bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk of infection following colonoscopy and sigmoidoscopy in symptomatic patients
Authors: Lin Jiun-Nong , Wang Chang-Bi , Yang Chih-Hui , Lai Chung-Hsu , Lin Hsi-Hsun 
Published: May 2017

Abstract
Background and study aims Previous studies describing the incidence of infection after colonoscopy and sigmoidoscopy are limited. The aim of this study was to determine the incidence of infection, and to propose a nomogram to predict the probability of infection following colonoscopy and sigmoidoscopy in symptomatic patients.
Patients and methods A nationwide retrospective study was conducted by analyzing the National Health Insurance Research Database of Taiwan. The incidence of infection within 30 days after colonoscopy and sigmoidoscopy was assessed and compared with a control group matched at a ratio of 1:1 based on age, sex, and the date of examination.
Results  In all, 112 543 patients who underwent colonoscopy or sigmoidoscopy and 112 543 matched patients who did not undergo these procedures were included. The overall incidence of infection within 30 days after colonoscopy and sigmoidoscopy was 0.37 %, which was significantly higher than that of the control group (0.04 %; P < 0.001). Diverticulitis, peritonitis, and appendicitis were the most common infections. Patients who underwent colonoscopy or sigmoidoscopy had a 9.38-fold risk of infection (95 % confidence interval, 6.81 – 12.93; P < 0.001) compared with the control group. The predicted infection-free rates of the nomogram were closely aligned with the actual infection-free rates, with a bootstrapping concordance index of 0.763.
Conclusions Colonoscopy and sigmoidoscopy are associated with an increased risk of infection, which may occur after these procedures. Our nomogram may provide clinicians with an easy tool to evaluate the risk of infection after colonoscopy and sigmoidoscopy in symptomatic patients.
C-Section Prevalence Among Obese Mothers and Neonatal Hypoglycemia: a Cohort Analysis of the Department of Gynecology and Obstetrics of the University of Lübeck
Authors: Neumann Kay , Indorf Ineke , Härtel Christoph , Cirkel Christoph , Rody Achim , Beyer Daniel 
Published: May 2017

Abstract
Introduction Data from the World Health Organization (WHO) demonstrates an increasing prevalence of obesity in Western countries. This study investigates the influence of obesity on the mode of delivery and the occurrence of hypoglycemia in newborns.
Materials and Methods A retrospective analysis of all deliveries at the Department of Gynecology and Obstetrics of the University of Lübeck, Germany was conducted over a period of eleven years with the primary outcome as non-elective C-sections and hypoglycemia of newborns from obese mothers. Patients were divided into six subgroups according to WHO weight classifications as follows: control group body mass index (BMI) 18.5 – 24.9 kg/m2, n = 7712; general obesity BMI ≥ 25 kg/m2, n = 4227; overweight BMI 25 – 29.9 kg/m2, n = 2628; obesity I° BMI 30 – 34.9 kg/m2, n = 1017; obesity II° BMI 35 – 39.9 kg/m2, n = 370; obesity III° BMI ≥ 40 kg/m2, n = 212.
Results Analysis of the primary outcome shows an increased incidence of non-elective C-sections with an elevated BMI (general obesity vs. control group: 20.5 vs. 15.9%, p < 0.001; OR 1.3; 95% CI 1.2 – 1.4) and elevated rates of neonatal hypoglycemia in newborns of obese mothers (general obesity vs. control group: 0.6 vs. 0.3%, p < 0.05; OR 1.8; 95% CI 1.0 – 3.0).
Conclusions Obesity is an essential obstetric risk factor. Obese women face an increased risk of non-elective C-sections, and newborns of obese mothers suffer from elevated rates of hypoglycemia.
Relationship Between Daily Dose, Serum Concentration, and Clinical Response to Quetiapine in Children and Adolescents with Psychotic and Mood Disorders
Authors: Albantakis Laura , Egberts Karin , Burger Rainer , Kulpok Christine , Mehler-Wex Claudia , Taurines Regina , Unterecker Stefan , Wewetzer Christoph , Romanos Marcel , Gerlach Manfred 
Published: May 2017

Abstract
Introduction In child and adolescent psychiatry, therapeutic drug monitoring (TDM) is strongly recommended. However, therapeutic ranges (TR) are defined only for adults. The objectives of this naturalistic study were to assess the relationships between serum quetiapine concentration, daily dose, and clinical outcomes as well as the determinants of pharmacokinetic variability. Furthermore, it was elucidated whether the recommended TR for adult patients with psychotic disorders is valid for children and adolescents.
Methods TDM was performed in 180 pediatric patients treated with quetiapine. Psychopathological changes were assessed by the Clinical Global Impression – Improvement scale (CGI-I). Adverse drug reactions (ADRs) were assessed by using a short form of the Udvalg for Kliniske Undersogelser (UKU) side effect rating scale.
Results A weak positive linear relationship between daily dose (mean 349.9±248.9 mg/day) and serum concentration of quetiapine (rs=0.496, p<0.001) was found (mean age 15.6±1.9 years, 45.6% male, 31.1% monotherapy), but no relationship between serum concentration and clinical outcome was found. Dose variation accounted for only 12.5% (rs
2=0.125) of the variability of serum concentrations. No effects by gender, age, body weight, smoking habits, and co-medication were found. The majority of patients with psychotic (67.8%) and mood disorders (74.5%) showed a serum concentration below the suggested lower limit (100 ng/mL) of the TR for adults.
Discussion There are several limitations of this study because of the naturalistic design, and our results should therefore be interpreted with caution. Notwithstanding, our data suggest that the lower limit of the TR for quetiapine is lower than the limit in adult patients.
Large Intra-subject Variability in Caffeine Pharmacokinetics: Randomized Cross-over Study of Single Caffeine Product
Authors: Hammami Muhammad , Alvi Syed 
Published: May 2017

Abstract
Background Average bioequivalence has been criticized for not adequately addressing individual variations. Importance of subjects’ blinding in bioequivalence studies has not been well studied. We explored the extent of intra-subject pharmacokinetic variability and effect of drug-ingestion unawareness in subjects taking single caffeine product.
Methods A single-dose randomized cross-over design was used to compare pharmacokinetics of 200 mg caffeine, described as caffeine (overt) or as placebo (covert). Maximum concentration (Cmax), Cmax first time (Tmax), area-under-the-concentration-time-curve, to last measured concentration (AUCT), extrapolated to infinity (AUCI), or to Tmax of overt caffeine (AUCOverttmax), and Cmax/AUCI were calculated blindly using standard non-compartmental method. Percentages of individual covert/overt ratios that are outside the ±25% range were determined. Covert-vs-overt effect on caffeine pharmacokinetics was evaluated by 90% confidence interval (CI) and 80.00–125.00% bioequivalence range.
Results 32 healthy subjects (6% females, mean (SD) age 33.3 (7.2) year) participated in the study (28 analysed). Out of the 28 individual covert/overt ratios, 23% were outside the ±25% range for AUCT, 30% for AUCI, 20% for AUCOverttmax, 30% for Cmax, and 43% for Tmax. There was no significant covert-vs-overt difference in any of the pharmacokinetic parameters studied. Further, the 90% CIs for AUCT, AUCI, Cmax, AUCOverttmax, and Cmax/AUCI were all within the 80.00–125.00% bioequivalence range with mean absolute deviation of covert/overt ratios of 3.31%, 6.29%, 1.43%, 1.87%, and 5.19%, respectively.
Conclusions Large intra-subject variability in main caffeine pharmacokinetic parameters was noted when comparing an oral caffeine product to itself. Subjects’ blinding may not be important in average bioequivalence studies.
Endoscopic hand-suturing for defect closure after gastric endoscopic submucosal dissection: a pilot study in animals and in humans
Authors: Goto Osamu , Sasaki Motoki , Akimoto Teppei , Ochiai Yasutoshi , Kiguchi Yoshiyuki , Mitsunaga Yutaka , Fujimoto Ai , Maehata Tadateru , Nishizawa Toshihiro , Takeuchi Hiroya , Kitagawa Yuko , Yahagi Naohisa 
Published: May 2017

Abstract
Background and study aims Mucosal suturing enables reliable and optimal defect closure after endoscopic treatments. We developed and investigated the feasibility of endoscopic hand-suturing (EHS) after gastric endoscopic submucosal dissection (ESD) in porcine in vivo models and in human clinical cases.
Patients and methods EHS involving continuous suturing of the mucosal layers using a through-the-scope needle-holder and absorbable barbed suture, was performed after gastric ESD in six live pigs and in eight consecutive patients. Success rates, adverse events, and suture maintenance were subsequently investigated.
Results EHS was successfully completed in all six pigs and eight patients (100 %) without severe adverse events. However, at 1 week postoperatively the suture closures had not been maintained in all six porcine cases and in the first four clinical cases. In the later four clinical cases, wider and tight suturing of the mucosal edges ensured that the defects remained closed until postoperative week 4.
Conclusion EHS is a feasible procedure that may facilitate secure and refined endoscopic surgeries. Mucosal closure in such cases can be maintained using firm suturing.Clinical trial number: UMIN000017125
Caffeine ingestion acutely enhances muscular strength and power but not muscular endurance in resistance‐trained men
Authors: Grgic Jozo , Mikulic Pavle 
Published: May 2017

AbstractThe goal of this randomized, double‐blind, cross‐over study was to assess the acute effects of caffeine ingestion on muscular strength and power, muscular endurance, rate of perceived exertion (RPE), and pain perception (PP) in resistance‐trained men. Seventeen volunteers (mean ± SD: age = 26 ± 6 years, stature = 182 ± 9 cm, body mass = 84 ± 9 kg, resistance training experience = 7 ± 3 years) consumed placebo or 6 mg kg−1 of anhydrous caffeine 1 h before testing. Muscular power was assessed with seated medicine ball throw and vertical jump exercises, muscular strength with one‐repetition maximum (1RM) barbell back squat and bench press exercises, and muscular endurance with repetitions of back squat and bench press exercises (load corresponding to 60% of 1RM) to momentary muscular failure. RPE and PP were assessed immediately after the completion of the back squat and bench press exercises. Compared to placebo, caffeine intake enhanced 1RM back squat performance (+2.8%; effect size [ES] = 0.19; p = .016), which was accompanied by a reduced RPE (+7%; ES = 0.53; p = .037), and seated medicine ball throw performance (+4.3%, ES = 0.32; p = .009). Improvements in 1RM bench press were not noted although there were significant (p = .029) decreases in PP related to this exercise when participants ingested caffeine. The results point to an acute benefit of caffeine intake in enhancing lower‐body strength, likely due to a decrease in RPE; upper‐, but not lower‐body power; and no effects on muscular endurance, in resistance‐trained men. Individuals competing in events in which strength and power are important performance‐related factors may consider taking 6 mg kg−1 of caffeine pre‐training/competition for performance enhancement.
Labeling Food Processes: The Good, the Bad and the Ugly
Authors: Messer Kent D. , Costanigro Marco , Kaiser Harry M. 
Published: May 2017

AbstractConsumers are increasingly exposed to labels communicating specific processing aspects of food production, and recent state and federal legislation in the United States has called for making some of these labels mandatory. This article reviews the literature in this area and identifies the positive and negative aspects of labeling food processes. The good parts are that, under appropriate third‐party or governmental oversight, process labels can effectively bridge the informational gap between producers and consumers, satisfy consumer demand for broader and more stringent quality assurance criteria, and ultimately create value for both consumers and producers. Despite the appeal of the “Consumer Right to Know” slogan, process labeling also can have serious unintentional consequences. The bad parts are that consumers can misinterpret these labels and thus misalign their personal preferences and their actual food purchases. The ugly parts are that these labels can stigmatize food produced with conventional processes even when there is no scientific evidence that they cause harm, or even that it is compositionally any different. Based on this review of the literature, we provide three policy recommendations: (i) mandatory labeling of food processes should occur only in situations in which the product has been scientifically demonstrated to harm human health; (ii) governments should not impose bans on process labels because this approach goes against the general desire of consumers to know about and have control over the food they are eating, and it can undermine consumer trust of the agricultural sector; and (iii) a prudent policy approach is to encourage voluntary process labeling, perhaps using smart phone technology similar to that proposed in 2016 federal legislation related to foods containing ingredients that were genetically engineered.
Disraeli, the East and Religion: Tancred in Context
Authors: Parry J P 
Published: May 2017

Abstract
Recently there has been much interest in Benjamin Disraeli’s writings, and particularly the importance to him of empire, race and Jewishness. His favourite among his own novels, Tancred (1847), set in the Near East, is now often said to advocate Asian imperialism and Jewish superiority and to mark a key stage in his ‘self-fashioning’ as a political leader. This article suggests that the problem with these interpretations, and with the older argument that Disraeli revelled in a lack of principle (which also draws on Tancred) is that they fail to put novel and author in the context of the time. By the 1840s, Disraeli’s books were not obsessed with his own identity; instead he used them to engage with important live issues. The Near Eastern themes which Tancred tackled included serious international questions and equally intense arguments about domestic Christianity, which were themselves heavily influenced by new perspectives on the East. The book discussed how the Church of England, weakened by sectarianism and materialism, could regain the leadership of national opinion. It attacked the liberal sectarian policy pursued by the Peel government in Syria and Lebanon, and European political, religious and economic intervention in the Ottoman Empire more broadly. Commentators have misunderstood what Disraeli meant by ‘empire’, and his (critical) remarks on modern Jews. They continue to present him as exotic, and have read Tancred accordingly, as a personal manifesto for unusual and one-sided causes. Once placed in the context of the time in which it was written, the book’s great theme is revealed as the opposite: the need to abandon partisanship for synthesis in Western and Eastern politics and religion, if a chaotic world is to be brought to order.
Disentangling the role of sea lice on the marine survival of Atlantic salmon
Authors: Vollset Knut Wiik , Dohoo Ian , Karlsen Ørjan , Halttunen Elina , Kvamme Bjørn Olav , Finstad Bengt , Wennevik Vidar , Diserud Ola H , Bateman Andrew , Friedland Kevin D , Mahlum Shad , Jørgensen Christian , Qviller Lars , Krkošek Martin , Åtland Åse , Barlaup Bjørn Torgeir 
Published: May 2017

AbstractThe effects of sea lice on the marine survival of wild salmonids are widely debated. In Norway this debate has reached a crescendo as the Norwegian government has recently ratified a management system where the growth in the salmonid aquaculture industry will be conditional on regional estimated impact of salmon lice on wild fish. Sea lice have thus become the most prominent obstacle to the stated political aim of quintupling aquaculture production in Norway by 2050. Scientific documentation that salmon lice impact the marine survival of salmon is robust. However, it is also evident that marine survival of salmon is strongly impacted by other factors, and that the effect of salmon lice is most likely an integral part of these other mortality factors. In this paper, our goal is to discuss and give advice on how managers and policy makers should handle this complexity, and to identify the greatest challenges in using scientific results to construct robust management rules. Inadequate extrapolation from the scale of known effects to the scale of management implementation may initially give a false impression of scientific certainty, but will eventually fuel upsetting disagreements among stakeholders as they gradually uncover the shaky foundation of the implemented policy. Thus, using a single model and parameter to determine management advice is not warranted, as no single data point reflects the natural complexity of nature. Furthermore, robust management rules should be based on unambiguous definitions of key concepts. Finally, despite the scientific consensus that salmon lice are a risk to salmon, studies on wild populations in situ that accurately quantify the impact of salmon lice are still urgently needed. We give advice on how this can be accomplished.
Stereotactic Radiosurgery for Brainstem Arteriovenous Malformations: A Multicenter Study
Authors: Cohen-Inbar Or , Starke Robert M , Lee Cheng-Chia , Kano Hideyuki , Huang Paul , Kondziolka Douglas , Grills Inga S , Silva Danilo , Abbassy Mohmoud , Missios Symeon , Barnett Gene H , Lunsford L Dade , Sheehan Jason P 
Published: May 2017

Abstract

BACKGROUND
The management of brainstem arteriovenous malformations (bAVMs) is a formidable challenge. bAVMs harbor higher morbidity and mortality compared to other locations.

OBJECTIVE
To review the outcomes following stereotactic radiosurgery (SRS) of bAVMs in a multicenter study.

METHODS
Six medical centers contributed data from 205 patients through the International Gamma Knife Research Foundation. Median age was 32 yr (6-81). Median nidus volume was 1.4 mL (0.1-69 mL). Favorable outcome (FO) was defined as AVM obliteration and no post-treatment hemorrhage or permanent symptomatic radiation-induced complications.

RESULTS
Overall obliteration was reported in 65.4% (n = 134) at a mean follow-up of 69 mo. Obliteration was angiographically proven in 53.2% (n = 109) and on MRA in 12.2% (n = 25). Actuarial rate of obliteration at 2, 3, 5, 7, and 10 yr after SRS was 24.5%, 43.3%, 62.3%, 73%, and 81.8% respectively. Patients treated with a margin dose >20 Gy were more likely to achieve obliteration (P = .001). Obliteration occurred earlier in patients who received a higher prescribed margin dose (P = .05) and maximum dose (P = .041). Post-SRS hemorrhage occurred in 8.8% (n = 18). Annual postgamma knife latency period hemorrhage was 1.5%. Radiation-induced complications were radiologically evident in 35.6% (n = 73), symptomatic in 14.6% (n = 30), and permanent in 14.6% (n = 30, which included long-tract signs and new cranial nerve deficits). FO was achieved in 64.4% (n = 132). Predictors of an FO were a higher Virginia radiosurgery AVM scale score (P = .003), prior hemorrhage (P = .045), and a lower prescribed maximum dose (P = .006).

CONCLUSION
SRS for bAVMs results in obliteration and avoids permanent complications in the majority of patients.
Contrast Time-Density Time on Digital Subtraction Angiography Correlates With Cerebral Arteriovenous Malformation Flow Measured by Quantitative Magnetic Resonance Angiography, Angioarchitecture, and Hemorrhage
Authors: Brunozzi Denise , Hussein Ahmed E , Shakur Sophia F , Linninger Andreas , Hsu Chih-Yang , Charbel Fady T , Alaraj Ali 
Published: May 2017

Abstract

BACKGROUND
Digital subtraction angiography (DSA) currently provides angioarchitectural features of cerebral arteriovenous malformations (AVMs) but its role in the hemodynamic evaluation of AVMs is poorly understood.

OBJECTIVE
To assess contrast time-density time (TT) on DSA relative to AVM flow measured using quantitative magnetic resonance angiography (QMRA).

METHODS
Patients seen at our institution between 2007 and 2014 with a supratentorial AVM and DSA and QMRA obtained prior to any treatment were retrospectively reviewed. Regions of interest were selected on the draining veins at the point closest to the nidus. TT on DSA was defined as time needed for contrast to change image intensity from 10% to 100%, 100% to 10%, and 25% to 25%. TT was correlated to AVM total flow, angioarchitectural features, and hemorrhage.

RESULTS
Twenty-eight patients (mean age 35.6 yr) were included. Six patients presented with hemorrhage. Mean AVM volume was 11.42 mL (range 0.3-57.7 mL). Higher total AVM flow significantly correlated with shorter TT100%-10% and TT25%-25% (P = .02, .02, respectively). Presence of venous stenosis correlated significantly with shorter TT100%-10% (P = .04) and TT25%-25% (P = .04). AVMs with a single draining vein exhibited longer TT25%-25% compared to those with multiple draining veins (P = .04). Ruptured AVMs had significantly shorter TT10%-100% compared to unruptured AVMs (P = .05).

CONCLUSION
TT on DSA correlates with cerebral AVM flow measured using QMRA and with AVM angioarchitecture and hemorrhagic presentation. Thus, TT may be used to indirectly estimate AVM flow during angiography in real-time and may also be an indicator of important AVM characteristics associated with outflow resistance and increased rupture risk, such as venous stenosis.
Tumor Progression Following Petroclival Meningioma Subtotal Resection: A Volumetric Study
Authors: Hunter Jacob B , O’Connell Brendan P , Carlson Matthew L , Chambless Lola C , Yawn Robert J , Wang Ray , Mistry Akshitkumar , Thompson Reid C , Weaver Kyle D , Wanna George B 
Published: May 2017

Abstract

BACKGROUND
One study has investigated postoperative growth rates following subtotal resection of petroclival meningiomas utilizing linear measurements, which are insensitive to the multidimensional complex growth of meningiomas, to estimate tumor volume.

OBJECTIVE
To describe petroclival meningioma growth patterns following less-than-complete resection utilizing volumetric analysis and to identify variables associated with tumor progression.

METHODS
Patients with surgically resected WHO grade I petroclival meningiomas were retrospectively reviewed (1999-2015). Image analysis software was utilized to perform volumetric analyses of tumor size and growth on serial MRI studies. The impact of preoperative and postoperative variables on tumor growth after subtotal resection was analyzed. An increase in tumor volume of at least 20% was defined as “tumor growth.”

RESULTS
Twenty-three patients had immediate preoperative and serial postoperative MRI studies available for review. The mean preoperative tumor volume was 20.9 cm3 (range 0.4-54.6). The mean extent of resection was 75.5% (range 31.5%-100.0%). At a mean follow-up of 24.8 mo, 12 tumors (66.7%) exhibited radiological tumor growth, while 6 tumors did not change in size. The median annual volumetric growth rate was 2.82 cm3/yr (range –0.34 to 10.1). Extent of resection and immediate postoperative tumor volume were significantly correlated with the annual volumetric growth rate following resection. At last follow-up, 3 (13%) patients required further intervention.

CONCLUSION
The majority of petroclival meningiomas exhibit growth following subtotal resection. Extent of resection is strongly associated with risk for disease progression following surgery.