bluuebunny/crossref_metadata_2025_split huggingface dataset:
The future of continuing medical education: the roles of medical professional societies and the health care industry
Authors:   ESC Board, Achenbach Stephan , Badimon Lina , Anker Stefan , Bax Jeroen , Bueno Hector , Casadei Barbara , Clarke Sarah Catherine , Clarke Nigel , Cosentino Francesco , Filippatos Gerasimos , Fitzsimons Donna , Graham Ian Maklim , Grobbee Diederick E , Haude Michael , Hindricks Gerhard , Kearney Peter , Kirchhof Paulus , Kristensen Steen Dalby , Leclercq Christophe , Lettino Maddalena , Linde Cecilia , Luscher Thomas F , Merkely Bela , Olsson Gunnar , Fausto Jose Pinto , Popescu Bogdan Alexandru , Ruschitzka Frank , Simoons Maarten L , Vahanian Alec , Weidinger Franz , Windecker Stephan , Zamorano Jose Luis 
Published: January 2018

Abstract
In recent years, wide ranging biomedical innovation has provided powerful new approaches for prevention, diagnosis and management of diseases. In order to translate such innovation into effective practice, physicians must frequently update their knowledge base and skills through continuing medical education and training. Medical Professional Societies, run as not-for-profit organizations led by peers, are uniquely placed to deliver balanced, disease oriented and patient centred education. The medical industry has a major role in the development of new, improved technology, devices and medication. In fact, the best innovations have been achieved through collaboration with scientists, clinical academics and practicing physicians. Industry has for many years been committed to ensure the optimal and safe application of its products by providing unrestricted support of medical education developed and delivered by international and national learned societies. Recently adopted Codes of Practice for the Pharmaceutical and Device industry were intended to enhance public trust in the relationship between biomedical industry and physicians. Unexpectedly, changes resulting from adoption of the Codes have limited the opportunity for unconditional industry support of balanced medical education in favour of a more direct involvement of industry in informing physicians about their products. We describe the need for continuing medical education in Cardiovascular Medicine in Europe, interaction between the medical profession and medical industry, and propose measures to safeguard the provision of high quality, balanced medical education.
Case Report: Metastasis of a Trigeminal Malignant Peripheral Nerve Sheath Tumor to the Corpus Callosum
Authors: Shutran Max , Mosbach David , Tataryn Zachary , Arkun Knarik , Wu Julian K 
Published: January 2018

Abstract

BACKGROUND AND IMPORTANCE
Malignant peripheral nerve sheath tumors (MPNST) are relatively rare tumors of peripheral nerves that are notable for their locally aggressive nature, ability to metastasize, poor prognosis, and association with Neurofibromatosis type I. We present the case of a patient with a trigeminal nerve MPNST who developed an unusual metastasis to the corpus callosum, in the absence of any other central nervous system or systemic metastatic disease. We review the pathology and presentation of MPNST.

CLINICAL PRESENTATION
A 53-yr-old woman presented with a 1-yr history of paroxysmal facial pain and dysesthesias in the right V1 and V2 distributions of the trigeminal nerve. She was initially diagnosed with trigeminal neuralgia although further imaging showed a cavernous sinus mass extending along the trigeminal nerve. She later developed an isolated lesion in the corpus callosum that was biopsied and consistent with MPNST.

CONCLUSION
This case reviews the pathology and aggressive nature of MPNST and demonstrates an unusual site of metastasis. Clinicians should remain aware that MPNST can metastasize to sites in the central nervous system as well as systemically. Furthermore, clinicians should have a high index of suspicion for secondary causes of trigeminal neuralgia in cases with atypical features.
DIFFUSE CHORIORETINOPATHY WITHOUT SEROUS DETACHMENT ASSOCIATED WITH CARDIAC TRANSPLANTATION
Authors: Marmor Michael F. 
Published: January 2018

Purpose:
To analyze an unusual case of widespread chorioretinopathy after cardiac transplantation for its potential etiology and clinical significance.

Methods:
Clinical examinations included widefield and macular color and fundus autofluorescence photography, spectral domain optical coherence tomography, fluorescein angiography and indocyanine green angiography, full-field electroretinography, and Goldmann visual fields.

Patient:
A 44-year-old Hispanic woman was referred to rule out retinitis pigmentosa. Medical history revealed cardiac transplantation 6 months previously for idiopathic cardiomyopathy.

Results:
Visual acuity was 20/20 in both eyes. The fundi showed widespread gray mottling and little pigmentation, but fundus autofluorescence revealed black speckling broadly across the fundus, and geographic retinal pigment epithelium loss in the nasal midperiphery of the left eye. Spectral domain optical coherence tomography showed normal inner retina, and surprising preservation of outer nuclear layer, but the ellipsoid zone line was fragmented, and the interdigitation zone line was replaced with irregular debris. Retinal pigment epithelium was very thin with occasional excrescences. Electroretinography showed mild loss of both rods and cones, with mild flicker peak delay only in the left eye. Fluorescein angiography showed no leakage, but a reticular pigment pattern in the macula. Indocyanine green angiography showed irregular arteriolar remodeling, and few large arteries.

Discussion and Conclusion:
Serous retinopathy is well known after organ transplantations, but this patient had retinal pigment epithelium and retinal damage well into the periphery and no leakage. Retinal dystrophy was deemed unlikely given the relatively good electroretinography. The indocyanine green vascular changes raise the possibility of a transient choroidal ischemic event during or shortly after cardiac surgery. The event altered retinal pigment epithelium diffusely, but allowed for enough regeneration to sustain retinal function. Diffuse transplant chorioretinopathy may be discovered if postcardiac transplant patients get peripheral retinal examinations.
3 Cases of Systemic Strongyloides in Human Immunodeficiency Virus–Infected Patients
Authors: Lumsden Sarah , Hemmige Vagish , Woc-Colburn Laila 
Published: January 2018

AbstractStrongyloides stercolarisis an intestinal nematode that is endemic in tropical and subtropical areas. In immunocompromised individuals such as individuals with human T-lymphotrophic virus 1 or history of corticosteroid use,Strongyloides(SS) infection can accelerate to hyperinfection or disseminated infection, conditions which are associated with high mortality. Human immunodeficiency virus (HIV) is not considered to be a risk factor for systemic SS infection; however, dozens of cases of HIV patients that have developed SS in the absence of recognized risk factors have been described in the literature. Although the burden of SS in HIV patients is not as high as would be expected if HIV was an equivalent risk factor to human T-lymphotrophic virus 1 or steroid usage, the number of reported cases indicates that there may be a relationship between HIV and SS. We report 3 additional cases of HIV patients with SS infections that presented at a major metropolitan county hospital in Houston, Tex.
Successful Treatment of Methicillin-Resistant Staphylococcus aureus Vertebral Osteomyelitis With Outpatient Oritavancin Therapy
Authors: Ruggero Michael A. , Ziegler Matthew J. , Tebas Pablo , Binkley Amanda , Kelly Brendan J. 
Published: January 2018

Abstract
Native vertebral osteomyelitis (NVO) is a difficult to treat infection often caused by hematogenous spread of bacteria to the bone, causing pain and inflammation. The Infectious Diseases Society of America recommends vancomycin intravenously as first-line treatment for NVO involving methicillin-resistant Staphylococcus aureus (MRSA) for 6 weeks. Alternatives include daptomycin and linezolid. Oritavancin (Orbactiv) is a lipoglypoglycopeptide, structurally similar to vancomycin approved by the Food and Drug Administration for the treatment of acute bacterial skin and skin structure infections caused by susceptible bacteria including S. aureus (both methicillin sensitive and resistant), Streptocococcus, and Enterococcus species. The clinical features of oritavancin are favorable for outpatient use given its broad spectrum of activity for gram-positive organisms and ease of administration; however, clinical experience with the medication is lacking. In this case report, we describe a patient presentation and the evidence for use of oritavancin for the treatment of NVO caused by MRSA. To our knowledge, this is the first reported case of oritavancin for NVO caused by MRSA, and further clinical studies to evaluate it for other indications should be considered.
Screening US Vietnam Veterans for Liver Fluke Exposure 5 Decades After the End of the War
Authors: Psevdos George , Ford Florence M. , Hong Sung-Tae 
Published: January 2018

Background
Clonorchiasis caused by Clonorchis sinensis and opisthorchiasis caused by Opisthorchis viverrini are prevalent in the Far East, including Vietnam. The causal relationship between the 2 liver flukes and cholangiocarcinoma (CCA) has been well documented. Cholangiocarcinoma, a rare tumor of bile ducts, usually occurs in the sixth-seventh decade of life. In the United States, 8000 people are diagnosed with CCA each year. US Vietnam Veterans, 5 decades after the end of the war, are being diagnosed with CCA. Although CCA is linked to several conditions, no study has been done to our knowledge linking C. sinensis or O. viverrini as the culprits for CCA diagnosis in Vietnam Veterans.

Methods
A pilot prospective epidemiological study was performed at the Northport Veterans Affairs Medical Center. We screened Vietnam Veterans for exposure to eating raw or undercooked fish from the rivers in Vietnam during their service. Serological testing was performed by the multiantigen enzyme-linked immunosorbent assay in Seoul National University of Medicine, South Korea.

Results
Of the 97 Veterans screened, 50 met the inclusion criteria with 1 Veteran being diagnosed with CCA. Of the 50 Veterans, 24% tested positive for serum IgG antibodies to C. sinensis. Those who tested positive had no detectable liver fluke parasites by fecal examination.

Conclusions
Our study is the first to show evidence of exposure to liver flukes in US soldiers during their service in the Vietnam War. Further research is needed to examine the possible link of liver fluke infection and risk for developing CCA in Vietnam Veterans.
Candida parapsilosis Lumbar Spondylodiscitis as a Cause of Chronic Back Pain
Authors: Khoo Teresa , Psevdos George , Wu Judy 
Published: January 2018

Abstract
Vertebral bone infections caused by Candida species are uncommon, but their reported frequency is increasing. Candida parapsilosis, a commensal of human skin, is currently an emerging human pathogen, with increasing prevalence and medical significance. We report the case of a Caucasian man who presented with C. parapsilosis spondylodiscitis, who was having a persistent low back pain for 3 months before diagnosis. He had no history of immunosuppression, fever, or elevation of inflammatory markers. The diagnosis was made by fine needle aspiration and culture. A combined medical and surgical intervention was necessary to achieve the best outcome in our case.
Comparison of the Effect of Cane, Tripod Cane Tip, and Quad Cane on Postural Steadiness in Healthy Older Adults
Authors: Bateni Hamid , Collins Prisca , Odeh Christina 
Published: January 2018

ABSTRACT

Objectives
Previous studies have shown that use of assistive devices may contribute to loss of balance and increased risk of falls. The purpose of this study was to compare postural steadiness of older adults using straight cane, tripod, and quad cane.

Methods
Sixteen healthy older adults (8 men, 8 women; age, 62–84 years) were recruited. Analyses focused on mean and root-mean-square distances from the mean center of pressure position, 95% confidence circle area, total power, 95% power frequencies, and centroidal frequency of the sway signal.

Results
Significant improvements in postural steadiness were found when the tripod cane tip was used as compared with straight cane. All measured variables of postural steadiness with the tripod cane tip, however, were significantly below those of the quad cane.

Discussion
The findings suggest that use of the tripod cane tip can significantly improve postural steadiness over use of the straight cane. Our findings, however, suggest that tripod canes provide less level of postural steadiness than quad canes.
Statistical significance of cluster membership for determination of cell identities in single cell genomics
Authors: Chung Neo Christopher 
Published: January 2018

AbstractSingle cell RNA sequencing (scRNA-seq) allows us to dissect transcriptional heterogeneity arising from cellular types, spatio-temporal contexts, and environmental stimuli. Cell identities of samples derived from heterogeneous subpopulations are routinely determined by clustering of scRNA-seq data. Computational cell identities are then used in downstream analysis, feature selection, and visualization. However, how can we examine if cell identities are accurately inferred? To this end, we introduce non-parametric methods to evaluate cell identities by testing cluster memberships of single cell samples in an unsupervised manner. We propose posterior inclusion probabilities for cluster memberships to select and visualize samples relevant to subpopulations. Beyond simulation studies, we examined two scRNA-seq data - a mixture of Jurkat and 293T cells and a large family of peripheral blood mononuclear cells. We demonstrated probabilistic feature selection and improved t-SNE visualization. By learning uncertainty in clustering, the proposed methods enable rigorous testing of cell identities in scRNA-seq.
Review shows that early foetal alcohol exposure may cause adverse effects even when the mother consumes low levels
Authors: Sarman Ihsan 
Published: January 2018

AbstractAimStudies are increasingly focusing on the effects of prenatal alcohol exposure (PAE) on child health. The aim of this review was to provide paediatricians with new insights to help them communicate key messages about avoiding alcohol during pregnancy.MethodsInspired by the 7th International Conference on Fetal Alcohol Spectrum Disorder, which focused on integrating research, policy and practice, we studied English language papers published since 2010 on how early PAE triggered epigenetic mechanisms that had an impact on the development of some chronic diseases. We also report the findings of a human study using three‐dimensional photography of the face to explore associations between PAE and craniofacial phenotyping.ResultsAnimal models with different alcohol exposure patterns show that early PAE may lead to long‐term chronic effects, due to developmental programming for some adult diseases in cardiovascular, metabolic and renal systems. The study with three‐dimensional photographing is very promising in helping paediatricians to understand how even small amounts of PAE can affect craniofacial phenotyping.ConclusionEven low levels of PAE can cause adverse foetal effects and not just in the brain. It is not currently possible to determine a safe period and level when alcohol consumption would not affect the foetus.
Dermoscopy vs. reflectance confocal microscopy for the diagnosis of lentigo maligna
Authors: Cinotti E. , Labeille B. , Debarbieux S. , Carrera C. , Lacarrubba F. , Witkowski A.M. , Moscarella E. , Arzberger E. , Kittler H. , Bahadoran P. , Gonzalez S. , Guitera P. , Agozzino M. , Farnetani F. , Hofmann‐Wellenhof R. , Ardigò M. , Rubegni P. , Tognetti L. , Łudzik J. , Zalaudek I. , Argenziano G. , Longo C. , Ribero S. , Malvehy J. , Pellacani G. , Cambazard F. , Perrot J.L. 
Published: January 2018

AbstractBackgroundSeveral dermoscopic and in vivo reflectance confocal microscopy (RCM) diagnostic criteria of lentigo maligna (LM)/lentigo maligna melanoma (LMM) have been identified. However, no study compared the diagnostic accuracy of these techniques.ObjectiveWe evaluated the diagnostic accuracy of dermoscopy and RCM for LM/LMM using a holistic assessment of the images.MethodsA total of 223 facial lesions were evaluated by 21 experts. Diagnostic accuracy of the clinical, dermoscopic and RCM examination was compared. Interinvestigator variability and confidence level in the diagnosis were also evaluated.ResultsOverall diagnostic accuracy of the two imaging techniques was good (area under the curve of the sROC function: 0.89). RCM was more sensitive (80%, vs. 61%) and less specific (81% vs. 92%) than dermoscopy for LM/LMM. In particular, RCM showed a higher sensitivity for hypomelanotic and recurrent LM/LMM. RCM had a higher interinvestigator agreement and a higher confidence level in the diagnosis than dermoscopy.ConclusionReflectance confocal microscopy and dermoscopy are both useful techniques for the diagnosis of facial lesions and in particular LM/LMM. RCM is particularly suitable for the identification of hypomelanotic and recurrent LM/LMM.
Underdiagnosis of Influenza Virus Infection in Hospitalized Older Adults
Authors: Hartman Lauren , Zhu Yuwei , Edwards Kathryn M. , Griffin Marie R. , Talbot H. Keipp 
Published: January 2018

ObjectivesTo describe factors associated with provider‐ordered influenza testing in hospitalized older adults.DesignInformation on participant demographics, symptoms, and provider‐ordered influenza testing were collected by questionnaire and chart review. We conducted prospective laboratory‐based surveillance using reverse‐transcriptase polymerase chain reaction (RT‐PCR), the criterion standard for diagnosis of influenza, to determine how participant characteristics and provider‐ordered testing affected accurate influenza diagnosis.SettingOne academic and three community hospitals in Davidson County, Tennessee.ParticipantsAdults aged 18 and older with acute respiratory illness or nonlocalizing fever (N=1,422).MeasurementsWe compared characteristics of participants with and without provider‐ordered testing for influenza using the Wilcoxon test and Pearson chi‐square test. Multivariable logistic regression models were used to identify factors predictive of provider‐ordered influenza testing.ResultsTwenty‐eight percent (399/1,422) of participants had provider‐ordered influenza testing. Participants who were tested were younger than those not tested (58 ± 18 vs 66 ± 15, p<.001) and more likely to have influenza‐like illness (ILI) (71% vs 49%, p<.001). ILI decreased with increasing age (aged 18–49, 63%; aged 50–64, 60%; aged ≥65, 48%). ILI and younger age were independent predictors of provider‐ordered testing. Of the 136 participants with influenza confirmed using RT‐PCR, ILI was the only significant predictor of provider‐ordered testing (adjusted odds ratio=3.43, 95% confidence interval=1.22–9.70).ConclusionAdults aged 65 and older hospitalized with fever or respiratory symptoms during influenza season are less likely to undergo a provider‐ordered influenza test than younger adults. Some, but not all, of this disparity is due to a lower likelihood of ILI. Further strategies are needed to increase clinician awareness and testing in this vulnerable group.
Carbon fluxes from subducted carbonates revealed by uranium excess at Mount Vesuvius, Italy
Authors: Avanzinelli Riccardo , Casalini Martina , Elliott Tim , Conticelli Sandro 
Published: January 2018

Abstract
The fate of carbonate-rich sediments recycled at destructive plate margins is a key issue for constraining the budget of deep CO2 supplied to the atmosphere by volcanism. Experimental studies have demonstrated that metasomatic melts can be generated by partial melting of subducted carbonate-pelitic sediments, but signatures of the involvement of such components in erupted magmas are more elusive. We have made new U-Th disequilibria, Sr-Nd-Pb isotope, and high-precision δ238U analyses on lavas from Mount Vesuvius (Italy) and show that their measured 238U excesses require a mantle source affected by the addition of U-rich carbonated melts, generated by partial melting of subducted calcareous sediments in the presence of residual epidote. Accordingly, we argue that the occurrence of 238U excesses in “sediment-dominated” arc magmas represents diagnostic evidence of addition of carbonate sediments via subduction, hence providing constraints on deep carbon cycling within Earth. Our quantitative enrichment model, combined with published experimental results, allows us to estimate a resulting flux of 0.15–0.8 Mt/yr CO2 from the subducted carbonates to the mantle source of Mount Vesuvius.
The Role of History of Gastro-Duodenal Ulcer in Patients with Upper Gastrointestinal Bleeding
Authors: Takatori Yusaku , Kato Motohiko , Sunata Yukie , Hirai Yuichiro , Kubosawa Yoko , Abe Keichiro , Takada Yoshiaki , Hirata Tetsu , Banno Shigeo , Wada Michiko , Kinoshita Satoshi , Mori Hideki , Takabayashi Kaoru , Kikuchi Miho , Kikuchi Masahiro , Suzuki Masayuki , Uraoka Toshio 
Published: January 2018

<b><i>Background:</i></b> Some scoring systems have been introduced to predict the need for performing urgent endoscopy in patients with upper gastrointestinal bleeding (UGIB). However, in an emergency situation, this intervention is insufficient and cannot easily provide the required treatment. <b><i>Aim:</i></b> To identify new risk factors that can predict the need for endoscopic intervention (EI) in UGIB patients. <b><i>Methods:</i></b> This is a retrospective cross-sectional study. Patients with UGIB admitted from April 2011 to August 2014 were included. The proportion of cases requiring EI and clinical factors (age, gender, antiplatelet/anticoagulant therapy, history of gastro-duodenal ulcer (GDU), systolic blood pressure, heart rate, hemoglobin, mean corpuscular volume, blood urea nitrogen-creatinine ratio (BUN/Cr ratio), prothrombin time-international normalized ratio, and Glasgow-Blatchford Score (GBS) were analyzed using logistic regression models. <b><i>Result:</i></b> Of 378 patients who were included in this study, 180 were found to be with GDU. The proportion of cases requiring EI was significantly higher in those with GDU than in other causes except variceal bleeding (53.5 vs. 37.0%, <i>p</i> &#x3c; 0.01). Multivariate analysis revealed that a history of GDU was an independent risk factor (OR 1.78, 95% CI 1.06–3.00) in addition to BUN/Cr ratio (OR 1.02, 95% CI 1.00–1.03) and GBS (OR 1.19, 95% CI 1.08–1.33). <b><i>Conclusion:</i></b> A history of GDU was an independent risk factor for predicting the need for EI in UGIB in addition to BUN/Cr ratio and GBS.
Adaptacão televisiva: uma análise das formas de tratamento pronominais do espanhol madrilenho e bogotano
Authors: Silva Adilson Da 
Published: January 2018

O presente artigo visa a apresentar alguns dos resultados da pesquisa de iniciação científica (PIBIC-CNPq) titulada “Aquí no hay quien viva: análise contrastiva de uma série espanhola e suas adaptações hispano-americanas” realizada no Departamento de Letras da EFLCH-Unifesp sob orientação da Profa. Dra. Andreia Menezes. Buscamos analisar a versão original espanhola e suas adaptações homônimas produzidas na Argentina (Telefé), no Chile (Chilevisión) e na Colômbia (RCN) no que tange às questões linguísticas e culturais imbricadas no processo de adaptação. Classificada como uma sitcom, esta série tornou-se um grande fenômeno de audiência da televisão espanhola. Graças ao sucesso televisivo, foi adaptada e transmitida em vários países, como Finlândia, Grécia e Portugal. Não obstante, foi levada também a países de língua espanhola através de adaptação (remake). Neste artigo, tratamos de analisar especificamente o primeiro capítulo da série original espanhola Aquí no hay quien viva (Antena 3, 2003-2006) e de sua versão homônima colombiana (RCN, 2008-2009) no que tange ao uso das formas de tratamento singulares informais, bem como comentar o processo adaptativo a partir dos estudos (sócio)linguísticos e culturais.