bluuebunny/crossref_metadata_2025_split huggingface dataset:
Observational demonstration of a high image rejection SIS mixer receiver using a new waveguide filter at 230 GHz
Authors: Hasegawa Yutaka , Asayama Shinichiro , Harada Ryohei , Tokuda Kazuki , Kimura Kimihiro , Ogawa Hideo , Onishi Toshikazu 
Published: September 2017

Abstract
A new sideband separation method was developed for use in millimeter-/submillimeter-band radio receivers using a novel waveguide frequency separation filter (FSF), which consists of two branch line hybrid couplers and two waveguide high-pass filters. The FSF was designed to allow the radio frequency (RF) signal to pass through to an output port when the frequency is higher than a certain value (225 GHz), and to reflect the RF signal back to another output port when the frequency is lower. The FSF is connected to two double sideband superconductor-insulator-superconductor (SIS) mixers, and an image rejection ratio (IRR) is determined by the FSF characteristics. With this new sideband separation method, we can achieve good and stable IRR without the balancing two SIS mixers such as is necessary for conventional sideband-separating SIS mixers. To demonstrate the applicability of this method, we designed and developed an FSF for simultaneous observations of the J = 2–1 rotational transition lines of three CO isotopes (12CO, 13CO, and C18O): the 12CO line is in the upper sideband and the others are in the lower sideband with an intermediate-frequency range of 4–8 GHz at the radio frequency of 220/230 GHz. This FSF was then installed in the receiver system of the 1.85 m radio telescope of Osaka Prefecture University, and was used during the 2014 observation season. The observation results indicate that the IRR of the proposed receiver is 25 dB or higher for the 12CO line, and no significant fluctuation larger than 1 dB in the IRR was observed throughout the season. These results demonstrate the practical utility of the FSF receiver for observations like extensive molecular cloud surveys in specified lines with a fixed frequency setting.
Acupuncture for the Treatment of Chronic Pain in the Military Population
Authors: Plunkett Anthony , Beltran Thomas , Haley Chelsey , Kurihara Connie , McCoart Amy , Chen Louis , Wilkinson Indy , Cohen Steven P. 
Published: September 2017

Objectives:
Acupuncture is characterized as an alternative or complementary medicine with a low complication rate and minimal side effects. There is a lack of robust evidence that shows acupuncture is an effective treatment for chronic pain. The purpose of this study was to determine which (if any) characteristics can predict successful response to acupuncture in chronic pain patients treated at military treatment facilities.

Methods:
Data from 222 patients who received treatment for a chronic pain condition were collected from 2 medical centers. The patients underwent at least 4 acupuncture treatments and had an average pain score of 4 or higher on a 0- to 10-point numerical rating scale or visual analog scale in the week before treatment initiation. A successful outcome was defined to be a 2-point or greater reduction on the numerical rating scale or visual analog scale 12 weeks postinitial treatment.

Results:
The overall treatment success rate was 42.3%. Multivariate logistic regression found a higher baseline pain rating and the use of stimulation needles to be associated with a positive outcome (odds ratio [OR]=1.26; 95% confidence interval [CI], 1.03-1.55; P=0.02 and OR=2.73; 95% CI, 1.39-5.32; P=0.03, respectively). Only the presence of one or more psychological comorbidities was found to be associated with treatment failure (OR=0.67; 95% CI, 0.49-0.92; P=0.01).

Discussion:
The use of electrical stimulation and higher baseline pain score were associated with a positive treatment outcome, while the presence of a psychological comorbidity diminished the likelihood of treatment success. Practitioners should consider using electrical stimulation more frequently, and addressing psychopathology before or concurrent to treatment, when initiating acupuncture.
Effects on Pulmonary Vascular Mechanics of Two Different Lung-Protective Ventilation Strategies in an Experimental Model of Acute Respiratory Distress Syndrome
Authors: Santos Arnoldo , Gomez-Peñalver Eva , Monge-Garcia M. Ignacio , Retamal Jaime , Borges João Batista , Tusman Gerardo , Hedenstierna Goran , Larsson Anders , Suarez-Sipmann Fernando 
Published: September 2017

Objectives:
To compare the effects of two lung-protective ventilation strategies on pulmonary vascular mechanics in early acute respiratory distress syndrome.

Design:
Experimental study.

Setting:
University animal research laboratory.

Subjects:
Twelve pigs (30.8 ± 2.5 kg).

Interventions:
Acute respiratory distress syndrome was induced by repeated lung lavages and injurious mechanical ventilation. Thereafter, animals were randomized to 4 hours ventilation according to the Acute Respiratory Distress Syndrome Network protocol or to an open lung approach strategy. Pressure and flow sensors placed at the pulmonary artery trunk allowed continuous assessment of pulmonary artery resistance, effective elastance, compliance, and reflected pressure waves. Respiratory mechanics and gas exchange data were collected.

Measurements and Main Results:
Acute respiratory distress syndrome led to pulmonary vascular mechanics deterioration. Four hours after randomization, pulmonary vascular mechanics was similar in Acute Respiratory Distress Syndrome Network and open lung approach: resistance (578 ± 252 vs 626 ± 153 dyn.s/cm5; p = 0.714), effective elastance, (0.63 ± 0.22 vs 0.58 ± 0.17 mm Hg/mL; p = 0.710), compliance (1.19 ± 0.8 vs 1.50 ± 0.27 mL/mm Hg; p = 0.437), and reflection index (0.36 ± 0.04 vs 0.34 ± 0.09; p = 0.680). Open lung approach as compared to Acute Respiratory Distress Syndrome Network was associated with improved dynamic respiratory compliance (17.3 ± 2.6 vs 10.5 ± 1.3 mL/cm H2O; p < 0.001), driving pressure (9.6 ± 1.3 vs 19.3 ± 2.7 cm H2O; p < 0.001), and venous admixture (0.05 ± 0.01 vs 0.22 ± 0.03, p < 0.001) and lower mean pulmonary artery pressure (26 ± 3 vs 34 ± 7 mm Hg; p = 0.045) despite of using a higher positive end-expiratory pressure (17.4 ± 0.7 vs 9.5 ± 2.4 cm H2O; p < 0.001). Cardiac index, however, was lower in open lung approach (1.42 ± 0.16 vs 2.27 ± 0.48 L/min; p = 0.005).

Conclusions:
In this experimental model, Acute Respiratory Distress Syndrome Network and open lung approach affected pulmonary vascular mechanics similarly. The use of higher positive end-expiratory pressures in the open lung approach strategy did not worsen pulmonary vascular mechanics, improved lung mechanics, and gas exchange but at the expense of a lower cardiac index.
Every‐other‐day Dosing of Oral Viscous Budesonide Is not Effective in the Management of Eosinophlic Esophagitis
Authors: Rubinstein Eitan , Hait Elizabeth E. , Mitchell Paul D. , Lee John J. 
Published: September 2017

ABSTRACTBackground:Eosinophilic esophagitis (EoE) is a clinicopathologic disorder characterized histologically by esophageal eosinophilia. Oral viscous budesonide (OVB) is an effective treatment with remission rates reported between 55% and 87%; however, topical corticosteroids are associated with increased risk of candidal esophagitis and adrenal suppression. Attempts to decrease the daily dose of topical steroids have resulted in disease relapse. The objective of this study was to determine whether or not reducing the frequency of OVB administration would be effective in controlling esophageal eosinophilia in children and adolescents.Methods:Data were obtained by retrospective chart review of patients at Boston Children's Hospital diagnosed with EoE, based on endoscopic findings of >15 eosinophils per high power field (eos/HPF) on esophageal biopsies while on acid blockade. Patients with histologic evidence of response (<15 eos/HPF) while on daily OVB had been offered the option of maintenance therapy based on a Monday‐Wednesday‐Friday (MWF) dosing regimen. Changes in peak esophageal eosinophil counts over time were examined.Results:Eight male patients ages 5 to 18 years attained clinical response while receiving daily OVB and were subsequently maintained on a MWF OVB dosing regimen for 3 to 7 months. All 8 patients showed an increase in peak esophageal eosinophils, with 7 of 8 (88%) experiencing disease relapse. In fact, the distribution of peak esophageal eosinophils after MWF dosing was not statistically different from peak levels at diagnosis (P = 0.95).Conclusions:An MWF dosing regimen of OVB was not effective at maintaining histologic response in children and adolescents with EoE. Larger prospective studies are warranted to confirm these results.
Prospective Study of Gastrointestinal Symptoms in School Children of South America
Authors: Saps Miguel , Velasco‐Benitez Carlos A. , Blom Puck J.J. , Benninga Marc A. , Nichols‐Vinueza Diana X. 
Published: September 2017

ABSTRACTObjectives:The aim of the study was to establish the prevalence of abdominal pain (AP) in school children in Pasto (Colombia) and determine the effect of AP on their daily activities; and compare the prevalence of AP and other gastrointestinal symptoms between school children from Pasto and Chicago.Methods:Fourth‐ and fifth‐grade students from a public school and a private school in Colombia were invited to participate in a prospective study using the same methods and questionnaires (Spanish version) as a previous study conducted in Chicago schools. Children completed weekly confidential surveys for 8 consecutive weeks.Results:A total of 332 children participated in the study (40% girls, mean age 9.97 years, median 10, range 8–12 years): public school (288), private school (44). A total of 2425 surveys were analyzed. Out of 2656 possible weekly surveys (332 children × 8 weeks), 91.3% were completed. Overall weekly prevalence of gastrointestinal symptoms: AP (39%), nausea (29.5%), constipation (14%), diarrhea (10.5%), vomiting (9%). Children with AP reported interference with activities: gym (21.9%), school (17.3%), difficulty sleeping (13.7%), and social activities (12.6%). Out of all children, 8.4% sought medical attention for AP during the study period.Conclusions:Gastrointestinal symptoms are common in school‐aged children in Colombia and interfere with both daily activities and school attendance. The prevalence of AP, diarrhea, and vomiting found in the present study was similar to published prevalence of American children using similar methods.
Ethical Considerations on Disclosure When Medical Error Is Discovered During Medicolegal Death Investigation
Authors: Wolf Dwayne A. , Drake Stacy A. , Snow Francine K. 
Published: September 2017

Abstract
In the course of fulfilling their statutory role, physicians performing medicolegal investigations may recognize clinical colleagues' medical errors. If the error is found to have led directly to the patient's death (missed diagnosis or incorrect diagnosis, for example), then the forensic pathologist has a professional responsibility to include the information in the autopsy report and make sure that the family is appropriately informed. When the error is significant but did not lead directly to the patient's demise, ethical questions may arise regarding the obligations of the medical examiner to disclose the error to the clinicians or to the family. This case depicts the discovery of medical error likely unrelated to the cause of death and describes one possible ethical approach to disclosure derived from an ethical reasoning model addressing ethical principles of respect for persons/autonomy, beneficence, nonmaleficence, and justice.
68Ga-DOTA-TATE PET/CT for Molecular Imaging of Somatostatin Receptor Expression in Metastasizing Epithelioid Hemangioendothelioma
Authors: Derlin Thorsten , Hueper Katja , Soudah Bisharah 
Published: September 2017

Abstract
Epithelioid hemangioendothelioma (EHE) is a rare tumor originating from vascular endothelial or pre-endothelial cells. It has the potential to metastasize. We present the case of a 51-year-old woman with metastasizing EHE who underwent both 18F-FDG and 68Ga-DOTA-TATE PET/CT for staging of disease and for evaluation of targeted radionuclide therapy potential. On 68Ga-DOTA-TATE PET scans, intense tracer accumulation was observed in metastases. Besides the increased glucose metabolism in EHE, this case highlights the potential of 68Ga-DOTA-TATE PET/CT for restaging of EHE and the option of targeted radionuclide therapy in this entity.
Concomitant 177Lu-DOTATATE and Capecitabine Therapy in Patients With Advanced Neuroendocrine Tumors
Authors: Ballal Sanjana , Yadav Madhav P. , Damle Nishikant A. , Sahoo Ranjit K. , Bal Chandrasekhar 
Published: September 2017

Purpose
The purpose of this study was to evaluate the outcome, toxicity, survival, and quality of life in patients with advanced neuroendocrine tumors.

Methods
One hundred sixty-seven patients were enrolled in the study. All patients underwent baseline 68Ga-DOTANOC PET/CT scans. 177Lu-DOTATATE therapy was administered quarterly along with oral capecitabine therapy in group 1 patients (n = 88), whereas group 2 patients (n = 79) were treated only with 177Lu-DOTATATE. Hematologic, kidney function, liver function tests and chromogranin A levels were recorded before and after therapy at 2-week, 4-week, and 3-month intervals. Biochemical and morphological responses were assessed with the trend in chromogranin A levels and Response Evaluation Criteria in Solid Tumors 1.1 criteria, respectively.

Results
There was no significant difference in the hemoglobin levels after 177Lu-DOTATATE therapy (P = 0.4892). In most patients, there was a decrease in the platelet levels; however, all the patients had platelet counts greater than 100,000/μL with no platelet toxicity. There was no toxicity related to leukocytes. Two patients showed renal insufficiencies. No hepatotoxicity was observed in any of the patients. According to Response Evaluation Criteria in Solid Tumors 1.1 criteria, in group 1 patients, the response was partial response in 34% of the patients, stable disease in 50.2%, and progressive disease in 6.8% versus partial response in 6.3%, stable disease in 60.9%, and progressive disease in 26.5% among group 2 patients. The median overall survival (OS) and progression-free survival (PFS) was not reached in group 1 patients. The median OS and PFS in group 2 patients were 48 months. Ki-67 tumor proliferation index was significantly associated with increased risk of disease progression.

Conclusions
Addition of capecitabine therapy with 177Lu-DOTATATE therapy lengthens the OS and PFS. Patients with aggressive disease may benefit from this synergetic therapeutic approach.
Quality and Safety in Health Care, Part XXXII
Authors: Harolds Jay A. 
Published: September 2017

Abstract
Mortality 12 months after a transcatheter aortic valve replacement (TAVR) is partly due to a number of reasons in addition to the usual preprocedural medical patient risk factors. In patients who need a permanent pacemaker placed after the procedure, the mortality risk goes up. The death rate following a TAVR varies considerably at different institutions, and the past death rate of TAVR patients at an institution is predictive of the mortality rate of new patients having this procedure. In addition, the quality of life of the individual before the procedure is predictive of the 12-month mortality outcome after the TAVR is done.
Diagnostic Challenge of Staging Metastatic Bone Disease in the Morbidly Obese Patients
Authors: Usmani Sharjeel , Marafi Fahad , Ahmed Najeeb , Esmail Abdulredha , Al Kandari Fareeda , Van den Wyngaert Tim 
Published: September 2017

Purpose
Optimizing diagnostic imaging may be challenging in obese patients. The quality of conventional bone scintigraphy can be poor in the morbidly obese due to a combination of factors including high background soft tissue activity. In comparison, sodium fluoride (18F-NaF PET-CT) has a better target-to-background ratio attributed to rapid single-pass extraction and fast clearance from the soft tissues. The aim of the present study is to assess the diagnostic efficacy of 18F-NaF PET-CT in the evaluation of bone metastases in obese cancer patients.

Patients and Methods
Two hundred twelve morbidly obese patients (body mass index, 45 ± 5.1 kg/m2; mean age, 57 years; range, 32–81 years) with body mass index greater than 40 kg/m2 referred for NaF PET-CT for osseous staging of malignancy were retrospectively analyzed. All patients underwent PET-CT scan by injecting 2.2 MBq/kg (0.06 mCi/kg) of 18F-NaF.

Results

18F-NaF PET-CT was definitely benign in 145, possibly benign in 3, equivocal in 4, possibly malignant in 13, and definitely malignant in 47 patients. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 18F-NaF PET-CT were 93.1%, 96.1%, 90%, 97.3%, and 95.2%, respectively (95% confidence interval).

Conclusions
The results of the present study indicate that 18F-NaF PET-CT retains its high diagnostic accuracy in morbidly obese patients and, by inference, can be a preferred functional modality in these patients.
Detection of Non–FDG-Avid Residual Sinonasal Malignant Melanoma in the Skull Base With 11C-Choline PET and Contrast-Enhanced MRI
Authors: Qin Chunxia , Hu Fan , Arnous Maher Mohamad Rajab , Lan Xiaoli 
Published: September 2017

Abstract
Primary sinonasal melanoma is a rare disease. We present a case of melanoma in sinuses without abnormal 18F-FDG activity anywhere in the scanned portion of the body. In further assessment, 11C-choline PET/CT revealed high activity in the paranasal sinuses, skull base, and adjacent brain, in agreement with the high signal on contrast-enhanced T1-weighted MRI scan, which suggested the residual tumor.
Mean Platelet Volume, Red Cell Distribution Width, and Neutrophil-to-Lymphocyte Ratio Before and After Surgery in Patients With Carotid Body Tumors
Authors: Bozan Nazim , Kocak Ömer Faruk , Dinc Mehmet Emre , Demir Canser Yilmaz , Turan Mahfuz , Kiroglu Ahmet Faruk 
Published: September 2017

Objective:
Carotid body tumors (CBTs) are rare hypervascular benign tumors that originate from the paraganglia at the carotid bifurcation. The red cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and mean platelet volume (MPV) may serve as markers in inflammatory, cardiovascular, and neoplastic diseases. However, their prognostic value in CBTs is unknown. The purpose of this study was to assess the leukocyte count, MPV, RDW, and NLR before and after surgery in patients with CBTs.

Methods:
This retrospective trial included data from 80 patients with CBTs and 65 age-matched healthy controls. The leukocyte, neutrophil, lymphocyte and platelet counts, RDW, and MPV were extracted and NLR was calculated from the complete blood count results of participants.

Results:
The leukocyte and neutrophil counts as well as RDW levels were significantly increased in patients with CBTs compared with healthy controls (P = 0.005, P = 0.003, and P = 0.026; respectively). Patients with CBTs had lower lymphocytes counts (P = 0.241) and higher NLRs (P = 0.054); however, the difference was statistically insignificant. Moreover, no statistically significant difference was detected between groups in terms of platelet counts and MPV levels. Furthermore, the leukocyte count, platelet numbers, MPV, RDW, and NLR levels in patients with CBTs were not statistically significant after surgery (all; P > 0.05).

Conclusion:
This is the first study that documents the increased RDW levels and leukocyte count in patients with CBTs. The combined use of RDW and the leukocyte count along with other clinical assessments can be used as a biomarker for CBTs. Further clinical trials with larger cases series are required to determine the actual predictive roles of these systemic biomarkers.
Dislocated Dental Prothesis Sitting at the Larynx in an Aphasic Patient: Potentially Fatal Situation
Authors: Türk Bilge , Ünsal Özlem , Kaya Kerem Sami , Coşkun Berna Uslu 
Published: September 2017

Introduction:
Foreign body in respiration tract is a life-threatening emergency and requires urgent treatment. The diagnosis and treatment requires awareness and suspicion of signs and symptoms of foreign body aspiration.

Case:
A unique case of total dental prothesis aspiration of a 44-year-old aphasic patient is presented. The prothesis is completely removed from the larynx.

Discussion:
Foreign-body aspiration is frequently suspected in children, it is rarely thought about in adults with subacute or chronic respiratory symptoms unless an evident history of an aspiration event is obtained. Facial trauma, dental procedures, central nervous system dysfunction due to stroke, mental retardation, metabolic encephalopathy, seizures, and alcoholism are precipitating factors in adults. Careful clinical history and physical examination is mandatory. Foreign bodies located in the laryngeal region are almost always treated with surgery.

Conclusion:
Loose dentures must be avoided especially in mental retarded, aphasic patients, and patients with central nervous system dysfunction.
Postoperative Orthognathic Surgery Edema Assessment With and Without Manual Lymphatic Drainage
Authors: Yaedú Renato Yassutaka Faria , Mello Marina de Almeida Barbosa , Tucunduva Rosana Adami , da Silveira Juliana Specian Zabotini , Takahashi Marina Prado Monson Santana , Valente Ana Carolina Bonetti 
Published: September 2017

Objective:
To evaluate the effects of manual lymphatic drainage (MLD) on facial edema and pain in patients who underwent orthognathic surgery from patient and professional perspectives and clinical measures.

Methods:
It is a randomized double-blind clinical trial, where 30 patients who underwent bimaxillary orthognathic surgery were divided into 2 groups (treatment and placebo). One group (treatment) received MLD from 2nd postoperative day, besides cryotherapy and postoperative medications. The other group (placebo) received cryotherapy, medications, and manual superficial sliding movements as placebo. For edema evaluation, facial measurements with tape and photographs were used. To evaluate patients’ perception, visual analog scale for pain and edema was used. In statistical analysis, quantitative data were analyzed using Student t test for normally distributed variables and Mann–Whitney test for non-normal to find differences between groups; 5% significance level was adopted.

Results:
No difference was found between groups in the amount of maximum developed edema (P = 0.290) nor on what day the edema peak occurred (P = 0.091). However, it was found that treatment group showed faster and greater regression of swelling compared with placebo (P < 0.001). Manual lymphatic drainage was not effective in relieving pain in these patients and nor in edema perception (P = 0.784 and P = 0.946, respectively).

Conclusion:
Manual lymphatic drainage was effective in reducing facial measurements in orthognathic surgery postoperatory. When considering patient's pain and swelling perception, no difference was found between groups.
Protection of the Temporomandibular Joint During Syndromic Mandibular Distraction With a Novel Condylar Offloading Device
Authors: Mehta Sagar T. , Moores Neal , Yamashiro Duane , Siddiqi Faizi , Gociman Barbu 
Published: September 2017

Abstract
Mandibular distraction for severe micrognathia in syndromic patients often leads to temporomandibular joint (TMJ) ankylosis, which requires further interventions to regain joint motion. The increased incidence of postdistraction ankylosis is likely related to increased prevalence of preoperative joint pathology in syndromic micrognathic patients. Previous studies have demonstrated that offloading the pressure on the condyle during the distraction process can prevent such TMJ pathology. In this article, the authors describe a successful new method for offloading the condyle to prevent postdistraction ankylosis using an external TMJ offloading device.