bluuebunny/crossref_metadata_2025_split huggingface dataset:
The ‘Emperor of Persia’
Authors: Mauntel Christoph 
Published: September 2017

From the late eleventh century onwards, the crusades brought Latin Christianity into direct contact with Muslim powers in the Near East. For the chroniclers of these events, the task of coping with the diversity of different Muslim actors the Christians faced was extremely challenging. Basically, they had two options to describe their respective political order: they could either use the rulers’ titles in the version supplied by the original language (i.e., sultan or caliph) or they could refer to them by using Latin terms (i.e., rex or imperator). An analysis of the way in which different crusade chroniclers described the political landscape of Islam in the Near East reveals interesting insights: ethnic denominations such as ‘Turks’ or ‘Saracens’ alternated with classical terms such as ‘Babylonians’ and ‘Persians’ thereby evoking ancient empires that were part of the medieval theory of translatio imperii. The Seljuk Sultan, for example, was frequently presented as the ‘emperor of Persia’. Thus, the Muslim states of the eleventh and twelfth centuries were at least to some extent presented as being part of the historical process of evolving and declining empires. The present article asks first how different chroniclers coped with the difficulty of naming and defining foreign political orders and thus developed distinctive interpretations of the history of these empires. Second, the article traces the way in which these models could be adopted by ‘non-crusade’ historiography: the example of William of Malmesbury shows that the English chronicler used the account by Fulcher of Chartres, but developed a remarkably distinctive version. Underlying his accounts is an overall theory of a continuing presence of eastern empires against the changing nature of politics in Christian Europe.
Therapy of highly active pediatric multiple sclerosis
Authors: Huppke Peter , Huppke Brenda , Ellenberger David , Rostasy Kevin , Hummel Hannah , Stark Wiebke , Brück Wolfgang , Gärtner Jutta 
Published: September 2017

Objective: Study aims were to determine the frequency of highly active disease in pediatric multiple sclerosis (MS), the response to natalizumab (NTZ) and fingolimod (FTY) treatment, and the impact of current treatment modalities on the clinical course. Methods: Retrospective single-center study in the German Center for MS in Childhood and Adolescence. Results: Of 144 patients with first MS manifestation between 2011 and 2015, 41.6% fulfilled the criteria for highly active MS. In total, 55 patients treated with NTZ and 23 with FTY demonstrated a significant reduction in relapse rate (NTZ: 95.2%, FTY: 75%), new T2 lesions (NTZ: 97%, FTY: 81%), and contrast-enhancing lesions (NTZ: 97%, FTY: 93%). However, seven patients switched from NTZ to FTY experienced an increase in disease activity. Comparing pediatric MS patients treated in 2005 with those treated in 2015 showed a 46% reduction in relapse rate and a 44% reduction in mean Expanded Disability Status Scale (EDSS). Conclusion: The rate of highly active disease among pediatric MS patients is high; more than 40% in our cohort. Response to NTZ and FTY treatment is similar if not better than observed in adults. Current treatment modalities including earlier treatment initiation and the introduction of NTZ and FTY have significantly improved the clinical course of pediatric MS.
Relationship between Pelvic Incidence Angle and Blood Concentration of Chromium and Cobalt Ions after Metal-on-Metal Hip Replacement: A Brief Report
Authors: Pernaa K. , Saltychev M. , Mäkelä K. 
Published: September 2017

Background and Aims: The wear of metal-on-metal hip implants may increase chromium or cobalt ion blood level. This phenomenon may depend among other things on the particularity of spinopelvic anatomy. The effect of pelvic incidence angle on the wear of metal-on-metal hip implants is not known. The objective of the study was to investigate whether such effect does exist. Material and Methods: The pelvic incidence and inclination of acetabular component angles of 89 patients after unilateral metal-on-metal hip replacement were compared with blood level of chromium and cobalt ions using Pearson correlation coefficient. Results: No significant correlations between pelvic incidence angle and the metal ion blood levels were observed. The correlation coefficients varied from −0.02 to 0.2 and all p values were >0.05. Conclusion: No evidence was found on the effect of pelvic incidence angle on metal wear after metal-on-metal hip replacement when measured by the blood levels of chromium and cobalt ions. It is reasonable to assume that other factors than pelvic tilt may affect the rate of implant wear.
Near-infrared spectroscopy can detect differences in vascular responsiveness to a hyperglycaemic challenge in individuals with obesity compared to normal-weight individuals
Authors: Soares Rogério Nogueira , Reimer Raylene A , Alenezi Zaid , Doyle-Baker Patricia K , Murias Juan Manuel 
Published: September 2017

Objective: To examine whether the near-infrared spectroscopy combined with vascular occlusion test technique could detect differences in vascular responsiveness during hyperglycaemia between normal-weight individuals and individuals with obesity. Methods: A total of 16 normal-weight individuals (body mass index, 21.3 ± 1.7 kg/m2) and 13 individuals with obesity (body mass index, 34.4 ± 2.0 kg/m2) were submitted to five vascular occlusion tests (Pre, 30, 60, 90 and 120 min after glucose challenge). Vascular responsiveness was determined by the Slope 2 (Slope 2 StO2) and the area under the curve (StO2AUC) of oxygen saturation derived from near-infrared spectroscopy–vascular occlusion test. Results: The Slope 2 StO2 increased from 1.07 ± 0.16%/s (Pre) to 1.53 ± 0.21%/s at 90 min ( p < 0.05) in the control group, while in obese it increased from 0.71 ± 0.09%/s (Pre) to 0.92 ± 0.14%/s at 60 min ( p < 0.05), and to 0.97 ± 0.10%/s ( p < 0.01) at 120 min after glucose ingestion. The StO2AUC decreased from 1729 ± 214% . sec (Pre) to 1259 ± 232% . sec at 60 min ( p < 0.05) and to 1034 ± 172% . sec at 90 min ( p < 0.05) in the normal-weight group, whereas it decreased at 90 min (637 ± 98% . sec; p < 0.05) and at 120 min (590 ± 93% . sec; p < 0.01) compared to 30 min (1232 ± 197% . sec) after glucose ingestion in individuals with obesity. Conclusion: Near-infrared spectroscopy–vascular occlusion test technique was capable of detecting differences in vascular responsiveness during hyperglycaemia between normal-weight individuals and individuals with obesity.
Quantification of pulmonary regurgitation in patients with repaired Tetralogy of Fallot by 2D phase-contrast MRI: Differences between the standard method of velocity averaging and a pixel-wise analysis
Authors: Sotelo Julio , Bächler Pablo , Urbina Jesús , Crelier Gerard , Toro Lida , Ferreiro Myriam , Valverde Israel , Andia Marcelo , Tejos Cristian , Irarrazaval Pablo , Uribe Sergio 
Published: September 2017

Objectives To compare the values of pulmonary regurgitation in patients with repaired Tetralogy of Fallot quantified from two-dimensional phase-contrast data, by using a new pixel-wise analysis and the standard velocity-averaging method. Design Quantitative in silico and in vivo analysis. Setting Hospital Sótero del Río. The magnetic resonance images were acquired using a Philips Achieva 1.5T scanner. Participants Twenty-five patients with repaired Tetralogy of Fallot who underwent cardiovascular magnetic resonance imaging requested by their referring physicians were included in this study. Main outcome measures Using a computational fluid dynamics simulation, we validated our pixel-wise method, quantifying the error of our method in comparison with the standard method. The patients underwent a standard two-dimensional phase-contrast magnetic resonance imaging acquisition for quantifying pulmonary artery flow. Pulmonary regurgitation fraction was estimated by using our pixel-wise and the standard method. The two-dimensional flow profiles were inspected looking for simultaneous antegrade and retrograde flows in the same cardiac phase. Statistical analysis was performed with t-test for related samples, Bland–Altman plots, and Pearson correlation coefficient. Results Estimation of pulmonary regurgitation fraction using the pixel-wise analysis revealed higher values compared with the standard method (39 ± 16% vs. 30 ± 22%, p-value <0.01). Eight patients (32%) had a difference of more than 10% between methods. Analysis of two-dimensional flow profiles in these patients revealed simultaneous antegrade and retrograde flows through the pulmonary artery during systole–early diastole. Conclusion Quantification of pulmonary regurgitation fraction in patients with repaired Tetralogy of Fallot through a pixel-wise analysis yields higher values of pulmonary regurgitation compared with the standard velocity-averaging method.
Outcome of coronary endarterectomy with coronary artery bypass grafting in patients with diffuse coronary artery disease in Bangladesh: A retrospective cohort study
Authors: Ranjan Redoy , Adhikary Dipannita , Mandal Sabita , Seedher Anjali , Adhikary Asit Baran 
Published: September 2017

Background In this study, we aimed to review the consequences of coronary endarterectomy with coronary artery bypass grafting, and assess outcomes of this combined surgical technique for patients with diffuse coronary artery disease in a single surgeon’s practice. Methods We retrospectively reviewed outcome of 1198 endarterectomized coronary artery in 1000 patients with diffuse coronary artery disease, who have had experienced coronary endarterectomy with off pump coronary artery bypass grafting in between 2009 and 2016. Results The mean age was 61.5 ± 5.5 years. Coronary endarterectomy was performed on 74.7% in the left coronary territory (43.2% left anterior descending, 26.6% diagonal, 4.9% Obtuse Marginal), and 25.3% in the right coronary territory. Post-operative intensive care unit mortality rate was 1.9%, and there were 11 (1.1%) late deaths. Mean intensive care unit stay was 36.6 ± 6.7 hours. Patients were extubated following a mean of 9.8 ± 1.25 hours. The mean duration of hospital stay was 10 ± 1 days. One-year survival rate was 97.8% and 89.5% survival rate was at 5 years follow up. However, 91.8% of patients were angina free at median follow-up of 2.5 years. Conclusion Coronary endarterectomy with off pump coronary artery bypass grafting is attainable and accomplishes surgical revascularization in coronary artery disease patients when there is no other alternative for sufficient revascularization.
Congenital Heart Disease in Cleft Lip and Palate Patients: How Common Is the Association?
Authors: Akhiwu Benjamin I. , Efunkoya Akinwale A. , Akhiwu Helen O. , Adebola Rafael A. 
Published: September 2017

Aims and Objectives: To determine the prevalence of congenital heart disease in patients with orofacial cleft in a Nigerian population. Materials and Methods: A retrospective review of all the case files of patients with orofacial cleft managed at the Dental and Maxillofacial Surgery unit of the Aminu Kano Teaching Hospital between 2007 and 2014. Data were analyzed using SPSS version 16. Results: A total of 133 patients with cleft lip and palate were seen during the period of study comprising 77 males and 56 females, giving an M:F ratio of 1:0.7. The age range was 15 days–36 years with a mean age of 6 years. There were five cases of congenital heart disease made up of two males and three females, giving a prevalence of 3.76 per cent. Conclusion: This study showed that the prevalence of congenital heart disease in patients with orofacial cleft was low. However, the need for routine echocardiography in all orofacial cleft patients especially children should not be overlooked.
Prevalence of Self-medication Practice among People Attending Oral Health Outreach Programmes in Madurai East, Tamil Nadu
Authors: Subhashini  , Garla Bharath Kumar , Karuppaiah Muthu , Taranath  
Published: September 2017

Aims and Objectives: The practice of self-medication may lead to lack of clinical evaluation by a trained medical professional and delay in effective therapy. This study was aimed to find the prevalence of self-medication and identify the common causes of illness/symptoms that necessitate self-medication awareness and develop perception regarding methods to prevent the growing trend of self-medication and associated factors among population those who visit a community outreach programme in Madurai, India. Material and Methods: A cross-sectional, questionnaire-based survey in which a semi-structured questionnaire was used to collect data. A total of 238 participants were included in the study with respect to the final sample size. Data were analysed using SPSS software with a significance level of 0.05, and statistical relationship between the variables was analysed using chi-square test. Results: The prevalence of self-medication is 69.32 per cent. Headache (59.6%), fever (60%), cough (51%) and toothache (25%) were the most common symptoms for self-medication. The most commonly used drugs/substances were analgesics (65.54%), warm saline (38.23%) and hot drinks (27.73%). The most common reason for resorting to self-medication practice was previous experience of successfully treating a similar illness. The majority of the participants (56.97%) were in their third–fourth decade of life. The association of self-medication with characteristics such as male gender, urban locality, and upper-and lower-middle class was statistically significant at a p-value of 0.005. Conclusion: Self-medication practices were quite high in this study, and these practices were also prevalent among the educated people. The physicians and health professionals have to spend some extra time in educating patients regarding the same. Improved knowledge and understanding about self-medication may result in rationale use and thus limit emerging microbial antibiotic resistance issues.
Quantifying Parental Influence on Youth Athlete Specialization: A Survey of Athletes’ Parents
Authors: Padaki Ajay S. , Ahmad Christopher S. , Hodgins Justin L. , Kovacevic David , Lynch Thomas Sean , Popkin Charles A. 
Published: September 2017

Background: Youth athlete specialization has been linked to decreased enjoyment, burnout, and increased injury risk, although the impact of specialization on athletic success is unknown. The extent to which parents exert extrinsic influence on this phenomenon remains unclear. Purpose/Hypothesis: The goal of this study was to assess parental influences placed on young athletes to specialize. It was hypothesized that parents generate both direct and indirect pressures on specialized athletes. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A survey tool was designed by an interdisciplinary medical team to evaluate parental influence on youth specialization. Surveys were administered to parents of the senior author’s orthopaedic pediatric patients. Results: Of the 211 parents approached, 201 (95.3%) completed the assessment tool. One-third of parents stated that their children played a single sport only, 53.2% had children who played multiple sports but had a favorite sport, and 13.4% had children who balanced their multiple sports equally. Overall, 115 (57.2%) parents hoped for their children to play collegiately or professionally, and 100 (49.7%) parents encouraged their children to specialize in a single sport. Parents of highly specialized and moderately specialized athletes were more likely to report directly influencing their children’s specialization ( P = .038) and to expect their children to play collegiately or professionally ( P = .014). Finally, parents who hired personal trainers for their children were more likely to believe that their children held collegiate or professional aspirations ( P = .009). Conclusion: Parents influence youth athlete specialization both directly and by investment in elite coaching and personal instruction. Parents of more specialized athletes exert more influence than parents of unspecialized athletes.
National Football League Skilled and Unskilled Positions Vary in Opportunity and Yield in Return to Play After an Anterior Cruciate Ligament Injury
Authors: Yang JaeWon , Hodax Jonathan D. , Machan Jason T. , Secrist Eric S. , Durand Wesley M. , Owens Brett D. , Eltorai Adam E.M. , Dodson Christopher C. 
Published: September 2017

Background: Anterior cruciate ligament (ACL) injuries pose a significant risk to the careers of players in the National Football League (NFL). The relationships between draft round and position on return to play (RTP) among NFL players are not well understood, and the ability to return to preinjury performance levels remains unknown for most positions. Purpose: To test for differences in RTP rates and changes in performance after an ACL injury by position and draft round. We hypothesized that skilled positions would return at a lower rate compared to unskilled positions. We further hypothesized that early draft-round status would relate to a greater rate of RTP and that skilled positions and a lower draft round would correlate with decreased performance for players who return to sport. Study Design: Case-control study; Level of evidence, 3. Methods: Utilizing a previously established database of publicly available information regarding ACL tears among NFL players, athletes with ACL tears occurring between the 2010 and 2013 seasons were identified. Generalized linear models and Kaplan-Meier time-to-event models were used to test the study hypotheses. Results: The overall RTP rate was 61.7%, with skilled players and unskilled players returning at rates of 64.1% and 60.4%, respectively ( P = .74). Early draft-round players and unskilled late draft-round players had greater rates of RTP compared to skilled late draft-round players and both unskilled and skilled undrafted free agents (UDFAs). Skilled early draft-round players constituted the only cohort that played significantly fewer games after an injury. Unskilled UDFAs constituted the only cohort to show a significant increase in the number of games started and ratio of games started to games played, starting more games in which they played, after an injury. Conclusion: Early draft-round and unskilled players were more likely to return compared to their later draft-round and skilled peers. Skilled early draft-round players, who displayed relatively high rates of RTP, constituted the only cohort to show a decline in performance. Unskilled UDFAs, who exhibited relatively low rates of RTP, constituted the only cohort to show an increase in performance. The significant effect of draft round and position type on RTP may be caused by a combination of differences in talent levels and in opportunities given to returning to play.
Transient Serous Retinal Detachment Possibly Related to Strenuous Exercise
Authors: Anderson Matthew Frederick , Fielden Michael , Ells Anna 
Published: September 2017

Purpose: To report a case of transient serous retinal detachment, which may have been caused by hypertensive choroidopathy associated with exercise. Methods: Case report with optical coherence tomography and fundus fluorescein angiography imaging. Results: A 26-year-old woman noticed loss of vision in her left eye following sprinting maximally on a treadmill. Her left vision reduced to Counting Fingers, and she had a serous retinal detachment involving the left macula and inferior fundus. Optical coherence tomography confirmed a serous retinal detachment. Fluorescein angiography showed multilobular pooling of dye in the subretinal space. One week later, her vision had improved spontaneously to 20/25, and the detachment had resolved. Results of her uveitis workup were normal. Conclusions: In the absence of other plausible etiologies, we suggest that the rapidly, spontaneously resolving detachment may have been due to hypertensive choroidopathy, secondary to marked elevation in her blood pressure during maximal exercise.
Predicting epiglottic collapse in patients with obstructive sleep apnoea
Authors: Azarbarzin Ali , Marques Melania , Sands Scott A. , Op de Beeck Sara , Genta Pedro R. , Taranto-Montemurro Luigi , de Melo Camila M. , Messineo Ludovico , Vanderveken Olivier M. , White David P. , Wellman Andrew 
Published: September 2017

Obstructive sleep apnoea (OSA) is characterised by pharyngeal obstruction occurring at different sites. Endoscopic studies reveal that epiglottic collapse renders patients at higher risk of failed oral appliance therapy or accentuated collapse on continuous positive airway pressure. Diagnosing epiglottic collapse currently requires invasive studies (imaging and endoscopy). As an alternative, we propose that epiglottic collapse can be detected from the distinct airflow patterns it produces during sleep.23 OSA patients underwent natural sleep endoscopy. 1232 breaths were scored as epiglottic/nonepiglottic collapse. Several flow characteristics were determined from the flow signal (recorded simultaneously with endoscopy) and used to build a predictive model to distinguish epiglottic from nonepiglottic collapse. Additionally, 10 OSA patients were studied to validate the pneumotachograph flow features using nasal pressure signals.Epiglottic collapse was characterised by a rapid fall(s) in the inspiratory flow, more variable inspiratory and expiratory flow and reduced tidal volume. The cross-validated accuracy was 84%. Predictive features obtained from pneumotachograph flow and nasal pressure were strongly correlated.This study demonstrates that epiglottic collapse can be identified from the airflow signal measured during a sleep study. This method may enable clinicians to use clinically collected data to characterise underlying physiology and improve treatment decisions.
“I have lost in every facet of my life”: the hidden burden of severe asthma
Authors: Foster Juliet M. , McDonald Vanessa M. , Guo Michael , Reddel Helen K. 
Published: September 2017

People with severe asthma are thought to face a sizeable daily disease burden. This study aimed to explore the little-known life experiences of people living with severe asthma.Adults with severe asthma were invited for telephone interview. Semistructured interviews were conducted until no new themes emerged. The 25 interviews were recorded, transcribed and analysed thematically.Four themes emerged. 1) “The body as a hindrance”: severe asthma placed broad limits on life from daily chores to career, relationships and family life that left interviewees feeling emotionally distressed. 2) “Burden of treatment”: participants mostly accepted the need to take treatment, but were particularly concerned about side-effects of oral corticosteroids. 3) “Alone with asthma”: interviewees felt misunderstood and alone in their experience of breathlessness and frightening exacerbations; practical and emotional support needs were often lacking and the emotional distress of severe asthma was amplified in those with little support. 4) “Striving to adapt”: patients used both positive strategies (acquiring self-management skills) and less positive strategies (avoidance of physical exertion) in the process of adjustment to living with severe asthma.Severe asthma imposes long-term, debilitating burdens and should be considered differently to milder disease. There is an urgent need to improve practical and emotional support services for patients and their carers.