bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional architecture of the somatosensory homunculus detected by electrostimulation
Authors: Roux Franck‐Emmanuel , Djidjeli Imène , Durand Jean‐Baptiste 
Published: December 2017

Key points
We performed a prospective electrostimulation study, based on 50 operated intact patients, to acquire accurate MNI coordinates of the functional areas of the somatosensory homunculus.
In the contralateral BA1, the hand representation displayed not only medial‐to‐lateral, little‐finger‐to‐thumb, but also rostral‐to‐caudal discrete somatotopy, with the tip of each finger located more caudally than the proximal phalanx.
The analysis of the MNI body coordinates showed rare inter‐individual variations in the medial‐to‐lateral somatotopic organization in these patients with rather different intensity thresholds needed to elicit sensations in different body parts.
We found some similarities but also substantial differences with the previous, seminal works of Penfield and his colleagues.
We propose a new drawing of the human somatosensory homunculus according to MNI space.
AbstractIn this prospective electrostimulation study, based on 50 operated patients with no sensory deficit and no brain lesion in the postcentral gyrus, we acquired coordinates in the standard MNI space of the functional areas of the somatosensory homunculus. The 3D brain volume of each patient was normalized to that space to obtain the MNI coordinates of the stimulation site locations. For 647 sites stimulated on Brodmann Area 1 (and 1025 in gyri nearby), 258 positive points for somatosensory response (40%) were found in the postcentral gyrus. In the contralateral BA1, the hand representation displayed not only medial‐to‐lateral and little‐finger‐to‐thumb somatotopy, but also rostral‐to‐caudal discrete somatotopy, with the tip of each finger located more caudally than the proximal phalanx. We detected a medial‐to‐lateral, tip‐to‐base tongue organization but no rostral‐to‐caudal functional organization. The analysis of the MNI body coordinates showed rare inter‐individual variations in the medial‐to‐lateral somatotopic organization in these patients with intact somatosensory cortex. Positive stimulations were detected through the ‘on/off’ outbreak effect and discriminative touch sensations were the sensations reported almost exclusively by all patients during stimulation. Mean hand (2.39 mA) and tongue (2.60 mA) positive intensity thresholds were lower (P < 0.05) than the intensities required to elicit sensations in the other parts of the body. Unlike the previous, seminal works of Penfield and colleagues, we detected no sensations such as sense of movement or desire to move, no somatosensory responses outside the postcentral gyrus, and no bilateral responses for face/tongue stimulations. We propose a rationalization of the standard drawing of the somatosensory homunculus according to MNI space.
Prevalence and determinants of tobacco use among young people in The Gambia
Authors: Jallow Isatou K , Britton John , Langley Tessa 
Published: December 2017

IntroductionTobacco consumption and consequent morbidity and mortality are expected to grow most markedly over coming decades in low-income and middle-income countries (LMICs). Preventing tobacco experimentation and uptake among young people in LMICs is therefore vital. However, data on smoking in these countries, particularly in sub-Saharan Africa, remain sparse.MethodWe used two-stage cluster random sampling to select students in upper and senior secondary schools throughout The Gambia, and a self-administered questionnaire to collect data on their tobacco use, risk factors and demographic details.ResultsOf 10 392 eligible students, 10 289 (99%; 55% girls and 44% boys, age 12–20 years) participated. The prevalence of ever smoking cigarettes, cigars or pipes was 16.7% (25.7% boys and 9.4% girls) and current (past 30 days) smoking 4.5% (7.9% boys and 1.5% girls). Smoking was more common among students attending private schools (OR 1.69, 95% CI 1.29 to 2.22), of Christian or other faiths compared with Muslims, living with parents (OR 1.39, 95% CI 1.06 to 1.81), who had smoking allowed in their homes (OR 1.67, 95% CI 1.30 to 2.13), with family members who smoked or had one or more friends who smoked. Most (55.6%) smokers want to stop, but only 22% received any stop smoking support. Ever smoking of shisha, at 8.1%, was unexpectedly high, and relatively prevalent among girls (11.4% of boys and 5.4% of girls).ConclusionsTobacco use is common among young people in The Gambia. Shisha smoking is also common in this population, and in relative terms especially among girls. Further work is required to determine whether this is a problem local to The Gambia or reflects a wider pattern of tobacco use in sub-Saharan Africa.
Population-level impact of diabetes integrated care on commissioner payments for inpatient care among people with type 2 diabetes in Cambridgeshire: a postintervention cohort follow-up study
Authors: Yu Dahai , Yang Wei , Cai Yamei , Zhao Zhanzheng , Simmons David 
Published: December 2017

ObjectivesFew studies have estimated the effect of diabetes integrated care at a population level. We have assessed the impact of introducing a community service-led diabetes integrated care programme on commissioner payments (tariff) for inpatient care in rural England.MethodsThe Diabetes Integrated Care Initiative was delivered by a separate enhanced community diabetes service, increasing specialist nursing, dietetic, podiatry and medical support to primary care and patients, while linking into other diabetes specialist services. Commissioner data were provided by the local authority. The difference in area between the two overlapping distribution curves of inpatient payments at baseline and follow-up (at 3 years) was used to estimate the effect of integrated care on commissioner inpatient payments on a population level.ResultsOver the 3-year period, reduced inpatient payments occurred in 2.7% (1.3% to 5.8%) of patients with diabetes aged more than 70 years in the intervention area. However, reduced diabetes inpatient payments occurred in 3.20% (1.77% to 7.20%) of patients aged <70 years and 4.1% (2.3% to 7.9%) of patients ≥70 years in one of the two adjacent areas.ConclusionThis enhanced community diabetes services was not associated with substantially reduced inpatient payments. Alternative diabetes integrated care approaches (eg, with direct primary and secondary care collaboration rather than with a community service) should be tested.
Pilot for the Australian Breast Device Registry (ABDR): a national opt-out clinical quality registry for breast device surgery
Authors: Hopper Ingrid , Best Renee L , McNeil John J , Mulvany Catherine M , Moore Colin C M , Elder Elisabeth , Pase Marie , Cooter Rodney D , Evans Sue M 
Published: December 2017

PurposeTo establish a pilot clinical quality registry (CQR) to monitor the quality of care and device performance for breast device surgery in Australia.ParticipantsAll patients having breast device surgery from contributing hospitals in Australia. A literature review was performed which identified quality indicators for breast device surgery.Findings to dateA pilot CQR was established in 2011 to capture prospective data on breast device surgery. An interim Steering Committee and Management Committee were established to provide clinical governance, and guide quality indicator selection. The registry’s minimum dataset was formulated in consultation with stakeholder groups; potential quality indicators were assessed in terms of (1) importance and relevance, (2) usability, (3) feasibility to collect and (4) scientific validity. Data collection was by a two-sided paper-based form with manual data entry. Seven sites were recruited, including one public hospital, four private hospitals and two day surgeries. Patients were recruited and opt-out consent used.Future plansThe pilot breast device registry provides high-quality population-based data. It provides a model for developing a national CQR for breast devices; its minimum dataset and quality indicators reflect the opinions of the broad range of stakeholders. It is easily scalable, and has formed the basis for other international surgical groups establishing similar registries.
Research protocol for the Picture Talk Project: a qualitative study on research and consent with remote Australian Aboriginal communities
Authors: Fitzpatrick Emily F M , Carter Maureen , Oscar June , Lawford Tom , Martiniuk Alexandra L C , D’Antoine Heather A , Elliott Elizabeth J 
Published: December 2017

IntroductionResearch with Indigenous populations is not always designed with cultural sensitivity. Few publications evaluate or describe in detail seeking consent for research with Indigenous participants. When potential participants are not engaged in a culturally respectful manner, participation rates and research quality can be adversely affected. It is unethical to proceed with research without truly informed consent.Methods and analysisWe describe a culturally appropriate research protocol that is invited by Aboriginal communities of the Fitzroy Valley in Western Australia. The Picture Talk Project is a research partnership with local Aboriginal leaders who are also chief investigators. We will interview Aboriginal leaders about research, community engagement and the consent process and hold focus groups with Aboriginal community members about individual consent. Cultural protocols will be applied to recruit and conduct research with participants. Transcripts will be analysed using NVivo10 qualitative software and themes synthesised to highlight the key issues raised by the community about the research process. This protocol will guide future research with the Aboriginal communities of the Fitzroy Valley and may inform the approach to research with other Indigenous communities of Australia or the world. It must be noted that no community is the same and all research requires local consultation and input. To conduct culturally sensitive research, respected local people from the community who have knowledge of cultural protocol and language are engaged to guide each step of the research process from the project design to the delivery of results.Ethics and disseminationEthics approval was granted by the University of Sydney Human Research Ethics Committee (No. 2012/348, reference:14760), the Western Australia Country Health Service Ethics Committee (No. 2012:15), the Western Australian Aboriginal Health Ethics Committee and reviewed by the Kimberley Aboriginal Health Planning Forum Research Sub-Committee (No. 2012–008). Results will be disseminated through peer review articles, a local Fitzroy Valley report and conference presentations.
Cohort profile: the Emory Cardiovascular Biobank (EmCAB)
Authors: Ko Yi-An , Hayek Salim , Sandesara Pratik , Samman Tahhan Ayman , Quyyumi Arshed 
Published: December 2017

PurposeThe Emory Cardiovascular Biobank (EmCAB) is an ongoing prospective registry of patients undergoing cardiac catheterisation, which was established to identify novel factors associated with the pathobiological process and treatment of cardiovascular disease.ParticipantsIndividuals aged 18 years and older undergoing cardiac catheterisation at three Emory Healthcare sites in Atlanta are asked to participate in this prospective registry. Around 95% agree to participate. Around 7000 unique patients have been enrolled. The current data set contains detailed phenotyping, patient outcomes, genomics, protein biomarkers, regenerative markers, transcriptomic analysis, metabolomics profiling and longitudinal follow-up for adverse cardiovascular outcomes.Findings to dateThus far, the EmCAB has approximately 3000 major cardiovascular events. About 48% of the EmCAB participants have more than 5 years of follow-up. It is a great resource for discovery of novel predictive factors for cardiovascular disease outcomes, including genomics, transcriptomics, protein biomarkers, oxidative stress markers and circulating progenitor cells. Several circulating inflammatory markers have shown to improve risk prediction metrics beyond standard risk factors.Future plansFuture integrative –omics analyses will provide the cardiovascular research community opportunities for subsequent mechanistic confirmation studies, which will promote the development of effective personalised therapy that leads to clinical care tailored to the individual patient.
Current outcomes of blunt open pelvic fractures: how modern advances in trauma care may decrease mortality
Authors: Siada Sammy S , Davis James W , Kaups Krista L , Dirks Rachel C , Grannis Kimberly A 
Published: December 2017

BackgroundOpen pelvic fracture, caused by a blunt mechanism, is an uncommon injury with a high mortality rate. In 2008, evidence-based algorithm for managing pelvic fractures in unstable patients was published by the Western Trauma Association (WTA). The use of massive transfusion protocols has become widespread as has the availability and use of pelvic angiography. The purpose of this study was to evaluate the outcome of open pelvic fractures in association with related advances in trauma care.MethodsA retrospective review was performed, at an American College of Surgeon verified level I trauma center, of patients with blunt open pelvic fractures from January 2010 to April 2016. The WTA algorithm, including massive transfusion protocol, and pelvic angiography were uniformly used. Data collected included injury severity score, demographic data, transfusion requirements, use of pelvic angiography, length of stay, and disposition. Data were compared with a similar study from 2005.ResultsDuring the study period, 1505 patients with pelvic fractures were analyzed; 87 (6%) patients had open pelvic fractures. Of these, 25 were from blunt mechanisms and made up the study population. Patients in both studies had similar injury severity scores, ages, Glasgow Coma Scale, and gender distributions. Use of angiography was higher (44% vs. 16%; P=0.011) and mortality was lower (16% vs. 45%; P=0.014) than in the 2005 study.ConclusionsChanges in trauma care for patients with open blunt pelvic fracture include the use of an evidence-based algorithm, massive transfusion protocols and increased use of angioembolization. Mortality for open pelvic fractures has decreased with these advances.Level of evidenceLevel IV.
CD47 Blockade as an Adjuvant Immunotherapy for Resectable Pancreatic Cancer
Authors: Michaels Alex D. , Newhook Timothy E. , Adair Sara J. , Morioka Sho , Goudreau Bernadette J. , Nagdas Sarbajeet , Mullen Matthew G. , Persily Jesse B. , Bullock Timothy N. J. , Slingluff Craig L. , Ravichandran Kodi S. , Parsons J. Thomas , Bauer Todd W. 
Published: December 2017

Abstract
Purpose: Patients with pancreatic ductal adenocarcinoma (PDAC) who undergo surgical resection and adjuvant chemotherapy have an expected survival of only 2 years due to disease recurrence, frequently in the liver. We investigated the role of liver macrophages in progression of PDAC micrometastases to identify adjuvant treatment strategies that could prolong survival.
Experimental Design: A murine splenic injection model of hepatic micrometastatic PDAC was used with five patient-derived PDAC tumors. The impact of liver macrophages on tumor growth was assessed by (i) depleting mouse macrophages in nude mice with liposomal clodronate injection, and (ii) injecting tumor cells into nude versus NOD-scid-gamma mice. Immunohistochemistry and flow cytometry were used to measure CD47 (“don't eat me signal”) expression on tumor cells and characterize macrophages in the tumor microenvironment. In vitro engulfment assays and mouse experiments were performed with CD47-blocking antibodies to assess macrophage engulfment of tumor cells, progression of micrometastases in the liver and mouse survival.
Results: In vivo clodronate depletion experiments and NOD-scid-gamma mouse experiments demonstrated that liver macrophages suppress the progression of PDAC micrometastases. Five patient-derived PDAC cell lines expressed variable levels of CD47. In in vitro engulfment assays, CD47-blocking antibodies increased the efficiency of PDAC cell clearance by macrophages in a manner which correlated with CD47 receptor surface density. Treatment of mice with CD47-blocking antibodies resulted in increased time-to-progression of metastatic tumors and prolonged survival.
Conclusions: These findings suggest that following surgical resection of PDAC, adjuvant immunotherapy with anti-CD47 antibody could lead to substantially improved outcomes for patients. Clin Cancer Res; 24(6); 1415–25. ©2017 AACR.
MYC Drives a Subset of High-Risk Pediatric Neuroblastomas and Is Activated through Mechanisms Including Enhancer Hijacking and Focal Enhancer Amplification
Authors: Zimmerman Mark W. , Liu Yu , He Shuning , Durbin Adam D. , Abraham Brian J. , Easton John , Shao Ying , Xu Beisi , Zhu Shizhen , Zhang Xiaoling , Li Zhaodong , Weichert-Leahey Nina , Young Richard A. , Zhang Jinghui , Look A. Thomas 
Published: December 2017

Abstract
The amplified MYCN gene serves as an oncogenic driver in approximately 20% of high-risk pediatric neuroblastomas. Here, we show that the family member MYC is a potent transforming gene in a separate subset of high-risk neuroblastoma cases (∼10%), based on (i) its upregulation by focal enhancer amplification or genomic rearrangements leading to enhancer hijacking, and (ii) its ability to transform neuroblastoma precursor cells in a transgenic animal model. The aberrant regulatory elements associated with oncogenic MYC activation include focally amplified distal enhancers and translocation of highly active enhancers from other genes to within topologically associating domains containing the MYC gene locus. The clinical outcome for patients with high levels of MYC expression is virtually identical to that of patients with amplification of the MYCN gene, a known high-risk feature of this disease. Together, these findings establish MYC as a bona fide oncogene in a clinically significant group of high-risk childhood neuroblastomas.
Significance: Amplification of the MYCN oncogene is a recognized hallmark of high-risk pediatric neuroblastoma. Here, we demonstrate that MYC is also activated as a potent oncogene in a distinct subset of neuroblastoma cases through either focal amplification of distal enhancers or enhancer hijacking mediated by chromosomal translocation. Cancer Discov; 8(3); 320–35. ©2017 AACR.
This article is highlighted in the In This Issue feature, p. 253
ПОШИРЕНІСТЬ ЛАЙМ-БОРЕЛІОЗУ СЕРЕД ХВОРИХ НА ТУБЕРКУЛЬОЗ
Authors: Melnyk L. P. , Vasylieva N. А. , Klymniuk S. I. , Shkilna M. I. 
Published: December 2017

Мета дослідження – виявити поширеність Лайм-бореліозу у хворих на туберкульоз та його вплив на перебіг основного захворювання.Пацієнти і методи. Спостерігали 99 пацієнтів з туберкульозом (ТБ), які лікувались стаціонарно протягом 2015-2017 рр. у Тернопільському обласному протитуберкульозному диспансері. Хворі дали відповіді на питання уніфікованої міжнародної анкети-опитувальника щодо наявності в анамнезі укусів кліща та бореліозу та обстежені методом ІФА на наявність антитіл до B. burgdorferi sensu lato.Результати. Антитіла хоча б одного класу IgM і/чи IgG до B. burgdorferi sensu lato виявлено у 25,2 % обстежених хворих на туберкульоз. З числа обстежених пацієнтів, які вказували на укуси кліщів, серологічне підтвердження бореліозу отримано у 9 із 53 (17,0 %), серед 46 хворих на туберкульоз, які не пам’ятали про укуси кліща, – у 16 (34,7 %) (p<0,05). У хворих на туберкульоз із супутнім ЛБ суттєво частіше відзначено сповільнене загоєння порожнин розпаду через 2 місяці ОКХТ - у (36,0±9,6) % випадків порівняно з (14,9±4,1) % хворих без нього та зміни ЕКГ (синусова брадикардія, сповільнення провідності та розлади реполяризації) (p<0,05). Висновки. Поширеність Лайм-бореліозу у хворих на туберкульоз становить 25,2 %. Супутній Лайм-бореліоз негативно впливає на перебіг туберкульозу, що проявляється у сповільненому загоєнні порожнин розпаду та змінами ЕКГ у даної категорії пацієнтів (p<0,05).
ЕФЕКТИВНІСТЬ ПРОТИВІРУСНОЇ ТЕРАПІЇ ЖИТЕЛІВ ТЕРНОПІЛЬЩИНИ З ХРОНІЧНИМИ ГЕПАТИТАМИ В І С, ЯКИХ ЛІКУВАЛИ ЗА ДЕРЖАВНОЮ ПРОГРАМОЮ
Authors: Vasylieva N. A. , Ivakhiv O. L. , Vyshnevska N. Yu. , Iosyk Ya. I. , Herasymenko O. A. 
Published: December 2017

Протягом останніх десятиліть до проблеми парентеральних вірусних гепатитів прикута увага не лише лікарів, а й громадськості через дуже небезпечні їх медико-соціальні наслідки.Мета роботи – оцінити ефективність сучасної противірусної терапії (ПВТ) хронічного гепатиту (ХГ)В, ХГ В+С і ХГС у жителів Тернопільської області, яких лікували за Державною програмою.Пацієнти і методи. У межах Державної програми у 2013-2016 рр. проліковано 79 хворих, у тому числі з ХГС – 47, ХГ В+С – 3, ХГВ – 29. Чоловіків було 74,7 %, жінок – 25,3 %. Ефективність ПВТ оцінювали за біохімічними, вірусологічними, гістологічними критеріями.Висновки. Використання софосбувіра при ХГС суттєво підвищує ефективність ПВТ. ПВТ ХГВ не достатня, що потребує подальшого її удосконалення. Ерадикація HCV не гарантує від прогресування фіброзу печінки
ОРГАНІЗАЦІЯ ФАРМАЦЕВТИЧНОЇ ДОПОМОГИ В УКРАЇНІ: РЕАЛІЇ АПТЕЧНОГО ВИГОТОВЛЕННЯ ЛІКАРСЬКИХ ЗАСОБІВ
Authors: Samborskyi О. S. , Ievtushenko О. М. , Slobodyanyuk N. N. 
Published: December 2017

Мета роботи. Аналіз стану екстемпорального виготовлення лікарських засобів в Україні та вивчення можливих шляхів подальшого розвитку цього виду фармацевтичної допомоги.Матеріали і методи. У роботі використано загальнонаукові та спеціальні методи: системного аналізу, історичний, аналітичний, маркетингових досліджень, кластерний аналіз. Інформаційну базу досліджень становили статистичні матеріали МОЗ України та інших організацій, сайти вітчизняних та закордонних аптек, публікації.Результати й обговорення. Проаналізовано асортимент виробничих аптек різних регіонів України. Отримані дані свідчать, що найбільш поширеними є групи екстемпоральних лікарських засобів, які застосовують в алергології, дерматології, педіатрії, стоматології, офтальмології, проктології, неврології, для лікування грипу та ГРВІ, анальгетики для місцевого застосування, засоби для електрофорезу. Проведено аналіз регіонів України щодо забезпеченості виробничими аптеками, який свідчить про суттєве скорочення останніх − частка виробничих аптек за областями не перевищує 3,8 % від загальної кількості аптек. Слід зазначити, що за певними територіями виробничу практику в аптеках зведено до мінімуму − у Вінницькій, Донецькій, Кіровоградській, Луганській, Полтавській та Закарпатській областях кількість виробничих аптек не перевищує 1%. Також проведено кластерний аналіз, що розподілив регіони України за ступенем забезпеченості виробничими аптеками та показниками захворюваності.Висновки. Охарактеризовано асортимент екстемпоральної рецептури українських аптек із погляду фармакологічної спрямованості препаратів, а також форм випуску. Проведено аналіз фізичної доступності виробничих аптек. Відзначається низька доступність екстемпоральної рецептури в сільській місцевості, де на сьогодні налічується 21 аптека за всіма регіонами, а це становить 5,9 % від загальної кількості усіх виробничих аптек по Україні. Проведений та опрацьований кластерний аналіз дав змогу показати взаємний вплив рівня забезпеченості аптеками (включно виробничі) та показників захворюваності в регіонах.