bluuebunny/crossref_metadata_2025_split huggingface dataset:
Polymorphic characterization and implications on biopharmaceutics properties of potential anti-inflammatory drug candidate eremantholide C from Lychnophora trichocarpha (Brazilian Arnica)
Authors: Caldeira Tamires G , Saúde-Guimarães Dênia A , De Lacerda Dâmaris L R , Mussel Wagner Da Nova , Yoshida Maria Irene , De Souza Jacqueline 
Published: February 2019

Abstract

Objectives
To perform the polymorphic and physicochemical characterization of the potential anti-inflammatory drug, eremantholide C (EREC), as well as to evaluate the influence of these characteristics on its biopharmaceutics classification.

Methods
Eremantholide C was obtained from chloroformic extract of Lychnophora trichocarpha and crystallized in two distinct solvents: chloroform (EREC 1) and ethyl acetate (EREC 2). To evaluate the polymorphism, EREC samples were submitted to melting point, purity, infrared spectroscopy, differential scanning calorimetry (DSC), X-ray powder diffraction, optical microscopy and scanning electron microscopy analysis. In addition, EREC samples crystallized after intrinsic dissolution study were submitted to DSC and X-ray powder diffraction analysis.

Key findings
EREC 1 showed fusion at 234.7–241.6 °C, while EREC 2 showed fusion at 238.6–243.7 °C. No polymorphic transitions were observed during the intrinsic dissolution experiment. A single sharp endothermic peak was obtained for the EREC samples. X-ray diffraction showed no crystallographic differences between the EREC samples. EREC 1 and EREC 2 showed birefringence under polarized light and indefinite morphology; however, the shape of the crystals was common to the two samples.

Conclusions
Eremantholide C does not present classical or morphological polymorphism; therefore, there is no influence of crystalline transitions in the solubility and consequently in its biopharmaceutics classification and oral absorption process.
The effect of oral contraceptive pill cessation on hepatocellular adenoma diameter: A retrospective cohort study
Authors: Haring Martijn P. D. , Gouw Annette S. H. , de Haas Robbert J. , Cuperus Frans J. C. , de Jong Koert P. , de Meijer Vincent E. 
Published: February 2019

AbstractBackground & AimsHepatocellular adenomas (HCA) are rare, hormone‐driven, benign liver tumours. HCA >50 mm are associated with haemorrhage and malignant transformation. Guidelines recommend cessation of oral contraceptive pills (OCP) for size reduction; however, it is currently unknown how HCA respond to cessation of OCP. We sought to investigate the effect of OCP cessation on HCA size.MethodsA retrospective cohort study was performed including HCA patients who stopped OCP intake within 6 months of imaging between 2005 and 2018. Biometrics and hormonal medication use were evaluated with self‐designed questionnaires. Response of the largest HCA was evaluated according to Response Evaluation Criteria in Solid Tumours (RECISTv1.1). Cox regression was performed for analysis of factors influencing HCA regression.ResultsSeventy‐eight HCA patients were included, diagnosed at a median (interquartile range) age of 32 (26‐41) years. Follow‐up was 1.6 (0.4‐2.9) years. HCA size at diagnosis ranged 10‐167 mm. After a median time of 1.3 (0.6‐2.6) years after OCP cessation, 37.2% of HCA showed ≥30% regression, 5.1% complete regression, 56.4% stability and 1.3% progression. No HCA‐induced complications were observed during follow‐up. Cox regression analysis demonstrated a significant association of HCA size with rate of regression; 50 ≤ HCA < 100 mm (HR 2.4, 95% CI 1.1‐5.3; P < 0.05), HCA ≥ 100 mm (HR 8.3, 95% CI 3.3‐21.6; P < 0.001).ConclusionsNinety‐eight per cent of HCA remained stable or regressed after OCP cessation. A longer wait‐and‐see period was associated with a larger proportion of regressing HCA, without HCA‐related complications during follow‐up.
Comparing resident–patient encounters and case presentations in a family medicine clinic
Authors: Skelly Kelly , Rosenbaum Marcy , Barlow Patrick , Priebe Garrick 
Published: February 2019

ObjectivesOral case presentations following resident–patient interactions provide the primary mechanism by which faculty supervisors assess resident competence. However, the extent to which these presentations capture the content and quality of resident–patient communication during the encounter remains unknown. We aimed to determine whether: (i) the resident–patient encounter content matched information conveyed in the case presentation; (ii) the quality of resident–patient communication was accurately conveyed, and (iii) supervisors addressed effective and ineffective communication processes.MethodsA total of 22 pairs of resident–patient encounters and family medicine resident case presentations were video‐ or audiorecorded, transcribed and compared for content. Resident–patient communication was assessed using adapted versions of the Calgary–Cambridge Guide to the Medical Interview and Explanation and Planning Scale.ResultsInterviews and presentations contained largely congruent content, but social history and the patient's perspective were consistently excluded from case presentations. Although six of 19 specific communication skills were used in over 80% of resident encounters, the effective use of communication skills was widely variable. In most presentations, the quality of resident–patient communication was not explicitly conveyed to the supervisor. Although resident presentations provided ‘cues’ about communication issues, supervisors rarely responded.ConclusionsThis study lends support to direct observation in workplace‐based learning of communication skills. When content areas such as the patient's perspective and education are excluded, supervisors cannot address them. In addition, presentations provided minimal insight about the quality of resident–patient encounters and limited the ability to address communication skills. These skills could be enhanced by attending to communication cues during case presentations, making increased use of direct observation and feedback, and promoting faculty development to address these missed teaching opportunities.
In vitro combination between antifungals and diphenyl diselenide against Cryptococcus species
Authors: Rossato Luana , Loreto Erico S. , Venturini Tarcieli P. , de Azevedo Maria Isabel , Al‐Hatmi Abdullah M. S. , Santurio Janio M. , Alves Sydney H. 
Published: February 2019

SummaryCryptococcus species are an encapsulated fungal pathogen that cause cryptococcal meningitis. There are limited therapeutic options for this infection. The management includes the use of different antifungals such as amphotericin B, flucytosine, or fluconazole, either alone or in combination. However, numerous therapeutic failures, as well as the limited effectiveness of such therapeutics, have been described. Diphenyl diselenide is a chemically synthesised molecule with was found to have antimicrobial activity. In this study, we evaluated the antifungal activities of fluconazole, amphotericin B and flucytosine, in combination with diphenyl diselenide against 30 clinical isolates of Cryptococcus spp. using CLSI M27‐A3 method and the checkerboard microdilution technique. Our results show that the combination of flucytosine and diphenyl diselenide displayed 100% of synergism. However, when we analysed (PhSe)2 plus AMB or FLZ we observed around 70% of indifference. Our results suggest that the combination of diphenyl diselenide with other antifungal agents deserves attention as a new option for the development of alternative therapies for cryptococcosis.
Harm reduction: Philosophical drivers of conceptual tensions and ways forward
Authors: Jiao Sunny 
Published: February 2019

AbstractOf the various debates surrounding harm reduction, a conceptual tension that perhaps has the most relevance for the provision of services is that of harm reduction as a technical solution versus a contextualized social practice. The aim of this paper was to examine this conceptual tension. First, the two perspectives will be presented through the use of examples. Second, philosophical drivers that serve to underpin and justify each perspective will be explicated at the level of the knowledge that we privilege; the ideologies that we subscribe to; and the interests that we stand to serve. In this paper, I argue that the existing tension between technical and social approaches to harm reduction is embedded within discord pertaining to ways of knowing, paradigms of inquiry, prevailing ideologies, and notions of harm and risk. Building on these sources of tension, I suggest a means of philosophical reconciliation between the two approaches and ways forward, namely through acknowledging multiple sources of knowledge, through embracing paradigmatic incommensurability, through considering alternative conceptions of people who use drugs as political subjects, through involving service providers and end‐users in shared decision‐making, and lastly through reaffirming people who use drugs as the intended beneficiaries of services.
Is gastroparesis a gastric disease?
Authors: Cogliandro Rosanna F. , Rizzoli Giada , Bellacosa Lara , De Giorgio Roberto , Cremon Cesare , Barbara Giovanni , Stanghellini Vincenzo 
Published: February 2019

AbstractBackgroundGastroparesis is a digestive syndrome characterized by delayed gastric emptying (GE) and by symptoms that are suggestive of gastroduodenal motor disorders. There are three grades of gastroparesis of increasing severity: (a) mild gastroparesis; (b) compensated gastroparesis; and (c) gastric failure. GE abnormalities are partially related to symptom type and severity, and other mechanisms may be involved.AimTo investigate enteric dysmotility (ED) in patients with suspected gastroparesis.MethodsPatients with symptoms suggestive of gastroparesis were consecutively included in the study and underwent a 13C‐octanoic acid GE breath test and small bowel manometry (SBM). Clinical features were recorded using predefined, validated questionnaires at entry.Key ResultsThe study enrolled 88 patients (71 women; mean age: 37.8 ± 14.3 years). Gastric emptying was delayed in 25 patients (28.4%), and 70 patients (79.5%) presented small bowel motor abnormalities including bursts, abnormal activity fronts, inability to respond to meal ingestion, and hypocontractility. Gastric emptying was delayed in 24 of the 70 patients with ED (34.3% vs 5.5% of patients with normal SBM). Enteric dysmotility was detected in 24 of 25 patients (96%) with delayed GE. Patients with and without delayed GE showed similar moderate/severe gastroparesis manifestations, but patients with ED significantly more often had moderate/severe gastroparesis manifestations than patients with normal SBM (grade 1:14% vs 39%, grade 2:62% vs 56%, grade 3:24% vs 5%, respectively).Conclusions and InferencesEnteric dysmotility was more frequent than delayed GE in patients with symptoms suggestive of gastroparesis. Gastroparesis severity was associated with small bowel motor abnormalities but not with delayed GE.
Pediatric chondrodermatitis nodularis helicis (CNH) in a child with Beckwith‐Wiedemann syndrome (BWS)
Authors: Fix William C. , Cornejo Christine , Duffy Kelly A. , Hathaway Evan R. , Kalish Jennifer M. , Rubin Adam I. , Treat James R. 
Published: February 2019

AbstractChondrodermatitis nodularis helicis is an idiopathic degenerative process that presents as a painful nodule, papule, or ulcer on the helix or antihelix. It predominantly affects adults and is thought to be associated with trauma to the ear. We describe a case of pediatric chondrodermatitis nodularis helicis occurring in a child with a history of Beckwith‐Wiedemann syndrome that was successfully treated with an excisional biopsy and relief from a recurrent source of pressure on the ear.
Preservice teachers’ mathematics task modification for emergent bilinguals
Authors: I Ji–Yeong 
Published: February 2019

AbstractImplementing mathematically challenging tasks is difficult for teachers when working with emergent bilinguals because cognitively demanding tasks in mathematics commonly have high language demand. Currently, inadequate teacher preparation for teaching emergent bilinguals is becoming a significant concern in the United States as this population of students is rapidly growing. This study investigated how two mathematics preservice teachers (PSTs) support middle school emergent bilinguals to understand cognitively demanding mathematical problems through task modification. Fieldwork with a concurrent intervention was designed for the PSTs to work with emergent bilinguals in a one‐on‐one setting. The PSTs modified cognitively demanding mathematics tasks and designed a lesson for the emergent bilinguals based on the modified tasks. The results revealed that the task modification made by the PSTs tended to shift from reducing cognitive demands in mathematics and language to maintaining the demands through learning strategies of contextual support.
Genome‐wide analysis of flanking sequences reveals that Tnt1 insertion is positively correlated with gene methylation in Medicago truncatula
Authors: Sun Liang , Gill Upinder S. , Nandety Raja Sekhar , Kwon Soonil , Mehta Perdeep , Dickstein Rebecca , Udvardi Michael K. , Mysore Kirankumar S. , Wen Jiangqi 
Published: February 2019

SummaryFrom a single transgenic line harboring five Tnt1 transposon insertions, we generated a near‐saturated insertion population in Medicago truncatula. Using thermal asymmetric interlaced‐polymerase chain reaction followed by sequencing, we recovered 388 888 flanking sequence tags (FSTs) from 21 741 insertion lines in this population. FST recovery from 14 Tnt1 lines using the whole‐genome sequencing (WGS) and/or Tnt1‐capture sequencing approaches suggests an average of 80 insertions per line, which is more than the previous estimation of 25 insertions. Analysis of the distribution pattern and preference of Tnt1 insertions showed that Tnt1 is overall randomly distributed throughout the M. truncatula genome. At the chromosomal level, Tnt1 insertions occurred on both arms of all chromosomes, with insertion frequency negatively correlated with the GC content. Based on 174 546 filtered FSTs that show exact insertion locations in the M. truncatula genome version 4.0 (Mt4.0), 0.44 Tnt1 insertions occurred per kb, and 19 583 genes contained Tnt1 with an average of 3.43 insertions per gene. Pathway and gene ontology analyses revealed that Tnt1‐inserted genes are significantly enriched in processes associated with ‘stress’, ‘transport’, ‘signaling’ and ‘stimulus response’. Surprisingly, gene groups with higher methylation frequency were more frequently targeted for insertion. Analysis of 19 583 Tnt1‐inserted genes revealed that 59% (1265) of 2144 transcription factors, 63% (765) of 1216 receptor kinases and 56% (343) of 616 nucleotide‐binding site‐leucine‐rich repeat genes harbored at least one Tnt1 insertion, compared with the overall 38% of Tnt1‐inserted genes out of 50 894 annotated genes in the genome.
Influence of tibial plateau leveling osteotomy and tibial tuberosity advancement on passive laxity of the cranial cruciate deficient stifle in dogs
Authors: Ober Ciprian A. , Factor Gilad , Meiner Yaron , Segev Gilad , Shipov Anna , Milgram Joshua 
Published: February 2019

AbstractObjectiveTo evaluate the effect of tibial plateau leveling osteotomy (TPLO) and tibial tuberosity transposition (TTA) on craniocaudal stability of the cranial cruciate ligament (CCL) deficient stifle at 3 joint angles.Study designEx vivo biomechanical study.Sample populationEight stifles from 4 dogs.MethodsOne of the hind limbs was randomly assigned to undergo TPLO or TTA, with the contralateral limb assigned to the alternate procedure. Each specimen was tested with the stifle at 150°, 135°, and 120° of flexion. Cranial translation of the tibia relative to the femur was measured under cranial loads ranging from 0.2 to 2.0 kg with a single motion tracking sensor (Nest of Birds) fixed to the tibia. Each stifle was tested before and after transection of the CCL and after performing the assigned procedure.ResultsTibial plateau leveling osteotomy and TTA caused a decrease in the cranial translation of the tibia relative to the femur, especially at greater angles of flexion. Tibial plateau leveling osteotomy caused a greater decrease in tibial cranial translation and was associated with a degree of translation that did not differ from joints with intact CCL, regardless of the degree of stifle flexion.ConclusionTibial plateau leveling osteotomy and TTA caused an angle dependent decrease in craniocaudal translation of the tibia in the CCL deficient stifle. Only TPLO restored translations similar to those of the intact joint at all angles tested.Clinical impactTibial plateau leveling osteotomy and TTA provide passive stability to the stifle. Tibial plateau leveling osteotomy seems more effective than TTA at restoring craniocaudal stability of the stifle.
Subtourniquet pressures generated by application of wide‐rubber tourniquets in standing, sedated horses
Authors: Plunkett Amanda H. , Schoonover Mike J. , Young Jenna M. , Taylor Jared D. , Holbrook Todd C. 
Published: February 2019

AbstractObjectiveTo determine the influence of location and movement on subtourniquet pressure (STP) generated by application of a wide‐rubber tourniquet (WRT) on equine limbs.Study designRandomized experimental cross‐over design.AnimalsSix standing, sedated horses.MethodsHorses were sedated with detomidine hydrochloride (0.2 μg/kg IV), and 4 investigators applied WRTs to the antebrachium (AB), gaskin (GK), and midmetacarpus (MC) of each horse in a predetermined, randomized order. Subtourniquet pressure was consequently measured at 10‐minute intervals (T0, T10, T20, T30) for 30 minutes. Indirect systolic blood pressure (SBP) was measured presedation, postsedation, and throughout the tourniquet application period. Target STP was established as SBP + 100 mm Hg. Limb movements at each location were classified as none, low, moderate, or high, on the basis of counts and magnitude.ResultsMean STP did not change with time (P = .93) and exceeded SBP by 163 mm Hg (95% CI 122–205), 185 mm Hg (95% CI 156–214), and 402 mm Hg (95% CI 351–454) at the AB, GK, and MC, respectively. Mean STP at each location exceeded the target STP in 59 of 70 (81%) of the trials. Limb movements affected STP generated by tourniquets at the AB (P = .04) and MC (P < .0001) but not at the GK (P = .67).ConclusionWide‐rubber tourniquets applied at the AB, GK, and MC generated STP >100 mm Hg above SBP for 30 minutes in standing, sedated horses.Clinical significanceWide‐rubber tourniquets as applied in this study can achieve and maintain the current recommended STP (SBP + 100 mm Hg) for equine IV regional limb perfusion. Number and magnitude of limb movement can decrease STP over time, potentially reducing the efficacy of a WRT.
Checklist design and implementation: critical considerations to improve patient safety for low-frequency, high-risk patient events
Authors: Turkelson Carman , Keiser Megan , Sculli Gary , Capoccia Diane 
Published: February 2019

Purpose: This pilot project describes the development and implementation of two specialised aviation-style checklist designs for a low-frequency high-risk patient population in a cardiac intensive care unit. The effect of the checklist design as well as the implementation strategies on patient outcomes and adherence to best practice guidelines were also explored. The long-term objective was to improve adherence to accepted processes of care by establishing the checklists as standard practice thereby improving patient safety and outcomes.Methods: During this project, 10specialised crisis checklists using two specific aviation-style designs were developed. A quasiexperimental prospective pre-post repeated measure design including surveys along with repetitive simulations were used to evaluate self-confidence and self-efficacy over time as well as the perceived utility, ease of use, fit into workflow and benefits of the checklists use to patients. Performance, patient outcomes and manikin outcomes were also used to evaluate the effectiveness of the crisis checklists on provider behaviours and patient outcomes.Results: Overall self-confidence and self-confidence related to skills and knowledge while not significant demonstrated clinically relevant improvements that were sustained over time. Perceptions of the checklists were positive with consistent utilisation sustained over time. More importantly, use of the checklists demonstrated a reduction in errors both in the simulated and clinical setting.Conclusion: Recommendations from this study consist of key considerations for development and implementation of checklists including: utilisation of stakeholders in the development phase; implementation in real and simulated environments; and ongoing reinforcement and training to sustain use.
P30 A PRISMA systematic review and meta-analysis of open and novel ‘minimally invasive’ techniques for mesial temporal lobe epilepsy (MTLE)
Authors: Vakharia N , Xiao F , O’Keeffe A , Sparks R , McEvoy W , Miserocchi A , Ourselin S , Duncan S 
Published: February 2019

ObjectivesOne third of patients with focal epilepsy fail to achieve seizure freedom despite best medical therapy. Surgery may provide seizure freedom if the epileptogenic zone can be safely remove. We compare the outcomes following open surgery, laser interstitial thermal therapy (LITT), radiofrequency ablation (RFA) and radiosurgery (RS).DesignPRISMA systematic review and meta-analysis.SubjectsMTLEMethodsStructured searchs of PubMed, Embase and Cochrane databases. Random effects meta-analysis to calculate effects sizes and a pooled estimate of the probability of remaining seizure free at one year following intervention.ResultsFrom 1212 screened publications, 57 articles were included in the quantitative analysis. Open surgery included anterior temporal lobectomy as well as transcortical, subtemporal and transsylvian selective amygdalohippocampectomy. The probability of remaining seizure free at one year was 0.89 (95% CI 0.83–0.93) with open surgery based on Level 1 and 2 evidence. RS resulted in 0.88 (95% CI 0.84–0.90) probability and a single RCT revealed RS was less efficacious than open surgery. Follow up duration and study sizes were limited with LITT and RFA providing a probability of remaining seizure free at one year of 0.71 (95% CI 0.65–0.76) and 0.86 (95% CI 0.76–0.92) respectively.ConclusionsThere is no evidence supporting novel ‘minimally invasive’ approaches as being as efficacious as open surgery. Secondary outcome measures such as neuropsychological outcome and intervention morbidity are poorly reported.