bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anti-Ace monoclonal antibody reduces Enterococcus faecalis aortic valve infection in a rat infective endocarditis model
Authors: Singh Kavindra V , Pinkston Kenneth L , Gao Peng , Harvey Barrett R , Murray Barbara E 
Published: November 2018

AbstractAce (Adhesin to collagen from Enterococcus faecalis) is a cell-wall anchored protein that is expressed conditionally and is important for virulence in a rat infective endocarditis (IE) model. Previously, we showed that rats immunized with the collagen binding domain of Ace (domain A), or administered anti-Ace domain A polyclonal antibody, were less susceptible to E. faecalis endocarditis than sham-immunized controls. In this work, we demonstrated that a sub nanomolar monoclonal antibody (mAb), anti-Ace mAb70, significantly diminished E. faecalis binding to ECM collagen IV in in vitro adherence assays and that, in the endocarditis model, anti-Ace mAb70 pre-treatment significantly reduced E. faecalis infection of aortic valves. The effectiveness of anti-Ace mAb against IE in the rat model suggests it might serve as a beneficial agent for passive protection against E. faecalis infections.
Filtering strategic coupling: territorial intermediaries in oil and gas global production networks in Southeast Asia
Authors: Breul Moritz , Revilla Diez Javier , Sambodo Maxensius Tri 
Published: November 2018

AbstractThe Global Production Network (GPN) approach has not yet considered the importance of territorial intermediaries for strategic coupling. This article demonstrates how the prospects of strategic coupling for the case of Vietnam and Indonesia with the oil and gas GPN are affected by the gateway role of Singapore. Based on interviews, the analysis reveals how Singapore influences regional economic development along the GPN through different filtering mechanisms, limiting the potential for strategic coupling for Vietnam and Indonesia. For GPN research, the identified filtering mechanisms illustrate how the territoriality of GPNs contributes to differentiated territorial outcomes. The findings therefore indicate the need to intensify the appreciation of the particular territorial configuration of GPNs as this yields considerable explanatory power for understanding the unequal contours of the global economy.
New insights into IgG4-related disease: emerging new CD4+ T-cell subsets
Authors: Kamekura Ryuta , Takahashi Hiroki , Ichimiya Shingo 
Published: November 2018

Purpose of review
New insights into IgG4-related disease (IgG4-RD) have recently been obtained. A better understanding of the mechanisms underlying this disease is important for identification of therapeutic targets, which will lead to the development of specific strategies for treatment.

Recent findings
Infiltration of activated T follicular helper (Tfh) cells is observed in affected tissues of IgG4-RD. Such Tfh cells have a greater capacity than tonsillar Tfh cells to help B cells produce IgG4. Circulating PD-1hiCXCR5- peripheral T helper (Tph)-like cells are also increased in patients with IgG4-RD. Because Tph-like cells express high levels of chemokine receptors and granzyme A, they have the capacity to infiltrate affected tissues and exert a cytotoxic function. Tph-like cells can also produce CXCL13, and CXCR5+ Tfh cells and B cells are therefore preferentially recruited to form ectopic lymphoid structures in the sites. Tph cells may have a role to ignite inflammation and maintain persistent fibroinflammation in collaboration with Tfh cells in lesions of IgG4-RD.

Summary
Recent advances in understanding the pathogenesis of IgG4-RD are remarkable. In this review, we summarize and discuss the possible pathologic role of CD4+ T-cell subsets in IgG4-RD.
Satisfactory Response With Achieving Maintenance Low-Dose Prednisone in Generalized Myasthenia Gravis
Authors: Abuzinadah Ahmad R. , Jabari Duaa , Jawdat Omar , Pasnoor Mamatha , Glenn Melanie , Herbelin Laura , McVey April L. , Barohn Richard J. , Dimachkie Mazen M. 
Published: November 2018

Abstract

Objectives:
To estimate the satisfactory response rate (SR%) with achieving maintenance, low-dose prednisone in acetylcholine receptor antibody–positive generalized myasthenia gravis.

Methods:
In this retrospective study, we estimate the SR% as defined by (remission/minimal manifestations status for at least 6 months using 7.5 mg or less of prednisone daily, for maintenance treatment at 2, 4, and 6 years after symptoms onset) for patients who were not taking steroid-sparing immunosuppressant (SSI) as a primary outcome and for patients taking an SSI as a secondary outcome.

Results:
Forty-five patients were not taking an SSI at 2 years, 34 patients at 4 years, and 17 patients at 6 years; SR% was 44.4%, 64.7%, and 58.8%, respectively. Thirty-six patients were taking an SSI at 2 years, 22 patients at 4 years, and 15 patients at 6 years; the SR% was 50.0%, 45.4%, and 66.7%, respectively.

Conclusions:
Nearly half of the generalized myasthenia gravis patients who were not taking an SSI achieved an SR.
Gender Differences in Skin Biopsy Findings in Small Fiber Neuropathy: A Retrospective Chart Review
Authors: Weaver Joshua , Kim Kyung-Wha , Carey Bridget T. , Langsdorf Jennifer A. , Chin Russell L. 
Published: November 2018

Abstract

Objectives:
To determine whether there are gender differences in the clinical presentation or skin biopsy measures of nerve fiber density in patients with small fiber neuropathy (SFN).

Methods:
Retrospective chart review of subjects with suspected SFN.

Results:
Of 218 cases (137 women and 81 men) with suspected SFN, 96 (44%), including 63% of the men and 33% of the women (P < 0.05), had low epidermal nerve fiber density (ENFD) or sweat gland nerve fiber density (SGNFD). There were no differences in the clinical presentation between men and women. In those with abnormal findings, low ENFD alone was more frequent in women than men (51.1% vs. 7.8%, P < 0.05), whereas abnormal SGNFD alone was more frequent in men than women (68.6% vs. 11.1%, P < 0.05). Both SGNFD and ENFD were low in 23.5% of men and 33.3% of women. Skin biopsy findings were independent of clinical presentation or etiology.

Conclusions:
The clinical presentation of SFN is similar in men and women. In skin biopsy studies, low ENFD is more common in women and low SGNFD in men.
Toxic Myopathy due to Antidopaminergic Medication Without Neuroleptic Malignant Syndrome
Authors: Harada Yohei , Virmani Tuhin , Gokden Murat , Stefans Vikki 
Published: November 2018

Abstract
Severe recurrent proximal muscle weakness without neuroleptic malignant syndrome secondary to antidopaminergic medication has rarely been reported. We report a 29-year-old man with history of obsessive compulsive disorder and Tourette syndrome who presented with 2 months of worsening dyspnea 3 weeks after starting ziprasidone 40 mg daily that required mechanical ventilation. A year before, after an increased risperidone dose from 0.5 to 1 mg daily, he had developed proximal muscle weakness that spontaneously improved 2 months after discontinuation of risperidone. On this admission, his creatine kinase (CK) was 3318 units/L, and ziprasidone was discontinued. He fully recovered 2 months after discontinuation of ziprasidone, and his CK was 62 units/L. Genetic testing for limb–girdle muscular dystrophy was negative. This case highlights the importance of evaluating CK level in patients taking antidopaminergic medication with any suggestion of muscle weakness to prevent potentially life-threatening complication.
Reconstruction of Complex Maxillary Defects Using Patient-specific 3D-printed Biodegradable Scaffolds
Authors: Han Hyun Ho , Shim Jin-Hyung , Lee Hyungseok , Kim Bo Young , Lee Jeong-Seok , Jung Jin Woo , Yun Won-Soo , Baek Chung Hwan , Rhie Jong-Won , Cho Dong-Woo 
Published: November 2018

Summary:
Reconstruction of maxilla defects has remained one of the most challenging problems in craniomaxillofacial reconstruction because it typically requires harvesting and grafting of autologous bone, which poses limitations related to the difficulties in accurately reconstructing the defected bone and the highly prolonged duration of surgery. We employed tissue-engineered, patient-specific, 3-dimensional (3D)-printed biodegradable scaffolds for maxillofacial bone reconstruction in patients with complex maxillary defects after surgical removal of cancer. A customized polycaprolactone (PCL) scaffold was designed and fabricated for each patient. For this purpose, we used computer-aided design and manufacturing combined with 3D printing technology. The patients implanted with the PCL scaffolds were followed up for up to 2 years with careful evaluation of morphological changes in the face. We confirmed that the patient-specific 3D-printed PCL scaffold effectively filled the maxillary defect and promoted regeneration of the deficient tissue while remaining stable in the body for a relatively long period. Employing customized tissue-engineered scaffolds built using the patient’s computed tomography data and an extrusion-based 3D printing system is safe and clinically feasible, helping create and maintain improved morphological features of the face, which represents the most important aspect from the perspective of the patients.
Building a Resilient Workforce: Promoting Joy in Clinical Care
Authors: West Page , Gee Perry M. 
Published: November 2018

SUMMARY
At Dignity Health, one of the nation’s largest healthcare systems, we believe that all people deserve access to quality medical care regardless of their background, ethnicity, or circumstances. Healing is our calling, and “Hello humankindness” is our brand purpose, which supports our mission to deliver compassionate, high-quality, and affordable patient-centered care with special attention to the poor and underserved. Through teamwork and innovation, faith and compassion, and advocacy and action, we endeavor every day to keep our patients and staff members healthy and fulfilled. This article highlights efforts at Dignity Health to reduce burnout and increase resilience in our employees. Our team is focusing on evidence-based interventions and strategic partnerships to tackle these complicated issues.
Microbiological Evaluation of Bandage Soft Contact Lenses Used in Management of Persistent Corneal Epithelial Defects
Authors: Feizi Sepehr , Masoudi Ali , Hosseini Seyed-Bagher , Kanavi Mozhgan Rezaei , Javadi Mohammad Ali 
Published: November 2018

Purpose:
To investigate the rate and agents of contamination in bandage soft contact lenses fitted for management of persistent corneal epithelial defects.

Methods:
This prospective comparative case series enrolled 57 consecutive eyes fitted with bandage contact lenses for treatment of persistent corneal epithelial defects. The lenses were collected at the time of epithelial closure or when it was necessary to exchange contact lenses and were immediately placed in sterile tubes containing an enriched thioglycolate liquid medium. When contamination of the contact lens was detected, the microorganism was cultured in different media and identified based on various tests. All isolates were tested for susceptibility to various antibiotics. Univariate analyses were used to evaluate the influence of different variables (duration of contact lens use, use of topical corticosteroids, presence of blepharitis, contact lens deposits, and presence of sutures) on bandage contact lens contamination.

Results:
Seventeen of the contact lenses (29.8%) were contaminated. The most commonly isolated pathogen was Staphylococcus epidermidis (n = 10), followed by Enterobacter cloacae (n = 3), Staphylococcus aureus (n = 1), Streptococcus viridans (n = 1), and Alcaligenes spp. (n = 1). One contact lens yielded a mixed infection with E. cloacae and Candida spp. Infectious keratitis was not observed in any eyes. Correlations between contact lens contamination and patient- and lens-related variables were not statistically significant.

Conclusions:
Most bandage contact lenses (70.2%) used for treatment of persistent corneal epithelial defects did not show bacterial growth. Staphylococcus epidermidis was the most common microorganism isolated from the contaminated contact lenses.
Do Hospital and Physician Volume Thresholds for the Volume-Outcome Relationship in Heart Failure Exist?
Authors: Chou Ying-Yi , Yu Tsung-Hsien , Tung Yu-Chi 
Published: November 2018

Background:Although volume-outcome relationships have been explored for various procedures and interventions, limited information is available concerning the effect of hospital and physician volume on heart failure mortality. Most importantly, little is known about whether there are optimal hospital and physician volume thresholds to reduce heart failure mortality.Objectives:We used nationwide population-based data to identify the optimal hospital and physician volume thresholds to achieve optimum mortality and to examine the relative and combined effects of the volume thresholds on heart failure mortality.Methods:We analyzed all 20,178 heart failure patients admitted in 2012 through Taiwan’s National Health Insurance Research Database. Restricted cubic splines and multilevel logistic regression were used to identify whether there are optimal hospital and physician volume thresholds and to assess the relative and combined relationships of the volume thresholds to 30-day mortality, adjusted for patient, physician, and hospital characteristics.Results:Hospital and physician volume thresholds of 40 cases and 15 cases a year, respectively, were identified, under which there was an increased risk of 30-day mortality. Patients treated by physicians with previous annual volumes <15 cases had higher 30-day mortality compared with those with previous annual volumes ≥15 cases, and the relationship was stronger in hospitals with previous annual volumes <40 cases.Conclusions:This is the first study to identify both the hospital and physician volume thresholds that lead to decreases in heart failure mortality. Identifying the hospital and physician volume thresholds could be applied to quality improvement and physician training.
Sexuality in Muslim Women With Gynecological Cancer
Authors: Serçekuş Ak Pinar , Partlak Günüşen Neslihan , Göral Türkcü Sinem , Özkan Sevgi 
Published: November 2018

Background
Sexuality is a multidimensional subject that can be negatively affected after a diagnosis of gynecological cancer.

Objective
The aim of this study was to reveal what sexuality difficulties Muslim women with gynecological cancers experience and how they overcome them.

Interventions/Methods
A qualitative approach was used. Data were gathered through semistructured interviews and analyzed by using a content analysis method. Eighteen Muslim women with gynecological cancers participated in the study.

Results
The study findings were grouped into 3 major categories: situations that make sexual life difficult, impact of cancer on sexual life, and coping.

Conclusions
Women with gynecological cancers experience sexual reluctance, orgasmic incapacity, lack of enjoyment of sexual intercourse, and decreased frequency of sexual intercourse. In individuals with cancer, social support is important to facilitate coping; however, some women do not receive sufficient support. Women who consider sexuality to be a taboo topic and feel shame about asking sexuality-related questions are not likely to seek or receive relevant information from health professionals.

Implications for Practice
Health professionals should provide information to women diagnosed with gynecological cancers about changes that they are likely to experience in their bodies and possible difficulties in sexuality. These women should be encouraged to talk about their sexual problems, and religious and cultural differences should be reflected in their cancer care.
Prospective Patterns of Help-Seeking Behavior Among Military Veterans With Probable Posttraumatic Stress Disorder and Major Depressive Disorder
Authors: Currier Joseph M. , McCormick Wesley H. , Carroll Timothy D. , Sims Brook M. , Isaak Steven L. 
Published: November 2018

Abstract
This study examined help-seeking behavior from professional, informal, and religious sources in veterans with a probable need for treatment. In total, 93 veterans who screened positive for posttraumatic stress disorder/major depressive disorder completed assessments of help-seeking at two time points spaced apart by 6 months. Less than half (40%) reached out to a mental health professional or physician; only 1 in 10 engaged with providers who specialize in evidence-based therapies to a minimally adequate degree. Although roughly two thirds pursued help from informal sources, less than 10% similarly sought help nine or more times. Veterans with high willingness to seek help from specific sources at baseline were more likely to report sustained engagement in help-seeking behavior along these same lines at follow-up. Assessing veterans' help-seeking intentions may add prognostic value in predicting engagement in services. Veterans may also benefit from tailoring service delivery models according to preferred sources of help in their families and communities.
Scurvy—Characteristic Features and Forensic Issues
Authors: Byard Roger W. , Maxwell-Stewart Hamish 
Published: November 2018

Abstract
Scurvy is a multisystem condition that arises from vitamin C deficiency. As humans cannot synthesize vitamin C, serum and tissue levels depend on bioavailability, utilization, and renal excretion. Deficiencies result in defective collagen formation with swelling of gums, leg ulceration, and bleeding manifestations. Death most often results from infection and hemorrhage. In a forensic context, scurvy may mimic inflicted injuries and may be responsible for sudden death by mechanisms that remain unclear. Cardiac failure and rhythm disturbances with chest pain, hypotension, cardiac tamponade, and dyspnea are associated with vitamin C deficiency. In addition, syncope and seizures may occur. Although far less common than in previous centuries, scurvy is still present in high-risk populations that include alcoholics, isolated elderly individuals, food faddists, institutionalized patients, those with mental illness, and those who have had bariatric surgery or with underlying gastrointestinal conditions. Scurvy should therefore be a diagnosis to consider in medicolegal cases of apparent trauma and sudden death.
Assessment of Pelvic Floor Anatomy for Male-to-Female Vaginoplasty and the Role of Physical Therapy on Functional and Patient-Reported Outcomes
Authors: Manrique Oscar J. , Adabi Kian , Huang Tony Chieh-Ting , Jorge-Martinez Jorys , Meihofer Laura E. , Brassard Pierre , Galan Ricardo 
Published: November 2018

BackgroundRapid increase in number of male-to-female vaginoplasties emphasizes the need for preoperative measures to optimize final surgical and patient-reported outcomes. Hormonal therapy and socioeconomic factors may contribute to a higher incidence of pelvic floor dysfunction in patients undergoing male-to-female vaginoplasty. The purpose of this study was to evaluate the incidence of pelvic floor dysfunction in this population and the role of physical therapy in its treatment.MethodsFrom July 2016 to July 2018, patients scheduled to undergo male-to-female vaginoplasty were evaluated by a physical therapist for pelvic floor dysfunction. Patient charts were reviewed for demographics, comorbidities, and length of hormonal therapy. Those with and without symptoms were compared. Symptomatic patients underwent therapy. Assessment of symptom severity and its impact on daily living were completed at 2- to 3-month intervals with physical therapy using the 6-item Urinary Distress Index 6 and 8-item Colorectal Anal Distress Index components of the 20-item Pelvic Floor Distress Inventory (PFDI-20) before and after surgery. A third component of the PFDI-20, the 6-item Pelvic Organ Prolapse Distress Inventory, was also included in the postoperative assessment.ResultsOver a 24-month period, a total of 40 patients with a mean age of 40.7 (19–72) years and body mass index of 27.1 kg/m2(22–39 kg/m2) were enrolled. Comorbidities included 4 patients (10%) with diabetes and 6 patients (15%) with hypertension. Patients with symptoms had a significantly higher mean age (P< 0.01). Only 1 patient (2.5%) had new-onset pelvic floor dysfunction after surgery, and there was no significant increase in severity of symptoms in those with a previous pelvic floor dysfunction postoperatively. Physical therapy significantly (P< 0.01) reduced severity of symptoms and its impact on daily living as assessed by the Urinary Distress Index and Colorectal Anal Distress Index before and after surgery and by the PFDI-20 and 7-item Pelvic Floor Dysfunction Index postoperatively.ConclusionsA high incidence of pelvic floor dysfunction may exist in patients undergoing male-to-female vaginoplasty preoperatively. Screening at this early stage with both preoperative and postoperative therapy can significantly reduce pelvic floor dysfunction and improve symptoms and quality of life for this population.
Nipple-sparing Mastectomy and Immediate Breast Reconstruction After Recurrence From Previous Breast Conservation Therapy
Authors: Lee Che-Hsiung , Cheng Ming-Huei , Wu Chih-Wei , Kuo Wen-Ling , Yu Chi-Chang , Huang Jung-Ju 
Published: November 2018

Purpose
Breast conservation therapy (BCT) is widely accepted for breast cancer treatment. Nipple-sparing mastectomy has been newly developed to preserve the nipple-areolar complex and enhance aesthetic results. The purpose of this study was to evaluate the oncological safety and results of nipple-sparing mastectomy (NSM) after previous BCT.

Methods
Eighteen patients who received NSM and immediate breast reconstruction for local recurrence after BCT were identified. An additional 127 affected breasts with NSM and immediate breast reconstruction for primary breast cancer were selected as the control group. The patient disease status, reconstructive method, postoperative complications, and oncological outcome were investigated.

Results
No apparent significant differences between the 2 groups were found regarding patient demographic data, tumor stage, reconstructive method, surgical complication, or tumor recurrence rate (all P values >0.05), except preoperative radiotherapy was higher in secondary NSM group (0% vs 77.8%, P < 0.001). The further nipple and secondary deep inferior epigastric artery perforator flap reconstruction rate was higher in the secondary NSM group (11.1% vs 0.8%, P = 0.041 and 16.7% vs 2.4%, P = 0.026, respectively).

Conclusions
Prior BCT did not contribute to higher surgical complications in patients who received NSM and immediate reconstruction as a salvage procedure after tumor local recurrence. The oncological safety, general surgical result, and postoperative patient-reported satisfaction remain safe and reliable despite prior ipsilateral surgery and radiation. Care should be taken for possible higher nipple necrosis in the secondary NSM patients.