bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Should We Treat Hospital-Acquired and Ventilator-Associated Pneumonia Caused by Extended-Spectrum β-Lactamase–Producing Enterobacteriaceae?
Authors: Timsit Jean-François , Pilmis Benoit , Zahar Jean-Ralph 
Published: June 2017

AbstractHospital-acquired and ventilator-associated pneumonia (HAP/VAP) due to extended-spectrum β-lactamase–producing Enterobacteriaceae (ESBL-PE) represent a growing problem. Indeed, ESBL-PE is endemic in many countries, and 5 to 25% of intensive care unit (ICU) patients are ESBL-PE carrier on ICU admission. ESBL-PE HAP/VAP is associated with a higher mortality than HAP/VAP due to susceptible Enterobacteriaceae because the resistance profile decreases the adequacy rate of empiric therapy. ESBL-PE should be considered in the empirical treatment in case of the high burden of ESBL-PE in the unit, in the case of previous ESBL-PE colonization, when the HAP/VAP occurs late, and in patients with shock. A negative active systematic surveillance culture on rectal swab reduced the risk of ESBL-PE VAP to less than 1%. Rapid diagnostic tests are now able to confirm the presence of ESBL-PE in VAP within 24 hours; new molecular methods will provide results within few hours.Adequate treatment usually required carbapenems. The alternative β-lactams such as β-lactams/β-lactamases inhibitor combinations could be proposed as a step-down therapy according to the antibiotic susceptibility result. Optimization of pharmacokinetics requires high dosage and continuous or prolonged infusions for β-lactams. When the patient is stabilized, a therapy of duration 7 to 8 days is recommended.
Racial Disparities in Delivery Gestational Age among Twin Pregnancies
Authors: Vladutiu Catherine , Manuck Tracy , Grant Jacqueline 
Published: June 2017

Objective This study aims to estimate the association between maternal race and delivery gestational age among women with twin gestations.
Study Design Secondary analysis of a prospective, randomized control trial of 17-α hydroxyprogesterone caproate versus placebo for preterm birth (PTB) prevention in twin gestations. Non-Hispanic (NH) black and whites were included. Demographic and antenatal characteristics were compared. The primary outcome was delivery gestational age. Secondary outcomes included a composite of major neonatal morbidity. Kaplan–Meier curves estimated survival probabilities for delivery gestational age by race. Cox proportional hazards models estimated hazard ratios (HR) and 95% confidence intervals (CI).
Results A total of 535 women with twin gestations were included; 150 were NH black. NH blacks delivered earlier than NH whites (33.6 ± 4.8 weeks vs. 35.1 ± 3.5 weeks, p < 0.001). Differences in delivery gestational age between NH blacks and whites were consistent across gestation. In adjusted analyses, NH black race (HR: 1.24, 95% CI: 1.02–1.51), prior PTB (HR: 1.59, 95% CI: 1.15–2.19), and cerclage (HR: 3.90, 95% CI: 2.00–7.60) were associated with an increased risk of earlier delivery. Major neonatal morbidity was higher for NH blacks compared with NH whites (12.7 vs. 7.0%, p = 0.036).
Conclusion NH blacks with twin gestations have an increased risk of early delivery and neonatal morbidity compared with NH whites.
Homöopathie in der brandenburgischen psychiatrischen Klinik: Zwei Fälle von Kalium bromatum und Ferrum carbonicum
Authors: Bitter Von Andrea , Geisler Julia , Thiele Claudia 
Published: June 2017

ZusammenfassungDie homöopathische Herangehensweise bei Patienten einer psychiatrischen Klinik wird anhand von 2 Kasuistiken erläutert. Die Patienten besserten sich unter Kalium bromatum und
Ferrum carbonicum.
Lebensweise und Alzheimer
Authors: Nehls Michael 
Published: June 2017

ZusammenfassungAlzheimer ist eine Mangelkrankheit, verursacht durch Diskrepanzen zwischen unseren natürlichen Bedürfnissen und Folgen der heutigen
Lebensweise: Chronischer Stress, ungesunde Ernährung, Mangel an Mikronährstoffen, Tiefschlaf, Bewegung, sozialen Aktivitäten sowie
Verlust des Lebenssinns. Basierend auf einer Allgemeinen Theorie der Alzheimer-Entstehung (Unified Theory of Alzheimer‘s Disease,
UTAD) beginnt die Erkrankung mit der gestörten Neubildung von Nervenzellen (Neurogenese) im hippocampalen Zentrum für das
autobiografische Erinnern. Die mangelhafte adulte Neurogenese führt zunächst zu einem chronisch erhöhten Level an Stresshormonen,
kurz- bis mittelfristig zu Depression und letztendlich zu den für Alzheimer typischen neuropathologischen und kognitiven
Veränderungen. Durch gezieltes Beheben der individuellen Mängel (der kausalen Risikofaktoren) im Rahmen einer systembiologischen
Intervention, lässt sich Alzheimer jedoch nicht nur vermeiden, im Frühstadium der Erkrankung ist der geistige Abbau sogar noch
umkehrbar.
International core curriculum for capsule endoscopy training courses
Authors: Fernandez-Urien Ignacio , Panter Simon , Carretero Cristina , Davison Carolyn , Dray Xavier , Fedorov Evgeny , Makins Richard , Mascarenhas Miguel , McAlindon Mark , McNamara Deirdre , Palmer Hansa , Rey Jean , Saurin Jean , Seitz Uwe , Spada Cristiano , Toth Ervin , Wiedbrauck Felix , Keuchel Martin 
Published: June 2017

AbstractCapsule endoscopy (CE) has become a first-line noninvasive tool for visualisation of the small bowel (SB) and is being increasingly used for investigation of the colon. The European Society of Gastrointestinal Endoscopy (ESGE) guidelines have specified requirements for the clinical applications of CE. However, there are no standardized recommendations yet for CE training courses in Europe. The following suggestions in this curriculum are based on the experience of European CE training courses directors. It is suggested that 12 hours be dedicated for either a small bowel capsule endoscopy (SBCE) or a colon capsule endoscopy (CCE) course with 4 hours for an introductory CCE course delivered in conjunction with SBCE courses. SBCE courses should include state-of-the-art lectures on indications, contraindications, complications, patient management and hardware and software use. Procedural issues require approximately 2 hours. For CCE courses 2.5 hours for theoretical lessons and 3.5 hours for procedural issued are considered appropriate. Hands-on training on reading and interpretation of CE cases using a personal computer (PC) for 1 or 2 delegates is recommended for both SBCE and CCE courses. A total of 6 hours hands-on session- time should be allocated. Cases in a SBCE course should cover SB bleeding, inflammatory bowel diseases (IBD), tumors and variants of normal and cases with various types of polyps covered in CCE courses. Standardization of the description of findings and generation of high-quality reports should be essential parts of the training. Courses should be followed by an assessment of traineesʼ skills in order to certify readers’ competency.
Bewegung und körperliche Aktivität im ambulanten Setting bei Demenzerkrankungen
Authors: Deimel Hubertus , Dexel Monika , Schreckling Sibylle 
Published: June 2017

ZusammenfassungMenschen mit Demenzerkrankungen werden oftmals im häuslichen Umfeld von Familienangehörigen betreut. Da pflegende Angehörige
umfassende Hilfe und Unterstützung bei dieser Aufgabe benötigen, spielen gemeindenahe Versorgungsangebote eine zunehmend
wichtigere Rolle. Hierbei finden primär nicht-pharmakologische Therapieansätze Anwendung. Sie sollen die verbliebenen
funktionellen und psychosozialen Fähigkeiten der Betroffenen möglichst lange erhalten oder ihren Abbau verlangsamen sowie
Entlastung für die pflegenden Angehörigen bieten. Bewegungsangebote können dazu beitragen, diese Ziele zu erreichen. Aufgrund der
heterogenen physischen, affektiven, kognitiven und psychosozialen Fähigkeiten von Menschen mit Demenz, ist es jedoch notwendig,
das Bewegungsangebot gut zu differenzieren und mit anderen Maßnahmen zu verknüpfen. Das lässt sich anhand der strukturellen
Rahmenbedingungen der „Arbeitsgemeinschaft für psychisch Kranke im Erftkreis e. V.“ sowie der angegliederten „Alzheimer
Gesellschaft Rhein-Erft-Kreis e. V.“ veranschaulichen. Als übergeordnetes Ziel der Maßnahmen gilt der Erhalt bzw. die Verbesserung
der Lebensqualität der betroffenen Teilnehmer sowie der pflegenden Angehörigen.
Privileg mit Tücken
Authors: Herz Mona 
Published: June 2017

SummaryLäuft uns der Schweiß, ist das meist eine gesunde Reaktion auf Überwärmung. Die dabei entstehende Verdunstungskälte kühlt den Körper. Bei Hyperhidrose schwitzt man auch außerhalb von körperlicher Bewegung und Aufenthalt in Wärme übermäßig. Neben der idiopathischen Hyperhidrose kann übermäßiges Schwitzen auf ernsthafte Erkrankungen wie Tumoren und hormonelle Störungen hinweisen.
Die Notwendigkeit der psychosozialen Begleitung von Eltern in der Neonatologie
Authors: Schäfer Nicole , Karutz Harald , Schenk Olaf 
Published: June 2017

Zusammenfassung
Hintergrund Erhebliche Fortschritte in der neonatologischen Medizin haben in den letzten Jahren zu einer Verringerung der Mortalitätsrate und zu einem Anstieg der Morbiditätsrate unter den zu früh- und risikogeborenen Kindern geführt. Häufig ist diese Entwicklung jedoch mit einer zunehmenden Belastung für die gesamte Familie, insbesondere für die Eltern, verbunden. Anhand einer umfangreichen Literaturarbeit wird daher die Notwendigkeit der psychosozialen Begleitung von Eltern in der Neonatologie herausgestellt.
Methodik In den Datenbanken Pubmed, Psyndex, CINAHl und medpilot wurde zunächst eine systematische Literaturrecherche durchgeführt. Um weitere relevante Publikationen zu finden, wurden außerdem die Referenzlisten der gefundenen Artikel überprüft. Eine anschließende Freitextsuche hatte die Ergänzung der Schlagwortsuche zum Ziel. Insgesamt konnten auf diese Weise 78 Veröffentlichungen aus den Jahren von 1975 bis 2015 in die Studie einbezogen werden.
Ergebnisse Die Bedeutung der psychosozialen Begleitung von Eltern in der Neonatologie lässt sich anhand der ausgewerteten Fachliteratur eindrucksvoll belegen. Allerdings fällt auf, dass die Notwendigkeit eines Assessments als Grundlage einer den individuellen Bedürfnissen der Familie entsprechenden Begleitung zwar bekannt ist, die Verwendung von validierten Screeninginstrumenten offenbar jedoch noch nicht zum Standard gehört. Ferner wird deutlich, dass der Bedarf an psychosozialer Unterstützung seitens der Eltern nicht allein vom medizinischen Risiko des Kindes abhängt.
Schlussfolgerungen Die vorliegenden Erkenntnisse implizieren insbesondere die Herausforderung, unter Berücksichtigung der in der Entwicklung befindlichen Eltern-Kind-Einheit, in einem Gesundheitssystem mit eingeschränkten Ressourcen und vor dem Hintergrund gesundheitsökonomischer Vorgaben, dennoch eine hoch individuelle Betreuung betroffener Familien möglich zu machen. Mitunter intuitiv ausgebildete Konzepte sollten in Zukunft weiter wissenschaftlich fundiert werden. Beiträge aus den Bereichen der Psychologie und Bindungsforschung sind dabei zu berücksichtigen.
Comprehensive toxicity and immunogenicity studies reveal minimal effects in mice following sustained dosing of extracellular vesicles derived from HEK293T cells
Authors: Zhu Xiaohua , Badawi Mohamed , Pomeroy Steven , Sutaria Dhruvitkumar S. , Xie Zhiliang , Baek Alice , Jiang Jinmai , Elgamal Ola A. , Mo Xiaokui , La Perle Krista , Chalmers Jeffrey , Schmittgen Thomas D. , Phelps Mitch A. 
Published: June 2017

ABSTRACTExtracellular vesicles (EVs) are under evaluation as therapeutics or as vehicles for drug delivery. Preclinical studies of EVs often use mice or other animal models to assess efficacy and disposition. However, as most EVs under evaluation are derived from human cells, they may elicit immune responses which may contribute to toxicities or enhanced EV clearance. Furthermore, EVs from different cell sources or EVs comprising various cargo may differ with respect to immunogenicity or toxicity. To assess EV‐induced immune response and toxicity, we dosed C57BL/6 mice with EVs intravenously and intraperitoneally for 3 weeks. EVs were harvested from wild type or engineered HEK293T cells which were modified to produce EVs loaded with miR‐199a‐3p and chimeric proteins. Blood was collected to assess hematology, blood chemistry, and immune markers. Spleen cells were immunophenotyped, and tissues were harvested for gross necropsy and histopathological examination. No signs of toxicity were observed, and minimal evidence of changes in immune markers were noted in mice dosed with engineered, but not with wild type EVs. This study provides a framework for assessment of immunogenicity and toxicity that will be required as EVs from varying cell sources are tested within numerous animal models and eventually in humans.
DNA base flipping analytical pipeline
Authors: Zhang Peng , Hastert Florian D. , Ludwig Anne K. , Breitwieser Kai , Hofstätter Maria , Cardoso M. Cristina 
Published: June 2017

AbstractDNA base modifications and mutations are observed in all genomes throughout the kingdoms of life. Proteins involved in their establishment and removal were shown to use a base flipping mechanism to access their substrates. To better understand how proteins flip DNA bases to modify or remove them, we optimized and developed a pipeline of methods to step-by-step detect the process starting with protein–DNA interaction, base flipping itself and the ensuing DNA base modification or excision. As methylcytosine is the best-studied DNA modification, here we focus on the process of writing, modifying and reading this DNA base. Using multicolor electrophoretic mobility shift assays, we show that the methylcytosine modifier Tet1 exhibits little DNA sequence specificity with only a slight preference for methylated CpG containing DNA. A combination of chloroacetaldehyde treatment and high-resolution melting temperature analysis allowed us to detect base flipping induced by the methylcytosine modifier Tet1 as well as the methylcytosine writer M.HpaII. Finally, we show that high-resolution melting temperature analysis can be used to detect the activity of glycosylases, methyltransferases and dioxigenases on DNA substrates. Taken together, this DNA base flipping analytical pipeline (BaFAP) provide a complete toolbox for the fast and sensitive analysis of proteins that bind, flip and modify or excise DNA bases.
China's flourishing synthetic organofluorine chemistry: innovations in the new millennium
Authors: Liu Qinghe , Ni Chuanfa , Hu Jinbo 
Published: June 2017

Abstract
The new millennium has witnessed the rapid development of synthetic organofluorine chemistry all over the world, and chemists in China have made significant contributions in this field. This review aims to provide a brief introduction to China's primary innovations from 2000 to early 2017, covering fluorination, fluoroalkylation, fluoromethylthiolation, fluoroolefination and polyfluoroarylation, as well as synthesis with fluorinated building blocks. Recent advances in the chemistry of difluorocarbene and the chemistry of carbon–fluorine bond activation are also discussed. As a conclusion, the review ends with some personal perspectives on the future development of China's synthetic organofluorine chemistry.
Wrist Arthroscopy in Children and Adolescent With Chronic Wrist Pain: Arthroscopic Findings Compared With MRI
Authors: Ramavath Ashok L. , Unnikrishnan P.N. , George Harvey L. , Sathyamoorthy Paramasivam , Bruce Colin E. 
Published: June 2017

Background:
Wrist arthroscopy is a dynamic diagnostic procedure and its indications are growing as a treatment modality in the adult population. The aim of the study was to retrospectively report our series of pediatric and adolescence with chronic wrist pain, with or without wrist instability who underwent wrist arthroscopy after failing at least 4 months of conservative management. Our secondary aim was to report the sensitivity and specificity of clinical examination and magnetic resonance imaging evaluation for various injury subgroups against the gold standard of the arthroscopic findings. Technical challenges, complications, and outcomes are also discussed.

Methods:
A retrospective review of the medical records of 32 pediatric and adolescent patients who underwent wrist arthroscopy was conducted. Preoperative clinical diagnosis, radiographic, and intraoperative findings including classifications of triangular fibrocartilage complex (TFCC) and interosseous ligaments were obtained. Patients were followed up to 1 year postoperatively and were discharged if symptom free.

Results:
Thirty-three wrist arthroscopies in 32 patients were performed from 1996 to 2004. There were 2 male and 30 female patients. At arthroscopy 16 wrists were found to have TFCC injuries, 11 wrists had scapholunate injuries, and 8 had lunotriquetral (LT) injuries. Clinical examination for diagnosis of TFCC injury was too sensitive and nonspecific; however, clinical diagnosis of scapholunate injury was sensitive and specific. LT injury was under diagnosed clinically. Magnetic resonance imaging was found to have a low sensitivity for diagnosis of LT injury but diagnosis of TFCC was sensitive and specific.

Conclusions:
The sex ratio of 2 males:30 females was startling. Nevertheless, this therapeutic level 3 study supports a thorough search for pathology in any patient with persistent wrist symptoms because pathology was identified in 32 of the 33 wrists at arthroscopy.

Level of Evidence:
Level III—Therapeutic.
Minimally invasive surgery in pelvic floor repair
Authors: Zwain Omar , Aoun Joelle , Eisenstein David 
Published: June 2017

Purpose of review
To review the use and efficacy of minimally invasive surgery in pelvic organ prolapse (POP) repair. This review summarizes surgical options for management of POP with special emphasis on minimally invasive surgical approach and discusses the recent experience and feasibility of integrating robot-assisted technology.

Recent findings
Minimally invasive approaches have equal efficacy and less morbidity than laparotomy for POP repair, particularly apical prolapse. Robotics may facilitate the rate of minimally invasive surgery for POP repair with greater cost and as yet no proven superiority for conventional laparoscopy.

Summary
Minimally invasive surgery is the preferred approach to POP repair. Conventional laparoscopic or robotic sacral colpopexy is recommended for apical defect and procidentia.
Fever and Pancytopenia in a Liver Transplant Recipient: Going Against the Rules of Occam's Razor
Authors: Lum Lionel Hon Wai , Chen Fei Wen , Jackett Louise , Strasser Simone I. , Davis Rebecca J. 
Published: June 2017

Abstract
The syndrome of fever and pancytopenia is not infrequently encountered postliver transplant, and a broad differential list of infectious and noninfectious aetiologies can be invoked. A transplant patient is susceptible to more than 1 opportunistic infection or disease process. We described the diagnostic conundrums in managing our patient who ran a complex protracted course postliver transplant. He was diagnosed to have both disseminated tuberculosis and graft-versus-host disease, a rare complication after solid organ transplantation.
RL-SKAT: An exact and efficient score test for heritability and set tests
Authors: Schweiger Regev , Weissbrod Omer , Rahmani Elior , Müller-Nurasyid Martina , Kunze Sonja , Gieger Christian , Waldenberger Melanie , Rosset Saharon , Halperin Eran 
Published: June 2017

AbstractTesting for the existence of variance components in linear mixed models is a fundamental task in many applicative fields. In statistical genetics, the score test has recently become instrumental in the task of testing an association between a set of genetic markers and a phenotype. With few markers, this amounts to set-based variance component tests, which attempt to increase power in association studies by aggregating weak individual effects. When the entire genome is considered, it allows testing for the heritability of a phenotype, defined as the proportion of phenotypic variance explained by genetics. In the popular score-based Sequence Kernel Association Test (SKAT) method, the assumed distribution of the score test statistic is uncalibrated in small samples, with a correction being computationally expensive. This may cause severe inflation or deflation of p-values, even when the null hypothesis is true. Here, we characterize the conditions under which this discrepancy holds, and show it may occur also in large real datasets, such as a dataset from the Wellcome Trust Case Control Consortium 2 (n=13,950) study, and in particular when the individuals in the sample are unrelated. In these cases the SKAT approximation tends to be highly over-conservative and therefore underpowered. To address this limitation, we suggest an efficient method to calculate exact p-values for the score test in the case of a single variance component and a continuous response vector, which can speed up the analysis by orders of magnitude. Our results enable fast and accurate application of the score test in heritability and in set-based association tests. Our method is available inhttp://github.com/cozygene/RL-SKAT.
Parallel diversifications ofCremastospermaandMosannona(Annonaceae), tropical rainforest trees tracking Neogene upheaval of the South American continent
Authors: Pirie Michael D. , Maas Paul J. M. , Wilschut Rutger A. , Melchers-Sharrott Heleen , Chatrou Lars W. 
Published: June 2017

AbstractThis preprint has been reviewed and recommended by Peer Community In Evolutionary Biology (http://dx.doi.org/10.24072/pci.evolbiol.100033).Much of the immense present day biological diversity of Neotropical rainforests originated from the Miocene onwards, a period of geological and ecological upheaval in South America. We assess the impact of the Andean orogeny, drainage of lake Pebas, and closure of the Panama Isthmus on two clades of trees (Cremastosperma, c. 31 spp.; andMosannona, c. 14 spp.; both Annonaceae) found in humid forest distributed across the transition zones between the Andes and Western (lowland) Amazonia and between Central and South America. We inferred phylogenies based on c. 80% of recognised species of each clade using plastid and nuclear encoded sequence markers, revealing similar patterns of geographically restricted clades. Using molecular dating we showed that diversifications in the different areas occurred in parallel, with timing consistent with Andean vicariance and Central American geodispersal. In apparent contradiction of high dispersal abilities of rainforest trees,Cremastospermaclades within Amazonia are also geographically restricted, with a southern/montane clade that appears to have diversified along the foothills of the Andes sister to one of more northern/lowland species that diversified in a region once inundated by lake Pebas. Ecological niche modelling approaches show phylogenetically conserved niche differentiation, particularly withinCremastosperma. Niche similarity and recent common ancestry of Amazon and GuiananMosannonaspecies contrasts with dissimilar niches and more distant ancestry of Amazon, Venezuelan and Guianan species ofCremastospermasuggesting that this element of the similar patterns of disjunct distributions in the two genera is instead a biogeographic parallelism, with differing origins. The results provide further independent evidence for the importance of the Andean orogeny, the drainage of Lake Pebas, and the formation of links between South and Central America in the evolutionary history of Neotropical lowland rainforest trees.