bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case report of spontaneous coronary artery dissection and the role of intravascular imaging for accurate diagnosis and successful management
Authors: Chen Chun-Chao , Liu Ju-Chi , Sung Li-Chin 
Published: January 2019

Abstract

Rationale:
Acute myocardial infarction (AMI) secondary to spontaneous coronary artery dissection (SCAD) is a rare condition. SCAD can be underdiagnosed on a coronary angiography (CAG). Therefore, the application of intravascular imaging including intravascular ultrasound (IVUS) and optical coherence tomography (OCT) is crucial for ensuring an accurate diagnosis and treatment.

Patients concerns:
A 72-year-old woman had an evolving AMI with ST elevation in the inferior leads (II, III, and aVF).

Diagnoses:
An emergent CAG showed that a double lumen had developed in the middle portion of the left circumflex artery. An IVUS examination revealed a coronary artery dissection and intramural hematoma.

Interventions:
First, the patient was treated with conservative management. We later placed a stent in response to the progression of the intramural hematoma observed during the IVUS follow-up.

Outcomes:
The patient remained symptom free after discharge. CAG with OCT at the 1-year follow-up after stent implantation showed in-stent restenosis with dissection flap with residual false lumen at the proximal site of stent. We treated this lesion with another stent.

Lessons:
From this case, we learned that in patients with AMI, SCAD should be considered as a possible diagnosis and that intravascular imaging tool can successfully guide clinical decision making and the treatment strategies.
Rare acute abdominal condition caused by mesenteric fibromatosis perforation
Authors: Li Jian , Xu Run , Hu Deng-Min 
Published: January 2019

Abstract

Rationale:
Mesenteric fibromatosis is a rare benign neoplasm with a tendency to spread and recur locally, without metastasis. It may present with a wide spectrum of clinical features; however, onset as a perforation is extremely rare.

Patient concerns:
The present patient was an 18-year-old female with a 10-hour history of increasing abdominal pain that arose suddenly with nausea and vomiting. She had experienced an appendectomy 2 years before this admission.

Diagnoses:
A gastrointestinal perforation was initially suspected on the basis of complaints and physical examination. The patient was thoroughly investigated for further diagnosis. Computed tomography showed a large well-defined intra-abdominal mass measuring 7.1 × 6.7 × 5.9 cm in the right lower quadrant, with adjacent small intestine compression and free intraperitoneal air. Then, the patient underwent a laparotomy. Finally, postoperative pathology and immunohistochemistry confirmed mesenteric fibromatosis, with a consecutive perforation from ileum to the bottom of tumor.

Interventions:
The patient has been treated by a resection of the mass with the adhesive small intestine, without chemotherapy or radiotherapy postoperatively.

Outcomes:
The patient had an uneventful postoperative recovery. Three months after surgery, the patient reviewed the colonoscopy, no intestinal polyps were noted. The present case has been followed up for 17 months without tumor recurrence.

Lessons:
Our case illustrates another possible cause of acute abdominal pain. Although rare, treating physicians should maintain a high suspicion index while managing a patient with an abdominal mass and pain. Close follow-up is essential because of the high incidence of local tumor recurrence.
Size and Prevalence of Pediatric Aerodigestive Programs in 2017
Authors: Gumer Lindsey , Rosen Rachel , Gold Benjamin D. , Chiou Eric H. , Greifer Melanie , Cohen Sherri , Friedlander Joel A. 
Published: January 2019

ABSTRACTObjective:Pediatric aerodigestive programs appear to be rapidly proliferating and provide multidisciplinary, coordinated care to complex, medically fragile children. Pediatric subspecialists are considered essential to these programs. This study evaluated the state of these programs in 2017 by surveying their size, composition, prevalence, and the number of patients that they serve.Methods:The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Aerodigestive Special Interest Group leadership distributed an 11‐question survey to the Pediatric Gastroenterology International Listserv. The mean time of the programs’ existence, number of half‐day clinics, number of procedure days, number of patients evaluated, and the lead primary specialty were evaluated.Results:Thirty‐four programs responded. Twenty‐five were based in academic centers. Thirty‐one programs were located across the United States. The average time of program existence was 5.3 years (standard deviation [SD] = 4.3; range 1–17 years). Approximately 64.7% were started in the past 5 years. Twelve programs were based in the division of gastroenterology. The average number of gastroenterologists serving aerodigestive programs was 2 (SD = 1.1). The mean number of half‐day clinic sessions and procedure days were 2.8 (SD = 2.9) and 2.6 (SD = 2), respectively. New and follow‐up visits per year in each program averaged 184 (SD = 168; range 10–750).Conclusions:Pediatric aerodigestive programs are prevalent, proliferating, and serve a large number of complex patients across North America and the world. This survey demonstrated that programs are predominantly based in academic settings. The number of patients cared for by aerodigestive centers varies widely depending on size and age of program.
Clinical and Endoscopy Findings in Children With Accidental Exposure to Concentrated Detergent Pods
Authors: Singh Avantika , Anderson Michael , Altaf Muhammad A. 
Published: January 2019

ABSTRACTBackground:Caustic ingestion with concentrated detergent pods (CDPs) is a common problem encountered in pediatric population. There is insufficient literature about endoscopic findings in CDP ingestion and hence no current consensus or guidelines regarding the need for endoscopic evaluation.Objectives:To review cases of children with exposure to CDPs from 2010 to 2016 at a tertiary care children's hospital and to identifying the possibility of a correlation between clinical presentation and the endoscopic findings.Methods:A retrospective review identified pediatric patients with accidental caustic exposure to CDPs. Data on demographics, type of exposure, clinical symptoms, physical examination, details of the hospital course were collected. Esophagogastroduodenoscopy (EGD) findings and direct laryngoscopy‐bronchoscopy findings were also collected. Descriptive statistics were computed for all demographic and clinical variables. The association between EGD findings and clinical presentation were tested using Fisher exact test.Results:A total of 23 (28%) cases of CDP ingestion were identified out of 83 total cases of caustic ingestion between January 2010 and June 2016. Median age was 15 months. gastrointestinal symptoms were present in 21 (91%) patients. Examination findings were present in 8 of 23 (35%) patients. EGD (done by gastroenterologists) evaluation was done in 21 (91%) patients and positive findings were seen in 5 of 21 (24%). The proportion of patients with positive examination findings was significantly higher in patients with positive EGD findings (80% vs 20%, respectively; P = 0.0307). Direct laryngoscopy‐bronchoscopy (done by otolaryngologists) evaluation was done in 6 (26%) patients and positive findings were seen in 4 of 6 (67%).Conclusions:Our results suggest that oropharyngeal examination findings increase the likelihood of endoscopy findings; hence, we recommend endoscopic evaluation of patients who have examination findings secondary to exposure to CDPs. In other patients, it will be reasonable to evaluate the need for endoscopy on a case‐by‐case basis.
Hand Assessment for Elderly People in the Community
Authors: Leow Mabel Qi He , Teo Wendy , Low Tzuemn Ling , Tay Shian Chao 
Published: January 2019

BACKGROUND:
Hand conditions are common in elderly persons.

PURPOSE:
To assess the prevalence of common hand conditions in elderly persons in a community setting, specifically osteoarthritis of the hand, trigger finger, and carpal tunnel syndrome.

METHODS:
The elderly persons were recruited from community groups for elderly persons. Data collection included participants' demographic and clinical data; quick disability, arm, shoulder, and hand (QuickDASH) questionnaire; and presence of hand conditions.

RESULTS:
Of the 55 elderly persons recruited, almost a third of them presented with a hand condition (n = 17, 30.8%). Hand conditions were more common in females (39% in females, 7% in males; χ2 = 4.97, p = .04). Quick-DASH scores were higher in those with hand conditions, indicating lower levels of function (greater disability) (t =−4.61, p = .002).

CONCLUSIONS:
Most elderly persons did not seek medical attention for their hand condition until the late stages. Nurses can play an important role in providing community hand assessment, education on hand symptoms, information about available treatment, and adaptive approaches to maximize functioning.
An Overview of Reviews on the Safety of Electroconvulsive Therapy Administered During Pregnancy
Authors: COSHAL SHANA , JONES KRISTIN , COVERDALE JOHN , LIVINGSTON ROBIN 
Published: January 2019

Objective:
To inform obstetricians and psychiatrists about the safety of electroconvulsive therapy (ECT) administration during pregnancy and to reconcile conflicting recommendations concerning this treatment.

Methods:
A systematically conducted overview was undertaken on the safety of ECT during pregnancy. The Cochrane Library, MEDLINE/PubMed, PsycINFO, and Ovid were independently searched by 2 of the authors from January 2015 to March 2017 using the following search terms: electroconvulsive therapy, ECT, and electroshock combined with pregnancy and reviews. Articles were reviewed and critically appraised using components of the PRISMA and AMSTAR systematic review assessment tools.

Results:
Of the 9 articles that were identified, 5 publications of varying methodological quality met inclusion criteria and involved a range of 32 to 339 patients. The most common problems that occurred in association with ECT were fetal arrhythmia, fetal bradycardia, premature birth, developmental delay, abdominal pain, uterine contraction, vaginal bleeding, placental abruption, and threatened abortion. The number of fetal deaths in each of the reviews ranged from 2 to 12. The authors of 1 of the 5 reviews recommended that ECT only be used as a last resort, whereas the authors of the other reviews took the stance that the administration of ECT during pregnancy was relatively safe. Differences in recommendations among reviews were in part due to inclusion criteria and how adverse events were attributed to ECT.

Conclusions:
Our overview supports the conclusion, which has also been endorsed by the American College of Obstetricians and Gynecologists and the American Psychiatric Association, that administration of ECT during pregnancy is relatively safe. Conclusions about safety, however, will become better established with the availability of more data.
One-Stage versus Two-Stage Arteriovenous Loop Reconstructions: An Experience on 103 Cases from a Single Center
Authors: Henn Dominic , Wähmann Matthias S. T. , Horsch Miriam , Hetjens Svetlana , Kremer Thomas , Gazyakan Emre , Hirche Christoph , Schmidt Volker J. , Germann Günter , Kneser Ulrich 
Published: January 2019

Background:
The optimal time for flap anastomosis to an arteriovenous loop remains controversial. Whether perforator flaps and axially vascularized muscle or fasciocutaneous flaps lead to comparable outcomes in conjunction with arteriovenous loops has not been investigated.

Methods:
Medical records from 103 patients undergoing arteriovenous loop reconstruction (76 one-stage and 27 two-stage) between 2007 and 2017 were reviewed. Postoperative outcomes were compared between one- and two-stage arteriovenous loop reconstructions and different types of free flaps.

Results:
Rates of flap thrombosis, major wound complications, and flap failure did not differ significantly between one- and two-stage arteriovenous loop reconstructions (14.47 percent versus 11.11 percent, p = 1.00; 30.26 percent versus 25.93 percent, p = 0.67; and 10.53 percent versus 7.41 percent, p = 1.00). For two-stage arteriovenous loop reconstructions, the time interval between arteriovenous loop placement and flap anastomosis was a predictor for thrombotic events (OR, 1.31; p < 0.05). Anterolateral thigh flaps in conjunction with arteriovenous loops showed higher failure rates (33.33 percent) compared with all other flaps (6.59 percent) (p < 0.05) and combined latissimus dorsi and parascapular flaps (0 percent) (p < 0.05). Thrombosis rates were higher in anterolateral thigh flaps (33.33 percent) compared with all other flaps (10.99 percent; p = 0.056), and combined latissimus dorsi and parascapular flaps (0 percent; p < 0.05).

Conclusions:
Two-stage arteriovenous loop reconstructions do not lead to increased postoperative complications compared to one-stage arteriovenous loop reconstructions and may be favorable in complicated cases because of shorter operative times. To avoid an increased thrombosis risk, flap anastomosis should not be delayed beyond 10 days in two-stage arteriovenous loop reconstructions. Anterolateral thigh flaps are less suitable for arteriovenous loop reconstructions because of higher complication rates.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Synovial Biopsy in the Diagnosis of Crystal-Associated Arthropathies
Authors: Moses Viju , Asirvatham Jaya Ruth , McHugh Jonathan , Ike Robert 
Published: January 2019

Background/ Objective
This study seeks to assess the utility of synovial biopsy in the diagnosis of crystal-associated arthropathies (CAAs) in a clinical setting.

Methods
In this retrospective study, we reviewed biopsy reports involving synovial tissue between 1988 and 2015. We then reviewed the records of patients where the biopsy was performed for a clinical suspicion of CAA—the clinical group—and calculated the frequency of a positive diagnosis. The t test, Mann-Whitney-Wilcoxon test, and Fisher test were used to compare clinical characteristics of patients with and without a tissue diagnosis of CAA. We also reviewed cases of unexpected detection of crystalline disease involving synovial tissue—the incidental group.

Results
Among 2786 biopsies involving the synovium, we identified 65 cases in the clinical group and 33 cases in the incidental group. In the clinical group, a relevant diagnosis was obtained from synovial tissue in 36.9%, and a CAA was diagnosed in 20%. Restricting analysis to clinical biopsies performed for a primary suspicion of CAA, a relevant diagnosis was obtained in 61.3%, and a CAA was diagnosed in 38.7%. The incidental group comprised 1.2% of all synovial biopsies and included 7 mass lesions. Basic calcium phosphate was not reported on any biopsy in the study period.

Conclusions
Synovial biopsy is a diagnostic option when suspected CAA is resistant to conventional modes of diagnosis. Crystalline diseases should be considered in the differential diagnosis of musculoskeletal mass lesions mimicking neoplasms.
Sensory and auditory evoked responses mimic synchronization of cortical oscillations induced by Transcranial Magnetic Stimulation
Authors: Krawinkel Lutz A. , Forisch Julia , Feldheim Jan F. , Backhaus Winifried , Quandt Fanny , Gerloff Christian 
Published: January 2019

AbstractBackgroundEntrainment of cortical oscillations by repetitive Transcranial Magnetic Stimulation (rTMS) is an attractive approach to modulate brain function non-invasively in humans. Here, we applied rTMS in order to modulate oscillatory activity in ventral premotor cortex (PMv), primary motor cortex (M1), and anterior intraparietal sulcus (aIPS). These areas are thought to contribute to recovery after motor stroke and our overarching goal is to enhance their impact by rTMS. To this end, we established a setup with bifocal, neuronavigated rTMS combined with EEG and tested its technical feasibility.MethodsBifocal zero-phase lag synchronized rTMS at 11Hz was applied in seven young healthy volunteers to the target pairs (i) PMv and M1 and (ii) aIPS and M1. Adapting to the close vicinity between target areas, we used two small, commercially available coils and applied subthreshold stimuli in order to avoid motor evoked potentials (MEPs). Besides a parieto-occipital sham stimulation, we also included auditory and sensory stimulation in a further control experiment.ResultsFirst, subthreshold TMS led to a phase synchronization and evoked time-averaged potentials in the EEG. However, the same findings could be elicited by peripheral, somatosensory stimulation combined with auditory stimulation. Second, despite the small coils neuronavigation analysis showed that in most participants aIPS and M1 or PMv and M1 could not precisely be targeted due to their vicinity and restriction in coil positioning. Third, bifocal subthreshold rTMS tended to sum up where the induced fields showed the greatest overlap resulting in overt MEPs and thus raising potential safety issues.ConclusionsThe presented data show refinements for bifocal rTMS studies regarding (i) spurious entrainment or resetting effects on brain oscillations, (ii) precise anatomical targeting of areas in close vicinity, and (iii) summing up of overlapping induced electrical fields.
Development and Characterization of a Fixed Repertoire of Blood Transcriptome Modules Based on Co-expression Patterns Across Immunological States
Authors: Altman Matthew C , Rinchai Darawan , Baldwin Nicole , Toufiq Mohammed , Whalen Elizabeth , Garand Mathieu , Kabeer Basirudeen Ahamed , Alfaki Mohamed , Presnell Scott , Khaenam Prasong , Benitez Aaron Ayllon , Mougin Fleur , Thébault Patricia , Chiche Laurent , Jourde-Chiche Noemie , Phillips J Theodore , Klintmalm Goran , O’Garra Anne , Berry Matthew , Bloom Chloe , Wilkinson Robert J , Graham Christine M , Lipman Marc , Lertmemongkolchai Ganjana , Bedognetti Davide , Thiebaut Rodolphe , Kheradmand Farrah , Mejias Asuncion , Ramilo Octavio , Palucka Karolina , Pascual Virginia , Banchereau Jacques , Chaussabel Damien 
Published: January 2019

SUMMARYAs the capacity for generating large scale data continues to grow the ability to extract meaningful biological knowledge from it remains a limitation. Here we describe the development of a new fixed repertoire of transcriptional modules. It is meant to serve as a stable reusable framework for the analysis and interpretation of blood transcriptome profiling data. It is supported by customized resources, which include analysis workflows, fingerprint grid plots data visualizations, interactive web applications providing access to a vast number of module-specific functional profiling reports, reference transcriptional profiles and give users the ability to visualize of changes in transcript abundance across the modular repertoire at different granularity levels. A use case focusing on a set of six modules comprising interferon-inducible genes is also provided. Altogether we hope that this resource will also serve as a framework for improving over time our collective understanding of the immunobiology underlying blood transcriptome profiling data.
Trophic complexity alters the diversity-multifunctionality relationship in experimental grassland mesocosms
Authors: Anujan Krishna , Heilpern Sebastian A. , Prager Case M. , Naeem Shahid 
Published: January 2019

AbstractHigher levels of diversity within trophic levels are necessary to sustain multiple ecosystem functions, but this diversity-multifunctionality relationship peaks at intermediate percent-function thresholds. The presence of multiple trophic levels, or trophic complexity, affects ecosystem multifunctionality but its effect on the diversity-multifunctionality relationship has not been experimentally tested. To test the sensitivity of the diversity-multifunctionality relationship to trophic complexity, we simultaneously manipulated plant diversity and trophic complexity in a multifactorial tall-grass prairie mesocosm experiment at Cedar Creek, Minnesota, USA. Trophic complexity altered the diversity-multifunctionality relationship, by lowering the height of the peak as well as by shifting to a negative effect at lower thresholds. These outcomes are consistent with decreases in both the “jack-of-all-trades” effect and complementarity among plant species. Our findings suggest that trophic complexity, which is experiencing widespread declines on a global scale, is important for sustaining ecosystem multifunctionality in the face of equally widespread declines in biodiversity.
Sulcal organization in the medial frontal cortex reveals insights into primate brain evolution
Authors: Amiez Céline , Sallet Jérome , Hopkins William D. , Meguerditchian Adrien , Hadj-Bouziane Fadila , Ben Hamed Suliann , Wilson Charles R.E. , Procyk Emmanuel , Petrides Michael 
Published: January 2019

ABSTRACTAlthough the relative expansion of the frontal cortex in primate evolution is generally accepted, the nature of the human uniqueness, if any, and between-species anatomo-functional comparisons of the frontal areas remain controversial. To provide a novel interpretation of the evolution of primate brains, sulcal morphological variability of the medial frontal cortex was assessed in old-world monkeys (macaque, baboon) and Hominoidea (chimpanzee, human). We discovered that both Hominoidea do possess a paracingulate sulcus, which was previously thought to be uniquely human and linked to higher cognitive functions like mentalizing. Also, we revealed systematic sulcal morphological organisations of the medial frontal cortex that can be traced from multiple old-world monkey to Hominoidea species, demonstrating an evolutionary conserved organizational principle. Our data provide a new framework to compare sulcal morphology, cytoarchitectonic areal distribution, connectivity, and function across the primate order, leading to clear predictions on how other primate brains might be anatomo-functionally organized.
Quantification and Isolation ofBacillus subtilisSpores using Cell Sorting and automated Gating
Authors: Karava Marianna , Bracharz Felix , Kabisch Johannes 
Published: January 2019

AbstractThe Gram-positive bacteriumBacillus subtilisis able to form endospores which have a variety of biotechnological applications. Due to this ability,B. subtilisis as well a model organism for cellular differentiation processes. Sporulating cultures ofBacillus subtilisform sub-populations which include vegetative cells, spore forming cells and spores. In order to readily and rapidly quantify spore formation we employed flow cytometric and fluorescence activated cell sorting techniques in combination with nucleic acid fluorescent staining in order to investigate the distribution of sporulating cultures on a single cell level. Moreover we tested different fluorescent dyes as well as different conditions in order to develop a method for optimal separation of distinct populations during sporulation. Automated gating procedures using k-means clustering and thresholding by gaussian mixture modeling were employed to avoid subjective gating and allow for the simultaneous measurement of controls. We utilized the presented method for monitoring sporulation over time in strains harboring different genome modifications. We identified the different subpopulations formed during sporulation by employing sorting and microscopy. Finally, we employed the technique to show that a double knock-out mutant of the phosphatase gene encoding Spo0E and of the spore killing factor SkfA results in faster spore formation.