bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single‐step simultaneous side‐by‐side placement of a self‐expandable metallic stent with a 6‐Fr delivery system for unresectable malignant hilar biliary obstruction: a feasibility study
Authors: Kawakubo Kazumichi , Kawakami Hiroshi , Kuwatani Masaki , Kudo Taiki , Abe Yoko , Kawahata Shuhei , Kubo Kimitoshi , Kubota Yoshimasa , Sakamoto Naoya 
Published: October 2014

AbstractBackgroundBilateral self‐expandable metallic stent (SEMS) placement for the management of unresectable malignant hilar biliary obstruction (UMHBO) is technically challenging to perform using the existing metallic stents with thick delivery systems. The recently developed 6‐Fr delivery systems could facilitate a single‐step simultaneous side‐by‐side placement through the accessory channel of the duodenoscope. The aim of this study was to evaluate the feasibility of this procedure.MethodsBetween May and September 2013, 13 consecutive patients with UMHBO underwent a single‐step simultaneous side‐by‐side placement of SEMS with the 6‐Fr delivery system. The technical success rate, stent patency, and rate of complications were evaluated from the prospectively collected database.ResultsTechnical success was achieved in 11 (84.6%, 95% confidence interval [CI]: 57.8–95.8) patients. The median procedure time was 25 min. Early and late complications were observed in 23% (one segmental cholangitis and two liver abscesses) and 15% (one segmental cholangitis and one cholecystitis) patients, respectively. Median dysfunction free patency was 263 days (95% CI: 37–263). Five patients (38%) experienced stent occlusion that was successfully managed by endoscopic stent placement.ConclusionsA single‐step simultaneous side‐by‐side placement of SEMS with a 6‐Fr delivery system was feasible for the management of UMHBO.
Spinal muscular atrophy: Diagnosis and management in a new therapeutic era
Authors: Arnold W. David , Kassar Darine , Kissel John T. 
Published: October 2014

ABSTRACTSpinal muscular atrophy (SMA) describes a group of disorders associated with spinal motor neuron loss. In this review we provide an update regarding the most common form of SMA, proximal or 5q‐SMA, and discuss the contemporary approach to diagnosis and treatment. Electromyography and muscle biopsy features of denervation were once the basis for diagnosis, but molecular testing for homozygous deletion or mutation of theSMN1gene allows efficient and specific diagnosis. In combination with loss ofSMN1, patients retain variable numbers of copies of a second similar gene,SMN2, which produces reduced levels of the survival motor neuron (SMN) protein that are insufficient for normal motor neuron function. Despite the fact that understanding of how ubiquitous reduction of SMN protein leads to motor neuron loss remains incomplete, several promising therapeutics are now being tested in early‐phase clinical trials. Muscle Nerve51: 157–167, 2015
Lambs to the Slaughter: A Zooarchaeological Investigation of Stone Circles in Mongolia
Authors: Broderick L. G. , Seitsonen O. , Bayarsaikhan J. , Houle J.‐L. 
Published: October 2014

AbstractStone circles are a common monumental feature of the Mongolian Bronze Age (c. 1500–800BC), frequently occurring in association with other monument types, especially khirigsuurs. Until now the content of the stone circles has not been identified, a fact which has hampered our understanding not only of khirigsuurs and their related cosmology but also of the contemporary economy, owing to a research paradigm that was monument‐focused until very recently. The identification of domestic bovids in these features thus has profound implications for our approach to studying the society of this period and region. These implications, including a well‐developed cosmology and economy which included the ritual sacrifice of at least three different kinds of livestock, are introduced here. Copyright © 2014 John Wiley & Sons, Ltd.
Why pediatric patients with cancer visit the emergency department: United States, 2006–2010
Authors: Mueller Emily L. , Sabbatini Amber , Gebremariam Achamyeleh , Mody Rajen , Sung Lillian , Macy Michelle L. 
Published: October 2014

BackgroundLittle is known about emergency department (ED) use among pediatric patients with cancer. We explored reasons prompting ED visits and factors associated with hospital admission.ProcedureA retrospective cohort analysis of pediatric ED visits from 2006 to 2010 using the Nationwide Emergency Department Sample, the largest all‐payer database of United States ED visits. Pediatric patients with cancer (ages ≤19 years) were identified using Clinical Classification Software. Proportion of visits and disposition for the top ten‐ranking non‐cancer diagnoses were determined. Weighted multivariate logistic regression was performed to analyze factors associated with admission versus discharge.ResultsThere were 294,289 ED visits by pediatric patients with cancer in the U.S. over the study period. Fever and fever with neutropenia (FN) were the two most common diagnoses, accounting for almost 20% of visits. Forty‐four percent of pediatric patients with cancer were admitted to the same hospital, with admission rates up to 82% for FN. Risk factors for admission were: FN (odds ratio (OR) 8.58; 95% confidence interval (CI) 5.97–12.34); neutropenia alone (OR 7.28; 95% CI 5.08–10.43), ages 0–4 years compared with 15–19 years (OR 1.19; 95% CI 1.08–1.31) and highest median household income ZIP code (OR 1.27; 95% CI 1.08–1.49) compared with lowest. “Self‐pay” visits had lower odds of admission (OR 0.42; 95% CI 0.35–0.51) compared with public payer.ConclusionFN was the most common reason for ED visits among pediatric patients with cancer and is the condition most strongly associated with admission. Socioeconomic factors appear to influence ED disposition for this population. Pediatr Blood Cancer 2015;62:490–495. © 2014 Wiley Periodicals, Inc.
Ovarian function in survivors of childhood medulloblastoma: Impact of reduced dose craniospinal irradiation and high‐dose chemotherapy with autologous stem cell rescue
Authors: Balachandar Sadana , Dunkel Ira J. , Khakoo Yasmin , Wolden Suzanne , Allen Jeffrey , Sklar Charles A. 
Published: October 2014

AbstractBackgroundData on ovarian function (OvF) in medulloblastoma (MB) survivors is limited, with most studies describing outcomes in survivors treated with craniospinal irradiation (CSI) doses >24 Gy ± standard chemotherapy. The objective of the current study is to report on OvF: (i) across a range of CSI doses; and (ii) following high‐dose chemotherapy with autologous stem cell rescue (ASCR).ProcedureRetrospective review of female MB survivors who were diagnosed in childhood and followed at Memorial Sloan Kettering Cancer Center. Patients were divided into three groups: (i) CSI ≤24 Gy +/− standard chemotherapy; (ii) CSI ≥35 Gy +/− standard chemotherapy; and (iii) high‐dose chemotherapy with ASCR +/− CSI.ResultsPrimary ovarian dysfunction (POD) occurred in 2/17 subjects in group 1, 3/9 subjects in group 2 and 5/5 subjects in group 3 (P < 0.01). Normalization of function was noted in four subjects with POD. Persistent POD requiring hormone replacement (POF) was observed in 1/17 subjects in group 1, 2/9 in group 2, and 3/5 in group 3 (P = 0.02). Neither age at treatment nor type of standard chemotherapy correlated with risk of POD or POF.ConclusionsBoth POD and POF appear to occur in a small proportion of patients who are treated with contemporary doses of CSI +/− standard chemotherapy. However, ovarian dysfunction requiring hormone replacement therapy is common following high‐dose chemotherapy associated with ASCR. These findings will assist clinicians in counseling patients regarding fertility preservation and risk of impaired ovarian function/future fertility. Pediatr Blood Cancer 2015;62:317–321. © 2014 Wiley Periodicals, Inc.
First trimester screening for early and late preeclampsia based on maternal characteristics, biophysical parameters, and angiogenic factors
Authors: Crovetto Francesca , Figueras Francesc , Triunfo Stefania , Crispi Fatima , Rodriguez‐Sureda Victor , Dominguez Carmen , Llurba Elisa , Gratacós Eduard 
Published: October 2014

AbstractObjectiveThe aim of this article is to develop the best first‐trimester screening model for preeclampsia (PE) based on maternal characteristics, biophysical parameters, and angiogenic factors in a low‐risk population.MethodsA prospective cohort of 9462 pregnancies undergoing first‐trimester screening is used. Logistic regression predictive models were developed for early and late PE (cut‐off of 34 weeks' gestation at delivery). Data included the a priori risk (maternal characteristics), mean arterial pressure (MAP), and uterine artery (UtA) Doppler (11–13 weeks) in all cases. Plasma levels (8–11 weeks) of human chorionic gonadotrophin, pregnancy‐associated plasma protein A, placental growth factor (PlGF), and soluble Fms‐like tyrosine kinase‐1 (sFlt‐1) were analyzed using a nested case–control study design.ResultsThe best model for early PE (n = 57, 0.6%) included a priori risk, MAP, UtA Doppler, PlGF, and sFlt‐1 achieving detection rates of 87.7% and 91.2% for 5% and 10% false‐positive rates, respectively (AUC: 0.98 [95% CI: 0.97–0.99]). For late PE (n = 246, 2.6%), the best model included the a priori risk, MAP, UtA Doppler, PlGF, and sFlt‐1 achieving detection rates of 68.3% and 76.4% at 5% and 10% of false‐positive rates, respectively (AUC: 0.87 [95% CI: 0.84–0.90]).ConclusionPreeclampsia can be predicted with high accuracy in general obstetric populations with a low risk for PE, by combined algorithms. Angiogenic factors substantially improved the prediction. © 2014 John Wiley & Sons, Ltd.
Biochemical analysis of ascites fluid as an aid to etiological diagnosis: a series of 100 cases of nonimmune fetal ascites
Authors: Dreux Sophie , Salomon Laurent J. , Rosenblatt Jonathan , Favre Romain , Houfflin‐Debarge Véronique , Broussin Bernard , Guimiot Fabien , Fenaux Honorine , Delezoide Anne‐Lise , Muller Françoise 
Published: October 2014

AbstractObjectiveThe aim of this study is to analyze the contribution of biochemistry and cytology of fetal ascites fluid to the etiological diagnosis of ascites after ultrasonographic scan, maternal blood sampling, and fetal karyotyping.MethodThis is a retrospective study of 100 consecutive cases of nonimmune fetal ascites in which ascites fluid was sampled. All women underwent referral ultrasound scan and fetal karyotyping. All cases of fetal ascites were studied by biochemistry (total protein, β2‐microglobulin, IgM, gamma‐glutamyl transpeptidase, aspartate aminotransferase, aminopeptidase M, and intestinal isoform of alkaline phosphatase) and cytology (lymphocyte count and vacuolated cells).ResultsThe etiology of ascites was diagnosed at ultrasound scan in only 50% of cases. We observed significantly (P < 0.001) low levels of total protein in ascites of urinary origin, high levels of digestive enzymes in ascites of digestive origin, and high β2‐microglobulin in infectious ascites. Vacuolated cells were observed in all ten storage metabolic diseases.ConclusionSampling of fetal ascites fluid for biochemical and cytological examination provides important additional information. We propose a two‐step management: (1) detailed ultrasound scan examination, maternal blood analysis, and fetal karyotyping and (2) biochemical and cytological analyses. On the basis of such an approach, 63% and 96% of etiologies would have been identified in our series after the first and second steps, respectively. © 2014 John Wiley & Sons, Ltd.
Presence and impact of allelic variations of two alternative s‐kdr mutations, M918T and M918L, in the voltage‐gated sodium channel of the green peach aphid Myzus persicae
Authors: Panini Michela , Anaclerio Matteo , Puggioni Vincenzo , Stagnati Lorenzo , Nauen Ralf , Mazzoni Emanuele 
Published: October 2014

AbstractBACKGROUNDPyrethroids have been widely employed in order to control several agricultural pests, including Myzus persicae. Target‐site resistance is the main mechanism that confers insensitivity to this class of compounds, and the most common amino acid substitutions are kdr (L1014F) and s‐kdr (M918T), but recently another mutation in the s‐kdr locus (M918L) has been described in French and Korean populations of M. persicae.RESULTSMolecular analysis of several Italian populations of M. persicae by pyrosequencing revealed the presence of the new s‐kdr mutation (M918L) in different forms. It was found in two different nucleotide polymorphisms (a/t or a/c substitution), in heterozygous or homozygous status, and also in combination with the classic kdr and s‐kdr. Bioassays on populations carrying the M918L mutation show that it strongly affects pyrethroid efficacy, particularly of type II pyrethroids such as lambda‐cyhalothrin, while it has no effect against DDT.CONCLUSIONThis work provides more information about the new s‐kdr M918L mutation in M. persicae, describing a more complicated situation arising from the possible combination with the classic L1014F and M918T. Our data open new questions concerning the origin of these new genotypes with different combinations of target‐site mutations, and also their possible influence on control strategies. © 2014 Society of Chemical Industry
Strain isolation: A simple mechanism for understanding and detecting structures of zero Poisson's ratio
Authors: Wang Ningling , Liu Wangyu , Tang Aimin , Huang Jiele , Lin Zhenqiong , Lei Shuwen 
Published: October 2014

There exist several honeycomb networks exhibiting zero Poisson's ratio (ZPR). Applications of these networks can be found in different fields. The ZPR properties of these structures have been mechanically modeled and tested. However, the underlying mechanism driving the ZPR behavior has not been paid much attention. The present work focuses on the deformation mechanism of the ZPR networks. Through the discussion and comparison of the deformation process of the ZPR, auxetic and common honeycomb networks, the strain‐isolation mechanism is proposed to explain the ZPR behavior. Then, according to this mechanism, the reversed semi‐re‐entrant (RSRE) honeycomb is created. With experimental measurements and finite‐element analysis (FEA), the ZPR properties of the RSRE can be proven. The strain‐isolation mechanism can not only explain the ZPR behavior but also be used in the design of new ZPR honeycomb networks. 3D ZPR structures are also derived from the 2D honeycomb networks. Their Poisson's ratios in 3D space are also discussed based on FEA results. The model of the 3D RSRE structure showing ZPR behaviors in three orthogonal planes.
Stepped‐wedge cluster randomised controlled trials: a generic framework including parallel and multiple‐level designs
Authors: Hemming Karla , Lilford Richard , Girling Alan J. 
Published: October 2014

Stepped‐wedge cluster randomised trials (SW‐CRTs) are being used with increasing frequency in health service evaluation. Conventionally, these studies are cross‐sectional in design with equally spaced steps, with an equal number of clusters randomised at each step and data collected at each and every step. Here we introduce several variations on this design and consider implications for power.One modification we consider is the incomplete cross‐sectional SW‐CRT, where the number of clusters varies at each step or where at some steps, for example, implementation or transition periods, data are not collected. We show that the parallel CRT with staggered but balanced randomisation can be considered a special case of the incomplete SW‐CRT. As too can the parallel CRT with baseline measures. And we extend these designs to allow for multiple layers of clustering, for example, wards within a hospital. Building on results for complete designs, power and detectable difference are derived using a Wald test and obtaining the variance–covariance matrix of the treatment effect assuming a generalised linear mixed model. These variations are illustrated by several real examples.We recommend that whilst the impact of transition periods on power is likely to be small, where they are a feature of the design they should be incorporated. We also show examples in which the power of a SW‐CRT increases as the intra‐cluster correlation (ICC) increases and demonstrate that the impact of the ICC is likely to be smaller in a SW‐CRT compared with a parallel CRT, especially where there are multiple levels of clustering. Finally, through this unified framework, the efficiency of the SW‐CRT and the parallel CRT can be compared. © 2014 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.
Self‐repair of thermal cracks in concrete sandwich panels
Authors: Van Tittelboom Kim , Gruyaert Elke , De Backer Pieter , Moerman Wim , De Belie Nele 
Published: October 2014

AbstractAlthough the use of insulated concrete sandwich panels results in more energy‐efficient buildings, the presence of this insulation layer can induce thermal cracks. As cracks form a preferential path for aggressive agents to enter and degrade the concrete matrix, and as they are not wanted in this application from an aesthetical point of view, they need to be treated. The aim of this study was to seal the cracks in concrete sandwich panels invisibly in an autonomous way. Therefore, the efficiency of various encapsulated healing agents was compared by inducing thermal cracks in concrete sandwich panels, thus causing capsule breakage and the release of the agents into the cracks. It was shown that encapsulation of both polyurethane and a water‐repellent agent can result in a reduction in the water uptake by cracks. However, only when a water‐repellent agent was released cracks were healed in an almost invisible way. This study has shown that the self‐healing approach involving encapsulated polymer‐based healing agents can also be applied to concrete sandwich panels, although more research will be needed to meet the specific healing requirements of this application.
Preoperative Chemoradiation Therapy Decreases the Number of Lymph Nodes Resected During Esophagectomy
Authors: Issaka Adamu , Ermerak Nezih Onur , Bilgi Zeynep , Kara Volkan Hasan , Celikel Cigdem Ataizi , Batirel Hasan Fevzi 
Published: October 2014

AbstractBackgroundThis study aimed to analyze the effect of preoperative chemoradiation on the adequacy of lymph node dissection.MethodsPatients with esophageal cancer treated with esophagectomy by the same surgeon between 2004 and 2011 were reviewed. Specimens were examined by the same pathologist. Patients were grouped into two depending on the type of treatment received.ResultsForty‐seven patients with curative esophagectomy were included in the study. Twenty patients had preoperative chemoradiation followed by surgery and 27 had surgery alone. Open and hybrid esophagectomy approaches were used. The average number of lymph nodes dissected was 16 ± 10 (1–39). There was a significant decrease in the number of lymph nodes examined in patients with preoperative chemoradiotherapy in comparison to surgery alone (p = 0.001). Median length of stay was 12 days. R0 resection rate was 96 %. The median survival was 36.3 months, with a 42 % 5‐year survival. Seven patients (25 %) had complete pathologic response following chemoradiation. No significant difference was recorded in terms of disease recurrence (p = 0.3). While morbidity was higher in the preoperative therapy group with 30 day mortality of 10 %, type of surgical approach does not seem to influence the number of lymph nodes dissected (p = 0.7).ConclusionsPreoperative chemoradiation decreases the number of harvested lymph nodes following esophagectomy regardless of the surgical technique used. The optimum number of lymph nodes currently recommended to be dissected for accurate nodal staging and survival needs revision in this group of patients.
The Effects of Wubeizi Ointment on the Proliferation of Keloid-Derived Fibroblasts
Authors: Ding Ji-cun , Tang Zhi-ming , Zhai Xiao-xiang , Chen Xiang-hui , Li Jing-guo , Zhang Cui-xia 
Published: October 2014

Abstract
To evaluate the effectiveness of the Wubeizi (WBZ) ointment on keloid-derived fibroblasts. The primary cells of the keloid-derived fibroblasts were cultured and the effectiveness of the WBZ ointment at different concentrations was examined by MTT colorimetric methods on keloid-derived fibroblasts. The WBZ ointment showed inhibitory effects on proliferating the keloid-derived fibroblasts (P < 0.01)in a time- and dose-dependent manner. The proportion of cells in S stage was significantly higher in each of the WBZ ointment group than in the control group (P<0.01), and the proportion of G2 + M stage cells was significantly lower than that of control group, which was statistically significant (P < 0.01).The inhibitory effects of the S and G2 + M stage increased with higher drug concentrations (P < 0.05). Conclusion: The WBZ ointment can inhibit the proliferation of the keloid-derived fibroblasts in a time- and dose- dependent manner.
Wall-separation and vortex-breakdown zones in a solid-body rotation flow in a rotating finite-length straight circular pipe
Authors: Rusak Zvi , Wang Shixiao 
Published: October 2014

AbstractThe incompressible, inviscid and axisymmetric dynamics of perturbations on a solid-body rotation flow with a uniform axial velocity in a rotating, finite-length, straight, circular pipe are studied via global analysis techniques and numerical simulations. The investigation establishes the coexistence of both axisymmetric wall-separation and vortex-breakdown zones above a critical swirl level, ${\it\omega}_{1}$. We first describe the bifurcation diagram of steady-state solutions of the flow problem as a function of the swirl ratio ${\it\omega}$. We prove that the base columnar flow is a unique steady-state solution when ${\it\omega}$ is below ${\it\omega}_{1}$. This state is asymptotically stable and a global attractor of the flow dynamics. However, when ${\it\omega}>{\it\omega}_{1}$, we reveal, in addition to the base columnar flow, the coexistence of states that describe swirling flows around either centreline stagnant breakdown zones or wall quasi-stagnant zones, where both the axial and radial velocities vanish. We demonstrate that when ${\it\omega}>{\it\omega}_{1}$, the base columnar flow is a min–max point of an energy functional that governs the problem, while the swirling flows around the quasi-stagnant and stagnant zones are global and local minimizer states and become attractors of the flow dynamics. We also find additional min–max states that are transient attractors of the flow dynamics. Numerical simulations describe the evolution of perturbations on above-critical columnar states to either the breakdown or the wall-separation states. The growth of perturbations in both cases is composed of a linear stage of the evolution, with growth rates accurately predicted by the analysis of Wang & Rusak (Phys. Fluids, vol. 8, 1996a, pp. 1007–1016), followed by a stage of saturation to either one of the separation zone states. The wall-separation states have the same chance of appearing as that of vortex-breakdown states and there is no hysteresis loop between them. This is strikingly different from the dynamics of vortices with medium or narrow vortical core size in a pipe.