bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysing the Investigation and Prosecution of Cryptocurrency Crime as Provided for by the South African Cybercrimes Bill
Authors: Reddy Eveshnie 
Published: January 2019

Abstract
The purpose of this article is to determine the effectiveness of the Cybercrimes Bill of 2018 in investigating and prosecuting cryptocurrency crime. The method used to determine this enquiry is based on the analysis of certain criminal, procedural, and investigatory support provisions of the bill, accompanied by recommendations where necessary. An analysis of the Cybercrimes Bill of 2018 in its entirety falls outside the scope of this article. The significance of this enquiry rests on the increasing use of cryptocurrencies in criminal activity (including money laundering, investment scams, fraud, hacking, and cyber extortion). The investigation and prosecution of such criminal activity may be exacerbated by the unique characteristics inherent in a cryptocurrency; a cryptocurrency is an unregulated, online, encrypted (and thus pseudonymous) ‘currency’ denominated in its own units of value. Cryptocurrencies are thus an international online ‘currency’ with multijurisdictional presence. Any criminal activity associated with its use will therefore invariably possess a cyber-element. Such criminal activity will thus need to be addressed from a legal basis that caters for the criminal and procedural processes necessary in the investigation and subsequent prosecution of such crime.
A Neurologic Examination for Anesthesiologists
Authors: Reshef Edith R. , Schiff Nicholas D. , Brown Emery N. 
Published: January 2019

Abstract
Anesthetics have profound effects on the brain and central nervous system. Vital signs, along with the electroencephalogram and electroencephalogram-based indices, are commonly used to assess the brain states of patients receiving general anesthesia and sedation. Important information about the patient’s arousal state during general anesthesia can also be obtained through use of the neurologic examination. This article reviews the main components of the neurologic examination focusing primarily on the brainstem examination. It details the components of the brainstem examination that are most relevant for patient management during induction, maintenance, and emergence from general anesthesia. The examination is easy to apply and provides important complementary information about the patient’s arousal level that cannot be discerned from vital signs and electroencephalogram measures.
Microbiology and Antibiotic Resistance in Peripartum Bacteremia
Authors: Wilkie Gianna L. , Prabhu Malavika , Ona Samsiya , Easter Sarah Rae , Tuomala Ruth E. , Riley Laura E. , Diouf Khady 
Published: January 2019

OBJECTIVE:
To examine the microbiology and associated antibiotic resistance patterns among febrile peripartum women with positive blood cultures.

METHODS:
We conducted a retrospective cohort study in which we reviewed all bacteremia cases between 2009 and 2016 that occurred between 7 days before and 30 days after delivery. Institutional guidelines include obtaining blood cultures and promptly initiating intravenous antibiotics for all obstetric patients with fever of 100.4°F or higher. We describe antibiotic resistance patterns for the most frequently isolated organisms and perform univariate analyses regarding maternal and neonatal outcomes based on type of bacteremia.

RESULTS:
Among 56,835 deliveries, 3,797 (6.7%) obstetric patients had blood cultures drawn and 120 (3.2%) had documented bacteremia. The most commonly cultured organisms were Escherichia coli (17.5%, n=21), Bacteroides species (10.8%, n=13), Enterococcus species (10.8%, n=13), group B streptococci (10.8%, n=13), and group A streptococci (5.0%, n=6). E coli had high rates of resistance to ampicillin (n=17, 81.0%) and extended spectrum beta lactams (n=10, 47.6%). Gram-positive bacteremia was noted in 65/120 patients (54.2%), gram-negative bacteremia in 39/120 (32.5%), and anaerobic bacteremia in 16/120 (13.3%) (P=.02). Neonatal bacteremia was identified in 8/120 cases (6.7%), of which 7/8 (87.5%) were attributable to gram-negative bacteria and 1/8 (12.5%) were attributable to gram-positive bacteremia (P=.004). There were no differences in neonatal death or maternal intensive care unit admission.

CONCLUSION:
Peripartum bacteremia is uncommon, with the most frequently isolated organism being E coli. The evolution of antibiotic resistance patterns in E coli at our institution may be of clinical significance in determining antibiotic choice for peripartum fever.
Concordance of Fingerstick and Venipuncture Sampling for Fertility Hormones
Authors: Burke Erin E. , Beqaj Safedin , Douglas Nataki C. , Luo Robert 
Published: January 2019

BACKGROUND:
Minimally invasive fingerstick sampling allows testing of reproductive hormone levels at home, providing women with increased access to tests that can screen for conditions such as polycystic ovarian syndrome, primary ovarian insufficiency, and pituitary and thyroid dysfunction.

METHOD:
We present a measurement procedure comparison study of matched venipuncture and fingerstick samples from 130 women aged 18–40 years, tested on menstrual cycle day 3. Samples were measured for anti-müllerian hormone, estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), testosterone, thyroid-stimulating hormone (TSH), and free thyroxine (T4) levels. Samples were tested using U.S. Food and Drug Administration–cleared immunoassays, with a modified reconstitution step for fingerstick samples.

EXPERIENCE:
Venipuncture and fingerstick hormone values were concordant and linear across all assay ranges. There was no evidence of systematic bias across the assay ranges, and bias measures were below recommended guidelines. The correlation between venipuncture and fingerstick was between 0.99 and 1.0 for each hormone. Each assay displayed a high degree of precision (less than 13% coefficient of variation) and a high level of accuracy (average recovery equaled 95.5–102.3%).

CONCLUSION:
Venipuncture and fingerstick samples can be used interchangeably to measure anti-müllerian hormone, E2, FSH, LH, PRL, testosterone, TSH, and free T4 levels. Fingerstick sampling provides doctors and women more convenient testing options.

FUNDING SOURCE:
The study was sponsored by Modern Fertility.
Effects of Delivery Volume and High-Risk Condition Volume on Maternal Morbidity Among High-Risk Obstetric Patients
Authors: Bozzuto Laura , Passarella Molly , Lorch Scott , Srinivas Sindhu 
Published: January 2019

OBJECTIVE:
To evaluate the effect of obstetric delivery volume, high-risk condition volume, and their combined effect on maternal outcomes.

METHODS:
This retrospective cohort study examined more than 10 million deliveries in three states from 1995 to 2009 using linked birth-hospital discharge records. Surgical high-risk patients had one of three prenatally identifiable conditions; the high-risk medical cohort had 1 or more of 14 complicating diagnoses. Hospitals were divided into quartiles of total obstetric delivery volume and tertiles of high-risk patient volume. The primary outcome was a composite outcome of severe maternal morbidity identified by International Classification of Diseases, 9th Revision, Clinical Modification, codes. Data were controlled for nonindependence using clustering by hospital and results were adjusted for patient and hospital level factors.

RESULTS:
We identified 142,194 high-risk surgical deliveries and 1,322,276 high-risk medical deliveries for evaluation. Among surgical high-risk patients, higher hospital total obstetric delivery volume was associated with 22% decreased risk for maternal morbidity (4th quartile adjusted odds ratio [AOR] 0.78; 95% CI 0.64–0.94); likewise for medical high-risk patients, higher total delivery volume was associated with a 28% decreased risk (4th quartile AOR 0.72; 95% CI 0.59–0.86). Conversely, as the volume of medical high-risk patients at hospitals increased, the AOR for severe morbidity increased (AOR=1.27, 95% CI 1.10–1.48). There was a significant interaction effect of both types of volume on maternal complications for both surgical (likelihood ratio [LR] χ2=18.2, P=.006) and medical high-risk patients (LR χ2=99.4, P<.001).

CONCLUSION:
Patients with high-risk medical and surgical conditions had decreasing adverse maternal outcomes as total obstetric delivery volume increased. There were increased odds of adverse maternal outcomes in centers with high volumes of high-risk patients. These two types of volume had significant combined effect on maternal risk. Both types of volume should be considered in assessing hospital obstetric performance.
Nivolumab to pembrolizumab switch induced a durable melanoma response
Authors: Lepir Tanja , Zaghouani Mehdi , Roche Stéphane P. , Li Ying-Ying , Suarez Miguel , Irias Maria Jose , Savaraj Niramol 
Published: January 2019

Abstract

Rationale:
While checkpoint inhibitors have revolutionized the treatment of melanoma, it is not known whether switching from one monoclonal antibody drug to another one would be justified in the case of a treatment failure. Herein, we report a case illustrating a durable response to pembrolizumab after a failure with nivolumab.

Patient concerns:
A 76-year-old white male noticed an enlarging papular lesion on his neck.

Diagnosis:
Malignant melanoma.

Interventions:
The patient underwent surgery in December 2013 and was found to have a B-Rapidly Accelerated Fibrosarcoma (BRAF) V600E mutated melanoma. Treatment with BRAF and MAPK/Erk kinase (MEK) inhibitors along with radiation was initiated. After 1 year, the disease progressed, and the treatment was switched to the cytotoxic T-lymphocyte antigen 4 (CTLA-4) blocking antibody, ipilimumab. As the tumor did not respond, the treatment was changed to programmed cell death receptor-1 (PD-1) blockers: nivolumab followed by pembrolizumab. Since the initial diagnosis, the tumor response was monitored by computed tomography (CT) scans. Immunohistochemistry (IHC) was also used for the assessment of programmed death ligand 1 PD-L1) expression in the neck, lung, and spleen lesions.

Outcomes:
The patient had an initial mixed response to nivolumab, but the disease ultimately progressed as evidenced by new metastases to the spleen, thus the treatment was switched to pembrolizumab. After 46 cycles of treatment, all sites of metastases disappeared, including a substantial shrinkage of the splenic metastasis. To gain understanding about the pharmacological differences between nivolumab and pembrolizumab, the PD-1–ligands interactions and conformational dynamics responsible for the PD-1/PD-L1 checkpoint blockade were investigated. The higher affinity of pembrolizumab might likely arise from a unique and large patch of interactions engaging the C’D loop of PD-1, thus forcing an important motion across the PD-1 immunoreceptor.

Lessons:
In this case report, we described the tolerance and response of a melanoma patient to a sequence of various agents, including ipilimumab, nivolumab, and pembrolizumab. To the best of our knowledge, this is the first clinical report highlighting differences between PD-1 blockers, as shown by the unexpected and durable response of the tumor to pembrolizumab, after a treatment failure with nivolumab.
Isolated hypothalamic-pituitary langerhans’ cell histiocytosis in female adult
Authors: Tan Huiwen , Yu Kai , Yu Yerong , An Zhengmei , Li Jianwei 
Published: January 2019

Abstract

Rationale:
Langerhans cell histiocytosis (LCH) is characterized by clonal proliferation of immature dendritic cells, mainly affects children. LCH in adult sellar region is extremely rare. In literature, optimal treatments remain unclear and only a few cases of LCH were treated using surgery. Here, we present a rare case of isolated hypothalamic-pituitary LHC in female adult. We focused on elucidating the clinical manifestations and immunohistochemical features of LCH, and exploring the proper treatment in adults.

Patient concerns:
A 50-year-old woman was admitted to our hospital, presenting with polydipsia and polyuria for over 3 months.

Diagnoses:
Radiological studies revealed lesions (0.5 × 0.9 × 0.4 cm) on posterior pituitary and enlarged pituitary stalk, which was moderately enhanced on contrast magnetic resonance imaging (MRI) of sellar region. In biopsy, pathological examination of Langerhans cells were observed with positive S-100 protein and Ki-67 antigen markers, findings were sufficient to establish a diagnosis of central nervous system (CNS) LCH.

Interventions:
The patient with LCH restricted in the sellar region received both surgery and chemotherapy. Gamma knife radiosurgery was performed after diagnosed as central diabetes insipidus (CDI) induced by pituitary lesion. And tumorectomy was performed 5 years later. However, in the latest MRI in 2017, the nodular shadow became larger (about 1.4 cm), chemotherapy and further systemic therapy were given.

Outcomes:
At 12-month follow-up, no local reoccurrence was noticed.

Lessons:
For LCH, though difficult to be diagnosed and none defined standard therapeutic approach to adults, surgery should be considered if there are neurological symptoms or histological diagnosis. The present study showed that some manifestations can be meaningful when central nervous system (CNS) is involved. For complex diseases in the sellar region, multi-disciplinary team (MDT) model of diagnosis and treatment should be helpful for better clinical efficacy.
Foot reconstruction with the superficial circumflex iliac artery perforator flap under local anesthesia
Authors: Hayashida Kenji , Yamakawa Sho , Saijo Hiroto , Fujioka Masaki 
Published: January 2019

Abstract

Rationale:
The superficial circumflex iliac artery perforator (SCIP) free flap is a popular method used in foot reconstruction. Although the SCIP flap has a relatively short pedicle and does not require intramuscular dissection, general anesthesia is largely preferred for SCIP flap reconstruction. We report 2 cases with the free SCIP flap for skin and soft tissue reconstruction of the foot under local anesthesia.

Patient concerns:
Case 1 was a 34-year-old man sustained a crush injury to the dorsal foot, resulting in a soft tissue defect with bone and tendon exposure. Case 2 was a 41-year-old man with type 2 diabetes was referred to our division for an intractable ankle wound after surgery for a calcaneal bone fracture.

Diagnosis:
The diagnosis was intractable wounds on feet caused by trauma and surgery. Patients were unable to receive general anesthesia because of asthma or elevated liver enzymes.

Interventions:
Two patients with tissue defects on their feet were treated with SCIP flaps under local anesthesia. Fifteen milliliter of 0.5% bupivacaine was injected for ankle block. SCIP flaps were harvested after injecting 10 to 15 mL of 1% lidocaine combined with epinephrine around the flap incisions.

Outcomes:
No complications related to the use of local anesthesia developed during the operation or postoperatively. Two flaps survived and fully took without complications.

Lessons:
With proper local anesthesia, successful foot reconstruction with a free SCIP flap was possible. This method can be considered a sufficient option for foot reconstruction for patients unable to receive general anesthesia.
Qishenyiqi dripping pill improves ventricular remodeling and function in patients with chronic heart failure
Authors: Chang Mingzheng , Cheng Lei , Shen Yaqian , Zhang Ying , Zhang Zhongwen , Hao Panpan 
Published: January 2019

Abstract

Background:
Qishenyiqi dripping pill for chronic heart failure (CHF) remains controversial due to lack of high-quality trials. Therefore, we conduct this pooled-analysis to evaluate the efficacy and safety of Qishenyiqi in CHF patients.

Methods:
We searched for randomized clinical trials for Qishenyiqi dripping pill in treating CHF up to August 2018 through China National Knowledge Infrastructure (CNKI), the PubMed Database, the Wanfang Database, the China Scientific Journal Database (VIP), and the Chinese Biomedicine Literature Service System. RevMan 5.3 was used for pooled analyses. Based on the New York Heart Association (NYHA) classification, the clinical therapeutic effect was collected as the primary endpoint.

Results:
The efficacy and safety of Qishenyiqi combined with routine treatment significantly increased NYHA functional classification, left ventricular ejection fraction, cardiac index, and 6-minute walking test and decreased brain natriuretic peptide, left ventricular end-diastolic, and end-systolic dimensions with no obvious side effects in comparison with routine therapy alone.

Conclusions:
Together these results provide important insights into Qishenyiqi is effective and safe in improving ventricular remodeling and function of CHF patients.

PROSPERO registration number:
PROSPERO106695.
Hyperhomocysteinemia in men with a reproductive history of fetal neural tube defects
Authors: Yu Yang , Jia Chunshu , Shi Qingyang , Zhu Yueying , Liu Yanhong 
Published: January 2019

Abstract

Rationale:
Hereditary hyperhomocysteinemia results from a polymorphism in the methylenetetrahydrofolate reductase (MTHFR) gene that reduces folate metabolism. Mutations in the MTHFR gene are common in parents who have given birth to children with neural tube defects (NTDs). Most research has focused on the risk for fetal NTDs in women with hyperhomocysteinemia and MTHFR gene mutations. Studies investigating the association between hyperhomocysteinemia, MTHFR gene mutations, and the risk for fetal NTDs in men are scarce.

Patient concerns:
Here, we report on 3 men with hyperhomocysteinemia and the MTHFR C677T homozygous TT genotype that have reproductive histories of fetal NTDs.

Diagnosis:
these 3 men were diagnosed as hyperhomocysteinemia and MTHFR C677T homozygous TT genotype.

Interventions:
Three men received homocysteine-lowering therapy.

Outcomes:
The first man's wife became pregnant, and a healthy infant was spontaneously delivered at term, the other 2 men's wives are still not pregnant.

Lessons:
Findings from this case reports and published literature imply that hereditary hyperhomocysteinemia in men affects sperm quality and sperm DNA methylation and causes epigenetic modifications that can result in fetal NTDs. We recommend monitoring homocysteine and folate levels in men before conception and supplementing with folate as needed, especially in men with a reproductive history of fetuses with neural tube or other birth defects.
Acupuncture for perimenopausal depression
Authors: Xiao Xiao , Zhang Jiayuan , Jin Yuxia , Wang Yunxia , Zhang Qi 
Published: January 2019

Abstract

Background:
Depression is one of common disease in the female perimenopausal period. It deprives women of their right to work and live normally, and even destroys the happiness of their families. Acupuncture is a promising treatment for perimenopausal depression.

Methods:
Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, China National Knowledge Internet (CNKI), Chongqing VIP (CQVIP), Wanfang Data, and on-line trial registries such as ClinicalTrials.gov (ClinicalTrials.gov/), European Medicines Agency (EMA)(www.ema.europa.eu/ema/), WHO International Clinical Trials Registry Platform (www.who.int/ictrp) will be searched from establishment of the database until Oct. 2018. There are no restrictions on the language of publication. The randomized controlled trials of acupuncture (electroacupuncture and manual acupuncture) for perimenopausal depression will be included, and all articles will be screened and collected by 2 reviewers independently. Revman 5.3.5 software will be used for meta-analysis. The specific process will refer to the Cochrane Handbook for Systematic Review.

Results:
The efficacy and safety of acupuncture for perimenopausal depression will be comprehensively assessed from the outcomes, including the effective rate, HAMD score, estrogen level and incidence of adverse events.

Conclusion:
This systematic review will provide evidence for whether acupuncture can improve perimenopausal depression.

Ethics and dissemination:
There is no requirement of ethical approval, and the review will be reported in a peer-reviewed journal.
Prenatal sonographic characteristics and postnatal outcomes of umbilical-portal-systemic venous shunts under the new in-utero classification
Authors: Wu Haifang , Tao Guowei , Cong Xiang , Li Qi , Zhang Jing , Ma Zhe , Zhang Zhonglu 
Published: January 2019

Abstract
An in-utero re-classification of umbilical-portal-systemic venous shunt (UPSVS) has recently been proposed. We retrospectively reviewed the sonograms of a large cohort of fetuses, identified and analyzed UPSVS cases, and presented the prenatal sonographic characteristics, birth outcomes, and follow-up results following the new classification system.
Sonograms and clinical data of all participants who visited our departments from April 2016 to July 2018 were retrospectively reviewed. Identified cases of UPSVS were analyzed according to the new classification: Type I: umbilical-systemic shunt (USS); Type II: ductus venosus-systemic shunt (DVSS); Type IIIa: intrahepatic portal-systemic shunt (IHPSS) and Type IIIb: extrahepatic portal-systemic shunt (EHPSS). Postnatal follow-ups ranged from 3 months to 1 year.
A total of 10 UPSVS cases were identified in 61,082 fetuses: 4 with Type I, 3 with Type II and 3 with Type IIIa. All 4 cases of USS had complete agenesis of the portal venous system, and had the umbilical vein drained into the inferior vena cava. Two USS cases also had trisomy 21. Pregnancy was terminated in all cases with a Type I shunt. Two fetuses with DVSS had normal portal venous system and were born full term. The pregnancy of 1 DVSS case was terminated due to the detection of trisomy 21. Three cases were IHPSS with full-term birth. One had chromosomal abnormality and 1 had surgery to repair the shunt 12-days post birth. In the 2 cases that did not receive repair surgery, sonographic examination revealed the portal-hepatic venous shunt was not closed at the 6-month follow-up period. However, the 1 case that had repair surgery appeared healthy at the 3-month follow-up period.
UPSVS is extremely rare. Type I shunts have the poorest prognosis, and the presence of the intrahepatic portal venous system is key to live birth in UPSVS regardless of types. Chromosomal abnormalities and other organ anomalies can occur in any types of UPSVS. Therefore, karyotyping and examination of other organs should be performed once UPSVS is detected.