bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Study on the Status of Proton Pump Inhibitor Prescriptions Using Diagnosis Procedure Combination Data in Japan
Authors: Sakata Yasuhisa , Tsuruoka Nanae , Takedomi Hironobu , Akutagawa Takashi , Shimoda Ryo , Esaki Motohiro , Fujimoto Kazuma 
Published: March 2019

Background/Aims: Proton pump inhibitors (PPIs) are widely used for the management of acid-related diseases. This study aimed to clarify the status of PPI use in hospitalized patients. Method: A retrospective observational study was performed. We analyzed PPI prescription data for the past 8 years (2009–2016) using Diagnosis Procedure Combination survey data from approximately 10,000 patients per year at Saga University Hospital. We investigated the trend in the number of hospitalized patients who were prescribed PPI for the past 8 years and the changes in patient characteristics. Results: We identified 11,009 patients using PPIs throughout the study period. PPI prescription proportions significantly increased over the study period. The use of PPIs increased steadily with increasing age. The proportion of PPIs prescribed was 1.3-times higher among men than compared with women. In most clinical departments, the number of patients prescribed PPIs was up to 3 times higher in the second half of the period (2013–2016) compared with the first half of the period (2009–2012). The number of patients taking concomitant PPIs and anticoagulants or dual antithrombotic combination therapy increased. Conclusion: PPI use has increased substantially in hospitalized patients. The prevalence of PPI prescription by doctors other than gastroenterologists also increased.
BULLOUS PEMPHIGOID A RARE AUTOIMMUNE DISEASE: A CASE REPORT
Authors: Biradar S. M. , Dhanavidya S. , Kavya P. , Keerthi T. , Sunanda N. , Marapur S. C. , Warad Vijaykumar , Kalyane N. V. 
Published: March 2019

Background. Bullous pemphigoid (BP) is a rare autoimmune blistering skin disease in the elderly and it is manifested by cutaneous blisters on the skin lesions.
The objective was to emphasize the rare case of BP.
Methods. A case report of BP in a 58-year-old male patient admitted to a dermatology ward is presented.
Results. A 58-year-old male patient with complaints of fluid-filled skin lesions, was examined initially over the trunk, gradually progressed involving B/L upper and lower extremities. Even though the patient was treated with the recommended therapy of corticosteroid (Dexamethasone) along with adjuvant drugs, new skin lesions continued to develop, and the patient’s condition worsened. The Prednisolone was started in place of Dexamethasone on the fifth day of treatment at its higher dose (50mg/day), the Prednisolone proved its efficacy to combat the extensive condition of BP.
Conclusions. Bullous pemphigoid is a distressing blistering skin disease. Untreated disease is often fatal because of the susceptibility to infection and fluid-electrolyte disturbances. The mortality of patients with bullous pemphigoid has been significantly reduced with the advent of new therapies and treatment modalities. The treatment with systemic and topical corticosteroids forms the mainstay of treatment along with other adjuvant drugs. In the present case study, the use of Prednisolone has proven its efficacy in the extensive disease state of BP and improved the patient’s quality of life.
PREVALENCE AND RISK FACTORS FOR VITAMIN D DEFICIENCY IN OVERWEIGHT AND OBESE ADOLESCENTS IN UKRAINE
Authors: Shulhai A-M. A. , Pavlyshyn H. A. 
Published: March 2019

Background. Vitamin D affects the function of many organs and systems. Lipid metabolism disorder is established to be one of the risk factors for vitamin D deficiency, and the amount of adipose tissue is crucial.
Objective. The aim of the study was to determine the prevalence and risk factors for vitamin D deficiency in overweight and obese adolescents.
Methods. 146 children with excessive weight and obesity as well as 63 healthy children with normal body weight were examined. In the study groups, there were no children taking vitamin D. Vitamin D status was evaluated by the level of 25(OH)D in blood serum. Vitamin D deficiency was diagnosed at the level of 25(OH)D between 20 and 29 ng/ml, and significant deficiency – below 20 ng/ml, normal calcidiol content was 30-100 ng/ml.
Results. The average level of 25(OH)D in the adolescents with normal body weight was 19.76±4.28 ng/ml, in the adolescents with excessive body weight – 15.24±3.47 ng/ml, and in the obese children – 13.87±2.71 ng/ml. The prevalence of vitamin D deficiency in the overweight adolescents was 70.62%, and in the adolescents with obesity – 77.19%.
Conclusions. Vitamin D deficiency is prevalent in the adolescents with overweight and obesity. To prevent the development of hypovitaminosis and vitamin D deficiency, it is necessary to carry out educational activities with adolescents for promotion of healthy lifestyle and healthy food, as well as to develop an optimal program for improving vitamin D status in the obese children.
MORPHOLOGICAL RESPONSE TO IMPLANTATION OF A POLYPROPYLENE MESH WITH A PRF MEMBRANE IN PATIENTS WITH POSTOPERATIVE VENTRAL HERNIA AND UNDIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA
Authors: Piatnochka V. I. , Prodan A. M. 
Published: March 2019

Background. Current herniology promotes the widespread usage of mesh implants in the primary treatment and, especially, in the for postoperative ventral hernias.
Objective. The aim of the research was to study the morphological response of the tissues of muscular aponeurotic layer to implantation of a polypropylene mesh with using PRF membrane-enriched platelets in the patients with postoperative ventral hernia and concomitant undifferentiated dysplasia of connective tissues.
Methods. The research involved 98 patients with postoperative ventral hernia, who underwent retro-muscular alogernioplasty by the Sublay technique of implantation of ‘light’ meshes, and a ‘light’ polypropylene mesh (PPM) in combination with a platelet-rich fibrin (PRF) membrane. The patients were divided into experimental groups according to the presence of undifferentiated connective tissue dysplasia syndrome.
Results. Microscopic studies carried out after the implantation of a polypropylene mesh with a PRF membrane has proved that structural changes in connective tissues are like those of a polypropylene mesh, but they are less significant. There was a leukocyte infiltration near the mesh material, but its area was small. The enlargement and blood filling of the vessels of microcirculatory channel was a manifestation of the increased vascularization of this area.
Conclusions. The usage of a polypropylene mesh in combination with a PRF membrane in the surgical treatment of postoperative ventral hernias reduces inflammatory changes in the tissues significantly and increases the activation of fibroblasts and signs of collagen fibers around the mesh material that is relevant especially for the patients with connective tissue pathology.
Abstract P252: Stress Echocardiography in Assessment of Symptoms in Obese Patients
Authors: Windish Stephanie , Smart Steven 
Published: March 2019

Introduction:
Obesity and obesity related illness continues to be an epidemic in the United States and worldwide. Obesity carries substantial risk of cardiovascular disease (CVD), and symptoms (shortness of breath, decreased exercise tolerance, etc) related to CVD can be nonspecific. Stress testing may identify the cause of these symptoms in obese patients (body mass index (BMI) > 30.) Stress echocardiography has evolved to be capable of comprehensive hemodynamic assessment as well as functional and myocardial perfusion analysis and may be ideal for symptom evaluation in the obese.

Methods:
1,615 consecutive patients (52% women, age 61±41 yrs, BMI 28±6) underwent stress perfusion ECHO (treadmill in 913, supine bike in 623 and dobutamine in 79 patients) between 2012 and 2014. Imaging included contrast/perfusion imaging and multi-method assessment of regional and global left and right heart systolic and diastolic function, left ventricular (LV) volumes, quantitative valve function, left and right heart pressures, peak/mean pulmonary artery pressures, pulmonary vascular resistance, and LV mass. Standard statistical methods were used.

Results:
Of the 1,615 patients analyzed, 516 (32%) were obese patients (BMI 36±5) and in the obese group females were 48% (vs 53% in non-obese). Both groups underwent similar stress modalities (58% vs 56% treadmill, 6% vs 4% dobutamine, and 36% vs 40% bike). Diabetes (21% vs 10%) and hypertension (57% vs 44%) were more common in obese (p< 0.05).

LV mass is disproportionately higher (113±30 vs 97±33 gm/M2) in obese patients (P< 0.01). Additionally, obese patients had statistically significant findings (p< 0.01) of LV hypertrophy (62% vs 26%), diastolic dysfunction (65% vs 44%), and at least moderate pulmonary hypertension (48% vs 34%). Overall, abnormal tests were more common in obese (83% vs 59%, p<0.01). Multiple abnormalities were more common (p<0.01): 1-3 abnormalities (13% vs 16%) and > 4 abnormalities (70% vs 43%).
Unexpectedly, the data showed no statistically significant difference between obese and non-obese in the incidence of ischemia (10% vs 11%), myocardial infarction (5% vs 4%), and cardiomyopathy (6% vs 5%).

Conclusions:
Comparative analysis of the data from stress ECHO revealed obese patients had disproportionally higher LV mass index/LV hypertrophy. Stress testing provoked worse diastolic dysfunction and much worse pulmonary vascular dysfunction in the obese patients. The triad of LV hypertrophy/diastolic dysfunction/pulmonary vascular disease with provoked moderate to severe pulmonary hypertension was the main cause of symptoms in obese patients. Hemodynamic stress ECHO is the ideal modality for evaluation of nonspecific symptoms of CVD in obese patients, as it can classify the cause of symptoms and the extent of pathology. Thereby, it may be the ideal test to guide treatment.
Global Climate Simulated by the Seoul National University Atmosphere Model Version 0 with a Unified Convection Scheme (SAM0-UNICON)
Authors: Park Sungsu , Shin Jihoon , Kim Siyun , Oh Eunsil , Kim Yoonjae 
Published: March 2019

AbstractAs a contribution to phase 6 of the Coupled Model Intercomparison Project (CMIP6), the global climate simulated by an atmospheric general circulation model (GCM), the Seoul National University Atmosphere Model version 0 with a Unified Convection Scheme (SAM0-UNICON), is compared with observation and climates simulated by the Community Atmosphere Model version 5 (CAM5) and Community Earth System Model version 1 (CESM1), on which SAM0-UNICON is based. Both SAM0-UNICON and CESM1 successfully reproduce observed global warming after 1970. The global mean climate simulated by SAM0-UNICON is roughly similar to that of CAM5/CESM1. However, SAM0-UNICON improves the simulations of the double intertropical convergence zone, shortwave cloud forcing, near-surface air temperature, aerosol optical depth, sea ice fraction, and sea surface temperature (SST), but is slightly poorer for the simulation of tropical relative humidity, Pacific surface wind stress, and ocean rainfall. Two important biases in the simulated mean climate in both models are a set of horseshoe-shaped biases of SST, sea level pressure, precipitation, and cloud radiative forcings in the central equatorial Pacific and a higher sea ice fraction in the Arctic periphery and Southern Hemispheric circumpolar regions. Both SAM0-UNICON and CESM1 simulate the observed El Niño–Southern Oscillation (ENSO) reasonably well. However, compared with CAM5/CESM1, SAM0-UNICON performs better in simulating the Madden–Julian oscillation (MJO), diurnal cycle of precipitation, and tropical cyclones. The aerosol indirect effect (AIE) simulated by SAM0-UNICON is similar to that from CAM5 but the magnitudes of the individual shortwave and longwave AIEs are substantially reduced.
The Atmospheric Pathway of the Cloud-Radiative Impact on the Circulation Response to Global Warming: Important and Uncertain
Authors: Voigt Aiko , Albern Nicole , Papavasileiou Georgios 
Published: March 2019

AbstractPrevious work showed that the poleward expansion of the annual-mean zonal-mean atmospheric circulation in response to global warming is strongly modulated by changes in clouds and their radiative heating of the surface and atmosphere. Here, a hierarchy and an ensemble of global climate models are used to study the circulation impact of changes in atmospheric cloud-radiative heating in the absence of changes in sea surface temperature (SST), which is referred to as the atmospheric pathway of the cloud-radiative impact. For the MPI-ESM model, the atmospheric pathway is responsible for about half of the total cloud-radiative impact, and in fact half of the total circulation response. Changes in atmospheric cloud-radiative heating are substantial in both the lower and upper troposphere. However, because SST is prescribed the atmospheric pathway is dominated by changes in upper-tropospheric cloud-radiative heating, which in large part results from the upward shift of high-level clouds. The poleward circulation expansion via the atmospheric pathway and changes in upper-tropospheric cloud-radiative heating are qualitatively robust across three global models, yet their magnitudes vary by a factor of 3. A substantial part of these magnitude differences are related to the upper-tropospheric radiative heating by high-level clouds in the present-day climate. A comparison with observations highlights the model deficits in representing the radiative heating by high-level clouds and indicates that reducing these deficits can contribute to improved predictions of regional climate change.
La “vera giustizia” di Natalia Ginzburg
Authors: Gaetani Marco 
Published: March 2019

Il saggio Serena Cruz o la vera giustizia (1990) di Natalia Ginzburg rappresenta per molti aspetti un lascito morale e un testamento intellettuale dell’autrice. Intervenendo nel vivo di un caso di cronaca giudiziaria che divise l’opinione pubblica nazionale, Ginzburg vi porta la propria inconfondibile “voce” saggistica. Il caso giuridico diviene lacerante dilemma etico, l’occasione per definire pubblicamente e “dal basso” un proprio concetto di giustizia. L’intervento ripercorre da vicino il saggio di Ginzburg, rilevando in esso (anche attraverso il costante riferimento all’intera produzione saggistica della scrittrice e un’adeguata contestualizzazione storica) i nodi di una riflessione civile che esorbita dalla contingenza e s’interroga sulla natura e la funzione della legge, sul ruolo della magistratura e delle altre istituzioni statuali nella vita e nelle scelte degli individui, sul senso di valori non negoziabili. La controversa adozione di una bambina offre inoltre all’autrice l’occasione per toccare alcuni temi cari alla propria narrativa (l’infanzia, la famiglia) e per richiamare, implicitamente, la sua stessa poetica, mostrandocela come strettamente connessa alla propria intima concezione del mondo.
Evaluation of hemorrhoidal disease and lower extremity venous insufficiency in primary adult varicocele: A prospective controlled study
Authors: Aslan Rahmi , Erbin Akif , Celik Sebahattin , Ucpinar Burak , Sahinalp Sahin , Yıldızhan Murat , Eryilmaz Recep , Taken Kerem 
Published: March 2019

Background The study investigated the association between varicocele, lower extremity venous insufficiency and hemorrhoidal disease. Methods The study included 62 patients with varicocele and 60 voluntary subjects with no varicocele. Patients who were diagnosed as having varicocele on physical examination and Doppler ultrasonography were included in the study group. Examination of lower extremity venous insufficiency was performed by physical examination and Doppler ultrasonography. Examination of hemorrhoidal disease was performed by a general surgery specialist. Results The patients with varicocele had a statistically significant ( p < 0.05) higher rates of venous insufficiency of the lower extremities and had a borderline significant difference of higher hemorrhoidal disease rates ( p = 0.05). Therewithal incidences of hemorrhoidal disease and lower extremity venous insufficiency were significantly higher in body mass index > 25 and age > 30 years of varicocele patients. Conclusion There is a statistically significant relation between varicocele, lower extremity venous insufficiency, and hemorrhoidal disease. In particular, varicocele patients who are aged over 30 years and overweight are at higher risk.
Functional connectivity of hypothalamus in chronic migraine with medication overuse
Authors: Lerebours Fleur , Boulanouar Kader , Barège Michèle , Denuelle Marie , Bonneville Fabrice , Payoux Pierre , Larrue Vincent , Fabre Nelly 
Published: March 2019

ObjectiveTo investigate the functional connectivity of the hypothalamus in chronic migraine compared to interictal episodic migraine in order to improve our understanding of migraine chronification.MethodsUsing task-free fMRI and ROI-to-ROI analysis, we compared anterior hypothalamus intrinsic connectivity with the spinal trigeminal nucleus in patients with chronic migraine (n = 25) to age- and sex-matched patients with episodic migraine in the interictal phase (n = 22). We also conducted a seed-to-voxel analysis with anterior hypothalamus as a seed.ResultsAll patients with chronic migraine had medication overuse. We found a significant connectivity (T = 2.08, p = 0.024) between anterior hypothalamus and spinal trigeminal nucleus in the chronic group, whereas these two regions were not connected in the episodic group. The strength of connectivity was not correlated with pain intensity (rho: 0.09, p = 0.655). In the seed-to-voxel analysis, three regions were more connected with the anterior hypothalamus in the chronic group: The spinal trigeminal nuclei (MNI coordinate x = 2, y = −44, z = −62), the right dorsal anterior insula (MNI coordinate x = 10, y = 10, z = 18), and the right caudate (MNI coordinate x = 12, y = 28, z = 6). However, these correlations were no longer significant after whole brain FWE correction.ConclusionAn increased functional connectivity between the anterior hypothalamus and the spinal trigeminal nucleus, as previously reported in preictal episodic migraine, was demonstrated in chronic migraine with medication overuse. This finding confirms a major role of the anterior hypothalamus in migraine and suggests that chronic migraineurs are locked in the preictal phase.
“It’s like having an evil twin”: an interpretative phenomenological analysis of the lifeworld of a person with Parkinson’s disease
Authors: Eatough Virginia , Shaw Karen 
Published: March 2019

Background This paper offers an understanding of the lifeworld of a person with Parkinson’s Disease derived from interpretative phenomenological analysis (IPA). Aims The paper has two main aims: firstly, to demonstrate how a focus on individual experience chimes with and can inform current ideas of a more personalised humanised form of healthcare for people living with Parkinson’s disease; and secondly, to demonstrate how an IPA study can illuminate particularity whilst being able to make, albeit cautiously, more general knowledge claims that can inform wider caring practices. Methods It achieves these aims through the detailed description and interpretation of one person’s experience of living with Parkinson's disease using the IPA approach. Results Three analytic themes point to how the various constituents of the lifeworld, such as embodiment, selfhood, temporality and relationality are made manifest. These enable the IPA researcher to make well-judged inferences, which can have value beyond the individual case. Conclusions A key feature of IPA is its commitment to an idiographic approach that recognises the value of understanding a situated experience from the perspective of a particular person or persons.
Health Provider Perspectives of Health Facility Preparedness and Organization in Implementation of Option B+ among Pregnant and Lactating Women in Central Uganda: A Qualitative Study
Authors: Mukose Aggrey David , Bastiaens Hilde , Buregyeya Esther , Naigino Rose , Makumbi Fredrick , Musinguzi Joshua , Van geertruyden Jean-Pierre , Wanyenze Rhoda K. 
Published: March 2019

Introduction: Uganda adopted Option B+ for prevention of mother-to-child transmission (PMTCT) of HIV in 2012. However, there is limited data on preparedness and organization of Option B+ services. These data are critical in informing PMTCT programs and provision of universal antiretroviral therapy (ART) for all populations. This study explored health providers’ experiences of preparedness and organization of Option B+ services in Central Uganda. Methods: Key informant interviews with 54 health providers from 6 health facilities in 3 districts were conducted. Thematic approach was employed to analyze data. Results: Themes identified on preparedness were training of frontline health providers and provision of Option B+ guidelines, supervision and mentorship, and provision of essential medicines and medical health supplies, whereas those concerning organization were HIV counseling and testing, ART initiation, follow-up, and patient support mechanisms. Innovations like use of expert clients, assessing women’s readiness to start Option B+, and retaining women in antenatal care clinic depending on the need are important in provision of Option B+. Conclusion: This study provides insights into preparedness and organization of Option B+ services which are important in provision of Option B+ and universal ART for all populations. Research around models of follow-up is recommended.
Multi-population GWAS and enrichment analyses reveal novel genomic regions and promising candidate genes underlying bovine milk fatty acid composition
Authors: Gebreyesus G. , Buitenhuis A. J. , Poulsen N. A. , Visker M. H. P. W. , Zhang Q. , van Valenberg H. J. F. , Sun D. , Bovenhuis H. 
Published: March 2019

Abstract
Background
The power of genome-wide association studies (GWAS) is often limited by the sample size available for the analysis. Milk fatty acid (FA) traits are scarcely recorded due to expensive and time-consuming analytical techniques. Combining multi-population datasets can enhance the power of GWAS enabling detection of genomic region explaining medium to low proportions of the genetic variation. GWAS often detect broader genomic regions containing several positional candidate genes making it difficult to untangle the causative candidates. Post-GWAS analyses with data on pathways, ontology and tissue-specific gene expression status might allow prioritization among positional candidate genes.

Results
Multi-population GWAS for 16 FA traits quantified using gas chromatography (GC) in sample populations of the Chinese, Danish and Dutch Holstein with high-density (HD) genotypes detects 56 genomic regions significantly associated to at least one of the studied FAs; some of which have not been previously reported. Pathways and gene ontology (GO) analyses suggest promising candidate genes on the novel regions including OSBPL6 and AGPS on Bos taurus autosome (BTA) 2, PRLH on BTA 3, SLC51B on BTA 10, ABCG5/8 on BTA 11 and ALG5 on BTA 12. Novel genes in previously known regions, such as FABP4 on BTA 14, APOA1/5/7 on BTA 15 and MGST2 on BTA 17, are also linked to important FA metabolic processes.

Conclusion
Integration of multi-population GWAS and enrichment analyses enabled detection of several novel genomic regions, explaining relatively smaller fractions of the genetic variation, and revealed highly likely candidate genes underlying the effects. Detection of such regions and candidate genes will be crucial in understanding the complex genetic control of FA metabolism. The findings can also be used to augment genomic prediction models with regions collectively capturing most of the genetic variation in the milk FA traits.