bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contemporary Reproductive Outcomes for Patients With Polycystic Ovary Syndrome: A Retrospective Observational Study
Authors: Rees D. Aled , Jenkins-Jones Sara , Morgan Christopher L. 
Published: February 2016

Abstract

Context:
Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility and may be associated with adverse pregnancy and neonatal outcomes. However, it is difficult to establish how much of this risk is due to PCOS and how much to obesity.

Objective:
This study aimed to determine the effect of PCOS upon fertility, pregnancy, and neonatal outcomes.

Design and Setting:
Data were extracted from the Clinical Practice Research Datalink (CPRD), a longitudinal anonymized primary care research database in the United Kingdom. Patients with a diagnosis of PCOS were matched to controls (1:2) by age (±1 y), body mass index (± 3 U), and CPRD practice. Standardized fertility ratios before and after diagnosis (index date) were calculated. Rates of miscarriage, pre-eclampsia, gestational diabetes, premature delivery, delivery method, and neonatal outcomes were compared.

Results:
Nine thousand sixty-eight women with PCOS matched study criteria. Prior to index date the standardized fertility ratio for patients with PCOS was 0.80 (95% confidence interval, 0.77–0.83); following index date it was 1.16 (1.12–1.20). The adjusted odds ratios (95% CI) for miscarriage (1.70; 1.56–1.84), pre-eclampsia (1.32; 1.16–1.49), gestational diabetes (1.41; 1.2–1.66), and premature delivery (1.25; 1.1–1.43) were all increased compared with controls. Of PCOS births, 27.7% were by Caesarean section compared with 23.7% of controls (1.13; 1.05–1.21). Infants born to mothers with PCOS had an increased risk of neonatal jaundice (1.20; 1.03–1.39) and respiratory complications (1.20; 1.06–1.37).

Conclusions:
PCOS is associated with subfertility but fertility rates are restored to those of the background population following diagnosis. Pregnancy complications and adverse neonatal outcomes are more prevalent for women with PCOS independently of obesity.
The Importance of the Saphenous Nerve in Ankle Surgery
Authors: Eglitis Nicholas , Horn Jean-Louis , Benninger Brion , Nelsen Sylvia 
Published: February 2016

BACKGROUND:
Recent evidence suggests that the saphenous nerve may be involved in the innervation of deeper structures at the medial ankle. In this study, we sought to determine the consistency and variability of the saphenous nerve innervation at the distal tibia and medial ankle joint capsule.

METHODS:
One hundred three lower extremities from 52 embalmed cadavers were dissected to identify the deep branches of saphenous nerve along its distal course.

RESULTS:
In all specimens, the saphenous nerve had branches, emerging between 3.9 and 8.2 cm above the medial malleolus, to the periosteum of the distal tibia and the medial capsule of the ankle joint.

CONCLUSIONS:
Deep branches of the saphenous nerve innervate the periosteum of the distal tibia and talocrural capsule.
The Effects of the Toll-Like Receptor 4 Antagonist, Ibudilast, on Sevoflurane’s Minimum Alveolar Concentration and the Delayed Remifentanil-Induced Increase in the Minimum Alveolar Concentration in Rats
Authors: Ruiz-Pérez Daniel , Benito Javier , Polo Gonzalo , Largo Carlota , Aguado Delia , Sanz Luis , Gómez de Segura Ignacio A. 
Published: February 2016

BACKGROUND:
Ultralow doses of naloxone, an opioid and toll-like receptor 4 antagonist, blocked remifentanil-induced hyperalgesia and the associated increase in the minimum alveolar concentration (MAC), but not tolerance. The aim was to determine the effects of the toll-like receptor 4 antagonist, ibudilast, on the MAC in the rat and how it might prevent the effects of remifentanil.

METHODS:
Male Wistar rats were randomly allocated to 5 treatment groups (n = 7 per group): 10 mg/kg ibudilast intraperitoneally, 240 µg/kg/h remifentanil IV, ibudilast plus remifentanil, remifentanil plus naloxone IV, or saline. The sevoflurane MAC was determined 3 times in every rat and every day (days 0, 2, and 4): baseline (MAC-A) and 2 further determinations were made after treatments, 1.5 hours apart (MAC-B and MAC-C).

RESULTS:
A reduction in baseline MAC was produced on day 0 by ibudilast, remifentanil, remifentanil plus ibudilast, remifentanil plus naloxone (P < 0.01), but not saline. Similar effects were found on days 2 and 4. A tolerance to remifentanil was found on days 0, 2, and 4, which neither ibudilast nor naloxone prevented. The MAC increase produced by remifentanil on day 4 (P = 0.001) was prevented by either ibudilast or naloxone.

CONCLUSIONS:
Ibudilast, besides reducing the MAC, prevented the delayed increase in baseline MAC produced by remifentanil but not the increase in MAC caused by tolerance to remifentanil.
Associations between chlorophyll a and various microcystin-LR health advisory concentrations
Authors: Hollister Jeffrey W. , Kreakie Betty J. 
Published: February 2016

Cyanobacteria harmful algal blooms (cHABs) are associated with a wide range of adverse health effects that stem mostly from the presence of cyanotoxins. To help protect against these impacts, several health advisory levels have been set for some toxins. In particular, one of the more common toxins, microcystin-LR, has several advisory levels set for drinking water and recreational use. However, compared to other water quality measures, field measurements of microcystin-LR are not commonly available due to cost and advanced understanding required to interpret results. Addressing these issues will take time and resources. Thus, there is utility in finding indicators of microcystin-LR that are already widely available, can be estimated quickly and in situ, and used as a first defense against high concentrations of microcystin-LR. Chlorophyll a is commonly measured, can be estimated in situ, and has been shown to be positively associated with microcystin-LR. In this paper, we use this association to provide estimates of chlorophyll a concentrations that are indicative of a higher probability of exceeding select health advisory concentrations for microcystin-LR. Using the 2007 National Lakes Assessment and a conditional probability approach, we identify chlorophyll a concentrations that are more likely than not to be associated with an exceedance of a microcystin-LR health advisory level. We look at the recent US EPA health advisories for drinking water as well as the World Health Organization levels for drinking water and recreational use and identify a range of chlorophyll a thresholds. A 50% chance of exceeding one of the microcystin-LR advisory concentrations of 0.3, 1, 1.6, and 2 g/L is associated with chlorophyll a concentration thresholds of 23.4, 67.0, 83.5, and 105.8, respectively. When managing for these various microcystin-LR levels, exceeding these reported chlorophyll a concentrations should be a trigger for further testing and possible management action.
Modern Trends in Financing of Economics and Social Development at the Regional Level
Authors: Катайкина  , Kataykina N. 
Published: February 2016

The author considers one of the tools of the mechanism of regulation of social
and economic development of the human potential of the region — the budget.
In modern conditions, education, health, play a decisive role in insuring of
human well-being, development of civil society, the creation of an innovative
economy based on knowledge and high technologies. The fulfillment of this
role is possible only if development of education, health, culture, art and other
important sectors is stable and continuous and the necessary amount of
financing of their development is observed.
Immport Substitution in Russian Economy: Problems and Prospects
Authors: Кошкин  , Koshkin A. , Моисеев  , Moiseev Vladimir 
Published: February 2016

The article deals with the problem of import substitution under Western
sanctions caused by the events in Ukraine. The political leadership of the
Russian Federation have repeatedly raised the issue of import substitution,
and only the events of recent years have allowed to translate public policy in
this area to the positive changes to the actual implementation of programs
developed its own production of goods and technology that were previously
imported from abroad.
Diagnosing and imaging renal calculi: what can be done in the pre-hospital environment?
Authors: McPherson Melinda (Dolly) 
Published: February 2016

Renal colic is a common pre-hospital presentation that is often conveyed to hospital due to diagnostic uncertainty. The use of the STONE score and a greater understanding of computerised tomography (CT) requirement in the diagnostic process can aid the pre-hospital clinician in making an informed decision about the management of these patients. Case: A 48-year-old female presenting with symptoms of renal colic who was assessed, managed and treated at home. Methods: A literature search was carried out on Medline, Cinahl, BNI and Embase. In addition, searches of the NHS evidence database ( www.evidence.nhs.uk ) and the Cochrane Database of Systematic Reviews ( www.cochrane.org ) were completed. Results: The search yielded 536 results, each of which were browsed for relevance, duplicates removed and their references reviewed. 16 articles were relevant to the use of CT to diagnose renal calculi and four addressed the derivation and validation of the STONE score. These were critically reviewed and conclusions drawn about their applicability to the pre-hospital environment. Conclusions: The STONE score, when combined with clinical judgement and if applied to the right patient group, is an appropriate clinical decision tool to identify uncomplicated renal calculi. CT imaging of this low-risk patient group is not required to confirm diagnosis; however, delayed CT scanning is required to form a management plan.
Clinical Significance of Circulating Tumor Microemboli as a Prognostic Marker in Patients with Pancreatic Ductal Adenocarcinoma
Authors: Chang Ming-Chu , Chang Yu-Ting , Chen Jia-Yang , Jeng Yung-Ming , Yang Ching-Yao , Tien Yu-Wen , Yang Shih-Hung , Chen Huai-Lu , Liang Ting-Yuan , Wang Chien-Fang , Lee Eva Y H P , Chang Ying-Chih , Lee Wen-Hwa 
Published: February 2016

Abstract

BACKGROUND
Characterization of circulating tumor cells (CTCs) has been used to provide prognostic, predictive, and pharmacodynamic information in many different cancers. However, the clinical significance of CTCs and circulating tumor microemboli (CTM) in patients with pancreatic ductal adenocarcinoma (PDAC) has yet to be determined.

METHODS
In this prospective study, CTCs and CTM were enumerated in the peripheral blood of 63 patients with PDAC before treatment using anti-EpCAM (epithelial cell adhesion molecule)–conjugated supported lipid bilayer–coated microfluidic chips. Associations of CTCs and CTM with patients' clinical factors and prognosis were determined.

RESULTS
CTCs were abundant [mean (SD), 70.2 (107.6)] and present in 81% (51 of 63) of patients with PDAC. CTM were present in 81% (51 of 63) of patients with mean (SD) 29.7 (1101.4). CTM was an independent prognostic factor of overall survival (OS) and progression free survival (PFS). Patients were stratified into unfavorable and favorable CTM groups on the basis of CTM more or less than 30 per 2 mL blood, respectively. Patients with baseline unfavorable CTM, compared with patients with favorable CTM, had shorter PFS (2.7 vs 12.1 months; P &lt; 0.0001) and OS (6.4 vs 19.8 months; P &lt; 0.0001). Differences persisted if we stratified patients into early and advanced diseases. The number of CTM before treatment was an independent predictor of PFS and OS after adjustment for clinically significant factors.

CONCLUSIONS
The number of CTM, instead of CTCs, before treatment is an independent predictor of PFS and OS in patients with PDAC.
American Indian Permission for Mascots: Resistance or Complicity within Rhetorical Colonialism?
Authors: Endres Danielle 
Published: February 2016

Abstract
In 2005 the National Collegiate Athletic Association banned the use of American Indian symbols such as mascots, nicknames, and imagery in postseason sporting events. However, several universities successfully appealed this decision by demonstrating permission from eponymous American Indian nations. The focus of this essay is on the rhetorical implications of this permission argument within American Indian rhetoric about American Indian mascots, nicknames, and imagery. Drawing from the lens of rhetorical colonialism and an examination of the University of Utah Utes, I reveal how American Indian permission for mascots can be seen as upholding rather than challenging the system of colonialism through a form of self-colonization.
Predictive Value of Gait Speed and Frailty Indicators on Survival Time and Time Until Discharge to Home in Ambulant Older Patients in a Specialized Rehabilitation Center
Authors: van der Ploeg Eva , van der Velde Yvette , Gobbens Robbert 
Published: February 2016

Background and Purpose:
“Frailty” is a frequently used term in both scientific research and clinical practice, but it has proven to be difficult to recognize and measure frailty. In this study, we aim to identify variables related to frailty as simple and unambiguous predictors of time until discharge to home and until mortality for ambulant individuals residing in a rehabilitation center for older people.

Methods:
This was a longitudinal cohort study. We included data on people admitted to a Dutch rehabilitation center for older people between September 15, 2013, and September 10, 2014 (n = 389). At admission, we collected data regarding participants' demography, details of their admission and origin as well as their gait speed. We also asked both participants and their physiotherapists whether the patients experienced problems as a consequence of fatigue, mobility, balance, or unintentional weight loss (yes/no), which are considered to be indicators of frailty. Date of discharge or death was recorded upon occurrence. We used survival analyses to establish associations between frailty indicators and gait speed with time until death and time until discharge to home.

Results and Discussion:
We found associations between patients' and physiotherapists' reports regarding indicators of frailty with mortality and discharge to home. Although patients' and physiotherapists' scores were strongly correlated, the physiotherapists' scores proved to be more accurate in predicting time until discharge to home and mortality. Time until death was best predicted by the physiotherapists' report that a patient was fatigued (hazard ratio = 4.09; 95% confidence interval = 1.41-11.83; P < .01). Time until discharge to home was strongly related to physiotherapists' reports of unintentional weight loss in the patient (hazard ratio = 0.67; 95% confidence interval = 0.48-0.95; P < .05). We did not find a relationship between gait speed and time until death and discharge to home.

Conclusions:
Simple yes/no reports by physiotherapists at the time of admission regarding patients feeling fatigued and losing weight unintentionally showed strong associations with time until death and time until discharge to home. These simple questions could be used for screening at admission to identify people at risk of prolonged rehabilitation and mortality.
Hybrid e-Book Business Strategy-Evaluation Model Using Fuzzy Multiple Criteria Analysis
Authors: Chang S. -C. , Tsai P. -H. 
Published: February 2016

Abstract
Evaluation of the e-book business strategy model is a critical problem and it plays a significant role in the success of e-book firm development. On the other hand, selecting the most appropriate e-book business strategy model among a pool of alternatives is a multiple criteria decision-making (MCDM) problem. Therefore, this study proposed a hybrid evaluation model based on the decision-making trial and evaluation laboratory (DEMATEL), fuzzy analytic network process (FANP), and the complex proportional assessment (COPRAS) method to help managers with the evaluation of proper business strategy model in a fuzzy environment, where the fuzziness and uncertainties are handled with linguistic terms parameterized by triangular fuzzy numbers (TFNs). The final results show the capability and effectiveness of the hybrid model.
Maintenance of Membrane Integrity and Permeability Depends on a Patched-Related Protein in Caenorhabditis elegans
Authors: Choi Myung-Kyu , Son Sangwon , Hong Mingi , Choi Min Sung , Kwon Jae Young , Lee Junho 
Published: February 2016

Abstract
Membrane integrity is critical for cell survival, defects of which cause pathological symptoms such as metabolic diseases. In this study, we used ethanol sensitivity of the nematode Caenorhabditis elegans to identify genetic factors involved in membrane integrity. In C. elegans, acute exposure to a high concentration (7% v/v) of ethanol changes membrane permeability, as measured by propidium iodide staining, and causes paralysis. We used the timing of complete paralysis as an indicator for alteration of membrane integrity in our genetic screen, and identified ptr-6 as a gene that confers ethanol resistance when mutated. PTR-6 is a patched-related protein and contains a sterol sensing domain. Inhibition of two PTR-encoding genes, ptr-15 and ptr-23, and mboa-1, encoding an Acyl Co-A: cholesterol acyltransferase homolog, restored ethanol sensitivity of the ptr-6 mutant, suggesting that these ptr genes and mboa-1 are involved in the maintenance of membrane integrity and permeability. Our results suggest that C. elegans can be used as a model system to identify factors involved in metabolic diseases and to screen for therapeutic drugs.
Phenotypic Plasticity Promotes Balanced Polymorphism in Periodic Environments by a Genomic Storage Effect
Authors: Gulisija Davorka , Kim Yuseob , Plotkin Joshua B 
Published: February 2016

AbstractPhenotypic plasticity is known to evolve in perturbed habitats, where it alleviates the deleterious effects of selection. But the effects of plasticity on levels of genetic polymorphism, an important precursor to adaptation in temporally varying environments, are unclear. Here we develop a haploid, two-locus population-genetic model to describe the interplay between a plasticity modifier locus and a target locus subject to periodically varying selection. We find that the interplay between these two loci can produce a “genomic storage effect” that promotes balanced polymorphism over a large range of parameters, in the absence of all other conditions known to maintain genetic variation. The genomic storage effect arises as recombination allows alleles at the two loci to escape more harmful genetic backgrounds and associate in haplotypes that persist until environmental conditions change. Using both Monte Carlo simulations and analytical approximations we quantify the strength of the genomic storage effect across a range of selection pressures, recombination rates, plasticity modifier effect sizes, and environmental periods.
ARTICULO ORIGINAL-2016: Características epidemiológicas y complicaciones de los pacientes operados por adenomas de hipófisis por vía transesfenoidal endoscópica en la Unidad de Cirugía de Base de Cráneo del Hospital México
Authors: Vargas Valenciano Emmanuelle , Esquivel Miranda Miguel Ángel , Obando Valverde Andrés , Quiroga Galindo Mónica 
Published: February 2016

<p>En el Hospital México, desde el año 2009 se constituyó una unidad de cirugía endoscópica de la base de cráneo que desde un abordaje multidisciplinario permite la valoración y tratamiento de estos pacientes. En el presente estudio se documentaron un total de 47 pacientes durante los años 2012 y 2013 presentando una edad promedio de 49 años, siendo de predominio femenino. Dentro de la cohorte, la mayoría de los adenomas se catalogaron como no funcionantes (70%), seguido de productores de GH (15%) y ACTH (15%). Aproximadamente la mitad de los casos presentaron déficit visual campimétrico y 25% tenían antecedente de cirugía previa por esa misma lesión. Se operaron 13% microadenomas, 74% macroadenomas y 13% adenomas gigantes. La duración promedio del procedimiento fue de 247 minutos. El porcentaje de fístula postoperatoria fue de 1,5%. No se presentaron muertes en esta serie. A pesar de que se documentó un porcentaje ligeramente mayor del 10% de insuficiencia suprarrenal y diabetes insípida postoperatoria la mayoría de estos casos presentaban esta condición de previo.</p>
ARTICULO ORIGINAL-2016: La Valoración de Incapacidades y los Síntomas Físicos Médicamente Inexplicables
Authors: Flores Sandí Grettchen 
Published: February 2016

<p>En la práctica médica diaria, la valoración de capacidad laboral independientemente del campo de actuación del médico evaluador, ya sea por enfermedad o accidente común o laboral, suponeun difícil reto que requiere incorporar un análisis de la validez de cada caso dadas las repercusiones personales y sociales. Además los síntomas físicos médicamente inexplicables son<br />frecuentes en las consultas, de alto costo, se asocian a incapacidad laboral, generan frustración al paciente y al médico, pudiendo ser denunciados en relación a contingencias profesionales. Con el objetivo de identificar el procedimiento del médico perito/evaluador para el otorgamiento de incapacidad laboral y parámetros útiles en caso de síntomas físicos médicamente inexplicables, se realizó una revisión descriptiva y se obtuvo que el impacto de estos síntomas en la incapacidad laboral varía de paciente a paciente y que existen pocos estudios en relación con implicaciones laborales. Además el análisis de la validez es una tarea muy compleja que requiere la apreciación de elementos/pruebas de carácter objetivo, que incluyen un adecuado abordaje clínico, comprensión de pruebas diagnósticas complementarias (incluida la valoración psiquiátrica) y de cargas de los puestos de trabajo, contrastada con otras variables de la capacidad funcional para el trabajo como edad, escolaridad, clasificación funcional de acuerdo a baremos, estructura lesionada y pronóstico de la lesión. De ahí que se concluye que a fin de mejorar la validez de los resultados adquieren importancia las habilidades, en lo que respecta a formación médica, conocimientos legales, experiencia, manejo de la información, capacidad de aprendizajecontinuo y razonamiento ético.</p>
TEMA 9-2016: Dependencia a tabaco y su tratamiento
Authors: Sandí Brenes Sofía , Sandí Esquivel Luis 
Published: February 2016

<p>El tabaco es una de las mayores amenazas para la salud pública que ha tenido que afrontar el mundo. Se le atribuyen aproximadamente 6 millones de muertes al año. Es además, la principal causa prevenible de mortalidad, y aquellas personas que dejan de fumar disminuyen el riesgo de desarrollar y potencialmente morir por enfermedades relacionadas al tabaco. Los avances en la investigación científica y la experiencia clínica acumulada en el campo del tabaquismo, hacen que hoy en día existan, basados en la evidencia, excelentes tratamientos y estrategias para ayudar a los fumadores a dejar de fumar</p>
TEMA 11-2016: Síndrome de Ovario Poliquistico
Authors: Borbón Cordero María Fernanda , Robles Quirós Fernán 
Published: February 2016

<p>El síndrome de ovario poliquístico afecta 5% a 10% de las mujeres en edad fértil. Es un síndrome heterogéneo caracterizado por anovulación crónica hiperandrogénica, secundaria a una disfunción ovárica intrínseca. Aunque las pacientes afectadas se ven muy perturbadas por las manifestaciones cutáneas, que incluyen acné, hirsutismo, alopecia y acantosis nigricans (1-2), elsíndrome de ovario poliquístico puede tener implicaciones mucho más serias que las encontradas en la piel; con frecuencia causa irregularidades menstruales e infertilidad y, además, está agravado debido a una hiperinsulinemia porresistencia a la insulina, con el consecuente riesgo de diabetes mellitus y síndrome metabólico. Dentro de los factores más importantes de su abordaje es la disminución de peso, así como determinar el deseo de concebir de una paciente,a partir de dichos puntos se decide su tratamiento</p>