bluuebunny/crossref_metadata_2025_split huggingface dataset:
An AI Approach to Noise Prediction
Authors: Brown A.G.P. , Coenen F.P. , Shave M.J. , Knight M.W. 
Published: January 2017

The goal of the work described here is to produce a computationally efficient technique, with output of data that can be easily visualised, for problems involving noise prediction. An AI (Artificial Intelligence) approach is adopted. The particular techniques being applied as a part of the approach here involves, firstly, defining the geometry of the volume that we are interested in (the Geographical Space) and then later elements within that space such as objects and constraints. This is the aspect of the work which is particularly interesting since we use a technique which effectively linearises three dimensional space. The result is a significant reduction in computational requirements and a consequent increase in speed and efficiency of analysis. The technique used here for spatial representation is termed Tesseral Addressing. This technique can be combined with that for performing analysis (more correctly reasoning) within the Geographical Space. The application of the combined techniques is illustrated in the form of an analysis of a potential noise pollution problem at a residential building.
Predictors of response to first-line immunosuppressive therapy in neuromyelitis optica spectrum disorders
Authors: Kim Su-Hyun , Hyun Jae-Won , Joung AeRan , Park Eun Young , Joo Jungnam , Kim Ho Jin 
Published: January 2017

Background: Azathioprine (AZA) and mycophenolate mofetil (MMF) are the most commonly used first-line therapies for patients with neuromyelitis optica spectrum disorders (NMOSD). However, some patients experience a relapse following AZA or MMF treatment. Objectives: To identify factors that predict a response to AZA or MMF in NMOSD. Methods: We retrospectively evaluated medical records from 116 patients who were initially treated with AZA or MMF for at least 6 months. Poor response was defined as ⩾2 relapses or ⩾1 severe relapse. Results: Among the 116 patients, 40 (34%) were classified as poor responders. Logistic regression analyses revealed that a poor response was independently associated with a pre-treatment history of a severe attack ( p < 0.001) and a younger age at disease onset ( p = 0.022). Among the 40 patients with a poor response, 29 (73%) switched to rituximab, and only 3 (10%) had a poor response to rituximab. Conclusion: Patients with a pre-treatment history of a severe attack and a younger age of onset exhibited an increased risk of a poor response to AZA or MMF therapy. Identifying patients who are unlikely to respond to AZA or MMF therapy may allow for treatment with more potent therapies that improve treatment outcomes.
The effects of telehealth use for post-acute rehabilitation patient outcomes
Authors: Hicks Stephanie A , Cimarolli Verena R 
Published: January 2017

Introduction Previous research has shown that home telehealth services can reduce hospitalisations and emergency department visits and improve clinical outcomes among older adults with chronic conditions. However, there is a lack of research on the impact of telehealth (TH) use on patient outcomes in post-acute rehabilitation settings. The current study examined the effects of TH for post-acute rehabilitation patient outcomes (i.e. discharge setting and change in functional independence) when controlling for other factors (e.g. cognitive functioning). Methods For this retrospective study, electronic medical records (EMRs) of 294 patients who were discharged from a post-acute rehabilitation unit at a skilled nursing facility were reviewed. Only patients with an admitting condition of a circulatory disease based on ICD-9 classification were included. Main EMR data extracted included use of TH, cognitive functioning, admission and discharge functional independence, and discharge setting (returning home vs. returning to acute care/re-hospitalisation). Results Results from a regression analysis showed that although TH use was unrelated to post-acute rehabilitation care transition, it was significantly related to change in functional independence. Patients who used TH during their stay had significantly more improvement in functional independence from admission to discharge when compared to those who did not use TH. Discussion Findings indicate that TH use during post-acute rehabilitation has the potential to improve patient physical functioning.
Intraoperative Frozen Section for Margin Assessment in Breast Conserving Surgery
Authors: Dener C. , Inan A. , Sen M. , Demirci S. 
Published: January 2017

Background and Aims: When excisional biopsy or lumpectomy is performed without margin assessment in early breast cancer, further surgery are required if positive margins exist. We evaluated the role of the intraoperative frozen section in breast conserving surgery (BCS). Clinicopathologic factors associated with re-excision were searched. Material and Methods: 190 tumors in 186 patients with early invasive breast cancer treated by BCS. Breast tumor was excised with 2 cm macroscopic margin, and microscopic margins examined by intraoperative frozen section. Results: After frozen section, 160 cases had negative margins (no re-excision), but 30 patients (16%) underwent re-excision because of close/positive margins. Negative margins were obtained in 24 patients but six patients underwent mastectomy due to persistent involved margins. Local recurrence was 2.1% and systemic recurrence was 2.6% with mean 62 months follow-up. Tumor type, tumor size, extranodal extension and extensive intraductal component were significant predictors of re-excision by multivariate analysis. Re-excision procedures haven't an impact on local recurrence. Conclusions: Intraoperative frozen section is an effective procedure in reducing the need of second operation. We have observed lower recurrence rates than other studies because of our 2 cm macroscopic margin width and > 2 mm microscopic negative margin which obtained by intraoperative frozen section.
Virtual Reality Laparoscopic Simulator as an Aid in Surgical Resident Education: Two Years' Experience
Authors: Kössi J. , Luostarinen M. 
Published: January 2017

Background and Aims: Virtual reality (VR) laparoscopic simulator training has been shown to augment the learning of skills needed in real laparoscopic operations. We report here our two-year experience of using a VR simulator in the training of surgical residents. Methods: A VR laparoscopic simulator was purchased for Päijät-Häme Central Hospital at the end of November 2005. From 1 December 2005 onwards surgical residents in our hospital were encouraged to voluntarily practise with the VR simulator. After the VR simulator had been in use for two years all the data stored in the simulator's computer memory was collected and analysed. Results: In this two-year period a total of 79 persons practised with the simulator. The total number of performed tasks stored in the computer was 2,090. The training activity varied greatly between residents (6–171 tasks). The performance in simulator tasks differentiated between residents and GI surgeons. The learning curve of the residents in basic tasks was steep but their performance failed to reach the level of experienced laparoscopic surgeons in most tasks. Conclusions: The VR simulator was well used. Practising with a VR simulator on a voluntary basis can result in inadequate training. The VR laparoscopic simulator differentiates between subjects with different laparoscopic skills and shows good construct validity.
Thromboprophylaxis following Surgery for Colorectal Cancer — Is it Worthwhile after Hospital Discharge?
Authors: Varpe P. , Huhtinen H. , Rantala A. , Grönroos J. 
Published: January 2017

Background: The efficacy of low-molecular-weight heparin (LMWH) in preventing venous thromboembolism (VTE) after surgery for colorectal cancer is well documented, but the optimal duration of postoperative thromboprophylaxis is not known. The aim of this retrospective study was to assess the occurrence of symptomatic VTE after surgery for colorectal cancer in patients in whom LMWH was continued only until hospital discharge. Methods: During 2003–2006 a total of 494 patients underwent abdominal surgery for colorectal cancer at our institution. Enoxaparin (Klexane® 40mg s.c.) prophylaxis was started 12 hours before surgery and continued once a day until hospital discharge. The median duration of thromboprophylaxis was 11 days. The follow-up data were collected retrospectively from electronic archives and analyzed up to three months after the operation. Results: Only three (0.6%) symptomatic VTEs occurred during the follow-up period. One patient presented with pulmonary embolism, while the remaining two had proximal deep-vein thrombosis. The 30-day-mortality was 1.6%. None of the deaths were obviously associated with VTE. Conclusion: LMWH given for a median of 11 days until hospital discharge seems to provide sufficient thromboprophylaxis after surgery for colorectal cancer combined with the use of graded compression stockings and early mobilization.
Laparoscopic Liver Surgery: New Frontiers
Authors: Edwin B. , Nordin A. , Kazaryan A. M. 
Published: January 2017

Laparoscopic liver resection (LHR) has shown classical advantages of minimally invasive surgery over open counterpart. In spite of introduction in early 1990's only few centres worldwide adapted LHR to routine practice. It was due to considerable technical challenges and uncertainty about oncologic outcomes. Surgical instrumentation and accumulation of surgical experience has largely enabled to solve many technical considerations. Intraoperative navigation options have also been improved. Consequently indications have been drastically expanded nearly reaching criteria equal to open liver resection in expert centres. Recent studies have verified oncologic integrity of LHR. However, mastering of LHR is still a quite demanding task limiting expansion of this patient friendly technique. This emphasizes the necessity of systematic training for laparoscopic liver surgery. This article reviews the state of the art of laparoscopic liver surgery lightening burning issues of research and clinical practice.
Association of GWAS Top Genes With Late-Onset Alzheimer’s Disease in Colombian Population
Authors: Moreno Diana Jennifer , Ruiz Susana , Ríos Ángela , Lopera Francisco , Ostos Henry , Via Marc , Bedoya Gabriel 
Published: January 2017

Objective: The association of variants in CLU, CR1, PICALM, BIN1, ABCA7, and CD33 genes with late-onset Alzheimer’s disease (LOAD) was evaluated and confirmed through genome-wide association study. However, it is unknown whether these associations can be replicated in admixed populations. Methods: The association of 14 single-nucleotide polymorphisms in those genes was evaluated in 280 LOAD cases and 357 controls from the Colombian population. Results: In a multivariate analysis using age, gender, APOE∊4 status, and admixture covariates, significant associations were obtained ( P < .05) for variants in BIN1 (rs744373, odds ratio [OR]: 1.42), CLU (rs11136000, OR: 0.66), PICALM (rs541458, OR: 0.69), ABCA7 (rs3764650, OR: 1.7), and CD33 (rs3865444, OR: 1.12). Likewise, a significant interaction effect was observed between CLU and CR1 variants with APOE. Conclusion: This study replicated the associations previously reported in populations of European ancestry and shows that APOE variants have a regulatory role on the effect that variants in other loci have on LOAD, reflecting the importance of gene–gene interactions in the etiology of neurodegenerative diseases.
Thoracic Disc Herniation Presenting with Transient Anterior Spinal Artery Syndrome
Authors: Guest J.D. , Griesdale D.E. , Marotta T. 
Published: January 2017

This report is a clinical and radiologic correlation of anterior spinal arterial distribution ischemia with a thoracic disc herniation affecting the artery of Adamkiewicz. We could only find one other similar reported case. A 38-year-old woman developed sudden onset of severe back pain and radiculopathy, followed by rapidly evolving paraparesis. The neurological examination was consistent with a deficit caused by anterior spinal artery ischemia. MRI revealed T2 signal change in the thoracolumbar spinal cord and a laterally placed, non-calcified disc herniation. Selective spinal angiography performed 30 hours after onset revealed displacement of the left T9 radicular feeding artery by the disc herniation; at this time the artery was patent. The patient experienced some resolution of symptoms within the first 24 hours and was managed conservatively and made a significant recovery within two weeks. Appropriately located thoracic disc herniations can disturb the blood supply to the thoracolumbar spinal cord.
Doubled Stenting for Effective Occlusion of a Dissecting Carotid Artery Aneurysm
Authors: Benndorf G. , Wellnhofer E. , Schneider G.H. 
Published: January 2017

Endovascular stent placement for treatment of symptomatic pseudoaneurysms in extracranial carotid arteries proved safe and effective. We aimed at increasing the efficacy of stenting for treatment of an internal carotid artery (ICA) dissecting aneurysm by reducing the stent porosity through placement of oversized overlapping stents. A 55-year-old woman presented with right sided hemiplegia and aphasia. CT revealed an infarction in the left hemisphere, and cerebral angiography showed an extracranial dissection of the left ICA with a 1.0 × 2.0 cm pseudoaneurysm at the C1-level. Two oversized self-expandable stents (8/30, 8/40 Wallstent) were placed, bridging the dissected segment and overlapping at the level of the aneurysmal neck. Immediate control angiography showed remarkably reduced filling of the pseudoaneurysm. Intravascular flow assessment depicted a significant reduction of intraaneurysmal flow (31/0 cm/s). Follow-up arteriograms performed after six days and nine months confirmed complete disappearance of the pseudoaneurysm and a patent vessel lumen. Reduced stent porosity causes significant haemodynamic changes inside the aneurysmal sac and accelerates intraaneurysmal thrombosis. Deployment of oversized and overlapping stents may be helpful in achieving rapid complete occlusion and avoiding additional coil packing.
Review of the Mechanism of Action for Supartz FX in Knee Osteoarthritis
Authors: Altman Roy D. , Dasa Vinod , Takeuchi Jun 
Published: January 2017

Objective Summarize the biologic effects of Supartz FX for knee osteoarthritis (OA), the first worldwide clinically approved intra-articular (IA) hyaluronic acid (HA) product. Design To determine the mechanism of action from preclinical and clinical studies, a literature search was conducted of Supartz FX using academic databases from 1987 to 2016. Articles on Supartz FX that deal with its mechanisms of action were extracted, categorized, and reviewed. Results Supartz FX has 2 potential mechanisms of action: (1) biomechanical: IA Supartz FX directly improves the viscoelasticity and lubrication of synovial fluid; (2) physiologic: IA Supartz FX penetrates synovium and cartilage tissues to reach HA receptors on the surface of synoviocytes and chondrocytes. In synovium, suppression of gene expression in inflammatory mediators results in improved endogenous HA production, improved properties of synovial fluid, and reduction in pain. In cartilage, suppression of gene expression of collagenases and aggrecanases suppresses cartilage degeneration. Conclusion The net results of basic and clinical studies is that IA Supartz FX provides a more favorable biomechanical and functional environment in the knee joint. Hence, it is not only a lubricant but is also physiologically active. These actions may help explain both short- and long-term improvement in pain and function often achieved from IA Supartz FX in knee OA.
Conforming with current regulation in Turkey regarding the freezing of oocytes: A case report of the first pregnancy in Turkey achieved through oocyte vitrification
Authors: Kahraman Semra , Ulker Kahraman , Pirkevi Çetinkaya Caroline , Kumtepe Colakoglu Yesim , Yelke Hakan K. , Yilanlioglu Cihangir 
Published: January 2017

Objectives: To present the first pregnancy achieved in Turkey with frozen–warmed oocytes in a case with previous nine unsuccessful assisted reproductive technology (ART) attempts. Methods: The clinical follow-up of a 33-year-old female applying to our ART centre after a long and complicated history of infertility is described. Results: In April 2013, the woman attempted our centre for her 10th ART trial. She informed us on oocyte pick-up (OPU) day that her husband had been hospitalized following a car crush in Albania and was unable to travel to our clinic to give a sperm sample. We were therefore placed in the position of having to make an emergency decision. OPU was done and seven oocytes were retrieved. Six metaphase II (MII) oocytes out of seven Cumulus Oocyte Complexes (COCs) were vitrified using the Kitazato Vitrification Cryotop Kit. Six months later, in November 2013, the patient applied for transfer. Two blastocysts were transferred and the ART trial resulted with a singleton pregnancy and the birth of a healthy new-born at term via cesarean section. Conclusion: Regulation Codes on Assisted Reproductive Procedures and Assisted Reproductive Technology Centres, published in the Official Gazette of the Republic of Turkey, on 6 March 2010 forbade the freezing of gonad cells and tissues except when essential for medical reasons and stated that this would be specified later. However, the Regulation Codes published in the Official Gazette of the Republic of Turkey, on 30 September 2014 provided no further clarification. Unfortunately, the wording of the regulations did not specifically address this unexpected emergency situation. However, we saw our decision to cryopreserve the oocytes as a valid interpretation of the regulations, bearing in mind also the requirement that sperm and oocyte in the IVF process must be those of a married couple. Turkish medicolegal regulations should be revised to increase the chances of more women taking advantage of the procedure to preserve their reproductive autonomy and to give guidance on what action may be taken in emergency situations.
Laparoscopic cervicopexy: a novel minimally invasive fertility conservative procedure for stages III and IV uterine prolapse – case series
Authors: El-saman Ali M , Abbas Ahmed M , Amin Ahmed F , Fetih Ahmed N , Bahloul Mustafa , Salem Mohammed N , Salem Hossam T 
Published: January 2017

Objective: To evaluate the safety and efficacy of laparoscopic anterior abdominal wall cervicopexy (LAWC), a novel minimally invasive procedure for management of stages III and IV uterine prolapse. Subjects and methods: The procedure was performed on 39 cases with symptomatic uterine prolapse during the period from June 2012 to January 2015. The procedure was started with obliteration of the pouch of Douglas through the approximation of the uterosacral ligaments with non-absorbable suture. Then, the procedure completed through anchoring the supravaginal cervix to the anterior abdominal wall by two non-absorbable sutures taken in good bites in the dense stroma of the supravaginal cervix. Results: Uterine prolapse was diagnosed as stage III in 36 (92.3%) women and stage IV in three cases. The procedure was conducted safely without any intraoperative complications. At 3 month follow-up, there was a statistically significant reduction in the extent of prolapse at all pelvic organ prolapse quantification (POP-Q) points as compared with preoperative assessment ( p = 0.000). Only five cases (12.8%) were found to have stage I uterine prolapse on evaluation by the POP-Q system after one year. Conclusion: LAWC is a minimally invasive, simple, and highly effective procedure to treat marked uterine prolapse and seems not to compromise fertility.
Malignant transformation of a duodenal duplication cyst in a cat
Authors: Hobbs Joshua , Penninck Dominique , Lyons Jeremy 
Published: January 2017

Case summary A 15-year-old domestic shorthair cat presented for lethargy, vomiting and anorexia. Abdominal ultrasound showed a bi-lobed cystic duodenal mass. Based on ultrasonographic features, malignant transformation of a duodenal duplication cyst was suspected. A resection and anastomosis was performed. Histology of the mass was consistent with carcinoma and an intestinal mucosa was present along the inner surface of the mass, suggestive of a duplication cyst. The patient returned 3 months postsurgery with recurrence of clinical signs. Abdominal ultrasound showed a recurrent duodenal mass at the surgery site and body wall nodules. Fine-needle aspirates of these lesions showed epithelial neoplasia. Owing to the poor prognosis, the owners elected euthanasia. Relevance and novel information Malignant transformation of duplication cysts in cats is rare but can be detected on ultrasound. The described ultrasonographic features can aid in prioritization of malignant transformation of duplication cysts as a differential diagnosis.
Zidovudine- versus Tenofovir-Based Antiretroviral Therapy for the Initial Treatment of HIV Infection in the Ethnic Minority Region of Liangshan Prefecture, Sichuan Province, China
Authors: Cheung Cedric P. , Lai Wen Hong , Shuter Jonathan 
Published: January 2017

Background: Tenofovir (TDF)-based highly active antiretroviral therapy (HAART), as recommended by the World Health Organization guidelines for HIV-naive patients, has been limited in resource-constrained settings. The aim of this study was to evaluate the effectiveness of zidovudine-(ZDV) versus TDF-based HAART in the Yi minority region of Sichuan Province, China at a single HIV treatment center. Methods: The primary end point was the attainment of an HIV viral load <50 copies/mL. Secondary end points included change in CD4 level, adverse reactions, mortality, and sustained virologic suppression. Results: Of the 361 total participants, recipients of TDF-based HAART were more likely to achieve viral load <50 copies/mL (60% versus 46%, odds ratio [OR] = 1.7, P = .016) as well as sustained virologic suppression (61% versus 28%, OR = 3.4, P = .001). Tenofovir (adjusted odds ratio [ORadj] = 1.71, P = .025) and female sex (ORadj = 1.93, P = .003) were identified as independent predictors of achieving HIV viral load <50 copies/mL in the multivariate logistic regression analysis. Conclusion: Among Chinese Yi minority HIV-infected participants, TDF-based HAART was superior to ZDV-based HAART for initial treatment of HIV infection, suggesting TDF-based HAART should be the regimen of choice in China.