bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shortened cataract surgery by standardisation of the perioperative protocol according to the Joint Commission International accreditation: a retrospective observational study
Authors: Okumura Yuichi , Inomata Takenori , Iwagami Masao , Eguchi Atsuko , Mizuno Ju , Shiang Tina , Kawasaki Shiori , Shimada Akie , Inada Eiichi , Amano Atsushi , Murakami Akira 
Published: June 2019

ObjectivesTo investigate the impact of standardisation of the perioperative protocol based on the Joint Commission International (JCI) accreditation guidelines for operating time in cataract surgery.DesignRetrospective observational study.SettingSingle centre in Japan.ParticipantsBetween March 2014 and June 2016, 3127 patients underwent cataract surgery under topical anaesthesia including 2581 and 546 patients before and after JCI accreditation, respectively.Primary and secondary outcomesWe compared three time periods, comprising the preprocedure/surgery time (pre-PT), PT and post-PT, and total PT (TPT) of cataract surgery between patients before and after JCI accreditation, by regression analysis adjusted for age, sex and cataract surgery-associated confounders.ResultsThe main outcomes were pre-PT, PT, post-PT and TPT. Pre-PT (19.8±10.5 vs 13.9±8.5 min, p<0.001) and post-PT (3.5±4.6 vs 2.6±2.1 min, p<0.001) significantly decreased after JCI accreditation, while PT did not significantly change (16.8±6.7 vs 16.2±6.3 min, p=0.065). Consequently, TPT decreased on average by 7.3 min per person after JCI accreditation (40.1±13.4 vs 32.8±10.9 min, p<0.001). After adjusting for confounders, pre-PT (β=−5.82 min, 95% CI −6.75 to −4.88), PT (β=−0.76 min, 95% CI −1.34 to −1.71), post-PT (β=−0.85 min, 95% CI −1.24 to −0.45) and TPT (β=−7.43 min, 95% CI −8.61 to −6.24) were significantly shortened after JCI accreditation.ConclusionPerioperative protocol standardisation, based on JCI accreditation, shortened TPT in cataract surgery under local anaesthesia.
Prevalence of Charcot-Marie-Tooth disease across the lifespan: a population-based epidemiological study
Authors: Theadom Alice , Roxburgh Richard , MacAulay Erin , O’Grady Gina , Burns Joshua , Parmar Priya , Jones Kelly , Rodrigues Miriam 
Published: June 2019

ObjectivesThis population-based study aimed to determine age-standardised prevalence of Charcot-Marie-Tooth disease (CMT) across the lifespan using multiple case ascertainment sources.DesignPoint-prevalence epidemiological study in the Auckland Region of New Zealand (NZ).SettingMultiple case ascertainment sources including primary care centres, hospital services, neuromuscular disease registry, community-based organisations and self-referral were used to identify potentially eligible participants.ParticipantsAdults (≥16 years, n=207, 87.7%) and children (<16 years, n=29, 12.3%) with a confirmed clinical or molecular diagnosis of CMT, hereditary sensory neuropathy, hereditary motor neuropathy or hereditary neuropathy with liability to pressure palsies who resided in the Auckland Region of NZ on 1 June 2016.Primary outcomePrevalence per 100 000 persons with 95% CIs by subtype, age and sex were calculated and standardised to the world population.ResultsAge-standardised point prevalence of all CMT cases was 15.7 per 100 000 (95% CI 11.6 to 21.0). Highest prevalence was identified in those aged 50–64 years 25.2 per 100 000 (95% CI 19.4 to 32.6). Males had a higher prevalence (16.6 per 100 000, 95% CI 10.9 to 25.2) than females (14.6 per 100 000, 95% CI 9.6 to 22.4). Prevalence of CMT1A was 6.9 per 100 000 (95% CI 5.6 to 8.4). The majority (93.2%) of cases were identified through medical records, with 6.8% of cases uniquely identified through community sources.ConclusionsA small but significant proportion of people with CMT are not connected to healthcare services. Epidemiological studies using medical records alone to identify cases may risk underestimating prevalence. Further studies using population-based methods and reporting age-standardised prevalence are needed to improve global understanding of the epidemiology of CMT.
Diffusion tensor cardiovascular magnetic resonance
Authors: Khalique Zohya , Pennell Dudley 
Published: June 2019

AbstractCardiac structure and function are complex and inter-related. Current in vivo techniques assess the heart on a macroscopic scale, but a novel technique called diffusion tensor cardiovascular magnetic resonance (DT-CMR) can now assess the cardiac microstructure non-invasively. It provides information on the helical arrangement of cardiomyocytes that drives torsion and offers dynamic assessment of the sheetlets (aggregated cardiomyocytes) that rotate through the cardiac cycle to facilitate wall thickening. Through diffusion biomarkers, the expansion and organisation of the underlying myocardium can be described. DT-CMR has already identified novel microstructural abnormalities in cardiomyopathy, and ischaemic and congenital heart disease. This new knowledge supports the potential of DT-CMR to improve diagnostics and prognostication in various cardiac diseases.
Online Vertex-Weighted Bipartite Matching
Authors: Huang Zhiyi , Tang Zhihao Gavin , Wu Xiaowei , Zhang Yuhao 
Published: June 2019

We introduce a weighted version of the ranking algorithm by Karp et al. (STOC 1990), and we prove a competitive ratio of 0.6534 for the vertex-weighted online bipartite matching problem when online vertices arrive in random order. Our result shows that random arrivals help beating the 1-1/e barrier even in the vertex-weighted case. We build on the randomized primal-dual framework by Devanur et al. (SODA 2013) and design a two dimensional gain sharing function, which depends not only on the rank of the offline vertex, but also on the arrival time of the online vertex. To our knowledge, this is the first competitive ratio strictly larger than 1-1/e for an online bipartite matching problem achieved under the randomized primal-dual framework. Our algorithm has a natural interpretation that offline vertices offer a larger portion of their weights to the online vertices as time increases, and each online vertex matches the neighbor with the highest offer at its arrival.
Medical Conditions and Modifiable Risk Factors for Myelodysplastic Syndrome: A Systematic Review
Authors: Sweeney Marina R. , Applebaum Katie M. , Arem Hannah , Braffett Barbara H. , Poynter Jenny N. , Robien Kim 
Published: June 2019

Abstract

Background:
The aim of this systematic review was to evaluate medical conditions and modifiable risk factors for myelodysplastic syndromes (MDS) using the 2001 or 2008 World Health Organization (WHO) diagnostic criteria.

Methods:
PubMed, MEDLINE, and Scopus databases were searched for studies published between January 2001 and August 2017. Study characteristics and findings were abstracted for each article.

Results:
Thirteen articles (4 cohort, 9 case–control) met the inclusion criteria. Smoking and alcohol use were each evaluated as potential MDS risk factors in four studies. Body mass index and anemia were each evaluated in two studies. Other potential risk factors evaluated in single studies included physical activity, dietary intake (tea, isoflavones, meat, fruit, or vegetables), history of allergies, autoimmune disorders and community-acquired infections, and use of antituberculosis drugs, traditional Chinese medicines, or hair dyes.

Conclusions:
Higher BMI, smoking, a history of autoimmune disorders, community-acquired infections, history of anemia, and use of antituberculosis drugs were associated with higher risk of MDS. Vigorous physical activity and tea and dietary isoflavone intake were associated with lower MDS risk. These findings suggest no association between the other factors and risk of MDS.

Impact:
Research on risk factors for MDS is limited, and further research in larger studies is needed.
The Evolving Modern Management of Brain Metastasis
Authors: Fecci Peter E. , Champion Cosette D. , Hoj Jacob , McKernan Courtney M. , Goodwin C. Rory , Kirkpatrick John P. , Anders Carey K. , Pendergast Ann Marie , Sampson John H. 
Published: June 2019

Abstract
The incidence of brain metastases is increasing as cancer therapies improve and patients live longer, providing new challenges to the multidisciplinary teams that care for these patients. Brain metastatic cancer cells possess unique characteristics that allow them to penetrate the blood–brain barrier, colonize the brain parenchyma, and persist in the intracranial environment. In addition, brain metastases subvert the innate and adaptive immune system, permitting evasion of the antitumor immune response. Better understanding of the above mechanisms will allow for development and delivery of more effective therapies for brain metastases. In this review, we outline the molecular mechanisms underlying development, survival, and immunosuppression of brain metastases. We also discuss current and emerging treatment strategies, including surgery, radiation, disease-specific and mutation-targeted systemic therapy, and immunotherapy.
Encapsulation of Temozolomide in a Calixarene Nanocapsule Improves Its Stability and Enhances Its Therapeutic Efficacy against Glioblastoma
Authors: Renziehausen Alexander , Tsiailanis Antonis D. , Perryman Richard , Stylos Evgenios K. , Chatzigiannis Christos , O'Neill Kevin , Crook Timothy , Tzakos Andreas G. , Syed Nelofer 
Published: June 2019

AbstractThe alkylating agent temozolomide (TMZ) is the first-line chemotherapeutic for glioblastoma (GBM), a common and aggressive primary brain tumor in adults. However, its poor stability and unfavorable pharmacokinetic profile limit its clinical efficacy. There is an unmet need to tailor the therapeutic window of TMZ, either through complex derivatization or by utilizing pharmaceutical excipients. To enhance stability and aqueous solubility, we encapsulated TMZ in a p-sulphonatocalix[4]arene (Calix) nanocapsule and used 1H-NMR, LC-MS, and UV–Vis spectroscopy to chart the stability of this novel TMZ@Calix complex according to FDA and European Medicines Agency guidelines. LC-MS/MS plasma stability assays were conducted in mice to further explore the stability profile of TMZ@Calix in vivo. The therapeutic efficacy of TMZ@Calix was compared with that of unbound TMZ in GBM cell lines and patient-derived primary cells with known O6-methylguanine-DNA methyltransferase (MGMT) expression status and in vivo in an intracranial U87 xenograft mouse model. Encapsulation significantly enhanced the stability of TMZ in all conditions tested. TMZ@Calix was more potent than native TMZ at inhibiting the growth of established GBM cell lines and patient-derived primary lines expressing MGMT and highly resistant to TMZ. In vivo, native TMZ was rapidly degraded in mouse plasma, whereas the stability of TMZ@Calix was enhanced threefold with increased therapeutic efficacy in an orthotopic model. In the absence of new effective therapies, this novel formulation is of clinical importance, serving as an inexpensive and highly efficient treatment that could be made readily available to patients with GBM and warrants further preclinical and clinical evaluation.
Vulnerabilidade aquífera e risco de contaminação da água subterrânea em meio urbano
Authors: Peixoto Filipe Da Silva , Cavalcante Itabaraci Nazareno 
Published: June 2019

Nas áreas urbanas, a contaminação da água subterrânea está ligada à forte pressão de ocupação e uso do solo. Por isso, é necessária a implantação de medidas restritivas que promovam a conservação da água subterrânea. O presente trabalho desenvolveu um Índice de Risco de Contaminação da Água Subterrânea (IRCAS) aplicado a aquíferos em ambiente urbano no município de Fortaleza, Ceará, Brasil. A construção do IRCAS foi realizada a partir da Metodologia de Vulnerabilidade Aquífera (GOD), anexando a esta o Índice de Saneamento Ambiental (ISA), calculado por setores censitários com dados do Censo 2010, do Instituto Brasileiro de Geografia e Estatística (IBGE). Os dados foram gerenciados em Sistema de Informação Geográfica (SIG) e validados com amostras de água subterrânea analisada quanto a concentrações de nitrato (N-NO3 -) em 212 poços. O IRCAS apontou áreas mais próximas à costa como zonas de alto risco, por conta da alta vulnerabilidade aquífera associada ao Sistema Aquífero Dunas (SAD) sob zonas de baixa qualidade sanitária. O principal fator do risco foi o esgotamento sanitário. As maiores concentrações de nitrato (24,4 – 40 mg/L) em 83% dos poços se mostraram associadas às zonas de alto risco.
Estratégias didáticas para o ensino da língua inglesa na educação básica
Authors: Fernandes Meirilene Alves , Felicetti Vera Lucia , Szezecinski Antonio Filipe Maciel 
Published: June 2019

O presente artigo investigou diferentes estratégias didáticas baseadas nas quatro habilidades – ouvir, falar, ler e escrever –, podem contribuir para a melhoria do processo de ensino e aprendizagem da Língua Inglesa no Ensino Fundamental. A pesquisa caracterizou-se por um estudo de caso, de caráter exploratório descritivo e abordagem qualitativa. Após a realização do pré-teste, estratégias didáticas foram desenvolvidas na contação da história de Snow White and the Seven Dwarfs. Após o desenvolvimento das estratégias aplicou-se o pós-teste. A análise realizada no pré-teste, pós-teste e no corpus constituído dos relatórios realizados em cada aula evidenciaram que diferentes estratégias didáticas usadas no ensino do Inglês podem contribuir para a melhoria não somente do processo de aprendizagem dos alunos, mas também do processo de ensino.
Impact of Cardiovascular Neurohormones on Onset of Vasovagal Syncope Induced by Head‐up Tilt
Authors: Torabi Parisa , Ricci Fabrizio , Hamrefors Viktor , Melander Olle , Sutton Richard , Benditt David G. , Fedorowski Artur 
Published: June 2019

Background
Vasovagal reflex is the most common form of syncope, but the pathophysiological mechanisms that initiate the reflex are not well understood. We aimed to study supine and early orthostatic levels of the neurohormones involved in control of circulatory homeostasis in relation to the onset of tilt‐induced vasovagal syncope (VVS).

Methods and Results

A total of 827 patients who were investigated for unexplained syncope with head‐up tilt test (HUT) and optional nitroglycerin provocation (Italian protocol) had blood samples collected while supine and after 3‐minutes of HUT. Of these, 173 (20.9%) patients developed VVS during drug‐free HUT, 161 of whom (males 44.7%; age 45±21 years) had complete data. We analyzed levels of epinephrine, norepinephrine, C‐terminal pro–arginine vasopressin, C‐terminal endothelin‐1, and midregional fragments of pro–atrial natriuretic peptide and pro‐adrenomedullin in relation to time from tilt‐up to onset of VVS. We applied a linear regression model adjusted for age and sex. The mean time to syncope was 11±7 minutes. Older age (β=0.13; SE=0.03,
P
<0.001), higher supine systolic blood pressure (β=0.06; SE=0.03,
P
=0.02), and higher supine midregional fragment of pro‐adrenomedullin predicted longer time to syncope (β=2.31; SE=0.77,
P
=0.003), whereas supine levels of other neurohormones were not associated with time to syncope. Among 151 patients who developed VVS later than 3 minutes of HUT, increase in epinephrine (β=−3.24; SE=0.78,
P
<0.001) and C‐terminal pro–arginine vasopressin (β=−2.07; SE=0.61,
P
=0.001) at 3 minutes of HUT were related to shorter time to syncope.

Conclusions
Older age, higher blood pressure, and higher level of pro‐adrenomedullin are associated with later onset of VVS during tilt testing, whereas greater increase of tilt‐induced epinephrine and vasopressin release correlate with shorter time to syncope.
“Ihr kennt weder mich noch meinen Vater”
Authors: Förster Hans 
Published: June 2019

AbstractJesus’ statement in John 8:19 is most often interpreted from the perspective of a theology of revelation. From a philological perspective, however, there is also a possible interpretation that understands Jesus’ interaction with his jewish audience in John 8:13-20 as a typical Johannine Misunderstanding.
Effect of Akin Osteotomy on Hallux Valgus Correction After Scarf Osteotomy With Hallux Valgus Interphalangeus
Authors: Kaufmann Gerhard , Hofer Philipp , Braito Matthias , Bale Reto , Putzer David , Dammerer Dietmar 
Published: June 2019

Background: Recurrence after hallux valgus correction is a relatively frequent occurrence. Little is known about the importance of initial correction on radiologic outcome. The objective of our study was to determine postoperative radiologic parameters correlating with loss of correction after scarf osteotomy and the combined scarf/akin osteotomy, respectively. Methods: Loss of correction was evaluated based on a group of 53 feet with isolated scarf osteotomy (S group) and a group of 17 feet with combined scarf and akin osteotomy (SA group) in a retrospective analysis. The intermetatarsal angle (IMA), the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA), the proximal to distal phalangeal articular angle (PDPAA), the position of the sesamoids, and joint congruity were measured in weight-bearing radiographs preoperatively and postoperatively throughout a mean follow-up of 44.8 ± 23.6 months. Results: Loss of correction was comparable between the S and the SA group ( P > .05). In contrast, we found higher loss of HVA correction in the S subgroup with a preoperative PDPAA above 8 degrees ( P = .011), whereas loss of correction in the S subgroup below 8 degrees of PDPAA was comparable to the SA group. In the S group, loss of correction showed significant correlation with postoperative IMA ( P = .015) and PDPAA ( P = .008), whereas in the SA group a correlation could be detected for IMA only ( P = .045). Conclusion: In cases with a PDPAA above 8 degrees, we recommend a combined scarf/akin osteotomy to diminish the potential for loss of correction. Level of Evidence: Level III, therapeutic, retrospective comparative series.
Renal biopsy findings during and after pregnancy
Authors: Conti-Ramsden Frances , Bass Paul , Chappell Lucy C , Bramham Kate 
Published: June 2019

Background Chronic kidney disease is estimated to affect up to 6% of women of reproductive age. Maternity care represents an opportunity for early diagnosis but there is limited understanding of chronic kidney disease aetiology occurring in or revealed by pregnancy. Methods A retrospective evaluation of renal biopsies during and after pregnancy between 2000 and 2015 was undertaken. A large academic health centre pathology database was searched for free text pregnancy-related terms, restricted to typology code 71000 (kidney). Indications and findings of postpartum renal biopsies were reviewed. Results Sixty-three renal biopsy reports were identified. Of 45 biopsies performed postpartum, 34 (75.6%) investigated persistent postpartum proteinuria. 20/34 (70.6%) of these biopsies yielded a primary renal disease, and 6/34 (17.6%) women had progressed to end stage renal disease at latest follow-up. Conclusion Renal biopsy findings of women investigated for persistent postpartum proteinuria revealed a high incidence of histological diagnosis of de novo renal disease.
Percutaneous pulmonary valve implantation in patients with right ventricular outflow tract dysfunction: a systematic review and meta-analysis
Authors: Ran Liyu , Wang Wuwan , Secchi Francesco , Xiang Yajie , Shi Wenhai , Huang Wei 
Published: June 2019

Background: Pulmonary valve replacement is required for patients with right ventricular outflow tract (RVOT) dysfunction. Surgical and percutaneous pulmonary valve replacement are the treatment options. Percutaneous pulmonary valve implantation (PPVI) provides a less-invasive therapy for patients. The aim of this study was to evaluate the effectiveness and safety of PPVI and the optimal time for implantation. Methods: We searched PubMed, EMBASE, Clinical Trial, and Google Scholar databases covering the period until May 2018. The primary effectiveness endpoint was the mean RVOT gradient; the secondary endpoints were the pulmonary regurgitation fraction, left and right ventricular end-diastolic and systolic volume indexes, and left ventricular ejection fraction. The safety endpoints were the complication rates. Results: A total of 20 studies with 1246 participants enrolled were conducted. The RVOT gradient decreased significantly [weighted mean difference (WMD) = −19.63 mmHg; 95% confidence interval (CI): −21.15, −18.11; p < 0.001]. The right ventricular end-diastolic volume index (RVEDVi) was improved (WMD = −17.59 ml/m²; 95% CI: −20.93, −14.24; p < 0.001), but patients with a preoperative RVEDVi >140 ml/m² did not reach the normal size. Pulmonary regurgitation fraction (PRF) was notably decreased (WMD = −26.27%, 95% CI: −34.29, −18.25; p < 0.001). The procedure success rate was 99% (95% CI: 98–99), with a stent fracture rate of 5% (95% CI: 4–6), the pooled infective endocarditis rate was 2% (95% CI: 1–4), and the incidence of reintervention was 5% (95% CI: 4–6). Conclusions: In patients with RVOT dysfunction, PPVI can relieve right ventricular remodeling, improving hemodynamic and clinical outcomes.
Lower oesophageal sphincter identification for gastro‐oesophageal reflux monitoring: The step‐up method revisited with use of basal impedance
Authors: Mauro Aurelio , Franchina Marianna , Consonni Dario , Penagini Roberto 
Published: June 2019

BackgroundOesophageal manometry is the gold standard for accurate positioning of multichannel intraluminal impedance pH (MII‐pH) monitoring. The pH step‐up method is not as accurate as oesophageal manometry and needs patients to be off proton pump inhibitor (PPI) therapy.ObjectiveThis study aimed to evaluate the feasibility of the impedance step‐up method for lower oesophageal sphincter (LOS) localisation.MethodsA total of 100 patients who underwent 24‐hour MII‐pH monitoring were enrolled. High‐resolution manometry (HRM) was performed before MII‐pH monitoring in order to locate the LOS by a different operator. The impedance step‐up was defined as an increase of ≥50% with respect to gastric baseline. Lin's concordance correlation coefficient (ρc) with 95% Bland–Altman limits of agreement (LOA) and Spearman's rho correlation coefficient were used when appropriate.ResultsThe median impedance step‐up was on average 0.8 cm caudal to the manometric upper border of the LOS. Agreement between two step‐up impedance performances and inter‐observer agreement were excellent (ρc = 0.98 and 0.95), although the LOA ranges were wide (–2.4 to 4.0 cm). Impedance step‐up performances were similar between patients off and on PPI.ConclusionsWe have described an alternative new method for pH impedance probe positioning using impedance step‐up. Although less accurate than HRM in locating the LOS, it has excellent intra‐ and inter‐observer agreement.
BRAF-V600E–mutated Rosai-Dorfman-Destombes disease and Langerhans cell histiocytosis with response to BRAF inhibitor
Authors: Mastropolo Rosemarie , Close Allison , Allen Steven W. , McClain Kenneth L. , Maurer Scott , Picarsic Jennifer 
Published: June 2019

Key PointsDemonstration of BRAF-V600E in Rosai-Dorfman-Destombes disease requires sensitive molecular assays and molecular-based tissue immunostain. BRAF-V600E blood testing is important for disease-monitoring BRAF-mutated histiocytosis and can guide inhibitor treatment plans.