bluuebunny/crossref_metadata_2025_split huggingface dataset:
Admission blood glucose as a predictor of shock and mortality in multiply injured patients
Authors: Winkelmann Marcel , Butz Ada Luise , Clausen Jan-Dierk , Blossey Richard David , Zeckey Christian , Weber-Spickschen Sanjay , Mommsen Philipp 
Published: May 2019

Introduction: Reliable diagnosis of shock in multiply injured patients is still challenging in emergency care. Point-of-care tests could have the potential to improve shock diagnosis. Therefore, this study aimed to analyze the impact of admission blood glucose on predicting shock in multiply injured patients.Methods: A retrospective cohort analysis of patients with an injury severity score (ISS) ≥ 16 who were treated in a level I trauma center from 01/2005 to 12/2014 was performed. Shock was defined by systolic blood pressure ≤ 90 mmHg and/or shock index ≥ 0.9 at admission. Laboratory shock parameters including glucose were measured simultaneously. Receiver-operating-characteristic (ROC) analysis and multivariate logistic regression analysis was performed.Results: Seven hundred and seventy-two patients were analyzed of whom 93 patients (12.0%) died. Two hundred and fifty-nine patients (33.5%) were in shock at admission. Mortality was increased if shock was present at admission (18.1% vs. 9.0%,p < 0.001). Mean glucose was 9.6 ± 4.0 mmol/L if shock was present compared to 8.0 ± 3.0 mmol/L (p < 0.001). Admission glucose positively correlated with shock (Spearman rho = 0.2,p < 0.001). Glucose showed an AUC of 0.62 (95% CI [0.58–0.66],p < 0.001) with an optimal cut off value of 11.5 mmol/L. Patients with admission glucose of > 11.5 mmol/L had a 2.2-fold risk of shock (95% CI [1.4–3.4],p = 0.001). Admission blood glucose of > 11.5 mmol/L positively correlated with mortality too (Spearman rho = 0.65,p < 0.001). Patients had a 2.5-fold risk of dying (95% CI [1.3–4.8],p = 0.004).Discussion: Admission blood glucose was proven as an independent indicator of shock and mortality and, therefore, might help to identify multiply injured patients at particular risk.
Stellungnahme zu den Leserbriefen von Jens Alm, Hamburg, und Karsten Hartmann, Freiburg
Authors: Mumme Achim 
Published: May 2019

Um allen Missverständnissen vorzubeugen möchten wir den folgenden Ausführungen ausdrücklich vorausschicken, dass wir eine Methodenvielfalt befürworten, in der die endovenöse Hitzeablation auch in unseren Augen einen großen Stellenwert hat. Jedes der phlebologischen Verfahren – Sklerosierung, Hitzeablation, Operation- ist aber mit seinen spezifischen Vor- und Nachteilen behaftet, die es im Sinne des Patienten abzuwägen gilt. Neben den unbestreitbaren Vorteilen der endovenösen Lasertherapie hat sich aber für diese Therapieoption der Nachteil vergleichsweise hoher Leistenrezidivraten gezeigt. Die sich daraus ergebenden Konsequenzen müssen diskutiert werden und wir freuen uns, dass mit Karsten Hartmann und Jens Alm zwei der namhaftesten Vertreter der endovenösen Therapie mit Leserbriefen Stellung bezogen haben.
MR-Guided Focused Ultrasound in Fibroid Treatment – Results of the 4th Radiological-Gynecological Expert Meeting
Authors: Kröncke Thomas , David Matthias 
Published: May 2019

AbstractMagnetic Resonance-guided focused ultrasound (MRgFUS; Syn.: HIFU = high intensity focused ultrasound) is a safe and effective thermoablative technique to treat fibroid-related symptoms. The evidence is limited due to a lack of randomized trials. The indication for treatment by MRgFUS are symptomatic uterine fibroids. This consensus paper covers criteria to measure success, contraindications, side effects and complications of MRgFUS treatment. The role of MRgFUS in the setting of family planning is part of this publication.
The Methylenetetrahydrofolate Reductase TT677 Genotype Is Associated with Venous Thrombosis Independently of the Coexistence of the FV Leiden and the Prothrombin
Authors: Margaglione Maurizio , D’Andrea Giovanna , d’Addedda Marina , Giuliani Nicola , Cappucci Giuseppe , Iannaccone Luigi , Vecchione Gennaro , Grandone Elvira , Brancaccio Vincenzo , Minno Giovanni Di 
Published: May 2019

SummaryA polymorphism, C→T677, in the methylenetetrahydrofolate reductase (MTHFR) gene has been identified as a cause of mild hyperhomocysteinemia, a risk factor for venous thrombosis. We have investigated the frequency of the TT genotype in 277 consecutive patients with confirmed deep venous thrombosis and 431 healthy subjects. The TT MTHFR genotype was more frequent in patients than in controls (25.6% vs. 18.1%; p = 0.016). The risk of thrombosis among carriers of this genotype was significantly increased [odds ratio: 1.6 (95% CI: 1.1-2.3)]. The estimated risk associated with the TT genotype was 2.0 (95% CI: 1.3-3.1) in subjects with (n = 122), and 1.3 (95% CI: 0.8-2.0) in those without (n = 155) predisposing (hereditary, acquired or circumstantial) risk factors for venous thrombosis. Factor V Leiden and prothrombin G→A20210 are known risk factors for venous thrombosis. After stratification for FV Leiden and prothrombin A20210 mutations, a significant association was also observed. After adjustment for sex, FV Leiden and prothrombin A20210 mutation, the estimated risk of venous thrombosis among carriers of the TT MTHFR genotype was 1.7 (95% CI: 1.2-2.6). The TT MTHFR genotype is independently associated with venous thrombosis, mainly among individuals with a high risk profile.
Factor V Leiden (G1691A), the Prothrombin 3’-Untranslated Region Variant (G20210A) and Thermolabile Methylenetetrahydrofolate Reductase (C677T): A Single Genetic Test Genotypes all Three Loci – Determination of Frequencies in the S. Wales Population of the UK
Authors: Bowen D. J. , Bowley S. , John M. , Collins P. W. 
Published: May 2019

SummarySimultaneous genetic diagnosis of factor V (FV) Leiden (G1691A), the prothrombin variant (G20210A) and the thermolabile methylenetetrahydrofolate reductase (MTHFR) variant (C677T) has been achieved using multiplex heteroduplex analysis. All three loci are amplified in a single polymerase chain reaction (PCR) containing test DNA and three heteroduplex generators, respectively detecting the three nucleotide substitutions. After PCR, the products are analysed directly without further manipulation and the resulting heteroduplex profiles permit straightforward interpretation of the respective genotypes. The multiplex test has been used to assess the prevalence and allele frequency of each of the three nucleotide substitutions in 300 individuals (150 males and 150 females) from the local (S. Wales) population. A prevalence of 8% and an allele frequency of 0.040 ± 0.015 (95% confidence interval) was obtained for FV Leiden; the prothrombin variant showed a prevalence of 1% and an allele frequency of 0.007 ± 0.006 (95% confidence interval); the MTHFR mutation showed a prevalence of 60% and an allele frequency of 0.377 ± 0.039 (95% confidence interval). This method is applicable to investigation of large cohorts of patients with arterial or venous thrombotic disease.
The 4G/5G Sequence Polymorphism in the Promoter of Plasminogen Activator Inhibitor-1 (PAI-1) Gene: Relationship to Plasma PAI-1 Level in Venous Thromboembolism
Authors: Stegnar Mojca , Uhrin Pavel , Peternel Polona , Mavri Alenka , Salobir-Pajnič Barbara , Stare Janez , Binder Bernd R. 
Published: May 2019

SummaryImpaired fibrinolysis due to increased plasminogen activator inhibitor-1 (PAI-1) is observed in up to 40% of patients with venous thromboembolism and might be causally related to the disease. There is evidence that genetic variations in the promoter of the PAI-1 gene and metabolic factors contribute to increased plasma PAI-1 levels.A single nucleotide insertion/deletion (4G/5G) polymorphism in the promoter region of the PAI-1 gene and metabolic factors were studied in 158 unrelated patients below the age of 61 years (43 ± 11 years, mean ± standard deviation) with history of objectively confirmed venous thromboembolism and in 145 apparently healthy controls.Patients had on average two times higher PAI activity (11.9 vs. 6.1 IU/ml) and by 40% higher PAI-1 antigen (14.8 vs. 10.7 ng/ml) than healthy controls, and also higher body mass index, lipid levels, fasting glucose and insulin. Patients differed significantly from healthy controls neither in the frequency of the 4G and 5G alleles (0.57/0.43 in patients and 0.52/0.48 in controls) nor in the distribution of the 4G/5G genotypes. Possession of the 4G/4G or the 4G/5G genotype did not increase relative risk for venous thromboembolic disease and the distribution of the 4G/5G genotypes was neither associated with recurrent nor with spontaneous disease. In patients association between the 4G/5G genotypes and PAI activity (adjusted for body mass index, triglyceride and glucose level) was observed, with the highest PAI activity values in the 4G/4G genotype (14.6 IU/ml), intermediate in the 4G/5G genotype (13.3 IU/ml) and the lowest in the 5G/5G genotype (5.2 IU/ml, all values means). Association between PAI activity and triglyceride level was the strongest in the 4G/4G genotype (correlation coefficient r = 0.47, p <0.01) and the weakest in the 5G/5G genotype (r = -0.04, not significant).In conclusion, the present case-control study shows an association between the 4G/5G polymorphism in the promoter of the PAI-1 gene and plasma PAI-1 levels in patients with venous thromboembolism. Similar distribution of the 4G/5G genotypes in patients and healthy controls suggests that this genetic variation by itself is not a major risk factor for venous thromboembolism.
Glottal Closure in Women with No Voice Complaints or Laryngeal Disorders
Authors: Cielo Carla Aparecida , Schwarz Karine , Finger Leila Susana , Lima Joziane Moraes , Christmann Mara Keli 
Published: May 2019

Introduction The understanding of normal vocal production is essential to guide any voice professional as it is fundamental to understand the effects of the posterior glottal gap on the vocal quality.
Objective The aim of the present study was to verify the association between glottic closure, acoustic parameters, and some characteristics of the videolaryngostroboscopy of young women without vocal complaints nor laryngeal disorders.
Methods This is a cross-sectional study with 56 women between 20 and 30 years old who underwent videolaryngostroboscopy. The acoustic parameters of the vowel /a:/ were analyzed using the Praat software, Release 4.6.10 (Paul Boersman and David Weenik, Amsterdam, Netherlands).
Statistical Analysis The chi-squared, Fischer, and Kruskall-Wallis tests were applied, with 5% significance.
Results Significant occurrence of posterior glottal gap (85.71%, p < 0.001), of normal vocal folds vibration amplitude (82.14%, p < 0.001), and of absence of significant constriction of the laryngeal vestibule (98.21%, p < 0.001); no significant association of the glottic closure with the vocal acoustic parameters; no significant association of glottic closure, vocal folds vibration amplitude, and constriction of the laryngeal vestibule.
Conclusion There was a predominance of posterior glottal gap, normal vocal folds vibration amplitude, and absence of laryngeal vestibule constriction, and no relation with the acoustic parameters, suggesting that the posterior glottal gap did not generate impact on the vocal production of the young adult women studied.
Swallowing Analyses of Neonates and Infants in Breastfeeding and Bottle-feeding: Impact on Videofluoroscopy Swallow Studies
Authors: Hernandez Ana Maria , Bianchini Esther Mandelbaum Gonçalves 
Published: May 2019

Introduction Dysphagia, when left untreated, can result in an increase in morbidity and mortality rates, especially among infants with history of life-threatening neonatal diseases. The videofluoroscopy swallowing study (VFSS) is considered the gold standard for the diagnosis of dysphagia. There are few imaging studies of infant swallowing based on videofluoroscopy, none of which were performed during breast-feeding.
Objective To analyze the similarities and differences in infant swallowing function –regarding the feeding method – breast or bottle – and the impact on videofluoroscopy findings.
Methods A retrospective study of 25 VFSSs of breastfeeding and bottle-feeding infants was performed. The studied variables were: oral capture and control; tongue versus mandible movement coordination; sucking pattern; mandible excursion; liquid flow; bolus retention; laryngeal penetration; tracheal aspiration; clearing of material collected in the pharynx; and gastroesophageal reflux (GER).
Results The study showed a statistically significant association between nipple/areole capture; oral control; sucking pattern; mandibular excursion; liquid flow and feeding method. The velar sealing deficit, the place that trigger the pharyngeal swallow, food retention in the pharyngeal recesses, laryngeal penetration and GER were also factors associated with the feeding method.
Conclusion The analysis of the swallowing characteristics of both feeding methods revealed significant differences between them, with an impact on the diagnosis in the VFSSs, especially regarding velar function.
Pulmonary Complications of Rheumatoid Arthritis
Authors: Farquhar Hamish , Vassallo Robert , Edwards Adrienne L. , Matteson Eric L. 
Published: May 2019

Rheumatoid arthritis (RA) is a common chronic autoimmune disorder that characteristically causes joint inflammation and damage. In addition, many patients develop extraarticular manifestations which may cause significant comorbidity and premature mortality.Some respiratory tract involvement of the upper and lower airways and parenchymal disease features are unique to RA, including cricoarytenoid arthritis and RA pulmonary nodulosis, and others, especially the interstitial parenchymal involvement, occur in many other idiopathic and autoimmune diseases. The pathophysiology of lung disease is not well understood. Rheumatoid lung disease may even predate the onset of joint disease, and could be triggered by chronic airway and alveolar epithelial injury. Chronic systemic inflammation and risk factors such as cigarette smoking, infection, host genetics, and immune dysregulation are contributors. Treatment of the respiratory disease is directed at reducing the systemic inflammation of RA. Less well understood is the management of the interstitial lung disease of RA, for which antifibrotic and immune suppressive agents may be helpful. The management of RA-related lung disease is perhaps the major remaining hurdle in reduction of the disease burden related to extraarticular manifestations of this disease.
Multidisciplinary Evaluation in Patients with Lung Disease Associated with Connective Tissue Disease
Authors: Wells Athol , Devaraj Anand , Renzoni Elizabetta A. , Denton Christopher P. 
Published: May 2019

AbstractMultidisciplinary diagnosis is now viewed as the diagnostic reference standard in interstitial lung disease (ILD). This process consists of the integration of the evidence base with clinical reasoning in the formulation of a diagnosis and requires input from clinicians, radiologists, and, in selected cases, histopathologists. In ILD associated with connective tissue disease (CTD-ILD), multidisciplinary evaluation is especially helpful when CTD is suspected but cannot be diagnosed using strict criteria. In this context, the integration of systemic clinical data, serologic information, and computed tomography and biopsy findings may allow CTD-ILD to be diagnosed. However, the value of multidisciplinary evaluation in CTD-ILD is not confined to diagnosis. The frequent coexistence of pulmonary processes other than ILD, including pulmonary vascular disease, extrapulmonic restriction, and airways disease, often has a major impact on symptoms and pulmonary function tests (PFTs). In this review, we highlight the value of multidisciplinary discussion (MDD) in reconciling clinical data, PFT, and imaging data in the accurate staging of disease severity, baseline prognostic evaluation, and the identification of progression of ILD. MDD also provides a means to combine the views of respiratory physicians and rheumatologists in formulating a treatment strategy. It is often possible to reach a robust view as to whether management should be driven by systemic disease, pulmonary disease, or both. When treatment needs to be introduced or modified for both systemic and pulmonary reasons, face-to-face discussion facilities the selection of therapeutic agents that are likely to be efficacious for both systemic and pulmonary diseases.
Laryngeal Cancer Attributable Factors and the Influence on Survival Rates: A Single Brazilian Institution Experience
Authors: Ramos Innocentini Lara Maria Alencar , Teixeira Alisson Henrique , Casemiro Luciana Assirati , Andrade Matheus Carrijo , Ferrari Tatiane Cristina , Ricz Hilton Marcos Alves , Macedo Leandro Dorigan de 
Published: May 2019

Introduction Epidemiological studies focused on prognostic factors associated with laryngeal cancer in the Brazilian population are poorly reported in the literature.
Objective To evaluate the influence of certain risk factors on the survival rates of patients with squamous cell carcinoma (SCC) of the larynx.
Methods This retrospective study was conducted on adult patients who were admitted to the outpatient clinic of the head and neck department in a tertiary care hospital. Evaluation of the influence of risk factors on the survival rates of patients registered in the hospital with laryngeal SCC was performed based on age, sex, initial stage, time of evolution, habits, educational levels and relapse and death. Overall survival (OS), disease-free survival (DFS) and clinical-demographic data were analyzed using the Kaplan-Meier method, Log-rank test and Cox regression.
Results A total of 107 patients with a mean age of 59.8 years (range 19–81) were included in this study. Stages III and IV were associated with decreased DFS (p = 0.02) and OS (p = 0.02). Smoking patients had a greater period of disease evolution than non-smoking patients (p = 0.003). Alcohol consumption in smokers increased the risk of death by 2.8 (p = 0.002) compared with non-drinking smokers. Male patients presented lower DFS average when compared with female patients (p = 0.04).
Conclusion Our study confirms that male gender, smoking habit combined with alcohol consumption, and advanced stages were strongly associated with poor prognosis.
Face Validity and Content Validity of a Game for Distal Radius Fracture Rehabilitation
Authors: Meijer Henriëtte A.W. , Graafland Maurits , Obdeijn Miryam C. , Goslings J. Carel , Schijven Marlies P. 
Published: May 2019

Background Patients recovering from a variety of wrist injuries are frequently advised to exercise to regain lost wrist and hand function. Treatment regimens to regain motion in the wrist are highly variable, and adherence to exercise protocols is known to be low. A serious game ReValidate! incorporating standardized exercise regimens was developed to motivate patients. In this study, the game is evaluated regarding its face validity and content validity.
Methods In this cross-sectional study, a mixed group of “users” (n = 53) including patients currently recovering from wrist injury, and a mixed group of “experts” (n = 46) including professionals advising patients on therapy regimen after wrist injury played at least one complete level of the serious game. Players evaluated the game by means of a structured questionnaire regarding its content, clinical applicability, and user experience. Questions were answered on a Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree).
Results All groups valued the game as being able to support wrist rehabilitation and being of use to patients recovering from a distal radius fracture (users: median 4, P25–P75 3–4 vs. experts: median 4, P25–P75 3.50–5; p = not significant). The types of exercises performed during the game were considered to be both realistic and complete compared with regular physiotherapy exercises (users: median 4, P25–P75 3–4 vs. experts: median 4, P25–P75 3–5, p = not significant).
Conclusions The ReValidate! serious game can be regarded as a valid tool for patients to regain their wrist function after injury.
Level of evidence This is a Level II study.
Mismatch Negativity in Children with Cochlear Implant
Authors: Fernandes Natalia Martinez , Gil Daniela , Azevedo Marisa Frasson de 
Published: May 2019

Introduction The mismatch negativity (MMN) is a negative long-latency auditory potential elicited by any discriminable change in a repetitive aspect of auditory stimulation. This evoked potential can provide cortical information about the sound processing, including in children who use cochlear implants.
Objective To identify MMN characteristics regarding latency, amplitude, and wave area in cochlear implanted children and to identify associations among language development, speech perception and family involvement.
Methods This is a descriptive, observational, cross-sectional study, which compared two groups: study group—children with cochlear implant, and control group—hearing children. The children were submitted to MMN evaluation with non-verbal tone burst stimulus, differing in frequency in sound field at 70 dBHL, with SmartEP equipment (Intelligent Hearing Systems, Miami, FL, USA). Speech perception and language development questionnaires were also applied, and the family participation in the rehabilitation process was classified.
Results The occurrence of MMN was 73.3% for the control group and 53.3% for the study group. Values of latency, amplitude and area of MMN of children using cochlear implants were similar to those of hearing children, and did not differ between groups. The occurrence of MMN was not correlated to the variables of hearing, language and family categories.
Conclusion Children with cochlear implants showed similar MMN responses to those of the children in the control group, with mean latency, amplitude and area of 208.9 ms (±12.8), -2.37 μV (±0.38) and 86.5 μVms (±23.4), respectively. There was no correlation between the presence of MMN and children's performance in the auditory and language development tests or family involvement during rehabilitation.
The behavioral model and game theory
Authors: Askari Gholamreza , Gordji Madjid Eshaghi , Park Choonkil 
Published: May 2019

AbstractThe rational choice theory is based on this idea that people rationally pursue goals for increasing their personal interests. Here, we present a new concept of rational choice as ahyper-rational choicein which the actor thinks about profit or loss of other actors in addition to his personal profit or loss and then will choose an action that is desirable to him. We implement the hyper-rational choice to generalize and expand the game theory. Results of this study will help to model the behavior of people considering environmental conditions, the type of behavioral interaction, valuation system of itself and others, and system of beliefs and internal values of societies. Hyper-rationality helps us understand how human decision-makers behave in interactive decisions.
Music in premature infants enhances high-level cognitive brain networks
Authors: Lordier Lara , Meskaldji Djalel-Eddine , Grouiller Frédéric , Pittet Marie P. , Vollenweider Andreas , Vasung Lana , Borradori-Tolsa Cristina , Lazeyras François , Grandjean Didier , Van De Ville Dimitri , Hüppi Petra S. 
Published: May 2019

Significance
Preterm babies are cared for in neonatal intensive care units (NICU), which are busy places with a lot of mechanical noise increasingly recognized to disrupt normal brain development. NICUs therefore invest in developmental care procedures, with music for example, but neurobiological evidence for these interventions is missing. We present results from a clinical trial to study the effects of a music intervention on preterm infants’ brain development. Based on resting-state fMRI, we provide evidence that music enhanced connectivity in a brain circuitry involving the salience network with regions implicated in sensory and higher-order cognitive functions, previously found to be altered in preterm infants. To our knowledge, this study is unique in observing an impact of music on brain development in preterm newborns.