bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implantation of platelet rich fibrin and allogenic mesenchymal stem cells facilitate the healing of muscle injury: An experimental study on animal
Authors: Utomo Dwikora N. , Mahyudin Ferdiansyah , Hernugrahanto Kukuh D. , Suroto Heri , Chilmi Muhammad Zaim , Rantam Fedik Abdul 
Published: March 2018

ABSTRACT

Introduction:
Muscle injury has caused adverse impacts on athletes' performance. Muscle injury treatments are based on the degree of severity. Unfortunately, in extensive injuries, surgical treatments are often unsatisfactory especially in athletes with high functional demand. More effort is needed to achieve a better result in muscle injury healing. The use of platelet-rich fibrin (PRF) and mesenchymal stem cell (MSC) would provide all the necessary factors to achieve good tissue healing: cells, growth factors, and scaffold. The study aims to evaluate the role of PRF and MSC in facilitating the healing of muscle injury on animal models.

Methods:
A model defect was created in the gastrocnemius muscle of each hind leg of twenty New Zealand white rabbits. All legs were randomly divided into four groups: (1) control; (2) PRF-only; (3) MSC-only, and (4) PRF-and-MSC group. After two and four weeks, the muscle was retrieved and sent for immunohistochemistry examination to evaluate the expression of Pax7 and MyoD protein.

Results:
The mean score of all treated group was higher compared to the control group. The group that received both PRF and MSC showed the highest score.

Conclusion:
Considering the promising result, application of PRF and MSC could be an option for the treatment of muscle injury as this would provide all necessary elements of tissue engineering to facilitate the healing process of muscle: the cells, the scaffold, and the growth factors.

Highlights:
Kernel Design and Distributed, Self-Triggered Control for Coordination of Autonomous Multi-Agent Configurations
Authors: DeVries Levi , Sims Aaron , Kutzer Michael D. M. 
Published: March 2018

SUMMARYAutonomous multi-agent systems show promise in countless applications, but can be hindered in environments where inter-agent communication is limited. In such cases, this paper considers a scenario where agents communicate intermittently through a cloud server. We derive a graph transformation mapping the kernel of a graph's Laplacian to a desired configuration vector while retaining graph topology characteristics. The transformation facilitates derivation of a self-triggered controller driving agents to prescribed configurations while regulating instances of inter-agent communication. Experimental validation of the theoretical results shows the self-triggered approach drives agents to a desired configuration using fewer control updates than traditional periodic implementations.
A definition of free sugars for the UK
Authors: Swan Gillian E , Powell Natasha A , Knowles Bethany L , Bush Mark T , Levy Louis B 
Published: March 2018

AbstractPublic Health England has set a definition for free sugars in the UK in order to estimate intakes of free sugars in the National Diet and Nutrition Survey. This follows the recommendation from the Scientific Advisory Committee on Nutrition in its 2015 report on Carbohydrates and Health that a definition of free sugars should be adopted. The definition of free sugars includes: all added sugars in any form; all sugars naturally present in fruit and vegetable juices, purées and pastes and similar products in which the structure has been broken down; all sugars in drinks (except for dairy-based drinks); and lactose and galactose added as ingredients. The sugars naturally present in milk and dairy products, fresh and most types of processed fruit and vegetables and in cereal grains, nuts and seeds are excluded from the definition.
In-between the Constitution and the European Court of Human Rights: Mobilizations Around Religion and Education in Greece
Authors: Markoviti Margarita 
Published: March 2018

AbstractThis paper examines the impact of European Court of Human Rights (ECtHR) decisions on the field of religion and education in Greece around the issues of the content and objectives of religious education, the exemption thereof, and religious symbols in school. The findings indicate that despite the relevance of ECtHR case law with the specific field in Greece, the Court's role in influencing such national debates is minimal. Drawing on empirical research and discourse analysis, the paper argues that this is due to the doctrine of the margin of appreciation, apparently linked to strategic references to and varying interpretations of the Court's judgments; the unwillingness of actors to litigate in a potentially sensitive, lengthy, and costly procedure; and to a shared belief in the perceived primacy of constitutional provisions on religion and education that precludes the formation of structured mobilizations.
A Mediterranean coastal database for assessing the impacts of sea-level rise and associated hazards
Authors: Wolff Claudia , Vafeidis Athanasios T. , Muis Sanne , Lincke Daniel , Satta Alessio , Lionello Piero , Jimenez Jose A. , Conte Dario , Hinkel Jochen 
Published: March 2018

AbstractWe have developed a new coastal database for the Mediterranean basin that is intended for coastal impact and adaptation assessment to sea-level rise and associated hazards on a regional scale. The data structure of the database relies on a linear representation of the coast with associated spatial assessment units. Using information on coastal morphology, human settlements and administrative boundaries, we have divided the Mediterranean coast into 13 900 coastal assessment units. To these units we have spatially attributed 160 parameters on the characteristics of the natural and socio-economic subsystems, such as extreme sea levels, vertical land movement and number of people exposed to sea-level rise and extreme sea levels. The database contains information on current conditions and on plausible future changes that are essential drivers for future impacts, such as sea-level rise rates and socio-economic development. Besides its intended use in risk and impact assessment, we anticipate that the Mediterranean Coastal Database (MCD) constitutes a useful source of information for a wide range of coastal applications.
FLO1K, global maps of mean, maximum and minimum annual streamflow at 1 km resolution from 1960 through 2015
Authors: Barbarossa Valerio , Huijbregts Mark A.J. , Beusen Arthur H.W. , Beck Hylke E. , King Henry , Schipper Aafke M. 
Published: March 2018

AbstractStreamflow data is highly relevant for a variety of socio-economic as well as ecological analyses or applications, but a high-resolution global streamflow dataset is yet lacking. We created FLO1K, a consistent streamflow dataset at a resolution of 30 arc seconds (~1 km) and global coverage. FLO1K comprises mean, maximum and minimum annual flow for each year in the period 1960–2015, provided as spatially continuous gridded layers. We mapped streamflow by means of artificial neural networks (ANNs) regression. An ensemble of ANNs were fitted on monthly streamflow observations from 6600 monitoring stations worldwide, i.e., minimum and maximum annual flows represent the lowest and highest mean monthly flows for a given year. As covariates we used the upstream-catchment physiography (area, surface slope, elevation) and year-specific climatic variables (precipitation, temperature, potential evapotranspiration, aridity index and seasonality indices). Confronting the maps with independent data indicated good agreement (R2values up to 91%). FLO1K delivers essential data for freshwater ecology and water resources analyses at a global scale and yet high spatial resolution.
The role of path length‐ and speed‐related factors for the enhancement of section performance in alpine giant slalom
Authors: Spörri Jörg , Kröll Josef , Schwameder Hermann , Müller Erich 
Published: March 2018

AbstractKnowing how to enhance alpine skiing performance is essential for effective coaching. The purpose of this study was to explore the role of path length‐ and speed‐related factors for performance enhancement, while skiing on a homogeneously set/constantly inclined giant slalom course section (average gate distance: 27 m; offset: 8 m; slope inclination: 26°). During a video‐based three‐dimensional kinematic field‐experiment, the data of six athletes who skied a two‐gate section on four different types of skis were collected. The performance parameter analysed was section time. The performance predictors analysed were centre of mass (CoM), path length and the change in specific mechanical energy per entrance speed along the analysed section. Furthermore, since the current study examined alpine skiing performance within short sections, the skier's entrance speed was also considered. Classified as a high‐performance and a low‐performance group based on section time, slow and fast trials significantly differed in CoM path length, the change in specific mechanical energy per entrance speed and entrance speed. The entrance speed of all trials analysed ranged between 15.25 and 17.66 m/s. In trials with both high and low entrance speed, the change in specific mechanical energy per entrance speed was found to be more relevant for the prediction of section time than CoM path length. However, further studies should investigate whether such a prioritization can be unrestrictedly generalized to other situations, such as entrance speeds, course sets, slope inclinations and competition disciplines different to those assessed in the current study.
Study Protocol: Early Stereotactic Gamma Knife Radiosurgery to Residual Tumor After Surgery of Newly Diagnosed Glioblastoma (Gamma-GBM)
Authors: Brehmer Stefanie , Grimm Mario Alexander , Förster Alex , Seiz-Rosenhagen Marcel , Welzel Grit , Stieler Florian , Wenz Frederik , Groden Christoph , Mai Sabine , Hänggi Daniel , Giordano Frank Anton 
Published: March 2018

Abstract

BACKGROUND
Glioblastoma (GBM) is the most common malignant brain tumor in adult patients. Tumor recurrence commonly occurs around the resection cavity, especially after subtotal resection (STR). Consequently, the extent of resection correlates with overall survival (OS), suggesting that depletion of postoperative tumor remnants will improve outcome.

OBJECTIVE
To assess safety and efficacy of adding stereotactic radiosurgery (SRS) to the standard treatment of GBM in patients with postoperative residual tumor.

METHODS
Gamma-GBM is a single center, open-label, prospective, single arm, phase II study that includes patients with newly diagnosed GBM (intraoperative via frozen sections) who underwent STR (residual tumor will be identified by native and contrast enhanced T1-weighted magnetic resonance imaging scans). All patients will receive SRS with 15 Gy (prescribed to the 50% isodose enclosing all areas of residual tumor) early (within 24-72 h) after surgery. Thereafter, all patients undergo standard-of-care therapy for GBM (radiochemotherapy with 60 Gy external beam radiotherapy [EBRT] plus concomitant temozolomide and 6 cycles of adjuvant temozolomide chemotherapy). The primary outcome is median progression-free survival, secondary outcomes are median OS, occurrence of radiation induced acute (<3 wk), early delayed (<3 mo), and late (>3 mo post-SRS) neurotoxicity and incidence of symptomatic radionecrosis.

EXPECTED OUTCOMES
We expect to detect efficacy and safety signals by the immediate application of SRS to standard-of-care therapy in newly diagnosed GBM.

DISCUSSION
Early postoperative SRS to areas of residual tumor could bridge the therapeutic gap between surgery and adjuvant therapies.
Transformative Learning and Professional Identity Formation During International Health Electives: A Qualitative Study Using Grounded Theory
Authors: Sawatsky Adam P. , Nordhues Hannah C. , Merry Stephen P. , Bashir M. Usmaan , Hafferty Frederic W. 
Published: March 2018

Purpose
International health electives (IHEs) are widely available during residency and provide unique experiences for trainees. Theoretical models of professional identity formation and transformative learning may provide insight into residents’ experiences during IHEs. The purpose of this study was to explore transformative learning and professional identity formation during resident IHEs and characterize the relationship between transformative learning and professional identity formation.

Method
The authors used a constructivist grounded theory approach, with the sensitizing concepts of transformative learning and professional identity formation to analyze narrative reflective reports of residents’ IHEs. The Mayo International Health Program supports residents from all specialties across three Mayo Clinic sites. In 2015, the authors collected narrative reflective reports from 377 IHE participants dating from 2001 to 2014. Reflections were coded and themes were organized into a model for transformative learning during IHEs, focusing on professional identity.

Results
Five components of transformative learning were identified during IHEs: a disorienting experience; an emotional response; critical reflection; perspective change; and a commitment to future action. Within the component of critical reflection, three domains relating to professional identity were identified: making a difference; the doctor–patient relationship; and medicine in its “purest form.” Transformation was demonstrated through perspective change and a commitment to future action, including continued service, education, and development.

Conclusions
IHEs provide rich experiences for transformative learning and professional identity formation. Understanding the components of transformative learning may provide insight into the interaction between learner, experiences, and the influence of mentors in the process of professional identity formation.
EC50 of Epidural Ropivacaine Combined With Dexmedetomidine for Labor Analgesia
Authors: Zhang Wp , Li Cuiling 
Published: March 2018

Background:
It has been reported that the optimal concentration of epidural dexmedetomidine for labor analgesia is 0.5 μg/mL when combined with 0.1% ropivacaine. This study investigated the median effective concentration (EC50) of epidural ropivacaine for labor analgesia when combined with 0.5 μg/mL dexmedetomidine.

Materials and Methods:
Sixty full-term primiparas were enrolled and divided into 2 groups in this prospective study. Group D received 10 mL solution (ropivacaine+0.5 μg/mL dexmedetomidine) in the induction of epidural anesthesia, and group C (control group) received 10 mL of ropivacaine alone. The dose of epidural ropivacaine was decided by using the up-and-down sequential allocation method with an initial concentration of 0.1%×0.01% gradient. Effective analgesia was defined as the visual analogue scale for pain as ≤3 within 30 minutes after epidural injection when cervical dilation is about 2 cm. The EC50 of ropivacaine was calculated by the Massey formula. Hemodynamic parameters, the stages of labor, and fetal heart rate were recorded. Neonatal Apgar scores and umbilical artery pH were also recorded. The side effects, if any, were noted.

Results:
The EC50 of ropivacaine was 0.062% (95% confidence interval [CI], 0.058%-0.066%) in the group D, and 0.083% (95% CI, 0.077%-0.089%) in the group C, there was a significant difference between the groups (P<0.05).

Conclusions:
The EC50 of epidural ropivacaine for labor analgesia was 0.083% (95% CI, 0.077%-0.089%) and decreased to 0.062% (95% CI, 0.058%-0.066%) when combined with 0.5 μg/mL dexmedetomidine (http://www.chictr.org.cn, registration number: ChiCTR-OPC-16008548).
Changing Neonatal Nurses' Perceptions of Caring for Infants Experiencing Neonatal Abstinence Syndrome and Their Mothers
Authors: Tobin Kobi Brooke 
Published: March 2018

Background:
Neonatal intensive care units (NICUs) are caring for an increasing number of infants born with neonatal abstinence syndrome (NAS). The literature identifies the need for education for NICU nurses on NAS including skills for interacting with the mother with substance use disorder.

Purpose:
An evidence-based practice project was developed to offer an educational presentation targeting these topics to 206 NICU participants (93% registered nurses, 1% licensed vocational nurses, and 6% nursing assistants) at a level IV NICU.

Methods:
A pretest/posttest was developed to assess knowledge of the participants prior to and after completion of the educational presentation. A posteducational questionnaire was developed to evaluate the skills learned for interacting with the mother with substance use disorder and the participant's professional readiness.

Results:
The posttest demonstrated a statistically significant (P < .001) increase in knowledge of NAS. On the post-educational questionnaire, 96% of participants correctly identified 3 skills they would use clinically with mothers with substance use disorder and 84% of participants identified 2 personal strengths and 2 weaknesses that influence their care of infants with NAS and their families (professional readiness).

Implications for Practice:
These results demonstrate that this educational presentation was effective and should be replicated at other facilities to improve the knowledge and skills of NICU nurses to promote improved care for infants with NAS.

Implications for Research:
Future studies should examine the impact on patient outcomes by preforming post-discharge interviews with the mothers of infants with NAS in the NICU pre- and post-educational intervention. Expanding the presentation into an interprofessional educational opportunity would promote increased knowledge and care by the entire multidisciplinary team.
Vertebral Body Lipoma
Authors: Sahinturk Fikret , Dere Umit Akin , Sonmez Erkin , Altinors Nur , Terzi Ayşen 
Published: March 2018

Study Design.
Case report.

Objective.
This case report is unique since this is the first vertebral lipom case that was treated by kyphoplasty alone.

Summary of Background Data.
Vertebral lipoma is extremely rare and our search of the English literature has revealed 20 patients in 16 reports.

Methods.
A 32-year-old female patient was admitted to our neurosurgery department with the chief complaint of low back pain that had lasted nearly 1 year. A lumbar MR suggested a hemangioma and the patient was operated on.

Results.
On microscopic examination, the lesion was seen to have a widely infiltrating appearance of mature fat tissue between bone trabeculae diagnosis was intraosseous lipoma.

Conclusion.
We believe that the management should be surgical total removal of the lesion even in incidentally found cases in order to obtain histologic diagnosis and pain relief.

Level of Evidence: 5
Epithelial Keratitis After Cataract Surgery
Authors: Cho Yang K. , Kwon Jin W. , Konda Sneha , Ambati Balamurali K. 
Published: March 2018

Purpose:
To evaluate the incidence, related perioperative factors, clinical characteristics, and possible etiologies of epithelial keratitis after cataract surgery.

Methods:
A retrospective chart review of 666 eyes in 666 patients who underwent cataract surgery was performed to evaluate the incidence of epithelial keratitis and related factors in the postoperative period.

Results:
Postoperative epithelial keratitis developed in 15 eyes. Eleven of the 15 eyes were diagnosed with herpes simplex keratitis (HSK); 10 of the 11 eyes were diagnosed by polymerase chain reaction, and the remaining 1 eye by clinical diagnosis. All patients diagnosed with HSK had no previous clinical history of the infection before undergoing cataract surgery. Initially, the diagnosis of all 15 eyes was toxic keratitis, but the final diagnosis of 11 of the initial 15 was found to be epithelial herpes keratitis. The incision location was shown to be related to the occurrence of HSK in our study (P < 0.05).

Conclusions:
HSK epithelial keratitis after cataract surgery is a relatively uncommon complication and can be misdiagnosed in its early disease course because of its relative rarity. This study explores the possibility that the temporal corneal penetrating incisional approach used in routine cataract surgery interrupts the corneal nerves and subsequently can trigger reactivation of HSK.
Overhanging-Dissecting Blebs: Immunohistochemical Characterization
Authors: Al-Beshri Ali S. , Edward Deepak P. , Haiti Khitam Al , Craven Earl R. 
Published: March 2018

Purpose:
The purpose of this study was to determine if glaucoma filtering blebs migrate over or under the cornea epithelium using histopathologic and immunohistochemical techniques to evaluate the likely origin of the surface epithelium and bleb matrix.

Methods:
Histologic and immunohistochemical evaluations were performed of normal conjunctiva (n=4), corneal overhanging-dissecting blebs (n=4), and leaking blebs over the scleral surface (n=6). Antibodies were used against epithelial [cytokeratin 3 (CK3)+12, CK13] and extracellular matrix [decorin and keratan sulfate (KS)] antigens. Labeling was graded in a semiquantitative manner.

Result:
The epithelium of dissecting (over cornea) blebs was labeled primarily with CK3+12 antibody. KS staining was faint and comparable in normal conjunctiva, and the stroma of dissecting and leaking blebs (P=0.12). Decorin staining in the normal conjunctival stroma was of moderate intensity and comparable with the dissecting bleb staining and; significantly greater than that in the leaking blebs (P=0.02).

Conclusions:
Histology and ICH indicate that the epithelium of the dissecting blebs has a corneal epithelial phenotype. The extracellular matrix immunophenotype was similar to the normal conjunctival stroma suggesting that dissecting blebs migrate under the corneal epithelium.
A Case of Congenital Insensitivity to Pain With Anhidrosis Comorbid With Attention Deficit Hyperactivity Disorder
Authors: Shirazi Elham , Sayyahfar Shirin , Motamed Mahtab , Alaghband-rad Javad 
Published: March 2018

Abstract
Congenital insensitivity to pain with anhidrosis (CIPA) is a rare autosomal recessive genetic disorder caused by a mutation in the neurotrophic tyrosine kinase receptor (NTRK1) gene. CIPA is accompanied by abnormal catecholamine metabolism and decreased blood concentration of dopamine and norepinephrine. Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder of heterogeneous etiology and presentation, and recent reports have suggested a pathophysiological role of neurotrophins in ADHD. Furthermore, dopamine and norepinephrine are known to play major roles in the pathophysiology of ADHD, and the imbalance of monoaminergic and cholinergic systems as an underlying cause of ADHD has recently been studied. Here, we report the case of an 11-year-old boy with CIPA and comorbid ADHD. Our observations have important clinical implications for patients with CIPA. Because of deficiencies in self-control, proper management of these patients necessitates a highly structured and monitored environment, made dually important by possible comorbidity of ADHD.