bluuebunny/crossref_metadata_2025_split huggingface dataset:
Government as Customer of Last Resort: The Stabilizing Effects of Government Purchases on Firms
Authors: Goldman Jim 
Published: June 2019

Abstract
I document a beneficial effect of the government’s participation in product markets. Exploiting the 2008–2009 financial crisis as a natural experiment, I show that federal procurement contracts insulated government contractors’ performance from the crisis. By 2009, government contractors had 15% higher market capitalization, had 18% higher capital expenditures, and received 26% more bank credit than did similar firms. This stabilizing effect, in turn, spilled over into neighboring firms. An average amount of government purchases reduced local employment losses by 35% in retail industries and by 48% in industries supplying government contractors. Spillovers were particularly strong in high economic slack areas.
Author has furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Molecular phylogeny and species delimitation of the genus Dicerapanorpa (Mecoptera: Panorpidae)
Authors: Hu Gui-Lin , Gao Kai , Wang Ji-Shen , Hebert Paul D N , Hua Bao-Zhen 
Published: June 2019

AbstractGiven that species is the fundamental unit in systematic biology, rigorous species delimitation is crucial for taxonomic studies, yet routine species delimitation remains an ongoing challenge in the taxonomic practice of insects. The two-horned scorpionfly Dicerapanorpa is a small genus in Panorpidae (Mecoptera) endemic to the Qinling-Bashan and Hengduan mountains, a biodiversity hotspot. However, species of Dicerapanorpa are difficult to delineate owing to marked intraspecific variation and interspecific similarity. Here, we investigate the diversity and species boundaries of Dicerapanorpa using an integrative approach based on DNA barcoding, morphological, geometric morphometric and molecular phylogenetic analyses. This integrative analyses confirmed the 13 described species of Dicerapanorpa and revealed three new species: Dicerapanorpa lativalva sp. nov., Dicerapanorpa hualongshana sp. nov. and Dicerapanorpa minshana sp. nov. Most molecular operational taxonomic units are in congruence with morphological clusters. Possible reasons for several discordances in Dicerapanorpa are tentatively discussed.
Interleukin-18 in pediatric rheumatic diseases
Authors: Prencipe Giusi , Bracaglia Claudia , De Benedetti Fabrizio 
Published: June 2019

Purpose of review
IL-18 is a pleiotropic cytokine involved in the regulation of innate and adaptive immune responses. IL-18 pro-inflammatory activities are finely regulated in vivo by the inhibitory effects of the soluble IL-18-binding protein (IL-18BP). The elevation of circulating levels of IL-18 has been described in children with systemic juvenile idiopathic arthritis (sJIA). In the recent years, the role of IL-18 in the pathogenesis of secondary haemophagocytic lymphohistiocytosis (sHLH), also referred to as macrophage activation syndrome (MAS), in the context of autoinflammatory diseases, including sJIA, is emerging.

Recent findings
A large number of studies in patients and animal models pointed to the imbalance in IL-18/IL-18BP levels, causing increased systemic levels of free bioactive IL-18, as a predisposing factor in the development of MAS. Although the exact mechanisms involved in the development of MAS are not clearly understood, increasing evidence demonstrate the role of IL-18 in upregulating the production of interferon (IFN)-γ.

Summary
On the basis of the first emerging data on the possibility of blocking IL-18, we here discuss the scientific rationale for neutralizing the IL-18/IFNγ axis in the prevention and treatment of sHLH and MAS.
A critical review of recent advances in the diagnosis, classification, and management of uterine adenomyosis
Authors: Tan Justin , Yong Paul , Bedaiwy Mohamed A. 
Published: June 2019

Purpose of review
The purpose of this review is to summarize and highlight recent critical advances in the diagnosis, classification, and management of adenomyosis.

Recent findings
Recent studies have clarified the specific mechanism through which adenomyotic lesions invade the underlying myometrium by epithelial–mesenchymal transition. Correlation studies using diagnostic MRI also strongly support the hypothesis of a different pathogenesis between the inner and outer myometrium forms of adenomyosis. Given advances in diagnostic imaging, several international organizations have also highlighted the importance of classification systems for adenomyosis. Finally, selective progesterone receptor modulators and gonadotropin-releasing hormone antagonists have demonstrated significant promise for treating pelvic pain and bleeding associated with adenomyosis, whereas novel fertility-preserving surgical techniques have been introduced to excise diffuse adenomyotic pathology while maintaining adequate uterine integrity.

Summary
Recent attempts at a uniform and reproducible classification system likely represent the first step for the development of a staging system for adenomyosis that can be correlated with the severity of clinical symptoms and promote an individualized therapeutic approach. Simultaneously, further insights into the etiology and pathogenesis as outlined in this review may also help in the development of targeted medical therapies.
Utility of Perilymph microRNA Sampling for Identification of Active Gene Expression Pathways in Otosclerosis
Authors: Wichova Helena , Shew Matthew , Staecker Hinrich 
Published: June 2019

Hypothesis:
Profiling of microRNA (miRNA) within perilymph samples collected at the time of stapedectomy can be used to identify active gene expression pathways in otosclerosis as compared with controls.

Background:
miRNAs are small non-coding RNAs that effect gene expression by post-transcription regulation and silencing. Perilymph sampling allows for a novel way to collect material actively involved in the disease process.

Methods:
Perilymph was collected at time of stapedectomy, underwent a microarray analysis, and significantly expressed miRNAs were correlated to known bone morphology pathways using a cochlear transcriptome library. To determine miRNA related specifically to otosclerosis, cochlear implant controls were used for statistical analysis.

Results:
A total of 321 significantly expressed miRNAs were identified within the four otosclerosis perilymph samples. miRNAs associated with 23 genes involved in bone morphology pathways were significantly expressed. A significant difference in the otosclerotic samples as compared with control was noted in miRNA expression regulating HMGA2, ITGB3, SMO, CCND1, TP53, TP63, and RBL2 gene pathways. No significant difference was noted in miRNAs expression associated with ACE, RELN, COL1A1, and COL1A2 genes which were previously correlated with otosclerosis.

Conclusions:
Perilymph miRNA profiling obtained at the time of stapedectomy consistently identifies differentially expressed genes compared with controls. Perilymph miRNA sampling with cochlear transcriptome library cross-referencing can be successfully used to identify active gene expression pathways in otosclerosis.
Collagen Allografts Compared With Autologous Tissue in Tympanoplasty
Authors: Cass Nathan D. , Patten Luke , Cass Stephen P. 
Published: June 2019

Objective:There are no direct comparisons between the success of collagen allografts versus traditional autografts for tympanic membrane (TM) repair. We sought to compare success rates in a large series of patients undergoing tympanoplasty using collagen allografts versus autologous tissues.Study Design:Retrospective review.Setting:Academic medical center.Subjects and Methods:Single institution retrospective chart review was performed for adult subjects with TM perforation undergoing tympanoplasty. Demographic, clinical, and surgical data were collected. Statistical analysis was completed using Rstudio. Each factor was examined to assess effect on graft success rate using logistic regression.Results:Two hundred sixty-five surgeries met criteria with four main grafting materials or combinations thereof. The overall graft success rate was 81.1% with failure rate of 18.9%. There was no significant association between failure rates and: age, sex, perforation cause, size, and location, primary or revision status, middle ear status (wet or dry), concomitant procedures (mastoidectomy or ossiculoplasty), presence of active cholesteatoma, or surgical technique. Although not statistically significant, the odds of success for perichondrium + cartilage were 7.5 times higher than collagen allografts (p = 0.07, 95% confidence interval [CI] = 0.81–69.6). The odds of success for the postauricular (odds ratio [OR] = 6.4) and transcanal approaches (OR = 24.8) were significantly greater than for endaural (p = 0.007 andp = 0.008, respectively).Conclusion:In tympanoplasty surgeries performed on patients with TM perforation, we found no statistically significant difference in graft failure rates between collagen allograft and other grafting materials or combinations, though the higher odds ratio of success with cartilage + perichondrium may be clinically relevant.
Efficacy of risk stratification protocols and clinical, physical, and biochemical parameters to previse signals and symptoms during cardiovascular rehabilitation programs
Authors: Vanzella Laís Manata , Takahashi Carolina , Ribeiro Felipe , Lima Isabelle Maina , Silva Anne Kastelianne França da , Christófaro Diego Giulliano Destro , Vanderlei Luiz Carlos Marques 
Published: June 2019

Abstract

Introduction
Despite the benefits, cardiovascular rehabilitation programs (CRPs) have been related to the appearance of signals and symptoms. Risk stratification protocols are commonly used to identify risks during the physical exercise; however, studies that investigate their efficacy to previse signals and symptoms are inconclusive. Furthermore, clinical, physical, and biochemical parameters have been used as risk markers for the appearance of adverse events, and to investigate their efficacy to previse signals and symptoms during the CRP sessions that could better guide the strategies adopted on these programs.

Objectives
The aim of this study was to evaluate the correlations between risk stratification protocols and clinical, physical, and biochemical parameters with the appearance of signals/symptoms during CRP, as well as to evaluate if modifications on clinical, physical, and biochemical parameters could influence in the appearance of signals/symptoms during CRP.

Materials and methods
The study was prospectively registered at ClinicalTrials.gov (NCT03446742). Forty-four patient participants of a CRP will be evaluated. First, their risk stratification is going to be performed by 2 evaluators and their clinical, physical, and biochemical parameters are going to be measured. Then, the patients are going to be followed during 24 sessions during their CRP routines in order to identify appearance of their signals/symptoms. So, the patients are going to perform their cardiovascular rehabilitation routines for 6 months and then, their clinical, physical, and biochemical parameters are going to be measured again and they are going to be followed during 24 sessions during their CRP routines in order to identify the appearance of their signals/symptoms.
The prescription patterns of traditional Chinese medicine for women with polycystic ovary syndrome in Taiwan
Authors: Lin Mei-Jiun , Chen Hsiao-Wei , Liu Pi-Hua , Cheng Wei-Jen , Kuo Shun-Li , Kao Ming-Chen 
Published: June 2019

Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disease of reproductive-age women, accounting for about 9% to 18% of all women in this age group. Hyperandrogenemia, oligomenorrhea, or amenorrhea or anovulation, and polycystic ovary morphology are the 3 main criteria used to diagnose PCOS currently. Substantial scientific evidence and consensus on treating Taiwanese PCOS was lacking. The aim of this study is to investigate the characteristics and utilization of traditional Chinese medicine (TCM) among Taiwanese women with PCOS.
The data used in this study were derived from the Longitudinal Health Insurance Database (LHID 2000 and LHID 2005). Demographic characteristics, TCM usage, the frequency, as well as average daily dose of Chinese herbal formulas and the single herbs prescribed for patients with PCOS, were analyzed. Chinese herbal formulas and the single herbs prescribed for PCOS women during 1999 to 2013 were extracted to build up Chinese Herbal Medicine prescription database.
In our study, 66.43% (n = 8205) women sought TCM treatment because of PCOS for infertility or menstrual disorders. The most commonly prescribed Chinese herbal formula was Jia-wei-xiao-yao-san (Supplemented Free Wanderer Powder). The most commonly prescribed single herb was Yi-mu-cao (Leonuri herba). Among top 20 Chinese herbal formulas, Si-wu-tang has the largest average daily dosage (9.60 g).
Our study identified the characteristics and prescription patterns of TCM for patients with PCOS in Taiwan. We may need do further longitudinal research for TCM and its long-term response for improvement of pregnancy rate and reduction of metabolic disease rate.
Peri-cardiac surgery coagulation management in a severe hemophilia A patient
Authors: Xu Hongfei , Henry Davies , Li Chengcheng , Zhao Haige , Yang Yanyan 
Published: June 2019

Abstract

Rationale:
Hemophilia A (HA) is an X-linked recessive disorder caused by clotting factor VIII (FVIII) deficiency. There is limited data on the use of replacement therapy in cardiac surgery. Since no international guideline for anticoagulation in such patient exists, careful thought should be taken to design an individualized anticoagulation strategy.

Patient concerns:
We report a 54-year-old male with severe HA with FVIII activity of 0.8% when he was first diagnosed, who underwent successful mitral valve repair and coronary artery bypass graft with FVIII replacement perioperatively.

Diagnoses:
Transthoracic echocardiography and coronary angiography confirmed the HA patient with the diagnosis of severe mitral valve regurgitation and left anterior descending artery stenosis.

Interventions:
Before surgery, a bolus of 1000 IU FVIII was injected, which obtained an FVIII of 80%. After induction, a 3750 IU bolus of FVIII was injected and subsequent FVIII level reached 135%. Mitral valve repair and coronary artery bypass graft with FVIII replacement were performed. After the surgery, a repeat FVIII activity level was 50.6%. The 400 mL of autologous blood and 700 mL of cardiopulmonary bypass (CPB) machine blood was returned to the patient as well as 4 units of fresh frozen plasma with an additional bolus of 1000 IU FVIII. 100 mg aspirin per day alone was given after surgery.

Outcomes:
The patient recovered uneventfully and 1-year follow-up showed no complications.

Lessons:
The anticoagulant or antiplatelet regimen of HA patient following surgery should be individualized based on the evaluation of the risk factors for bleeding and thrombosis and the lowest FVIII activity ever recorded after FVIII replacement therapy.
Primary Ewing's sarcoma of the vertebral body
Authors: Zhao Duo-Yi , Zhang Wei-Lin , Cui Yan , Ma Cheng-Bin , Ni Sheng-Hui , Zhang Zhi-Yu 
Published: June 2019

Abstract

Rational:
The occurrence of Ewing's sarcoma in the vertebral body of elderly women is extremely rare, and the case of Ewing's sarcoma in the spine with secondary surgical repair after wrong diagnosis and treatment has not been reported. We report a case involving primary Ewing's sarcoma of the vertebral body in an elderly female. Owing to its rarity and controversial issues, we report a case report to discuss its clinical features, treatments, radiological, and histological characteristics.

Patient concerns:
The elderly female patient came to see us with the manifestation of total paralysis of both lower limbs. The patient with a vertebral compression fracture as the primary manifestation was misdiagnosed in another hospital. The patient underwent inappropriate surgical treatment and was transferred to our hospital for diagnosis and second-stage surgery.

Diagnoses:
The postoperative pathological examination and immunohistochemical examination in our hospital confirmed: Ewing's sarcoma; Surgical history at other hospitals suggests: after Bone cement injection.

Interventions:
The patient underwent a T6 and T8 laminectomy and T5/6-T9 pedicle screw fixation.

Outcomes:
Reexamination 1 month after the surgery showed that the tumor had been partially resected, the spinal cord compression was relieved, the tumor did not grow further, and the patient's lower limb physical ability, tactile sense, algesia and temperature sense recovered slightly.

Lessons:
For patients with ewing's tumor in the spinal canal with symptoms of spinal cord compression, even if the patients with poor results after a unadvisable operation, it is still necessary to be actively in spinal cord compression by surgery. The differential diagnosis of Ewing's sarcoma and compression fractures is very important. For patients with vertebral tumors, special attention should be taken during vertebroplasty for bone cement leakage caused by excessive bone cement injection and increased local pressure. And some experience with imaging and laboratory findings.
Minimally invasive triangular osteosynthesis for highly unstable sacral fractures
Authors: Kanezaki Shozo , Miyazaki Masashi , Notani Naoki , Ishihara Toshinubu , Sakamoto Tomonori , Sone Takashi , Kataoka Masashi , Tsumura Hiroshi 
Published: June 2019

Abstract
Triangular osteosynthesis involves unilateral L5 iliac posterior instrumentation combined with an iliosacral screw fixation. The aim of this study was to describe this procedure and report the preliminary clinical results in patients with unstable sacral fractures treated with minimally invasive triangular osteosynthesis (MITO). Between 2012 and 2017, 10 patients (6 men and 3 women, mean age, 50 ± 23 years) with sacral fractures were treated with MITO and were followed up for a mean of 15.0 ± 8.5 months in our institution. Classification of sacral fracture, operative time, intraoperative bleeding, timing of full weight bearing, bone union, complications, and clinical outcomes were investigated. Two cases were classified as Denis zone 1, 2 cases as zone 2, and 6 as zone 3. Four patients had Roy-Camille type 1 fracture and 2 patients had type 2. All patients underwent MITO, which involved bilateral lumbopelvic fixation and a uni/bilateral iliosacral screw with stab incisions for percutaneous fixation or central longitudinal incision. The operative time was a mean of 182 ± 64 minutes, and the amount of intraoperative bleeding was a mean of 63 ± 74 g. Full-weight bearing was initiated at a mean of 8.2 ± 2.4 weeks. Eight fractures healed; 1 patient had pulmonary embolism and 1 had implant loosening. Based on Majeed score, 8 patients had “excellent” clinical outcomes, 1 patient had a “good” clinical outcome, and the other had a “fair” clinical outcome. MITO could be less invasive on the soft tissues and be a reliable procedure for bony union. It might provide sufficient stability to accelerate the commencement of post-operative rehabilitation, even in patients with highly unstable sacral fractures.
A nomogram for predicting survival in patients with nodular melanoma
Authors: Yang Jin , Pan Zhenyu , Zhao Fanfan , Feng Xiaojie , Liu Qingqing , Li Yuanjie , Lyu Jun 
Published: June 2019

Abstract
The use of traditional American Joint Committee on Cancer (AJCC) staging alone has limitations in predicting patient survival with nodular melanoma (NM). We aimed to establish a comprehensive prognostic nomogram and compare its prognostic value with the AJCC staging system.
A nomogram was constructed to predict the 3-year and 5-year survival rates of NM patients by Cox regression. Several common model-validation parameters were used to evaluate the performance of our survival model.
The multivariate analyses demonstrated that the age at diagnosis; being divorced, separated, or widowed; AJCC stages II, III, and IV; a regional SEER stage and the lymph-node density (LND) were risk factors for survival. The concordance index, the area under the time-dependent receiver operating characteristic curve, and calibration plots indicated that the nomogram performed well, while the net reclassification improvement and the integrated discrimination improvement showed that the nomogram performed better than the AJCC staging system. Finally, the decision curve analyses curves of the nomogram yielded net benefits that were higher than when using AJCC staging system with either the training or the validation cohort.
The prognostic value of the nomogram is better than that of the AJCC staging system alone. In addition, we found that LND is an important risk factor for the survival of NM patients. The nomogram developed in this study may be a valuable tool for clinical practice when advising patients about their survival risk over the next 3 to 5 years.
Pancreatic schwannoma mimicking pancreatic cystadenoma
Authors: Wang Shunda , Xing Cheng , Wu Huanwen , Dai Menghua , Zhao Yupei 
Published: June 2019

Abstract

Introduction:
Schwannomas, also known as neurilemmoma, are benign neoplasms that originating from Schwann cells in peripheral nerve sheaths. The head, neck, and extremities are the most common sites; however, pancreatic schwannomas are rare neoplasms. Accurate preoperative diagnosis of these tumors is very tough because of pancreatic schwannomas usually mimicking other cystic tumors. Here we present a case of pancreatic schwannoma misdiagnosed as pancreatic cystadenoma.

Patient concerns:
We presented a rare case of a 55-year-old female admitted to our hospital for abdominal distension. The physical examination and results of laboratory testing reveal no abnormalities.

Diagnosis:
A computed tomography (CT) scan detected a hypodense 2.4 cm × 2.6 cm mass with a clear margin at the neck of the pancreas. Pancreatic cystadenoma was strongly suspected.

Interventions:
The patient underwent robotic distal pancreatectomy with splenectomy. The gross specimen showed a pale and solid mass with a capsule.

Outcomes:
Histological examination of the surgical specimen demonstrated a pancreatic schwannoma. Immunohistochemistry results were as follows: S-100 (+), CD117 (−), SMA (−), and Desmin (−). She was discharged on postoperative day 6 and no recurrence of the tumor happened during the 12-month follow-up.

Conclusion:
Precise preoperative diagnosis of pancreatic schwannomas is very difficult despite the application of multiple imaging modalities. Surgery is the most effective treatment for this rare disease and the final diagnosis usually relies on pathology. Following complete tumor removal, patients with pancreatic schwannomas generally have a good prognosis.