bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of ultrasound to predict difficult intubation in Chinese population by assessing the ratio of the pre‐epiglottis space distance and the distance between epiglottis and vocal folds
Authors: Chan Sze Man Mandy , Wong Wai Yip , Lam Shing Kit Tommy , Wong Oi Fung , Law Wing Sze Stephanie , Shiu Wing Yung Yolanda , Mak Pui Yee Emma 
Published: February 2018

Objective:To investigate the accuracy of using the ratio of pre‐epiglottis space distance (Pre‐E) and the distance between the epiglottis and the vocal folds (Pre‐E/E‐VF) measured by the ultrasound to predict potential difficult airway in the Chinese population.Design:A prospective clinical study.Setting:The pre‐operative assessment service clinic of Tuen Mun Hospital.Patients:Patients with age of 18 years or above, who were scheduled for elective surgery requiring general anesthesia with direct laryngoscopy and tracheal intubation.Results:A total of 113 patients with direct laryngoscopic assessment during elective operations were included. Thirty‐nine (34.5%) patients had potential difficult airway which was defined as documented Cormack–Lehane classification grade 2b, 3, or 4 by the anesthetists. Measurement of the distance from the epiglottis to the anterior vocal folds (Pre‐E/aVF) ratio had better inter‐rater reliability and accuracy comparing to the measurements of the distances from the epiglottis to the midpoint between the vocal folds and to the posterior vocal folds. The performance of using the Pre‐E/aVF ratio to predict potential difficult airway was compared with other clinical tests (the Mallampati classification, the thyromental distance and the neck circumference to thyromental distance ratio). By using the Pre‐E/aVF ratio of 1, the sensitivity and specificity to predict a potential difficult airway were 79.5% and 39.2%, respectively (p = 0.044). The ultrasound assessment method had a comparable predictive value as the Mallampati classification (the area under the receiver operator characteristic curves 0.648 vs 0.687). The negative likelihood ratio of the ultrasound assessment method was the lowest among all the other airway assessment methods.Conclusion:The ultrasound airway assessment method could serve as a non‐invasive test and supplement the currently used clinical assessment methods. A lower cut‐off point of the Pre‐E/E‐VF ratio should be used in the Chinese population.
Medical Decision-Making for Adults Who Lack Decision-Making Capacity and a Surrogate: State of the Science
Authors: Kim Hyejin , Song Mi-Kyung 
Published: February 2018

Background: Adults who lack decision-making capacity and a surrogate (“unbefriended” adults) are a vulnerable, voiceless population in health care. But little is known about this population, including how medical decisions are made for these individuals. Objective: This integrative review was to examine what is known about unbefriended adults and identify gaps in the literature. Methods: Six electronic databases were searched using 4 keywords: “unbefriended,” “unrepresented patients,” “adult orphans,” and “incapacitated patients without surrogates.” After screening, the final sample included 10 data-based articles for synthesis. Results: Main findings include the following: (1) various terms were used to refer to adults who lack decision-making capacity and a surrogate; (2) the number of unbefriended adults was sizable and likely to grow; (3) approaches to medical decision-making for this population in health-care settings varied; and (4) professional guidelines and laws to address the issues related to this population were inconsistent. There have been no studies regarding the quality of medical decision-making and its outcomes for this population or societal impact. Conclusion: Extremely limited empirical data exist on unbefriended adults to develop strategies to improve how medical decisions are made for this population. There is an urgent need for research to examine the quality of medical decision-making and its outcomes for this vulnerable population.
Selected Parameters of Angiogenesis and the JAK2, CALR, and MPL Mutations in Patients With Essential Thrombocythemia
Authors: Gadomska Grażyna , Bartoszewska-Kubiak Alicja , Boinska Joanna , Matiakowska Karolina , Ziołkowska Katarzyna , Haus Olga , Rość Danuta 
Published: February 2018

The aim of the study was to evaluate selected angiogenic factors in patients with essential thrombocythemia (ET) depending on JAK2V617F, calreticulin gene (CALR) and myeloproliferative leukemia virus oncogene (MPL) mutations. Sixty ET patients and 20 healthy volunteers were enrolled in the study. The following tests were performed: vascular endothelial growth factor- A (VEGF-A), soluble vascular endothelial growth factor receptor-1 (sVEGFR-1),soluble vascular endothelial growth factor receptor-2 (sVEGFR-2), platelet-derived growth factor( PDGF-BB), and stromal-derived factor-1α (SDF-1α). We observed an increased PDGF-BB level in patients with ET compared to the controls. Patients with CALR mutation had significantly higher concentration of PDGF-BB and lower concentration of SDF-1α than patients with JAK2V617F mutation. High concentration of PDGF-BB and low concentration of SDF-1α in patients with CALR(+) ET may indicate a contribution of these chemokines in disturbed Ca2+ metabolism in platelets.
Assessing Collaboration
Authors: Greenwald Howard P. , Zukoski Ann P. 
Published: February 2018

This essay addresses challenges in evaluating collaboration by examining two distinct approaches to its measurement. Evaluators frequently assess collaboration on the basis of relationships, climate, and expectations (RCE), and, less often, via extent of collaboration (EC). RCE measures are based on perceptions by coalition members regarding satisfaction with the collaboration, representativeness of the surrounding community, confidence in the leadership, and related areas. EC measures reflect more direct and concrete features of coalitions, such as regularity of communication and commitment of resources. An illustrative study of programs sponsored by a private foundation and a federal agency compares these approaches, finding that RCE and EC measures reflect different underlying features of collaboration and that higher levels of collaboration are likely to be found when evaluators use RCE indicators. Substantively, the study finds large differences in extent of collaboration across areas of operation within each program and a rarity of very high levels of collaboration in most areas. Both face validity and findings from the illustrative study suggest that EC is the more essential measure of collaboration. Comparison of these measures raises issues for both evaluation and grant making.
Real-Time Detection of Infusion Site Failures in a Closed-Loop Artificial Pancreas
Authors: Howsmon Daniel P. , Baysal Nihat , Buckingham Bruce A. , Forlenza Gregory P. , Ly Trang T. , Maahs David M. , Marcal Tatiana , Towers Lindsey , Mauritzen Eric , Deshpande Sunil , Huyett Lauren M. , Pinsker Jordan E. , Gondhalekar Ravi , Doyle Francis J. , Dassau Eyal , Hahn Juergen , Bequette B. Wayne 
Published: February 2018

Background: As evidence emerges that artificial pancreas systems improve clinical outcomes for patients with type 1 diabetes, the burden of this disease will hopefully begin to be alleviated for many patients and caregivers. However, reliance on automated insulin delivery potentially means patients will be slower to act when devices stop functioning appropriately. One such scenario involves an insulin infusion site failure, where the insulin that is recorded as delivered fails to affect the patient’s glucose as expected. Alerting patients to these events in real time would potentially reduce hyperglycemia and ketosis associated with infusion site failures. Methods: An infusion site failure detection algorithm was deployed in a randomized crossover study with artificial pancreas and sensor-augmented pump arms in an outpatient setting. Each arm lasted two weeks. Nineteen participants wore infusion sets for up to 7 days. Clinicians contacted patients to confirm infusion site failures detected by the algorithm and instructed on set replacement if failure was confirmed. Results: In real time and under zone model predictive control, the infusion site failure detection algorithm achieved a sensitivity of 88.0% (n = 25) while issuing only 0.22 false positives per day, compared with a sensitivity of 73.3% (n = 15) and 0.27 false positives per day in the SAP arm (as indicated by retrospective analysis). No association between intervention strategy and duration of infusion sets was observed ( P = .58). Conclusions: As patient burden is reduced by each generation of advanced diabetes technology, fault detection algorithms will help ensure that patients are alerted when they need to manually intervene. Clinical Trial Identifier: www.clinicaltrials.gov,NCT02773875
The in vivo tissue effect of endoscopic balloon‐based radiofrequency ablation in treating esophageal squamous cell neoplasia
Authors: Wang Wen-Lun , Chang I-Wei , Chen Chien-Chuan , Chang Chi-Yang , Tseng Cheng-Hao , Tai Chi-Ming , Lin Jaw-Town , Wang Hsiu-Po , Lee Ching-Tai 
Published: February 2018

BackgroundEndoscopic radiofrequency ablation (RFA) is a rapidly evolving therapeutic modality for early flat esophageal squamous cell neoplasms (ESCNs). However, the in vivo tissue effects of RFA on the esophageal wall are uncertain.MethodsWe prospectively enrolled eight patients with flat‐type early ESCNs who were treated with balloon‐based RFA. We evaluated the in vivo tissue effect on the esophagus using endoscopic ultrasound (EUS) and the histology of retrieved coagulum.ResultsThe mean tumor length was 6.1 cm, and six of the eight patients achieved a complete response after primary RFA. Real‐time evaluation of the tissue effect showed that the mucosa and submucosal layer were more edematous and thicker after RFA than before the procedure (mean 4.89 vs. 2.04 mm, p<.001), suggesting that the thermal effect of RFA may injure the submucosa. Histological evaluation of retrieved coagulum showed a severe cauterization (burning) effect with extensive cell necrosis; however, four cases had some residual viable neoplastic cells. Even though there were viable cells in the sloughed coagulum, half of the patients still achieved complete remission after RFA.ConclusionsOur findings suggest that the thermal effect of RFA may injure the submucosal layer and enable neoplastic epithelium to slough off without “burning.”
Integrated molecular profiling of juvenile myelomonocytic leukemia
Authors: Murakami Norihiro , Okuno Yusuke , Yoshida Kenichi , Shiraishi Yuichi , Nagae Genta , Suzuki Kyogo , Narita Atsushi , Sakaguchi Hirotoshi , Kawashima Nozomu , Wang Xinan , Xu Yinyan , Chiba Kenichi , Tanaka Hiroko , Hama Asahito , Sanada Masashi , Ito Masafumi , Hirayama Masashi , Watanabe Arata , Ueno Toshihide , Kojima Seiji , Aburatani Hiroyuki , Mano Hiroyuki , Miyano Satoru , Ogawa Seishi , Takahashi Yoshiyuki , Muramatsu Hideki 
Published: February 2018

Key Points
Targetable ALK/ROS1 tyrosine kinase fusions were detected in JMML patients without canonical RAS pathway mutations. Genome-wide methylation analysis identified the hypermethylation profile associated with poor clinical outcome.
Biokinetics, dosimetry, and radiation risk in infants after 99mTc-MAG3 scans
Authors: Soares Machado J. , Tran-Gia J. , Schlögl S. , Buck A. K. , Lassmann M. 
Published: February 2018

Abstract
Background
Renal scans are among the most frequent exams performed on infants and toddlers. Due to the young age, this patient group can be classified as a high-risk group with a higher probability for developing stochastic radiation effects compared to adults. As there are only limited data on biokinetics and dosimetry in this patient group, the aim of this study was to reassess the dosimetry and the associated radiation risk for infants undergoing 99mTc-MAG3 renal scans based on a retrospective analysis of existing patient data.
Consecutive data were collected from 20 patients younger than 20 months (14 males; 6 females) with normal renal function undergoing 99mTc-MAG3 scans. To estimate the patient-specific organ activity, a retrospective calibration was performed based on a set of two 3D-printed infant kidneys filled with known activities. Both phantoms were scanned at different positions along the anteroposterior axis inside a water phantom, providing depth- and size-dependent attenuation correction factors for planar imaging. Time-activity curves were determined by drawing kidney, bladder, and whole-body regions-of-interest for each patient, and subsequently applying the calibration factor for conversion of counts to activity. Patient-specific time-integrated activity coefficients were obtained by integrating the organ-specific time-activity curves. Absorbed and effective dose coefficients for each patient were assessed with OLINDA/EXM for the provided newborn and 1-year-old model. The risk estimation was performed individually for each of the 20 patients with the NCI Radiation Risk Assessment Tool.

Results
The mean age of the patients was 7.0 ± 4.5 months, with a weight between 5 and 12 kg and a body size between 60 and 89 cm. The injected activities ranged from 12 to 24 MBq of 99mTc-MAG3. The patients’ organ-specific mean absorbed dose coefficients were 0.04 ± 0.03 mGy/MBq for the kidneys and 0.27 ± 0.24 mGy/MBq for the bladder. The mean effective dose coefficient was 0.02 ± 0.02 mSv/MBq. Based on the dosimetry results, an evaluation of the excess lifetime risk for the development of radiation-induced cancer showed that the group of newborns has a risk of 16.8 per 100,000 persons, which is about 12% higher in comparison with the 1-year-old group with 14.7 per 100,000 persons (all values are given as mean plus/minus one standard deviation except otherwise specified).

Conclusion
In this study, we retrospectively derived new data on biokinetics and dosimetry for infants with normal kidney function after undergoing renal scans with 99mTc-MAG3. In addition, we analyzed the associated age- and gender-specific excess lifetime risk due to ionizing radiation. The radiation-associated stochastic risk increases with the organ doses, taking age- and gender-specific influences into account. Overall, the lifetime radiation risk associated with the 99mTc-MAG3 scans is very low in comparison to the general population risk for developing cancer.
Major Histocompatibility Complex Class II and Programmed Death Ligand 1 Expression Predict Outcome After Programmed Death 1 Blockade in Classic Hodgkin Lymphoma
Authors: Roemer Margaretha G.M. , Redd Robert A. , Cader Fathima Zumla , Pak Christine J. , Abdelrahman Sara , Ouyang Jing , Sasse Stephanie , Younes Anas , Fanale Michelle , Santoro Armando , Zinzani Pier Luigi , Timmerman John , Collins Graham P. , Ramchandren Radhakrishnan , Cohen Jonathon B. , De Boer Jan Paul , Kuruvilla John , Savage Kerry J. , Trneny Marek , Ansell Stephen , Kato Kazunobu , Farsaci Benedetto , Sumbul Anne , Armand Philippe , Neuberg Donna S. , Pinkus Geraldine S. , Ligon Azra H. , Rodig Scott J. , Shipp Margaret A. 
Published: February 2018

Purpose Hodgkin Reed-Sternberg (HRS) cells evade antitumor immunity by multiple means, including gains of 9p24.1/ CD274(PD-L1)/ PDCD1LG2(PD-L2) and perturbed antigen presentation. Programmed death 1 (PD-1) receptor blockade is active in classic Hodgkin lymphoma (cHL) despite reported deficiencies of major histocompatibility complex (MHC) class I expression on HRS cells. Herein, we assess bases of sensitivity to PD-1 blockade in patients with relapsed/refractory cHL who were treated with nivolumab (anti–PD-1) in the CheckMate 205 trial. Methods HRS cells from archival tumor biopsies were evaluated for 9p24.1 alterations by fluorescence in situ hybridization and for expression of PD ligand 1 (PD-L1) and the antigen presentation pathway components—β2-microglobulin, MHC class I, and MHC class II—by immunohistochemistry. These parameters were correlated with clinical responses and progression-free survival (PFS) after PD-1 blockade. Results Patients with higher-level 9p24.1 copy gain and increased PD-L1 expression on HRS cells had superior PFS. HRS cell expression of β2-microglobulin/MHC class I was not predictive for complete remission or PFS after nivolumab therapy. In contrast, HRS cell expression of MHC class II was predictive for complete remission. In patients with a > 12-month interval between myeloablative autologous stem-cell transplantation and nivolumab therapy, HRS cell expression of MHC class II was associated with prolonged PFS. Conclusion Genetically driven PD-L1 expression and MHC class II positivity on HRS cells are potential predictors of favorable outcome after PD-1 blockade. In cHL, clinical responses to nivolumab were not dependent on HRS cell expression of MHC class I.
GnRH Receptor Expression and Reproductive Function Depend on JUN in GnRH Receptor‒Expressing Cells
Authors: Jonak Carrie R , Lainez Nancy M , Boehm Ulrich , Coss Djurdjica 
Published: February 2018

Abstract
Gonadotropin-releasing hormone (GnRH) from the hypothalamus regulates synthesis and secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the anterior pituitary gonadotropes. LH and FSH are heterodimers composed of a common α-subunit and unique β-subunits, which provide biological specificity and are limiting components of mature hormone synthesis. Gonadotrope cells respond to GnRH via specific expression of the GnRH receptor (Gnrhr). GnRH induces the expression of gonadotropin genes and of the Gnrhr by activation of specific transcription factors. The JUN (c-Jun) transcription factor binds to AP-1 sites in the promoters of target genes and mediates induction of the FSHβ gene and of the Gnrhr in gonadotrope-derived cell lines. To analyze the role of JUN in reproductive function in vivo, we generated a mouse model that lacks JUN specifically in GnRH receptor‒expressing cells (conditional JUN knockout; JUN-cKO). JUN-cKO mice displayed profound reproductive anomalies such as reduced LH levels resulting in lower gonadal steroid levels, longer estrous cycles in females, and diminished sperm numbers in males. Unexpectedly, FSH levels were unchanged in these animals, whereas Gnrhr expression in the pituitary was reduced. Steroidogenic enzyme expression was reduced in the gonads of JUN-cKO mice, likely as a consequence of reduced LH levels. GnRH receptor‒driven Cre activity was detected in the hypothalamus but not in the GnRH neuron. Female, but not male, JUN-cKO mice exhibited reduced GnRH expression. Taken together, our results demonstrate that GnRH receptor‒expression levels depend on JUN and are critical for reproductive function.
Self-Assembly of Discrete Organic Nanotubes
Authors: Shimizu Toshimi 
Published: February 2018

Abstract
Not only amphiphiles but also non-amphiphilic or π–conjugated molecules, if rationally designed, have been found to self-assemble in liquid media to form discrete tubular architectures with well-defined dimensions. This review covers most of the molecular building blocks that spontaneously produce organic nanotubes (ONTs) through self-assembly. Starting with the comparison of synthetic procedures and physical properties between the ONTs and carbon nanotubes (CNTs), the author discusses the classification of formation mechanism for the self-assembled ONTs. Then, membrane- or sheet-based, nanoring- or nanotoroid-based, stacking-based, and supramolecular stacking-based pathways of the self-assembly are described in relation to the presence or absence of intermediate structures. Concerning the membrane- or sheet-based mechanism, the molecular design and functionalities of each building block, and the dimensions of obtained ONTs are discussed in terms of the self-assembling features of amino acids, bile acids, carbohydrates, nucleotides, photoresponsive amphiphiles, functional dyes, fused aromatics, carbon allotropes, heterocycles, peptide derivatives, and other related molecules. Naphthalenediimide, porphyrins, and azobenzene amphiphiles are introduced to feature the ONT formation mediated by nanoring or nanotoroid structures. Cyclic peptides, polymer cyclic peptides, and peptide helices are then described as building blocks that result in the stacking-based self-assembly of the ONTs. Trimesic acids, pyrimido pyrimidine, ferrocene aromatics, and bent-shaped or cyclic aromatic amphiphiles are also discussed from the viewpoint of supramolecular stacking into the ONTs. Finally, currently important but critical issues for further development of the ONTs toward practical applications are described.
PDMS-Based Microfluidic Device for Infrared-Transmission Spectro-Electrochemistry
Authors: Suea-Ngam Akkapol , Srisa-Art Monpichar , Furutani Yuji 
Published: February 2018

Abstract
Polydimethylsiloxane (PDMS) is a well-known material used in making microfluidic devices through soft lithography. PDMS strongly absorbs infrared (IR) light in the mid infrared region, which can be alleviated by using thin-film PDMS devices. However, IR detection with PDMS devices usually requires an IR-transparent backbone material. Here, we report a microfluidic system using a 160 µm PDMS thin-film device (50-µm path length) without a supporting backbone for IR spectroelectrochemistry (IR-SEC). The PDMS device is assembled with four layers: microchannel-supporting window, microchannel thin film, electrode-embedded thin film, and electrode-supporting window. In this work, mapping of ferrocyanide oxidation was investigated under an IR microscope. An electrochemical reaction, occurring between the working and counter electrodes, was observed clearly. Moreover, the electron-transfer process of ferrocyanide oxidation was investigated from the IR absorbance spectrum. This mapping study demonstrates that the relationship between the electrochemical reactants and products partly agree well with the Nernst equation. Accordingly, PDMS thin-film devices have the capability for studying electrochemical reactions by using IR-SEC measurements with low sample consumption.
Παρατηρήσεις στις τοιχογραφίες του καθολικού της μονής της Κοιμήσεως της Θεοτόκου στο Τορνίκι Γρεβενών (1481/82)
Authors: ΤΣΙΓΑΡΙΔΑΣ (Ethymios N. Tsigaridas) Ευθύμιος Ν. 
Published: February 2018

Στην μελέτη αυτή δημοσιεύονται οι παλαιότερες τοιχογραφίες του καθολικού της μονής της Κοιμήσεως της Θεοτόκου στο Τορνίκι Γρεβενών. Οι τοιχογραφίες, οιοποίες χρονολογούνται στο 1481/82, παρουσιάζουν κοινά χαρακτηριστικά με την ζωγραφική έργων της «σχολής » Καστοριάς του τελευταίου τετάρτου του 15ου αιώνα.
The sinaitic icon of the Heavenly Ladder and Saint Anthony archbishop
Authors: MACHAIRAS (Χαράλαμπος ΜΑΧΑΙΡΑΣ) Charalampos 
Published: February 2018

Στην εικόνα της Ουρανοδρόμου Κλίμακος, που χρονολογείται στα τέλη του 12ου αιώνα και σήμερα βρίσκεται στην Ιερά Μονή του Θεοβαδίστου Όρους Σινά,απεικονίζονται δύο άγιοι να ανέρχονται τα σκαλοπάτια της Κλίμακας. Επιγραφές αναφέρουν ότι πρόκειται για τον άγιο Ιωάννη της Κλίμακος και τον άγιο Αντώνιο αρχιεπίσκοπο. Ο τελευταίος ταυτίζεται με τον πατριάρχη της Κωνσταντινούπολης άγιο Αντώνιο Β΄ (893-901), ο οποίος ίδρυσε τη μονή του Καυλέα στην Κωνσταντινούπολη.
Λύχνοι πρωτοβυζαντινής περιόδου από την Πάτρα. Εισαγωγές και στοιχεία τοπικής παραγωγής
Authors: ΒΑΣΙΛΑΚΗΣ (Nikolaos VASILAKIS) Νικόλαος , ΘΕΟΔΩΡΟΠΟΥΛΟΥ (Maria THEODOROPOULOU) Μαρία 
Published: February 2018

Από σωστικές ανασκαφές στον πολεοδομικό ιστό της Πάτρας προέρχονται λύχνοι της πρωτοβυζαντινής περιόδου, που με βάση την τυπολογία και το θεματολόγιοτου διακόσμου εντάσσονται σε δύο γενικές κατηγορίες: αττικού και βορειοαφρικανικού τύπου. Οι λύχνοι αυτοί αποτελούν τόσο προϊόντα εισαγωγής από εργαστήρια κεραμικής της Κορίνθου, ως επακόλουθο των στενών εμπορικών σχέσεων με την πρωτεύουσα της επαρχίας Αχαΐας, όσο και προϊόντα πιθανότατατοπικών εργαστηρίων. Τα δείγματα που δύνανται να προσγραφούν στην τοπική παραγωγή, σε συνδυασμό με τις μήτρες τύπου Broneer XXVIII και XXXI πουβρέθηκαν σε εργαστηριακούς χώρους, δηλώνουν ότι κατά την εξεταζόμενη περίοδο αναπτύχθηκε στην Πάτρα μια τοπική παραγωγή λύχνων.