jimnoneill/paper-to-field-training huggingface dataset:
PWE-148 Bouveret's syndrome: leaving no stone unturned: Abstract PWE-148 Figure 1

Field: Medicine (Health Sciences)

Introduction Bouveret's syndrome is a clinically distinct form of gallstone ileus caused by the formation of a fistula between the biliary tract and duodenum. Early recognition and treatment can significantly improve morbidity and mortality. We present two cases that have been successfully treated at our hospital. Methods Patient A is 71-year-old lady who was referred for gastroscopy after a CT abdomen that was performed to investigate her weight loss showed deformity of the duodenal cap. The gastroscopy showed a large gallstone obstructing the pyloric opening (Abstract PWE-148 figure 1A). Endoscopic removal was unsuccessful. She then developed vomiting and abdominal pain. Blood tests showed raised inflammatory markers and liver function tests. Repeat gastroscopy showed that the gallstone had passed down the pylorus, revealing a fistula opening in the duodenum (Abstract PWE-148 figure 1B). Diagnosis was confirmed on repeat CT abdomen which showed pneumobilia and two large gallstones that had migrated to the ileum (Abstract PWE-148 figure 1C). Patient B is 87-year-old lady who presented with a 1-week history of vomiting and haematemesis. Her blood tests on admission showed raised inflammatory markers with normal liver function tests. Gastroscopy showed oesophagitis, a duodenal ulcer and obstructing gallstone. Gastrograffin studies then showed that the gallstone had migrated to the proximal jejunum (Abstract PWE-148 figure 1D) and this was confirmed on CT abdomen. Abstract PWE-148 Figure 1 Results Patient A was treated with a Ryle's tube insertion for stomach decompression, intravenous fluids, antibiotics and peripheral parenteral nutrition. She underwent a laparotomy, which showed distended fluid filled small bowel, with a large 5×3 cm gallstone lodged in the ileum. An ileal enterotomy was performed and the gall stone excised. Patient B was treated with a Ryle's tube insertion, intravenous fluids and peripheral parenteral nutrition. She underwent a laparotomy, in which a gallstone was found lodged in the proximal jejunum and surgically removed. Both patients made a full recovery and were discharged home. Conclusion Bouveret's syndrome is rare and accounts for 1–3% of gallstone ileus. We have now encountered two cases in our hospital recently. This may reflect the rise in our ageing population, as a major risk factor for developing this syndrome is age >70 years. Establishing the diagnosis early requires an awareness of this syndrome and prompt recognition of the signs. Contrast enhanced CT is the investigation of choice. In addition to this, a combined care approach between the gastroenterologists, surgeons and nutrition team is crucial to a successful outcome, hence our wish to present these cases. Competing interests None declared. Reference 1. Cappell MS , Davis M. Characterization of Bouveret's syndrome: a comprehensive review of 128 cases. Am J Gastroenterology 2006; 101 :2139–46.
Treatment of Severe Systemic Inflammatory Response Syndrome and Sepsis With a Novel Bradykinin Antagonist, Deltibant (CP-0127)<subtitle>Results of a Randomized, Double-blind, Placebo-Controlled Trial</subtitle>

Field: Medicine (Health Sciences)

Objective.

—To test the effect of a novel bradykinin antagonist, deltibant (CP-0127), on survival, organ dysfunction, and other outcomes in patients with the systemic inflammatory response syndrome (SIRS) and presumed sepsis.

Design.

—Multicenter, randomized, placebo-controlled, double-blind, parallel, dose-ranging trial. Follow-up for 28 days or until death.

Setting.

—A total of 47 US referral hospitals.

Patients.

—A total of 504 patients with SIRS and documented evidence of infection plus either hypotension or dysfunction of 2 organ systems.

Interventions.

—Three-day continuous intravenous infusion of either placebo or 1 of 3 doses (0.3,1.0, or 3.0 μg.kg-1.man-1) of deltibant. Concurrent therapy at the discretion of the treating physician.

Main Outcome Measure.

—Risk-adjusted, 28-day, log-normal intent-to-treat survival analysis. Risk adjustment was performed using a study-specific risk model derived from the APACHE III database.

Results.

—Deltibant had no significant effect on risk-adjusted 28-day survival. In a posthoc analysis, risk-adjusted 7-day survival showed a nonsignificant trend toward improvement (P=.09). The 28-day risk-adjusted survival in the prospectively defined subset of patients with gram-negative infections showed a statistically significant improvement (P=.005).

Conclusions.

—Deltibant may have some effect on survival in patients with SIRS and gram-negative sepsis; however, additional studies would be required to prove this.
Brain morphology and behaviour in the guppy (Poecilia reticulata) : Effects of plasticity and mosaic brain evolution

Field: Neuroscience (Life Sciences)

Understanding how brains have evolved and subsequently culminated in the huge variation in brain morphology among contemporary vertebrate species has fascinated researchers for many decades. It has been recognized that brain morphology is both genetically and environmentally determined. Adaptations to ecological challenges, for one, has been proposed to be a major force in brain diversification processes. Considering the large energetic costs of neural tissue, it is believed that brain evolution is a highly complex process, involving a delicate balance between the corresponding costs and benefits. Using the guppy (Poecilia reticulata) as the model organism, I first examined the conditions under which diversity in brain morphology is generated. This was done by investigating factors known to exert an influence on brain plasticity, namely environmental and cognitive effects (Paper I). Existing studies generally indicate that the provision of environmental enrichment lead to the enlargement of specific brain structures. While plastic alterations in brain morphology was found to respond to environmental complexity in my study, successful performance in two cognitive tasks did not produce any significant changes. I next assessed the feasibility of the mosaic brain evolution hypothesis by artificially selecting for an increase and decrease in the relative size of the telencephalon (Paper II). Telencephalon size was shown to respond rapidly to divergent selection pressures, with no substantial changes in any of the other brain regions. A comparison with wild fish revealed that fish from the unselected control treatment had telencephalon sizes most similar to that of wild populations, whereas both up-selected and down-selected fish had considerably larger and smaller telencephalon, respectively. I tested fish from the artificial selection lines in a test battery to determine if known differences in telencephalon size affects boldness (Paper III). Individuals were subjected to an emergence test, an open field test and a novel object test. I found no differences in boldness levels across selection treatments, but distinct sex differences were noted whereby males were more active and bolder. The cognitive benefits associated with a larger telencephalon were examined in males in a test of self-control (Paper IV). Guppies from the up-selected lines attained a steeper learning curve and made more correct detours compared to their down-selected conspecifics. In conclusion, I provide experimental evidence for the mosaic brain evolution hypothesis by showing that a specific brain region (telencephalon) can evolve rapidly and independently under directed selection. Future tests on other cognitive benefits as well as implicated costs, together with underlying neuronal changes would help to further unravel the factors governing brain evolution.
Concealing Coloration in Animals J. Diamond and A.B. Bond . 2013. Belknap Press of Harvard University Press. ISBN 9780674052352. 288 p. $29.95 (hardcover).

Field: Agricultural and Biological Sciences (Life Sciences)

Ichthyology & Herpetology (formerly Copeia) publishes work on the biology of fishes, amphibians, and reptiles, or work using those organisms as models for testing hypotheses of broad significance.
Developing the Next Generation Shell Buckling Design Factors and Technologies

Field: Engineering (Physical Sciences)

a. knockdown factors) and design and analysis technologies for light-weight stiffened metallic launch vehicle (LV) structures.Preliminary design studies indicate that implementation of these new knockdown factors can enable significant reductions in mass and mass-growth in these vehicles and can help mitigate some of NASA's LV development and performance risks.In particular, it is expected that the results from this project will help reduce the reliance on testing, provide high-fidelity estimates of structural performance, reliability, robustness, and enable increased payload capability.The SBKF project objectives and approach used to develop and validate new design technologies are presented, and provide a glimpse into the future of design of the next generation of buckling-critical launch vehicle structures.
Application of Nutritional Risk Score-2002 Questionnaire and Other Nutritional Status Parameters Among Hospitalized Elderly

Field: Health Professions (Health Sciences)

Background: Proper nutritional status is an important factor of successful aging and wellbeing of elderly patients. Screening and then treatment of malnutrition should be one of the main focuses of public health. The main aim of this study is to evaluate the usefulness of Nutritional Risk Score-2002 (NRS-2002), and the anthropometric and biochemical parameters in the context of nutritional status. Methods: Total of 1100 patient records from September 2012 to December 2014 were analyzed in terms of nutritional status assessment. The following were included for the analysis: NRS questionnaire, Body Mass Index (BMI), arm (AC) and calf circumference (CC), and concentration of albumin. Results: Mean age was 80.5 ± 7.3 years. The most frequent NRS-2002 score was indicating “risk of malnutrition” and its value increased with age. Mean albumin concentration was 3.49 ± 0.53 g/dl. Significant correlations between albumin concentration and arm and calf circumferences were found (p < 0.0001). Conclusions: Percentage of patients at nutritional risk determined with NRS was 18.8%. This result was significantly lower than in other studies. With accordance to results of other researchers, values of the NRS increased with age. Results regarding the relationship between the NRS values and albumin concentration, AC and CC (negative correlations) and albumin concentration with CC and AC (positive correlations) were consistent with the results of other researchers. In the assessment of the nutritional status of hospitalized elderly, the NRS-2002 should be combined with basic anthropometric measurements.
Older People Need Dental Care Too

Field: Dentistry (Health Sciences)

The characteristics of our society are changing dramatically. Not only are we living longer but the older generations are keeping their natural teeth longer and quite often all of their lives. Some of these older individuals have special difficulty keeping their oral health. The most common problem arises because of physical or intellectual deterioration, which makes it more difficult to clean the teeth and eat a healthy diet. This in itself can make chewing and eating uncomfortable, and this further aggravates the problem. Older people are more likely to wear dentures, and particularly complete dentures. Many of the older generation became denture wearers 30 or more years ago, when removing all the teeth in a single operation was a popular form of treatment. As we get older, the gums shrink progressively so that dentures become loose and ill-fitting over time. Elderly people are less likely to ask for new dentures than younger people, and often struggle on with badly fitting and worn ones. Ageing of the population is one of the most important demographic facts that came to the foreground in the 21st century. There are also associations between oral health, general health and well being of older people. This review is aimed to highlight the oral health needs of older adults and describes the general dental problems of elderly population.
Comparison of Upper Extremities of Children Who Playing and Not Playing Basketball

Field: Health Professions (Health Sciences)

In this study, it is aimedto compare the upper extremities of children who play and do not playbasketball. In this study, measurements were taken in the upper extremities ofa total of 200 secondary school students playing basketballand non-playing, with a mean age range of 11 ± 1.08 (did play sports) - 11 ±0.8 (did not play sports). The averageheight and weight ratio of the students who did and did not play sports were153.5 ± 12.9 - 149.2 ± 8.1 cm and 46.7 ± 12.04 - 43.08 ± 12.9 kg respectively. Inthe right and left upper extremities of the students who play sports, armlength was 28.4 ± 3.1 - 28.4 ± 3.01, the forearm length was 24.1 ± 2.4 - 24.1 ± 2.4, hand length was 15.9 ±1.8 to 15.9 ± 1.6, arm circumference was 23.2 ±3.9 - 23.0 ± 3.8, the circumference of forearm was 20.8 ± 2.5 - 20.6 ± 2.5,hand width was 7.8 ± 0.8 to 7.9 ± 0.8. The results of thebiacromial width and bideltoid width measurements were 25.5 ± 3.13 and 39.2 ±4.7, respectively. In the right and left upper extremities of students who didnot do sports, arm length was 26.8 ± 2.5 - 26.6 ± 2.4, forearm length was 23.3 ±2.1 - 23.3 ± 2.0, hand length was 16.0 ± 1.5 -16.2 ± 1.5, arm circumference was 22.4 ± 3.5 to 22.4 ±3.5, circumference of forearm was19.4 ± 2.5 - 19.4 ± 2.5, hand width was 7.6 ±0.9 - 7.7 ± 0.9.The results of thebiacromial and bideltoid width measurements were 28.8 ± 3.8 and 37.6 ± 4.4,respectively. As a result of the evaluation made, there was a difference betweenarm circumference measurements (p = 0.02) when the measurements taken from theright and left extremities of the students who did sports and did not do sportswere compared. It was observed that the difference between right - left armlength (p = 0.001) and right - left hand length (p = 0.02) was significant inthe students who did not do sports. Playing basketball increases the armcircumference and forearm circumference in children.
OPTIMAL AND HEURISTIC SOLUTIONS FOR THE MULTI‐ITEM NEWSVENDOR PROBLEM WITH A SINGLE CAPACITY CONSTRAINT

Field: Decision Sciences (Social Sciences)

This research considers a multi‐item newsvendor problem with a single capacity constraint. While this problem has been addressed in the literature, the focus here is on developing simple, closed‐form expressions for the order quantities. The benefit of such an approach is that the solutions are straightforward to calculate and have managerial appeal. Additionally, we show these expressions to be optimal under a variety of conditions. For more general cases when these optimality conditions do not hold, we use these expressions as heuristic solutions. Via computational studies, we demonstrate that these heuristics are extremely effective when the optimality conditions are not satisfied.
Management of imported complicated urogenital schistosomiasis in Europe: a TropNet retrospective study

Field: Medicine (Health Sciences)

Abstract Background Schistosomiasis is a neglected tropical disease caused by trematodes of the genus Schistosoma. Schistosoma haematobium causes urogenital schistosomiasis (UGS), a chronic disease characterized by pathology of the urogenital tract leading to potentially severe morbidity for which the treatment is poorly standardized. We conducted a survey in TropNet centres on the clinical presentations and management strategies of complicated urogenital schistosomiasis (cUGS). Methods We reviewed the clinical records of patients seen at TropNet centres over a 20-year timespan (January 2001–December 2020). Case definition for cUGS included the presence of urogenital cancer, obstructive uropathy, kidney insufficiency of all grades and female or male genital involvement leading to infertility. Collected data included demographic information, patient category (traveller or migrant), imaging data, microbiological data (serology results and presence/absence of eggs in urine), histological features and outcome at last visit recorded. Results Eight centres contributed with at least one case. Overall, 31 patients matched the inclusion criteria. Sub-Saharan Africa was the most likely place of infection for included patients. Median age was 30.6 years (range 21–46, interquartile ranges, IQR 27–33). Most patients (28/31, 90.3%) were males. Hydronephrosis was the most frequent complication, being present in 18 (58.1%) patients, followed by cancer, present in 5 patients (16.1%); 27 patients (87.1%) required surgical management of some sort. Use of praziquantel varied across centres, with six different regimens employed. Discussion Very few cases of cUGSs were found in our survey, possibly indicating underdiagnosis of this condition. Hydronephrosis was the most frequently observed urogenital complication, and most patients required invasive procedures. Infection by S. haematobium can result in considerable morbidity, resulting in clinically challenging presentations requiring a multidisciplinary approach. As such, development of common protocols for early diagnosis and treatment is urgently needed.
A phase II trial of perioperative concurrent chemoradiotherapy (CCRT) and gefitinib (G) in locally advanced esophagus (E) and gastroesophageal junction (GEJ) cancer

Field: Medicine (Health Sciences)

4547 Background: Since 1999, Cleveland Clinic protocols for locally advanced E or GEJ cancer have used peri-operative CCRT. Despite high locoregional control (LRC) rates, distant metastatic control (DMC) and overall survival (OS) are suboptimal. This phase II study added G to our CCRT regimen in an effort to improve these outcomes. Methods: Eligibility required a diagnosis of E or GEJ squamous cell or adenocarcinoma (ACA), with an esophageal ultrasound stage of at least T3, N1, or M1a. Four-day (d) continuous IV infusions of cisplatin (20mg/m2/d), and fluorouracil (1,000 mg/m2/d) began on d1 of pre-operative radiation (30Gy at 1.5Gy bid). Surgery followed in 4–6 weeks (wks), followed by identical CCRT given 6–10 wks postoperatively. G (250 mg/d) was also started on d1 and given for 4 wks. It was restarted with the postoperative CCRT and given for 2 years. Targeted accrual was 80 patients (pts) with primary endpoints of OS and DMC. Results were retrospectively compared to 93 pts treated with an identical regimen without G. Results: Between 4/03 and 7/06, 80 pts were enrolled. Pt and tumor characteristics were similar to the non-G cohort. Median age was 58 (range 33–75) years; 73 pts (91%) were male and 75 (94%) Caucasian. Tumor began in distal E in 28 pts (35%) and GEJ in 46 (57%), and was an ACA in 75 (94%). Clinical staging was T3N0 in 15 pts (19%), T2–3N1 in 41 (51%) and T4 or M1a in 24 (30%). Induction toxicity was similar in G v. non-G pts except for grade 3–4 esophagitis in 3% v. 14% (p=0.007), neutropenia <1,000/mm3 in 14% v. 38% (p<0.001), and neutropenic fever in 5% v. 17% (p=0.012) respectively. G-specific toxicity included grade >1 rash in 42 pts (53%), and grade >1 diarrhea in 44 (55%). Resection was accomplished in 73 pts (91%) and post-operative CCRT completed in 60 (75%). With a median follow up of 33 (range 11–54) months, 3-year Kaplan-Meier estimates (G v. non-G pts) include: OS (40% v. 28%, p=0.07), DMC (46% v. 33%, P=0.20), and LRC (82% v. 77%, p=0.28). Only 50% of pts are projected to complete 2 years of maintenance G. Conclusions: Although toxicity was not increased by adding G to peri-operative CCRT, maintenance G was difficult. The suggestion of a survival advantage in this retrospective comparison merits additional investigation. No significant financial relationships to disclose.
Overcoming Organizational Silos: Role of New Clients in Post-Merger Integration

Field: Business, Management and Accounting (Social Sciences)

Since an organization is ideally expected to be a cooperative system among organizational members, the phenomena of organizational silos, as exemplified by insufficient or lack of communication and mutual support beyond any subunits of an organization, would greatly reduce the efficiency and effectiveness of the organization. While the silo phenomena can be seen everywhere regardless of types and sizes of any organizations, or contexts with which organizations are embedded, we especially focus on the phenomena of organizational silos in the phase of post-merger integration because a merger process itself urges existing organizational members to notice their silo mentality between a merging firm and a merged firm, and it also enforces them to change their behaviors that could serve to organizational integration. In order to examine the issues of how and to what extent organizational silos could be overcome over time in the longitudinal process of post-merger integration, we use data on Japanese audit firm partners who experienced one of the largest merger cases occurred in the mid 1980s, later became the largest audit firm in Japan in the 2000s and thereafter. By examining the longitudinal evolution of the client-professional (accountants) relationship and audit firm-professional relationship respectively before and after the merger experience, we investigate the degree of client-sharing behaviors between members of a merging firm and those of a merged firm after the merger. Based on the examination of collaborations among individual partners who used to be affiliated with a merging firm or a merged firm, we found that 1) inter-unit collaboration as a driver of organizational integration is not symmetrically observed between a merging firm and a merged firm.; 2) the importance of inter-generational collaboration becomes larger over time.; 3) inter-unit collaboration and inter-generational collaboration are more frequently observed for the newly acquired clients rather than the old clients before the merger. Finally, rather than importance of adopting new internal organizational practices, we suggest that the success of merger through organizational integration that results in dissolution of organizational silos depends more on how many new clients are acquired after the merger.
Policy Environment for the Tourism Sector's Adaptation to Climate Change in the South Pacific – The Case of Samoa

Field: Social Sciences (Social Sciences)

Samoa and its neighbouring Pacific Island Countries are highly vulnerable to climate change risks because their population and infrastructure are mostly located on low-lying coastal areas. Impacts of climate change are potentially disastrous to tourism, the major economic sector in the region. This research examines the conduciveness of the policy environment in Samoa for the tourism sector to adapt to climate change along three dimensions: stakeholders’ will and commitment, resources available, and policy-making mechanisms [Wong, E.P.Y., Mistilis, N., & Dwyer, L. (2011). A framework for analyzing intergovernmental collaboration – the case of ASEAN tourism. Tourism Management, 32, 367–376]. Samoa is used as an exemplar case study to understand how the Pacific island tourism sector can best adapt to climate change. It was found that the policy environment in Samoa is generally conducive. However, there is a strong need for closer public–private cooperation.