bluuebunny/crossref_metadata_2025_split huggingface dataset:
Calcaneal reconstruction after total calcanectomy with iliac crest free flap
Authors: Innocenti Marco , Lucattelli Elena , Daolio Primo Andrea , Bastoni Stefano , Marini Eleonora , Scoccianti Guido , Menichini Giulio 
Published: March 2019

IntroductionCalcaneal tumors being a rare occurrence, surgical options and outcomes are not well‐known. Extensive defects following wide resection, especially in weight‐bearing areas, still remain a challenge and different reconstructive techniques have been proposed. The aim of this report was to analyze the clinical and functional long‐term outcomes of heel reconstruction using an iliac crest free flap.Patients and methodsFour patients who underwent calcaneal reconstruction between 1999 and 2012 were included. Two were females and mean age was 27 years, ranging 18–42 years. Each patient underwent total calcanectomy, for two osteoblastomas, one osteosarcoma, and one Ewing's sarcoma. An iliac crest flap was harvested and shaped to fit the residual space. After the articular cartilage at recipient site was debrided, the flap was fixed to the talus and the cuboid.ResultsThe average size of the flaps was 2 x 7 x 5 cm. Postoperatively wound dehiscence, screw breaking, and graft fracture healed conservatively. All the arthrodesis healed successfully and no donor site complication occurred. At an average follow‐up of 13 years (range 6–19 years) any patient claimed pain, evident limp or limitation of daily activities. Computerized pedobarographic examination and gait analysis revealed a satisfactory result and an acceptable weight‐bearing area in the reconstructed limb in each patient.ConclusionsCalcaneal reconstruction with iliac crest free flap is likely to provide good chances of a long‐lasting result, especially in young patients. Particularly, it provides the possibility to adequately shape the graft to fit the bone loss while using the crest as the weight‐bearing surface.
Sensitization of Human Liver Cells Toward Fas‐Mediated Apoptosis by the Metabolically Activated Pyrrolizidine Alkaloid Lasiocarpine
Authors: Ebmeyer Johanna , Franz Luise , Lim Ramonique , Niemann Birgit , Glatt Hansruedi , Braeuning Albert , Lampen Alfonso , Hessel‐Pras Stefanie 
Published: March 2019

ScopePyrrolizidine alkaloids (PAs) are common phytotoxins. Intoxication can lead to liver damage. Previous studies showed PA‐induced apoptosis in liver cells. However, the exact role of the extrinsic apoptotic pathway has not been investigated yet. This study aims to analyze whether the PA representative lasiocarpine sensitizes human liver cells toward extrinsic Fas‐mediated apoptosis.Methods and resultsHepG2 cells with limited xenobiotic metabolic activity are used to analyze metabolism‐dependent effects. External in vitro metabolism is simulated using rat or human liver enzymes. Additionally, metabolically competent HepaRG cells are used to confirm the observed effects in a human liver cell system with internal xenobiotic metabolism. Metabolized lasiocarpine decreases cell viability and induces Fas receptor gene expression in both cell lines. Increased Fas receptor protein expression on the cell surface is demonstrated by flow cytometry. The addition of a Fas ligand–simulating antibody induces apoptosis. Induction of extrinsic Fas‐mediated apoptosis is verified by Western blotting for cleaved caspase 8, the initiator caspase of extrinsic apoptosis. All effects are dependent on lasiocarpine metabolism.ConclusionThe results demonstrate that metabolically metabolized lasiocarpine sensitizes human liver cells toward Fas‐mediated apoptosis. They broaden our knowledge on the hepatotoxic molecular mechanisms of PA as widely distributed food contaminants.
Nurses’ experiences of health concerns, teamwork, leadership and knowledge transfer during an Ebola outbreak in West Africa
Authors: Holmgren Jessica , Paillard‐Borg Stéphanie , Saaristo Panu , von Strauss Eva 
Published: March 2019

AbstractAimTo describe nurses’ experiences of health concerns, teamwork, leadership and management and knowledge transfer during an Ebola outbreak in West Africa.DesignThe study has a qualitative descriptive design.MethodsThe 44 nurses who had worked in an Ebola Treatment Centre in Kenema in 2014 and 2015 were invited by email to respond to a questionnaire. The qualitative, open‐ended answers were analysed using a thematic analysis. Data have been coded systematically, with the identification of semantic patterns presented in four themes.ResultsThe themes are as follows: personal health management—a way to feel safe and secure for delegates and affiliates; pre‐deployment training—crucial for a joint value base and future collaboration; the importance of a professional democratic approach and being a good role model; and the value of timely in‐depth knowledge transfer of experienced former delegates.
Safety and Effectiveness of Longer‐Term Phentermine Use: Clinical Outcomes from an Electronic Health Record Cohort
Authors: Lewis Kristina H. , Fischer Heidi , Ard Jamy , Barton Lee , Bessesen Daniel H. , Daley Matthew F. , Desai Jay , Fitzpatrick Stephanie L. , Horberg Michael , Koebnick Corinna , Oshiro Caryn , Yamamoto Ayae , Young Deborah R. , Arterburn David E. 
Published: March 2019

ObjectiveThe aim of this work was to study weight loss and risk of cardiovascular disease (CVD) or death associated with longer‐term phentermine use.MethodsUsing electronic health record data, 13,972 adults were identified with a first phentermine fill in 2010 to 2015, creating exposure categories according to a patient’s duration of use (referent: ≤ 3 months). Multivariable linear models were used to compare percent weight loss across categories at 6, 12, and 24 months, and Cox proportional hazards models were used to compare risk of composite CVD or death, up to 3 years after starting phentermine.ResultsThe cohort was 84% female and 45% white, with a mean (SD) baseline age 43.5 (10.7) years and BMI of 37.8 (7.2) kg/m2. In multivariable models, longer‐term users of phentermine experienced more weight loss; patients using continuously for > 12 months lost 7.4% more than the referent group at 24 months (P < 0.001). The composite CVD or death outcome was rare (0.3%, 41 events), with no significant difference in hazard ratios between groups.ConclusionsGreater weight loss without increased risk of incident CVD or death was observed in patients using phentermine monotherapy for longer than 3 months. Despite the limitations of the observational design, this study supports the effectiveness and safety of longer‐term phentermine use for low‐risk individuals.
Capped antithrombin III dosing is cost effective in the management of asparaginase‐associated thrombosis
Authors: Young Jennifer , Sawyer Jaclyn , Jenkins Meredith , O'Brien Maureen , Luchtman‐Jones Lori , Breese Erin H. 
Published: March 2019

AbstractAsparaginase therapy induces a transient antithrombin III (ATIII) deficiency, which contributes to the risk of asparaginase‐induced thrombosis. At Cincinnati Children's Hospital Medical Center, management of asparaginase‐induced thrombosis includes ATIII supplementation during therapeutic anticoagulation with enoxaparin. Due to the expense associated with ATIII, a capped dosing approach for ATIII was evaluated in this population. Peak ATIII levels were obtained following capped doses to evaluate response. In this pilot evaluation, 11 patients received a total of 138 capped doses for a total cost savings of $803 782. This pilot evaluation represents the first reported analysis of capped ATIII dosing in oncology patients.
A novel SAMD9 variant identified in patient with MIRAGE syndrome: Further defining syndromic phenotype and review of previous cases
Authors: Perisa Michael P. , Rose Melissa J. , Varga Elizabeth , Kamboj Manmohan K. , Spencer John D. , Bajwa Rajinder P.S. 
Published: March 2019

AbstractWe present here a case of MIRAGE syndrome due to novel variant (c.2318T>C) in the sterile α motif domain‐containing protein 9 (SAMD9) gene. Previous reports have described the clinical phenotype, which includes myelodysplasia, recurrent infections, restriction of growth and development, adrenal insufficiency, genitourinary abnormalities, and enteropathies, often resulting in fatality within the first few years of life. This report illustrates the variability in phenotype by describing an 11‐year‐old male, diagnosed with MIRAGE at age 9 years when his novel variant was identified through whole exome sequencing. A brief review of previously published cases of MIRAGE syndrome and the genotypic and phenotypic spectrum are presented.
Implications of hepatic dysfunction in Kawasaki disease: Time‐related changes in aspartate aminotransferase, alanine aminotransferase, total bilirubin, and C‐reactive protein levels
Authors: Tomita Yasuhiko , Fukaya Takashi , Yamaura Yasuko , Tsujiguchi Rie , Muratani Haruko , Shimaya Maki 
Published: March 2019

AbstractImportanceThe cause of the hepatic dysfunction that commonly accompanies Kawasaki disease (KD) remains unclear.ObjectiveWe tried to clarify the cause of the hepatic dysfunction.MethodsA total of 381 consecutive patients with acute KD, who had undergone inpatient treatment with intravenous immunoglobulin until the 7th day of illness, were divided into a group of 199 patients with an alanine aminotransferase (ALT) level ≥ 40 IU/L on admission (group I), a group of 52 patients with an ALT level ≥ 40 IU/L at some point after admission (group II), and a group of 130 patients with ALT levels consistently < 40 IU/L throughout hospitalization (group III). Aspartate aminotransferase (AST), ALT, total bilirubin (T‐Bil), and C‐reactive protein (CRP) levels were analyzed over time, and time‐courses were compared.ResultsIn the initial stage of illness, in group I, AST, ALT, T‐Bil peaked on days 1–3, and AST tended to improve significantly on the 4th day (P < 0.001). T‐Bil improved on day 5 (P < 0.01), and ALT improved significantly on day 6 (P < 0.001). CRP increased every day up to day 6 (P < 0.001). In group II, AST and ALT increased after admission, and thereafter CRP increased, then decreased. The frequency of use of aspirin and aspirin doses did not differ significantly in the three groups.InterpretationRecovery from liver dysfunction occurred in the initial stage of illness in group I—within the period of CRP exacerbation, which is an indicator of systemic inflammation.
Modulation of Autonomic Function by Physical Exercise in Patients with Fibromyalgia Syndrome: A Systematic Review
Authors: Andrade Alexandro , Vilarino Guilherme Torres , Serafim Thiago Teixeira , Pereira Júnior Altair Argentino , de Souza Cícero Augusto , Sieczkowska Sofia Mendes 
Published: March 2019

ObjectiveTo evaluate the effects of physical exercise on autonomic dysfunction in patients with fibromyalgia syndrome (FM).Literature Survey and MethodologyA systematic review of experimental studies published until December 2017 that analyzed the effect of physical exercise on autonomic dysfunction in patients with FM was performed using the PubMed, Pedro, Scopus, ScienceDirect, and Web of Science databases.SynthesisA total of 1105 articles were identified, 12 of which were included in the final analysis. The most analyzed exercise modalities were aerobic and resistance exercises. Overall, the studies demonstrated that aerobic exercise performed twice a week with moderate to high intensity was effective in reducing autonomic dysfunction by increasing heart rate variability. Resistance training was associated with reduced symptoms of anxiety and depression as well as increased muscle strength; however, it did not reduce autonomic dysfunction in these patients in the short or long term.ConclusionsPreliminary evidence suggests that aerobic exercise reduces autonomic dysfunction in patients with FM, whereas resistance training reduces psychological symptoms such as anxiety and depression.Level of EvidenceI
Water structure and mobility in acrylamide copolymer glycohydrogels with galactose and siloxane pendant groups
Authors: Fogel April L. , Ravichandran Ashwin , Mani Sriramvignesh , Upadhyay Bishal , Khare Rajesh , Morgan Sarah E. 
Published: March 2019

ABSTRACTGlycohydrogels containing 2′‐acrylamidoethyl‐β‐d‐galactopyranoside and varying levels of N,N′ methylene bisacrylamide and 3‐acrylamidopropyltris(trimethylsiloxy)silane were synthesized to determine the effects of crosslinker and amphipathic balance on equilibrium water content (EWC), bound water population, and hydrogen bonding dynamics at the water–polymer interface. Analogous dimethylacrylamide hydrogels were synthesized for comparison with a system containing lower hydrogen bonding propensity. An approach combining experiment (proton nuclear magnetic resonance, thermogravimetric analysis, differential scanning calorimetry, and dynamic vapor sorption analysis) and molecular dynamics simulations was employed to examine the relationship between bulk hydrogel properties, molecular water mobility, and hydrogen bonding characteristics. It was found that copolymer composition (hydrophobic content) and crosslink concentration in high water content glycohydrogels affect EWC, and by extension, structural water population. The organization of water at the polymer interface is greatly impacted by the surrounding environment, where hindered molecular water mobility promotes water–polymer binding and decreases water–water clustering. © 2019 Wiley Periodicals, Inc. J. Polym. Sci., Part B: Polym. Phys. 2019, 57, 584–597
Explosive Emulsion Characterisation using Nuclear Magnetic Resonance
Authors: Hayward Nathan E. , Ling Nicholas N. A. , Johns Michael L. 
Published: March 2019

AbstractExplosive emulsions are frequently employed in mining operations as they offer a comparatively robust, safe and effective product. These are typically formulated as concentrated ammonium nitrate solutions dispersed in an oil phase in the form of a highly concentrated water‐in‐oil emulsion. Being highly concentrated, determining the droplet size distribution (which is critical to assessing long‐term emulsion stability and explosive effectiveness) of these emulsions is challenging. Here we demonstrate that this is readily achieved using bench‐top Nuclear Magnetic resonance (NMR) Pulsed Field Gradient (PFG) techniques. The initial mean droplet size is shown to decrease with an increase in the concentration of ammonium nitrate or emulsifier or when inert salt was added to the composition, it was found to increase as the concentration of the aqueous (oxidiser) phase was increased. The emulsion droplet size distributions were observed to remain constant for a 3‐month period over the composition range explored.
Current weight of evidence of viruses associated with peri‐implantitis and peri‐implant health: A systematic review and meta‐analysis
Authors: Akram Zohaib , Al‐Aali Khulud Abdulrahman , Alrabiah Mohammed , Alonaizan Faisal Abdullah , Abduljabbar Tariq , AlAhmari Fatemah , Javed Fawad , Vohra Fahim 
Published: March 2019

SummaryThe pathological role of human herpesviruses (HHVs) (Epstein‐Barr virus [EBV], Human cytomegalovirus [CMV], and Herpes simplex virus [HSV]) in peri‐implant health needs clarification quantitatively. To determine the weight of evidence for HHVs in patients with peri‐implantitis (PI) and substantiate the significance of HHVs in peri‐implant inflammation, electronic databases including EMBASE, MEDLINE, Cochrane Oral Health Group Trials Register, and Cochrane Central Register of Controlled Trials were searched from 1964 up to and including November 2018. Meta‐analyses were conducted for prevalence of HHVs in PI and healthy controls. Forest plots were generated that recorded risk difference (RD) of outcomes and 95% confidence intervals (CI). Five clinical studies were considered and included. Four clinical studies reported data on EBV while three clinical studies reported data on CMV. Considering the risk of these viruses in PI, significant heterogeneity for CMV (χ2 = 53.37, p < 0.0001, I2 = 96.25%) and EBV (χ2 = 14.14, p = 0.002, I2 = 78.79%) prevalence was noticed between PI and healthy control sites. The overall RD for only EBV (RD = 0.20, 95% CI, 0.01‐0.40, p = 0.03) was statistically significant between both groups. Frequencies of the viruses were increased in patients with PI compared with healthy nondiseased sites. However, the findings of the present study should be interpreted with caution because of significant heterogeneity and small number of included studies.
Critical Thinking Is Critical: Octopuses, Online Sources, and Reliability Reasoning
Authors: Pilgrim Jodi , Vasinda Sheri , Bledsoe Christie , Martinez Elda 
Published: March 2019

AbstractThe ability to analyze and evaluate online sources for credibility continues to be a universal concern. In a 2006 study by the University of Connecticut, seventh graders lacked the ability to discredit a hoax website about a tree octopus. Using the same website in this qualitative study, 68 elementary students shared rationales about the source's authenticity during an exploration of reliability reasoning. Student responses provided insight into the application of web literacy skills and highlighted a need for increased instructional emphasis on critical thinking and explicit modeling of reliability reasoning during online searches.
Intraoperative Body Fluid Amylase as a Novel Indicator of Postgastrectomy Pancreatic Fistula
Authors: Tanioka Toshiro , Kojima Kazuyuki , Saito Toshifumi , Kanemoto Emi , Okuno Keisuke , Gokita Kentaro , Kobayashi Kenta , Nakagawa Masatoshi , Inokuchi Mikito 
Published: March 2019

AbstractBackgroundAlthough many methods to prevent the development of postoperative pancreatic fistula (POPF) after gastrectomy have been reported, POPF can only be identified after it has occurred. Various therapeutic measures could be taken if signs of POPF could be detected intraoperatively.MethodsWe conducted a prospective study in which we attempted to predict POPF by measuring the intraoperative amylase concentration in the peripancreatic body fluid. To collect the body fluid, three sponges were placed around the pancreas at lymph node station Nos. 6, 8, and 11 during lymphadenectomy. The amylase concentration was measured in the body fluid squeezed from the sponges. We investigated whether the intraoperative body fluid amylase concentration (IBAC) was associated with POPF formation.ResultsIn total, 109 patients were enrolled from February 2016 to March 2018, and we analyzed 81 eligible patients. Clavien–Dindo grade ≥ II POPF occurred in eight patients (9%). The IBAC was significantly higher in sponges No. 6 (P = 0.044) and No. 8 (P = 0.007). The incidence of POPF was predicted by using an IBAC cutoff value for No. 6 (1047 IU/L; sensitivity 87.5%; specificity 65.0%; positive likelihood ratio 2.5) and No. 8 (400 IU/L; sensitivity 87.5%; specificity 68.5%; positive likelihood value 2.8), respectively. The IBAC in sponge No. 11 tended to be higher (P = 0.054).ConclusionsBy measuring the IBAC, surgeons might predict POPF easily and noninvasively during surgery. This method is one of the most effective ways to predict POPF intraoperatively.
The Operative Output of District Hospitals in KwaZulu‐Natal Province is Heavily Skewed Toward Obstetrical Care
Authors: Tefera Aida , Lutge Elizabeth , Sartorius Benn , Clarke Damian 
Published: March 2019

AbstractIntroductionDistrict hospitals are key to providing universal coverage of essential surgery and for strengthening surgical care in general. This audit set out to quantify the surgical output of all the district hospitals in KwaZulu‐Natal Province (KZN) over a 6‐month period to see whether district hospitals were delivering the surgical care they are expected to deliver.ResultsThere were a total of 18,871 operations performed at 37 district hospitals in KwaZulu‐Natal from July to December 2015. The number of operations per hospital varied widely between 2150 at a single large district hospital and 68 at a small district hospital, respectively. Surgical operations for obstetrical conditions made up by far the majority of operations at 57%, with gynecological operations making up the second highest at 15%. Only 12% of operations were for general surgical conditions. With regards to the bellwether procedures, 96.1% of these were cesarean sections, 2.1% were laparotomies and 1.8% were ORIFs. For almost all the 37 hospitals, the percentage of laparotomies and ORIFs performed was small to negligible, while the percentage of cesarean sections performed was high. The number of bellwether operations performed per 100,000 population was much higher than the number of general surgical or orthopedic operations performed, primarily because of the preponderance of cesarean sections conducted in each hospital. We observed a strong and significant positive correlation (+0.691, 95% CI +0.538 to +0.800, p < 0.001) between increasing distance to nearest regional referral hospital and rate of laparotomies and ORIF procedures performed.ConclusionsThe surgical output of district hospitals in KZN is heavily skewed toward obstetrics and gynecology. Further work is required to understand the reasons for this, but the current data imply that district hospitals are not delivering surgical and orthopedic care at district hospitals in KwaZulu‐Natal.
A study of accidental impact scenarios for composite wing damage tolerance evaluation
Authors: Dubinskii S. , Feygenbaum Y. , Senik V. , Metelkin E. 
Published: March 2019

ABSTRACTThe field data characterising aircraft accidental in-service damage was collected, sorted and processed. By means of probabilistic analysis, the wing damageability statistical parameters were determined. The scenarios of wing accidental impacts were described and the qualitative distribution of impact intensity over the wing surfaces was obtained. By means of original analytical method, the metal dent depth data were converted into impact energy data and energy probabilistic distributions were established. It was shown that the functional relationships generated on domestic data are generally consistent with similar foreign results obtained on other types of aircraft with serious differences in operating conditions. Along with realistic impact damage scenarios, the high energy impact events were considered. It was noted that in some cases severe damage events should not be addressed as extremely improbable and should be included into design and certification process.
The Indonesian Constitutional Court: Reconfiguring Decentralization for Better or Worse?
Authors: BUTT Simon 
Published: March 2019

AbstractAfter Soeharto stepped down in 1998, Indonesia began a radical decentralization program, one aspect of which was granting wide-ranging lawmaking powers to subnational governments. The national legislation establishing the decentralization framework gave power to the central government to review provincial-level laws, and, from 2014, for provincial governors to review city and county laws, and to invalidate them if they are inconsistent with national laws, morality, or public order. In 2017, the Constitutional Court declared these review mechanisms unconstitutional, deciding that these reviews should be conducted by the Supreme Court rather than the national or provincial executive governments. This decision reversed the trend of successive reforms from 2004 that had begun restoring political and legal power to the centre. It was also one of the most problematic in the Court’s history, as this article demonstrates. The legal reasoning was poor and incomplete, the Court appeared to be equally split (though the Court did not acknowledge this), and the consequences of the decision (which the Court did not appear to consider) are likely dire. The decision has caused great confusion, but despite its flaws may well lead to reforms requiring the Constitutional Court, rather than the Supreme Court, to review subnational laws.