bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficiency of Tissue Penetration by Currents Induced by 3 Electrotherapeutic Techniques: A Comparative Study Using a Novel Deep-Tissue Measuring Technique
Authors: Ariel Efrat , Ratmansky Motti , Levkovitz Yechiel , Goor-Aryeh Itay 
Published: January 2019

Abstract

Background
Electrotherapy provides a wide range of treatment alternatives for musculoskeletal pathologies. However, for the electrical stimulation to exert a significant therapeutic effect, the induced current must often penetrate deep inside the target tissue.

Objective
The objective was to systematically compare the penetration efficiency of 3 electrotherapeutic stimulation modalities: transcutaneous electrical nerve stimulation (TENS), interferential (IF) stimulation, and combined therapy with pulsed ultrasound and IF current (CTPI).

Design
This was a comparative, experimental laboratory study.

Methods
The penetration efficiency was evaluated as a voltage difference between 2 of an 8-contact spinal cord stimulation array. Each of 20 participants with a preimplanted spinal cord stimulation array was stimulated with TENS (3 different electrode configurations), IF current (3 configurations), and CTPI (1 configuration).

Results
Significant differences in penetration efficiency were found between the various stimulation conditions and electrode configurations. CTPI showed the highest penetration efficiency, followed by IF, and finally TENS. Penetration efficiency was inversely and significantly correlated with skinfold thickness in all conditions, but this correlation was lowest for the CTPI stimulation.

Limitations
Our study design did not include a condition of combined therapy with pulsed ultrasound and TENS, and it did not directly control for current or voltage density under the stimulating electrodes. In addition, further research is required to determine whether a higher stimulation intensity of the target tissue is advantageous clinically.

Conclusions
Pending further testing, CTPI stimulation could prove more effective than IF and TENS in reaching deeper tissues, especially considering the variability in adipose tissue thickness in the population, for example, in cases of patients with obesity.
Immigrants and the Making of America
Authors: Sequeira Sandra , Nunn Nathan , Qian Nancy 
Published: January 2019

AbstractWe study the effects of European immigration to the U.S. during the Age of Mass Migration (1850–1920) on economic prosperity. Exploiting cross-county variation in immigration that arises from the interaction of fluctuations in aggregate immigrant flows and of the gradual expansion of the railway network, we find that counties with more historical immigration have higher income, less poverty, less unemployment, higher rates of urbanization, and greater educational attainment today. The long-run effects seem to capture the persistence of short-run benefits, including greater industrialization, increased agricultural productivity, and more innovation.
‘These Are the Medicines That “Make” Monsters’: Thalidomide in Southern Africa, 1958–1962
Authors: Parle Julie , Wimmelbücker Ludger 
Published: January 2019

Summary
Thalidomide is amongst the most notorious drugs of all time. The majority of accounts of its distribution to the early 1960s focus on those countries where thalidomide caused the most extensive damage, most notably in economically developed countries. This article raises, however, questions about intended, explored, initiated or sometimes thwarted markets for thalidomide-containing preparations outside ‘the West’. It does so by focusing on Southern African markets for thalidomide, particularly those in Angola, Mozambique, (now) Zimbabwe, Namibia and South Africa. We place differences in the drug’s distribution channels in the context of the political economies of pharmaceuticals markets in the region in the decades after World War 2 and argue that colonial legacies and circuits of commerce can contribute to an understanding of why some regions ‘escaped a thalidomide disaster’. Finally, from late 1961 through 1962, we chart Southern African attempts to establish, or deny, the local presence of the teratogen.
Dickkopf-1 Expression in Androgenetic Alopecia and Alopecia Areata in Male Patients
Authors: Mahmoud Enas Abulkheir , Elgarhy Lamia H. , Hasby Eiman A. , Mohammad Laila 
Published: January 2019

Background:
Androgenetic alopecia (AGA) results from shortening of the anagen phase of the hair cycle and, subsequently, miniaturization of hair follicles. Alopecia areata (AA) is a disease of autoimmunity where T cells attack anagen hair follicles and shows multifactorial etiology. Dickkopf-1 (DKK-1) is a gene that is responsible for transformation of anagen to catagen, which suggests that it is involved in development of both diseases.

Objectives:
To evaluate the tissue levels of dickkopf-1 in male patients with AGA and AA in comparison with controls, in an attempt to know its role in the pathogenesis of both disorders.

Methods:
DKK-1 immunohistochemical expression was evaluated in lesional scalp biopsies taken from 20 male patients with AGA evaluated clinically by the modified Norwood–Hamilton score, 20 male patients with AA evaluated clinically by SALT score, and 20 healthy controls within the same age and sex of the studied patients.

Results:
A highly significant difference in DKK-1 expression between patients with AGA and healthy controls was found (P
2 < 0.001). There were also significant differences in DKK-1 expression between patients with AA and healthy controls (P
3 = 0.013), and between both patient groups (P
1 = 0.002).

Conclusions:
Both AGA and AA showed significant increase in DKK-1 immunohistochemical expression. This may enhance the idea of its possible role in the pathogenesis of AGA and AA, and being a new target for treatment of these hair disorders.
Polycystic ovary syndrome: is the cardiometabolic risk increased after menopause?
Authors: Alur-Gupta Snigdha , Dokras Anuja 
Published: January 2019

Abstract
Although more commonly known for its fertility sequelae, dermatologic, metabolic, and psychological morbidities associated with polycystic ovary syndrome (PCOS) are not well recognized. This Practice Pearl reviews the effect of PCOS on cardiometabolic risk during the reproductive years and the consequence of these findings in middle-aged women. Current screening and management recommendations are reviewed.
Relationships between menopausal symptoms, sense of coherence, coping strategies, and quality of life
Authors: Ngai Fei Wan 
Published: January 2019

Abstract

Objectives:
The aims of this study were to examine the relationships between menopausal symptoms, sense of coherence (SOC), coping strategies, and quality of life, and to test the mediating effects of SOC and coping strategies on the relationships between menopausal symptoms and quality of life among Chinese women during menopausal transition.

Methods:
Two hundred one women aged 40 to 60 years and currently undergoing menopausal transition were recruited at community centers between June and August 2017. Menopausal symptoms, SOC, coping strategies, and quality of life were assessed by the Menopause Rating Scale, the Sense of Coherence Scale, the Brief COPE Inventory, and the Medical Outcomes Study Short-Form-36, respectively. Data were analyzed by path analysis.

Results:
Menopausal symptoms were associated with poorer quality of life, and both SOC and maladaptive coping were found to mediate the effects of menopausal symptoms on quality of life. The results suggest that SOC might alleviate the adverse effects of menopausal symptoms on quality of life, whereas maladaptive coping strategies might aggravate the adverse effects of menopausal symptoms on quality of life.

Conclusions:
The results provide new insights into the importance of considering SOC and coping strategies and their interactions with menopausal symptoms and quality of life in the situation of menopausal transition.
HIGHER-ORDER ABERRATIONS IN EYES WITH SILICONE OIL TAMPONADE
Authors: Shin Joo Youn , Chung In Kwon , Han Ga Hee , Byeon Suk Ho , Kim Jin Hyoung , Lee Doh , Lee Jonghyun 
Published: January 2019

Purpose:
To investigate the changes in higher-order aberrations (HOAs) after silicone oil removal and to evaluate their associations with visual acuity.

Methods:
Fifty-nine eyes of 58 patients who underwent SO removal were included. Total, corneal, and internal optic HOAs, and best-corrected visual acuity were measured before and 1 month after SO removal, and changes were compared between phakic and pseudophakic eyes.

Results:
Total ocular and internal optic HOAs decreased significantly after SO removal both in pseudophakic (n = 40, all P < 0.001) and phakic eyes (n = 19, P = 0.017, P = 0.004). Preoperative HOAs (P < 0.001) and changes in HOAs (P = 0.006) were greater in pseudophakic eyes than in phakic eyes. Best-corrected visual acuity was significantly improved after SO removal, from 20/105 to 20/78 (P < 0.001) in pseudophakic eyes, whereas there was no difference in phakic eyes (P = 0.714). Preoperative HOAs and the reduction in HOAs after SO removal were greater in best-corrected visual acuity–improved eyes than best-corrected visual acuity–unchanged eyes (P < 0.001).

Conclusion:
Silicone oil tamponade induced an increase in HOAs, and these increases were greater in pseudophakic eyes than in phakic eyes. Silicone oil may cause additional visual impairments because of HOAs, beyond those caused by retinal diseases, particularly in pseudophakic eyes.
ADVERSE EFFECT OF MACULAR INTRARETINAL HEMORRHAGE ON THE PROGNOSIS OF SUBMACULAR HEMORRHAGE DUE TO RETINAL ARTERIAL MACROANEURYSM RUPTURE
Authors: Doi Shinichiro , Kimura Shuhei , Morizane Yuki , Hosokawa Mio M. , Shiode Yusuke , Hirano Masayuki , Toshima Shinji , Takahashi Kosuke , Hosogi Mika , Fujiwara Atsushi , Okanouchi Toshio , Inoue Yasushi , Shiraga Fumio 
Published: January 2019

Purpose:
To investigate the clinical course of submacular hemorrhage associated with ruptured retinal arterial macroaneurysm using swept-source optical coherence tomography.

Methods:
This study included 23 eyes of 23 consecutive patients diagnosed with submacular hemorrhage associated with ruptured retinal arterial macroaneurysm. Cases underwent displacement of submacular hemorrhage (vitrectomy + subretinal injection of tissue plasminogen activator + air tamponade) and were followed up for 6 months after surgery. Localization of the preoperative hemorrhage and its effect on preoperative and postoperative best-corrected visual acuity, central retinal thickness, and continuity of the ellipsoid zone were measured.

Results:
Macular intraretinal hemorrhage (IRH) was observed in 17 eyes (73.9%, IRH [+] group) and was not observed in 6 eyes (26.1%, IRH [−] group). The IRH (+) group showed worse postoperative best-corrected visual acuity values compared with the IRH (−) group (0.89 ± 0.47 in logarithm of the minimal angle of resolution units, Snellen equivalent 20/155 and 0.16 ± 0.23, 20/29, respectively; P < 0.01), smaller central retinal thickness values (97.7 ± 53.5 μm, 173.0 ± 32.3 μm, respectively; P < 0.01), and a higher rate of ellipsoid zone disruption (100%, 33.3%, respectively; P < 0.01).

Conclusion:
Patients with preoperative macular IRH showed lower postoperative visual acuity and worse macular contour after submacular hemorrhage displacement compared with patients without macular IRH.
Extended-release gabapentin for failed back surgery syndrome: results from a randomized double-blind cross-over study
Authors: Gewandter Jennifer S. , Frazer Maria E. , Cai Xueya , Chiodo Valerie F. , Rast Shirley A. , Dugan Michelle , Carter Hudson A. , Rahmani Redi , Stone Jonathan J. , Markman John D. 
Published: January 2019

Abstract
Persistent pain after lumbar surgery (failed back surgery syndrome [FBSS]) remains a leading indication for chronic analgesia. However, no analgesics have proven efficacious for this condition. Although trials have evaluated gabapentinoids for chronic low back pain, none of these trials focused solely on FBSS. This randomized, double-blind cross-over trial evaluated the efficacy of gabapentin (1800 mg/day) for FBSS. Eligible patients had a diagnosis of FBBS, an average daily pain score of at least 4 of 10, a neuropathic pain component (indicated by the PainDetect), and reported at least half of their pain radiating in their lower extremity. Participants were randomized to 2, 7-week study periods separated by a 10-day washout. The primary outcome measure was a 0 to 10 numeric rating scale (NRS) of average pain. Secondary measures included the McGill Pain Questionnaire and Patient Global Impression of Change. The treatment effect was analyzed using a mixed effect analysis of covariance with fixed effects for treatment, period, and baseline 7-day mean NRS pain score and a random effect for the participant. The outcome of the model was the mean 7-day NRS score for the last 7 days of each treatment period. Thirty-two participants were randomized and included in the primary analysis; 25 completed both study periods. No difference was detected between treatments on any outcome measure, including the primary (least square mean difference in NRS: −0.01 confidence interval: [−0.22 to 0.20]). Given the escalating rate of complex lumbar surgery, future research to develop novel therapies for this prevalent syndrome is needed.
Sex differences in central nervous system plasticity and pain in experimental autoimmune encephalomyelitis
Authors: Catuneanu Ana , Paylor John W. , Winship Ian , Colbourne Fred , Kerr Bradley J. 
Published: January 2019

Abstract
Multiple sclerosis (MS) is a neurodegenerative autoimmune disease with many known structural and functional changes in the central nervous system. A well-recognized, but poorly understood, complication of MS is chronic pain. Little is known regarding the influence of sex on the development and maintenance of MS-related pain. This is important to consider, as MS is a predominantly female disease. Using the experimental autoimmune encephalomyelitis (EAE) mouse model of MS, we demonstrate sex differences in measures of spinal cord inflammation and plasticity that accompany tactile hypersensitivity. Although we observed substantial inflammatory activity in both sexes, only male EAE mice exhibit robust staining of axonal injury markers and increased dendritic arborisation in morphology of deep dorsal horn neurons. We propose that tactile hypersensitivity in female EAE mice may be more immune-driven, whereas pain in male mice with EAE may rely more heavily on neurodegenerative and plasticity-related mechanisms. Morphological and inflammatory differences in the spinal cord associated with pain early in EAE progression supports the idea of differentially regulated pain pathways between the sexes. Results from this study may indicate future sex-specific targets that are worth investigating for their functional role in pain circuitry.
The Case for an Amharic Term for Stroke: “Ye-Angol Tikat”
Authors: Aseffa Sosena , Stutzman Sonja , Kamal Abulkadir , Measho Dawit , Gebreyohanns Mehari 
Published: January 2019

ABSTRACT

Background: This study was developed to explore the efficacy of introducing the Amharic phrase “Ye-Angol Tikat,” which translates to “brain attack“ in English, as a mechanism to enhance stroke education among the Amharic-speaking Ethiopian community. Methods: A prospective, nonrandomized, survey was completed by 294 Amharic-speaking persons. The survey explored support and desire for a culturally appropriate terminology for stroke. Results: Most of the participants (93%) support the need for an Amharic term to describe stroke. Conclusion: This pilot project demonstrates a strong support for a descriptive and standardized terminology for stroke within the Amharic-speaking community.
Decision to deploy coronary reperfusion is not affected by the volume of ST-segment elevation myocardial infarction patients managed by prehospital emergency medical teams
Authors: Lapostolle Frédéric , Bataille Sophie , Loyeau Aurélie , Simon Benoît , Laborne François-Xavier , Dupas François , Boche Thévy , Lamhaut Lionel , Pirès Virginie , Lefort Hugues , Mapouata Mireille , Le Bail Gaëlle , Weisslinger Lisa , Juliard Jean-Michel , Lambert Yves 
Published: January 2019

Objective
Mortality in patients with ST-segment elevation myocardial infarction (STEMI) has been associated with the volume of activity of percutaneous coronary intervention (PCI) facilities. This observational study investigated whether the coronary reperfusion-decision rate is associated with the volume of activity in a prehospital emergency setting.

Methods
Prospectively collected data for the period 2003–2013 were extracted from a regional registry of all STEMI patients handled by eight dispatch centers (SAMUs) in and around Paris [41 mobile ICU (MICUs)]. A possible association between volume of activity (number of STEMIs) and coronary reperfusion-decision rate, and subsidiarily between volume of activity and choice of technique (fibrinolysis vs. primary PCI), were investigated. Explanatory factors (patient age, sex, delay between pain onset and first medical contact, and access to a PCI facility) were analyzed in a multivariate analysis.

Results
Overall, 18 162 patients; male/female 3.5/1; median age 62 (52–72) years were included in the analysis. The median number of STEMIs per MICU was 339 (IQ 220–508) and that of reperfusion-decisions was 94% (91–95). There was no association between the decision rate and the number of STEMIs (P = 0.1). However, the decision rate was associated with age, sex, delay, and access to a PCI facility (P < 0.0001) in a highly significant way. Fibrinolysis was a more frequent option for low-volume (remoter PCI facilities) than high-volume MICUs (30 vs. 16%).

Conclusion
The decision of coronary reperfusion in a prehospital emergency setting depended on patient characteristics, delay between pain onset and first medical contact, and access to a PCI facility, but not on volume of activity. Promoting fibrinolysis use in underserved areas might help increase the reperfusion-decision rate.
Molecular regulation of plasma lipid levels during systemic inflammation and sepsis
Authors: Trinder Mark , Boyd John H. , Brunham Liam R. 
Published: January 2019

Purpose of review
Sepsis is a common syndrome of multiorgan system dysfunction caused by a dysregulated inflammatory response to an infection and is associated with high rates of mortality. Plasma lipid and lipoprotein levels and composition change profoundly during sepsis and have emerged as both biomarkers and potential therapeutic targets for this condition. The purpose of this article is to review recent progress in the understanding of the molecular regulation of lipid metabolism during sepsis.

Recent findings
Patients who experience greater declines in high-density lipoprotein during sepsis are at much greater risk of succumbing to organ failure and death. Although the causality of these findings remains unclear, all lipoprotein classes can sequester and prevent the excessive inflammation caused by pathogen-associated lipids during severe infections such as sepsis. This primordial innate immune function has been best characterized for high-density lipoproteins. Most importantly, results from human genetics and preclinical animal studies have suggested that several lipid treatment strategies, initially designed for atherosclerosis, may hold promise as therapies for sepsis.

Summary
Lipid and lipoprotein metabolism undergoes significant changes during sepsis. An improved understanding of the molecular regulation of these changes may lead to new opportunities for the treatment of sepsis.
Face Transplantation for Granulomatosis With Polyangiitis (Wegener Granulomatosis)
Authors: Hashem Ahmed M. , Djohan Risal , Bernard Steven , Hendrickson Mark , Schwarz Graham , Gharb Bahar B. , Rampazzo Antonio , Hoffman Gary S. , Doumit Gaby , Bergfeld Wilma , Zins James E. , Siemionow Maria , Papay Francis , Gastman Brian 
Published: January 2019

Background
We report new data for a rare face transplant performed 3 years ago. Granulomatosis with polyangiitis (GPA) (Wegener) is a severe autoimmune necrotizing vasculitis and parenchymal inflammatory disease that can affect any organ including those of the craniofacial region. Skin involvement manifests as malignant pyoderma. This account (1) highlights the technical details of face transplantation for this unique indication, (2) reports the 3-year posttransplant outcome, and (3) describes relevant immunological aspects.

Methods
A Le Fort III near-total face and near-total scalp transplant was performed after extensive trauma and subsequent bone and soft tissue infection in a patient with GPA. Incisions were planned along facial aesthetic subunits. The vascular pedicle comprised the facial and superficial temporal arteries bilaterally. The functioning left eye was preserved and fitted into the donor tissues.

Results
The procedure took 21 hours, and transfusion was limited to 4 units of packed red cells. Early medical and surgical complications were successfully treated. At 3 years, acceptable aesthetic outcome was achieved with adequate color match and scalp hair growth. The patient has recovered light touch, temperature, and 2-point discrimination and has evidence of symmetric cheek elevation albeit with limited eyelid and frontalis function. GPA relapse did not occur. Four acute rejections were fully reversed.

Conclusions
This case represents a new underlying disease (trauma + GPA) leading to face transplantation and a unique clinical scenario where allografting was indicated for potentially life-threatening and sight-preserving reasons and not for mere functional and aesthetic concerns. Despite complexity, 3-year clinical outcome is encouraging, and the patient is no longer at risk for dural exposure, meningitis, and related morbidity.
Geographic Variation in Breast Reconstruction Modality Use Among Women Undergoing Mastectomy
Authors: Anderson Spencer R. , Sieffert Michelle R. , Talarczyk Colonel Matthew R. , Johnson R. Michael , Fox Major Justin P. 
Published: January 2019

Purpose
Despite changes in legislation and an increase in public awareness, many women may not have access to the various types of breast reconstruction. The purpose of this study was to evaluate variation in reconstructive modality at the health service area (HSA) level and its relationship to the plastic surgeon workforce in the same area.

Methods
Using the Arkansas, California, Florida, Nebraska, and New York state inpatient databases, we conducted a cross-sectional study of adult women undergoing mastectomy for cancer from 2009 to 2012. The primary outcomes were receipt of reconstruction and the reconstructive modality (autologous tissue versus implant) used. All data were aggregated to the HSA level and augmented with plastic surgeon workforce data. Correlation coefficients were calculated for the relationship between the outcomes and workforce.

Results
The final sample included 67,984 women treated across 103 HSAs. The average patient was 58.5 years, had private insurance (53.5%), and underwent unilateral mastectomy for invasive cancer. At the HSA level, the median immediate breast reconstruction rate was 25.0% and varied widely (interquartile range, 43.2%). In areas where reconstruction was performed, the median autologous (10.2%) and free tissue (0.4%) reconstruction rates were low, with more than 30% of HSAs never using autologous tissue. There was a direct correlation between an HSA's plastic surgeon density and autologous reconstruction rate (r = 0.81, P < 0.001).

Conclusions
Despite efforts to remove financial barriers and improve patients' awareness, accessibility to various modalities of reconstruction is inadequate for many women. Efforts are needed to improve the availability of more comprehensive breast reconstruction care.