bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of patients with thoracic aortic aneurysm taking into account
risk factors, procedure and prognosis in 5-year clinical observation
Authors: Dąbek Józefa , Potyka Katarzyna , Skorus Paweł , Swoboda Michał , Gąsior Zbigniew 
Published: October 2018

WstępTętniakami nazywamy każde poszerzenie światła naczynia tętniczego przekraczające 50% średnicy w stosunku do średnicy uważanej za normę dla danego odcinka aorty. Wykrywane są często przypadkowo podczas wykonywania innych badań. Tętniaki aorty piersiowej dzielą się na prawdziwe i rozwarstwiające.Materiał i metodyBadaniem objęto wszystkich chorych z rozpoznanym tętniakiem aorty piersiowej, hospitalizowanych w Klinice Kardiologii w latach 2010–2014. Badana grupa obejmowała 50 chorych w wieku 33–92 lat (średnia wieku 64 lata), w tym 9 kobiet i 41 mężczyzn. Analizie poddano dane z historii choroby dotyczące występowania czynników ryzyka rozwoju tętniaków aorty, wywiadu chorobowego oraz wyniki przeprowadzonych badań, w tym obrazowych, oraz sposób leczenia i rokowanie.WynikiZ badanej grupy 25 osób (50%) było leczonych zachowawczo, a 25 (50%) operacyjnie. Z czynników predysponujących najczęściej występowały u badanych: nadciśnienie tętnicze (n = 42; 84%), dyslipidemia (n = 25; 50%), ChNS (n = 20; 40%), palenie tytoniu (n = 14; 28%) oraz obciążający wywiad rodzinny (n = 14; 28%). W grupie chorych z tętniakami rozwarstwiającymi leczenie operacyjne było częściej wybieranym sposobem leczenia (n = 23; 60,5%). Natomiast leczenie zachowawcze było preferowane u chorych z tętniakiem prawdziwym (n = 10; 83,3%).WnioskiBadana grupa chorych z tętniakiem aorty piersiowej obarczona była licznymi czynnikami ryzyka ich rozwoju. Analiza sposobu leczenia badanych nie wykazała przewagi żadnej z zastosowanych metod (chirurgicznej vs. farmakologicznej), a śmiertelność podczas hospitalizacji w obu grupach była taka sama.
Munchausen syndrome – forgotten but dangerous disease. Diagnostic challenges in female patient
Authors: Sołtysik Mariusz , Sołtysik Anna , Jarząb Magdalena , Kluczewska Ewa , Piegza Magdalena , Klemens Jolanta , Pudlo Robert 
Published: October 2018

WPROWADZENIEWedług Międzynarodowej Klasyfikacji Chorób i Problemów Zdrowotnych ICD-10, zespół Münchhausena jest zaburzeniem psychicznym, zaliczanym do kategorii diagnostycznej F68.1 „Zamierzone wytwarzanie lub naśladowanie objawów czy niewydolności fizycznych lub psychicznych (zaburzenia pozorowane)”. W przeciwieństwie do osób świadomie symulujących dolegliwości w celu uzyskania konkretnych korzyści, chorzy z podejrzeniem zespołu Münchhausena zgłaszając się kolejny raz do placówek służby zdrowia nie są świadomi swoich wewnętrznych motywów (społeczna gratyfikacja, potrzeba kontroli, wysoki poziom autoagresji), narażając się na długi proces diagnostyczny.CEL PRACY:Przedstawienie trudności związanych z różnicowaniem, rozpoznawaniem i odpowiednim leczeniem zespołu Münchhausena.
Przedstawiony opis przypadku dotyczy młodej pacjentki, wielokrotnie hospitalizowanej z powodu licznych dolegliwości somatycznych, u której mimo wielu przeprowadzonych badań, w tym obrazowych i zabiegowych, nie można było postawić żadnego, tłumaczącego występujące objawy, rozpoznania. Dopiero hospitalizacja psychiatryczna, z pełną analizą dotychczasowej historii chorobowej pacjentki, pozwoliła na postawienie diagnozy zespołu Münchhausena i podjęcie właściwego leczenia. Paradoksalnie rozpoznanie to mogło przyczynić się do umniejszania zgłaszanych przez pacjentkę w późniejszym okresie dolegliwości, które pojawiły się w związku z rozrastającym się guzem mózgu.KOMENTARZ:Właściwe rozumienie prezentowanych przez chorą objawów mogło doprowadzić do znacznie szybszego postawienia diagnozy. Późniejsze, tragiczne w skutkach objawy pokazują, iż nie można zamykać się w obrębie jednego rozpoznania. Istotną rolę zdają się odgrywać właściwie zaplanowane badania obrazowe.
Scientific output of professors and doctors habilitatus from Medical University of Silesia in Katowice – a comparison of two schools of medicine
Authors: Pluskiewicz Wojciech , Drozdzowska Bogna , Adamczyk Piotr , Kuźniewicz Roman 
Published: October 2018

WstępCelem pracy było porównanie dorobku naukowego profesorów i doktorów habilitowanych Wydziału Lekarskiego z Oddziałem Lekarsko-Dentystycznym w Zabrzu (w październiku 2015 r.) z analogicznymi danymi dla Wydziału Lekarskiego w Katowicach (w październiku 2016 r.) Śląskiego Uniwersytetu Medycznego w Katowicach.Materiał i metodyDane dotyczące dorobku naukowego dla publikacji pełnotekstowych zostały zebrane z baz Web of Science i Scopus.WynikiŚrednie wartości wieku badanych naukowców, wieku uzyskania stopnia doktora i doktora habilitowanego, wieku uzyskania tytułu profesora, czasu od doktoratu do habilitacji oraz czasu od habilitacji do profesury nie różniły się między wydziałami. Spośród parametrów bibliometrycznych tylko całkowita liczba publikacji wynosząca 144,6 ± 124,2 dla wydziału w Zabrzu oraz 260,6 ± 227 dla wydziału w Katowicach różniła się znamiennie (p < 0,0001). Pozostałe kryteria, czyli liczba prac z Impact Factor, całkowita wartość Impact Factor, indeks cytacji według baz Web of Science i Scopus bez wykluczenia i po wykluczeniu autocytacji i cytacji współautorów, a także współczynnik h według obu baz nie różniły się istotnie.WnioskiDorobek naukowy obu wydziałów lekarskich nie różni się z wyjątkiem całkowitej liczby publikacji.
Effect of pawpaw (<em>Carica papaya</em>) leaf meal and dietary enzymes on broiler performance, digestibility, carcass and blood composition
Authors: Oloruntola Olugbenga David , Ayodele Simeon Olugbenga , Oloruntola Deborah Adebukola 
Published: October 2018

Exogenous enzymes and phytogenic feed additives are proposed as alternatives to antibiotic growth promoters in poultry production. This study assessed the effect of pawpaw leaf meal (PLM) inclusion and enzyme (E) supplementation in the diet of broiler chickens. In total 288 Arbor-Acre day-old broiler chickens were used. Four diets were formulated to be isocaloric and isonitrogenous: diet 1, control (0% PLM, 0% E), diet 2 (0% PLM, 0.05% E), diet 3 (5% PLM, 0% E), and diet 4 (5% PLM, 0.05% E). Each diet was replicated six times with 12 chickens in each batch. E improved (p < 0.05) the body weight gain at three weeks. The dry matter (DM), crude protein (CP), ether extract and ash digestibility were improved (p < 0.05) with E, whereas PLM inclusion produced (p < 0.05) an increase in DM and CP digestibility. The E x PLM effect was significant (p < 0.05) for DM and CP digestibility. E improved (p < 0.05) the slaughter weight and reduced the liver weight. Platelets varied across diets and increased (p < 0.05) with enzyme supplementation. E reduced (p < 0.05) low-density lipoproteins (LDL), whereas PLM reduced (p < 0.05) cholesterol and LDL. In conclusion, the association of E and PLM improved chicken growth, and E or PLM inclusion should benefit chicken health.
Identifying Unreported Opioid Deaths Through Toxicology Data and Vital Records Linkage: Case Study in Marion County, Indiana, 2011–2016
Authors: Lowder Evan M. , Ray Bradley R. , Huynh Philip , Ballew Alfarena , Watson Dennis P. 
Published: October 2018

Objectives. To demonstrate the severity of undercounting opioid-involved deaths in a local jurisdiction with a high proportion of unspecified accidental poisoning deaths. Methods. We matched toxicology data to vital records for all accidental poisoning deaths (n = 1238) in Marion County, Indiana, from January 2011 to December 2016. From vital records, we coded cases as opioid involved, specified other substance, or unspecified. We extracted toxicology data on opioid substances for unspecified cases, and we have reported corrected estimates of opioid-involved deaths after accounting for toxicology findings. Results. Over a 6-year period, 57.7% of accidental overdose deaths were unspecified and 34.2% involved opioids. Toxicology data showed that 86.8% of unspecified cases tested positive for an opioid. Inclusion of toxicology results more than doubled the proportion of opioid-involved deaths, from 34.2% to 86.0%. Conclusions. Local jurisdictions may be undercounting opioid-involved overdose deaths to a considerable degree. Toxicology data can improve accuracy in identifying opioid-involved overdose deaths. Public Health Implications. Mandatory toxicology testing and enhanced training for local coroners on standards for death certificate reporting are needed to improve the accuracy of local monitoring of opioid-involved accidental overdose deaths.
Paid Family Leave Effects on Breastfeeding: A Quasi-Experimental Study of US Policies
Authors: Hamad Rita , Modrek Sepideh , White Justin S. 
Published: October 2018

Objectives. To test whether paid family leave policies in California and New Jersey improved breastfeeding practices, overall and among key subgroups.Methods. We conducted difference-in-differences analyses, comparing pre–post policy changes in California and New Jersey with changes in states where no paid family leave policies were implemented. We examined a large, diverse sample of children born during 2001 to 2013 (n = 306 266), drawn from the 2003 to 2015 National Immunization Survey waves. Outcomes included ever breastfed, breastfed exclusively at 3 and 6 months, and still breastfed at 6 and 12 months, as well as duration of any breastfeeding and exclusive breastfeeding. We examined heterogeneity in policy response by maternal characteristics.Results. Paid family leave policies resulted in a modestly greater likelihood of exclusively breastfeeding at 6 months. Subgroup analyses were mixed, although several breastfeeding outcomes were consistently improved among married, White, higher-income, and older mothers.Conclusions. Exclusive breastfeeding improved after implementation of paid family leave policies in the overall sample, and additional benefits were noted for more advantaged mothers. This contributes critical evidence to an ongoing policy discussion, suggesting that subsequent paid family leave policies should be designed to target more vulnerable mothers.
Estimating the Risk of Exposure to Fentanyl in New York City: Testing Drug Residue in Used Syringes
Authors: Blachman-Forshay Jaclyn , Nolan Michelle L. , McAteer Jonathan M. , Paone Denise 
Published: October 2018

Objectives. To estimate the risk of exposure to fentanyl among syringe exchange program (SEP) participants in New York City. Methods. We recruited a convenience sample from 11 SEPs in New York City between March and June 2017. Consenting participants (n = 434) received a labeled syringe for their next injection. We tested collected syringes with gas chromatography–mass spectrometry and liquid chromatography–quadrupole–time-of-flight mass spectrometry. Fentanyl or fentanyl analogs detected in quantities greater than 10% of the residue mass were reported. Results. The final analysis included 271 syringes; 46 (17.0%) contained fentanyl or a fentanyl analog. Fentanyl was the most frequently identified fentanyl compound, identified in 36 (13.3%) syringes. Furanylfentanyl was detected in 10 (3.7%) syringes, and 4-fluoroisobutyryl fentanyl was detected in 5 (1.8%) syringes. Conclusions. The risk of exposure to fentanyl in syringes used by SEP participants was significantly lower significantly lower than the amount of fentanyls identified among overdose decedents in New York City. Further research is needed to understand how people who use drugs have adapted to fentanyl in the drug market. Understanding the risk of exposure to fentanyls is critical to development of targeted public health messaging.
Shade as an Environmental Design Tool for Skin Cancer Prevention
Authors: Holman Dawn M. , Kapelos George Thomas , Shoemaker Meredith , Watson Meg 
Published: October 2018

Little work has been done to explore the use of shade for skin cancer prevention in the context of the built environment. In an effort to address this gap and draw attention to the intersection between architectural and public health practice, we reviewed research on shade design, use, and policies published from January 1, 1996, through December 31, 2017. Our findings indicate that various features influence the sun-protective effects of shade, including the materials, size, shape, and position of the shade structure; the characteristics of the surrounding area; and weather conditions. Limited research suggests that shade provision in outdoor spaces may increase shade use. Shade audit and design tools are available to inform shade planning efforts. Shade policies to date have mostly been setting specific, and information on the implementation and effects of such policies is limited. Integrating shade planning into community design, planning, and architecture may have a substantial impact and will require a multidisciplinary approach.
Five-Year Follow-up Results of a Randomized Controlled Study Comparing Intramedullary Nailing with Plate Fixation of Completely Displaced Midshaft Fractures of the Clavicle in Adults
Authors: Fuglesang Hendrik F.S. , Flugsrud Gunnar B. , Randsborg Per-Henrik , Hammer Ola-Lars , Utvåg Stein Erik 
Published: October 2018

Background:
Surgical management of completely displaced midshaft fractures of the clavicle is becoming more frequent, although long-term follow-up with Level-I evidence is scarce. Plate fixation (PF) of comminuted fractures provides faster functional recovery than elastic stable intramedullary nailing (ESIN). The 12-month follow-up of this randomized controlled trial, published previously, found no clinical differences at that time on the group level, but subtle differences on the subgroup level indicated that the results after closed ESIN were better than those after open ESIN. The primary aim of the study reported here was to compare the long-term clinical outcomes and sequelae after open reduction with those after closed reduction and to help surgeons develop a treatment strategy of either PF or ESIN for selected patients.

Methods:
At a median follow-up of 66 months (range, 49 to 89 months), the 123 patients in the original study were invited to an online secure survey. We used the survey results to compare the PF and ESIN treatment arms and to perform predetermined subgroup analyses of closed compared with open ESIN in relation to Disabilities of the Arm, Shoulder and Hand (DASH) score, pain assessment, and implant removal.

Results:
The questionnaire was completed by 114 (93%) of the 123 patients. There were no differences between the 2 treatment arms with regard to the DASH score (ESIN, 3.1 ± 7.0 and PF, 3.7 ± 7.5; p = 0.9). The 27 patients who had been treated with closed ESIN had a significantly superior DASH score compared with the 27 patients who had been treated with open ESIN (closed, 0.7 ± 1.4 and open, 5.2 ± 8.9; p = 0.015) and compared with the patients who had been treated with PF (closed ESIN, 0.7 ± 1.4 and PF, 3.9 ± 7.5; p = 0.002). Patients who had been treated with closed ESIN also reported fewer sequelae than patients who had been treated with open ESIN or PF.

Conclusions:
The results of this study, combined with those of our prior 1-year follow-up of the same patients, indicate that it seems to be advantageous to perform closed ESIN. The long-term results after PF were similar to those after open ESIN, but PF resulted in faster functional recovery and fewer patients needing to have the implant removed. Therefore, if open reduction is necessary for a comminuted fracture, it seems that the advantages of the minimally invasive ESIN procedure are lost, and the surgeon should consider conversion to PF.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Comparison of 90-Day Complication Rates and Cost Between Single and Multiple Joint Procedures for End-Stage Arthropathy in Patients with Hemophilia
Authors: Feng Bin , Xiao Ke , Gao Peng , Liu Yong , Zhang Baozhong , Ren Yi , Weng Xisheng 
Published: October 2018

Background:
Multiple joint procedures during a single anesthetic episode have been proposed for patients with hemophilia as a way to reduce cost. The postoperative 90-day complication rate and the cost distribution between multiple joint procedures and single joint procedures for patients with hemophilia have not been well studied.

Methods:
Between January 1996 and December 2016, 124 patients underwent 177 surgical procedures (total knee arthroplasty, total hip arthroplasty, and ankle arthrodesis) for the treatment of hemophilic end-stage arthropathy. Forty-eight patients (39%) underwent multiple joint procedures during 1 hospitalization, and 76 patients (61%) underwent single joint procedures. The medical records were retrospectively reviewed. The patients were evaluated for complications within 90 days postoperatively and the cost during hospitalization. Risk factors related to complications were further analyzed.

Results:
Twenty-seven of the 124 patients experienced 29 complications within 90 days postoperatively, representing a complication rate of 16.4% for all procedures. The patients who had undergone multiple joint procedures had a higher rate of surgical complications than those who had undergone a single joint procedure (14.6% vs. 3.9%; p = 0.039). The patients who had had multiple joint procedures had similar rates of hematological complications (8.3% vs. 9.2%; p = 0.867) and total complications (31.3% vs. 18.4%; p = 0.100) compared with those who had had a single joint procedure. There was no difference between the patients who had had multiple joint procedures and those who had had a single joint procedure with regard to the cost of the coagulation factor (p = 0.212).

Conclusions:
The performance of multiple joint procedures during a single anesthetic episode is a safe approach for patients with hemophilia with end-stage arthropathy, with no substantial increase in the 90-day complication rate in comparison with that following a single joint procedure. The performance of multiple joint procedures under a single anesthetic episode can save cost and is more cost-effective when managing patients with hemophilia who have end-stage arthropathy.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Supplemental Nitrogen Applications on Corn in Lower Mississippi River Delta Alluvial Soils
Authors: Mascagni Henry J. , Tubana Brenda , Dalen Marilyn 
Published: October 2018

Core Ideas
Corn optimal N rate on two alluvial soils ranged from 200 to 265 kg N ha−1.
Supplemental N applied at early silk increases corn grain yield on two alluvial soils.
Relative chlorophyll readings did not consistently diagnose need for supplemental N.
Nitrogen deficiency may occur late in the corn (Zea mays L.) growing season due to N fertilizer loss, particularly on poorly drained clay soils, or increased plant demand. Results from field trials conducted from 2006 to 2014 at the Northeast Research Station, St. Joseph, LA, were summarized to evaluate the influence of supplemental N (SN) on corn at early silk (R1). Four non‐irrigated and eight irrigated trials on Sharkey clay (Vertic Haplaquept) and six trials on the Commerce silt loam (Aeric Fluvaquent) were evaluated. Early season N (ESN) rates of a no‐N control plus 200, 235, 265, and 300 kg N ha−1 on Sharkey clay and 135, 170, 200, 235, and 265 kg N ha−1 on Commerce silt loam were applied after emergence. Additionally, a SN application of 65 kg N ha−1 was applied along with one of the ESN rates at R1. Grain yield was maximized at 200 to 265 kg N ha−1 on Sharkey clay and 200 kg N ha−1 on Commerce silt loam soil. Averaged across years, SN significantly increased grain yield of corn on irrigated Sharkey clay and non‐irrigated Commerce silt loam soils by 16 and 10%, respectively. The SN application at R1 may be effective if N is deficient; however, in many cases, there were no grain yield differences between the SN and the equivalent ESN rate. Relative chlorophyll reading was not reflective of the need for SN at R1, perhaps due to the significant changes on environmental factors post R1 until harvest.
Potassium Nutrition Affects Anthracnose on Annual Bluegrass
Authors: Schmid Charles J. , Clarke Bruce B. , Murphy James A. 
Published: October 2018

Core Ideas
This study provides evidence that K deficiency can increase anthracnose severity of annual bluegrass turf.
Deficiency can be identified with testing of mat layer and tissue K concentrations.
Potassium values less than 43 mg kg−1 in the mat layer (Mehlich 3 extractant) and 20 g kg−1 in leaf tissue will increase anthracnose severity of annual bluegrass.
Potassium fertilization can improve stress tolerances in turfgrass; however, its effect on turfgrass diseases is inconsistent and not well understood. A 3‐yr field study was initiated to determine the effect of K fertilization rate and K source on anthracnose disease of annual bluegrass turf. Potassium chloride and K2SO4 were applied at K rates of 54, 109, and 218 kg ha−1 yr−1 as a 2 × 3 factorially arranged randomized complete block design with four replications. Potassium nitrate and K2CO3 were also included at the 218 kg K ha−1 yr−1 rate, as well as an untreated check. Nonlinear regression models were used to estimate critical concentrations of K in the mat layer and tissue with respect to anthracnose severity. All K treatments reduced disease severity compared to the untreated check (no K); however, KCl was less effective than the other sources when applied at the 218 kg K ha−1 yr−1 rate. The Cate–Nelson regression model predicted that K values less than 43 mg kg−1 in the mat layer (Mehlich 3 extractant) and 20 g kg−1 in leaf tissue will increase anthracnose severity of annual bluegrass (ABG). This study provides evidence that K fertilization can reduce anthracnose severity and that the severity of this disease can be correlated with mat and tissue K concentrations. Thus, it is important to monitor K in ABG turf and to maintain sufficient levels to reduce disease severity and improve turfgrass quality.
Composition, Forage Production, and Costs Are Variable in Three‐Way Cover Crop Mixes as Fall Forage
Authors: Farney Jaymelynn Kay , Sassenrath Gretchen F. , Davis Cathryn Joyce , Presley DeAnn 
Published: October 2018

Core Ideas
Brassicas predominate percent composition of mixture in a warmer, higher‐moisture year.
Grasses and legumes produce more forage mass in cooler, lower‐moisture environment.
Oats and barley produced more forage mass than wheat or rye for 90 days after planting.
Radishes produced more forage mass than turnips.
Winter pea yielded more forage mass than berseem clover.
The purpose of this study is to evaluate plant species composition and forage mass production in three‐way cover crop mixtures and evaluate costs associated with specific plant species in a mixture. A 2‐year study (2014 and 2015) was completed in a randomized complete block design with 16 mixtures composed of a grass/brassica/legume combination based on four grass species, two brassica species, and two legume species. Brassicas and grasses together contributed between 54 and 100% of the total forage mass in mixtures. Brassicas were a greater portion of the composition in 2014 than 2015 while grasses and legumes made up a higher percentage of the composition in 2015 than 2014. Oats (Avena sativa) produced more forage mass than barley (Hordeum vulgare) with wheat (Triticum aestivium) and rye (Secale cereal) producing the lowest forage mass. Radish (Raphanus sativus) produced more forage mass than turnip (Brassica rapa), and winter pea (Pisum sativum subsp. arvense) had greater forage mass production than berseem clover (Trifolium alexandrinum). In six of eight mixtures, radish growth altered grass composition within year; peas contributed little to the biomass composition regardless of year, and all brassicas had a higher percent biomass production in 2014 than 2015. As fall forage for cattle, oats are the most economical option for grass. Both radish and turnip are similarly priced based on production; and clover is a cheaper legume option, even with limited growth.