bluuebunny/crossref_metadata_2025_split huggingface dataset:
Electronic Health Record–Based Registries: Clinical Research Using Registries in Colon and Rectal Surgery
Authors: Carlson Jacob , Laryea Jonathan 
Published: January 2019

AbstractElectronic health records (EHRs) or electronic medical records (EMRs) contain a vast amount of clinical data that can be useful for multiple purposes including research. Disease registries are collections of data in predefined formats for population management, research, and other purposes. There are differences between EHRs and registries in the data structure, data standards, and protocols. Proprietary EHR systems use different coding systems and data standards, which are usually kept secret. For EHR data to flow seamlessly into registries, there is the need for interoperability between EHR systems and between EHRs and registries. The levels of interoperability required include functional, structural, and semantic interoperability. EHR data can be manually mapped to registry data, but that is a tedious, resource-intensive endeavor. The development of data standards that can be used as building blocks for both EHRs and registries will help overcome the problem of interoperability.
Role of Endothelial Cells in Acute and Chronic Thrombosis
Authors: Bochenek Magdalena L. , Schäfer Katrin 
Published: January 2019

AbstractHaemostasis encompasses a set of strictly regulated actions, such as vasoconstriction, platelet activation and blood coagulation. Endothelial cells play a crucial role in all of these processes and are an integral part of the vascular response to injury resulting in thrombus formation. Healthy endothelium expresses mediators to prevent platelet activation, including prostacyclin and nitric oxide, and to inhibit coagulation, such as thrombomodulin or RNase1. Upon activation, endothelial cells expose von Willebrand factor, integrins and other receptors to interact with activated platelets, erythrocytes and coagulation factors, respectively, resulting in blood clot formation. The endothelial cell response to cytokines and growth factors released from activated platelets and immune cells abundantly present in arterial and venous thrombi also plays an important role for thrombus resolution, whereas failure to completely resolve thrombi may initiate fibrotic remodelling and chronic vascular occlusion both in the arterial and venous tree. Therefore, endothelial cells are increasingly recognized as potential target to prevent thrombotic events and to accelerate thrombus resolution. Here, we discuss recent publications from our group in the context of other studies on the role of the endothelium during acute and chronic thrombotic events.
Technical Repeatability and Reproducibility of the Stress Radiographs Performed with the Vezzoni-Modified Badertscher Hip Distension Device
Authors: De Rycke Lieve , Vezzoni Aldo , Polis Ingeborgh , Saunders Jimmy , Broeckx Bart , Bertal Mileva 
Published: January 2019

Objective The aim of this study was to evaluate the repeatability and reproducibility of the radiographical stress technique using the Vezzoni-modified Badertscher distension device (VMBDD).
Materials and Methods Stress radiographs of 10 dogs obtained with the VMBDD were performed consecutively by two different operators and then measured twice by a third veterinarian. The technical repeatability was first assessed individually for the two operators who took the stress radiographs, followed by the technical reproducibility. The obtained variances were used to calculate the 95% limits of agreement for the measurement repeatability, the technical repeatability and the technical reproducibility.
Results Both the technical repeatability and reproducibility of the VMBDD technique were good, with the 95% limits of agreement of the measurement repeatability and technical repeatability equalling ± 0.07 overall, and the 95% limits of agreement of the technical reproducibility being ± 0.09.
Clinical Significance These results, in combination with the previous results for the measurement of the laxity index, support the use of the VMBDD as a reliable in-house evaluation method to assess the hip joint by trained clinicians. For screening purposes, however, we suggest to limit the number of evaluators, to limit the variability.
A Pharmacogenomics Clinical Decision Support Service Based on FHIR and CDS Hooks
Authors: Dolin R.H. , Boxwala A. , Shalaby J. 
Published: January 2019

Objectives Pharmacogenomics (PGx) is often considered a low-hanging fruit for genomics–electronic health record (EHR) integrations, and many have expressed the notion that drug–gene interaction checking might one day become as much a commodity in EHRs as drug–drug and drug–allergy checking. In addition, the U.S. Office of the National Coordinator has recognized the trend toward storing complete sequencing data outside the EHR in a Genomic Archiving and Communication System (GACS) and has emphasized the need for “pilots that test Fast Healthcare Interoperability Resources (FHIR) Genomics for GACS integration with EHRs.” We sought to develop a PGx clinical decision support (CDS) service, leveraging the emerging FHIR and CDS Hooks standards, and based on an assumption that pharmacogene sequencing data would be stored alongside the EHR in a GACS.
Methods We developed a PGx CDS service as a functional prototype. The service is triggered by a medication order in the EHR. When evoked, the service looks for relevant genetic data in a GACS and returns corresponding recommendations back to the ordering clinician. Where the patient has no genetic data on file, the service can recommend pretreatment genetic testing where applicable.
Results Overall, we were able to meet our objectives and deploy a functional prototype, interfaced with a commercial EHR. We identified several areas where FHIR or CDS Hooks lacked necessary semantics or have implementation ambiguity. Primary FHIR challenges included multiple ways to say the same thing, which exacerbated the complexity of variant to allele conversion and lack of representation of deoxyribonucleic acid region(s) studied. Primary CDS Hooks challenges included the complexity of executing an authenticated query against one system (GACS) upon being triggered by a different system (the EHR), and limitations in the types of actionable recommendations that can be returned to the EHR.
Conclusions In conclusion, we have found that PGx CDS based on FHIR and CDS Hooks appears to represent a promising means of genomics–EHR integration. More real-world testing along with a set of use-case driven GACS interface requirements will push us closer to the U.S. National Human Genome Research Institute vision of a plug-in PGx app.
Rigid Bronchoscopy
Authors: Peralta A. , Debiane Labib , Simoff Michael , Diaz-Mendoza Javier 
Published: January 2019

AbstractRigid bronchoscopy is one of the oldest medical techniques used in the respiratory and thoracic fields. Even though its use declined after the development of flexible bronchoscopy, it has again gained importance with the growth of interventional pulmonology, becoming a critical technique taught as part of the training in this subspecialty. The therapeutic advantages compared to other approaches of thoracic pathologies makes rigid bronchoscopy a primary component in the present and future of interventional pulmonary medicine.
Physical Therapy Management of Adults with Mild Traumatic Brain Injury
Authors: Diaz Deborah , Moore Carolyn , Kane Ashley 
Published: January 2019

AbstractRehabilitation for individuals after mild traumatic brain injury (mTBI) or concussion requires emphasis on both cognitive and physical rest, with a gradual return to activity including sports. As the client becomes more active, the rehabilitation professional should pay close attention to symptoms associated with mTBI, such as headache, dizziness, nausea, and difficulty concentrating. The systematic approach to return to play provided by the Berlin Consensus Statement on Concussion in Sport can apply to adults with mTBI. This protocol calls for gradually increasing the intensity of physical activity while attending to postconcussion symptoms. During the incident that led to an mTBI, the injured individual may incur injuries to the vestibular and balance system that are best addressed by professionals with specific training in vestibular rehabilitation, most commonly physical therapists. Benign paroxysmal positional vertigo is a condition in which otoconia particles in the inner ear dislodge into the semicircular canals, resulting in severe vertigo and imbalance. This condition frequently resolves in a few sessions with a vestibular physical therapist. In conditions such as gaze instability, motion sensitivity, impaired postural control, and cervicogenic dizziness, improvement is more gradual and requires longer follow-up with a physical therapist and a home exercise program. In all of the above-stated conditions, it is essential to consider that a patient with protracted symptoms of mTBI or postconcussion syndrome will recover more slowly than others and should be monitored for symptoms throughout the intervention.
True Colours – Heterogenität des Fettgewebes
Authors: Fischer-Posovszky P. , Tews D. 
Published: January 2019

ZusammenfassungDas Fettgewebe ist ein dynamisches endokrines Organ. Es spiegelt die Energiehomöostase des Körpers wider und steht über seine Sekretionsprodukte in ständigem Informationsaustausch mit anderen Organsystemen. Das Fettgewebe zeichnet sich durch eine beachtliche anatomische, zelluläre und funktionelle Heterogenität aus, welche sich in einer Vielzahl unterschiedlicher Typen von Fettzellen ausdrückt. Dieser Übersichtsartikel stellt die verschiedenen „Farbnuancen” des Fettgewebes vor und diskutiert ihre funktionelle Relevanz im Organismus.
Cochlear Implantation in Sporadic Vestibular Schwannoma: A Systematic Literature Review
Authors: Bartindale Matthew Robert , Tadokoro Kent Sean , Kircher Matthew Lowell 
Published: January 2019

Objective This study was aimed to perform a systematic literature review by examining outcomes in patients with sporadic vestibular schwannoma (VS) undergoing ipsilateral cochlear implant (CI).
Data Sources PubMed-NCBI (National Center for Biotechnology Information) and Scopus databases were searched through October 2017.
Study Selection Studies reporting auditory outcomes for each patient when a CI was placed with an ipsilateral sporadic VS were included.
Main Outcome Measures Demographic variables, VS characteristics, preoperative hearing metrics, duration of deafness, CI type, approach to tumor resection, postoperative auditory outcomes, and postoperative tinnitus outcomes were reported for each eligible patient within studies. Each study was evaluated for quality and bias.
Results Fifteen studies and 45 patients met inclusion criteria. Mean speech discrimination score (SDS) improved from 30.0 to 56.4% after CI placement. The majority when reported had an improvement in tinnitus. Preoperative ipsilateral SDS was a negative predictor of postoperative SDS, while neither tumor resection status, tumor location, duration of deafness, ipsilateral pure tone average, nor timing of CI placement had a significant effect on patient outcome.
Conclusions Notwithstanding the challenges inherent with surveillance magnetic resonance imaging (MRI) in the setting of a cochlear implant magnet, select sporadic vestibular schwannoma patients can be considered for cochlear implantation.
Bronchoscopic Lung Volume Reduction in Patients with Severe Emphysema
Authors: Labarca Gonzalo , Herth Felix , Fernandez-Bussy Sebastian 
Published: January 2019

AbstractBronchoscopic lung volume reduction (BLVR) is a minimally invasive procedure for patients with symptomatic severe emphysema who may not be candidates for surgical lung volume reduction. BLVR has been shown to improve both functional and clinical outcomes with a relatively low risk of severe complications. Any potential candidate to BLVR should be on optimal pharmacological and nonpharmacological treatment. Radiographic and pulmonary function testing provide key data to help identify potential BLVR candidates. A variety of BLVR techniques have been published with different associated benefits and risks. Current strategies include either blocking procedures such as endobronchial valves and intrabronchial valves or nonblocking procedures such as endobronchial coils and bronchoscopic thermal vapor ablation. The aim of this review is to describe current options of BLVR including their efficacy and safety based on available data.
Child–Pugh Classification: Time to Abandon?
Authors: Kok Beverley , Abraldes Juan 
Published: January 2019

AbstractThe Child–Pugh classification is one of the commonest and oldest bedside tools utilized in estimating prognosis in patients with cirrhosis. However, its usage as a risk prediction tool or indeed a decision-making tool should be revisited. In this review, we discuss some inherent issues with the Child–Pugh classification and present a few contexts in which the current usage of Child–Pugh warrants reassessment, elaborating on its utility in acute variceal bleeding, specifically its role in decision-making on early transjugular intrahepatic portosystemic shunt, as well as its use in the context of hepatocellular carcinoma and drug development and dose adjustment.
Apolipoprotein C-III Strongly Correlates with Activated Factor VII–Anti-Thrombin Complex: An Additional Link between Plasma Lipids and Coagulation
Authors: Martinelli Nicola , Baroni Marcello , Castagna Annalisa , Lunghi Barbara , Stefanoni Filippo , Tosi Federica , Croce Jacopo , Udali Silvia , Woodhams Barry , Girelli Domenico , Bernardi Francesco , Olivieri Oliviero 
Published: January 2019

AbstractActivated factor VII–anti-thrombin (FVIIa-AT) complex is a potential biomarker of pro-thrombotic diathesis reflecting FVIIa–tissue factor (TF) interaction and has been associated with mortality in patients with coronary artery disease (CAD). Previous data indicated plasma lipids as predictors of FVIIa-AT variability, and plasma lipoproteins as potential stimulators of the coagulation cascade. Our aim was to evaluate the relationships between FVIIa-AT plasma concentration and a broad apolipoprotein profile (including ApoA-I, ApoB, ApoC-III and ApoE). Within the framework of the observational Verona Heart Study, we selected 666 subjects (131 CAD-free and 535 CAD, 75.4% males, mean age: 61.1 ± 10.9 years) not taking anticoagulant drugs and for whom plasma samples were available for both FVIIa-AT assay and a complete lipid profile. Plasma concentration of FVIIa-AT levels significantly and directly correlated with total and high-density lipoprotein cholesterol, triglycerides, ApoA-I, ApoC-III and ApoE levels. ApoC-III showed the strongest correlation (R = 0.235, p = 7.7 × 10−10), confirmed in all the sub-group analyses (males/females and CAD/CAD-free). Only ApoC-III remained associated with FVIIa-AT plasma concentration, even after adjustment for sex, age, CAD diagnosis, body mass index, renal function, smoking status, lipid-lowering therapies and FVIIa levels. The APOC3 gene locus-tagging polymorphism rs964184, previously linked with cardiovascular risk and plasma lipids by genome-wide association studies, was associated with both ApoC-III and FVIIa-AT plasma concentration. Our results indicate a strong association between ApoC-III and FVIIa-AT levels, thereby suggesting that an increased ApoC-III concentration may identify subjects with a pro-thrombotic diathesis characterized by an enhanced TF-FVIIa interaction and activity.
Thoracoscopy: Advances and Increasing Role for Interventional Pulmonologists
Authors: Lee Pyng , Folch Erik 
Published: January 2019

AbstractThoracoscopy is an increasingly common procedure that provides significant clinical information and therapeutic applications. The procedure allows the physician to biopsy the parietal pleura under direct visualization with high accuracy. In addition, one can drain pleural fluid, place a chest tube in a precise location, and perform poudrage pleurodesis. Medical thoracoscopy (MT) is carried out in the operating room or procedure suite under moderate sedation with spontaneous ventilation. In comparison, video-assisted thoracoscopic surgery (VATS) is performed under general anesthesia with single lung ventilation and through multiple ports in the operating room. MT is less invasive, has a comparable diagnostic yield, and may be better tolerated in high-risk patients. The indications, complications, and advances in thoracoscopy will be discussed in this article. In the era of rapidly evolving therapeutics for lung cancer, immune-modulation and ever-increasing risks of immunosuppression, MT will evolve and continue to play a pivotal role in the evaluation and research of pleuropulmonary diseases.
Ultrasound-Guided versus Conventional Caudal Block in Children: A Prospective Randomized Study
Authors: Karaca Omer , Pinar Huseyin Ulas , Gokmen Zeynel , Dogan Rafi 
Published: January 2019

Background Injection to the accurate area without any complications is the main factor for the efficiencies of caudal block. The aim of this study was to compare success and the complications of conventional and ultrasound method for caudal block in children.
Materials and Methods Two-hundred sixty-six American Society of Anesthesiologists (ASA) category 1 children aged between 6 months and 6 years undergoing hypospadias, circumcision, or both surgeries were randomly allocated two groups (Group C or Group H, n = 133). About 0.25% bupivacaine with 1/200000 adrenaline (total volume: 0.5 mL/kg) was injected after the needle was inserted into the sacral canal in Group C, or right after the needle pierced the sacrococcygeal ligament under longitudinal ultrasound view in Group H. Success rate of block, block performing time, number of needle puncture, success at first puncture, complication rate, age and weight of the patients encountering these complications were recorded.
Results The success rate of block was similar between two groups (94.7% in Group C vs 96.2% in Group U, p > 0.05). Success at first puncture was higher in Group U than in Group C (90.2 vs 66.2%, respectively; p < 0.001). Number of needle puncture, blood aspiration, subcutaneous bulging, and bone contact was higher in Group C but none in Group U (p < 0.001) and these complications were occurred in children weighing < 16 kg and less younger than 6 years old.
Conclusion We observed that the complications were not encountered, number of needle puncture was lesser, and the success rate of first puncture was higher under ultrasound with longitudinal view.
Epidermoid Cyst in the Cerebellopontine Angle: Technical Description Video
Authors: de Morais Marcus Vinicius , Mota Romulo Almino de Alencar Arrais , Marques Thais Aparecida , Loduca Rafael Duarte de Souza , Melo Paulo Mácio de Porto 
Published: January 2019

Objectives To describe the operative technique for treatment of epidermoid cysts in the cerebellopontine angle (CPA).
Design The present video is a case report.
Setting Patient is positioned in three-quarters prone. Retrosigmoid approach should be made under neurological monitoring and with neuronavegation to help achieve maximal safe resection. The skin incision is vertical, slightly curved, 5 mm medial to the mastoid notch. Craniectomy is superiorly limited by the transverse sinus and laterally limited by the sigmoid sinus. A C-shaped durotomy is made with its base protecting the sigmoid sinus. The lesion is removed in piecemeal fashion (Fig. 1). The neurological monitoring helps.
Results The patient was discharged 2 days later without neurological deficits.
Conclusions The surgical treatment associated with neurological monitoring and neuronavegation is a safe procedure to treat epidermoid cysts in the CPA.The link to the video can be found at: https://youtu.be/sEuFyq9c2sw.
Endogenous Procoagulant Activity in Trauma Patients and Its Relationship to Trauma Severity
Authors: Prior Shannon , Park Myung , Mann Kenneth , Butenas Saulius 
Published: January 2019

Background It has been observed that trauma patients have elevated plasma procoagulant activity that could be assigned to an elevated concentration of tissue factor (TF). However, in many instances there is a discrepancy between the levels of TF and the procoagulant activity observed. We hypothesized that factor XIa (FXIa) could be responsible for this additional activity and that the presence and levels of both proteins could correlate with trauma severity.
Methods Citrate plasma from 98 trauma patients (47 blunt, 17 penetrating, and 34 thermal) were evaluated in clotting assays for the presence of FXIa and TF activity using respective inhibitory antibodies.
Results When the three trauma patient groups were divided into two cohorts (Injury Severity Score [ISS] > 25 and ISS ≤ 25), higher frequencies and concentrations of both TF and FXIa were observed for all the more severe injury subgroups.
Conclusions The majority of trauma patients have active FXIa in their plasma, with a significant fraction having active TF as well. Additionally, both TF and FXIa frequency and concentration directly relate to trauma severity. These data suggest the use of these two proteins as potential markers for the stratification of trauma patients.
Neutrophil Extracellular Traps in Arterial and Venous Thrombosis
Authors: Laridan Elodie , Martinod Kimberly , De Meyer Simon 
Published: January 2019

AbstractThrombotic complications are still a major health risk worldwide. Our view on the pathophysiology of thrombosis has significantly changed since the discovery of neutrophil extracellular traps (NETs) and their prothrombotic characteristics. Generated by neutrophils that release their decondensed chromatin as a network of extracellular fibers, NETs promote thrombus formation by serving as a scaffold that activates platelets and coagulation. The thrombogenic involvement of NETs has been described in various settings of thrombosis, including stroke, myocardial infarction, and deep vein thrombosis. The aim of this review is to summarize existing evidence showing the presence of NETs in human thrombus material. Following an introduction on NETs and their role in thrombus formation, the authors address studies showing the presence of NETs in arterial or venous thrombi. In addition, they focus on potential novel therapeutic opportunities to resolve or prevent thrombosis by targeting NETs.
The Elusive Diagnosis of Disseminated Intravascular Coagulation: Does a Diagnosis of DIC Exist Anymore?
Authors: Thachil Jecko 
Published: January 2019

AbstractDisseminated intravascular coagulation (DIC) is an intermediary mechanism of disease known to develop as a complication in other conditions like sepsis, trauma, cancer, or obstetrical disorders. Patients with DIC may present to different specialists depending on symptomology and as such a good understanding of the pathophysiological process is necessary to ensure best management. However, more recently, controversy has risen where experts doubt whether DIC really exists in many of the historically well-established diagnoses. This has led to confusion among both basic science researchers and clinical practitioners about when to consider DIC diagnosis. In this review, the various issues which have led to this uncertainty are addressed, including the problem with different terminologies, simpler explanation of current DIC diagnostic criteria, and reasons behind why the diagnosis may be overlooked or not considered at all, along with their possible solutions. It is hoped that the diagnostic aspects of DIC will come full circle, wherein the recent research can build up on what history had taught us and not refute its existence.