bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transaminase levels reflect disease severity in children ventilated for respiratory syncytial virus (RSV) bronchiolitis
Authors: Thorburn Kentigern , Fulton Crawford , King Charlotte , Ramaneswaran Difijah , Alammar Abdulaziz , McNamara Paul S. 
Published: January 2018

AbstractBronchiolitis, often caused by respiratory syncytial virus (RSV), is the commonest cause of hospitalisation in infancy. Serum transaminases are sometimes raised in children with bronchiolitis. We tested the hypothesis that raised transaminases are associated with increased disease severity in children ventilated for bronchiolitis. Prospective observational cohort study of mechanically ventilated children with community-acquired RSV bronchiolitis. Alanine transaminase (ALT) and aspartate transaminase (AST) levels were measured daily. Children with normal transaminases were compared with those with elevated levels. Over 11 consecutive winters, 556 children with RSV bronchiolitis were mechanically ventilated – 226 had comorbidities and therefore excluded; 313 of remaining 330 were under 2 years age; 305 had early transaminase measurements. 57/305 (19%) had elevated transaminase (AST and/or ALT) levels. For the first time we show that duration of ventilation and length of admission were both significantly longer, and paediatric index of mortality and C-reactive protein higher, in those with elevated AST levels on admission (but not those with elevated ALT levels). Furthermore, transaminase elevations were transient, generally having normalised by seven days following admission. RSV bronchiolitis was more severe in children with early elevated AST levels and could be used early in the illness as a predictor for disease severity.
Clinical Application of Flexible Endoscopic Evaluation of Swallowing in Stroke
Authors: Murray Joseph , Pisegna Jessica 
Published: January 2018

AbstractThis article aims to review the use of laryngoscopy to assess swallowing function in the stroke population. Since its inception in 1988, fiberoptic endoscopic evaluation of swallowing (FEES) has become an established procedure with distinct objective findings and practical applications, enabling many to choose it as the primary instrumental tool in evaluating poststroke dysphagia. In this article, we outline the decision-making process of when to use FEES. We highlight considerations for the acute stroke patient and visual signs that guide decision making during a FEES, such as secretions, swallowing frequency, and pharyngeal squeeze elicitation. The application of the ice chip protocol for stroke patients who have been nil per os is discussed, along with common observable events on FEES performed on stroke patients like a delay, penetration/aspiration, and bolus retention. Finally, we briefly review testing interventions and follow-up readiness with FEES.
Current Status of Arterial Revascularization for the Treatment of Critical Limb Ischemia in Infrainguinal Atherosclerotic Disease
Authors: Velioglu Yusuf , Cayir Mustafa , Kumtepe Gencehan , Gurbuz Orcun , Yuksel Ahmet 
Published: January 2018

AbstractCritical limb ischemia (CLI) is the most severe form of peripheral arterial disease (PAD) that may result in limb loss and even death; thus, the fast and proper treatment should be employed as earlier as possible to prevent these catastrophic consequences. Arterial revascularization is almost always an indispensable treatment option for CLI. Although both endovascular and surgical revascularization procedures have an important role, nowadays, the hybrid revascularization as a combination of these revascularization procedures has also gained increasing popularity in the treatment of patients with CLI. This review provides an update on the arterial revascularization strategies for the treatment of CLI.
Expanded Endoscopic Endonasal Resection of Retrochiasmatic Craniopharyngioma
Authors: Davanzo Justin , Goyal Neerav , Zacharia Brad 
Published: January 2018

AbstractThis video abstract demonstrates the use of the expanded endoscopic endonasal approach for the resection of a retrochiasmatic craniopharyngioma. These tumors are notoriously difficult to treat, and many approaches have been tried to facilitate safe and effective resection. The endoscopic endonasal approach has been increasingly utilized for selected sellar/suprasellar pathology. We present the case of a 39-year-old man who was found to have a cystic, partially calcified suprasellar mass consistent with a craniopharyngioma. To facilitate robust skull base repair, a vascularized nasoseptal flap was harvested. A wide sphenoidotomy was performed and the sella and tuberculum were exposed. After the dural opening and arachnoid dissection, the stalk was identified, merging seamlessly with the tumor capsule. The lesion was then internally debulked with the use of an ultrasonic aspirator. The capsule was then dissected off of the optic chiasm, thalamus, and hypothalamus. The cavity was inspected with an angled endoscope to ensure complete resection. A multilayered reconstruction was performed using autologous fascia lata, the previously harvested nasoseptal flap, and dural sealant. Postoperatively, the patient did have expected panhypopituitarism but remained neurologically intact and had improvement in his vision. In conclusion, this video demonstrates how an expanded endonasal approach can be used to safely resect a craniopharyngioma, even when in close proximity to delicate structures such as the optic chiasm.The link to the video can be found at: https://youtu.be/tahjHmrXhc4.
Nierenmanifestationen bei Amyloidose und Sarkoidose
Authors: Beimler Jörg , Zeier Martin 
Published: January 2018

AbstractAmyloidosis is a rare disease characterized by extracellular deposition of fibrils. Among the most common forms of systemic amyloidosis with renal involvement are AL-amyloidosis based on plasma cell dyscrasia and AA-amyloidosis in chronic inflammatory diseases. Depending on the affected renal compartment, the clinical appearance of renal amyloidosis varies. The pattern of renal amyloid deposition can be glomerular, interstitial, tubular or even vascular. Renal amyloid deposits are detected by renal biopsy. Patients with glomerular deposits typically show severe nephrotic syndrome with volume overload. Patients with predominantly tubulo-interstitial or vascular deposits typically exhibit lower proteinuria and progressive renal impairment. Treatment strategies for renal amyloidosis are primarily based on the treatment of the underlying disease including chemotherapy or stem cell transplantation in AL-amyloidosis or treatment of chronic inflammatory diseases in AA-amyloidosis. Granulomatous interstitial nephritis is the most common renal lesion occurring in sarcoidosis. Therapy of granulomatous interstitial nephritis is mainly based on the use of glucocorticoids.
Nierenbeteiligung bei ANCA-assoziierten Vaskulitiden
Authors: Haubitz Marion 
Published: January 2018

AbstractIn patients with ANCA-associated vasculitis renal involvement is frequently seen and the severity of renal manifestation is very important for therapeutic strategies and prognosis. Clinically rapid loss of renal function, nephritic sediment and proteinuria in a non-nephrotic range are characterizing a focal segmental necrotizing pauci-immune glomerulonephritis with extrarenal proliferations. Induction treatment depends on the severity of manifestations. With a normal renal function methotrexate can be used in combination with steroids. In patients with organ threatening involvement but creatinine below 500 µmol/l cyclophosphamide pulses or Rituximab should be used together with steroids, initially with i. v. pulses. Rituximab is more effective in PR3-ANCA vasculitis and should be used in relapsing disease, in young patients to avoid gonadal toxicity and in patients with an increased risk of malignancies. In patients on dialysis or with creatinine > 500 µmol/l plasma exchange should be added. Maintenance treatment (mainly with azathioprine) is necessary as at least 50 % of the patients develop relapses. Rituximab seems more effective, however it is not approved for maintenance treatment and no long-term data are available. Adjuvant treatment, long-term side effects and the increased incidence of cardiovascular events have to be included in the follow-up of vasculitis patients. In end-stage renal disease patients relapses occur but are more difficult to diagnose and treat with higher incidence of infections. Transplantation should be offered as patient and transplant survival is good.
Letrozole vs. Placebo Pretreatment in the Medical Management of First Trimester Missed Miscarriage: a Randomized Controlled Trial
Authors: Torky Haitham A. , Marie Heba , ElDesouky ElSayed , Gebreel Samy , Raslan Osama , Moussa Asem A. , Ahmad Ali M. , Zain Eman , Mohsen Mohamed N. 
Published: January 2018

Abstract
Introduction Misoprostol is used for the medical management of miscarriage as it is more effective in the early stages of pregnancy. Letrozole has an anti-estrogen effect and is used
for the pretreatment of miscarriage with misoprostol.
Aim The aim of this study was compare the efficacy and safety of letrozole with placebo pretreatment in the medical management of first trimester missed miscarriage.
Design This was a prospective randomized case-control study.
Patients and Methods Four hundred and thirty-eight women were randomly divided into two groups of 219; the placebo group received placebo tablets twice daily for 3 days, followed by
800 micrograms of misoprostol vaginally on the fourth day of enrolment, while the letrozole group received letrozole 10 mg twice daily for three days followed by 800 micrograms misoprostol
administered vaginally. Symptoms and side effects were recorded, and the women advised to return to hospital if they experienced severe pain or bleeding or intolerable side effects and to
report to hospital for a check-up one week after misoprostol administration. Ultrasound was done seven days after misoprostol administration to monitor outcomes. Surgical evacuation was
carried out if medical management failed.
Results There were significant differences between the two groups, with better outcomes found for the letrozole group in terms of rates of complete miscarriage, onset of vaginal
bleeding, and interval between induction and onset of expulsion (p < 0.001). A higher rate of nausea and vomiting was reported for the letrozole group (p = 0.002). Differences between
groups with regard to pre- and post-termination hemoglobin levels, fever, severe pain and severe bleeding needing evacuation were not statistically significant.
Conclusion Adding letrozole to misoprostol improves the success rate and decreases the interval between induction and expulsion in cases of first trimester miscarriage; however,
nausea and vomiting is higher with letrozole.
Klinische und soziodemografische Unterschiede zwischen Patienten mit und ohne Migrationshintergrund in einer Psychiatrischen Institutsambulanz
Authors: Brandl Eva , Dietrich Nora , Mell Nicoleta , Winkler Johanna , Gutwinski Stefan , Bretz Joachim , Schouler-Ocak Meryam 
Published: January 2018

Zusammenfassung
Ziel der Studie Die Untersuchung diente einem besseren Verständnis soziodemografischer und klinischer Unterschiede zwischen psychiatrischen Patientinnen und Patienten mit und ohne Migrationshintergrund.
Methodik Soziodemografische und klinische Daten zu Diagnosen, Psychopharmaka, Behandlungsdauer und subjektive Symptombelastung (SCL-14) wurden an 423 Personen erhoben.
Ergebnisse Es bestanden signifikante Unterschiede bezüglich demografischer Faktoren. Personen mit Migrationshintergrund gaben eine höhere Symptombelastung an.
Schlussfolgerung Die Daten verdeutlichen die großen Unterschiede zwischen Personen mit und ohne Migrationshintergrund bezüglich soziodemografischer und klinischer Faktoren, was in der psychiatrischen Behandlung von Personen mit Migrationshintergrund berücksichtigt werden sollte.
Smoking Decreases Endometrial Thickness in IVF/ICSI Patients
Authors: Heger Anna , Sator Michael , Walch Katharina , Pietrowski Detlef 
Published: January 2018

Abstract
Introduction Smoking is a serious problem for the health care system. Many of the compounds identified in cigarette smoke have toxic effects on the fertility of both females and males. The purpose of this study was to determine whether smoking affects clinical factors during IVF/ICSI therapy in a single-center reproductive unit.
Material and Methods In a retrospective study of 200 IVF/ICSI cycles, endometrial thickness and the outcome of IVF/ICSI therapy were analyzed.
Results Endometrial thickness was significantly lower in smoking patients than in non-smoking patients (10.4 ± 1.5 mm vs. 11.6 ± 1.8 mm). Age was significantly higher in women who failed to conceive. The total dose of gonadotropins administered was significantly lower in pregnant patients and the highest pregnancy rate was achieved with an rFSH protocol. BMI and number of cigarettes smoked did not influence treatment outcomes in this study.
Conclusion We showed that smoking has a negative effect on endometrial thickness on the day of embryo transfer. This may help to further explain the detrimental influence of tobacco smoke on implantation and pregnancy rates during assisted reproduction therapy.
Human bone perivascular niche-on-a-chip for studying metastatic colonization
Authors: Marturano-Kruik Alessandro , Nava Michele Maria , Yeager Keith , Chramiec Alan , Hao Luke , Robinson Samuel , Guo Edward , Raimondi Manuela Teresa , Vunjak-Novakovic Gordana 
Published: January 2018

Significance
Improved human preclinical models are needed to better predict patients’ responses to anticancer drugs. Increasing the complexity of models may be a successful strategy only if crucial components of a tumor are identified, replicated, and controlled in vitro. We developed a perivascular niche to study metastatic colonization of the bone. Using a microfluidic chip, we exposed the niche to interstitial flow, oxygen gradients, and external forces, and established a dense vascular network. Cancer cells colonizing the bone resisted targeted therapy by entering a slow proliferative state. We expect that microfluidic niche-on-chip models will facilitate the development of drugs targeting persistent tumor cells into the bone and help manage the risk of metastatic relapse.
Deep Learning–Based Noise Reduction Approach to Improve Speech Intelligibility for Cochlear Implant Recipients
Authors: Lai Ying-Hui , Tsao Yu , Lu Xugang , Chen Fei , Su Yu-Ting , Chen Kuang-Chao , Chen Yu-Hsuan , Chen Li-Ching , Po-Hung Li Lieber , Lee Chin-Hui 
Published: January 2018

Objective:We investigate the clinical effectiveness of a novel deep learning–based noise reduction (NR) approach under noisy conditions with challenging noise types at low signal to noise ratio (SNR) levels for Mandarin-speaking cochlear implant (CI) recipients.Design:The deep learning–based NR approach used in this study consists of two modules: noise classifier (NC) and deep denoising autoencoder (DDAE), thus termed (NC + DDAE). In a series of comprehensive experiments, we conduct qualitative and quantitative analyses on the NC module and the overall NC + DDAE approach. Moreover, we evaluate the speech recognition performance of the NC + DDAE NR and classical single-microphone NR approaches for Mandarin-speaking CI recipients under different noisy conditions. The testing set contains Mandarin sentences corrupted by two types of maskers, two-talker babble noise, and a construction jackhammer noise, at 0 and 5 dB SNR levels. Two conventional NR techniques and the proposed deep learning–based approach are used to process the noisy utterances. We qualitatively compare the NR approaches by the amplitude envelope and spectrogram plots of the processed utterances. Quantitative objective measures include (1) normalized covariance measure to test the intelligibility of the utterances processed by each of the NR approaches; and (2) speech recognition tests conducted by nine Mandarin-speaking CI recipients. These nine CI recipients use their own clinical speech processors during testing.Results:The experimental results of objective evaluation and listening test indicate that under challenging listening conditions, the proposed NC + DDAE NR approach yields higher intelligibility scores than the two compared classical NR techniques, under both matched and mismatched training-testing conditions.Conclusions:When compared to the two well-known conventional NR techniques under challenging listening condition, the proposed NC + DDAE NR approach has superior noise suppression capabilities and gives less distortion for the key speech envelope information, thus, improving speech recognition more effectively for Mandarin CI recipients. The results suggest that the proposed deep learning–based NR approach can potentially be integrated into existing CI signal processors to overcome the degradation of speech perception caused by noise.
Determination of Examination-Specific Diagnostic Reference Level in Computed Tomography by A New Quality Control-Based Dose Survey Method
Authors: Parsi Masoumeh , Sohrabi Mehdi , Mianji Fereidoun , Paydar Reza 
Published: January 2018

Abstract
A new “quality-control-based (QC-based) dose survey method” has been developed for determination of diagnostic reference levels (DRL) in Computed Tomography (CT) examinations. The “QC-based dose survey method” is based on the use of retrospective data in the QC documents and reports, which are typically available from the National Regulatory Authority database. The method was applied to 70 CT scanners in Tehran, Iran, by using the available QC reports from the database. The commonly used “data collection method” was also applied by filling each questionnaire on-site to validate the new method. Using the new QC-based and data collection methods, the DRLs of four common CT examinations: head, sinus, chest, and abdomen/pelvis were determined and compared. The DRLs determined by the “QC-based method” for head, sinus, chest, and abdomen/pelvis are 59, 29, 10, and 13 mGy, respectively, for the volume computed tomography dose index (CTDIVol) and 834, 235, 233, and 522 mGy-cm for the dose length product (DLP), respectively. The difference between the DRLs obtained by the two methods is on the average 6.7 ± 5.7%, which is within the acceptance tolerance level of the IAEA for QC dosimetry tests. The “QC-based dose survey method” is believed to be an effective alternative method to the other commonly used “data collection” and “direct dose measurement method” for determination of CT examination DRLs. This new method has unique characteristics such as simplicity, time and cost effectiveness, highly reduced clinical interruptions and collaborations, and potential for large-scale surveys with capability for more frequent review of national DRL values.
Initial Experience of Single-port Laparoscopic Multivisceral Resection for Locally Advanced Colon Cancer
Authors: Tei Mitsuyoshi , Otsuka Masahisa , Suzuki Yozo , Akamatsu Hiroki 
Published: January 2018

Aim:
The aim of this study was to evaluate the safety and feasibility of single-port laparoscopic multivisceral resection (SLMVR) for locally advanced colon cancer invading or adhering to neighboring organs.

Method:
A prospectively collected database was collated of all patients undergoing SLMVR from January 2011 to December 2014. Short-term and long-term oncologic outcomes were evaluated.

Results:
Thirty consecutive patients who underwent SLMVR were identified and the completion rate was 90%. The R0 resection rate of the primary tumor was 100%. The postoperative complication rate was 23.3%. The 3-year relapse-free survival rates of patients with stage II (n=11) and stage III (n=12) disease were 80.8% and 54.6%, respectively. The 5-year overall survival rates of patients with stage II and stage III disease were 75.8% and 75.0% over a median follow-up of 42 months, respectively.

Conclusions:
SLMVR for locally advanced colon cancer is safe and feasible in selected patients.
Linear-Nonlinear-Time-Warp-Poisson models of neural activity
Authors: Lawlor Patrick N. , Perich Matthew G. , Miller Lee E. , Kording Konrad P. 
Published: January 2018

AbstractProminent models of spike trains assume only one source of variability – stochastic (Poisson) spiking – when stimuli and behavior are fixed. However, spike trains may also reflect variability due to internal processes such as planning. For example, we can plan a movement at one point in time and execute it at some arbitrary later time. Neurons involved in planning may thus share an underlying time-course that is not precisely locked to the actual movement. Here we combine the standard Linear-Nonlinear-Poisson (LNP) model with Dynamic Time Warping (DTW) to account for shared temporal variability. When applied to recordings from macaque premotor cortex, we find that time warping considerably improves predictions of neural activity. We suggest that such temporal variability is a widespread phenomenon in the brain which should be modeled.
A hypermorphic Nfkbid allele represents an Idd7 locus gene contributing to impaired thymic deletion of autoreactive diabetogenic CD8+ T-cells in NOD mice
Authors: Presa Maximiliano , Racine Jeremy J. , Dwyer Jennifer R. , Lamont Deanna J. , Ratiu Jeremy J. , Sarsani Vishal Kumar , Chen Yi-Guang , Geurts Aron , Schmitz Ingo , Stearns Timothy , Allocco Jennifer , Chapman Harold D. , Serreze David V. 
Published: January 2018

AbstractIn both NOD mice and humans, the development of type 1 diabetes (T1D) is dependent in part on autoreactive CD8+ T-cells recognizing pancreatic ß-cell peptides presented by often quite common MHC class I variants. Studies in NOD mice previously revealed the common H2-Kd and/or H2-Db class I molecules expressed by this strain acquire an aberrant ability to mediate pathogenic CD8+ T-cell responses through interactions with T1D susceptibility (Idd) genes outside the MHC. A gene(s) mapping to the Idd7 locus on proximal Chromosome 7 was previously shown to be an important contributor to the failure of the common class I molecules expressed by NOD mice to mediate the normal thymic negative selection of diabetogenic CD8+ T-cells. Using an inducible model of thymic negative selection and mRNA transcript analyses we initially identified an elevated Nfkbid expression variant is likely an NOD Idd7 region gene contributing to impaired thymic deletion of diabetogenic CD8+ T-cells. CRISPR/Cas9-mediated genetic attenuation of Nfkbid expression in NOD mice resulted in improved negative selection of autoreactive diabetogenic AI4 and NY8.3 CD8+ T-cells. These results indicated allelic variants of Nfkbid represent an Idd7 gene contributing to the efficiency of intrathymic deletion of diabetogenic CD8+ T-cells. However, while enhancing thymic deletion of pathogenic CD8+ T-cells, ablation of Nfkbid expression surprisingly accelerated T1D onset in NOD mice likely at least in part by numerically decreasing regulatory T- and B-lymphocytes (Tregs/Bregs), thereby reducing their peripheral immunosuppressive effects.
Imaging neural activity in the ventral nerve cord of behaving adultDrosophila
Authors: Chen Chin-Lin , Hermans Laura , Viswanathan Meera C. , Fortun Denis , Unser Michael , Cammarato Anthony , Dickinson Michael H. , Ramdya Pavan 
Published: January 2018

AbstractTo understand neural circuits that control limbs, one must measure their activity during behavior. Until now this goal has been challenging, because the portion of the nervous system that contains limb premotor and motor circuits is largely inaccessible to large-scale recording techniques in intact, moving animals – a constraint that is true for both vertebrate and invertebrate models. Here, we introduce a method for 2-photon functional imaging from the ventral nerve cord of behaving adultDrosophila melanogaster. We use this method to reveal patterns of activity across nerve cord populations during grooming and walking and to uncover the functional encoding of moonwalker ascending neurons (MANs), moonwalker descending neurons (MDNs), and a novel class of locomotion-associated descending neurons. This new approach enables the direct investigation of circuits associated with complex limb movements.