bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment Options of Lemmel’s Syndrome: A Case of Benign Obstructive Jaundice in The Elderly
Authors: Prasetyaningtyas Abigail , Rahman Perdana Aditya , Sudoyo Aru Wisaksono , Fauzi Achmad 
Published: April 2017

Lemmel’s syndrome, also known as duodenal diverticulum obstructive jaundice, is a rare cause of benign obstructive jaundice that should be included in the differential diagnosis of biliary obstruction when PAD is present, in the absence of cholelithiasis or other detectable obstacle. Diagnosing Lemmel’s syndrome could be challenging, but being aware of this condition is important to avoid mismanagement and it begins with identification of PAD, while interpreting any bile duct imaging. It can be misinterpreted as periampullary tumors, biliary stones, or pancreatic pseudocyst. Symptomatic patients can be successfully managed endoscopically in many cases but surgical management would be necessary in selected cases.We present a patient with benign obstructive jaundice caused by Lemmel’s syndrome who was successfully treated with endoscopic sphicterectomy. A 67 years old female presented to the emergency department with chief complaint of jaundice. The patient was assesed to have obstructive jaundice cause by a duodenal mass, elevation of transaminase enzime supected caused by drug induced liver injury, hypertension (controlled), and anterior extensive coronary ischemia. Endoscopic retrograde cholangiopancreatografi (ERCP) showing mutiple giant diverticle in second part of duodenum, stenosis of the distal CBD with compression of diverticular extra luminal as a differential diagnosis. Endoscopic ultrasound (EUS) was performed to exlude a periampullary tumor, resulting distal CBD stenosis due to compression of multiple periampullary diverticula (PAD). We performed an endoscopic sphinterectomy (EST) and the stent was removed. A further evaluation of the tuberculous lymphadenitis was planned as outpatient setting. One month follow-up, no recurence of jaundice was observed.
Ethnopharmacological evaluation of Cenchrus ciliaris for multiple gastrointestinal disorders
Authors: Aleem Ambreen , Janbaz Khalid Hussain 
Published: April 2017

This study was conducted to rationalize the traditional uses of Cenchrus ciliaris in gastrointestinal disorders using in vivo and ex vivo assays. The antidiarrheal effect was evaluated in rats by the castor oil-induced diarrheal model. C. ciliaris (100, 300 and 500 mg/kg) reduced the castor oil-induced diarrhea significantly. Another study carried out in mice to determine the intestinal transit rate showed that C. ciliaris (100 and 200 mg/kg) inhibited the transit rate significantly. Ex vivo assay demonstrated that C. ciliaris (0.011 mg/mL) relaxed the spontaneous and K+ (80 mM)-induced contractions, like verapamil. The crude extract (75, 100 and 150 mg/kg) also exhibited significant anti-emetic activity in chicks. These results indicate the presence of antispasmodic, antidiarrheal and antiemetic activities in C. ciliaris, thus providing the scientific basis for its traditional uses.
Video Clip of Methodology: 56 sec Full Screen Alternate
Vitamin D and polycystic ovary syndrome: an integrating review
Authors: Lopes Ione Maria Ribeiro Soares , Meireles Caroliny Gonçalves Rodrigues , Ferreira Iarlla Silva , Moura Nadya Dos Santos , Negreiros Francisca Diana Da Silva , Pequeno Alice Maria Correia 
Published: April 2017

Introduction: Polycystic ovary syndrome (PCOS) is the most common endocrinopathyin women of reproductive age. It causes a metabolic syndrome characterized by insulin resistance, hyperinsulinemia, and dyslipidemia. Vitamin D deficiency and its association with PCOS still represents a controversial subject in the literature.
Objective: In this context, this study aimed to understand the association between polycystic ovary syndrome and vitamin D deficiency, and how it occurs.
Method: It was an integrative review conducted in the PubMed, Scopus, LILACS, and CINAHL databases from August 2016 to January 2017, with a sample of 7 articles analyzed in their entirety.
Results: The evidences according to the studies conducted and the conclusions they identified.
Conclusions: It was concluded that we cannot yet assume that vitamin D deficiency contributes to the pathogenesis of PCOS, nor that the syndrome causes vitamin D deficiency, since the studies are controversial and there is a need for research with higher levels of evidence to clarify these doubts.
A Possible Solution for the M/L–[Fe/H] Relation of Globular Clusters in M31. II. The Age–Metallicity Relation
Authors: Haghi Hosein , Khalaj Pouria , Zonoozi Akram Hasani , Kroupa Pavel 
Published: April 2017

Abstract
This is the second paper in a series in which we present a new solution to reconcile the prediction of single stellar population (SSP) models with the observed stellar mass-to-light (M/L) ratios of globular clusters (GCs) in M31 and their trend with respect to

. In the present work, our focus is on the empirical relation between age and metallicity for GCs and its effect on the M/L ratio. Assuming that there is an anti-correlation between the age of M31 GCs and their metallicity, we evolve dynamical SSP models of GCs to establish a relation between the M/L ratio (in the V and K band) and metallicity. We then demonstrate that the established M/L–[Fe/H] relation is in perfect agreement with that of M31 GCs. In our models, we consider both the canonical initial mass function (IMF) and the top-heavy IMF, depending on cluster birth density and metallicity as derived independently from Galactic GCs and ultra-compact dwarf galaxies by Marks et al. Our results signify that the combination of the density- and metallicity-dependent top-heavy IMF, the anti-correlation between age and metallicity, stellar evolution, and standard dynamical evolution yields the best possible agreement with the observed trend of M/L–[Fe/H] for M31 GCs.
Photospheric Velocity Structures during the Emergence of Small Active Regions on the Sun
Authors: Khlystova Anna , Toriumi Shin 
Published: April 2017

Abstract
We study the plasma flows in the solar photosphere during the emergence of two small active regions, NOAA 9021 and 10768. Using Solar and Heliospheric Observatory/Michelson Doppler Imager data, we find that the strong plasma upflows appear at the initial stage of active region formation, with maximum upflow velocities of −1650 and −1320 m s−1. The structures with enhanced upflows have size ∼8 Mm in diameter, and they exist for 1–2 hr. The parameters of the enhanced upflows are consistent with those of the large active region NOAA 10488, which may suggest the possibility that the elementary emerging magnetic loops that appear at the earliest phase of active region formation have similar properties, irrespective of scales of active regions. Comparison between the observations and a numerical simulation of magnetic flux emergence shows a striking consistency. We find that the driving force of the plasma upflow is at first the gas pressure gradient and later the magnetic pressure gradient.
Extended Ionized Gas Clouds in the Abell 1367 Cluster∗
Authors: Yagi Masafumi , Yoshida Michitoshi , Gavazzi Giuseppe , Komiyama Yutaka , Kashikawa Nobunari , Okamura Sadanori 
Published: April 2017

Abstract
We surveyed a central 0.6 deg2 region of the Abell 1367 cluster for extended ionized gas clouds (EIGs) using the Subaru prime-focus camera (Suprime-Cam) with a narrowband filter that covers Hα. We discovered six new EIGs in addition to five known EIGs. We also found that the Hα tail from the blue infalling group is extended to about 330 kpc in projected distance, which is about twice longer than previously reported. Candidates of star-forming blobs in the tail are detected. The properties of the EIG parent galaxies in Abell 1367 basically resemble those in the Coma cluster. A noticeable difference is that there are significantly fewer detached EIGs in Abell 1367, while the fraction of blue member galaxies is higher. The results suggest a difference in the evolutionary stage of the clusters; Abell 1367 is at an earlier stage than the Coma cluster.
Detection of Supermassive Black Holes in Two Virgo Ultracompact Dwarf Galaxies
Authors: Ahn Christopher P. , Seth Anil C. , Brok Mark den , Strader Jay , Baumgardt Holger , van den Bosch Remco , Chilingarian Igor , Frank Matthias , Hilker Michael , McDermid Richard , Mieske Steffen , Romanowsky Aaron J. , Spitler Lee , Brodie Jean , Neumayer Nadine , Walsh Jonelle L. 
Published: April 2017

Abstract
We present the detection of supermassive black holes (BHs) in two Virgo ultracompact dwarf galaxies (UCDs), VUCD3 and M59cO. We use adaptive optics assisted data from the Gemini/NIFS instrument to derive radial velocity dispersion profiles for both objects. Mass models for the two UCDs are created using multi-band Hubble Space Telescope imaging, including the modeling of mild color gradients seen in both objects. We then find a best-fit stellar mass-to-light ratio (M/L) and BH mass by combining the kinematic data and the deprojected stellar mass profile using Jeans Anisotropic Models. Assuming axisymmetric isotropic Jeans models, we detect BHs in both objects with masses of

4.4

−
3.0

+
2.5

×

10

6

M
⊙ in VUCD3 and

5.8

−
2.8

+
2.5

×

10

6

M
⊙ in M59cO (3σ uncertainties). The BH mass is degenerate with the anisotropy parameter,

β

z

;

for the data to be consistent with no BH requires

β

z

=
0.4

and

β

z

=
0.6

for VUCD3 and M59cO, respectively. Comparing these values with nuclear star clusters shows that, while it is possible that these UCDs are highly radially anisotropic, it seems unlikely. These detections constitute the second and third UCDs known to host supermassive BHs. They both have a high fraction of their total mass in their BH; ∼13% for VUCD3 and ∼18% for M59cO. They also have low best-fit stellar M/Ls, supporting the proposed scenario that most massive UCDs host high-mass fraction BHs. The properties of the BHs and UCDs are consistent with both objects being the tidally stripped remnants of

∼

10

9

M

⊙

galaxies.
Circumstellar Disks and Outflows in Turbulent Molecular Cloud Cores: Possible Formation Mechanism for Misaligned Systems
Authors: Matsumoto Tomoaki , Machida Masahiro N. , Inutsuka Shu-ichiro 
Published: April 2017

Abstract
We investigate the formation of circumstellar disks and outflows subsequent to the collapse of molecular cloud cores with the magnetic field and turbulence. Numerical simulations are performed by using an adaptive mesh refinement to follow the evolution up to ∼1000 years after the formation of a protostar. In the simulations, circumstellar disks are formed around the protostars; those in magnetized models are considerably smaller than those in nonmagnetized models, but their size increases with time. The models with stronger magnetic fields tend to produce smaller disks. During evolution in the magnetized models, the mass ratios of a disk to a protostar is approximately constant at ∼1%–10%. The circumstellar disks are aligned according to their angular momentum, and the outflows accelerate along the magnetic field on the 10–100 au scale; this produces a disk that is misaligned with the outflow. The outflows are classified into two types: a magnetocentrifugal wind and a spiral flow. In the latter, because of the geometry, the axis of rotation is misaligned with the magnetic field. The magnetic field has an internal structure in the cloud cores, which also causes misalignment between the outflows and the magnetic field on the scale of the cloud core. The distribution of the angular momentum vectors in a core also has a non-monotonic internal structure. This should create a time-dependent accretion of angular momenta onto the circumstellar disk. Therefore, the circumstellar disks are expected to change their orientation as well as their sizes in the long-term evolutions.
Dynamical Timescale of Pre-collapse Evolution Inferred from Chemical Distribution in the Taurus Molecular Cloud-1 (TMC-1) Filament
Authors: Choi Yunhee , Lee Jeong-Eun , Bourke Tyler L. , II Neal J. Evans 
Published: April 2017

Abstract
We present observations and analyses of the low-mass star-forming region, Taurus Molecular Cloud-1 (TMC-1). CS (J = 2–1)/N2H+ (J = 1–0) and C17O (J = 2–1)/C18O (J = 2–1) were observed with the Five College Radio Astronomy Observatory and the Seoul Radio Astronomy Observatory, respectively. In addition, Spitzer infrared data and 1.2 mm continuum data observed with Max-Planck Millimetre Bolometer are used. We also perform chemical modeling to investigate the relative molecular distributions of the TMC-1 filament. Based on Spitzer observations, there is no young stellar object along the TMC-1 filament, while five Class II and one Class I young stellar objects are identified outside the filament. The comparison between column densities calculated from dust continuum and C17O 2–1 line emission shows that CO is depleted much more significantly in the ammonia peak than in the cyanopolyyne peak, while the column densities calculated from the dust continuum are similar at the two peaks. N2H+ is not depleted much in either peak. According to our chemical calculation, the differential chemical distribution in the two peaks can be explained by different timescales required to reach the same density, i.e., by different dynamical processes.
Biologic Disease-modifying Antirheumatic Drug (bDMARD)-induced Neutropenia: A Registry from a Retrospective Cohort of Patients with Rheumatic Diseases Treated with 3 Classes of Intravenous bDMARD
Authors: Espinoza Francisco , Le Blay Pierre , Combe Bernard 
Published: April 2017

Objective.To examine the rate, risks factors, and consequences of neutropenia induced by intravenous (IV) biologic disease-modifying antirheumatic drugs (bDMARD).Methods.We conducted a retrospective cohort study in 499 patients with rheumatic diseases treated by IV abatacept (ABA), infliximab (IFX), or tocilizumab (TCZ).Results.Rheumatoid arthritis (RA) was the most frequent diagnosis (72%). Fifty-two patients (10.4%) experienced at least 1 episode of neutropenia. No episodes of grade 4 neutropenia were documented. TCZ was more frequently related to neutropenia than ABA or IFX (18.6% vs 3.8% and 2.8%, respectively, p < 0.001). The following factors were identified as predictors of experiencing neutropenia with IV bDMARD: history of neutropenia with methotrexate (MTX; synthetic DMARD; OR 1.56, 95% CI 1.17–7.14), concomitant treatment by MTX (OR 1.21, 95% CI 1.01–2.64), and TCZ treatment (OR 2.72, 95% CI 1.53–9.05). Patients experiencing a TCZ-induced neutropenia did not show a higher risk of severe infections; however, this group had a shorter drug survival (9 mos vs 20 mos, p < 0.02) compared with TCZ patients without neutropenia.Conclusion.Among 3 different classes of IV bDMARD, TCZ is associated with the higher risk of neutropenia. No increased frequency of infection episodes was documented in this group.
Takayasu Arteritis and Spondyloarthritis: Coincidence or Association? A Study of 14 Cases
Authors: Rivière Elodie , Arnaud Laurent , Ebbo Mikael , Allanore Yannick , Claudepierre Pascal , Dernis Emmanuelle , Ziza Jean-Marc , Miceli-Richard Corinne , Philippe Peggy , Richez Christophe , Soubrier Martin , Belkhir Rakiba , Seror Raphaèle , Mariette Xavier , Pavy Stephan ,   on behalf of the Club Rhumatismes et Inflammations
Published: April 2017

Objective.Spondyloarthritis (SpA) and Takayasu arteritis (TA) are 2 chronic inflammatory diseases; their coexistence in a single patient is uncommon. The aims of our study were to describe clinical features of patients having SpA associated with TA and to identify some characteristics of the types of patients with SpA associated with TA. We also analyzed treatments used in this context.Methods.This French multicenter retrospective survey called for observations on behalf of the Club Rhumatismes et Inflammations, with a standardized questionnaire established by the investigators.Results.We included 14 patients (women: 10/14; median age at SpA diagnosis: 43.5 yrs, ranging from 19 to 63). Subtypes of SpA were ankylosing spondylitis (n = 11), psoriatic arthritis (n = 2), and synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome (n = 1). HLA-B27 was positive in 3 cases, negative in 9, and unknown in 2. SpA was diagnosed before TA in 13 cases. Imaging findings compatible with the diagnosis of TA were found with computed tomography (11/14) and/or Doppler ultrasound (10/14). Laboratory tests showed increased acute-phase reactants in all cases (C-reactive protein ≥ 25 mg/l in 71% of the cases). All patients except 1 received corticosteroids and 7 were treated with anti–tumor necrosis factor (anti-TNF).Conclusion.Association of SpA and TA is rare but probably not coincidental. Peripheral pulse palpation and vascular auscultation should be systematic and are the first indicators of TA in patients with SpA. Moreover, increased acute-phase reactants during SpA followup should lead to search for TA. Finally, there are therapeutic implications because anti-TNF are efficient in SpA and might be efficient in TA.
Interferon-α for Induction and Maintenance of Remission in Eosinophilic Granulomatosis with Polyangiitis: A Single-center Retrospective Observational Cohort Study
Authors: Seeliger Benjamin , Förster Martin , Happe Janett , Forberg Thomas , Moeser Anne , Neumann Thomas , Kroegel Claus 
Published: April 2017

Objective.Eosinophilic granulomatosis with polyangiitis (EGPA) is characterized by frequent relapses following induction therapy. Interferon-α (IFN-α) can reverse the underlying Th2-driven immune response and has successfully induced remission in previous reports. We undertook this study to investigate its efficacy and safety in patients with EGPA.Methods.We conducted a retrospective monocentric cohort study including 30 patients (16 women) with active EGPA under IFN-α treatment. Primary endpoints were remission induction, occurrence of relapses, prednisolone (PSL) dosage at time of remission, and adverse events. Remission was defined by a Birmingham Vasculitis Activity Score (BVAS) of 0. Pulmonary function tests were recorded at baseline and at time of remission. Health-related quality of life was analyzed by questionnaire at baseline and following 12 months of treatment.Results.At baseline, the median BVAS was 6 (interquartile range 4–13.5) and remission or partial response was achieved in 25/30 patients. After initiation of IFN-α treatment, the median PSL dosages could be reduced from 17.5 mg/day at baseline to 5.5 mg/day at time of remission. Following remission, 17 relapses (5 major) in 16 patients were observed. Pulmonary function tests improved and the time of hospitalization decreased. Adverse events at initiation of treatment were common, but mostly transient. Severe adverse events occurred during treatment in 4 patients (autoimmune hepatitis, n = 1; drug-induced neuropathy, n = 3).Conclusion.IFN-α treatment results in high rate of remission and maintenance in EGPA with significant reduction in oral corticosteroids, although reversible adverse events may occur. IFN-α represents an alternative therapeutic option in cases of refractory to standard treatment.
Antitumor Necrosis Factor-α Therapy Associated with Inflammatory Bowel Disease: Three Cases and a Systematic Literature Review
Authors: Bieber Amir , Fawaz Abdallah , Novofastovski Irina , Mader Reuven 
Published: April 2017

Objective.Antitumor necrosis factor-α (anti-TNF-α) therapy is the most prescribed biologic agent therapy in rheumatology and gastroenterology. However, a number of serious side effects have been reported with these drugs. Only a handful of cases of new-onset inflammatory bowel disease (IBD), mostly in children diagnosed with juvenile idiopathic arthritis (JIA), have been reported during anti-TNF-α therapy. We present 3 cases of adult IBD following anti-TNF-α therapy and a literature review on this topic.Methods.We searched PubMed MESH for all relevant terms, papers were reviewed, and patient-specific data were extracted. Relevant clinical data were calculated and presented.Results.The PubMed search resulted in 137 articles, of which 11 articles and 4 cited publications were included in our analysis. We found 53 cases of IBD after anti-TNF-α therapy reported in the literature; most of them were case series collected retrospectively from national databases or studies. Almost all the patients developed IBD after the introduction of etanercept (ETN); 2 patients with rheumatoid arthritis were also included. The average age at IBD onset was 17.3 years and the average time from ETN introduction to IBD onset was 27 months (± 24). Gastrointestinal symptoms have been reported as improving or subsiding in most of the patients after discontinuing ETN.Conclusion.Although this manifestation is not common, it should be taken into consideration as an adverse effect of ETN. Rheumatologists, and in particular rheumatologists treating adult patients, should be aware of this possible complication. Further investigation about the pathogenic process underlying this phenomenon is warranted.
The Association of Low Income with Functional Status and Disease Burden in German Patients with Rheumatoid Arthritis: Results of a Cross-sectional Questionnaire Survey Based on Claims Data
Authors: Callhoff Johanna , Luque Ramos Andres , Zink Angela , Hoffmann Falk , Albrecht Katinka 
Published: April 2017

Objective.To assess the influence of income on self-reported disease and work productivity outcomes.Methods.Persons with rheumatoid arthritis (RA) diagnosis (International Classification of Diseases, 10th ed. codes M05/M06) on health insurance claims data in at least 2 quarters of 2013 were randomly selected. They were mailed questionnaires covering RA diagnosis, household income, functional capacity [Hannover functional status questionnaire (FFbH), 0–100], RA Impact of Disease questionnaire (RAID; 0–10), self-reported swollen joint count (SJC; 0–48), tender joint count (TJC; 0–50), and effect of RA on work productivity (change of work, fewer working hours, sick leave, application for disability pension, and others). Weighted multivariable linear regression models were used to assess the association between income and disease outcomes.Results.A total of 1492 persons of working age who confirmed RA diagnosis were available for analysis. The mean age was 55 years, 82% were women, and 74% were under rheumatologic care. A total of 27%, 52%, and 21% had a low (< €1500), medium (€1500–3200), and high monthly income (> €3200), respectively. Respondents with low income had the worst mean FFbH, RAID, SJC, and TJC values. This was confirmed in the regression model: mean FFbH low versus high income −8.65 (95% CI −9.72 to −7.58), RAID 0.73 (0.59–0.86), and SJC 3.47 (2.86–4.08). Sick leave (8.7%/3.5%/1.8%) and disability pension (18.1%/9.6%/6.9%) were more frequent in patients with low versus medium versus high income (p < 0.05).Conclusion.The association of low income with a higher disease burden, more functional disability, and higher rates of work loss emphasizes the need to focus on these outcomes when choosing treatment strategies for patients in the lower income groups.
Structural Validity of the Rheumatology Attitudes Index in Systemic Sclerosis: Analysis from the UCLA Scleroderma Quality of Life Study
Authors: Gholizadeh Shadi , Mills Sarah D. , Fox Rina S. , Merz Erin L. , Roesch Scott C. , Clements Philip J. , Kafaja Suzanne , Furst Daniel E. , Khanna Dinesh , Malcarne Vanessa L. 
Published: April 2017

Objective.To evaluate the structural validity of the Rheumatology Attitudes Index (RAI), a widely used measure of rheumatic disease–related helplessness in patients with systemic sclerosis (SSc).Methods.Patients with physician-confirmed SSc from the University of California, Los Angeles (UCLA) Scleroderma Quality of Life Study (n = 208) received clinical examinations and completed self-report questionnaires. The structural validity of the RAI was examined through confirmatory and exploratory factor analysis (CFA/EFA).Results.A tenable factor structure was not identified through CFA or EFA.Conclusion.The present structural analysis did not support the use of the RAI with SSc patients.