bluuebunny/crossref_metadata_2025_split huggingface dataset:
Practical Input on Bone Tumor Imaging: Pathological Fracture, Risk Features, and When to Contact Orthopaedics
Authors: Anderson Suzanne , Havakeshian Sina , Würzburg Andreas , Lunkiewicz Magdalena 
Published: January 2019

AbstractAwareness of risk factors associated with impending fracture and its radiologic appearance allows early diagnosis, supports prophylactic surgical treatment, and prevents the multiple complications of a pathologic fracture. Because the femur is the most common long bone affected by metastatic bone lesions, we address this clinically relevant site in this review. The key to early detection of risky bone lesions is familiarity with the possible clinical presentation, biomechanical effects of the anatomical site (femoral head and neck, intertrochanteric zone, proximal diaphysis), and the lesion types (lytic, blastic, or mixed). Awareness of the possible treatment strategies depending on the characteristics just listed allows high-quality targeted reporting.
Ewing's Sarcoma and Primary Osseous Lymphoma: Spectrum of Imaging Appearances
Authors: Papakonstantinou Olympia , Nikodinovska Violeta , Vanhoenacker Filip , Weber Marc-André 
Published: January 2019

Ewing's sarcoma (ES) is a rare, highly malignant anaplastic stem cell tumor. Histologically, the tumor consists of uniform densely packed small monomorphic cells with round nuclei. The typical appearance at hematoxylin and eosin (H&E) staining is small blue round cells without any matrix formation. On conventional radiography, ES typically presents as a permeative lesion in the diaphysis of a long bone in a child. A large soft tissue component is another characteristic feature, best depicted by magnetic resonance imaging.Primary osseous lymphomas are most commonly highly malignant B-cell lymphomas. At H&E histologic staining, the tumor stroma consists of diffuse round-cell infiltrates that resembles the appearance of ES. Although there is no typical imaging appearance of an osseous lymphoma, it should be considered in an adult presenting with a Lodwick grade II or III lesion in the metaphysis or diaphysis of a large long bone, the pelvis, or the vertebral column. Histologic confirmation is mandatory.
Analytical Assessment of the New Roche Cobas t 711 Fully Automated Coagulation Analyzer
Authors: Lippi Giuseppe , Salvagno Gian , Gelati Matteo , Poli Giovanni , Giavarina Davide , Favaloro Emmanuel 
Published: January 2019

AbstractThis study aimed to provide a preliminary evaluation of the analytical performance of the new Roche cobas t 711 fully automated coagulation analyzer, which uses both liquid and lyophilized reagent cassettes. The analytical assessment included analysis of imprecision and linearity of prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen on cobas t 711 analyzer. Test results of 120 routine plasma samples were also compared with those obtained using two other coagulation analyzers (Instrumentation Laboratory ACL TOP 700 and Stago STA-R MAX). The accuracy, imprecision, and comparability of manual and automatic lyophilized material resuspension were also evaluated using 200 routine plasma samples. Overall, automatic resuspension was found to be more precise than, and equally accurate as, manual reconstitution, with coefficient of variations (CV%) three- to sixfold lower compared with manual reconstitution. The analytical imprecision was found to be excellent, as attested by total CV% of 0.7% for PT, 1.7 to 1.8% for APTT, and 1.9 to 3.2% for fibrinogen. Linearity was excellent over a clinically significant range of PT, APTT, and fibrinogen values, displaying correlation coefficients comprised between 0.994 and 0.999. Methods comparison studies revealed that results of PT, APTT, and fibrinogen on cobas t 711 are globally aligned with those obtained using identical plasma samples on IL ACL TOP 700 and Stago STA-R MAX, displaying correlation coefficients of 0.97 for PT, 0.81 and 0.88 for APTT, 0.90 and 0.94 for fibrinogen, respectively. In conclusion, the results of this preliminary evaluation demonstrate that PT, APTT, and fibrinogen on cobas t 711 coagulation analyzer displays excellent performance for routine use in clinical laboratories.
Estimation of Intraoperative Stimulation Threshold of the Facial Nerve in Patients Undergoing Microvascular Decompression
Authors: Feroze Rafey A. , McDowell Michael M. , Balzer Jeffrey , Crammond Donald J. , Thirumala Partha , Sekula Raymond F. 
Published: January 2019

Introduction Facial weakness can result from surgical manipulation of the facial nerve. Intraoperative neuromonitoring reduces functional impairment but no clear guidelines exist regarding interpretation of intraoperative electrophysiological results. Most studies describe subjects with facial nerves encumbered by tumors or those with various grades of facial nerve weakness. We sought to obtain the neurophysiological parameters and stimulation threshold following intraoperative facial nerve triggered electromyography (t-EMG) stimulation during microvascular decompression for trigeminal neuralgia to characterize the response of normal facial nerves via t-EMG.
Methods Facial nerve t-EMG stimulation was performed in seven patients undergoing microvascular decompression for trigeminal neuralgia. Using constant current stimulation, single stimulation pulses of 0.025 to 0.2 mA intensity were applied to the proximal facial nerve. Compound muscle action potentials, duration to onset, and termination of t-EMG responses were recorded for the orbicularis oculi and mentalis muscles. Patients were evaluated for facial weakness following the surgical procedure.
Results Quantifiable t-EMG responses were generated in response to all tested stimulation currents of 0.025, 0.05, 0.1, and 0.2 mA in both muscles, indicating effective nerve conduction. No patients developed facial weakness postoperatively.
Conclusions The presence of t-EMG amplitudes in response to 0.025 mA suggests that facial nerve conduction can take place at lower stimulation intensities than previously reported in patients with tumor burden. Proximal facial nerve stimulation that yields responses with thresholds less than 0.05 mA may be a preferred reference baseline for surgical procedures within the cerebellopontine angle to prevent iatrogenic injury.
Evaluation of Carotid Artery Stenting with Distal Filter Protection Device
Authors: Banode Pankaj , Kharche Ashutosh 
Published: January 2019

Abstract
Objectives To assess the use of proximal protection devices in consecutive patients as the preferred means of cerebral embolic protection for primary carotid stenting.
Methods and Results This was a prospective single-center study to evaluate the technical and clinical success of proximal protection devices as the first choice for embolic protection in symptomatic (≥ 50%) and asymptomatic (≥ 70%) carotid stenosis. Proximal protection devices were used for embolic protection in 115 consecutive patients. No patients were excluded for anatomical reasons. The filter used was of diameters 6 mm in all cases (Emboshield NAV filter device, Abbotts Healthcare Pvt. Ltd. [Lake Bluff, Il]). In all cases, self-expanding closed-cell designed stent was used (X-act closed-cell self-expanding nitinol carotid-tapered stent, Abbotts Healthcare Pvt. Ltd.). Plaque characterization was done by using real-time high-resolution ultrasound (HR USG) equipment (Aloka Prosound Alpha 7 [Chiyoda, Tokyo, Japan]) using high-frequency linear transducers (> 7 MHz). Follow-up duration was 30 days. Mean age was 61.9 ± 8.27 years. There was male predominance observed in study accounting for 73 out of total 115 studied population. Fifty-six of 115 (48.89%) treated stenoses were symptomatic. Technical success was achieved in 115 of 115 (100%) cases. In both the cases, additional distal filter devices were used. Carotid stenting was successful in 115 (100%) lesions. This study observed higher number of debris in symptomatic and high-risk plaques. This study also observed higher sensitivity, specificity, and accuracy of updated classification for assessing risk of microembolism (captured debris) (sensitivity 73.91%, specificity 95.65%, positive predictive value [PPV] 91.89%, negative predictive value [NPV] 84.62%, accuracy 86.95%). In our study, minor stroke was seen in three (2.61%) patients within 48 hours, and no adverse events were seen within 48 hours to 1 month.
Conclusion Proximal protection is a safe method as the first choice for embolic protection. It can be used with a high rate of technical success.
Utility of Non-EPI DWI MRI in the Management of Pediatric Cholesteatoma
Authors: T.M Sreenivasa Murthy , Nagadi Anita , Mohan Sneha Krishna 
Published: January 2019

Abstract
Introduction Cholesteatoma in children can be acquired or congenital and is generally extensive. The most commonly used technique for the removal of cholesteatoma is intact canal wall mastoidectomy. This invariably leads to second-look surgery to assess for recurrence or residual cholesteatoma. Magnetic resonance imaging (MRI) with non–echo-planar imaging (non-EPI) diffusion-weighted imaging (DWI) is an accurate noninvasive imaging option that can be used in diagnosing primary cholesteatoma. This can also be used to diagnose residual or recurrent cholesteatoma in patients who have undergone intact canal wall mastoidectomy.
Case Report A 7-year-old male patient presented with a 1-week history of foul-smelling discharge from the right ear. On examination, a polypoidal mass with keratinized debris was seen. A diagnosis of cholesteatoma of right ear was made. Imaging with high-resolution computed tomography (HRCT) of the temporal bone and non-EPI DWI MRI confirmed the same. The child underwent an intact canal wall mastoidectomy and was followed up at 2 years with non-EPI DWI MRI to monitor any residual or recurrent cholesteatoma.
Conclusion Non-EPI DWI MRI provides a convenient, accurate, and noninvasive method of evaluating and monitoring for residual or recurrent cholesteatoma and thus helps avoid unnecessary second-look surgery.
1H Quantitative NMR analyses of β-asarone and related compounds for quality control of Acorus rhizome herbal drugs in terms of the effects of their constituents on in vitro acetylcholine esterase activity
Authors: Lynn Nwe Haymar , Linn Thein Zaw , Yanmei Cui , Shimozu Yuuki , Taniguchi Shoko , Hatano Tsutomu 
Published: January 2019

ABSTRACT
We used quantitative nuclear magnetic resonance analyses to measure the contents of major constituents of Acorus rhizome materials used as herbal drugs. The inhibitory effects of crude n-hexane extracts and their individual constituents on in vitro acetylcholine esterase activity were evaluated. The crude extracts had unexpectedly weak inhibitory effects (46–64% inhibition at 1.0 mg/mL), despite the high content (46–64%) of β-asarone, which independently had a potent effect (IC50 2.9 µM [0.61 µg/mL]). Further investigation revealed participation of eudesmin A, a lignan constituent, in the suppression of the inhibitory effect of β-asarone.
An experimental strategy unveiling exosomal microRNAs 486‐5p, 181a‐5p and 30d‐5p from hypoxic tumour cells as circulating indicators of high‐risk rectal cancer
Authors: Bjørnetrø Tonje , Redalen Kathrine Røe , Meltzer Sebastian , Thusyanthan Nirujah Sivarajah , Samiappan Rampradeep , Jegerschöld Caroline , Handeland Karianne Risberg , Ree Anne Hansen 
Published: January 2019

ABSTRACTTumour hypoxia contributes to poor treatment outcome in locally advanced rectal cancer (LARC) and circulating extracellular vesicles (EVs) as potential biomarkers of tumour hypoxia and adverse prognosis have not been fully explored. We examined EV miRNAs from hypoxic colorectal cancer cell lines as template for relevant miRNAs in LARC patients participating in a prospective biomarker study (NCT01816607). Five cell lines were cultured under normoxia (21% O2) or hypoxia (0.2% O2) for 24 h, and exosomes were isolated by differential ultracentrifugation. Using a commercial kit, exosomes were precipitated from 24 patient plasma samples collected at the time of diagnosis. Exosome size distribution and protein cargo were determined by cryo‐electron microscopy, nanoparticle tracking analysis, immunoblotting and flow cytometry. The vesicles harboured strong cell line‐specific miRNA profiles with 35 unique miRNAs differentially expressed between hypoxic and normoxic cells. Six of these miRNAs were considered candidate‐circulating markers of tumour hypoxia in the patients based on the frequency or magnitude of variance in hypoxic versus normoxic cell line experiments and prevalence in patient plasma. Of these, low plasma levels of exosomal miR‐486‐5p and miR‐181a‐5p were associated with organ‐invasive primary tumour (p = 0.029) and lymph node metastases (p = 0.024), respectively, both attributes of adverse LARC prognosis. In line with this, the plasma level of exosomal miR‐30d‐5p was elevated in patients who experienced metastatic progression (p = 0.036). Our strategy confirmed that EVs from colorectal cancer cell lines were exosomes containing the oxygen‐sensitive miRNAs 486‐5p, 181a‐5p and 30d‐5p, which were retrieved as circulating markers of high‐risk LARC.
The transport and surface reactivity of O atoms during the atmospheric plasma etching of hydrogenated amorphous carbon films
Authors: Mokhtar Hefny Mohamed , Nečas David , Zajíčková Lenka , Benedikt Jan 
Published: January 2019

Abstract
A remote microscale atmospheric pressure plasma jet with a He/O2 gas mixture is used to etch a hydrogenated amorphous carbon layer. The etched profiles are measured by means of imaging spectroscopic reflectometry, a powerful technique providing a 2D map of the film thickness (etched profile) and also film properties. Additionally, the 2D axially symmetric fluid model of the gas flow and species transport combined with the basic kinetic model of the reaction of O atoms with O2 molecules has been solved to study the transport and surface reactivity of O atoms. The model provides a spatially resolved and surface-integrated O atom loss rate at the surface. The situation with convection-dominated species transport and fast recombination reactions of O atoms in the volume leads to a strong dependence of the etched profile on the O2 admixture and O atom surface loss probability β. By comparing etched profiles with the simulation results, the O atom surface reaction probability of β = 0.2%–0.6% could be estimated. The modeled O atom loss rate at the surface was always higher and with the same trend as the etching rate, corroborating that O atoms are the main etching species. The presented data and simulation results show that the fastest surface-integrated etching rate is achieved not under conditions with the highest O density on the jet axis, but at lower O2 admixtures due to reduced recombination losses in the gas phase.
Safety and Efficacy of C-reactive Protein–guided Antibiotic Use to Treat Acute Respiratory Infections in Tanzanian Children: A Planned Subgroup Analysis of a Randomized Controlled Noninferiority Trial Evaluating a Novel Electronic Clinical Decision Algorithm (ePOCT)
Authors: Keitel Kristina , Samaka Josephine , Masimba John , Temba Hosiana , Said Zamzam , Kagoro Frank , Mlaganile Tarsis , Sangu Willy , Genton Blaise , D’Acremont Valerie 
Published: January 2019

AbstractBackgroundThe safety and efficacy of using C-reactive protein (CRP) to decide on antibiotic prescription among febrile children at risk of pneumonia has not been tested.MethodsThis was a randomized (1:1) controlled noninferiority trial in 9 primary care centers in Tanzania (substudy of the ePOCT trial evaluating a novel electronic decision algorithm). Children aged 2–59 months with fever and cough and without life-threatening conditions received an antibiotic based on a CRP-informed strategy (combination of CRP ≥80 mg/L plus age/temperature-corrected tachypnea and/or chest indrawing) or current World Health Organization standard (respiratory rate ≥50 breaths/minute). The primary outcome was clinical failure by day (D) 7; the secondary outcomes were antibiotic prescription at D0, secondary hospitalization, or death by D30.ResultsA total of 1726 children were included (intervention: 868, control: 858; 0.7% lost to follow-up). The proportion of clinical failure by D7 was 2.9% (25/865) in the intervention arm vs 4.8% (41/854) in the control arm (risk difference, –1.9% [95% confidence interval {CI}, –3.7% to –.1%]; risk ratio [RR], 0.60 [95% CI, .37–.98]). Twenty of 865 (2.3%) children in the intervention arm vs 345 of 854 (40.4%) in the control arm received antibiotics at D0 (RR, 0.06 [95% CI, .04–.09]). There were fewer secondary hospitalizations and deaths in the CRP arm: 0.5% (4/865) vs 1.5% (13/854) (RR, 0.30 [95% CI, .10–.93]).ConclusionsCRP testing using a cutoff of ≥80 mg/L, integrated into an electronic decision algorithm, was able to improve clinical outcome in children with respiratory infections while substantially reducing antibiotic prescription.Clinical Trials RegistrationNCT02225769.
Effect of Early Oseltamivir Treatment on Mortality in Critically Ill Patients With Different Types of Influenza: A Multiseason Cohort Study
Authors: Lytras Theodore , Mouratidou Elisavet , Andreopoulou Anastasia , Bonovas Stefanos , Tsiodras Sotirios 
Published: January 2019

AbstractBackgroundThe available evidence on whether neuraminidase inhibitors reduce mortality in patients with influenza is inconclusive and focuses solely on influenza A/H1N1pdm09. We assessed whether early oseltamivir treatment (≤48 hours from symptom onset) decreases mortality compared to late treatment in a large cohort of critically ill patients with influenza of all types.MethodsThe study included all adults with laboratory-confirmed influenza hospitalized in intensive care units (ICUs) in Greece over 8 seasons (2010–2011 to 2017–2018) and treated with oseltamivir. The association of early oseltamivir with mortality was assessed with log-binomial models and a competing risks analysis estimating cause-specific and subdistribution hazards for death and discharge. Effect estimates were stratified by influenza type and adjusted for multiple covariates.ResultsA total of 1330 patients were studied, of whom 622 (46.8%) died in the ICU. Among patients with influenza A/H3N2, early treatment was associated with significantly lower mortality (relative risk, 0.69 [95% credible interval {CrI}, .49–.94]; subdistribution hazard ratio, 0.58 [95% CrI, .37–.88]). This effect was purely due to an increased cause-specific hazard for discharge, whereas the cause-specific hazard for death was not increased. Among survivors, the median length of ICU stay was shorter with early treatment by 1.8 days (95% CrI, .5–3.5 days). No effect on mortality was observed for A/H1N1 and influenza B patients.ConclusionsSeverely ill patients with suspected influenza should be promptly treated with oseltamivir, particularly when A/H3N2 is circulating. The efficacy of oseltamivir should not be assumed to be equal against all types of influenza.
Competent demand pull and technological flows within sectoral systems: the evidence on differences within Europe
Authors: Antonelli Cristiano , Gehringer Agnieszka 
Published: January 2019

Abstract
The paper implements the competent demand-pull hypothesis that grafts the advances of the economics of knowledge on the Kaldor–Schmookler demand-pull approach. Demand-pulling effects occur only if the increase of derived demand for both capital and intermediary inputs is accompanied by knowledge interactions carried by market transactions. The competent demand-pull hypothesis rejuvenates the standard demand-pull approach through the focus on the sectoral architecture of market-embedded inter-sectoral knowledge linkages between competent users and innovative producers. We measure such market-embedded and competent influence with the derived demand for intermediates—taken from input–output tables—accounting for productivity increases downstream. The empirical evidence from dynamic panel estimations for the European Union (EU) over the period 1995–2007 suggests the presence of strong and positive competent demand impulses, but the effects vary between three EU sectoral systems, the EU core, the East and the South.
A Kaldor–Schumpeter model of cumulative growth
Authors: Romero João P 
Published: January 2019

AbstractTaking into account the relevance of the Kaldorian and the Schumpeterian contributions to macroeconomic growth theory, this paper proposes a growth model that combines the insights of these two traditions while solving some of the most important limitations of the original Kaldor–Dixon–Thirlwall model. This model takes into account the main factors emphasised by the Kaldorian and the Schumpeterian literatures, while keeping the importance of both demand- and supply-side factors for economic growth. The model shows that higher research intensity can generate higher equilibrium growth, stressing the possibility that an increase in the growth rate of foreign output can exert a negative impact on the domestic economy, provided that the negative effect of higher foreign non-price competitiveness is larger than the positive demand effect. The proposed Kaldor–Schumpeter growth model was also transposed to a multi-sectoral setting that indicates that changes in the performance of a given sector affect the performance of the other sectors through inter-sector demand externalities by easing the balance-of-payment constraint.
Coronary vascular function in patients with resistant hypertension and normal myocardial perfusion: a propensity score analysis
Authors: Gaudieri Valeria , Acampa Wanda , Rozza Francesco , Nappi Carmela , Zampella Emilia , Assante Roberta , Mannarino Teresa , Mainolfi Ciro , Petretta Mario , Verberne Hein J , Arumugam Parthiban , Cuocolo Alberto 
Published: January 2019

AbstractAimsImpaired myocardial perfusion reserve (MPR) may occur earlier than coronary atherosclerosis and it may be an early manifestation of developing coronary artery disease (CAD) in patients with resistant hypertension (RH). We evaluated the relationship between RH and MPR in patients with systemic arterial hypertension after balancing for coronary risk factors.Methods and resultsWe studied 360 subjects without overt CAD and normal myocardial perfusion at stress-rest 82Rb positron emission tomography/computed tomography. To account for differences in baseline characteristics between patients with resistant and controlled hypertension, we created a propensity score-matched cohort considering clinical variables and coronary risk factors. Before matching, patients with RH were significantly older, had higher prevalence of male gender and hypercholesterolaemia, and showed significantly lower global hyperaemic myocardial blood flow (MBF) and MPR compared with those with controlled hypertension, while baseline MBF and coronary artery calcium (CAC) content were similar in both groups. After matching, there were no significant differences in clinical variables and coronary risk factors between patients with resistant and controlled hypertension, but patients with RH still had lower hyperaemic MBF and MPR (both P < 0.001). At univariable and multivariable linear regression analyses, age, RH, and CAC resulted significant predictors of lower MPR values (all P < 0.05).ConclusionAfter balancing clinical characteristic by propensity score analysis, patients with RH had a blunted hyperaemic MBF and MPR compared with patients with controlled hypertension. The identification of impaired MPR could help to identify early structural alterations of the arterial walls in patients with RH.