bluuebunny/crossref_metadata_2025_split huggingface dataset:
First-in-Human Experience With Integration of a Hydrocephalus Shunt Device Within a Customized Cranial Implant
Authors: Gordon Chad R , Wolff Amir , Santiago Gabriel F , Liebman Kenneth , Veznedaroglu Erol , Vrionis Frank D , Huang Judy , Brem Henry , Luciano Mark 
Published: February 2019

Abstract

BACKGROUND
Implantable shunt devices are critical and life saving for hydrocephalus patients. However, these devices are fraught with high complication rates including scalp dehiscence, exposure, and extrusion. In fact, high shunt valve profiles are correlated with increased complications compared to those with lower profiles. As such, we sought a new method for integrating shunt valves for those challenging patients presenting with scalp-related complications.

OBJECTIVE
To safely implant and integrate a hydrocephalus shunt valve device within a customized cranial implant, in an effort to limit its high-profile nature as a main contributor to shunt failure and scalp breakdown, and at the same time, improve patient satisfaction by preventing contour deformity.

METHODS
A 64-yr-old male presented with an extruding hydrocephalus shunt valve and chronic, open scalp wound. The shunt valve was removed and temporary shunt externalization was performed. He received 2 wk of culture-directed antibiotics. Next, a contralateral craniectomy was performed allowing a new shunt valve system to be implanted within a low-profile, customized cranial implant. All efforts were made, at the patient's request, to decrease the high-profile nature of the shunt valve contributing to his most recent complication.

RESULTS
First-in-human implantation was performed without complication. Postoperative shunt identification and programming was uncomplicated. The high-profile nature of the shunt valve was decreased by 87%. At 10 mo, the patient has experienced no complications and is extremely satisfied with his appearance.

CONCLUSION
This first-in-human experience suggests that a high-profile hydrocephalus shunt device may be safely integrated within a customized cranial implant.
NSV 1440: first WZ Sge-type object in AM CVn stars and candidates
Authors: Isogai Keisuke , Kato Taichi , Monard Berto , Hambsch Franz-Josef , Myers Gordon , Starr Peter , Cook Lewis M , Nogami Daisaku 
Published: February 2019

AbstractIn 2015 and 2017, the AM CVn candidate NSV 1440 showed superoutbursts that had the characteristic features of WZ Sge-type dwarf novae (DNe). By analogy with hydrogen-rich cataclysmic variables (CVs), we can interpret these outbursts as “double superoutbursts” which are composed of a first superoutburst with early superhumps and a second superoutburst with ordinary superhumps. The object also showed multiple rebrightenings after the main superoutbursts. Early superhumps had never before been observed in AM CVn stars and candidates, thus NSV 1440 is the first confirmed WZ Sge-type AM CVn candidate. We obtained an early superhump period of 0.0252329(49) d and a growing (stage A) superhumps period of 0.025679(20) d from the 2015 superoutburst. We regarded the early superhump period as the orbital one. By using these periods we estimated the mass ratio q = 0.045(2). This value suggests that NSV 1440 is indeed an AM CVn star and that the secondary is a semi-degenerate star.
Outcomes and resource usage of infants born at ≤ 25 weeks gestation in Canada
Authors: Shafey Amy , Bashir Rani Ameena , Shah Prakesh , Synnes Anne , Yang Junmin , Kelly Edmond N ,   Canadian Neonatal Network and Canadian Neonatal Follow-Up Network Investigators, Shah Prakesh S , Harrison Adele , Synnes Anne , Ting Joseph , Yee Wendy , Aziz Khalid , Toye Jennifer , Fajardo Carlos , Kalapesi Zarin , Sankaran Koravangattu , Daspal Sibasis , Seshia Mary , Alvaro Ruben , Shivananda Sandesh , Da Silva Orlando , Nwaesei Chuks , Lee Kyong-Soon , Dunn Michael , Lemyre Brigitte , Dow Kimberly , Pelausa Ermelinda , Barrington Keith , Drolet Christine , Piedboeuf Bruno , Claveau Martine , Faucher Daniel , Bertelle Valerie , Masse Edith , Canning Roderick , Makary Hala , Ojah Cecil , Monterrosa Luis , Deshpandey Akhil , Afifi Jehier , Kajetanowicz Andrzej , Lee Shoo K , Pillay Thevanisha , Synnes Anne , Sauvé Reg , Hendson Leonora , Reichert Amber , Bodani Jaya , Sankaran Koravangattu , Moddemann Diane , Nwaesei Chuks , Daboval Thierry , Dow Kimberly , Lee David , Ly Linh , Kelly Edmond , el Helou Salhab , Church Paige , Pelausa Ermelinda , Riley Patricia , Levebrve Francine , Demers Charlotte , Bélanger Sylvie , Canning Roderick , Monterrosa Luis , Makary Hala , Vincer Michael , Murphy Phil 
Published: February 2019

ABSTRACTObjectivesTo determine the outcomes and resource usage of infants born at ≤ 25 weeks gestational age (GA).MethodsRetrospective study of infants born between April 2009 and September 2011 at ≤ 25 weeks’ GA in all neonatal intensive care units in Canada with follow-up in the neonatal follow-up clinics. Short-term morbidities, neurodevelopmental impairment, significant neurodevelopmental impairment, and resource utilization of infants born at ≤ 24 weeks were compared with neonates born at 25 weeks.ResultsOf 803 neonates discharged alive, 636 (80.4%) infants born at ≤ 25 weeks’ GA were assessed at 18 to 24 months. Caesarean delivery, lower birth weight, and less antenatal steroid exposure were more common in infants born ≤ 24 weeks as compared with 25 weeks. They had significantly higher incidences of ductus arteriosus ligation, severe intracranial hemorrhage, retinopathy of prematurity as well as longer length of stay, central line days, days on respiratory support, days on total parenteral nutrition, days on antibiotics, and need for postnatal steroids. Neurodevelopmental impairment rates were 68.9, 64.5, and 55.6% (P=0.01) and significant neurodevelopmental impairment rates were 39.3, 29.6, and 20.9% (P&lt;0.01) for infants ≤ 23, 24, and 25 weeks GA, respectively. Postdischarge service referrals were higher for those ≤ 23 weeks. Nonsurviving infants born at 25 weeks GA had higher resource utilization during admission than infants born less than 25 weeks.ConclusionsAdverse outcomes and resource usage were significantly higher among infants born ≤ 24 weeks GA as compared with 25 weeks GA.
State Responsibility and Differential Inclusion: Addressing Honor-Based Violence in the Netherlands and Germany
Authors: Yurdakul Gökçe , Korteweg Anna C 
Published: February 2019

AbstractFrom 2004, the Dutch parliament developed a comprehensive response to honor-based violence, initially in consultation with immigrant and nonimmigrant political actors, while German politicians used honor-based violence to justify the restriction of immigrants from membership, portraying them as problematic subjects. More recently, the influence of immigrant actors on Dutch policy has waned, while in Germany policy continues to develop haphazardly with generally limited support for gendered violence services. Analyzing media and policy debates, we turn to the concepts of state responsibility and differential inclusion to show how actors engaged with these policies intersectionally produce national membership along gendered and racialized lines.
Menopausal Symptoms and Surgical Complications After Opportunistic Bilateral Salpingectomy, A Register-based Cohort Study
Authors: Collins Elin , Strandell Annika , Granåsen Gabriel , Idahl Annika 
Published: February 2019

(Abstracted from Am J Obstet Gynecol 2019;220:85.e1–85.e10)
Recent studies have suggested that the fallopian tubes may play a critical role in the pathogenesis of various types of ovarian cancer. These findings have led to an increase in opportunistic salpingectomies when performing hysterectomy as a preventive measure for ovarian cancer.
Risks of Ovarian, Breast, and Corpus Uteri Cancer in Women Treated With Assisted Reproductive Technology in Great Britain, 1991–2010: Data Linkage Study Including 2.2 Million Person Years of Observation
Authors: Williams Carrie L. , Jones Michael E. , Swerdlow Anthony J. , Botting Beverley J. , Davies Melanie C. , Jacobs Ian , Bunch Kathryn J. , Murphy Michael F. G. , Sutcliffe Alastair G. 
Published: February 2019

(Abstracted from BMJ 2018;362:k2644)
Assisted reproductive therapy such as exposure of women to supraphysiological levels of estradiol, exogenous gonadotropins, and multiple ovarian punctures are suspected to incur an increased risk of cancer. Studies investigating the carcinogenic effects of these exposures are largely inconsistent.
Cell-free Fetal DNA Analysis in Maternal Plasma as Screening Test for Trisomies 21, 18, and 13 in Twin Pregnancy
Authors: Le Conte G. , Letourneau A. , Jani J. , Kleinfinger P. , Lohmann L. , Costa J.-M. , Benachi A. 
Published: February 2019

(Abstracted from Ultrasound Obstet Gynecol 2018;52(3):318–324)
Increased use of fertility treatment and advanced maternal age contribute to the increased prevalence of twin pregnancy, which is currently approximately 3% in the United States. Screening for trisomy 21 in twins largely relies on maternal age and nuchal translucency measurement in the first trimester, as well as first- and second-trimester serum screening.
Screening for Syphilis Infection in Pregnant Women: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force
Authors: Lin Jennifer S. , Eder Michelle L. , Bean Sarah I. 
Published: February 2019

(Abstracted from JAMA 2018;320(9):918–925)
Congenital syphilis is an infectious disease caused by the vertical transmission of Treponema pallidum; thus, prevention and detection of congenital syphilis depend on the identification of syphilis in pregnant women. Two screening protocols are commonly used: the traditional screening algorithm (ie, nontreponemal testing with reflex to treponemal testing) and the reverse sequence screening algorithm (ie, treponemal testing with reflex to nontreponemal testing).
ICU Utilization for Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease Receiving Noninvasive Ventilation
Authors: Myers Laura C. , Faridi Mohammad Kamal , Currier Paul , Camargo Carlos A. 
Published: February 2019

Objectives:
We investigated whether patients with chronic obstructive pulmonary disease could safely receive noninvasive ventilation outside of the ICU.

Design:
Retrospective cohort study.

Setting:
Twelve states with ICU utilization flag from the State Inpatient Database from 2014.

Patients:
Patients greater than or equal to 18 years old with primary diagnosis of acute exacerbation of chronic obstructive pulmonary disease and secondary diagnosis of respiratory failure who received noninvasive ventilation.

Interventions:
None.

Measurements and Main Results:
Multilevel logistic regression models were used to obtain hospital-level ICU utilization rates. We risk-adjusted using both patient/hospital characteristics. The primary outcome was in-hospital mortality; secondary outcomes were invasive monitoring (arterial/central catheters), hospital length of stay, and cost. We examined 5,081 hospitalizations from 424 hospitals with ICU utilization ranging from 0.05 to 0.98. The overall median in-hospital mortality was 2.62% (interquartile range, 1.72–3.88%). ICU utilization was not significantly associated with in-hospital mortality (β = 0.01; p = 0.05) or length of stay (β = 0.18; p = 0.41), which was confirmed by Spearman correlation (ρ = 0.06; p = 0.20 and ρ = 0.02; p = 0.64, respectively). However, lower ICU utilization was associated with lower rates of invasive monitor placement by linear regression (β = 0.05; p < 0.001) and Spearman correlation (ρ = 0.28; p < 0.001). Lower ICU utilization was also associated with significantly lower cost by linear regression (β = 14.91; p = 0.02) but not by Spearman correlation (ρ = 0.09; p = 0.07).

Conclusions:
There is wide variability in the rate of ICU utilization for noninvasive ventilation across hospitals. Chronic obstructive pulmonary disease patients receiving noninvasive ventilation had similar in-hospital mortality across the ICU utilization spectrum but a lower rate of receiving invasive monitors and probably lower cost when treated in lower ICU-utilizing hospitals. Although the results suggest that noninvasive ventilation can be delivered safely outside of the ICU, we advocate for hospital-specific risk assessment if a hospital were considering changing its noninvasive ventilation delivery policy.
Coils migrate into the biliary-jejunum anastomosis
Authors: Xu Jianwei , Zhan Hanxiang , Li Feng , Hu Sanyuan , Wang Lei 
Published: February 2019

Abstract

Rationale:
Coils migration following endovascular treatment of arterial bleeding is rare. There was no clear route to deal with this complication.

Patient concerns:
A 55-year-old woman underwent choledochal cyst excision with hepaticojejunostomy. At the 18th day after operation, intra-abdominal hemorrhage occurred. Angiography showed active bleeding of 1 branch of the right hepatic artery and the gastroduodenal artery. That was treated by micro-coils embolization. 122 days after embolization, the patient was readmitted for chills, fever with temperature of 40°C, and jaundice.

Diagnosis:
Obstructive cholangitis.

Interventions:
Endoscopy was performed, which showed the micro-coils were embedded in biliary-jejunum anastomosis. Biliary sludges were adherent around micro-coils that were considered the cause of obstructive jaundice, which were washed by endoscopy.

Outcomes:
Two days later endoscopy therapy, the total bilirubin (TBIL) was decreased to 58.7 μmol/L, and the patient was discharged. After 2 months of follow-up, the level of TBIL was in normal range.

Lessons:
Coils migration following endovascular treatment of arterial bleeding is rare. For cases with coils migrated into the biliary tract, further treatment is often needed because of the secondary cholangitis or stones. Endoscopy might be useful to deal with this intractable problem.
Insufficient education is a key factor of incorrect interpretation of HIV self-test results by female sex workers in Democratic Republic of the Congo
Authors: Tonen-Wolyec Serge , Batina-Agasa Salomon , Longo Jean De Dieu , Mboumba Bouassa Ralph-Sydney , Bélec Laurent 
Published: February 2019

Abstract
We report on field interpretation of HIV self-testing among female sex workers (FSWs) and non-FSWs living in Democratic Republic of the Congo.
Two hundred and eight participants [76 (36.5%) FSWs; 132 (63.5%) non-FSWs] were enrolled in Kisangani and Bunia to evaluate their ability to read and interpret the results of a prototype HIV self-test (Exacto Test HIV, Biosynex, Strasbourg, France), according to WHO recommendations. Thirteen standardized tests (6 positive, 5 negative, 2 invalid) were proposed after successive random selection.
Two thousand seven hundred and four standardized tests (1248 positive, 1040 negative, 416 invalid) were interpreted; 2435 (90.1%) were correctly interpreted, whereas 269 (9.9%) were misinterpreted. In FSWs and non-FSWs, the test results were similarly correctly interpreted in 87.4% (864/988) and 91.6% (1571/1716), respectively. In multivariate logistic regression analysis, only the variable “educational level” remained strongly associated with the interpretation of positive, negative, and invalid HIV self-test results, but not the variables “commercial sex work” and “language chosen for instructions for use.” Incorrect interpretation was significantly higher in participants with insufficient educational level than in those with sufficient education level for positive (13.1% vs 2.6%; adjusted OR: 4.5), negative (22.3% vs 2.6%; adjusted OR: 5.3), and invalid test results (23.8% v 6.4%; adjusted OR: 3.6).
Incorrect interpretation of HIV self-test was as common in FSWs and non-FSWs. The lower was the educational level, the greater was the difficulty to interpret results correctly. These observations point that insufficient education level, rather than commercial sex work by itself, constitutes a key factor of incorrect interpretation of HIV self-test.
Swyer-James-Macleod syndrome as a rare cause of unilateral hyperlucent lung
Authors: Machado Daniela , Lima Filipa , Marques Catarina , Monteiro Regina 
Published: February 2019

Abstract

Rationale:
Swyer-James-Macleod syndrome (SJMS) is a rare lung disorder characterized by unilateral hyperlucent lungs which arises as a complication of bronchiolitis obliterans. It is typically diagnosed during childhood, although some patients may only be diagnosed in adulthood, often as an incidental finding, but others due to recurrent chest infections.

Patient concerns:
Three patients were referred to our institution with complaints of dyspnea on exertion, chronic productive cough, and recurrent pulmonary infections. Two of them had a history of lower respiratory tract infections during childhood.

Diagnosis:
A computed tomography scan was performed and showed unilateral reduced density of the lung and bronchiectasis in the 3 patients. Based on the clinical presentation and radiologic features, the diagnosis of SJMS was established.

Interventions:
Patients started inhaled corticosteroids and long acting beta agonist, vaccines to prevent respiratory infections were administered and airway clearance techniques were taught.

Outcomes:
Two patients became asymptomatic with inhaled therapy and no recurrent chest infections were observed over a 3-year follow-up period, being discharged from our institution to the general practitioner. The 3rd patient had some improvement in the frequency of pulmonary infections and dyspnea, without improvement in respiratory function tests, maintaining vigilance at our center.

Lessons:
These cases highlight the importance of being aware of this condition and its frequent association with bronchiectasis, which may adversely affect the prognosis, to manage patients appropriately and prevent recurrent pulmonary infections.
Successful rescue of antepartum eclampsia in a Chinese patient
Authors: Cao Weiping , Wang Xinzhi , Chen Tingmei , Qin Mingmei , Wang Zuxian , Wang Qin , Xie Bing , Xu Wenlin 
Published: February 2019

Abstract

Rationale:
Eclampsia is a life-threatening complication of pregnancy. Eclampsia is a leading cause of maternal and neonatal morbidity and mortality with most injury being associated with the seizures that mark the onset of the disease. It is vital that medical worker managing eclampsia have an understanding of the disease process.

Patient concerns:
A 28-year-old female, G4P1, with history of caesarean section was admitted at GA34+6, in addition to headache and severe hypertension (180/120 mm Hg) and proteinuria (+++). The evaluation of coagulation parameters showed positive D-dimer and increased fibrinogen and fibrinogen degradation product (FDP) and PT percent activity. Her biochemical analysis showed a decrease in total protein and an increase in alanine transaminase (ALT) and lactate dehydrogenase (LDH) and high serum uric acid and hyperlipidemia.

Diagnoses:
She was diagnosed with severe preeclampsia (PE).

Interventions:
First, the patient received magnesium sulfate therapy for convulsions control. Next, antihypertensive management of labetalol orally at a dose 100 mg and nifedipine orally at a dose 10 mg and glycerin trinitrate10 mg iv were used to maintain blood pressure in a safe range. Then, corticosteroid was given for enhancing fetal lung maturation. During preparation for cesarean section, the patient experienced suddenly seizures that lasted approximately 2 to 8 minutes. The immediate therapy is to stop the convulsions and reduce blood pressure.

Outcomes:
The patient and her baby were discharged from the hospital on the 7th day after the operation with normal blood pressure and being in a satisfactory condition.

Lessons:
Eclampsia is defined as the occurrence of convulsions superimposed on the preeclampsia. The awareness of eclampsia enhances early diagnosis and timely administration of magnesium sulfate and calmative drug which are critical to avoid feto-maternal complications.
Drug resistance mutations and viral load in human immunodeficiency virus type 2 and dual HIV-1/HIV-2 infected patients in Ghana
Authors: Abana Christopher Z. , Sagoe Kwamena W.C. , Bonney Evelyn Y. , Maina Edward K. , Aziati Ishmael D. , Agbosu Esinam , Mawuli Gifty , Styer Linda M. , Ishikawa Koichi , Brandful James A.M. , Ampofo William K. 
Published: February 2019

Abstract
Antiretroviral therapy (ART) and drug resistance studies worldwide have focused almost exclusively on human immunodeficiency virus type 1 (HIV-1). As a result, there is limited information on ART and drug resistance in HIV-2 patients. In Ghana, the HIV epidemic is characterized by the domination of HIV-1, with cocirculating HIV-2. We, therefore, sought to determine viral load and drug resistance mutations in HIV-2 patients to inform the clinical management of such individuals in Ghana.
We used purposive sampling to collect blood from 16 consented patients, confirmed as HIV-2 or HIV-1/2 dual infections by serology. A 2-step real-time RT-PCR assay was used to determine plasma HIV-2 RNA viral loads. For drug resistance testing, nucleic acids were extracted from plasma and peripheral blood mononuclear cells. The reverse transcriptase and protease genes of HIV-2 were amplified, sequenced and analyzed for drug resistance mutations and HIV-2 group.
HIV-2 viral load was detected in 9 of 16 patients. Six of these had quantifiable viral loads (range: 2.62–5.45 log IU/mL) while 3 had viral loads below the limit of quantification. Sequences were generated from 7 out of 16 samples. Five of these were classified as HIV-2 group B and 2 as HIV-2 group A. HIV-2 drug resistance mutations (M184V, K65R, Y115F) were identified in 1 patient.
This study is the first to report HIV-2 viral load and drug resistance mutations in HIV-2 strains from Ghana. The results indicate the need for continuous monitoring of drug resistance among HIV-2- infected patients to improve their clinical management.
Hybrid repair for a complex infection aortic pseudoaneurysm with continued antibiotic therapy
Authors: Chen Xiyang , Yuan Ding , Zhao Jichun , Huang Bin , Yang Yi 
Published: February 2019

Abstract

Introduction:
Treatment of infection aortic pseudoaneurysm (PSA) is a great challenge to surgeons for 3 reasons: high mortality for rupture or threatened rupture; potential risk for infection of prosthetic material which probably bring a devastating result for patients; and long-term antibiotic therapy requirement. Endovascular repair is an alternative to open surgery for a less invasive, which is a trouble procedure for aortic PSA with complex aortic anatomy. The purpose of this article is to report the novel hybrid repair of an infection aortic PSA and antibiotics therapy.

Clinical finding:
A 61-year-old man with complaints of repeated abdominal pain and fever for 3 months was admitted. He had a fever of 39.0°C and normal blood pressure. The blood leukocyte count was 14.9 × 109/L, C-reactive protein was 132 mg/L. There was no evidence for urinary tract infection. The small effusion was identified in bilateral thoracic cavity and pelvis cavity, and the severe lung function impairment was detected. Klebsiella pneumoniae was identified in blood cultures. Computer tomographic (CT) angiography showed a 6 cm × 6 cm aortic PSA involving bilateral renal arteries and a subhepatic inflammatory mass (identified by percutaneous puncture).

Diagnosis:
According to the symptoms, CT and lab test, the main diagnosis for this patient were: infective aortic PSA involving bilateral renal arteries, and Bacteremia with K pneumoniae.

Intervention and outcomes:
A hybrid procedure combined open surgical and endovascular was performed for managing the paravisceral infection aortic PSA in a 61-year-old man with high risk. To decrease the risk of graft infection, autologous saphenous vein graft was adopted, and long-term antibiotic therapy was used. At 2 years follow-up, the patient was in good clinical condition with continued antibiotic therapy.

Conclusion:
Hybrid procedure is an alternative approach according to high risk patients with complex anatomy for open repair of infection aortic PSA. The postoperative long-time continued antibiotic therapy must be emphasized for infection PSA.