bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pathology of Antineutrophil Cytoplasmic Antibody–Associated Pulmonary and Renal Disease
Authors: Smith Maxwell L. 
Published: January 2017

Context.—Antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis commonly presents with pulmonary and renal involvement that may present diagnostic challenges.
Objectives.—To highlight the updates in the classification of small vessel vasculitis, present the patterns of pulmonary and renal pathology in which ANCA-associated vasculitis is included in the differential diagnosis, analyze the screening and specific antineutrophil cytoplasmic antibody testing methods in the clinical laboratory, compare and contrast the 3 major ANCA-associated vasculitis diseases, and review the pathophysiologic mechanisms of tissue injury in this setting.
Data Sources.—Data are derived from published literature and clinical experience.
Conclusions.—Although rare, ANCA-associated vasculitis diseases are often considered in the differential diagnosis of many pathologic patterns of pulmonary and renal disease. Histopathologic diagnosis of specific entities in this context nearly always requires correlation of the pathology with clinical and serologic data.
Local Staging of Prostate Cancer Using Three Dimensional (3D) Transrectal Ultrasound Assisted with Power Doppler Capability
Authors: Ashraf Talaat Youssef  
Published: January 2017

Introduction: The ability to differentiate between carcinoma confined to the prostate and the extra-capsular extension (ECE) of the tumor is the key point for management. ECE of prostate cancer can lead to failure of radical prostatectomy and every attempt should be made to localize the tumor and assess its extensions preoperatively. The study aimed to evaluate the value of three dimensional (3D) Transrectal ultrasound (TRUS) assisted with power Doppler in local staging of prostate cancer. Methodology: -3D TRUS assisted with the power Doppler capability was performed for 120 patients were complaining of burning urination, difficult urination or blood in urine, among them 95 patients were subjected to 3D TRUS guided biopsies. Results: 33 patients showed prostatic carcinomas, 2 patients showed prostatic sarcoma. In patients with proven prostate cancer 3D TRUS showed an estimated sensitivity 85.7% and specificity 90% with a positive predictive value 83.3%, negative predictive value 91.5% and total accuracy 90.9%. 77% of our cancer patients (27/35) showed hypervascularity by power Doppler ultrasonography while 8 patients (23%) showed no abnormal high vascularity. Power Doppler increased the sensitivity of 3D TRUS in the detection of prostate cancer from 85.7% to 88.5% 3D TRUS clearly identified the extra-prostatic spread in 15 out of 18 patients of an estimated sensitivity (83%). Conclusion: 3D TRUS aided with power Doppler is a valuable tool in local staging of prostate cancer .The expected benefits in local staging of prostate cancer from the combination of 3D TRUS, power Doppler and 3D TRUS guided biopsy as one sitting exam, will be highly promising.
L’espace judiciaire pénal CEMAC : regard sur la déterritorialisation du droit pénal
Authors: Gatsi Éric-Adol T 
Published: January 2017

Les enjeux liés à la lutte contre la criminalité transfrontalière et le raffermissement du Marché commun ont amené le législateur communautaire à jeter les bases d’un espace pénal commun dans la Communauté économique et monétaire des États de l’Afrique centrale (CEMAC). Intervenant dans un domaine où la souveraineté de l’État a longtemps été considérée comme un obstacle à toute harmonisation, la construction de l’espace pénal communautaire est perceptible sur les plans matériel et procédural. Sur le plan matériel, elle se manifeste par une communautarisation des règles pénales au moyen de l’institution d’infractions communautaires assorties de sanctions. Sur le plan procédural, la construction de l’espace pénal commun procède de la consécration, bien qu’imparfaite, du principe de la reconnaissance et de l’exécution mutuelles des décisions judiciaires en matière pénale, d’une part, et d’une procédure de coopération judiciaire qui emprunte progressivement la voie des organes communautaires, d’autre part.
Le fédéralisme coopératif entre territorialité et fonctionnalité : le cas des valeurs mobilières
Authors: Karazivan Noura 
Published: January 2017

L’histoire constitutionnelle canadienne, et le fédéralisme en particulier, oscillent traditionnellement entre deux horizons analytiques contrastés : le premier, issu d’une approche territoriale ou dualiste, considère les compétences exclusives comme un terrain à morceler; le second repose sur une interprétation fonctionnelle des chefs de compétence et rejette l’étanchéité du partage des compétences que suppose le dualisme. Celui-ci alimente les écrits de juristes soucieux de préserver une fédération centralisée, où le palier fédéral aurait les coudées franches pour adopter des politiques législatives uniformes et efficaces à travers le pays. De ces deux visions contrastées, le fédéralisme coopératif est l’héritier, un peu désorienté, un peu en quête d’identité. Même s’il est fréquemment associé à une conception plus fonctionnelle du partage des compétences, il demeure balisé, voire astreint, par les limites imposées par le dualisme.
Chacune de ces visions sera explorée dans la première partie de cet article, à travers les écrits de deux figures de proue de l’histoire constitutionnelle canadienne, les juges, doyens et auteurs Jean Beetz et Bora Laskin. Une attention particulière sera portée à la manière dont chacun de ces auteurs a entrevu le fédéralisme coopératif, ses potentialités, ses risques. La seconde partie de ce texte étudie les divers usages du fédéralisme coopératif dans la jurisprudence constitutionnelle canadienne, en distinguant le recours au fédéralisme coopératif dans l’assouplissement de doctrines interprétatives, d’une part, et le recours à ce même principe en présence de régimes coopératifs intégrés, d’autre part. La troisième partie prend le litige des valeurs mobilières pour point d’ancrage, en effectuant, d’abord, un retour sur le Renvoi relatif à la Loi sur les valeurs mobilières, et en anticipant le rôle potentiel que le fédéralisme coopératif pourrait jouer dans le second renvoi, qui s’est amorcé, à l’automne 2016, devant la Cour d’appel du Québec.
Use of Patient-Authored Prehistory to Improve Patient Experiences and Accommodate Federal Law
Authors: Warner Michael J. , Simunich Thomas J. , Warner Margaret K. , Dado Joseph 
Published: January 2017

Abstract

Context: Although federal law grants patients the right to view and amend their medical records, few studies have proposed a process for patients to coauthor their subjective history in their medical record. Allowing patients to fully disclose and document their medical history is an important step to improve the diagnostic process.

Objective: To evaluate patients’ office experience before and after they authored their subjective medical history for the electronic health record.

Methods: Patients were mailed a prehistory form and presurvey to be completed before their family medicine office visit. On arrival to the office, the prehistory form was scanned into the electronic health record while the content was transcribed by hospital staff into the appropriate fields in the history component of the encounter note. Postsurveys were given to patients to be completed after their visit. Pre- and postsurveys measured the patients’ perception of office visit quality as well as completeness and accuracy of their electronic health record documentation before and after their appointment. Medical staff surveys were collected weekly to measure the staff’s viewpoint of the federal law that allows patients to view and amend their medical records.

Results: Of 405 patients who were asked to participate, 263 patients aged 14 to 94 years completed a presurvey and a prehistory form. Of those 263 patients, 134 completed a postsurvey. The pre- and postsurveys showed improved patient satisfaction with the office visit and high scores for documentation accuracy and completeness. Before filling out the prehistory form, 116 of 249 patients (46.6%) agreed or strongly agreed that they felt more empowered in their health care by completing the prehistory form compared with 110 of 131 (84.0%) who agreed or strongly agreed after the visit (P<.001). Staff members agreed that patients should have the right to view and amend their medical records in accordance with federal law.

Conclusion: Empowering patients to contribute subjective information to their electronic health record has the potential to improve the diagnostic process. When conducting a medical encounter, the authors recommend having patients complete a prehistory form beforehand to improve the patient experience while accommodating federal law.
Somatic Dysfunction in the Diagnosis of Uncommon Ectopic Pregnancies: Surgical Correlation and Comparison With Related Pathologic Findings
Authors: Martingano Daniel , Canepa Hannah , Fararooy Setareh , Rybitskiy Dmitriy , Shahem Sam , Martingano Francis X. , Aglialoro George 
Published: January 2017

Abstract

Background: Ectopic pregnancies occur when the implantation of a fertilized ovum occurs outside the endometrial cavity. Such pregnancies occur in approximately 1.5% to 2.0% of all pregnancies and cause 6% of maternal deaths.

Objectives: To evaluate osteopathic structural examination (OSE) findings in patients with ectopic pregnancies of uncommon locations and to establish the utility of these findings in the diagnosis of these ectopic pregnancies.

Methods: In this prospective case series, a focused OSE was performed on each patient with an ectopic pregnancy at her initial presentation after the patient history but before other diagnostic or laboratory tests were performed and surgical treatment was initiated. Chapman reflex points (CRPs) were evaluated pre- and postoperatively. For comparison, patients who had otherwise normal first pregnancies, underwent elective postpartum bilateral tubal ligation, or had simple ovarian cysts were also included and received OSEs.

Results: Seven cases with ectopic pregnancies outside the fallopian tube were included. Two primary ovarian pregnancies and 1 heterotopic pregnancy (uterine and ovarian) had somatic dysfunction at the T10-T11 spinal levels and CRPs posterior for the ovary, 1 primary omental pregnancy with somatic dysfunction at the T9-T12 spinal levels and CRPs anterior and posterior for the ileum and jejunum, and 1 tubal pregnancy with somatic dysfunction at the T10-L1 spinal levels and CRPs anterior and posterior for the fallopian tube. Two cornual ectopic pregnancies were not associated with unique findings. These somatic dysfunctions and CRP findings appear to be distinct from those of comparison cases, including first pregnancies at any trimester, simple ovarian cysts, and elective bilateral tubal ligation.

Conclusion: The OSE findings demonstrated in these cases aided in the final diagnosis and thus can potentially prove helpful in cases of ovarian, tubal, and omental pregnancies to provide clues to abnormal ectopic pregnancy locations where diagnostic imaging results are insufficient or equivocal. Osteopathic structural examinations may allow osteopathic physicians to better prepare for treatment approaches, including surgery.
Common Foot and Ankle Injuries: What Not to Miss and How Best to Manage
Authors: Reissig Jessica , Bitterman Adam , Lee Simon 
Published: January 2017

Abstract
Injuries to the foot and ankle are commonly encountered, especially among athletes, and can lead to morbidity if not managed appropriately. Health care professionals must have a firm understanding of injury anatomy, diagnoses, and management. This article provides a review of lateral talus process fractures, os trigonum injuries, Lisfranc injuries, turf toe, navicular stress fractures, and syndesmotic injuries.
Long Thoracic Nerve Injury Caused by Overhead Weight Lifting Leading to Scapular Dyskinesis and Medial Scapular Winging
Authors: Berthold Justin B. , Burg Timothy M. , Nussbaum Ryan Paul 
Published: January 2017

Abstract
Scapular winging represents a rare phenomenon that most commonly results from nerve damage to either the long thoracic nerve, spinal accessory nerve, or, less commonly, the dorsal scapular nerve. This injury results in an abnormal scapulohumeral interaction during kinetic motion known as scapular dyskinesis. In this case report, the patient presented with scapular dyskinesis and medial scapular winging caused by overhead weight-lifting exercises, and a long thoracic nerve injury was diagnosed. Physicians are encouraged to consider long thoracic nerve damage in a patient with a history of repetitive overhead movements who presents with scapular dyskinesis and the corresponding restriction of overhead arm motions. Potential mechanisms of injury and treatment options are also discussed.
Cloud droplet activation through oxidation of organic aerosol influenced by temperature and particle phase state
Authors: Slade Jonathan H. , Shiraiwa Manabu , Arangio Andrea , Su Hang , Pöschl Ulrich , Wang Jian , Knopf Daniel A. 
Published: January 2017

AbstractChemical aging of organic aerosol (OA) through multiphase oxidation reactions can alter their cloud condensation nuclei (CCN) activity and hygroscopicity. However, the oxidation kinetics and OA reactivity depend strongly on the particle phase state, potentially influencing the hydrophobic‐to‐hydrophilic conversion rate of carbonaceous aerosol. Here, amorphous Suwannee River fulvic acid (SRFA) aerosol particles, a surrogate humic‐like substance (HULIS) that contributes substantially to global OA mass, are oxidized by OH radicals at different temperatures and phase states. When oxidized at low temperature in a glassy solid state, the hygroscopicity of SRFA particles increased by almost a factor of two, whereas oxidation of liquid‐like SRFA particles at higher temperatures did not affect CCN activity. Low‐temperature oxidation appears to promote the formation of highly‐oxygenated particle‐bound fragmentation products with lower molar mass and greater CCN activity, underscoring the importance of chemical aging in the free troposphere and its influence on the CCN activity of OA.
Martian electron foreshock from MAVEN observations
Authors: Meziane K. , Mazelle C. X. , Romanelli N. , Mitchell D. L. , Espley J. R. , Connerney J. E. P. , Hamza A. M. , Halekas J. , McFadden J. P. , Jakosky B. M. 
Published: January 2017

AbstractFlux enhancements of energetic electrons are always observed when the Mars Atmosphere and Volatile EvolutioN (MAVEN) spacecraft is magnetically connected to the shock. The observations indicate that the foreshock electrons consist of two populations. The most energetic (E≥237 eV) originate from a narrow region at the nearly perpendicular shock. They always appear as spikes, and their flux level reaches a maximum when the angle θBn approaches 90°. The other population emanates from the entire Martian bow shock surface, and the flux level decreases slightly from the quasi‐parallel to quasi‐perpendicular regions. A detailed examination of the pitch angle distribution shows that the enhanced fluxes are associated with electrons moving sunward. Annulus centered along the interplanetary magnetic field direction is the most stringent feature of the 3‐D angular distribution. The gyrotropic character is observed over the whole range of shock geometry. Although such signatures in the electron pitch angle distribution function strongly suggest that the reflection off the shock of a fraction of the solar wind electrons is the main mechanism for the production of Martian foreshock electrons, the decay of the flux of the second population on the other hand has yet to be understood.
Extreme daily precipitation in coastal western Norway and the link to atmospheric rivers
Authors: Azad Roohollah , Sorteberg Asgeir 
Published: January 2017

AbstractThis work investigates the link between the most extreme daily precipitation (EDP) events observed since 1900 on the west coast of Norway and the large‐scale moisture fluxes over the North Atlantic Ocean. Using station precipitation data, vertically integrated water vapor (IWV) from Special Sensors Microwave Imager/Sounder (SSMIS) satellite observations and the state of the art NOAA‐twentieth Century (NOAA‐20C) reanalysis, it is shown that 55 out of 58 EDPs are associated with narrow plumes of intense low‐level moisture defined as atmospheric rivers. Despite the high spatial correlation between IWV fields in the SSMIS and NOAA‐20C data sets, the significant positive relationship between the maximum amount of observed precipitation at all stations and the IWV content hitting the coastal terrain is only observed in the SSMIS data set. Further, the composite analyses of synoptic conditions show that the preferred circulation type consists of a mean sea level pressure (MSLP) dipole pattern where a high‐pressure system over central Europe and a series of low‐pressure systems to the east of Iceland and over the Norwegian Sea are present. The west coast of Norway is located in the exit region of the anticyclonically curved upper tropospheric polar jet stream implying that the coupling of upper troposphere and surface dynamics begins to weaken at the time of EDPs. It is also found that the primary synoptic‐scale precursors are persistent positive 500 hPa height geopotential and MSLP anomalies over central Europe up to 10 days before the occurrence of EDP events.
Impacts of precipitation and potential evapotranspiration patterns on downscaling soil moisture in regions with large topographic relief
Authors: Cowley Garret S. , Niemann Jeffrey D. , Green Timothy R. , Seyfried Mark S. , Jones Andrew S. , Grazaitis Peter J. 
Published: January 2017

AbstractSoil moisture can be estimated at coarse resolutions (>1 km) using satellite remote sensing, but that resolution is poorly suited for many applications. The Equilibrium Moisture from Topography, Vegetation, and Soil (EMT+VS) model downscales coarse‐resolution soil moisture using fine‐resolution topographic, vegetation, and soil data to produce fine‐resolution (10–30 m) estimates of soil moisture. The EMT+VS model performs well at catchments with low topographic relief (≤124 m), but it has not been applied to regions with larger ranges of elevation. Large relief can produce substantial variations in precipitation and potential evapotranspiration (PET), which might affect the fine‐resolution patterns of soil moisture. In this research, simple methods to downscale temporal average precipitation and PET are developed and included in the EMT+VS model, and the effects of spatial variations in these variables on the surface soil moisture estimates are investigated. The methods are tested against ground truth data at the 239 km2 Reynolds Creek watershed in southern Idaho, which has 1145 m of relief. The precipitation and PET downscaling methods are able to capture the main features in the spatial patterns of both variables. The space‐time Nash‐Sutcliffe coefficients of efficiency of the fine‐resolution soil moisture estimates improve from 0.33 to 0.36 and 0.41 when the precipitation and PET downscaling methods are included, respectively. PET downscaling provides a larger improvement in the soil moisture estimates than precipitation downscaling likely because the PET pattern is more persistent through time, and thus more predictable, than the precipitation pattern.
Diagnostic Value and Validity of Early Spondyloarthritis Features: Results From a National Spanish Cohort
Authors: Joven Beatriz E. , Navarro‐Compán Victoria , Rosas Jose , Fernandez Dapica Pilar , Zarco Pedro , de Miguel Eugenio ,   on behalf of the Esperanza Working Group
Published: January 2017

ObjectiveTo evaluate the validity of different spondyloarthritis (SpA) features included in the Berlin diagnostic algorithm and the Assessment of SpondyloArthritis international Society (ASAS) classification criteria in an early SpA cohort.MethodsThis was a longitudinal multicenter study including patients from the ESPeranza program cohort who were suspected to have SpA. Subjects were ≤45 years old, and SpA symptom duration was 3–24 months. Patients with axial SpA symptoms were selected and categorized according to diagnosis (yes/no) of axial SpA. Descriptive analysis was performed, and the sensitivity, specificity, predictive value, and likelihood ratio (LR) of each feature were calculated.ResultsOf 775 patients suspected to have SpA, 665 had predominantly axial symptoms and 516 of these patients were diagnosed with axial SpA. The most useful SpA features were sacroiliitis on magnetic resonance imaging (positive LR 6.6) or radiograph (positive LR 31.1) and peripheral arthritis (positive LR 8.9). The features with the lowest diagnostic utility were a family history of SpA (positive LR 1.5) and good response to nonsteroidal antiinflammatory drugs (positive LR 1.6). Inflammatory back pain (IBP; according to ASAS criteria) was described in only 27% of SpA patients, with a positive LR of 2.3. HLA–B27 positivity was present in 245 (48%), and the positive LR was 2.8.ConclusionThe diagnostic value of SpA features in patients with early axial SpA seems to be different than in patients with longstanding disease. Chronic back pain is better than IBP as an entry point to the diagnostic algorithm. Sacroiliitis on imaging is very important for early diagnosis, while the use of HLA–B27 status as a key factor is questionable.
Risk of Myocardial Infarction and Stroke in Newly Diagnosed Systemic Lupus Erythematosus: A General Population‐Based Study
Authors: Aviña‐Zubieta J. Antonio , To Fergus , Vostretsova Kateryna , De Vera Mary , Sayre Eric C. , Esdaile John M. 
Published: January 2017

ObjectiveTo estimate the future risk and time trends of newly diagnosed myocardial infarction (MI), ischemic stroke, or both (cardiovascular disease [CVD]) in individuals with systemic lupus erythematosus (SLE).MethodsUsing a population‐based database that includes all residents of British Columbia, Canada, we conducted a matched cohort study of all patients with incident SLE and up to 10 age‐, sex‐, and entry time–matched individuals from the general population. We compared incidence rates (IRs) of MI, ischemic stroke, or CVD (i.e., MI or ischemic stroke) between the 2 groups according to SLE disease duration. We calculated hazard ratios (HRs), adjusting for confounders.ResultsAmong 4,863 individuals with SLE (86% female, mean age 48.9 years), the IRs of MI, stroke, and CVD were 6.4, 4.4, and 9.9 events per 1,000 person‐years, respectively, versus 2.8, 2.3, and 4.7 events per 1,000 person‐years in the comparison cohort. Compared with non‐SLE individuals, the fully adjusted multivariable HRs among SLE patients were 2.61 (95% confidence interval [95% CI] 2.12–3.20) for MI, 2.14 (95% CI 1.64–2.79) for stroke, and 2.28 (95% CI 1.90–2.73) for CVD. The age‐, sex‐, and entry time–matched HRs for MI, stroke, and CVD were highest during the first year after SLE diagnosis: 5.63 (95% CI 4.02–7.87), 6.47 (95% CI 4.42–9.47), and 6.28 (95% CI 4.83–8.17), respectively.ConclusionPatients with SLE have an increased risk of cardiovascular events, particularly during the first year after diagnosis. Increased vigilance in monitoring for these potentially fatal outcomes and their modifiable risk factors is recommended in this patient population.