bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and Pharmacokinetics of Standardized Extract of Centella asiatica (ECa 233) Capsules in Healthy Thai Volunteers: A Phase 1 Clinical Study
Authors: Songvut Phanit , Chariyavilaskul Pajaree , Tantisira Mayuree , Khemawoot Phisit 
Published: January 2019

AbstractThe aim of this study was to investigate the safety and pharmacokinetic profiles of a newly developed, standardized extract of Centella asiatica (ECa 233) capsule in healthy Thai volunteers. This study was designed as an open-labeled, 2-sequence dosage, single- and repeated-dose study investigated under fasting conditions. Plasma concentrations of the parent compounds and their relative acid metabolites were measured and pharmacokinetic parameters were calculated using noncompartmental analysis. Tolerability was assessed based on physical examinations, monitoring of vital signs, clinical laboratory tests, and any observed adverse events. A key finding of this study was that the pharmacokinetics of ECa 233 in healthy volunteers did not correspond with its pharmacokinetics in animal studies. As indicated in human pharmacokinetic parameters, maximum plasma concentration and area under the curve of the parent compounds (madecassoside and asiaticoside) were very low, while their respective metabolites (madecassic acid and asiatic acid) demonstrated higher values. Based on the pharmacokinetic results observed in the dose comparison, accumulation of active metabolites after repeated dose is highly suggestive. In addition, the asiatic acid profile showed 2-fold increase in Cmax and AUC(0–t) after increasing dose from 250 to 500 mg of ECa 233. Lastly, the safety and tolerability evaluation illustrated that single and multiple doses in both 250 and 500 mg oral administration of ECa 233 were well tolerated, and none of the volunteers discontinued their participation due to adverse effects during the study.
T2-weighted Hypointense Tumors and Tumor-like Lesions
Authors: Isaac Amanda , Dalili Danoob , Noebauer-Huhmann Iris-Melanie , Papakonstantinou Olympia 
Published: January 2019

AbstractMost musculoskeletal tumors are hyperintense on T2-weighted images. However, some T2-weighted hypointense tumors and tumor-like lesions are encountered in everyday clinical practice. We explore the spectrum of such T2 hypointense tumors and tumor mimickers that can arise from (1) the bones, presenting as diffuse processes or focal lesions; (2) the joints including diffuse or focal synovial disorders, loose bodies, or substance depositions; and (3) soft tissues, comprising T2 hypointense tumors and tumor mimickers (those that contain abundant fibrous tissue, mineralization, or hemosiderin deposits). Appropriate magnetic resonance imaging sequence selection is required to identify and characterize these lesions confidently when imaging musculoskeletal tumors.
Nerve Tumors: What the MSK Radiologist Should Know
Authors: Isaac Amanda , Bignotti Bianca , Rossi Federica , Zaottini Federico , Martinoli Carlo , Tagliafico Alberto 
Published: January 2019

AbstractNerve tumors are rare and heterogeneous soft tissue tumors arising from a peripheral nerve or showing nerve sheath differentiation. In a radiologic setting it is necessary to recognize soft tissue lesions that are of neural origin, their association with a peripheral nerve, and whether they are a true tumor or a so-called pseudotumor such as a neuroma, fibrolipoma, or peripheral nerve sheath ganglion. Ultrasound (US) and magnetic resonance imaging are the best modalities to characterize these lesions. US can be used to guide biopsy in difficult and uncertain cases when the lesion is either indeterminate or possibly malignant. At present, no single imaging feature or reproducible criteria, or a combination, can differentiate reliably between a neurofibroma and a schwannoma or discriminate with certainty between benign and malignant neurogenic tumors. Adequate imaging and consultation with a nerve tumors/sarcoma unit is advised.
Effects of Homeopathic Preparations of Mercurius corrosivus on the Growth Rate of Severely Mercury-Stressed Duckweed Lemna gibba L.
Authors: Jäger Tim , Würtenberger Sandra , Baumgartner Stephan 
Published: January 2019

Background We developed a bioassay with mercury-stressed duckweed (Lemna gibba L.) to study potential effects of homeopathically potentised mercury(II) chloride (Mercurius corrosivus [Merc-c.]). The response of this bioassay to homeopathic treatments as a function of stress intensity was also of interest.
Methods Duckweed was severely stressed with mercury(II) chloride for 48 hours. Afterwards plants grew in either Merc-c. (seven different potency levels, 24x to 30x) or water controls (unsuccussed and succussed water) for 7 days. Growth rates of the frond (leaf) area were determined using a computerised image analysis system for different time intervals between the measurements on days 0, 3 and 7. Three independent experiments with potentised Merc-c. each were evaluated. Additionally, three water control experiments were analysed to investigate the stability of the experimental set-up (systematic negative control [SNC] experiments). All experiments were randomised and blinded.
Results Unsuccussed and succussed water did not significantly differ in terms of duckweed growth rate. The SNC experiments did not yield any significant effects, providing evidence for the stability of the experimental system. Data from the two control groups and the seven treatment groups (Merc-c. 24x–30x) were each pooled to increase the statistical power. Duckweed growth rates for day 0 to 3 were reduced (p < 0.05) after application of Merc-c. compared with the controls. Growth rates for day 3 to 7 were not influenced by the homeopathic preparations.
Conclusions The present test system with Lemna gibba L. that was severely stressed by mercury yielded evidence for specific effects of Merc-c. 24x to 30x, namely a growth reduction in the first time period (day 0–3). This is in contrast to former experiments with slightly arsenic-stressed duckweed, where a growth increase was observed in the second time period (day 2–6). We hypothesise that the differing results are associated with the level of stress intensity (severe versus slight).
Rare Spontaneous Attenuation of Childhood Inflammatory Cerebral Adrenoleukodystrophy
Authors: Choi Hyoung Won , Raymond Gerald Vincent , Miller Weston 
Published: January 2019

AbstractX-linked adrenoleukodystrophy (ALD) is a neurodegenerative peroxisomal disorder with variable clinical phenotypes. Childhood cerebral ALD (CCALD) is at the most severe end of the disease spectrum. In CCALD, the clinical manifestations include increasing deficits in behavior, vision, hearing, coordination, and motor function, as well as seizures. Without treatment, CCALD often results in apparent vegetative state within 1 to 2 years of appearance of initial signs and symptoms. We present the case of a boy with classic inflammatory CCALD who exhibited spontaneous attenuation in disease progression. While extremely rare, spontaneous arrest of disease progression may occur in boys with inflammatory CCALD.
Early Infectious Disease Outpatient Follow-up of Outpatient Parenteral Antimicrobial Therapy Patients Reduces 30-Day Readmission
Authors: Saini Ena , Ali Mohammad , Du Ping , Crook Tonya , Zurlo John 
Published: January 2019

Abstract
We conducted a case-control study to examine the association between outpatient infectious disease (ID) follow-up and risk of 30-day readmission in 384 patients receiving outpatient parenteral antimicrobial therapy. ID outpatient follow-up within 2 weeks was associated with lower risk of all-cause 30-day readmission (adjusted odds ratio, 0.33; P = .0001).
Bilateral trade agreements and price distortions in agricultural markets
Authors: Hirsch Cornelius , Oberhofer Harald 
Published: January 2019

AbstractAgricultural support levels are at a crossroad with reduced distortions in OECD countries and increasing support for agricultural producers in emerging economies observable over the last decades. This paper studies the determinants of distortions in the agricultural markets by putting a specific focus on the role of trade policy. Applying various different dynamic panel data estimators and explicitly accounting for potential endogeneity of trade policy agreements, we find that an increase in the number of bilateral free trade agreements exhibits significant short- and long-run distortion reducing effects. By contrast, our evidence suggests that WTO’s Uruguay Round Agreement on Agriculture has not been successful in systematically contributing to a reduction in agricultural trade distortions. From a policy point of view, our findings thus point to a lack of effectiveness of multilateral trade negotiations.
Gender differences in incidence and in-hospital outcomes of surgical aortic valve replacement in Spain, 2001–15
Authors: López-de-Andrés Ana , Méndez-Bailón Manuel , Perez-Farinos Napoleon , Hernández-Barrera Valentín , de Miguel-Díez Javier , Muñoz-Rivas Nuria , Jiménez-García Rodrigo 
Published: January 2019

Abstract

Background
we aim to examine trends in the incidence of surgical aortic valve replacement (SAVR) among women and men in Spain from 2001 to 2015; compare in-hospital outcomes for mechanical and bioprosthetic SAVR by gender and; to identify factors associated with in-hospital mortality (IHM) after SAVR.

Methods
We performed a retrospective study using the Spanish National Hospital Discharge Database, 2001–15. We included patients that had SAVR as procedure in their discharge report. Propensity score matching (PSM) was performed to assess the impact of gender on the outcomes of mechanical and bioprosthetic SAVR.

Results
We identified 86 578 patients who underwent SAVR (40% women). Incidence of SVAR was higher in men (incidence rate ratio 1.57; 95%CI 1.55–1.59). In 2001, 73.36% of the men and 71.57% of women received a mechanical prosthesis; these proportions decreased to 43.04% in men and 35.89% in women in 2015, whereas bioprosthetic SAVR increased to 56.96% and 64.11%. After PSM we found that IHM was higher in women than in matched men for mechanical (8.94% vs. 6.79%; P < 0.001) and bioprosthetic (6.51 vs. 5.42%; P = 0.001) SAVR. The mean length of hospital stay was longer (19.54 vs. 18.74 days; P < 0.001) among females than males undergoing mechanical SAVR. Higher IHM after SAVR was associated with older age, comorbidities (except diabetes and atrial fibrillation), concomitant coronary artery bypass graft and emergency room admission.

Conclusions
This nation-wide analysis over 15 years of gender-specific outcomes after SAVR showed that, after PSM women have significantly higher IHM after mechanical and bioprosthetic SAVR than men.
Defining standards of CARE for invasive fungal diseases in the ICU
Authors: Cuenca-Estrella Manuel , Kett Daniel H , Wauters Joost 
Published: January 2019

Abstract
The aim of this article is to review the current recommendations for the diagnosis and treatment of invasive fungal infection in the ICU setting and to explore whether there are standards of care for this patient population. The text focuses mainly on the two most common invasive fungal diseases that afflict non-neutropenic patients: candidaemia and invasive candidosis (IC), and invasive pulmonary aspergillosis (IPA).
‘Specimens Distributed’
Authors: Cornish Caroline , Driver Felix 
Published: January 2019

Abstract
This paper presents research on the dispersal of objects from the Museum of Economic Botany at the Royal Botanic Gardens, Kew (rbgk) from 1847 to 1914. Established by William Hooker, the museum received thousands of objects from around the world, the display of which was designed to illustrate plants’ properties and economic potential. The paper argues that the conventional focus in museum studies on processes of acquisition and accumulation captures only one side of collections’ history. Drawing on research in archives and collections at Kew and elsewhere, we highlight the redistribution of specimens and artefacts from Kew’s museum through a variety of channels. We focus on three modes of circulation: firstly, Kew’s role as a clearing house for collections; secondly the exchange of objects; and thirdly the distribution of specimens and artefacts to schools across the British Isles, a practice which became prevalent towards the end of the period.
Extracellular fluid volume expansion, arterial stiffness and uncontrolled hypertension in patients with chronic kidney disease
Authors: Braam Branko , Lai Chung Foon , Abinader Joseph , Bello Aminu K 
Published: January 2019

AbstractBackgroundHypertension is prevalent in patients with chronic kidney disease (CKD) and is related to extracellular fluid volume (ECFV) expansion. Arterial stiffening is another implication of CKD that can be caused by ECFV expansion. In this study, we hypothesized that CKD patients with uncontrolled hypertension are more likely to be fluid volume expanded than normotensive patients, which in turn is associated with increased arterial stiffness.MethodsAdult hypertensive patients with mild–severe CKD (n = 82) were recruited. ECFV was assessed using multifrequency bioimpedance and arterial stiffness by applanation tonometry and oscillometry.ResultsPatients with uncontrolled hypertension had fluid volume expansion compared with controls (1.0 ± 1.5 versus 0.0 ± 1.6 L, P &lt; 0.001), and had a higher augmentation index (AIx) and pulse wave velocity. Fluid volume expansion was more prevalent in patients with uncontrolled hypertension (58%) than patients who were at target (27%). Fluid volume expansion was correlated with age, AIx and systolic blood pressure. In a binary logistic regression analysis, AIx, age and fluid volume status were independent predictors of uncontrolled hypertension in both univariate and multivariate models.DiscussionIn summary, uncontrolled hypertension among hypertensive CKD patients is associated with ECFV expansion. Our data suggest a relationship between ECFV expansion, increased arterial stiffness and uncontrolled hypertension.
Validation and Application for the Berlin Grading System of Moyamoya Disease in Adult Patients
Authors: Teo Mario , Furtado Sunil , Kaneko Osamu F , Azad Tej D , Madhugiri Venkatesh , Do Huy M , Steinberg Gary K 
Published: January 2019

Abstract

BACKGROUND
Traditional moyamoya disease (MMD) classification relies on morphological digital subtraction angiography (DSA) assessment, which do not reflect hemodynamic status, clinical symptoms, or surgical treatment outcome.

OBJECTIVE
To (1) validate the new Berlin MMD preoperative symptomatology grading system and (2) determine the clinical application of the grading system in predicting radiological and clinical outcomes after surgical revascularization.

METHODS
Ninety-six MMD patients (192 hemispheres) with all 3 investigations (DSA, magnetic resonance imaging [MRI], Xenon-CT) performed preoperatively at our institution (2007-2013) were included. Two clinicians independently graded the imaging findings according to the proposed criteria. Patients’ modified Rankin Score (mRS) scores (preoperative, postoperative, last follow-up), postoperative infarct (radiological, clinical) were collected and statistical correlations performed.

RESULTS
One hundred fifty-seven direct superficial temporal artery-middle cerebral artery bypasses were performed on 96 patients (66 female, mean age 41 yr, mean follow-up 4.3 yr). DSA, MRI, and cerebrovascular reserve capacity were independent factors associated hemispheric symptomatology (when analyzed individually or in the combined grading system). Mild (grade I), moderate (grade II), severe (grade III) were graded in 45, 71, and 76 hemispheres respectively; of which, clinical symptoms were found in 33% of grade I, 92% of grade II, 100% of grade III hemispheres (P < .0001). Two percent of grade I, 11% of grade II, 20% of grade III hemispheres showed postoperative radiological diffusion weighted image-positive ischemic changes or hemorrhage on MRI (P = .018). Clinical postoperative stroke was observed in 1.4% of grade II, 6.6% of grade III hemispheres (P = .077). The grading system also correlated well to dichotomized mRS postoperative outcome.

CONCLUSION
The Berlin MMD grading system is able to stratify preoperative hemispheric symptomatology. Furthermore, it correlated with postoperative new ischemic changes on MRI, and showed a strong trend in predicting clinical postoperative stroke.
Reduction in Exposure to Selected Harmful and Potentially Harmful Constituents Approaching Those Observed Upon Smoking Abstinence in Smokers Switching to the Menthol Tobacco Heating System 2.2 for 3 Months (Part 1)
Authors: Haziza Christelle , de La Bourdonnaye Guillaume , Donelli Andrea , Poux Valerie , Skiada Dimitra , Weitkunat Rolf , Baker Gizelle , Picavet Patrick , Lüdicke Frank 
Published: January 2019

Abstract

Introduction
The Tobacco Heating System (THS) is a “heat-not-burn” tobacco product designed to generate significantly lower levels of harmful and potentially harmful constituents (HPHCs) and present lower risk of harm than cigarettes. This study assessed the exposure reduction to selected HPHCs in smokers switching to menthol Tobacco Heating System (mTHS) 2.2 compared with smokers continuing smoking menthol cigarettes (mCCs) and smoking abstinence (SA) for 5 days in a confined setting, followed by an 86-day ambulatory period.

Methods
A total of 160 healthy adult US smokers participated in this randomized, three-arm parallel group, controlled clinical study. Biomarkers of exposure to 16 HPHCs were measured in blood and 24-hour urine. Safety was monitored throughout the study. Information was also gathered on product evaluation, product use, subjective effects, and clinical risk markers (co-publication Part 2).

Results
Nicotine uptake was comparable in both exposure groups (mTHS:mCC ratio of 96% on day 90). On day 5, biomarker of exposure levels to other HPHCs were reduced by 51%–96% in the mTHS group compared with the mCC group, and these reductions were sustained for most biomarkers of exposure over ambulatory period. After 90 days of use, the level of satisfaction with mTHS and suppression of urge to smoke were comparable to mCC.

Conclusion
Switching from mCCs to mTHS significantly reduced the exposure to HPHCs to levels approaching those observed in subjects who abstained from smoking for the duration of the study.

Implications
This study compared the impact of switching to mTHS on biomarkers of exposure, relative to continued smoking or SA.

Clinical Significance

Trial Registration
NCT01989156 (ClinicalTrials.gov).
Long-term Follow-up of Patients Treated with Percutaneous Radiofrequency Thermocoagulation via the Foramen Rotundum for Isolated Maxillary Nerve Idiopathic Trigeminal Neuralgia
Authors: Ran Bing , Wei Jun , Zhong Qiong , Fu Min , Yang Jun , Chen XinRong , Wen XinYuan , Liu Yong , Wu Yun , Deng Xin 
Published: January 2019

Abstract

Objective
The purpose of this study is to evaluate the effectiveness and safety of percutaneous radiofrequency thermocoagulation (PRT) via the foramen rotundum (FR) for the treatment of isolated maxillary (V2) idiopathic trigeminal neuralgia (ITN) and assess the appropriate puncture angle through the anterior coronoid process to reach the FR.

Methods
Between January 2011 and October 2016, 87 patients with V2 ITN refractory to conservative treatment were treated by computed tomography (CT)–guided PRT via the FR at our institution. The outcome of pain relief was assessed by the visual analog scale (VAS) and Barrow Neurological Institute (BNI) pain grade and grouped as complete pain relief (BNI grades I–III) or unsuccessful pain relief (BNI grades IV–V). Recurrence and complications were also monitored and recorded. The puncture angle for this novel approach was assessed based on intraoperative CT images.

Results
Of the 87 treated patients, 85 (97.7%) achieved complete pain relief, and two patients (2.3%) experienced unsuccessful pain relief immediately after operation. During the mean follow-up period of 44.3 months, 15 patients (17.2%) experienced recurring pain. No severe complications occurred, except for hypoesthesia restricted to the V2 distribution in all patients (100%) and facial hematoma in 10 patients (11.5%). The mean puncture angle to reach the FR was 33.6° ± 5.7° toward the sagittal plane.

Discussion
CT-guided PRT via the FR for refractory isolated V2 ITN is effective and safe and could be a rational therapy for patients with V2 ITN.
Ordering of Diagnostic Imaging by Physical Therapists: A 5-Year Retrospective Practice Analysis
Authors: Keil Aaron P , Baranyi Brian , Mehta Sameer , Maurer Amma 
Published: January 2019

Abstract

Background
Significant progress has been made in implementing direct access. As more therapists transition into direct access roles, it seems prudent to consider how additional resources common to other first-contact providers might impact patient care.

Objectives
Direct referral for diagnostic imaging by physical therapists is relatively rare in the civilian setting and little has been published on the subject. The primary objective of this study was to examine the appropriateness of diagnostic imaging studies referred by civilian physical therapists at an academic medical center. Secondary objectives were to track reimbursement data and overall use rates.

Design
This was a single-center, retrospective practice analysis of 10 physical therapists over a period of nearly 5 years.

Methods
The electronic medical record was reviewed for each patient who had an imaging referral placed by a physical therapist. Relevant clinical exam findings and patient history were provided to a radiologist who then applied the American College of Radiology Appropriateness Criteria to determine appropriateness. Reimbursement data and therapist use rates were also evaluated.

Results
Of the 108 total imaging studies, 91% were considered appropriate. Overall, use rates per direct access evaluation were 9% for plain film x-rays and 4% for advanced imaging. Reimbursement was 100%.

Limitations
This study was limited to 10 physical therapists at 1 practice location. Appropriateness was evaluated by 1 radiologist. The educational background of referring therapists was not evaluated.

Conclusions
Physical therapists demonstrated appropriate use of diagnostic imaging in the vast majority of cases (91%). They were judicious in their use of imaging, and there were no issues with reimbursement. These findings could be useful for physical therapists interested in acquiring diagnostic imaging referral privileges.
Multi-floor laboratory transportation technologies based on intelligent mobile robots
Authors: Thurow Kerstin , Zhang Lei , Liu Hui , Junginger Steffen , Stoll Norbert , Huang Jiahao 
Published: January 2019

AbstractTransportation technologies for mobile robots include indoor navigation, intelligent collision avoidance and target manipulation. This paper discusses the research process and development of these interrelated technologies. An efficient multi-floor laboratory transportation system for mobile robots developed by the group at the Center for Life Science Automation (CELISCA) is then introduced. This system is integrated with the multi-floor navigation and intelligent collision avoidance systems, as well as a labware manipulation system. A multi-floor navigation technology is proposed, comprising sub-systems for mapping and localization, path planning, door control and elevator operation. Based on human–robot interaction technology, a collision avoidance system is proposed that improves the navigation of the robots and ensures the safety of the transportation process. Grasping and placing operation technologies using the dual arms of the robots are investigated and integrated into the multi-floor transportation system. The proposed transportation system is installed on the H20 mobile robots and tested at the CELISCA laboratory. The results show that the proposed system can ensure the mobile robots are successful when performing multi-floor laboratory transportation tasks.