bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of Intravascular Near-Infrared Spectroscopy in Off-Pump Myocardial Revascularization
Authors: Bernet Franziska H. , Matt Peter , Zerkowski Hans-Reinhard , Baykut Doan 
Published: January 2019

Objectives The intravascular application of near-infrared spectroscopy was previously evaluated in acute ischemia-reperfusion studies in animal experiments. The objective of our study was to assess the technical feasibility and clinical reliability of an online myocardial ischemia monitoring by using intravascular near-infrared spectroscopy during off-pump coronary bypass surgery. Methods Intravascular near-infrared spectroscopy of coronary sinus blood was performed in 10 elective patients selected for off-pump coronary bypass surgery. Light signals were transferred through a fiberoptic catheter for emission and collection from the coronary sinus blood. Spectrometric analyses were performed before and after revascularization with internal thoracic artery and saphenous vein grafts. Changes in spectroscopic data were compared with hemodynamic parameters and electrocardiographic, transesophageal echocardiographic, and laboratory findings. Results All of the operations were finished as off-pump procedures. No remarkable intraoperative myocardial ischemia was observed in the patient group, as indicated by electrocardiography and transesophageal echocardiography. Reproducible absorption spectra of coronary sinus blood were obtained at every defined step of the surgical procedure. Clear ischemia-related changes were detected in none of the patients. Conclusions Our initial results showed that intravascular near-infrared spectroscopic ischemia monitoring is technically feasible. However, the method must be further evaluated and standardized under varying conditions to determine the role of near-infrared spectroscopy as an ischemia monitoring tool in off-pump coronary bypass surgery.
Initial Results of Minimally Invasive Ivor Lewis Esophagectomy after Induction Chemoradiation (50.4 Gy) for Esophageal Cancer
Authors: Thomay Alan A. , Snyder Justin A. , Edmondson Donna M. , Scott Walter J. 
Published: January 2019

Objective Esophageal cancer patients receiving induction chemoradiation to 41 Gy randomized to minimally invasive (MIS) esophagectomy have fewer postoperative pulmonary complications compared with those who underwent open procedures. We evaluated the feasibility of MIS Ivor Lewis esophagectomy in patients treated with induction chemoradiation to 50.4 Gy. Methods We retrospectively analyzed clinical data from 30 consecutive patients undergoing MIS Ivor Lewis esophagectomy after induction chemoradiation to a mean dose of 50.4 Gy by a single surgeon at a tertiary institution since 2010. Data collected included patient demographics, preoperative risk factors, neoadjuvant treatment modalities, histology, staging, operative factors, and perioperative complications. Results The mean age of the patients was 61 ± 9.5 years, and 87% were men. The dominant histology was adenocarcinoma (90%), with most tumors (70%) located at the gastroesophageal junction. A total of 22 patients (73%) presented with dysphagia, but only 15 (50%) had associated weight loss (mean 12.2% total body mass). All patients had R0 resections; mean number of resected lymph nodes was 27.1 ± 11.4. Mean operating room time was 535 ± 120 minutes, with the last 10 operations 2 hours shorter than the preceding 20. Four patients (13.3%) had major complications. including 2 (6.7%) anastomotic leaks. There was no operative mortality. Conclusions Minimally invasive Ivor Lewis esophagectomy after chemoradiation to 50.4 Gy can be performed with decreased morbidity and mortality compared with historical series of open Ivor Lewis esophagectomy. Oncologic outcomes were acceptable as demonstrated by lymph node retrieval and complete resection rates. Operative time decreased significantly after 20 cases.
Double Potential Mapping: A Novel Technique for Locating the Site of Incomplete Ablation
Authors: Nitta Takashi , Wakita Masaki , Watanabe Yoshiyuki , Ohmori Hiroya , Sakamoto Shun-ichiro , Ishii Yosuke , Ochi Masami 
Published: January 2019

Objective Double potential mapping using bipolar electrodes that straddle the ablation line should identify the site of incomplete ablation as a conduction gap without constructing the activation maps. Methods Bipolar electrograms were recorded during pacing using 11 custom-made bipolar electrodes straddling the ablation line created by a bipolar radiofrequency ablation device on the lateral right atrium in seven canines. A linear ablation was made with an ablation device, of which one jaw was inserted into the atrium through a purse-string suture. A 3-mm-wide tape was placed on both jaws 10 mm from the tip of the ablation electrode to intentionally create an incomplete ablation lesion. The activation times at each dipole across the ablation line were defined as the times of the maximum positive and negative derivatives of the double potentials, and the site of conduction gap was determined as the site of the earliest activation across the linear ablation. The lateral right atrium was mapped simultaneously with 45 different bipolar electrodes to construct the activation maps and the earliest activation site across the ablation line was determined. Results The double potential mapping located the conduction gap on a real-time basis without displaying any maps. There was no significant change in the accuracy between the different times after ablation and different pacing cycle lengths. Conclusions Double potential mapping locates the conduction gap on a real-time basis and would be useful in beating-heart epicardial ablation in off-pump setting.
Mucosal Schwann cell hamartomas do occur the gastric mucosa – report of two cases mimicking fundic gland polyps
Authors: Oliveira Castro Márcia Helena , Felipe Rodrigo Jose , Fernandes Cardoso Amanda , Martins Guimarães Carlos Leonardo , Fontes Athanazio Paulo Roberto , Abensur Athanazio Daniel 
Published: January 2019

AbstractMucosal Schwann cell hamartomas (MSCHs) are recently characterized benign spindle cell lesions of the colon and rectum. There is only one report of MSCHs in the stomach (antrum). Herein, we present the first reports of MSCHs occurring in the fundic mucosa as lesions that endoscopically mimicked a typical fundic gland polyp. Case 1. A 56-year-old woman sought medical attention due to epigastric pain. A small polypoid lesion in the fundic mucosa was removed with an endoscopic impression of a fundic gland polyp. Case 2. A 66-year-old man sought medical attention due to epigastric pain. The patient underwent antral and corporal biopsies that showed mild non-active gastritis without Helicobacter pylori infection. Small polypoid lesions in the fundic mucosa were seen; one was removed with an endoscopic impression of the fundic gland polyp. At the microscope, both lesions were entirely intramucosal, ill-defined spindle cell aggregations, suggesting a fascicular growth pattern. Both lesions were strongly and diffusely positive for S100. Awareness of this lesion is relevant to avoid the diagnosis of other benign spindle cell lesions that are associated with familial syndromes.
Progesterone Is Important for Transgender Women’s Therapy—Applying Evidence for the Benefits of Progesterone in Ciswomen
Authors: Prior Jerilynn C 
Published: January 2019

AbstractBackgroundAlthough the 2017 Endocrine Society Guidelines for gender dysphoria stipulated that cross-sex hormone therapy (CHT) achieve gonadal steroid levels equivalent to those of a cisperson of the chosen sex, for transgender women (male-to-female gender dysphoria), current gonadal therapy is usually estradiol. Accumulated evidence indicates that normally ovulatory menstrual cycles are necessary for ciswomen’s current fertility, as well as for later-life bone and cardiovascular health and the prevention of breast and endometrial cancers.Evidence AcquisitionExtensive past clinical experience with transgender women’s CHT using estradiol/estrogen combined with progesterone/medroxyprogesterone and pioneering the addition of spironolactone. Comprehensive progesterone physiology research plus a brief review of transgender women’s literature to assess current therapy and clinical outcomes, including morbidity and mortality.PurposeTo emphasize that both ovarian hormones, progesterone as well as estradiol, are theoretically and clinically important for optimal transgender women’s CHT.Evidence SynthesisIt is important to add progesterone to estradiol and an antiandrogen in transgender women’s CHT. Progesterone may add the following: (i) more rapid feminization, (ii) decreased endogenous testosterone production, (iii) optimal breast maturation to Tanner stages 4/5, (iv) increased bone formation, (v) improved sleep and vasomotor symptom control, and (vi) cardiovascular health benefits.ConclusionsEvidence has accrued that normal progesterone (and ovulation), as well as physiological estradiol levels, is necessary during ciswomen’s premenopausal menstrual cycles for current fertility and long-term health; transgender women deserve progesterone therapy and similar potential physiological benefits.
A Mitochondrial Progesterone Receptor Increases Cardiac Beta-Oxidation and Remodeling
Authors: Dai Qunsheng , Likes Creighton E , Luz Anthony L , Mao Lan , Yeh Jason S , Wei Zhengzheng , Kuchibhatla Maragatha , Ilkayeva Olga R , Koves Timothy R , Price Thomas M 
Published: January 2019

AbstractProgesterone is primarily a pregnancy-related hormone, produced in substantial quantities after ovulation and during gestation. Traditionally known to function via nuclear receptors for transcriptional regulation, there is also evidence of nonnuclear action. A previously identified mitochondrial progesterone receptor (PR-M) increases cellular respiration in cell models. In these studies, we demonstrated that expression of PR-M in rat H9c2 cardiomyocytes resulted in a ligand-dependent increase in oxidative cellular respiration and beta-oxidation. Cardiac expression in a TET-On transgenic mouse resulted in gene expression of myofibril proteins for remodeling and proteins involved in oxidative phosphorylation and fatty acid metabolism. In a model of increased afterload from constant transverse aortic constriction, mice expressing PR-M showed a ligand-dependent preservation of cardiac function. From these observations, we propose that PR-M is responsible for progesterone-induced increases in cellular energy production and cardiac remodeling to meet the physiological demands of pregnancy.
What Is Ethnohistory?: A Sixty-Year Retrospective
Authors: Riehm Grace E. , Brambila Lydia , Brown Brittany A. , McDougal Lauren Collins , Effre Danielle N. , Ethridge Robbie , Komlo Morgan , Kowalewski Stephen A. , Lulewicz J. Jacob , McDonald Caitlin M. , Plesher Caitlin F. , Ritchison Brandon T. , Smith Colleen N. , Sutton Amanda J. , Thompson Victor D. 
Published: January 2019

Abstract
In honor of Ethnohistory’s sixtieth anniversary, this paper compiles data on the journal and analyzes patterns and trends throughout the publication. We divided observations into four categories: (1) authorship of each article, particularly focusing on gender in authorship and coauthorship, (2) the region represented in each article, (3) the topic, and (4) data sources used by the author(s). We then analyzed each category in representative ten-year intervals from 1954 to 2013. Such data reveals trends that mirror intellectual, scholarly, and demographic changes in the social sciences overall. Female authorship, for example, steadily increases until the most recent decade, while coauthorship shows steady growth in raw numbers, but still represents a varying percentage with each decade. The North American region composes the majority of regional representation since the beginning, but Latin American regional representation as well as that outside of the Americas, shows significant increases over time. Meanwhile, fluctuating topics and data sources demonstrate diversification and expanding breadth within Ethnohistory.
A Model of Secular Stagnation: Theory and Quantitative Evaluation
Authors: Eggertsson Gauti B. , Mehrotra Neil R. , Robbins Jacob A. 
Published: January 2019

This paper formalizes and quantifies the secular stagnation hypothesis, defined as a persistently low or negative natural rate of interest leading to a chronically binding zero lower bound (ZLB). Output-inflation dynamics and policy prescriptions are fundamentally different from those in the standard New Keynesian framework. Using a 56-period quantitative life cycle model, a standard calibration to US data delivers a natural rate ranging from − 1.5 percent to − 2 percent, implying an elevated risk of ZLB episodes for the foreseeable future. We decompose the contribution of demographic and technological factors to the decline in interest rates since 1970 and quantify changes required to restore higher rates. (JEL E12, E23, E31, E32, E43, E52)
Case Report: Recurrent hypokalemic periodic paralysis associated with distal renal tubular acidosis (type 1) and hypothyroidism secondary to Hashimoto´s thyroiditis
Authors: Meregildo-Rodríguez E. Dante , Failoc-Rojas Virgilio E. 
Published: January 2019

Background: Hypokalemic periodic paralysis (HypoKPP) is characterized by transient episodes of flaccid muscle weakness. We describe the case of a teenaged boy with HypoKPP and hyperthyroidism due to Hashimoto's thyroiditis with initial manifestation of renal tubular acidosis. This combination is rare and little described previously in men. Case presentation: A 17-year-old boy was admitted after three days of muscular weakness and paresthesia in the lower limbs with an ascending evolution, leading to prostration. Decreased strength was found in the lower limbs without a defined sensory level, reduced patellar and ankle reflexes. Positive antithyroid antibodies were found. He received hydration treatment, IV potassium and levothyroxine, with which there was a clinical improvement. Other examinations led to the diagnosis of type 1 renal tubular acidosis. Conclusion: HypoKPP is a rare disorder characterized by acute episodes of muscle weakness. Type 1 renal tubular acidosis can occur as a consequence of thyroiditis, which is explained by the loss of potassium. This combination is unusually rare, and has not been described before in men. The etiopathogenesis of the disease as well as a dynamic explanation of what happened with the patient are discussed in this report.
Lithuanian Literature in 1918–1940: The Dynamics of Influences and Originality
Authors: Vanagaitė Gitana 
Published: January 2019

Lithuanian independence (1918–1940), which lasted for twentytwo years, and its symbolic center, the provisional capital Kaunas, have been very important for the country’s political, social, and cultural identity. In 1918, changes in the social, economic, and political status of an individual as well as transformations in the literary field followed the change of the political system. In what ways the relationship between the center and the periphery and the spheres of literary influences were altered by the new forms of life? Lithuania, the former geographic periphery of tsarist Russia, after the change of the political system became a geographical and cultural periphery of Europe. Nevertheless, political freedom provided an opportunity to use the dichotomy of center-periphery creatively. Lithuanian writers, who suddenly found themselves living in Europe with old cultural traditions, tried to overcome the insignificance of their own literature, its shallow themes and problems by “borrowing” ideas and ways to express them. In fact, the imitation was not mechanical, so the new influences enabled writers to expand significantly the themes and forms of Lithuanian literature.
The article examines the development of new cultural centers in independent Lithuania. It also discusses the avant-garde movement which emerged under the influence of Russian futurists and German expressionists. In addition, it focuses on individual authors, such as Antanas Vaičiulaitis, Kazys Binkis and Petras Cvirka, and the influence that affected their works.
The prognostic significance of macroscopic serosal change in subserosal invasion (stage T3) gastric cancer
Authors: Zhao B , Mei D , Zhang J , Zou S , Lu Hn , Xu H , Huang B 
Published: January 2019

Background For patients with gastric cancer intraoperative macroscopic serosal change is not always consistent with pathological T stage. We investigated whether macroscopic serosal change is associated with unfavourable prognosis of patients with gastric cancer. Methods We reviewed 856 patients with stage T3 gastric cancer who underwent curative gastrectomy in our institution. All patients were classified as serosa negative and serosa positive according to the macroscopic serosal change during the operation. The prognostic difference between two groups was compared and clinicopathologic features were analysed. Results The percentage of macroscopic serosal change accounted for 55.7% of all patients. Compared with normal serosal surface, the patients with macroscopic serosal change had larger tumour size, more extensive stomach involvement and more advanced stage N. The prognosis of stage T3 with macroscopic serosal change was significantly poorer than that of those with normal serosal surface, especially for those with stages T3N0 and T3N1. Multivariate analysis identified macroscopic serosal change as an independent factor associated with unfavourable prognosis of stage T3 cancer. Conclusion Although the depth of tumour invasion mainly depends on pathological evaluation after surgery, the prognostic significance of intraoperative macroscopic serosal change should not be ignored for those patients with subserosal invasion.
The effects of foam sclerotherapy on ulcer healing: a single-centre prospective study
Authors: Cuffolo G , Hardy E , Perkins J , Hands LJ 
Published: January 2019

Introduction This prospective study of foam sclerotherapy for varicose veins aimed to determine the outcomes of treatment including ulcer healing and complication rates in our unit. Data were collected prospectively over a 10-year period and maintained on a database by our vascular sciences unit, which performed the planning and post-treatment venous duplex scans. Patients undergoing treatment due to venous ulceration were identified from this database. An initial cohort of patients underwent a follow-up scan and assessment at one year. Materials and methods Patients were treated with foam sclerotherapy, in multiple sessions if required, to occlude all incompetent superficial veins greater than 3 mm in size. We used 3% sodium tetradecyl sulphate as our sclerosing agent, according to our departmental protocol, followed by a period of compression therapy. Patients underwent pre- and post-treatment scans to assess venous competence, the effects of treatment and any complications that arose. Results We identified 336 patients treated for clinical, aetiological, anatomical and pathophysiological stage 5/6 venous ulceration. At six weeks post-treatment, 21% had fully healed ulcers and a further 46.1% were clinically improving with no further venous incompetence. The remainder continued treatment. An initial cohort of 162 patients was assessed at one year and 77.1% ulcers remained healed. The remainder demonstrated some venous incompetence and ultimately 12.5% required further treatment. Our complication rates were similar to those quoted in published meta-analyses including a deep vein thrombosis rate of 1.16%. Conclusions Foam sclerotherapy remains a useful treatment option for venous ulceration with a low morbidity rate.
Does a dedicated hip fracture unit improve clinical outcomes? A five-year case series
Authors: Walton TJ , Bellringer SF , Edmondson M , Stott P , Rogers BA 
Published: January 2019

Introduction The aim of the study was to establish whether a dedicated hip fracture unit, geographically separate from the local major trauma centre, could improve clinical outcomes for patients sustaining proximal femoral fragility fractures. Materials and methods This study was a retrospective case series, using data collected from Brighton and Sussex University Hospitals NHS Trust’s submissions to the National Hip Fracture Database between 1 April 2011 and 16 September 2016. The outcomes measured were mortality, length of hospital stay, time from admission to surgical intervention and return to premorbid residence. Patients were compared before and after reconfiguration of services into a separate dedicated hip fracture unit geographically distinct from the major trauma centre. Results A total of 2117 patients (2178 injuries) were managed before the existence of the hip fracture unit, while 660 patients (673 injuries) were treated within the hip fracture unit. During the five-year study period, the 30-day mortality rate (pre-hip fracture unit 5.47% vs hip fracture unit 3.13%, P = 0.014), variance in the length of hospital stay (P < 0.001), mean time to surgical intervention (P = 0.044) and return to premorbid residence were significantly improved. An immediate 12-month comparison demonstrated significantly improved variance in length of hospital stay (P = 0.020) and return to premorbid residence (P = 0.015). Discussion The reconfiguration of services significantly reduced variance in length of stay, enabling accurate resource planning in future. Multiple incremental improvements in service provision, in addition to the hip fracture unit, may explain the lower mortality observed. Conclusion While further research is required, replication of the hip fracture unit service model may potentially afford significant clinical and financial gains.
Effectiveness Of Early Excisional Debridement In Burn Injuries To Sepsis Incidence And Mortality Rate At Burn Unit Of Hasan Sadikin Hospital
Authors: Bowo Setiagung Ambari , Soedjana Hardisiswo 
Published: January 2019

Background: Sepsis is an important cause of mortality in patients with burn, although many factors influence it. Early excision debridement as source control treatment has been done routinely in our center. It was intended to prevent sepsis and decrease mortality rate.
Methods: We performed a retrospective, cross sectional study over 4 years (2012-2014) among patients with flame burns in Burn Unit Dr. Hasan Sadikin Hospital who underwent early excisional debridement. The criteria of patients were adult, with full thickness burn, without inhalation injury and co morbid disease. The mortality, length of stay, and incidence of sepsis were analyzed by simple regression linier statistics using SPSS 16.0 for Windows.
Results: Mortality rate of all patients was 43.3%, and 42.3% was directly caused by sepsis. Thirty-nine patients matched the criteria, 20 patients had early excision (< 3 days) and 19 patients had late excision (> 3 days). In early excision group, 75% got sepsis and 55% died. Mortality and incidence of sepsis wasn’t significantly different in both groups (p=0.252 and p=0.855). Both groups have same length of stay (mean : 13.1 and p=0.236). Sex as confounding factor wasn’t significantly different (p=0.774). The extent of TBSA and age were significant factors causing mortality rate (p < 0.05).
Conclusion: There are many factors that contribute to the success of treating burn patient. Excision debridement was proven by this study not a major factor and ineffective to decrease sepsis and mortality in burned patients.