bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ad4BP/SF-1 regulates cholesterol synthesis to boost the production of steroids
Authors: Baba Takashi , Otake Hiroyuki , Inoue Miki , Sato Tetsuya , Ishihara Yasuhiro , Moon Ju-Yeon , Tsuchiya Megumi , Miyabayashi Kanako , Ogawa Hidesato , Shima Yuichi , Wang Lixiang , Sato Ryuichiro , Yamazaki Takeshi , Suyama Mikita , Nomura Masatoshi , Choi Man Ho , Ohkawa Yasuyuki , Morohashi Ken-ichirou 
Published: March 2018

AbstractHousekeeping metabolic pathways such as glycolysis are active in all cell types. In addition, many types of cells are equipped with cell-specific metabolic pathways. To properly perform their functions, housekeeping and cell-specific metabolic pathways must function cooperatively. However, the regulatory mechanisms that couple metabolic pathways remain largely unknown. Recently, we showed that the steroidogenic cell-specific nuclear receptor Ad4BP/SF-1, which regulates steroidogenic genes, also regulates housekeeping glycolytic genes. Here, we identify cholesterogenic genes as the targets of Ad4BP/SF-1. Further, we reveal that Ad4BP/SF-1 regulates Hummr, a candidate mediator of cholesterol transport from endoplasmic reticula to mitochondria. Given that cholesterol is the starting material for steroidogenesis and is synthesized from acetyl-CoA, which partly originates from glucose, our results suggest that multiple biological processes involved in synthesizing steroid hormones are governed by Ad4BP/SF-1. To our knowledge, this study provides the first example where housekeeping and cell-specific metabolism are coordinated at the transcriptional level.
Study on the lightning strike discharge characteristics of switchgear air gap at low air pressure condition
Authors: Zhang Zhijin , Wei Donghong , Zhang Dongdong , Zhu Junyu , Li Chen 
Published: March 2018

The usage of medium‐voltage switchgear is more and more common in high altitude areas. Few relative standards about the selection of switchgear air gap in low air pressure conditions are currently available for referring. In this study, four different types of switchgear air gaps, as well as a typical rod‐plane gap, are taken as the samples, and their positive and negative lightning strike discharge characteristics under low air pressure are tested in the artificial climate chamber. The effects of the electrode structure, polarity, air pressure, humidity, and gap distance on the discharge performances are analysed as well. Research results indicate that the four switchgear air gaps and typical rod‐plane gap differs greatly in lightning impulse discharge performances and polarity effects. In low air pressure conditions, the lightning impulse breakdown voltage of either positive or negative polarity can be corrected by U50 = U50,0 × (P/P0)n. The discharge voltage under positive lightning impulse is more easily affected by air pressure than that under negative lightning impulse. Atmosphere humidity will cause dispersiveness of air‐gap lightning impulse discharge voltage, which performs to be non‐linear with a gap distance lower under 400 mm. Research results are referable for the design, selection and installation of medium‐voltage switchgear in high altitude areas.
Experimental analyses and clustering of travel choice behaviours by floating car big data in a large urban area
Authors: Fusco Gaetano , Bracci Agnese , Caligiuri Tommaso , Colombaroni Chiara , Isaenko Natalia 
Published: March 2018

This study introduces a general methodology to process sparse floating car data, reconstruct the routes followed by the drivers, and cluster them to achieve suitable choice sets of significantly different routes for calibrating behavioural models. This methodology is applied to a large set of floating car data collected in Rome in 2010. Results underlined that routes assigned to different clusters are actually very different to each other. Nevertheless, as expected according to Wardrop's principle, the clusters belonging to the same origin–destination have rather similar average route travel times, even if there is a large range between their minimum and maximum values. A focus on drivers’ behaviour highlighted their propensity to follow the same route to their usual destination, though the 12% of the drivers switched to an alternative route. However, the analysis conducted over the 1 month of observations did not reveal the existence of any systematic correlation between neither the change of route nor the change of departure time and the travel time experienced the day before.
Quantitative and Qualitative Assessment of Pulmonary Emphysema with T2-Weighted PROPELLER MRI in a High-Risk Population Compared to Low-Dose CT
Authors: Meier-Schroers Michael , Sprinkart Alois , Becker Manuel , Homsi Rami , Thomas Daniel 
Published: March 2018

Purpose To determine the suitability of T2-weighted PROPELLER MRI for the assessment of pulmonary emphysema.
Materials and Methods 60 participants in a lung cancer screening program (30 subjects with pulmonary emphysema, and 30 control subjects without emphysema) were included for this retrospective study. All subjects were examined with low-dose CT (LDCT) and MRI within the screening program. The use of a T2-weighted PROPELLER sequence for the assessment of emphysema was analyzed and correlated with the results of LDCT. The presence and the extent of pulmonary emphysema were first assessed qualitatively using a three-point score, and then quantitatively with a semi-automated software program to obtain emphysema indices.
Results All 30 cases with pulmonary emphysema were accurately detected by MRI. There were 3 cases with emphysema according to MRI without emphysematous changes on LDCT (false-positive results). The qualitative scores as well as the emphysema indices were significantly higher in the emphysema group compared to the control group for MRI and LDCT (p < 0.001). Both the scores and the indices correlated significantly between MRI and LDCT (qualitative score of severity: r = 0.912/p < 0.001 in the emphysema group and r = 0.668/p < 0.001 in the control group; emphysema index: r = 0.960/p < 0.001 in the emphysema group and r = 0.746/p < 0.001 in the control group).
Conclusion The presence and the extent of pulmonary emphysema may be assessed qualitatively and quantitatively by T2-weighted PROPELLER MRI with very good correlation to LDCT.
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Claisen Rearrangements of Benzyl Vinyl Ethers and Heterobenzyl Vinyl Ethers
Authors: McGeary Ross , Burns Jed , Krenske Elizabeth 
Published: March 2018

The Claisen rearrangement of benzylic substrates (benzyl vinyl­ ethers) has received considerably less attention than its well-known aliphatic and normal aromatic variants. Here, we review the rearrangement of both benzylic and heterobenzylic substrates, with examples of the reaction’s use in the synthesis of natural products and drug-like molecules.1	Introduction2	Early Attempts at the Benzyl-Claisen Rearrangement3	Successful Benzylic Examples4	Heterobenzylic Examples5	Conclusion
Unicompartmental Knee Arthroplasty: The Past, Current Controversies, and Future Perspectives
Authors: Johal Sim , Nakano Naoki , Baxter Mark , Hujazi Ihab , Pandit Hemant , Khanduja Vikas 
Published: March 2018

AbstractUnicompartmental knee arthroplasty (UKA) is a bone conserving and ligament-sparing procedure that reliably restores normal knee kinematics and function for arthritis limited either to the medial or the lateral compartment of the knee. Although there is enough evidence to demonstrate that the UKA offers good medium to long-term success given the correct patient selection, prosthesis design, and implantation technique, there are several reports to suggest inferior survival rates in comparison with the total knee arthroplasty (TKA). Furthermore, it is a specialized procedure which works well in the hands of the experienced operator and therefore different authors' tend to draw different conclusions based on the same evidence, and as a result, there is great variability in the usage of the UKA. The aim of this current concept's review is to present to the readers the history of the UKA especially with reference to implant design, discuss current controversies, and outline the future perspectives of this novel procedure.
The Reliability of Electronic Health Record Data Used for Obstetrical Research
Authors: Altman Molly , Colorafi Karen , Daratha Kenn 
Published: March 2018

Background Hospital electronic health record (EHR) data are increasingly being called upon for research purposes, yet only recently has it been tested to examine its reliability. Studies that have examined reliability of EHR data for research purposes have varied widely in methods used and field of inquiry, with little reporting of the reliability of perinatal and obstetric variables in the current literature.
Objective To assess the reliability of data extracted from a commercially available inpatient EHR as compared with manually abstracted data for common attributes used in obstetrical research.
Methods Data extracted through automated EHR reports for 3,250 women who delivered a live infant at a large hospital in the Pacific Northwest were compared with manual chart abstraction for the following perinatal measures: delivery method, labor induction, labor augmentation, cervical ripening, vertex presentation, and postpartum hemorrhage.
Results Almost perfect agreement was observed for all four modes of delivery (vacuum assisted: kappa = 0.92; 95% confidence interval [CI] = 0.88–0.95, forceps assisted: kappa = 0.90; 95%CI = 0.76–1.00, cesarean delivery: kappa = 0.91; 95%CI = 0.90–0.93, and spontaneous vaginal delivery: kappa = 0.91; 95%CI = 0.90–0.93). Cervical ripening demonstrated substantial agreement (kappa = 0.77; 95%CI = 0.73–0.80); labor induction (kappa = 0.65; 95%CI = 0.62–0.68) and augmentation (kappa = 0.54; 95%CI = 0.49–0.58) demonstrated moderate agreement between the two data sources. Vertex presentation (kappa = 0.35; 95%CI = 0.31–0.40) and post-partum hemorrhage (kappa = 0.21; 95%CI = 0.13–0.28) demonstrated fair agreement.
Conclusion Our study demonstrates variability in the reliability of obstetrical data collected and reported through the EHR. While delivery method was satisfactorily reliable in our sample, other examined perinatal measures were less so when compared with manual chart abstraction. The use of multiple modalities for assessing reliability presents a more consistent and rigorous approach for assessing reliability of data from EHR systems and underscores the importance of requiring validation of automated EHR data for research purposes.
The Value of Monitoring Clinical Decision Support Interventions
Authors: Yoshida Eileen , Fei Shirley , Bavuso Karen , Lagor Charles , Maviglia Saverio 
Published: March 2018

Background Well-functioning clinical decision support (CDS) can facilitate provider workflow, improve patient care, promote better outcomes, and reduce costs. However, poorly functioning CDS may lead to alert fatigue, cause providers to ignore important CDS interventions, and increase provider dissatisfaction.
Objective The purpose of this article is to describe one institution's experience in implementing a program to create and maintain properly functioning CDS by systematically monitoring CDS firing rates and patterns.
Methods Four types of CDS monitoring activities were implemented as part of the CDS lifecycle. One type of monitoring occurs prior to releasing active CDS, while the other types occur at different points after CDS activation.
Results Two hundred and forty-eight CDS interventions were monitored over a 2-year period. The rate of detecting a malfunction or significant opportunity for improvement was 37% during preactivation and 18% during immediate postactivation monitoring. Monitoring also informed the process of responding to user feedback about alerts. Finally, an automated alert detection tool identified 128 instances of alert pattern change over the same period. A subset of cases was evaluated by knowledge engineers to identify true and false positives, the results of which were used to optimize the tool's pattern detection algorithms.
Conclusion CDS monitoring can identify malfunctions and/or significant improvement opportunities even after careful design and robust testing. CDS monitoring provides information when responding to user feedback. Ongoing, continuous, and automated monitoring can detect malfunctions in real time, before users report problems. Therefore, CDS monitoring should be part of any systematic program of implementing and maintaining CDS.
Contemporary Perioperative Analgesia in Total Knee Arthroplasty: Multimodal Protocols, Regional Anesthesia, and Peripheral Nerve Blockade
Authors: Neilio Jonathan , Kunze Lisa , Drew Jacob 
Published: March 2018

AbstractPerioperative care of the total knee arthroplasty (TKA) patient has evolved considerably over the past decade. Among the changes driving this evolution toward shorter hospitalization and accelerated rehabilitation have been regional anesthesia, peripheral nerve blockade, and multimodal analgesia protocols. These complementary techniques are increasingly supported by scientific evidence, though considerable uncertainty persists regarding the optimal combination of strategies. Continued refinement of technique and critical evaluation is trending toward greater characterization of the comparative effectiveness of myriad options. Contemporary interdisciplinary arthroplasty care teams have the opportunity to individualize the TKA patient's perioperative pain control to optimize not only the clinical outcome but also patient satisfaction.
Patient-Specific Instrument Can Improve Functional and Radiographic Results during Learning Curve for Oxford Unicompartmental Knee Arthroplasty
Authors: Matas-Diez Jose , Carbo-Laso Esther , Perez-Mañanes Ruben , Vaquero-Martín Javier , Sanz-Ruiz Pablo 
Published: March 2018

AbstractThe true value of use of patient-specific instrumentation (PSI) systems by inexperienced surgeons during their learning curve to improve the clinical and radiographic outcome of unicompartmental knee arthroplasty (UKA) has not been previously studied. Fifty patients with a mean age of 64.3 years undergoing surgery for Oxford UKA were prospectively divided into two groups. Twenty-five patients were operated on by a surgeon with no prior experience in UKA using a PSI system and the other 25 patients by an experienced surgeon using a conventional procedure. Patients were scored using joint range of motion (ROM), the Knee Society Score (KSS), the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the 12-item Short-Form (SF-12) before and 3 months and 2 years after surgery. Impact of use of PSI was measured by comparing clinical and radiographic outcome, complications, and implant survival. No evidence of poorer clinical outcome was seen in any subscale of KSS, KOOS, and SF-12 for inexperienced surgeons using PSI (p = 0.45, p = 0.32, and p = 0.61, respectively). No difference was found between the two procedures in precision of radiographic alignment of components (p = 0.53). No complication occurred in any group. PSI may improve precision of component alignment during the learning curve of surgeons, thus achieving functional results similar to those of more experienced surgeons using a conventional procedure.
Factors Affecting Subjective and Objective Outcomes and Return to Play in Anterior Cruciate Ligament Reconstruction: A Retrospective Cohort Study
Authors: Rosso Federica , Bonasia Davide , Cottino Umberto , Cambursano Simone , Dettoni Federico , Rossi Roberto 
Published: March 2018

Purpose To analyze the prognostic factors influencing subjective and objective outcomes and return to play (RTP) after anterior cruciate ligament reconstruction (ACL-R).
Methods Primary ACL-Rs using a transtibial technique performed between 2008 and 2012 were included. Data regarding patients, surgery, sports, and rehabilitation, including an on-field rehabilitation (OFR) and duration of the rehabilitation program, were collected. The International Knee Documentation Committee (IKDC) subjective and objective evaluation forms, and the Knee Injury and Osteoarthritis Outcome Score and Lysholm questionnaires were used for the assessment of subjective and objective outcomes. The Subjective Patient Outcome for Return to Sports and ACL–return to sport after injury (RSI) scores were used for RTP evaluation. Several potential predictors of outcome were tested with a univariate analysis. All the variables with p < 0.1 were retested in a logistic regression model to evaluate their association with the outcomes.
Results In total, 176 cases were included with an average follow-up of 44.1 months. Of the patients, 92.2% were rated as normal or nearly normal at the IKDC evaluation. In addition, 90.1% of the patients returned to sport, with 57.6% returning to the same preinjury level. Objective outcomes were negatively influenced by late rehabilitation (odds ratio [OR] = 2.75). Performing an OFR phase during the rehabilitation was associated with better subjective outcomes (OR = 2.71). Length of rehabilitation strongly influenced the RTP rate (OR = 13.16). Conversely, higher ACL-RSI score was inversely related to RTP. Objective IKDC score was inversely related to the ACL-RSI (OR = 0.31), whereas subjective score was correlated with both the total ACL-RSI score (OR = 0.15) and the level of activity (OR = 0.20).
Conclusion This study confirmed the role of rehabilitation on subjective and objective outcomes and on RTP. Particularly, the complete adherence to a rehabilitation program, including an OFR phase, resulted in better subjective outcomes and higher RTP rate. The relationship between psychological factors, measured through the ACL-RSI score, and RTP was confirmed.
Level of Evidence Level III, observational study without a control group.
Local Experience in using Hormonal Therapies according to the UKISS Studies in the Treatment of Infantile Spasms in Hong Kong
Authors: Mo Chung Yin , Yuen Chi Lap 
Published: March 2018

AbstractInfantile spasms constitute severe epileptic encephalopathy in infancy with characteristic seizure semiology and electroencephalographic patterns. Besides the spasms, the most detrimental effect is the impact on future developmental outcomes. Different treatment methods are used, but hormonal therapy is the most well-accepted method for treating infantile spasms in nontuberous sclerosis cases. After the launch of the original United Kingdom Infantile Spasms Study (UKISS) and the two follow-up articles, the regimens of hormonal therapy became more structured and the expected treatment outcomes were studied better. We would like to share our local experience using this protocol to treat patients with infantile spasms in Hong Kong with a case series of four patients.
Surgical Treatment of Objective Patellar Instability: Long-Term Results
Authors: Berruto Massimo , Uboldi Francesco , Ferrua Paolo , Vergottini Giovanni , Manunta Andrea 
Published: March 2018

Purpose To evaluate the long-term results of classical “à la carte” surgical treatment of objective patellar instability as proposed by Dejour in 1987.
Methods A multicentric retrospective study was conducted evaluating patients that underwent surgical procedure with a 10-year minimum follow-up (mean 12.7; range, 10–15). Surgical procedures were medial transfer of the tibial tubercle transfer according to Elmslie and Trillat et al in 38 cases, plasty of the vastus medialis obliquus according to Insall in 15 cases, open lateral retinacular release in 13 cases, capsuloplasty in 3 cases, and trochleoplasty in 1 case. Different combinations of surgical procedures were adopted according to the pathological features. Subjective outcome was assessed with the visual analog scale (VAS), Kujala score, subjective International Knee Documentation Committee (IKDC) score, Tegner score, and Crosby and Insall scale. Radiographic exams were used to assess the patellar tilt by the Laurin's angle and patellofemoral osteoarthritis (OA) according to the Iwano radiological OA scale.
Results Forty patients were evaluated. Subjectively, 60% of patients achieved a result judged good, 34% sufficient, and 6% poor. There were only two cases of recurrence of instability. Mean score results were Kujala score 73.4 ± 9.9 (range, 55–95), VAS 4.5 ± 1.2 (range, 1–6), IKDC 64.8 ± 7.9 (range, 51–88), and Tegner score 4. Only nine patients returned to sports activities). Ten patients developed a grade I patellofemoral OA, 8 patients a grade II, and 22 patients a grade III. Average patellar tilt was 10° ±  3.9°.
Conclusion This retrospective study showed that the traditional surgical procedure was successful for the treatment of patellar instability, but it did not prevent symptomatic patellofemoral OA.
Level of Evidence Level IV, retrospective case series.
EUS-guided gastroenterostomy in management of benign gastric outlet obstruction
Authors: Chen Yen-I , James Theodore , Agarwal Amol , Baron Todd , Itoi Takao , Kunda Rastislav , Nieto Jose , Bukhari Majidah , Gutierrez Olaya , Sanaei Omid , Moran Robert , Fayad Lea , Khashab Mouen 
Published: March 2018

Abstract
Background and study aims Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) in malignant gastric outlet obstruction (GOO) appears to be promising; however, its role in benign GOO is unclear. The aim of this study was to ascertain the clinical efficacy and safety of EUS-GE in benign GOO.
Patients and methods This was an international retrospective series involving 5 tertiary centers. Consecutive patients who underwent EUS-GE between 1/2013 – 10/2016 for benign GOO were included. The primary endpoint was the rate of clinical success defined as ability to tolerate oral intake without vomiting. Secondary endpoints included technical success and rate of adverse events (AE).
Results Overall, 26 patients (46.2 % female; mean age 57.7 ± 13.9 years) underwent EUS-GE for benign GOO due to strictures from chronic pancreatitis (n = 11), surgical anastomosis (n = 6), peptic ulcer disease (n = 5), acute pancreatitis (n = 1), superior mesentery artery syndrome (n = 1), caustic injury (n = 1), and hematoma (n = 1). Technical success was achieved in 96.2 %. Dilation of the lumen apposing metal stent was performed in 13/25 (52 %) with a mean maximum diameter of 14.6 ± 1.0 mm. Mean procedure time was 44.6 ± 26.1 min. Clinical success was observed in 84.0 % with a mean time to oral intake of 1.4 ± 1.9 days and a median follow-up of 176.5 (IQR: 47 – 445.75) days. Rate of unplanned re-intervention was 4.8 %. 3 AE were noted including 2 misdeployed stents and 1 gastric leak needing surgical intervention following elective GE stent removal.
Conclusions EUS-GE is a promising treatment for benign GOO. Larger and prospective data are needed to further validate this novel endoscopic technique in treating benign GOO of various etiologies.