bluuebunny/crossref_metadata_2025_split huggingface dataset:
The feedback of an HC HII region on its parental molecular core
Authors: Moscadelli L. , Rivilla V. M. , Cesaroni R. , Beltrán M. T. , Sánchez-Monge Á , Schilke P. , Mottram J. C. , Ahmadi A. , Allen V. , Beuther H. , Csengeri T. , Etoka S. , Galli D. , Goddi C. , Johnston K. G. , Klaassen P. D. , Kuiper R. , Kumar M. S. N. , Maud L. T. , Möller T. , Peters T. , Van der Tak F. , Vig S. 
Published: March 2018

Context. G24.78+0.08 is a well known high-mass star-forming region, where several molecular cores harboring OB young stellar objects are found inside a clump of size ≈1 pc. This article focuses on the most prominent of these cores, A1, where an intense hypercompact (HC) HII region has been discovered by previous observations.
Aims. Our aim is to determine the physical conditions and the kinematics of core A1, and study the interaction of the HII region with the parental molecular core.
Methods. We combine ALMA 1.4 mm high-angular resolution (≈0.′′2) observations of continuum and line emission with multi-epoch Very Long Baseline Interferometry data of water 22 GHz and methanol 6.7 GHz masers. These observations allow us to study the gas kinematics on linear scales from 10 to 104 au, and to accurately map the physical conditions of the gas over core A1.
Results. The 1.4 mm continuum is dominated by free-free emission from the intense HC HII region (size ≈1000 au) observed to the North of core A1 (region A1N). Analyzing the H30α line, we reveal a fast bipolar flow in the ionized gas, covering a range of LSR velocities (VLSR) of ≈60 km s−1. The amplitude of the VLSR gradient, 22 km s−1 mpc−1, is one of the highest so far observed towards HC HII regions. Water and methanol masers are distributed around the HC HII region in A1N, and the maser three-dimensional (3D) velocities clearly indicate that the ionized gas is expanding at high speed (≥200 km s−1) into the surrounding molecular gas. The temperature distribution (in the range 100–400 K) over core A1, traced with molecular (CH3OCHO, 13CH3CN, 13CH3OH, and CH3CH2CN) transitions with level energy in the range 30 K ≤ Eu/k ≤ 300 K, reflects the distribution of shocks produced by the fast-expansion of the ionized gas of the HII region. The high-energy (550 K ≤ Eu/k ≤ 800 K) transitions of vibrationally excited CH3CN are likely radiatively pumped, and their rotational temperature can significantly differ from the kinetic temperature of the gas. Over core A1, the VLSR maps from both the 1.4 mm molecular lines and the 6.7 GHz methanol masers consistently show a VLSR gradient (amplitude ≈0.3 km s−1 mpc−1) directed approximately S–N. Rather than gravitationally supported rotation of a massive toroid, we interpret this velocity gradient as a relatively slow expansion of core A1.
Cricopharyngeal myotomy with thulium laser through flexible endoscopy: proof-of-concept study
Authors: Siboni Stefano , Aiolfi Alberto , Ceriani Chiara , Tontini Gian , Bonavina Luigi 
Published: March 2018

Abstract
Background and study aims Endoscopic treatment of Zenker’s diverticulum has proven feasible, but electrocautery and CO2 laser technology carry the risk of collateral thermal injury. Thulium laser septum incision may overcome this limitation. We describe for the first time the use of thulium laser through flexible endoscopy in a small cohort of patients with Zenker diverticulum.
Patients and methods Thulium laser septum division was performed via flexible endoscopy under general anesthesia in consecutive symptomatic patients with primary or recurrent Zenker diverticulum. Primary study outcomes were feasibility and safety of the procedure. A 1.9-μm laser fiber was used with an emission power of 10 – 16 W.
Results Five patients were treated between May and June 2017. Two patients presented with recurrent symptomatic diverticulum after previous transoral septum stapling. Complete division of the septum was achieved in all patients. There was no bleeding nor need of adjunctive electrocautery devices to complete the procedure. The postoperative course was uneventful in all patients; the chest film and gastrographin swallow study on postoperative Day 1 were negative for pneumomediastinum, leaks or residual pouch. All patients were discharged within 48 hours on a soft diet. At the 1- and 3-month follow-up visits, all patients were satisfied with the procedure and reported improved swallowing and absence of regurgitation and cough.
Conclusions Division of Zenker’s septum with thulium laser is feasible and safe through flexible endoscopy. Longer-term follow-up is required to establish efficacy and effectiveness of this novel procedure.
Synthesis of 2-Azabicyclo[n.2.0]alkane-Derived Building Blocks
Authors: Grygorenko Oleksandr , Kurkunov Maksym , Levandovskiy Igor , Tymtsunik Andriy 
Published: March 2018

An approach to 2-azabicyclo[n.2.0]alkane derivatives (n = 1, 2), which relies on a tandem Strecker reaction–intramolecular nucleophilic cyclization (STRINC) sequence of the corresponding 2-(ω-chloroalkyl)cyclobutanones (in turn prepared by [2+2] cycloaddition of keteniminium salts and ethylene) is described. The utility of the method is demonstrated by multigram syntheses of bicyclic proline analogues, monoprotected diamines, as well as parent 2-azabicyclo[4.2.0]octane.
Recent Advances in Water-Tolerance in Frustrated Lewis Pair Chemistry
Authors: Ingleson Michael , Fasano Valerio 
Published: March 2018

A water-tolerant frustrated Lewis pair (FLP) combines a sterically encumbered Lewis acid and Lewis base that in synergy are able to activate small molecules even in the presence of water. The main challenge introduced by water comes from its reversible coordination to the Lewis acid which causes a marked increase in the Brønsted acidity of water. Indeed, the oxophilic Lewis acids typically used in FLP chemistry form water adducts whose acidity can be comparable to that of strong Brønsted acids such as HCl, thus they can protonate the Lewis base component of the FLP. Irreversible proton transfer quenches the reactivity of both the Lewis acid and the Lewis base, precluding small molecule activation. This short review discusses the efforts to overcome water-intolerance in FLP systems, a topic that in less than five years has seen significant progress.1	Introduction2	Water-Tolerance (or Alcohol-Tolerance) in Carbonyl Reductions3	Water-Tolerance with Stronger Bases4	Water-Tolerant Non-Boron-Based Lewis Acids in FLP Chemistry5	Conclusions
Supracricoid Laryngectomy: The Function of the Remaining Arytenoid in Voice and Swallowing
Authors: Buzaneli Elaine , Zenari Marcia , Kulcsar Marco , Dedivitis Rogerio , Cernea Cláudio , Nemr Kátia 
Published: March 2018

Introduction Supracricoid laryngectomy still has selected indications; there are few studies in the literature, and the case series are limited, a fact that stimulates the development of new studies to further elucidate the structural and functional aspects of the procedure.
Objective To assess voice and deglutition parameters according to the number of preserved arytenoids.
Methods Eleven patients who underwent subtotal laryngectomy with cricohyoidoepiglottopexy were evaluated by laryngeal nasofibroscopy, videofluoroscopy, and auditory-perceptual, acoustic, and voice pleasantness analyses, after resuming oral feeding.
Results Functional abnormalities were detected in two out of the three patients who underwent arytenoidectomy, and in six patients from the remainder of the sample. Almost half of the sample presented silent laryngeal penetration and/or vallecular/hypopharyngeal stasis on the videofluoroscopy. The mean voice analysis scores indicated moderate vocal deviation, roughness and breathiness; severe strain and loudness deviation; shorter maximum phonation time; the presence of noise; and high third and fourth formant values. The voices were rated as unpleasant. There was no difference in the number and functionality of the remaining arytenoids as prognostic factors for deglutition; however, in the qualitative analysis, favorable voice and deglutition outcomes were more common among patients who did not undergo arytenoidectomy and had normal functional conditions.
Conclusion The number and functionality of the preserved arytenoids were not found to be prognostic factors for favorable deglutition efficiency outcomes. However, the qualitative analysis showed that the preservation of both arytenoids and the absence of functional abnormalities were associated with more satisfactory voice and deglutition patterns.
Effect of Fractal Tones on the Improvement of Tinnitus Handicap Inventory Functional Scores among Chronic Tinnitus Patients: An Open-label Pilot Study
Authors: Simonetti Patricia , Vasconcelos Laura , Oiticica Jeanne 
Published: March 2018

Introduction Music-based sound therapies become recently a trend in the treatment of tinnitus. Few publications have studied the therapeutic use of fractal tones to treat chronic tinnitus.
Objective The aim of this study was to determine the benefits of using fractal tones as a unique sound therapy for chronic tinnitus sufferers.
Methods Twelve participants were recruited; however, six could not be assigned. At baseline and at 1, 3 and 6 months, the participants were provided with the Tinnitus Handicap Inventory (THI) and Hearing Handicap Inventory for Adults (HHIA) questionnaires, and their visual analog scale score was recorded. Tinnitus pitch and loudness matching was performed before fitting and after 6 months of use.
Results The visual analog scale (VAS) score, pitch and loudness matching and minimal masking levels did not result in significant improvement at the end of the treatment. The mean THI measured at baseline was 45, and the final one was 25. A paired sample t-test showed that this 20-point difference was statistically significant.
Conclusions We measured the benefits of using fractal tone therapy for the treatment of chronic tinnitus and found that most of the benefits were in the THI functional domain, which includes concentration, reading, attention, consciousness, sleep, social activities, and household tasks. For all patients with bothersome chronic tinnitus and high scores on the THI functional scale, fractal tones should be considered a promising initial sound therapy strategy. The findings from this open-label pilot study are preliminary, and further trials are needed before these results can be generalized to a larger tinnitus population.
Mammary Hibernoma: A Case Report of a Rare Disease
Authors: Neves Filho Eduardo Henrique Cunha , Lima Geórgia de Aguiar Feitosa , Alves Ângelo Roncalli Melo , Sousa Valdenrique Macêdo de , Cunha Maria do Perpétuo Socorro Saldanha da 
Published: March 2018

AbstractMammary hibernomas are extremely rare benign tumors composed of brown fat cells, with only five cases previously reported in the literature. We report the case of a 42-year-old female patient with a painless growing mass in her right breast. A partial mastectomy was performed, and the diagnosis of hibernoma was confirmed by the histological features and the immunohistochemical profile. Although hibernoma is a benign tumor, its main differential diagnoses include aggressive lesions, making the accurate diagnosis essential to provide adequate care to the patient.
Determination of Factors Associated with Critical Weight Loss in Oral Cavity Carcinoma Patients: A Retrospective Cohort Study
Authors: Iftikhar Haissan , Suhail Anwar , Nathani Karim , Urooba Amna , Shahzad Noman , Awan Sohail , Dhanani Rahim 
Published: March 2018

Introduction Critical weight loss is defined as an unintentional weight loss of ≥ 5% at 1 month or ≥ 10% at 6 months from the start of treatment. Critical weight loss leads to deterioration of the immune function and reduced tolerance to treatment (surgery ± radiochemotherapy) as well as increased complication rates.
Objective Critical weight loss, defined as a weight loss of ≥ 5% after 1 month or ≥ 10% after 6 months from the start of treatment, is not uncommon in head and neck cancer patients. We aimed to assess the factors associated with critical weight loss during the treatment of oral cavity squamous cell carcinoma patients.
Methods A retrospective cohort study was performed at the Aga Khan University Hospital, in Karachi, Pakistan, on 125 patients. Patients receiving adjuvant therapy were considered exposed, and the outcome was critical weight loss.
Results The mean age of presentation was 46.9 ± 12.8 years in patients undergoing surgery and adjuvant therapy, with 119 (79.3%) of them being male and 31 (20.7%) female. One hundred and twelve patients (81.3%) developed critical weight loss at 6 months from the start of treatment, and the only significant variable associated with critical weight loss was the stage of the disease (p = 0.03).
Conclusion A large proportion of patients with oral cancer developed critical weight loss requiring a need for intervention. The overall stage of the disease is a significant predictor of critical weight loss in patients undergoing treatment.
The diagnostic yield of open-access endoscopy of the upper gastrointestinal tract in the Netherlands
Authors: Crouwel Femke , Meurs-Szojda M. , Klemt-Kropp M. , Fockens P. , Grasman M. 
Published: March 2018

Abstract
Background and study aims Since the introduction of open-access esophago-gastroduodenoscopy (OAE) there is an increase in the total number of performed OAEs whilst the frequency of clinical relevant findings has decreased. The aim of this study was to assess the appropriate use and the diagnostic yield of OAE in the Netherlands and to determine which patient variables are able to predict a malignant finding.
Patients and methods A retrospective chart review of all referrals for diagnostic OAE between October 2012 and October 2016 at the Northwest Clinics was performed. The indications were recorded from the referral letter and were classified as “appropriate” or “inappropriate” according to the NHG guideline. Logistic regression was used to detect significant predictive variables for a malignancy.
Results A total of 2006 patients were included, of whom 59.6 % had an ‘appropriate’ referral indication. The diagnostic yield of finding a clinical relevant finding was significantly higher for OAEs with an “appropriate” referral indication. Independent risk factors for malignancy were alarm symptoms, age and male gender with a combined AUC of 0.868.
Conclusions Only 3.8 % of the malignancies would be missed by strict adherence to the guideline. This indicates that the open-access system in the Netherlands works well. Further improvement of the system can be achieved by only accepting appropriate indications for OAE and by treating patients under the age of 40 without OAE. We showed that a risk-prediction model based on the variables age, alarm symptoms and male gender is a good predictor of malignant finding.
Additional flap on plastic stents for improved antimigration effect in the treatment of post-cholecystectomy bile leak
Authors: Kwon Chang-Il , Gromski Mark , Oh Hyoung-Chul , Easler Jeffrey , El Hajj Ihab , Watkins James , Fogel Evan , McHenry Lee , Sherman Stuart , Lehman Glen 
Published: March 2018

Abstract
Background and study aims In plastic stent insertion for treatment of post-cholecystectomy bile leak, stent migration may be more common due to the absence of a shelf to anchor the stent. We evaluated how adding a flap to straight plastic stents for this indication might influence the rate of stent migration when compared to use of conventional plastic stents.
Patients and methods This is a retrospective study including patients referred for ERCP for treatment of post-cholecystectomy bile leak. Patients with a customized anti-migration flap stent had the additional flap created on the distal end of straight plastic stents, intended to aid in anchoring in the distal supra-sphincteric biliary duct. The primary endpoint is stent migration events. The secondary endpoint is bile leak resolution after first ERCP session.
Results Thirty-two patients were treated with the experimental additional flap stents and 225 patients were treated with standard straight biliary stents. The total failure rate of bile leak resolution after a single endoscopic treatment for all treated was 10.5 % (27/257) and the total stent migration rate for all enrolled was 15.2 % (39/257). Stent migration rate was lower in the additional flap stent group than in the conventional group (3.1 % vs. 16.9 %, respectively, P = 0.04). Furthermore, significantly more patients had resolution of their bile leak after the first ERCP session in the group with the additional flap (100 % vs. 88 %, respectively, P = 0.03).
Conclusion A plastic biliary stent with an extra flap may have improved performance with regard to stent migration and resolution of bile leak over standard plastic biliary stents.
Clinicopathological examination of ESD as salvage therapy for esophageal cancer after definitive chemo-radiation therapy
Authors: Kagawa Tomo , Ishikawa Shigenao , Inaba Tomoki , Colvin Mariko , Toyosawa Junki , Aoyama Yuki , Ishida Masaya , Kuraoka Sakiko , Okamoto Kunio , Sakakihara Ichiro , Izumikawa Koichi , Yamamoto Kumiko , Takahashi Sakuma , Tanaka Shigetomi , Matsuura Mihoko , Hasui Toshimi , Wato Masaki , Ando Midori , Nakamura Satoko , Mizobuchi Koichi 
Published: March 2018

Abstract
Background and study aims Salvage therapy for esophageal cancer following chemo-radiation therapy (CRT) has not been established. We aimed to evaluate endoscopic submucosal dissection (ESD) as a salvage therapy based on histopathological features of lesions.
Patients and methods We compared 10 lesions in eight patients with local residual, recurrent, or metachronous esophageal squamous cell carcinoma treated by ESD after CRT (CRT group) and 59 lesions treated by ESD without CRT (non-CRT group) during the same period.
Results The en bloc resection rate was 100 % while the complete resection rate was 80.0 % in the lesions after CRT, indicating no difference between the CRT and non-CRT groups. Pathological examination showed that fibrosis was more intense in the lamina propria mucosa, muscularis mucosa, and submucosa. The muscularis mucosa was thicker in both non-tumor and tumor sites in the CRT group compared to the non-CRT group. However, severe submucosal fibrosis was observed only in one lesion in the CRT group. The maximum diameter of the submucosal artery was significantly larger in the CRT group (P < 0.001).
Conclusions Compared to the non-CRT group, the lesions in the CRT group were accompanied by fibrosis while the muscularis mucosa were thicker; however, severe fibrosis of the submucosa was rare. It is important to dissect the muscularis mucosa appropriately during ESD, which makes successful dissection of the submucosa possible. Attention should be paid to bleeding from large arteries.
Towards rational design of metal-organic framework-based drug delivery systems
Authors: Simagina Anna A. , Polynski Mikhail V. , Vinogradov Alexander V. , Pidko Evgeny A. 
Published: March 2018

Metal-organic frameworks comprise a class of crystalline porous coordination polymers with unique chemical and physical properties. On the one hand, due to high specific surface area, biocompatibility and stability in biological media, framework materials are ideal candidates for the development of new dosage forms, in particular, for drug delivery systems. On the other hand, the modular structure of frameworks provides an opportunity for computational screening and predictive calculations. This opens new prospects for the design of modern functional materials. The computational screening and simulation of adsorption – desorption processes play a key role in the development of drug delivery systems, as they provide data that are difficult to obtain solely from experiments. These data can greatly assist in the development of drug delivery systems. The first part of the review gives a brief overview of the metal-organic frameworks which have already proved to be potential drug carriers as well as frameworks which are currently being extensively studied and gain attention in this area. The second part addresses the concept of rational design and computer-aided design of such systems.
The bibliography includes 216 references.
An Electronic Intervention to Improve Safety for Pain Patients Co-Prescribed Chronic Opioids and Benzodiazepines
Authors: Zaman Tauheed , Rife Tessa L. , Batki Steven L. , Pennington David L. 
Published: March 2018

Background: Co-prescribing opioids and benzodiazepines increases overdose risk. A paucity of literature exists evaluating strategies to improve safety of co-prescribing. This study evaluated an electronic intervention to improve safety for patients co-prescribed chronic opioids for pain and benzodiazepines at 3 and 6 months. Methods: A prospective cohort study was conducted from December 2015 through May 2016 at San Francisco Veterans Affairs Health Care System. A clinical dashboard identified 145 eligible patients prescribed chronic opioids and benzodiazepines. Individualized taper and safety recommendations were communicated to prescribers via electronic medical record progress note and encrypted e-mail at baseline. Primary outcome was number of patients co-prescribed chronic opioids and benzodiazepines. Secondary outcomes included daily dose of opioids and benzodiazepines and number prescribed ≥100 mg morphine equivalent daily dose. Safety outcomes included number with opioid overdose education and naloxone distribution, annual urine drug screening, annual prescription drug monitoring program review, and signed opioid informed consent. Linear mixed models and generalized estimating equations were used to examine within-group change in outcomes between baseline and 3 and 6 months. Results: Among the 145 patients, mean (standard deviation) age was 62 (11) years and 91.7% (133/145) were male. Number co-prescribed significantly decreased from 145/145 (100%) at baseline to 93/139 (67%) at 6-month follow-up (odds ratio [OR] = 0.53, 95% confidence interval [CI]: 0.34–0.81, P = .003). Mean opioid and benzodiazepine doses significantly decreased from 84.61 to 65.63 mg (95% CI: 8.32–27.86, P < .001) and from 16.10 to 13.45 mg (95% CI: 1.6–3.9, P < .001), respectively, from baseline to 6-month follow-up. Patients prescribed ≥100 mg morphine equivalent daily dose significantly decreased from 39/145 (26.8%) at baseline to 26/139 (18.7%) at end of study (OR = 0.59, 95% CI: 0.44–0.78, P < .001), and patients with opioid overdose education and naloxone distribution significantly increased from 3/145 (2.1%) at baseline to 46/139 (33.1%; OR = 23.4, 95% CI: 7.61–71.99, P < .001) by the end of study. Number of patients with annual urine drug screening tended to increase from 123/145 (84.8%) at baseline to 132/145 (91.4%) by the end of study (OR = 1.89, 95% CI: 0.95–3.76, P = .07), and there were no significant changes across time in numbers of patients with annual prescription drug monitoring program review or signed opioid informed consent. Conclusions: Electronic interventions may provide an effective strategy to improve safety for patients co-prescribed chronic opioids for pain and benzodiazepines.