bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intra-procedural bronchial artery embolization planning: the usefulness of cone-beam CT
Authors: Grosse Ulrich , Grözinger Gerd , Syha Roland , Ketelsen Dominik , Partovi Sasan , Nikolaou Konstantin , Hoffmann Rüdiger 
Published: March 2019

Background Bronchial artery embolization (BAE) can be a challenging intervention due to variations of the vascular anatomy. Purpose To evaluate the utility of C-arm cone-beam computed tomography (CBCT) for BAE in patients with hemoptysis and indefinite bronchial artery (BA) anatomy on pre-interventional CT imaging. Material and Methods From November 2016 to July 2017, 17 patients (mean age = 64.3 ± 14.7 years) with hemoptysis underwent BAE including pre-interventional CT, aortography, and CBCT during the procedure. CBCT, angiography, and CT were independently evaluated by readers A and B (with one and three years of experience in interventional radiology) with regard to number and origin of detected BA, image quality, and diagnostic confidence for BA detection (using a Likert scale). Consensus reading by two experienced interventional radiologists served as gold standard (GS). Seventeen consecutive patients who underwent BAE before the installation of the CBCT in October 2016 served as control group. Spearman rank correlation and Wilcoxon signed-rank test were conducted. Results Both readers showed a statistically significant increase in diagnostic confidence for CBCT compared to pre-procedural CT (A: P = 0.003; B: P = 0.03) and for CBCT compared to aortography (A+B: P < 0.001). Correlation coefficient between GS and CBCT regarding the number of detected BA was: r = 0.855 (A), r = 0.877 (B); GS and CT: r = 0.250 (A), r = 0.317 (B); GS and aortography: r = 0.290 (A); r = 0.429 (B). Time to BA catheterization was 32.6 ± 12.5 min (control group 38.5 ± 24.6 min; P = 0.72). Significantly less angiographic series were acquired until BA catheterization after CBCT (1.3 ± 0.7; control group: 3.6 ± 2.9; P = 0.003). Conclusion CBCT supports the assessment of the BA anatomy during BAE in patients with hemoptysis.
Renal function, complications, and outcomes of a reduction in tumor size after transarterial embolization for renal angiomyolipomas: a meta-analysis
Authors: Lin Letao , Li Xinfei , Guan Haitao , Wang Jian , Tong Xiaoqiang , Yang Min , Zou Yinghua 
Published: March 2019

Objective The present study aimed to evaluate renal function, complications, and changes in tumor size after transarterial embolization for patients with renal angiomyolipomas. Methods We performed a meta-analysis of transarterial embolization in patients with renal angiomyolipomas from January 1994 to April 2018. Endpoints of interest were the estimated glomerular filtration rate, serum creatinine levels, blood urea nitrogen levels, complications, and reduction of tumors. Results A total of 30 studies comprising 653 patients were included. A total of 32.0% of patients were treated by urgent transarterial embolization for spontaneous ruptured renal angiomyolipomas. Other patients sought to relieve symptoms or received embolism prophylactically. The estimated glomerular filtration rate showed no significant difference between before and after embolization. In 363 patients with data on complications, post-embolization syndrome occurred most frequently (54.0%). Only 16 (4.4%) patients had major complications. The diameter of sporadic angiomyolipomas was reduced by a mean of 2.09 cm (95% confidence interval [CI], 0.73–3.45 cm; I2 = 29.3%) and they were reduced in size by 30.0% (95% CI, 16.0%–44.0%; I2 = 27.9%). Conclusions Transarterial embolization of renal angiomyolipomas affects renal function preservation, with a low complication rate. Transarterial embolization is useful for sporadic and tuberous sclerosis complex-related angiomyolipomas.
Chatbots and Conversational Agents in Mental Health: A Review of the Psychiatric Landscape
Authors: Vaidyam Aditya Nrusimha , Wisniewski Hannah , Halamka John David , Kashavan Matcheri S. , Torous John Blake 
Published: March 2019

Objective: The aim of this review was to explore the current evidence for conversational agents or chatbots in the field of psychiatry and their role in screening, diagnosis, and treatment of mental illnesses. Methods: A systematic literature search in June 2018 was conducted in PubMed, EmBase, PsycINFO, Cochrane, Web of Science, and IEEE Xplore. Studies were included that involved a chatbot in a mental health setting focusing on populations with or at high risk of developing depression, anxiety, schizophrenia, bipolar, and substance abuse disorders. Results: From the selected databases, 1466 records were retrieved and 8 studies met the inclusion criteria. Two additional studies were included from reference list screening for a total of 10 included studies. Overall, potential for conversational agents in psychiatric use was reported to be high across all studies. In particular, conversational agents showed potential for benefit in psychoeducation and self-adherence. In addition, satisfaction rating of chatbots was high across all studies, suggesting that they would be an effective and enjoyable tool in psychiatric treatment. Conclusion: Preliminary evidence for psychiatric use of chatbots is favourable. However, given the heterogeneity of the reviewed studies, further research with standardized outcomes reporting is required to more thoroughly examine the effectiveness of conversational agents. Regardless, early evidence shows that with the proper approach and research, the mental health field could use conversational agents in psychiatric treatment.
Current Practice of Therapeutic Hypothermia for Mild Hypoxic Ischemic Encephalopathy
Authors: Saw Chia L. , Rakshasbhuvankar Abhijeet , Rao Shripada , Bulsara M , Patole Sanjay 
Published: March 2019

Context: Therapeutic hypothermia is the recommended treatment for neonates with moderate or severe hypoxic ischemic encephalopathy (HIE). There is an increasing trend to use therapeutic hypothermia even in infants with mild hypoxic ischemic encephalopathy, even though there is little evidence to support/refute this. Objective: To estimate the incidences of mild hypoxic ischemic encephalopathy among infants who received therapeutic hypothermia, and its short- and long-term outcomes. Data Sources and Study Selection: PubMed, Embase, CINAHL, and Cochrane library were searched to identify observational studies reporting on therapeutic hypothermia in term and near-term infants with mild hypoxic ischemic encephalopathy. The JBI (Joanna Briggs Institute) tools were used to assess the risk of bias in the included studies. Random effects meta-analysis was conducted to find out the percentage of cooled infants who had only mild hypoxic ischemic encephalopathy. Results: A total of 3590 citations were screened, of which 13 were included. Of the 2783 infants who received therapeutic hypothermia, 573 had mild hypoxic ischemic encephalopathy. Meta-analysis found that 22% of the infants who underwent therapeutic hypothermia had only mild hypoxic ischemic encephalopathy (95% confidence interval: 16%-27%; I2 statistic = 90.5%). Five studies provided information on adverse effects of therapeutic hypothermia in mild hypoxic ischemic encephalopathy. The reported adverse effects were extreme hypothermia, bradycardia, hypoglycemia, sepsis, skin necrosis, pulmonary hypertension, and systemic hypotension. Limitation: The limitations included relatively small sample size and the lack of data for short- and long-term neurodevelopmental outcome. Conclusions: A significant proportion of infants who received therapeutic hypothermia had mild hypoxic ischemic encephalopathy. Randomized trials are urgently needed to evaluate the efficacy and safety of therapeutic hypothermia in infants with mild hypoxic ischemic encephalopathy.
Conceptualizations of the Holocaust in Soviet and Post-Soviet Ukraine and Belarus: Public Debates and Historiography
Authors: Baranova Olga 
Published: March 2019

This article belongs to a forthcoming special section, ‘Conceptualizations of the Holocaust in Germany, Lithuania, Poland, and Ukraine since the 1990s’ guest edited by Grzegorz Rossoliński-Liebe. This article investigates how the Holocaust was recollected, presented, and interpreted in Ukraine and Belarus during the Soviet era. It further examines the changes that have taken place in the representation of the Holocaust in Ukraine and Belarus in the post-communist period. First, the article aims to explain the ideological reasons why the Jewish origin of many Nazi victims was largely played down or ignored in the Soviet historiography. Second, it investigates the new political dynamics in independent post-communist Ukraine and Belarus that have influenced public discourse and historiographical reflections on various issues of the Second World War, including the persecution of the Jews. As well as historiography, the article investigates the developments that have taken place in contemporary Ukraine and Belarus regarding commemorative practices, monuments, museum exhibitions, and education initiatives to honor the victims of the Holocaust and to promote knowledge about this event.
Risk Factors for Delayed Onset of Lactogenesis II Among Primiparous Mothers from a Brazilian Baby-Friendly Hospital
Authors: Rocha Beatriz de Oliveira , Machado Marcia Penido , Bastos Livia Lima , Barbosa Silva Livia , Santos Ana Paula , Santos Luana Caroline , Ferrarez Bouzada Maria Candida 
Published: March 2019

Background: Low milk supply is frequently reported as a reason for exclusive breastfeeding cessation. Research aims: To determine the occurrence of, and the risk factors associated with, delayed onset of lactogenesis II among primiparas seen at a Baby-Friendly Hospital in Brazil. Method: We conducted a prospective longitudinal observational cohort study of 224 primiparas who had a singleton delivery. Data were first collected at the hospital. We assessed the onset of lactogenesis on day four postpartum, based on maternal reports of changes in breast fullness. Breastfeeding practices and Edinburgh Postnatal Depression Scale were evaluated on day seven postpartum. Using Poisson regression, we assessed significant factors associated with delayed onset of lactogenesis II. Results: Delayed lactogenesis II occurred in 18.8% ( n = 42) of participants and was significantly associated with alcohol drinking during pregnancy (IRR = 2.710, 95% CI [1.469, 4.996]); Edinburgh Postnatal Depression Scale scores ≥ 10 (IRR = 2.092, 95% CI [1.118, 3.916]), and the age of the mother (IRR: 1.081, 95% CI [1.039, 1.125]). Conclusion: Postpartum depression and alcohol ingestion during pregnancy may be associated with lactogenesis II delay, but more research is needed to elucidate the directionality of these relationships. Older mothers are at risk of delayed lactogenesis II onset. The frequency of delayed lactogenesis in this population is similar to the rates seen in previous Latin America studies and much lower than the ranges seen in North America, possibly because of the low proportion of obesity and severe gestational diabetes in this sample.
Fracture of a polyimide–elastimide posterior chamber intraocular lens following blunt orbital trauma
Authors: Friehmann Asaf , Sharon Tal , Ophir Shira Sheen , Assia Ehud I 
Published: March 2019

Purpose: Fracture of a three-piece polyimide–elastimide intraocular lens at the optic–haptic junction following blunt trauma is a possible complication after cataract surgery. We report a case of an isolated posterior chamber intraocular lens fracture caused by direct ocular blunt trauma. Case: A 51-year-old patient underwent blunt orbital trauma caused by a raw chicken egg that was thrown at him, as he was walking. The posterior chamber intraocular lens was found in the anterior chamber, with a broken optic–haptic junction. The intraocular lens was exchanged, followed by iris fixation and pupilloplasty, with satisfactory postoperative anatomical and optical outcomes. Discussion: The three-piece polyimide–elastimide intraocular lens was fractured at the optic–haptic junction. Although the fractured intraocular lens surface had a regular appearance, it has been previously reported that the polyimide haptic’s durability is probably inferior to that of polymethylmethacrylate. Therefore, it is highly susceptible to shear stress induced by a blunt trauma. Conclusion: To our knowledge, this is an uncommon report of an implanted posterior chamber polyimide–elastimide intraocular lens fracture following blunt orbital trauma. Intraocular lens exchange and fixation had successful optical and anatomical results.
Cerebral blood flow and cerebrovascular reactivity correlate with severity of motor symptoms in Parkinson’s disease
Authors: Pelizzari Laura , Laganà Maria Marcella , Rossetto Federica , Bergsland Niels , Galli Mirco , Baselli Giuseppe , Clerici Mario , Nemni Raffaello , Baglio Francesca 
Published: March 2019

Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder that is mainly characterized by movement dysfunction. Neurovascular unit (NVU) disruption has been proposed to be involved in the disease, but its role in PD neurodegenerative mechanisms is still unclear. The aim of this study was to investigate cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) within the regions belonging to the motor network, in patients with mild to moderate stages of PD. Methods: Twenty-eight PD patients (66.6 ± 8.6 years, 22 males, median [interquartile range, IQR] Hoehn & Yahr = 1.5 [1–1.9]) and 32 age- and sex-matched healthy controls (HCs) were scanned with arterial spin labeling (ASL) magnetic resonance imaging (MRI) for CBF assessment. ASL MRI was also acquired in hypercapnic conditions to induce vasodilation and subsequently allow for CVR measurement in a subgroup of 13 PD patients and 13 HCs. Median CBF and CVR were extracted from cortical and subcortical regions belonging to the motor network and compared between PD patients and HCs. In addition, the correlation between these parameters and the severity of PD motor symptoms [quantified with Unified Parkinson’s Disease Rating Scale part III (UPDRS III)] was assessed. The false discovery rate (FDR) method was used to correct for multiple comparisons. Results: No significant differences in terms of CBF and CVR were found between PD patients and HCs. Positive significant correlations were observed between CBF and UPDRS III within the precentral gyrus, postcentral gyrus, supplementary motor area, striatum, pallidum, thalamus, red nucleus, and substantia nigra (pFDR < 0.05). Conversely, significant negative correlation between CVR and UPDRS III was found in the corpus striatum (pFDR < 0.05). Conclusion: CBF and CVR assessment provides information about NVU integrity in an indirect and noninvasive way. Our findings support the hypothesis of NVU involvement at the mild to moderate stages of PD, suggesting that CBF and CVR within the motor network might be used as either diagnostic or prognostic markers for PD.
The impact of technical and clinical factors on fecal microbiota transfer outcomes for the treatment of recurrent Clostridioides difficile infections in Germany
Authors: Peri Rosemarie , Aguilar Rebeca Cruz , Tüffers Kester , Erhardt Andreas , Link Alexander , Ehlermann Philipp , Angeli Wolfgang , Frank Thorsten , Storr Martin , Glück Thomas , Sturm Andreas , Rosien Ulrich , Tacke Frank , Bachmann Oliver , Solbach Philipp , Stallmach Andreas , Goeser Felix , Vehreschild Maria JGT ,   for the German Clinical Microbiome Study Group (GCMSG)
Published: March 2019

IntroductionFecal microbiota transfer (FMT) is highly effective in the treatment and prevention of recurrent Clostridioides difficile infection (rCDI) with cure rates of about 80% after a single treatment. Nevertheless, the reasons for failure in the remaining 20% remain largely elusive. The aim of the present study was to investigate different potential clinical predictors of response to FMT in Germany.MethodsInformation was extracted from the MicroTrans Registry (NCT02681068), a retrospective observational multicenter study, collecting data from patients undergoing FMT for recurrent or refractory CDI in Germany. We performed binary logistic regression with the following covariates: age, gender, ribotype 027, Eastern Co‐operative Oncology Group score, immunosuppression, preparation for FMT by use of proton pump inhibitor, antimotility agents and bowel lavage, previous recurrences, severity of CDI, antibiotic induction treatment, fresh or frozen FMT preparation, and route of application.ResultsTreatment response was achieved in 191/240 evaluable cases (79.6%) at day 30 (D30) post FMT and 78.1% at day 90 (D90) post FMT. Assessment of clinical predictors for FMT failure by forward and confirmatory backward‐stepwise regression analysis yielded higher age as an independent predictor of FMT failure (p = 0.001; OR 1.060; 95%CI 1.025–1.097).ConclusionFMT in Germany is associated with high cure rates at D30 and D90. No specific pre‐treatment, preparation or application strategy had an impact on FMT success. Only higher age was identified as an independent risk factor for treatment failure. Based on these and external findings, future studies should focus on the assessment of microbiota and microbiota‐associated metabolites as factors determining FMT success.
Bridge-Enhanced Anterior Cruciate Ligament Repair: Two-Year Results of a First-in-Human Study
Authors: Murray Martha M. , Kalish Leslie A. , Fleming Braden C. ,   BEAR Trial Team, Flutie Brett , Freiberger Christina , Henderson Rachael N. , Perrone Gabriel S. , Thurber Laura G. , Proffen Benedikt L. , Ecklund Kirsten , Kramer Dennis E. , Yen Yi-Meng , Micheli Lyle J. 
Published: March 2019

Background: Bridge-enhanced anterior cruciate ligament repair (BEAR) combines suture repair of the anterior cruciate ligament (ACL) with a specific extracellular matrix scaffold (the BEAR scaffold) that is placed in the gap between the torn ends of the ACL to facilitate ligament healing. Purpose/Hypothesis: The purpose of this study was to report the 12- and 24-month outcomes of patients who underwent the BEAR procedure compared with a nonrandomized concurrent control group who underwent ACL reconstruction (ACLR) with an autograft. We hypothesized that the BEAR group would have physical examination findings, patient-reported outcomes, and adverse events that were similar to those of the ACLR group. Study Design: Cohort study; Level of evidence, 2. Methods: Ten patients underwent BEAR, and 10 underwent ACLR with a 4-stranded hamstring autograft. At 24 months, 9 of the 10 BEAR patients and 7 of the 10 ACLR patients completed a study visit. Outcomes reported included International Knee Documentation Committee (IKDC) subjective and objective results, knee anteroposterior (AP) laxity findings via an arthrometer, and functional outcomes. Results: There were no graft or repair failures in the first 24 months after surgery. The IKDC subjective scores in both groups improved significantly from baseline ( P < .0001) at 12 and 24 months, to 84.6 ± 17.2 in the ACLR group and to 91.7 ± 11.7 in the BEAR group. An IKDC objective grade of A (normal) was found in 44% of patients in the BEAR group and in 29% of patients in the ACLR group at 24 months; no patients in either group had C (abnormal) or D (severely abnormal) grades. Arthrometer testing demonstrated mean side-to-side differences in AP laxity that were similar in the 2 groups at 24 months (BEAR, 1.94 ± 2.08 mm; ACLR, 3.14 ± 2.66 mm). Functional hop testing results were similar in the 2 groups at 12 and 24 months after surgery. Hamstring strength indices were significantly higher in the BEAR group compared with the ACLR group ( P = .0001). Conclusion: In this small, first-in-human study, BEAR produced similar outcomes to ACLR with a hamstring autograft. BEAR may result in knee stability and patient-reported outcomes at 2 years sufficient to warrant longer term studies of efficacy in larger groups of patients.
Effect of Oral Contraceptives on Soft Tissue Injury Risk, Soft Tissue Laxity, and Muscle Strength: A Systematic Review of the Literature
Authors: Konopka Jaclyn A. , Hsue Lauren J. , Dragoo Jason L. 
Published: March 2019

Background: Female patients are more likely than male patients to experience various musculoskeletal (MSK) injuries. Because MSK tissues are sensitive to the female hormones relaxin, estrogen, and progesterone, studies have examined whether hormonal contraceptives, which change female hormone levels, can alter the female MSK injury risk. These studies have reached contradictory conclusions, leaving unclear the influence of hormonal contraception on female MSK injury risk. Hypothesis: Hormonal contraceptives act to decrease female soft tissue injury risk and soft tissue laxity. Study Design: Systematic review; Level of evidence, 3. Methods: Reviewers searched for clinically relevant studies evaluating the relationship between hormonal contraceptive use and soft tissue injuries, soft tissue laxity, muscle injuries, and muscle strength in the PubMed, Cochrane, Scopus, CINAHL, and Embase databases. Studies meeting inclusion criteria were scored by 2 independent researchers for risk of bias, imprecision, inconsistency, and indirectness with a template designed using the British Medical Journal Clinical Evidence GRADE (Grades of Recommendation Assessment, Development and Evaluation) scoring system and GRADEPro guidelines. Scores were uploaded into the GRADEPro scoring system software, which calculated each study’s final GRADE score ( very low, low, moderate, or high quality). Results: A total of 29 studies met inclusion criteria. Of the 7 studies evaluating oral contraceptive (OC) use and soft tissue injury risk, only 2 received a high quality-of-evidence score; all other studies received a very low score. The high-quality studies concluded that OC use decreases anterior cruciate ligament (ACL) injury risk. Only 1 of the 10 studies evaluating OC use and soft tissue laxity was found to have a high quality of evidence; this study determined that OC use decreases ACL laxity. Conclusion: Higher quality studies suggest that OCs decrease a female patient’s risk of ACL injuries and ACL laxity. The strength of these findings, however, is weak. Female patients are up to 8 times more likely to tear their ACLs than male patients. OCs may serve a therapeutic role in decreasing the sex disparity in ACL injury rates.
Inflammatory consequences of inherited disorders affecting neutrophil function
Authors: Dinauer Mary C. 
Published: March 2019

AbstractPrimary immunodeficiencies affecting the function of neutrophils and other phagocytic leukocytes are notable for an increased susceptibility to bacterial and fungal infections as a result of impaired leukocyte recruitment, ingestion, and/or killing of microbes. The underlying molecular defects can also impact other innate immune responses to infectious and inflammatory stimuli, leading to inflammatory and autoimmune complications that are not always directly related to infection. This review will provide an update on congenital disorders affecting neutrophil function in which a combination of host defense and inflammatory complications are prominent, including nicotinamide dinucleotide phosphate oxidase defects in chronic granulomatous disease and β2 integrin defects in leukocyte adhesion deficiency.