505 to - 0.495, p ≤ 0.001) and between SUVmean and the ratio ADCmean/ADCmus (r = - 0.501 to - 0.493, p = 0.001). After treatment ADC was significantly increased whereas SUV was significantly decreased (p = 0.001). There was significant correlation in percent change between the initial and follow-up values of ADCmin and SUVmax (r = 0.750 to 0.773, p ≤ 0.005). The ADCmin was increased by 163% and SUVmax was decreased by 61% in 11 patients with treatment response.

Conclusion:
ADC at 3T MR DWI and SUV at 18F-FDG PET/CT have an inverse correlation in musculoskeletal tumours.

Advances in knowledge:
Our study showed that ADC at 3T DWI and SUV at 18F-FDG PET/CT had an inverse correlation in musculoskeletal tumours.
Adjuvant volumetric modulated arc therapy compared to 3D conformal radiation therapy for newly diagnosed soft tissue sarcoma of the extremities: outcome and toxicity evaluation
Authors: Di Brina Lucia , Fogliata Antonella , Navarria Pierina , D'Agostino Giuseppe , Franzese Ciro , Franceschini Davide , De Rose Fiorenza , Comito Tiziana , Bertuzzi Alexia , Marrari Andrea , Colombo Piergiuseppe , Quagliuolo Vittorio , Santoro Armando , Scorsetti Marta 
Published: July 2019

Objective:
To assess the impact of adjuvant volumetric modulated arc therapy (VMAT) compared with three-dimensional conformal radiation therapy (3DCRT) in terms of toxicity and local control (LC) in patients with soft tissue sarcoma of the extremities.

Methods:
From 2004 to 2016, 109 patients were treated, initially using 3DCRT and subsequently with VMAT. Clinical outcome was evaluated by contrast-enhanced MRI, thoracic and abdominal CT 3 months after treatments and then every 6 months. Toxicity was evaluated with Common Terminology Criteria for Adverse Events scale v. 4.3.

Results:
Patients presented Stage III soft tissue sarcoma disease (77%), localized tumor (95%) at the lower extremity (87%), adipocytic histotype (46%). Surgical resection was performed in all patients, followed by adjuvant 3DCRT in 38, and VMAT in 71. The median total dose was 66 Gy/33 fractions (range 60–70 Gy;25–35 fractions). More successful bone sparing was recorded using VMAT (p &lt; 0.001). Median follow-up was 61 months, 93 and 58 months for 3DCRT and VMAT group, respectively. The 2- and 5 year LC were 95.3±2.1%, and 87.4±3.4% for the whole cohort, 92.0±4.5%, 82.9±6.4% for 3DCRT, 97.1±2.0%, 89.6±4.1% for VMAT (p = 0.150). On univariate and multivariate analysis the factors recorded as conditioning LC were the status of the surgical resection margins (p = 0.028) and the total dose delivered (p = 0.013).

Conclusion:
The availability of modern radiotherapy technique permit a better conformity on the target with maximum sparing of normal tissue and acceptable side-effects. VMAT is a safe and feasible treatment with limited rate of toxicity, compared to 3DCRT. Results on LC of VMAT are encouraging.

Advances in knowledge:
Soft tissue sarcoma of the extremities can benefit from the use of VMAT, with a reduction of the high dose to bones to avoid radiation osteonecrosis. An adequate total dose of at least 66 Gy and a radical surgical margin allow a good local control.
Prognosis associated with geometric patterns of left ventricular remodeling: systematic review and network meta-analysis
Authors: Zheng Qishi , Loo Germaine , Le Thu-Thao , Shi Luming , Chan Edwin Shih-Yen , Chin Calvin W. L. 
Published: July 2019

Background:There are four geometric patterns (normal geometry, concentric remodeling, concentric and eccentric hypertrophy) used to describe cardiac remodeling. Although left ventricular hypertrophy (LVH) is associated with adverse prognosis, the incremental prognostic value of geometric patterns is less certain. We examined characteristics and prognosis associated with the four conventional patterns of left ventricle (LV) remodeling.Methods:A comprehensive literature search was performed on MEDLINE/PubMed, Embase and the Cochrane Library until January 2019. Network meta-analysis was used to pool data from direct and indirect prognostic comparisons of the four geometric patterns. All-cause mortality was defined as the study outcome. Results:A total of 22 echocardiographic studies (76,142 individuals; 50.1% males; 64.4±7.9 years) of diverse cardiovascular diseases were included. Concentric LVH was associated with the highest prevalence of cardiovascular risk factors and diseases; and eccentric hypertrophy was associated with a high prevalence of atrial fibrillation and low LV ejection fraction. Compared to normal geometry, the risk of all-cause mortality was increased in concentric hypertrophy (risk ratio 1.97 [95% confidence interval 1.63-2.39]) but similar to eccentric hypertrophy (risk ratio 1.15 [95% confidence interval 0.97-1.36]). Conclusions:The study populations examined in the meta-analysis were heterogeneous. Concentric LVH conferred the highest risk of all-cause mortality that overlapped with eccentric hypertrophy. Strategies to improve LVH risk stratification should be examined in future research.
KOMPONEN-KOMPONEN PEMBELAJARAN AL-KITÂBAH BAHASA ARAB
Authors: Huda Nurul 
Published: July 2019

The main component of Arabic learning covers the same four language skills for all competencies. They are: listening (istimâ’), speaking (kalâm), reading (qirâ’ah), and writing (kitâbah). Those four skills mutually connected. For instance, listening skill contributes to speaking skill and vice versa. In turn, those two skills will be strengthened by student reading skill or vice versa. Speaking skill is very close related to listening skill. Speaking and listening skill refer to all means to communicate orally. Because of the importance of this writing skill, the writer sees the need of al-Kitabah study map and its parts that can be delivered to student systematically, start from the lowest level (Ibtidâiyyah) to the next level (I’dadiyyah) based on students condition and psychology, including components in Al-kitâbah.
A step forward in the quest for a mobile EEG-designed epoch for psychophysiological studies
Authors: Balart-Sánchez Sebastián A. , Vélez-Pérez Hugo , Rivera-Tello Sergio , Gómez Velázquez Fabiola R. , González-Garrido Andrés A. , Romo-Vázquez Rebeca 
Published: July 2019

Abstract
The aim of this study was to compare a reconfigurable mobile electroencephalography (EEG) system (M-EMOTIV) based on the Emotiv Epoc® (which has the ability to record up to 14 electrode sites in the 10/20 International System) and a commercial, clinical-grade EEG system (Neuronic MEDICID-05®), and then validate the rationale and accuracy of recordings obtained with the prototype proposed. In this approach, an Emotiv Epoc® was modified to enable it to record in the parieto-central area. All subjects (15 healthy individuals) performed a visual oddball task while connected to both devices to obtain electrophysiological data and behavioral responses for comparative analysis. A Pearson’s correlation analysis revealed a good between-devices correlation with respect to electrophysiological measures. The present study not only corroborates previous reports on the ability of the Emotiv Epoc® to suitably record EEG data but presents an alternative device that allows the study of a wide range of psychophysiological experiments with simultaneous behavioral and mobile EEG recordings.
EGFR and EGFR ligands in serum in healthy women; reference intervals and age dependency
Authors: Kjær Ina Mathilde , Olsen Dorte Aalund , Alnor Anne , Brandslund Ivan , Bechmann Troels , Madsen Jonna Skov 
Published: July 2019

Abstract

Background
The epidermal growth factor receptor (EGFR) system is involved in cancer pathogenesis and serves as an important target for multiple cancer treatments. EGFR and its ligands epidermal growth factor (EGF), heparin-binding epidermal growth factor (HB-EGF), betacellulin (BTC), amphiregulin (AREG) and transforming growth factor α (TGF-α) have potential applications as prognostic or predictive serological biomarkers in cancer. The aim was to establish EGFR and EGFR ligand reference intervals in healthy women.

Methods
EGFR and EGFR ligands were measured in serum from 419 healthy women aged 26–78 years. The need for age partitioned reference intervals was evaluated using Lahti’s method. EGFR and EGF were analyzed using ELISA assays, whereas HB-EGF, BTC, AREG and TGF-α were analyzed using the highly sensitive automated single molecule array (Simoa) enabling detection below the lower reference limit for all six biomarkers.

Results
Reference intervals for EGFR and the EGFR ligands were determined as the 2.5th and 97.5th percentiles. All six biomarkers were detectable in all serum samples. For EGFR, EGF, HB-EGF and TGF-α, reference intervals were established for women <55 years and for women >55 years, whilst common reference intervals were established for AREG and BTC including women aged 26–78 years.

Conclusions
Age specific reference intervals were determined for EGFR, EGF, HB-EGF, BTC, AREG and TGF-α.
On Convergence of Difference Schemes for Dirichlet IBVP for Two-Dimensional Quasilinear Parabolic Equations with Mixed Derivatives and Generalized Solutions
Authors: Matus Piotr , Poliakov Dmitriy , Hieu Le Minh 
Published: July 2019

Abstract
For Dirichlet initial boundary value problem (IBVP) for two-dimensional
quasilinear parabolic equations with mixed derivatives monotone linearized difference scheme is constructed.
The ellipticity conditions

c
1

⁢

∑

α
=
1

2

ξ
α
2

≤

∑

α
,
β

=
1

2

k

α
⁢
β

⁢

(
u
)

⁢

ξ
α

⁢

ξ
β

≤

c
2

⁢

∑

α
=
1

2

ξ
α
2

c_{1}\sum_{\alpha=1}^{2}\xi_{\alpha}^{2}\leq\sum_{\alpha,\beta=1}^{2}k_{\alpha%
\beta}(u)\xi_{\alpha}\xi_{\beta}\leq c_{2}\sum_{\alpha=1}^{2}\xi_{\alpha}^{2}

are assumed to be fulfilled for the sign alternating solution

u
⁢

(
𝐱
,
t
)

∈

D
¯

⁢

(
u
)

{u(\mathbf{x},t)\in\bar{D}(u)}

only in the domain of exact solution values (unbounded nonlinearity).
On the basis of the proved new corollaries of the maximum principle, not only two-sided estimates for the approximate solution y but also its belonging to the domain of exact solution values are established.
We assume that the solution is continuous and its first derivatives

∂
⁡
u

∂
⁡

x
i

{\frac{\partial u}{\partial x_{i}}}

have discontinuities of the first kind in the neighborhood of the finite number of discontinuity lines.
No smoothness of the time derivative is assumed.
The convergence of an approximate solution to a generalized solution of a differential problem in the grid norm

L
2

{L_{2}}

is proved.