bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laryngotracheal presentation of anaplastic thyroid carcinoma with squamous differentiation: seven cases demonstrating an under‐recognized diagnostic pitfall
Authors: Toner Mary , Banville Niamh , Timon Conrad I 
Published: March 2014

AimsTo describe a series of anaplastic thyroid carcinomas that mimicked primary head and neck squamous cell carcinoma (HNSCC) by virtue of both morphology and clinical presentation.Methods and resultsSeven cases were identified in a 15‐year period where a biopsy of an airway lesion that appeared to be squamous cell carcinoma was, in fact, anaplastic thyroid carcinoma. The tumours had squamous and/or spindle cell morphology, with only the squamous component being apparent in the airway biopsy. Some tumours arose within metaplastic (n = 3) or atypical (n = 3) epithelium, supporting the diagnosis of a primary mucosal tumour. Positive PAX8 (n = 5) and TTF‐1 (n = 4) staining was identified.ConclusionsAn endotracheal presentation of anaplastic thyroid carcinoma with squamous morphology may be misdiagnosed as a primary head and neck squamous cell carcinoma. PAX8 and TTF‐1 expression are helpful in making the distinction, but the problem lies in suspecting a thyroid carcinoma in what appears to be a straightforward diagnosis of HNSCC.
Patterns of adherence to antiretroviral therapy and HIV drug resistance over time in the Stratall ANRS 12110/ESTHER trial in Cameroon
Authors: Meresse M , March L , Kouanfack C , Bonono R‐C , Boyer S , Laborde‐Balen G , Aghokeng A , Suzan‐Monti M , Delaporte E , Spire B , Carrieri M‐P , Laurent C ,   Stratall ANRS 12110/ESTHER Study Group
Published: March 2014

ObjectivesThe emergence of HIV drug resistance is a crucial issue in Africa, where second‐line antiretroviral therapy (ART) is limited, expensive and complex. We assessed the association between adherence patterns and resistance emergence over time, using an adherence measure that distinguishes low adherence from treatment interruptions, in rural Cameroon.MethodsWe performed a cohort study among patients receiving nonnucleoside reverse transcriptase inhibitor (NNRTI)‐based ART in nine district hospitals, using data from the Stratall trial (2006−2010). Genotypic mutations associated with antiretroviral drug resistance were assessed when 6‐monthly HIV viral loads were > 5000 HIV‐1 RNA copies/mL. ART adherence data were collected using face‐to‐face questionnaires. Combined indicators of early (1−3 months) and late (6 months to t − 1; t is the time point when the resistance had been detected) adherence were constructed. Multivariate logistic regression and Cox models were used to assess the association between adherence patterns and early (at 6 months) and late (after 6 months) resistance emergence, respectively.ResultsAmong 456 participants (71% women; median age 37 years), 45 developed HIV drug resistance (18 early and 27 late). Early low adherence (< 80%) and treatment interruptions (> 2 days) were associated with early resistance [adjusted odds ratio (95% confidence interval) 8.51 (1.30–55.61) and 5.25 (1.45–18.95), respectively]. Early treatment interruptions were also associated with late resistance [adjusted hazard ratio (95% confidence interval) 3.72 (1.27–10.92)].ConclusionsThe emergence of HIV drug resistance on first‐line NNRTI‐based regimens was associated with different patterns of adherence over time. Ensuring optimal early adherence through specific interventions, adequate management of drug stocks, and viral load monitoring is a clinical and public health priority in Africa.
Contribution of bone marrow‐derived mesenchymal stem cells to the morphological changes in the bladder after partial outlet obstruction: A preliminary study
Authors: Kanno Yukiko , Mitsui Takahiko , Sano Hiroshi , Kitta Takeya , Moriya Kimihiko , Nonomura Katsuya 
Published: March 2014

ObjectivesTo investigate the contribution of bone marrow‐derived mesenchymal stem cells to the changes in bladder morphology in response to partial bladder outlet obstruction.MethodsAllogenic bone marrow cells were transplanted from transgenic rats expressing green fluorescent protein into female Sprague–Dawley rats 1 day after their bone marrow‐derived mesenchymal stem cells had been destroyed by irradiation. This generated chimeric rats in which green fluorescent protein labeled bone marrow‐derived mesenchymal stem cells replaced host bone marrow‐derived mesenchymal stem cells. The animals received partial bladder outlet obstruction or sham surgery 6 weeks later. The animals were killed 6 weeks after the surgery, and bladder tissue was prepared for immunofluorescence with antibodies against a urothelium marker (AE1/AE3), a myofibroblast marker (vimentin), a smooth muscle marker and green fluorescent protein.ResultsMore labeled bone marrow‐derived mesenchymal stem cells were found in the partial bladder outlet obstruction group than in the in the sham group. Most bone marrow‐derived mesenchymal stem cells were present around the basement membrane (laminin) and lamina propria below the urothelium. Bone marrow‐derived mesenchymal stem cells were also found in the urothelium layer, and some of them were double‐stained with green fluorescent protein and AE1/AE3. Some bone marrow‐derived mesenchymal stem cells, which were located in the interstitial tissue, were double‐stained with green fluorescent protein and vimentin. Bone marrow‐derived mesenchymal stem cells, which migrated into the smooth muscle layer, showed fusiform morphology, and some were double‐stained with green fluorescent protein and smooth muscle marker.ConclusionsBone marrow‐derived mesenchymal stem cells home to the partial bladder outlet obstruction bladder, and these cells have the potential to differentiate into the several components of bladder tissue including the urothelium, myofibroblasts and smooth muscle cells. Thus, bone marrow‐derived mesenchymal stem cells contribute to the morphological changes of the bladder in response to partial bladder outlet obstruction.
Maastricht Social Protocol Revisited: Origins of theEuropean Industrial Relations System
Authors: Nakano Satoshi 
Published: March 2014

AbstractThe Protocol and the Agreement on Social Policy annexed to the Treaty onEuropeanUnion (the so‐called ‘social protocol’) stipulated the procedural rules of theEuropean system of industrial relations about twenty years ago. It has been pointed out, however, that the procedure has such distinct features as centricity of cross‐sectoral agreements and a close nexus between legislation and negotiations, which most of the national social systems lack. This article locates the origins of these features in the historical processes towards the 1991 social partners' agreement through some primary and secondary documents as well as a series of structured questionnaire studies and hearings. It is discussed that, contrary to what some conventional interpretations assume, the social protocol was an original model of horizontal subsidiarity, with actors' different preferences on the desirability of labour market order governed by both legislation and negotiations in its background.
Labial soft tissue volume evaluation of different techniques for ridge preservation after tooth extraction: a randomized controlled clinical trial
Authors: Schneider David , Schmidlin Patrick R. , Philipp Alexander , Annen Beat M. , Ronay Valerie , Hämmerle Christoph H. F. , Attin Thomas , Jung Ronald E. 
Published: March 2014

AbstractObjectiveTo volumetrically evaluate soft tissue changes of different ridge preservation techniques compared to spontaneous healing 6 months after tooth extraction.Materials and MethodsIn each of 40 patients, one single‐rooted tooth was extracted and four treatment modalities were randomly assigned to the following groups (n = 10 each): A) ß‐tricalcium‐phosphate‐particles with a polylactid coating (ß‐TCP), B) demineralized bovine bone mineral with 10% collagen covered with a collagen matrix (DBBM‐C/CM), C) DBBM with 10% collagen covered with an autogenous soft tissue punch graft (DBBM‐C/PG), D) spontaneous healing (control). Impressions were obtained before extraction and 6 months later, casts were digitized and volumetric changes at the buccal soft tissues were determined. One‐way anova was performed and pair‐wise Wilcoxon rank sum test with Bonferroni‐Holm method was applied for comparison of differences between two groups.ResultsAfter 6 months, horizontal contour changes accounted for −1.7 ± 0.7 mm (A), −1.2 ± 0.5 mm (B), −1.2 ± 0.7 mm (C) and −1.8 ± 0.8 mm (D). None of the group comparisons reached statistical significance.ConclusionsSix months after tooth extraction all groups revealed a horizontal volume change in the buccal soft tissue contour. Application of DBBM‐C/CM or DBBM‐C/PG reduced the amount of volume resorption compared to ß‐TCP or spontaneous healing without reaching statistically significant difference.
GPs' perspectives on the diagnostic work‐up in patients with shoulder pain: a qualitative study
Authors: Ottenheijm Ramon P. G. , Hesselmans Nicolle J. J. M. , Kemper Anouk , Moser Albine , de Bie Rob A. , Dinant Geert‐Jan , Cals Jochen W. L. 
Published: March 2014

AbstractRationale, aims and objectivesThe diagnostic work‐up of patients with shoulder pain in general practice is complex. General practitioners' (GPs) guidelines advise a pragmatic diagnostic work‐up in which additional imaging has a limited role. However, diagnostic ultrasounds are increasingly ordered by GPs, which seems to reflect complexity in management of shoulder pain. This study aimed to explore GPs' perspectives on the diagnostic work‐up of patients with shoulder pain.MethodThis study has a qualitative exploratory design with an inductive approach and was carried out in Dutch general practice. The study population consisted of 18 Dutch GPs who were sampled purposefully with a spread in clinical experience and ordering diagnostic ultrasound. Data were gathered by means of semi‐structured interviews and analysed following principles of the constant comparative method.ResultsThree main categories with subcategories emerged that captured the diagnostic work‐up of shoulder pain: variety in diagnostic classifications [(non‐)specific diagnosis and interdisciplinary differences], establishing strategies for diagnostic work‐up (use of existing tools and motives to deviate from existing tools), and strategies dealing with diagnostic uncertainties (accepting diagnostic uncertainties, diagnostic imaging tests, and interdisciplinary consultation and referral).ConclusionsDespite the availability of evidence‐based shoulder guidelines, GPs experience uncertainties during diagnostic work‐up and apply different strategies when dealing with these uncertainties. At some point, GPs as well as patients seem to have a need for a specific diagnosis. Currently, there appears to be little agreement if, or in which phase of shoulder pain, diagnostic ultrasound is useful or indicated.
Esthetic Management of Developmental Enamel Opacities in Young Permanent Maxillary Incisors with Two Microabrasion Techniques—A Split Mouth Study
Authors: Sheoran Neha , Garg Shalini , Damle Satyawan G. , Dhindsa Abhishek , Opal Shireen , Gupta Shivani 
Published: March 2014

AbstractPurposeThis study evaluated the effectiveness of two microabrasion materials for the removal of developmental enamel opacities in young permanent maxillary incisors.Materials and MethodsUsing a split‐mouth study design, 37% phosphoric acid and 18% hydrochloric acid were used for removal of visually unesthetic developmental enamel opacities of young permanent maxillary anterior teeth from 25 subjects (11–13 years old) by two microabrasion techniques for 10 and 5 seconds respectively. This procedure was repeated four to six times during each clinical appointment. The subjects were evaluated about their satisfaction with the treatment. Two blinded evaluators appraised both sides of the mouth using visual analog scale. The records were analyzed using Wilcoxon test.ResultsThe majority of the subjects (approximately 97%) reported satisfaction at the end of the treatment (p = 0.001**). Statistical significant reduction in enamel opacities was observed by evaluators immediately after microabrasion technique in group 1 (81.75%) and in group 2 (81.4%) (p < 0.002). Reduction was increased to 97.2% in group 1 and 96.7% in group 2 after 1 month.ConclusionsBoth microabrasion techniques showed comparative highly significant successful results in esthetic management of enamel opacities clinically and in terms of subject's satisfaction.Clinical SignificanceDevelopmental enamel defects like diffuse opacities due to high‐fluoride content in water and demarcated opacities associated with positive dental history and are commonly seen in young permanent maxillary incisors of both boys and girls in their developing years. They are aware of unesthetic appearance of these newly erupted permanent anterior teeth and become highly motivated when informed about minimally invasive, patient friendly, cost‐effective, and safe treatment like microabrasion for esthetic improvement. Both noninvasive microabrasion techniques using 37% phosphoric acid (group 1) and 18% hydrochloric acid (group 2) show comparatively high success results in treating enamel defects successfully to the subject's satisfaction along with their parents.
Intermittent Drying of Nopal (Opuntia Ficus Indica) in a Fluidized Bed Pilot Dryer Adapted with Revolving Chambers
Authors: Vega–Valencia Y. , Cruz y Victoria M.T. , Vizcarra Mendoza M.G. , Anaya Sosa I. 
Published: March 2014

AbstractIntermittent drying is a novel method for improving the food drying kinetics, enhancing product quality and reducing energy consumption per unit of moisture removed at the lab scale. However, the drying protocol itself makes it difficult to implement it at the pilot plant scale without important energy loses. Taking this into account, an accessory for a fluidized bed pilot dryer was developed using an arrangement of revolving chambers that could increase the efficiency of the drying process; nopal (Opuntia ficus indica) was employed as a food material. Several drying experiments were conducted at the laboratory scale in order to establish the most appropriate drying condition to be further tested at the pilot plant scale. No statistical difference was observed between the drying curves obtained in the laboratory and pilot plant dryers under conventional and intermittent drying conditions, which means that the arrangement of chambers guarantees equal and consistent treatment of the solid. Interestingly, the results indicate that a drying protocol of nopal size “E” using the adapted fluidized bed dryer with tempering cycles at pilot plant scale can be regarded as an excellent and cost‐effective methodology for processing vegetables without chemical quality losses.Practical ApplicationsIn this work, the performance of a novel fluidized bed dryer, adapted with an arrangement of revolving chambers specially designed to increase the efficiency of intermittent drying at the pilot plant scale, was evaluated. Cubes of nopal (Opuntia ficus indica) was chosen to take advantage of a biomaterial with high nutrimental characteristics. It was concluded that the arrangement of the equipment was able to maintain an equal and consistent treatment of the solid that in consequence, lead to a high chemical quality of the final dried product, comparable to that obtained at the laboratory scale. Additionally, the results indicate that the scaling of the process in the dryer prototype was highly efficient as it allowed to increase 300% the amount of biomaterial to be processed in one single drying operation. It was proposed that the use of the dryer adaptor has a great potential to increase the efficiency of drying processes of other biomaterials.
Effect of Modified Atmosphere Packaging on Physicochemical, Sensory and Microbiological Properties of Spray‐Dried Sea Buckthorn Fruit Juice Powder
Authors: Selvamuthukumaran Meenakshisundaram , Khanum Farhath 
Published: March 2014

AbstractSea buckthorn fruit juice powder was developed in order to assess the shelf stability by spray drying process. The developed product was packed in paper foil polyethylene pouch, sealed under different modified atmosphere packaging conditions, viz. air, CO2, N2 and vacuum, and stored at room temperature. Physicochemical properties of juice powder show that the sugars significantly increased, while vitamins C and E, total phenols, carotenoids and anthocyanins significantly reduced during storage at the above conditions. Moisture, bulk density, solubility, dispersibility and browning exhibited slight insignificant changes. Sensory properties of stored juice powder show that the vacuum‐packed samples recorded highest organoleptic scores and air‐packed samples showed least scores. Microbiological properties show that the product exhibited nil microbial growth and they were acceptable up to a period of 8 months. Vacuum‐stored samples exhibited superior qualities when compared to air‐, CO2‐ and N2‐stored samples in terms of physicochemical, sensory and microbiological properties.Practical ApplicationsSea buckthorn fruit juice can be converted into powder form and can be utilized throughout the year because of spray drying process. The product stability can be enhanced by adopting modified atmosphere packing as a novel technique; therefore, this study will help the entrepreneur to successfully utilize this product by reconstituting it into juice and further it into products such as jam, ready to serve and squash during off‐season period also. This study will find a path to market the product successfully because of its higher shelf stability.
Estimation of Life Cycle Material Costs of Cadmium Telluride– and Copper Indium Gallium Diselenide–Photovoltaic Absorber Materials based on Life Cycle Material Flows
Authors: Marwede Max , Reller Armin 
Published: March 2014

SummaryChalcogenide and chalcopyrite photovoltaic (PV) technologies are highly suitable for solar energy conversion because of their high efficiency, long‐term stable performance, and low‐cost production. However, the absorber materials that are used, such as indium, gallium, and tellurium, are regarded as critical, and their limited availability can hinder market expansion. Therefore, we assess how material efficiency measures along the PV module's life cycle can reduce the net material demand of the absorber materials and thus the material costs. In order to estimate the material flows, we developed a closed‐loop model for the life cycle representing the phasesmodule production,module collection,module recycling, andrefinement. In order to reflect the variety and uncertainty in each phase, we compose three different efficiency scenarios by varying material efficiency measures on process and product levels. For each scenario, we compute the life cycle material costs based on the computed material flows. The results show that, in the long term, the material demand can be reduced down to one fourth of the required feedstock for module manufacturing; that is, three fourths of the absorber material stays in the life cycle in a very efficient scenario. Thus, total material costs along the life cycle could be significantly reduced, because the costs for material recycling are lower than the costs for “new” technical‐grade material. This reduction in life cycle material costs means that cadmium telluride– and copper indium gallium diselenide–PV can still be financially viable even if the price of the absorber materials increases significantly. Hence those technologies will still be competitive against crystalline silicon PV in the mid to long term.
Interleukin‐6, but Not C‐Reactive Protein, Predicts the Occurrence of Cardiovascular Events after Drug‐Eluting Stent for Unstable Angina
Authors: CHEN SHAO‐LIANG , LIU YAN , LIN LING , YE FEI , ZHANG JUN‐JIE , TIAN NAI‐LIANG , ZHANG JUN‐XIA , HU ZUO‐YING , XU TIAN , LI LI , XU BO , LATIF FAISAL , NGUYEN THACH 
Published: March 2014

BackgroundEvidences concerning the predictive value of baseline inflammatory biomarkers after drug‐eluting stent (DES) placement are controversial, mainly because the use of statin was not precisely defined.ObjectivesThe aim was to compare the differences between interleukin (IL)‐6 and high‐sensitivity C‐reactive protein (hs‐CRP) in predicting cardiovascular events 2 years after stenting in patients with unstable angina (UA) who had not received statin pretreatment.MethodsThere were 1,896 patients included in this study. The primary end‐point was the occurrence of cardiac death or myocardial infarction (MI). Secondary endpoints included all‐cause death, stent thrombosis (ST), target lesion revascularization (TLR), target vessel revascularization (TVR), or a composite of major adverse cardiac events (MACE) at 2 years after the procedure.ResultsDuring the median follow‐up of 2.77 years, 96 patients experienced cardiac death (n = 37, 1.95%) or MIs (n = 70, 3.69%), 94 TLRs, 123 TVRs, 215 MACEs, and 21 definite or probable STs. In multivariable Cox proportional‐hazards models and discrimination analysis, elevated IL‐6 levels were superior to hs‐CRP in predicting the occurrence not only of cardiac death or MI (HR 1.337, 95% CI 1.234–1.449, P < 0.001), but also of MACE and late‐occurring definite/probable ST. Incorporation of IL‐6 into conventional variables resulted in significantly increased c statistic for the prediction of end‐points, with the exception of TLR and TVR.ConclusionElevated IL‐6 levels were independent predictors of cardiac death or MI, MACE, and late ST in patients with UA who had not received statin pretreatment, suggesting a role for IL‐6 in the inflammatory risk assessment. Pathological studies have confirmed that atherosclerosis is a chronic inflammatory disease. Serum levels of high‐sensitivity C‐reactive protein (hs‐CRP), matrix metalloproteinase, plasminogen activator inhibitor‐1, the complement components C3a or C5a, and interleukin(IL)‐6 were reported to provide strong and independent indications of the risk for future cardiovascular (CV) events, even among individuals who are thought to be free of vascular disease. (J Interven Cardiol 2014;27:142–154)
Renal Sympathetic Denervation in Patients with Aortic Dissection
Authors: DIVCHEV DIMITAR , TURAN GÖKMEN , REHDERS TIM , NIENABER CHRISTOPH A. 
Published: March 2014

BackgroundWe report on feasibility, safety, and mid‐term outcomes of renal sympathetic denervation (RSD) in hypertensive patients after endovascular treatment for aortic dissection.MethodsSix patients were subjected to RSD after receiving endovascular treatment for complicated aortic dissection. Between April 2011 and May 2012, RSD procedure was applied for persistent hypertension despite maximized antihypertensive drug therapy using the Symplicity® catheter system. Endovascular aortic treatment was performed for malperfusion or rapid expansion by virtue of a stent‐graft system (Valiant®, n = 5) or an open cell stent (Smart®; n = 1).ResultsSystolic blood pressure (BP) was 189.8 ± 32.2 mmHg and diastolic BP 96.2 ± 11.1 mmHg at baseline on 24 hours readings; after RSD, a successful reduction to 129.5 ± 11.8 mmHg (P = 0.004) for systolic and to 77.7 ± 10.7 (P = 0.004) for diastolic BP at 3‐month follow‐up was documented on ambulatory 24‐hour BP readings with sustained reduction at 1‐year follow‐up (127.2 ± 11.8 mmHg [P = 0.002] and 77.7 ± 7.7 [P = 0.011]).ConclusionRSD using the Symplicity® catheter system is feasible and safe in hypertensive patients previously subjected to endovascular repair for complicated aortic dissection. (J Interven Cardiol 2014;27:334–339)