bluuebunny/crossref_metadata_2025_split huggingface dataset:
Iatrogenic Vascular Injuries of the Abdomen and Pelvis: The Experience at a Hellenic University Hospital
Authors: Filis Konstantinos , Sigala Fragiska , Stamatina Triantafyllou , Georgia Doulami , Zografos Georgios , Galyfos George 
Published: June 2019

Background: The aim of this study is to present the experience of a Vascular Division at a Hellenic University hospital concerning the management of iatrogenic vascular injuries (IVIs) of the abdomen or pelvis. Patients and Methods: This is a retrospective study evaluating all IVIs reported during a 10-year period in our institution. Only injuries warranting a vascular surgeon consultation were included in the study. Non-iatrogenic injuries were not included. Mortality and major complications within 30 days were evaluated. Results: Overall, 70 cases were recorded, with 41% being venous and 59% being arterial injuries. Iliac arteries (51%) were the most common location and rupture/lacerations (73%) were the most common type of injury. General surgery (61.5%) and cardiology (30%) procedures were the most frequently involved procedures. A 30-day mortality was 5.7%, with 30% of cases treated conservatively. Synthetic bypass grafting (odds ratio [OR] = 65.0; 95% confidence interval [CI], 4.022-1050.358; P = .003) and male gender (OR = 83.77; 95% CI, 4.040-1736.738; P = .004) were associated with death. Conclusions: Iatrogenic vascular injuries of the abdomen or pelvis are usually associated with general surgery and endovascular procedures. When vascular consultation is requested early, mortality could remain low. However, a selected number of stable patients with retroperitoneal or pelvic hematomas could be treated conservatively, yielding satisfying results.
Efficacy and safety of lanreotide in postoperative dumping syndrome: A Phase II randomised and placebo‐controlled study
Authors: Wauters Lucas , Arts Joris , Caenepeel Philip , Holvoet Lieselot , Tack Jan , Bisschops Raf , Vanuytsel Tim 
Published: June 2019

BackgroundData on the efficacy and safety of the long‐acting somatostatin analogue lanreotide (LAN) for postoperative dumping syndrome are lacking.ObjectiveWe performed a double‐blind, randomised and placebo‐controlled crossover study of LAN Autogel® 90 mg in postoperative dumping.MethodsAdults with a positive prolonged oral glucose tolerance test or spontaneous hypoglycaemia and total dumping score (DS) ≥ 10 despite dietary measures were treated with three monthly injections of LAN or placebo in a randomised crossover fashion with an eight‐week wash‐out period. Primary outcome was the effect of LAN on total DS versus placebo. Secondary outcomes were the effect on early and late DS, treatment assessment, quality of life and safety.ResultsOf 24 included patients (66.7% female; age 49.1 ± 2.1 years), 12 were randomised to LAN first. Pooled DS after three injections were lower compared to baseline after LAN (median=14 (interquartile range (IQR) 11.5–23) vs. median = 22 (IQR 16–27); p = 0.03) but not placebo (median = 20 (IQR 15–27) vs. median = 23 (IQR 13–29); p = 0.15). Improvement of early (median = 7.5 (IQR 4.5–13) vs. median = 12 (IQR 9–16); p = 0.03) but not late (median = 7 (IQR 6–10.3) vs. median = 9 (IQR 6–13); p = 0.26) DS was seen. Overall treatment assessment correlated with change in DS (r = –0.69, p = 0.004). Symptom improvement was not associated with changes in quality of life. Of the 81 reported adverse events, 44 occurred on LAN compared to 37 on placebo (p > 0.05), with seven serious adverse events on LAN.ConclusionsLAN is effective for treating early postoperative dumping symptoms, although side effects are common and quality of life is not significantly affected.
Costs of illness progression for different multiple sclerosis phenotypes: a population-based study in Sweden
Authors: Gyllensten Hanna , Kavaliunas Andrius , Murley Chantelle , Alexanderson Kristina , Hillert Jan , Tinghög Petter , Friberg Emilie 
Published: June 2019

Background Little is known of how the cost of illness and health-related quality of life changes over time after a diagnosis of multiple sclerosis. Objectives The aim was thus to explore the progression of annual direct and indirect costs and health-related quality of life among people with multiple sclerosis of working ages, following diagnosis with relapsing–remitting multiple sclerosis (RRMS), primary progressive multiple sclerosis (PPMS) or conversion to secondary progressive multiple sclerosis (SPMS) after RRMS. Methods Swedish nationwide registers were linked to estimate the annual cost of illness in 2006–2013 among people with a registered new multiple sclerosis phenotype, including: direct costs, indirect costs, and health-related quality of life. Results Drugs and indirect costs for sick leave were the main cost drivers after diagnosis with RRMS. After conversion to SPMS, the RRMS cost drivers were replaced by indirect costs for disability pension. The main cost driver in newly diagnosed PPMS was indirect costs for sick leave, later replaced by disability pension. Health-related quality of life scores were similar after RRMS and SPMS. Conclusions After initial high indirect costs for sick leave, people with RRMS had higher drug costs compared to people with PPMS. Cost drivers during SPMS initially followed the pattern in the RRMS population, but were replaced by indirect costs for disability pension.
A Qualitative Investigation of the Experiences of Students and Preceptors Taking Part in Remote and Rural Community Experiential Placements During Early Medical Training
Authors: Ross Brian M , Cameron Erin , Greenwood David 
Published: June 2019

Background: Medical education can help alleviate the chronic undersupply of physicians to rural communities. Providing students with early rural clinical experiences may allow the gaining of necessary knowledge and skills to practice and live rurally, as well as the desire to do so. Purpose: This study aims to provide a detailed understanding of Remote and Rural Community Placements (RRCPs) which occur in the second year of a Doctor of Medicine programme. Methodology/Approach: Using a thematic analysis approach, we examined the experiences of students and preceptors in the RRCP. Data were collected using semi-structured interviews and focus groups. Findings/Conclusions: Students valued RRCPs as a formative clinical experience and preceptors gained professionally from participating. The RRCPs enhanced students regard for, and knowledge of, rural medicine. Yet, contrary to the stated aims of the placement, students spent very little time in activities outside of the clinic, neither learning about the community nor about the life of a physician as a community member. Implications: Medical educators should recognise that students and preceptors will inevitably place different value on the different sociocultural and perceptual aspects of placements, namely clinical and non-clinical. As such, the curriculum should draw clearly articulated links between each.
Interoperable chemical structure search service
Authors: Kratochvíl Miroslav , Vondrášek Jiří , Galgonek Jakub 
Published: June 2019

Abstract

Motivation
The existing connections between large databases of chemicals, proteins, metabolites and assays offer valuable resources for research in fields ranging from drug design to metabolomics. Transparent search across multiple databases provides a way to efficiently utilize these resources. To simplify such searches, many databases have adopted semantic technologies that allow interoperable querying of the datasets using SPARQL query language. However, the interoperable interfaces of the chemical databases still lack the functionality of structure-driven chemical search, which is a fundamental method of data discovery in the chemical search space.

Results
We present a SPARQL service that augments existing semantic services by making interoperable substructure and similarity searches in small-molecule databases possible. The service thus offers new possibilities for querying interoperable databases, and simplifies writing of heterogeneous queries that include chemical-structure search terms.

Availability
The service is freely available and accessible using a standard SPARQL endpoint interface. The service documentation and user-oriented demonstration interfaces that allow quick explorative querying of datasets are available at https://idsm.elixir-czech.cz.
Centralization of High-Risk Cancer Surgery Within Existing Hospital Systems
Authors: Sheetz Kyle H. , Dimick Justin B. , Nathan Hari 
Published: June 2019

PURPOSE Centralization is often proposed as a strategy to improve the quality of certain high-risk health care services. We evaluated the extent to which existing hospital systems centralize high-risk cancer surgery and whether centralization is associated with short-term clinical outcomes. PATIENTS AND METHODS We merged data from the American Hospital Association’s annual survey on hospital system affiliation with Medicare claims to identify patients undergoing surgery for pancreatic, esophageal, colon, lung, or rectal cancer between 2005 and 2014. We calculated the degree to which systems centralized each procedure by calculating the annual proportion of surgeries performed at the highest-volume hospital within each system. We then estimated the independent effect of centralization on the incidence of postoperative complications, death, and readmissions after accounting for patient, hospital, and system characteristics. RESULTS The average degree of centralization varied from 25.2% (range, 6.6% to 100%) for colectomy to 71.2% (range, 8.3% to 100%) for pancreatectomy. Greater centralization was associated with lower rates of postoperative complications and death for lung resection, esophagectomy, and pancreatectomy. For example, there was a 1.1% (95% CI, 0.8% to 1.4%) absolute reduction in 30-day mortality after pancreatectomy for each 20% increase in the degree of centralization within systems. Independent of volume and hospital quality, postoperative mortality for pancreatectomy was two times higher in the least centralized systems than in the most centralized systems (8.9% v 3.7%, P < .01). Centralization was not associated with better outcomes for colectomy or proctectomy. CONCLUSION Greater centralization of complex cancer surgery within existing hospital systems was associated with better outcomes. As hospitals affiliate in response to broader financial and organization pressures, these systems may also present unique opportunities to improve the quality of high-risk cancer care.
Single cell dynamics of embryonic muscle progenitor cells in zebrafish
Authors: Sharma Priyanka , Ruel Tyler D. , Kocha Katrinka M. , Liao Shan , Huang Peng 
Published: June 2019

ABSTRACT
Muscle stem cells hold a great therapeutic potential in regenerating damaged muscles. However, the in vivo behavior of muscle stem cells during muscle growth and regeneration is still poorly understood. Using zebrafish as a model, we describe the in vivo dynamics and function of embryonic muscle progenitor cells (MPCs) in the dermomyotome. These cells are located in a superficial layer external to muscle fibers and express many extracellular matrix (ECM) genes, including collagen type 1 α2 (col1a2). Utilizing a new col1a2 transgenic line, we show that col1a2+ MPCs display a ramified morphology with dynamic cellular processes. Cell lineage tracing demonstrates that col1a2+ MPCs contribute to new myofibers in normal muscle growth and also during muscle regeneration. A combination of live imaging and single cell clonal analysis reveals a highly choreographed process of muscle regeneration. Activated col1a2+ MPCs change from the quiescent ramified morphology to a polarized and elongated morphology, generating daughter cells that fuse with existing myofibers. Partial depletion of col1a2+ MPCs severely compromises muscle regeneration. Our work provides a dynamic view of embryonic muscle progenitor cells during zebrafish muscle growth and regeneration.
MRP4-mediated cAMP efflux is essential for mouse spermatozoa capacitation
Authors: Alonso C. A. I. , Lottero-Leconte R. , Luque G. M. , Vernaz Z. J. , Di Siervi N. , Gervasi M. G. , Buffone M. G. , Davio C. , Perez-Martinez S. 
Published: June 2019

ABSTRACT
Mammalian spermatozoa must undergo biochemical and structural changes to acquire the capacity for fertilization, in a process known as capacitation. Activation of PKA enzymes is essential for capacitation, and thus cAMP levels are tightly regulated during this process. Previously, we demonstrated that during capacitation, bovine spermatozoa extrude cAMP through multidrug resistance-associated protein 4 (MRP4, also known as ABCC4), which regulates intracellular levels of the nucleotide and provides cAMP to the extracellular space. Here, we report the presence of functional MRP4 in murine spermatozoa, since its pharmacological inhibition with MK571 decreased levels of extracellular cAMP. This also produced a sudden increase in PKA activity, with decreased tyrosine phosphorylation at the end of capacitation. Blockade of MRP4 inhibited induction of acrosome reaction, hyperactivation and in vitro fertilization. Moreover, MRP4 inhibition generated an increase in Ca2+ levels mediated by PKA, and depletion of Ca2+ salts from the medium prevented the loss of motility and phosphotyrosine inhibition produced by MK571. These results were supported using spermatozoa from CatSper Ca2+ channel knockout mice. Taken together, these results suggest that cAMP efflux via MRP4 plays an essential role in mouse sperm capacitation.
This article has an associated First Person interview with the first author of the paper.
Sarcoplasmic reticulum Ca2+-ATPase (SERCA) activity during the transition to endothermy in an altricial bird
Authors: Price Edwin R. , Sirsat Tushar S. , Sirsat Sarah K. G. , Dzialowski Edward M. 
Published: June 2019

ABSTRACTSarco(endo)plasmic reticulum Ca2+-ATPase (SERCA) is a transmembrane pump critical to muscle calcium cycling during contraction, and SERCA has also been proposed as the basis for a non-shivering thermogenesis mechanism in birds. Despite its potential importance to both shivering and non-shivering thermogenesis, the activity of this transporter has rarely been studied in altricial birds, and never during the developmental transition from ectothermy to endothermy. Here, we describe SERCA activity in the pectoralis muscle and heart ventricle of red-winged blackbird (Agelaius phoeniceus) nestlings, fledglings and adults. Additionally, using a diet manipulation, we tested the hypothesis that muscle SERCA activity is affected by dietary fatty acid composition, as has been shown in some previous studies. In blackbird hearts, SERCA activity increased throughout development and into adulthood, conspicuously jumping higher just prior to fledging. In pectoralis muscle, SERCA activity increased throughout the nestling period, but then declined after fledging, an effect we attribute to remodeling of the muscle from a primarily heat-generating organ to a primarily force-generating organ. SERCA activity of the pectoralis muscle was correlated with the proportion of linoleic acid in muscle phospholipids when including all ages in the control group. However, in diet-manipulated birds, there was no consistent relationship between SERCA activity and muscle membrane fatty acid composition at any tested age (5–9 days old). It is unclear whether SERCA might be affected by developmental changes in fatty acid composition at younger ages.
Recommendations on the Use of Ultrasound Guidance for Adult Lumbar Puncture: A Position Statement of the Society of Hospital Medicine
Authors: Soni Nilam J , Franco‐Sadud Ricardo , Kobaidze Ketino , Schnobrich Daniel , Salame Gerard , Lenchus Joshua , Kalidindi Venkat , Mader Michael J , Haro Elizabeth K , Dancel Ria , Cho Joel , Grikis Loretta , Force the SHM Point‐of‐care Ultrasound Task 
Published: June 2019

EXECUTIVE SUMMARY1) When ultrasound equipment is available, along with providers who are appropriately trained to use it, we recommend that ultrasound guidance should be used for site selection of lumbar puncture to reduce the number of needle insertion attempts and needle redirections and increase the overall procedure success rates, especially in patients who are obese or have difficult‐to‐palpate landmarks.2) We recommend that ultrasound should be used to more accurately identify the lumbar spine level than physical examination in both obese and nonobese patients.3) We suggest using ultrasound for selecting and marking a needle insertion site just before performing lumbar puncture in either a lateral decubitus or sitting position. The patient should remain in the same position after marking the needle insertion site.4) We recommend that a low‐frequency transducer, preferably a curvilinear array transducer, should be used to evaluate the lumbar spine and mark a needle insertion site. A high‐frequency linear array transducer may be used in nonobese patients.5) We recommend that ultrasound should be used to map the lumbar spine, starting at the level of the sacrum and sliding the transducer cephalad, sequentially identifying the lumbar spine interspaces.6) We recommend that ultrasound should be used in a transverse plane to mark the midline of the lumbar spine and in a longitudinal plane to mark the interspinous spaces. The intersection of these two lines marks the needle insertion site.7) We recommend that ultrasound should be used during a preprocedural evaluation to measure the distance from the skin surface to the ligamentum flavum from a longitudinal paramedian view to estimate the needle insertion depth and ensure that a spinal needle of adequate length is used.8) We recommend that novices should undergo simulation‐based training, where available, before attempting ultrasound‐guided lumbar puncture on actual patients.9) We recommend that training in ultrasound‐guided lumbar puncture should be adapted based on prior ultrasound experience, as learning curves will vary.10) We recommend that novice providers should be supervised when performing ultrasound‐guided lumbar puncture before performing the procedure independently on patients.
Autism and toe-walking: Are they related? Trends and treatment patterns between 2005 and 2016
Authors: Leyden J. , Fung L. , Frick S. 
Published: June 2019

Purpose This study quantified toe-walking trends and treatment decisions in patients with autism spectrum disorder (ASD) in the United States between 2005 and 2016 using a large national private-payer database. Methods A retrospective database review was performed on paediatric patients with ASD, and for International Classification of Diseases-9/10 diagnosis codes for toe-walking. Patients were filtered based on treatment type by Current Procedural Terminology (CPT) code. Continued toe-walking rates were assessed for each patient population and treatment group. A Pearson's chi-squared test was used to evaluate differences in group characteristics. Results Of 2 221 009 paediatric patients in the database, 5739 patients had a diagnosis of ASD, and 8.4% of patients with ASD also had a diagnosis of toe-walking (n = 484). For typically developing children in the database, 0.47% of patients had a diagnosis of persistent toe-walking. In all, 59.3% of ASD patients underwent physical therapy, 7.4% serial casting and 3.3% surgical correction, compared with 38.1%, 3.6% and 1.2% of normally developing children, respectively (chi-square 6.4031; p < 0.040699). Without intervention, 63.6% of patients with ASD continued to toe-walk within ten years of their diagnosis, with 19.3% of patients without ASD (chi-square 82.9762; p < 0.0001). Conclusion This study supports the association between a greater prevalence of toe-walking in children with ASD. We showed that patients with ASD and toe-walking receive surgical correction at nearly triple the rate of children without ASD who toe-walk. The continued rate of toe-walking is comparable between treatment groups as well as between ASD and typically developing children. Typically developing children have higher rates of toe-walking resolution without intervention than children with ASD. Level of evidence Level II
Experimental Investigation on the Erosion Threshold and Rate of Gravel and Silty Clay Mixtures
Authors: Gao Xiaojing , Wang Qiusheng , Ma Guowei 
Published: June 2019

Abstract. The field of cohesive and noncohesive mixture erosion is not fully understood because of the numerous factors that influence soil erodibility. In this study, erosion experiments were conducted on mixtures of gravel and silty clay in proportions varying from 0% to 100% by weight. The critical shear stress of erosion and the erosion rate were quantified using an erosion function apparatus (EFA). Experimental data revealed that the mixture critical shear stress first decreased and then increased with an increasing cohesive fraction for mixtures with silty clay contents up to 50%. The critical shear stress of the mixture showed an increasing trend as the silty clay content varied from 60% to 100%. A transition from noncohesive to cohesive erosion behavior occurred at silty clay contents between 30% and 35%. The appropriateness of a dimensionless nonlinear excess shear stress model and the Wilson model was tested based on the EFA experimental data. The dimensionless excess shear stress model was shown to be appropriate for noncohesive mixtures, while the Wilson model performed better than the dimensionless excess shear stress model for cohesive mixtures. Keywords: Critical shear stress, Erosion rate, Dimensionless nonlinear excess shear stress, Soil mixture, Wilson model.
O MST COMO FRUTO DA LUTA PELA TERRA NO BRASIL E SEU PAPEL POLÍTICO-SOCIAL NA GARANTIA DOS DIREITOS FUNDAMENTAIS E SOCIAIS
Authors: Dantas Saulo Lucio 
Published: June 2019

RESUMO O presente artigo tem como escopo refletir sobre algumas características da história da luta pela terra no Brasil, sendo o Movimento dos Trabalhadores Rurais Sem Terra – MST fruto desta história, dialogando com a atual seara brasileira, perguntando qual seria o papel político desse movimento social na garantia e promoção dos direitos fundamentais e sociais esculpidos na Constituição da República Federativa do Brasil de 1988 – CRFB/88. Para tanto, abordamos as principais características desse movimento de luta pela terra, suas formas de luta, como por exemplo, a ocupação de latifúndios em pro de chamar a atenção do Poder Público para a implementação da Reforma Agrária – esta por sua vez uma política de Estado – e alguns dilemas trazidos pela própria CRFB/88 acerca dos conflitos normativos que à luz da realidade, entram em rota de colisão, exemplificando, o direito de propriedade – terra – em face de demais direitos e princípios constitucionais como direito à vida, igualdade, liberdade, moradia, trabalho e dignidade da pessoa humana. Palavras-chave: História daLuta pela Terra; Movimento Sem Terra; Constituição do Brasil de 1988.
Pill-Induced Esophagitis From Intake of Dietary Supplements
Authors: O'Donnell Conor , Tandon Parul , Govardhanam Vivek , Habal Flavio 
Published: June 2019

ABSTRACT
Cases of pill-induced esophagitis can be associated with significant acute symptoms leading to hospitalization and have resulted in mediastinal penetration and hemorrhage. Clinicians often consider the diagnosis in patients taking classically associated medications. However, because many patients take dietary supplements, it is important to consider these as a potential etiology in a patient presenting with esophageal symptoms. We present a case of pill-induced esophagitis in a 40-year-old woman after the ingestion of l-arginine, selenium, and vitamin E supplements. Literature review revealed 6 cases of l-arginine–induced esophagitis reported, and no previous cases associated with vitamin E or selenium.