bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of magnetic field strength on the properties of wind generated from hot accretion flow
Authors: Bu De-Fu , Mosallanezhad Amin 
Published: May 2018

Context. Observations indicate that wind can be generated in hot accretion flow. Wind generated from weakly magnetized accretion flow has been studied. However, the properties of wind generated from strongly magnetized hot accretion flow have not been studied. Aims. In this paper, we study the properties of wind generated from both weakly and strongly magnetized accretion flow. We focus on how the magnetic field strength affects the wind properties.
Methods. We solve steady-state two-dimensional magnetohydrodynamic equations of black hole accretion in the presence of a largescale magnetic field. We assume self-similarity in radial direction. The magnetic field is assumed to be evenly symmetric with the equatorial plane.
Results. We find that wind exists in both weakly and strongly magnetized accretion flows. When the magnetic field is weak (magnetic pressure is more than two orders of magnitude smaller than gas pressure), wind is driven by gas pressure gradient and centrifugal forces. When the magnetic field is strong (magnetic pressure is slightly smaller than gas pressure), wind is driven by gas pressure gradient and magnetic pressure gradient forces. The power of wind in the strongly magnetized case is just slightly larger than that in the weakly magnetized case. The power of wind lies in a range PW ~ 10−4–10−3 Ṁinc2, with Ṁin and c being mass inflow rate and speed of light, respectively. The possible role of wind in active galactic nuclei feedback is briefly discussed.
General Awareness about Epilepsy in a Cohort of Female and Male Students: A Statistical Comparison
Authors: Jaseja Harinder , Verma Jai , Mehndiratta Man , Govila Anand , Tiwari Jyoti , Gupta Sandeep , Grover Vijmendra , Kumari Priti , Parashar Gajendra , Bansal Neeraj 
Published: May 2018

Abstract
Background and Objective A survey on general awareness toward epilepsy was conducted on a cohort of female and male medical and paramedical students that represent a model educated section of the society. It is, therefore, imperative that this section of the society acquires correct knowledge about epilepsy.
Materials and Methods The subjects were undergraduate students from medical and paramedical institutes in Gwalior region who were gathered to celebrate the National Epilepsy Day on November 17, 2016. A self-administered questionnaire of 50 questions on general awareness about epilepsy was completed at the very beginning before the celebrations. The results were subjected to various statistical analyses.
Results A total of 251 respondents (149 females and 102 males) in the age group of 17 to 31 years participated in the survey. All the respondents had heard about epilepsy. One-hundred fifty-eight participants were from medical and dental institutes, whereas 93 participants were from paramedical institutes. In general, the female participants exhibited significantly greater general knowledge about epilepsy in comparison to the male respondents.
Conclusion The results indicate a favorable degree of awareness about epilepsy. A definite knowledge gap was observed between the medical and paramedical students. However, the awareness still needs to be enhanced even among students pursuing medical and paramedical courses through various programs apart from their academic curriculum, as a certain degree of misconceptions and superstitious beliefs associated with epilepsy continues to prevail even in this educated section of the society.
Understanding the Presentations and Patterns of Traumatic Spinal Cord Injuries to Develop the Data Collection Format
Authors: Pal Ranabir , Singh Mithasha , Kumar Kiran , Sharma Vinay , Jahanavi Mundlapudi , Jena Ranjan , Munivenkatappa Ashok , Bhandarkar Prashant , Agrawal Amit 
Published: May 2018

Abstract
Background The intensity of the damage to the nerve fibers is not measured through the severity of the spinal cord injury.
Objective To understand the pattern of neurologic features in traumatic spinal cord injuries.
Methods This was a case series of the total care of patients with consecutive acute spinal cord injury at different levels during the years 2015 to 2017, from extrication and transportation following the accident to death, or the completion of primary definitive rehabilitation. This work examined demographic and clinical characteristics of 220 consecutive cases of acute spinal injuries with or without neurologic symptoms subjected to conservative and surgical interventions. Age, sex, addiction patterns of smoking and alcohol, presenting symptoms, neurologic status, and postoperative outcomes are compared with the preoperative findings.
Results The registry included 220 patients with spinal injury; majority in 41 to 50 years age group (28.6%) and males (77.7%). Nearly one-half had cervical (46.3%) injuries; 84.3% male; comparable proportion of dorsal and lumbar injuries had male dominance. One-fifth of the patients were smokers and alcoholics, all males. Mean hospital stay was 36.7 ± 140.5 days. Majority presented with neck pain (48.9%), radicular pain (56.4%), limb weakness (73.3%), and tingling sensation (47.7%); 14.4% reported tightness in limbs and 18.8% bladder involvement. In postoperative period, symptoms persisted in varied proportions. Significantly of postoperative neck pain was observed more among males (88.5%), yet symptoms that reduced postoperatively were neck pain, limb weakness, and tingling sensation. However, bladder involvement increased significantly.
Conclusion The results showed that greater attention should be paid to older and male population that has more spinal cord injuries while comparable to those of the other studies in neurodeficits and clinical features.
Civilian Occult Orbitocranial Penetrating Injury Presenting with Cerebral Abscess in Elderly Patient
Authors: Mulla Mazhar , Bhende Bhagyashri , Patil Swapnil , Patil Aditya , Diyora Batuk 
Published: May 2018

AbstractOrbital penetrating injuries are uncommon and occur following accidental entry of objects through orbit. The authors report an interesting case of right frontal abscess resulting from orbitocranial penetrating injury due to accidental penetration of wooden stick into the right eye, which remained undiagnosed. A 70-year-man presented with complaints of headache and vomiting for few days. His computed tomographic (CT) scan of the brain revealed peripheral rim-enhancing cystic lesion in the right frontal lobe with perilesional edema, mass effect, and midline shift. Orbital CT scan revealed hyperdense lesion just lateral to medial orbital wall. Magnetic resonance imaging of the brain showed cystic peripheral rim-enhancing lesion that was homogenous hypointense on T1-weighted images and homogenous hyperintense on T2-weighted images. The patient underwent right frontal craniotomy. Pus was drained out, and abscess wall was excised. Foreign bodies protruding through fractured orbital roof were found and removed. He made good clinical recovery. He has received intravenous antibiotics for 2 weeks followed by 4 weeks of oral antibiotics. He had no visual symptoms. The authors report the case, review the literature, and highlight need for imaging in every case of orbital penetrating injury to prevent the life-threatening cerebral parenchymal complications.
Four Quadrant Osteoplastic Decompressive Craniotomy versus Conventional Decompressive Craniectomy for Traumatic Brain Injury: A Randomized Controlled Trial
Authors: Vankipuram Siddharth , Sasane Sumeet , Chandra Anil , Ojha Bal , Singh Sunil , Srivastava Chittij , Jaiswal Somil , Bajaj Ankur 
Published: May 2018

Abstract
Objective Four quadrant osteoplastic decompressive craniotomy (FoQOsD) has been described as a novel technique in the management of patients with traumatic brain injury requiring decompressive surgery. There has not been a randomized controlled trial comparing its outcomes with conventional decompressive craniectomy (DECRA) as yet.
Methods A randomized controlled trial of 55 patients was conducted, of whom 29 underwent DECRA and 26 patients underwent FoQOsD. The preoperative baseline demographics, clinical conditions, and radiologic features were similar in both the groups. Clinical outcome was decided by the use of Glasgow coma outcome scale extended (GOS-e) at 3 months. Radiographic outcomes were assessed by measurement of the change in midline shift and brain width expansion (ipsilateral and contra-lateral to hematoma) on the postoperative computed tomographic (CT) scan.
Results No significant differences were identified in baseline demographics, clinical condition, Rotterdam CT score, and radiographic characteristics between both the groups. At 3-month follow-up, the mean GOS-e score was comparable in both the groups (3.23 in DECRA group and 3.35 in FoQOsD group, p = 0.856). Mortality analysis at 3 months revealed that nine patients died in the DECRA group and eight died in FoQOsD group. Postoperative imaging characteristics, including Rotterdam score, also did not differ significantly. The percentage reduction in midline shift and percentage brain width expansion on the postoperative CT scan was similar in both the groups (p > 0.05).
Conclusion FoQOsD appears to be at least as efficacious as DECRA in providing equivalent clinical outcomes with the added benefit of avoiding a second surgery.
Risk Factors for Group A Streptococcus Colonization During an Outbreak Among People Experiencing Homelessness in Anchorage, Alaska, 2017
Authors: Adebanjo Tolulope , Mosites Emily , Van Beneden Chris A , Onukwube Jennifer , Blum Matthew , Harper Michael , Rudolph Karen , Frick Anna , Castrodale Louisa , McLaughlin Joseph , Bruce Michael G , Gounder Prabhu 
Published: May 2018

Abstract
We identified risk factors for any emm type group A streptococcal (GAS) colonization while investigating an invasive emm26.3 GAS outbreak among people experiencing homelessness in Alaska. Risk factors included upper extremity skin breakdown, sleeping outdoors, sharing blankets, and infrequent tooth brushing. Our results may help guide control efforts in future outbreaks.
Educator perspectives on factors influencing children’s school-based physical activity
Authors: Domville Matthew S , Watson Paula M , Richardson Dave J , Graves Lee E F 
Published: May 2018

Summary
Formative research is an important first step in the design and development of children’s school-based physical activity (PA) interventions. Exploration of educator [headteacher and physical education (PE)-co-ordinator] perceptions toward the promotion of school-based PA, including PE delivery has however been limited. This study took a socio-ecological approach to explore the barriers and facilitators of children’s school-based PA from the perspective of school educators. Interviews were conducted with headteachers (n = 4), PE-co-ordinators (n = 4) and a deputy headteacher (n = 1) and data thematically analysed using Nvivo software (version 10). Findings suggested that, at an organizational level headteachers were the predominant driving force in the promotion of PA opportunities, yet institutional barriers including low priority for PA and PE were perceived to negate delivery. At an interpersonal level, strategies to increase the delivery of school-based PA were developed, however poor teacher-coach relationships and significant others reduced PA promotion opportunities. Child PA was further negated through intrapersonal factors, including lack of PE-specific teacher training and varying teacher interest in PA and sport. To increase primary school children’s school-based PA, barriers and facilitators at the organizational, interpersonal and intrapersonal level must be considered and targeted and researchers and schools should work in partnership to develop future interventions.
Unstructured clinical documentation reflecting cognitive and behavioral dysfunction: toward an EHR-based phenotype for cognitive impairment
Authors: Gilmore-Bykovskyi Andrea L , Block Laura M , Walljasper Lily , Hill Nikki , Gleason Carey , Shah Manish N 
Published: May 2018

AbstractDespite increased risk for negative outcomes, cognitive impairment (CI) is greatly under-detected during hospitalization. While automated EHR-based phenotypes have potential to improve recognition of CI, they are hindered by widespread under-diagnosis of underlying etiologies such as dementia—limiting the utility of more precise structured data elements. This study examined unstructured data on symptoms of CI in the acute-care EHRs of hip and stroke fracture patients with dementia from two hospitals. Clinician reviewers identified and classified unstructured EHR data using standardized criteria. Relevant narrative text was descriptively characterized and evaluated for key terminology. Most patient EHRs (90%) had narrative text reflecting cognitive and/or behavioral dysfunction common in CI that were reliably classified (κ 0.82). The majority of statements reflected vague descriptions of cognitive/behavioral dysfunction as opposed to diagnostic terminology. Findings from this preliminary derivation study suggest that clinicians use specific terminology in unstructured EHR fields to describe common symptoms of CI. This terminology can inform the design of EHR-based phenotypes for CI and merits further investigation in more diverse, robustly characterized samples.
Survival Outcomes After Intracranial Hemorrhage in Liver Disease
Authors: Lagman Carlito , Nagasawa Daniel T , Azzam Daniel , Sheppard John P , Chen Cheng Hao Jacky , Ong Vera , Nguyen Thien , Prashant Giyarpuram N , Niu Tianyi , Tucker Alexander M , Kim Won , Kaldas Fady M , Pouratian Nader , Busuttil Ronald W , Yang Isaac 
Published: May 2018

Abstract

BACKGROUND
Survival outcomes for patients with liver disease who suffer an intracranial hemorrhage (ICH) have not been thoroughly investigated.

OBJECTIVE
To understand survival outcomes for 3 groups: (1) patients with an admission diagnosis of liver disease (end-stage liver disease [ESLD] or non-ESLD) who developed an ICH in the hospital, (2) patients with ESLD who undergo either operative vs nonoperative management, and (3) patients with ESLD on the liver transplant waitlist who developed an ICH in the hospital.

METHODS
We retrospectively reviewed hospital charts from March 2006 through February 2017 of patients with liver disease and an ICH evaluated by the neurosurgery service at a single academic medical center. The primary outcome was survival.

RESULTS
We included a total of 53 patients in this study. The overall survival for patients with an admission diagnosis of liver disease who developed an ICH (n = 29, 55%) in the hospital was 22%. Of those patients with an admission diagnosis of liver disease, 27 patients also had ESLD. Kaplan–Meier analysis found no significant difference in survival for ESLD patients (n = 33, 62%) according to operative status. There were 11 ESLD patients on the liver transplant waitlist. The overall survival for patients with ESLD on the liver transplant waitlist who suffered an in-hospital ICH (n = 7, 13%) was 14%.

CONCLUSION
ICH in the setting of liver disease carries a grave prognosis. Also, a survival advantage for surgical hematoma evacuation in ESLD patients is not clear.
Preparing patients for biologic medications for dermatologic and rheumatic diseases
Authors: Smith Benjamin J. , Nuccio Brigitta C. , Graves Katelyn Y. , McMillan Victor M. 
Published: May 2018

ABSTRACT
Psoriasis, psoriatic arthritis, and rheumatoid arthritis are prevalent conditions that often require a team of primary care and specialist healthcare professionals for the most optimum patient outcomes. Primary care providers can facilitate referrals to dermatology and rheumatology specialists by obtaining the needed screening workup for patients who need treatment with immunosuppressive therapies. This article reviews tuberculosis screening, hepatitis screening, and vaccinations to be administered before patients begin biologic medications.
Endometrial cancer in the elderly: does age influence surgical treatments, outcomes, and prognosis?
Authors: Koual Meriem , Ngo Charlotte , Girault Aude , Lécuru Fabrice , Bats Anne-Sophie 
Published: May 2018

Abstract

Objective:
To compare clinicopathological characteristics, surgical outcomes, and survival rates for nonelderly (<75 years old) and elderly (≥75 years old) women with endometrial cancer (EC).

Methods:
This retrospective study included consecutive patients who underwent surgery for EC at the gynecologic-oncologic surgery department of Hôpital Européen Georges-Pompidou (Paris, France) from January, 2002 to December, 2015. Independent-group t tests and chi-square tests were used to compare elderly and nonelderly women. Survival rates were compared using log-rank (Mantel-Cox) tests.

Results:
In the nonelderly and elderly groups, the mean age at EC diagnosis was 63 (range 33-74) and 81 (range 75-95) years, respectively. Compared with nonelderly patients, elderly patients (n = 104) presented with more advanced disease and more aggressive histological findings. However, surgical approaches did not differ between the two groups, and 76% of all patients underwent minimally invasive surgery. Pelvic lymphadenectomy was performed in 65% and 44% of nonelderly and elderly patients, respectively (P = 0.01), whereas para-aortic lymphadenectomy was performed in 26% and 9% of nonelderly and elderly patients, respectively (P < 0.0001). The incidence of perioperative complications was almost the same in the elderly and nonelderly groups. The 5-year disease-free survival rate was higher in the nonelderly group (P = 0.023), and the 5-year cancer-specific mortality rate was higher in the elderly group (P = 0.042).

Conclusions:
Although elderly patients present with cancers that are more aggressive, the management of EC in this population is not optimal. Further clinical studies need to be conducted for elderly women with EC, and specific treatment guidelines should be developed to improve their prognosis.
A New Approach to Nipple-sparing Mastectomy and Reconstruction in the High Risk Ptotic Patient
Authors: Schwartz Jean-Claude 
Published: May 2018

Summary:
Nipple-sparing mastectomy (NSM) and reconstruction is challenging in ptotic patients with additional risk factors. Here, these problems are addressed with a staged strategy that extends NSM and reconstruction to patients with grade 3 ptosis and additional risk factors of diabetes, obesity, and macromastia. Three stages are used to perform a mastectomy, reposition the nipple, and reduce the skin envelope using the Wise pattern. This is followed by definitive implant placement in a final fourth stage. All patients successfully completed their reconstructions without a single instance of implant loss. Using a staged approach, NSM and reconstruction in high-risk ptotic patients is feasible. This is facilitated by using multiple surgical delays and insuring a well-healed skin envelope and optimal nipple position before any prosthetic device is placed.
Multiplex Real-time PCR Detection of Intestinal Protozoa in HIV-infected Children in Malawi
Authors: Huibers Minke H. W. , Moons Peter , Maseko Nelson , Gushu Monfort B. , Iwajomo Oluwadamilola H. , Heyderman Robert S. , Boele van Hensbroek Michael , Brienen Eric A. , van Lieshout Lisette , Calis Job C. J. 
Published: May 2018

Background:Intestinal protozoa are common opportunistic infections in HIV patients. Longitudinal studies on either the clinical relevance or the effect of immune reconstitution by antiretroviral therapy on intestinal protozoan infections in children are lacking however. This study investigates prevalence and clinical relevance of intestinal protozoa in HIV-infected Malawian children before and during their first year of antiretroviral treatment (ART).Methods:Stool samples collected at enrolment and during follow-up were tested for nonopportunistic (Giardia lamblia,Dientamoeba fragilis,Entamoeba histolytica) and opportunistic protozoa (Enterocytozoon bieneusi,Encephalitozoonspp.,Cryptosporidiumspp. andCystoisospora belli) using multiplex real-time polymerase chain reaction. Associations between infections and clinical symptoms were evaluated using univariate methods.Results:Nonopportunistic and opportunistic protozoa were detected in 40% (14/35) and 46% (16/35) of children at baseline, respectively.E. bieneusiwas the most prevalent protozoa (37%, 13/35) and associated with gastrointestinal complaints (43% in positive (10/13) versus 18% (4/22) inE. bieneusi-negative children,P= 0.001. Body mass index recovery during 12 months of ART was more commonly delayed inE. bieneusi-positive children (+0.29 +standard deviation 0.83) thanE. bieneusi-negative children (+1.03 +standard deviation 1.25;P= 0.05).E. bieneusiwas not detected after 12 months of ART.Conclusions:E. bieneusiwas the most prevalent opportunistic intestinal protozoa, present in over a third of study participants before initiation of ART. Although all children clearedE. bieneusiafter 12 months of ART,E. bieneusiwas associated with gastrointestinal complaints and may delay body mass index recovery. Trials to assess effect of treatment ofE. bieneusion nutritional status should be considered in HIV-infected African children.
Seroprevalence of Toxoplasma gondii Infection Among Β-Thalassemia Major Pediatric Population: Implications for Transfusion Transmissible Toxoplasmosis
Authors: El-Tantawy Nora , Darwish Ahmad , Eissa Eman 
Published: May 2018

Background:
Children with β-thalassemia major who regularly receive blood transfusion are at risk of developing transfusion-transmitted infection. Toxoplasmosis is a common and a serious parasitic disease with high prevalence and could be transmitted through blood transfusion from healthy asymptomatic donors. However, screening Toxoplasma gondii before blood donation has not been considered. The objective of this study was to determine the prevalence of T. gondii antibodies among thalassemia children undergoing blood transfusion.

Methods:
In a case–control study, serum samples from 211 thalassemia children and 100 control children were investigated for Toxoplasma IgM and IgG using the enzyme-linked immunosorbent assay. Positive serum samples for IgG antibodies to T. gondii were further subjected to IgG avidity enzyme-linked immunosorbent assay.

Results:
The seroprevalence of Toxoplasma infection among thalassemia children was 23.2% and 53.6% for IgM and IgG anti-Toxoplasma antibodies, respectively. Whereas in the control group, the prevalence was 5% and 18% for IgM and IgG anti-Toxoplasma antibodies, respectively. There is a significant statistical difference between thalassemia and control groups regarding the prevalence of toxoplasmosis. From these positive IgG samples, 65.5% have low avidity indicating recent infection while 38.73% have high avidity indicating past infection.

Conclusion:
Due to the high serologic infection rate of toxoplasmosis among thalassemia pediatric population in this study with no existing effective therapies and no available T. gondii vaccine, appropriate strategies are critical for reducing the risk of that infection. Screening of blood for T. gondii antibodies should be considered before transmission to those children especially in countries with a high prevalence of toxoplasmosis.