bluuebunny/crossref_metadata_2025_split huggingface dataset:
Poly(ε-caprolactone) electrospun nanofibers containing cinnamon essential oil nanocapsules: A promising technique for controlled release and high solubility
Authors: Amiri Sahar , Rahimi Azam 
Published: March 2018

Nowadays, cinnamon essential oil is one of the most popular spices for food flavoring and also for medicinal uses such as anti-inflammation agent, but its low solubility, irritations, and allergic reactions limit its applications. To overcome these limitations, cinnamon essential oil-loaded nanocontainers were prepared via inclusion complexation between the cyclodextrins and cinnamon essential oil under two different conditions, i.e., at room temperature or under sonic energy. The resulting supramolecular nanocontainers were characterized by XRD, SEM, DSC, and FTIR. Successful insertion of cinnamon essential oil in the cyclodextrins’ cavity was confirmed by the significant differences between the FTIR, DSC, and XRD spectra of initial mixtures and those of the complexes. XRD results indicated that crystalline complexes adopted a mixture of head to head channel-type and cage conformation for cinnamon essential oil/cyclodextrins at various conditions. Solubility, bioavailability, and in vitro dissolution of obtained cinnamon essential oil nanocapsules were investigated, and results show that by encapsulation of cinnamon essential oil, solubility improved and its release is controllable. The solubility of cinnamon essential oil increased linearly as the concentration of cyclodextrins was increased, confirming the 1:1 stoichiometry of the complex. Electro-spun nanofibers of poly-ɛ-caprolactone containing cinnamon essential oil/cyclodextrins inclusion complex at various conditions indicated that these nanofibers did not show beading defect with controlled release of cinnamon essential oil.
Mechanical thrombectomy in MCA-mainstem occlusion in patients with low NIHSS scores
Authors: Kaschner Marius Georg , Caspers Julian , Rubbert Christian , Lande Raul , Kraus Bastian , Lee John-Ih , Gliem Michael , Jander Sebastian , Turowski Bernd 
Published: March 2018

Introduction While effectiveness of mechanical thrombectomy (MTE) in M1 segment occlusion is approved for patients with severe impairment, there is a lack of evidence for a potential benefit of MTE in patients with minor to moderate symptoms. The purpose of this study was to evaluate neurological outcome and occurrence of periprocedural complications after MTE in patients with low National Institutes of Health Stroke Scale (NIHSS) scores. Materials and methods A retrospective analysis of 1081 consecutive patients with anterior circulation ischemic stroke due to M1 occlusion detected by computed tomography angiography and treated with MTE at our hospital between February 2012 and November 2017 was performed. NIHSS, Barthel Index (BI) and modified Rankin Scale (mRS) scores between admission and discharge were compared with paired Mann–Whitney test, and recanalization rate and complications were assessed in patients with NIHSS ≤ 5 at admission. Results Thirty patients were included with a median NIHSS score of 4. NIHSS score (median: 4 vs. 1; p < 0.001), BI (median: 43 vs. 80; p < 0.001) and mRS (2 vs. 1; p < 0.001) showed significant improvement from admission to discharge after MTE. Recanalization rate was Thrombolysis in Cerebral Infarction (TICI) 2b to 3 in 29 of 30 patients (96.7%). One case of an intracerebral reperfusion hematoma (ECASS: PH2) required surgical treatment. Conclusion MTE might lead to a significantly improved clinical outcome also for patients with low NIHSS score due to M1 segment occlusion. Periprocedural complications appeared infrequently. These results encourage further evaluation of the benefit-risk profile of MTE compared to standard treatment in patients with low NIHSS scores in future randomized trials.
Foreign body ingestion and food impaction in adults: better to scope than to wait
Authors: Libânio Diogo , Garrido Mónica , Jácome Filipa , Dinis-Ribeiro Mário , Pedroto Isabel , Marcos-Pinto Ricardo 
Published: March 2018

Background and objectiveTo assess clinical outcomes after foreign body ingestion and food impaction; to identify predictors of foreign body presence at the time of endoscopy.MethodsA prospective study including consecutive adult patients with foreign body ingestion or suspected food impaction between May 2014 and August 2016.ResultsIn total, 521 patients were included, 320 with foreign body ingestion and 201 with suspected food impaction. Food impaction patients were significantly older and more frequently had a history of oesophageal disease. The foreign body was encountered in the upper digestive tract in 43% of the patients with foreign body ingestion, and food impaction was confirmed in 87%. Older age (odds ratio (OR)year 1.04, 95% confidence interval (CI) 1.02–1.06) and early presentation (ORfirst six hours 4.41, 95% CI 2.24–8.66) were independent predictors of foreign body presence, while a history of psychiatric disease was an independent predictor of food impaction (OR 6.69, 95% CI 1.66–26.9). Successful endoscopic treatment was achieved in more than 90% of the cases, with adverse events occurring in fewer than 5%. Foreign body forceps was the preferred device in foreign body ingestion, while retrieval basket and mobilisation were preferred in food impaction. The need to use more than one instrument was significantly higher in food impaction.ConclusionForeign bodies are encountered at endoscopy in almost half of the cases. Older age and earlier presentation are independent predictors of its presence. Given the high proportion of patients with foreign body at endoscopy and the low risk of complications, endoscopic evaluation is probably justified in the majority of cases.
Treatment Changes in General Practice Patients With Chronic Mental Disorders Following a Psychiatric–Psychosomatic Consultation
Authors: Linden Michael , Muschalla Beate , Noack Nils , Heintze Christoph , Doepfmer Susanne 
Published: March 2018

Objective: To determine whether a psychiatric–psychosomatic consultation can identify unmet treatment needs and improve treatment of patients with mental disorders in general practice. Methods: In 40 primary care practices, 307 consecutive primary patients who met criteria for chronic mental disorders were assessed by a psychiatric–psychosomatic consultant. After random assignment, general practitioners (GPs) were informed for half of the patients about the results of the assessment and received recommendations on how to improve treatment. Changes in treatment and patient status were reevaluated after 6 months. Results: Patients were mostly having depression, adjustment, or anxiety disorders, with 28.8% on sick leave. Contact with their respective GPs was longer than a year in 77.2% of cases. Patients had already received pharmacotherapy (60.9%), psychotherapeutic counseling by GPs themselves (27.7%), psychotherapy by specialists (73.9%), psychiatric outpatient care (57%), inpatient psychiatric treatment (12.1%), inpatient psychosomatic rehabilitation (ie, specialized behavioral medicine facilities for patients with work problems; 41.4%), and a broad spectrum of other diagnostic and therapeutic measures. Newly recommended interventions included leisure activities (42%), a new specialist psychotherapy (37.5%), or inpatient psychosomatic treatment (15.3%). Most recommendations were agreed upon by the GP. Nevertheless, there was only a limited increase in therapeutic actions 6 months later, and no statistically significant improvement in the status of patients. Conclusion: General practitioners undertake a broad spectrum of therapeutic interventions in patients with chronic mental disorders. According to our results, additional psychiatric–psychosomatic consultations can intensify treatment but does not significantly change the general course of chronic mental disorders.
Successful passive sentence comprehension among Danish adolescents with autism spectrum disorders
Authors: Jensen de López Kristine , Schroeder Kristen , Gavarró Anna 
Published: March 2018

Background and aims Language abilities vary greatly across children with autism spectrum disorders (ASD). In the present study, we investigate passive sentence comprehension, which has been underexplored among individuals with autism spectrum disorders and found to be delayed among other clinical populations. This study is the first to assess grammatical comprehension among Danish-speaking adolescents with autism spectrum disorders. Methods Fifteen Danish-speaking adolescents with autism (mean age: 14.9 years; age range: 13–18 years) participated in a picture selection task assessing comprehension of passive sentences relative to active sentences. We compared our findings for adolescents with autism spectrum disorders to those of 15 typically developing Danish-speaking adolescents matched for age and nonverbal reasoning as measured by the Matrix subtest of the WISC-IV/WAIS-IV. We also analyzed associations between passive comprehension and nonverbal reasoning. Results The results showed ceiling effects for both groups on all sentence types indicating that Danish adolescents with autism spectrum disorders do not face problems comprehending passive sentences. However, when considering variation within the autism spectrum disorder group, correct passive comprehension was highly significantly associated with nonverbal reasoning for the autism spectrum disorder group ( r = .75), while this was not the case for the typically developing adolescents. Analyses of the few errors produced showed a preference for Theta-role reversal errors in the autism spectrum disorder and the typically developing groups. Conclusions Danish-speaking adolescents with high-functioning autism spectrum disorders do not show impairment in passive sentence comprehension. Correlation analyses however show that for adolescents with autism spectrum disorders, passive sentence comprehension is associated with nonverbal reasoning. We discuss how these results can be viewed as consistent with the few previous studies on passive comprehension in individuals with autism spectrum disorders. Implications Our study provides additional cross-linguistic evidence that passive comprehension is not problematic for individuals with high-functioning autism spectrum disorders. The finding of the relationship between nonverbal reasoning and passive sentence comprehension may inform clinical best practices as children with autism spectrum disorders who underperform in measures of nonverbal reasoning may benefit from additional receptive language screening.
Enhancing functional platelet release in vivo from in vitro–grown megakaryocytes using small molecule inhibitors
Authors: Jarocha Danuta , Vo Karen K. , Lyde Randolph B. , Hayes Vincent , Camire Rodney M. , Poncz Mortimer 
Published: March 2018

Key PointsDrugs shown to enhance megakaryocyte ploidy and size variably effect terminal injury and apoptosis of in vitro–grown megakaryocytes. The number of functional platelets released in vivo from infused megakaryocytes can be enhanced by these drug treatments.
Factors Associated With Delays in Obtaining Cancer Care in Botswana
Authors: Bhatia Rohini , Rayne Sarah , Rate William , Bakwenabatsile Lame , Monare Barati , Narasimhamurthy Mohan , Dryden-Peterson Scott , Grover Surbhi 
Published: March 2018

Abstract 61 Purpose As life expectancy increases with widespread access to HIV treatment, cancer has become a leading cause of death in Botswana. Delays in the diagnosis and treatment of cancer can lead to the development of late-stage disease with poor survival. These delays represent a multifaceted problem that is attributable to patient, provider, and systemic factors. We aimed to quantify the delay intervals from symptom onset to treatment start among patients with cancer in Botswana as well as to understand knowledge, attitudes, and fears associated with these intervals. Methods From December 2015 to January 2017, we surveyed patients who were seen in an oncology clinic in Gaborone, Botswana. We calculated the proportions of patients who experienced delays in appraisal (between detecting symptoms and perceiving a reason to discuss with a provider, defined as > 1 month), getting help (between deciding to discuss and the first consultation with a provider, defined as > 1 month), diagnosis (between first consultation and receiving a diagnosis, defined as > 3 months), and treatment (between diagnosis and starting treatment, defined as > 2 months). We looked at the association of covariates, including beliefs and stigmas about cancer, with these delays. Results Among 214 patients with cancer who completed the survey, median age at diagnosis was 46 years, and the most common cancer was cervical (42.2%). Of patients, 81.3% were female, 60.7% were HIV infected, and 57.1% presented with advanced cancer (stage III and IV). Of patients, 25.7% experienced a delay in appraisal, 35.5% in getting help, 63.1% in diagnosis, and 76.85% in treatment. Patient income, education, and age were not associated with delays; however, patients who lived with larger families presented faster (odds ratio [OR], 0.89; P = .023). In multivariable analysis, males were more likely to experience an appraisal delay (OR, 2.31; P = .02). Patients with Kaposi’s sarcoma were more likely to have an appraisal delay (OR, 9.77; P < .001), whereas patients with breast cancer were more likely to have a treatment delay (OR, 9.12; P < .001). Patients who felt their symptoms were less serious were more likely to experience an appraisal delay (OR, 2.49; P = .02). Conclusion Nearly all patients who were surveyed experienced a delay in obtaining cancer care in Botswana. In a setting in which care is provided to patients without charge, cancer type and male sex were more important predictors of delays than socioeconomic factors. Improving cancer awareness by families, patients, and primary providers could reduce delays in cancer care. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.
Bilateral Adrenalectomy in Congenital Adrenal Hyperplasia: A Systematic Review and Meta-Analysis
Authors: MacKay Diana , Nordenström Anna , Falhammar Henrik 
Published: March 2018

Abstract

Context
Management of congenital adrenal hyperplasia (CAH) involves suppression of the hypothalamic–pituitary–adrenal axis using supraphysiological doses of exogenous glucocorticoids. This can pose a challenge, with Cushing syndrome a frequent complication of adequate suppression. Bilateral adrenalectomy, with subsequent replacement of glucocorticoids and mineralocorticoids at physiological doses, has been proposed as an alternative therapeutic strategy.

Objective
To review the outcomes after bilateral adrenalectomy for CAH.

Data Sources
A systematic search of PubMed/MEDLINE and Web of Science, identifying relevant reports published up to 10 January 2018.

Study Selection
Case reports or case series were included if they reported individual patient data from patients with CAH who had undergone bilateral adrenalectomy.

Data Extraction
Information regarding the following was extracted: first author, country, sex, age at adrenalectomy, year of adrenalectomy, diagnosis, molecular abnormality, pre- and postoperative biochemistry, pre- and postoperative medications, pre- and postoperative body mass index, indication for adrenalectomy, surgical technique, gross and microscopic adrenal characteristics, follow-up duration, and short- and long-term postoperative outcomes.

Data Synthesis
We identified 48 cases of bilateral adrenalectomy for CAH, with patients aged from 4 months to 56 years at surgery. The most common indication for surgery was the inability to control hyperandrogenism/virilization and/or Cushing syndrome (n = 30; 62%). Most patients (n = 34; 71%) reported symptomatic improvement postoperatively, with some cases of short-term (n = 5; 10%) and long-term (n = 13; 27%) adverse outcomes.

Conclusions
Bilateral adrenalectomy for CAH appears to be a reasonable therapeutic option for carefully selected patients who have had unsatisfactory outcomes with conventional medical management.
Thrombophlebitis und Varikothrombose: Wann wie therapieren?
Authors: Woitalla-Bruning J. 
Published: March 2018

ZusammenfassungIm Allgemeinen wird die Thrombophlebitis als eine Thrombose und Entzündung der oberflächlichen Venen und ihrer Umgebung definiert. Da sie pathophysiologische und histologische Gemeinsamkeiten mit der tiefen Venenthrombose aufweist, wird sie neuerdings auch als oberflächliche Venenthrombose (OVT) bezeichnet. Man unterscheidet die OVT in primär gesunden Venen (Thrombophlebitis) von einer Varikothrombose, bei der es sich um eine Thrombose in varikös veränderten Venen handelt. Die OVT ist mit einer Prävalenz von 5,3% eine häufige Erkrankung. Sie tritt in 90 % der Fälle an den unteren Extremitäten auf und ist in bis zu 30% der Fälle mit einer tiefen Venenthrombose assoziiert, seltener mit einer Lungenembolie. In einigen Fällen sind auch tiefe Beinvenenthrombosen an mehreren Lokalisationen gleichzeitig beschrieben. Zur initialen Diagnostik sollte aus diesem Grund immer eine Duplexsonographie durchgeführt werden, um Lokalisation und Ausmaß der Thrombose exakt lokalisieren zu können. Die Therapie richtet sich nach Lokalisation und Ausdehnung der OVT. Die Therapiemöglichkeiten umfassen konservative sowie operative Maßnahmen. Einzig zugelassenes Medikament zur Therapie der OVT ist Fondaparinux. Niedermolekulare Heparine sind wirksam. Da die OVT Folge einer ernsthaften Grunderkrankung sein kann, sollte insbesondere bei Verdacht auf eine Thrombophlebitis oder bei rezidivierender Varikothrombose an eine Tumorsuche gedacht und bei jüngeren Patienten eventuell ein Thrombophilie Screening durchgeführt werden.
Evaluating disparities in the U.S. technology transfer ecosystem to improve bench to business translation
Authors: Weis James , Bashyam Ashvin , Ekchian Gregory J. , Paisner Kathryn , Vanderford Nathan L. 
Published: March 2018

Background: A large number of highly impactful technologies originated from academic research, and the transfer of inventions from academic institutions to private industry is a major driver of economic growth, and a catalyst for further discovery. However, there are significant inefficiencies in academic technology transfer. In this work, we conducted a data-driven assessment of translational activity across United States (U.S.) institutions to better understand how effective universities are in facilitating the transfer of new technologies into the marketplace. From this analysis, we provide recommendations to guide technology transfer policy making at both the university and national level. Methods: Using data from the Association of University Technology Managers U.S. Licensing Activity Survey, we defined a commercialization pipeline that reflects the typical path intellectual property takes; from initial research funding to startup formation and gross income. We use this pipeline to quantify the performance of academic institutions at each step of the process, as well as overall, and identify the top performing institutions via mean reciprocal rank. The corresponding distributions were visualized and disparities quantified using the Gini coefficient. Results: We found significant discrepancies in commercialization activity between institutions; a small number of institutions contribute to the vast majority of total commercialization activity. By examining select top performing institutions, we suggest improvements universities and technology transfer offices could implement to emulate the environment at these high-performing institutions. Conclusion: Significant disparities in technology transfer performance exist in which a select set of institutions produce a majority share of the total technology transfer activity. This disparity points to missed commercialization opportunities, and thus, further investigation into the distribution of technology transfer effectiveness across institutions and studies of policy changes that would improve the effectiveness of the commercialization pipeline is warranted.
Rising incidence of thyroid cancer in Singapore not solely due to micropapillary subtype
Authors: Shulin JH , Aizhen J , Kuo SM , Tan WB , Ngiam KY , Parameswaran R 
Published: March 2018

IntroductionThe annual incidence of thyroid cancer is known to vary with geographic area, age and gender. The increasing incidence of thyroid cancer has been attributed to increase in detection of micropapillary subtype, among other factors. The aim of the study was to investigate time trends in the incidence of thyroid cancer in Singapore, an iodine-sufficient area.Materials and methodsData retrieved from the Singapore National Cancer Registry on all thyroid cancers that were diagnosed from 1974 to 2013 were reviewed. We studied the time trends of thyroid cancer based on gender, race, pathology and treatment modalities where available.ResultsThe age-standardised incidence rate of thyroid cancer increased to 5.6/100,000 in 2013 from 2.5/100,000 in 1974. Thyroid cancer appeared to be more common in women, with a higher incidence in Chinese and Malays compared with Indians. Papillary carcinoma is the most common subtype. The percentage of papillary microcarcinoma has remained relatively stable at around 38% of all papillary cancers between 2007 and 2013. Although the incidence of thyroid cancer has increased since 1974, the mortality rate has remained stable.ConclusionThis trend of increase in incidence of thyroid cancer in Singapore compares with other published series; however, the rise seen was not solely due to micropapillary type. Thyroid cancer was also more common in Chinese and Malays compared with Indians for reasons that needs to be studied further.
Contributory factors in surgical incidents as delineated by a confidential reporting system
Authors: Mushtaq F , O’Driscoll C , Smith FCT , Wilkins D , Kapur N , Lawton R 
Published: March 2018

Background Confidential reporting systems play a key role in capturing information about adverse surgical events. However, the value of these systems is limited if the reports that are generated are not subjected to systematic analysis. The aim of this study was to provide the first systematic analysis of data from a novel surgical confidential reporting system to delineate contributory factors in surgical incidents and document lessons that can be learned. Methods One-hundred and forty-five patient safety incidents submitted to the UK Confidential Reporting System for Surgery over a 10-year period were analysed using an adapted version of the empirically-grounded Yorkshire Contributory Factors Framework. Results The most common factors identified as contributing to reported surgical incidents were cognitive limitations (30.09%), communication failures (16.11%) and a lack of adherence to established policies and procedures (8.81%). The analysis also revealed that adverse events were only rarely related to an isolated, single factor (20.71%) – with the majority of cases involving multiple contributory factors (79.29% of all cases had more than one contributory factor). Examination of active failures – those closest in time and space to the adverse event – pointed to frequent coupling with latent, systems-related contributory factors. Conclusions Specific patterns of errors often underlie surgical adverse events and may therefore be amenable to targeted intervention, including particular forms of training. The findings in this paper confirm the view that surgical errors tend to be multi-factorial in nature, which also necessitates a multi-disciplinary and system-wide approach to bringing about improvements.