bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of chronic hypoxia on proximal pulmonary artery wave propagation and mechanical properties in rats
Authors: Su Junjing , Logan Charmilie C. , Hughes Alun D. , Parker Kim H. , Dhutia Niti M. , Danielsen Carl Christian , Simonsen Ulf
Published: March 2018

Arterial stiffness and wave reflection are important components of the ventricular afterload. Therefore, we aimed to assess the arterial wave characteristics and mechanical properties of the proximal pulmonary arteries (PAs) in the hypoxic pulmonary hypertensive rat model. After 21 days in normoxic or hypoxic chambers (24 animals/group), animals underwent transthoracic echocardiography and PA catheterization with a dual-tipped pressure and Doppler flow sensor wire. Wave intensity analysis was performed. Artery rings obtained from the pulmonary trunk, right and left PAs, and aorta were subjected to a tensile test to rupture. Collagen and elastin content were determined. In hypoxic rats, proximal PA wall thickness, collagen content, tensile strength per unit collagen, maximal elastic modulus, and wall viscosity increased, whereas the elastin-to-collagen ratio and arterial distensibility decreased. Arterial pulse wave velocity was also increased, and the increase was more prominent in vivo than ex vivo. Wave intensity was similar in hypoxic and normoxic animals with negligible wave reflection. In contrast, the aortic maximal elastic modulus remained unchanged, whereas wall viscosity decreased. In conclusion, there was no evidence of altered arterial wave propagation in proximal PAs of hypoxic rats while the extracellular matrix protein composition was altered and collagen tensile strength increased. This was accompanied by altered mechanical properties in vivo and ex vivo.

NEW & NOTEWORTHY In rats exposed to chronic hypoxia, we have shown that pulse wave velocity in the proximal pulmonary arteries increased and pressure dependence of the pulse wave velocity was steeper in vivo than ex vivo leading to a more prominent increase in vivo.
Calcitonin gene-related peptide hyperpolarizes mouse pulmonary artery endothelial tubes through KATP channel activation
Authors: Norton Charles E. , Segal Steven S.
Published: March 2018

The sensory neurotransmitter calcitonin gene-related peptide (CGRP) is associated with vasodilation of systemic arteries through activation of ATP-sensitive K+ (KATP) channels in smooth muscle cells (SMCs); however, its effects on endothelial cell (EC) membrane potential ( Vm) are unresolved. In pulmonary arteries (PAs) of C57BL/6J mice, we questioned whether CGRP would hyperpolarize ECs as well as SMCs. Intact PAs were isolated and immunostained for CGRP to confirm sensory innervation; vessel segments (1–2 mm long, ∼150 µm diameter) with intact or denuded endothelium were cannulated and pressurized to 16 cmH2O at 37°C. Increasing concentrations (10−10–10−6 M) of CGRP progressively dilated PAs preconstricted with UTP (10−5 M); SMCs hyperpolarized similarly (Δ Vm ∼20 mV) before and after endothelial denudation. To study native intact PA ECs, SMCs were dissociated to isolate endothelial tubes, and their integrity was confirmed by vital dye uptake, nuclear staining, and reproducible electrical and intracellular Ca2+ responses to acetylcholine (10−5 M) over 2 h. Increasing [CGRP] hyperpolarized ECs in a manner similar to SMCs, with each cell layer demonstrating robust immunostaining for CGRP receptor proteins. Increasing concentrations (10−10–10−6 M) of pinacidil, a KATP channel agonist, resulted in progressive hyperpolarization of SMCs of intact PAs (Δ Vm ∼30 mV), which was blocked by glibenclamide (10−6 M), as was hyperpolarization of ECs and SMCs to CGRP. Inhibition of protein kinase A with protein kinase inhibitor (10−5 M) also inhibited hyperpolarization to CGRP. We demonstrate [CGRP]-dependent hyperpolarization of ECs for the first time while validating freshly isolated PA endothelial tubes as an experimental model. Redundant electrical signaling to CGRP in ECs and SMCs implies an integral role for KATP channels in PA dilation.
One-week cocoa flavanol intake increases prefrontal cortex oxygenation at rest and during moderate-intensity exercise in normoxia and hypoxia
Authors: Decroix Lieselot , Tonoli Cajsa , Lespagnol Elodie , Balestra Constantino , Descat Amandine , Drittij-Reijnders Marie José , Blackwell Jamie R. , Stahl Wilhelm , Jones Andrew M. , Weseler Antje R. , Bast Aalt , Meeusen Romain , Heyman Elsa
Published: March 2018

During exercise in hypoxia, O2 delivery to brain and muscle is compromised, and oxidative stress is elicited. Cocoa flavanols (CF) have antioxidant capacities and can increase blood flow by stimulating endothelial function. We aimed to examine the effects of 7-day CF intake on oxidative stress, nitric oxide production, and tissue oxygenation in response to exercise in normobaric hypoxia (14.3% O2). In a randomized, double-blind, cross-over study, 14 well-trained male cyclists completed four trials: exercise in normoxia or hypoxia, after 7-day CF or placebo intake. Flow-mediated dilation (FMD) was measured before intake of the last dose CF or placebo. One hundred minutes later, 20-min steady-state (SS; 45% V̇o2max) and 20-min time trial (TT) (cycling) were performed. Blood samples were taken. Prefrontal and muscular oxygenation was assessed by near-infrared spectroscopy. At baseline, FMD was increased by CF. Hypoxia increased exercise-induced elevations in lipid peroxidation and antioxidant capacity. CF suppressed exercise-induced lipid peroxidation but did not influence antioxidant capacity. At rest and during SS, prefrontal and muscular oxygenation was decreased by hypoxia. CF elevated prefrontal oxygenation but did not impact muscular oxygenation. During TT, hypoxia accelerated the exercise-induced decrease in prefrontal oxygenation, but not in muscular oxygenation. During TT, CF did not alter prefrontal and muscular oxygenation. CF did not change plasma nitrite, nitrate, and arginine:citrulline. During high-intensity exercise, CF improved neither tissue oxygenation nor performance in well-trained athletes. At rest and during moderate-intensity exercise, CF reduced exercise-induced lipid peroxidation and partially restored the hypoxia-induced decline in prefrontal oxygenation.

NEW & NOTEWORTHY For the first time, we showed that CF had beneficial effects on endothelial function at rest, as well as on prefrontal oxygenation at rest and during moderate-intensity exercise, both in normoxia and hypoxia. Moreover, we showed that CF intake inhibited oxidative stress during exhaustive exercise in hypoxia.
Propolis and Its Potential to Treat Gastrointestinal Disorders
Authors: Silva Luisa Mota da , Souza Priscila de , Jaouni Soad K. Al , Harakeh Steve , Golbabapour Shahram , de Andrade Sérgio Faloni
Published: March 2018

There are a number of disorders that affect the gastrointestinal tract. Such disorders have become a global emerging disease with a high incidence and prevalence rates worldwide. Inflammatory and ulcerative processes of the stomach or intestines, such as gastritis, ulcers, colitis, and mucositis, afflict a significant proportion of people throughout the world. The role of herbal‐derived medicines has been extensively explored in order to develop new effective and safe strategies to improve the available gastrointestinal therapies that are currently used in the clinical practice. Studies on the efficacy of propolis (a unique resinous aromatic substance produced by honeybees from different types of species of plants) are promising and propolis has been effective in the treatment of several pathological conditions. This review, therefore, summarizes and critiques the contents of some relevant published scientific papers (including those related to clinical trials) in order to demonstrate the therapeutic value of propolis and its active compounds in the treatment and prevention of gastrointestinal diseases.
Key Variables Screening of Near-Infrared Models for Simultaneous Determination of Quality Parameters in Traditional Chinese Food “Fuzhu”
Authors: Wang Jiahua , Wang Jun , Zhang Xiaowei , Cheng Jingjing , Li Qingyu
Published: March 2018

The traditional Chinese food Fuzhu is a dried soy protein-lipid film formed during the heating of soymilk. This study investigates whether a simple and accurate model can nondestructively determine the quality parameters of intact Fuzhu. The diffused reflectance spectra (1000–2499 nm) of intact Fuzhu were collected by a commercial near-infrared (NIR) spectrometer. Among various preprocessing methods, the derivative by wavelet transform method optimally enhanced the characteristic signals of Fuzhu spectra. Uninformative variable elimination based on Monte Carlo (MC-UVE), random frog (RF), and competitive adaptive reweighted sampling (CARS) were proposed to select key variables for partial least squares (PLS) calculation. The strong performance of the developed models is attributed to the high ratios of prediction to deviation values (3.32–3.51 for protein, 3.62–3.89 for lipid, and 4.27–4.55 for moisture). The prediction set was used to assess the performances of the best models of protein (CARS-PLS), lipid (RF-PLS), and moisture (CARS-PLS), which resulted in greater coefficients of determination of 0.958, 0.966, and 0.976, respectively, and lower root mean square errors of prediction of 0.656%, 0.442%, and 0.123%, respectively. Combined with chemometrics methods, the NIR technique is promising for simultaneous testing of quality parameters of intact Fuzhu.
The Liquefaction Behavior of Poorly Graded Sands Reinforced with Fibers
Authors: Karakan Eyyüb , Eskişar Tuğba , Altun Selim
Published: March 2018

This study focuses on the performance of fibers, improving the resistance to liquefaction in loose sands, medium sands, and dense sands in Izmir, Turkey. A systematic testing schedule consisting of cyclic triaxial tests was held under stress‐controlled and undrained conditions on saturated sand specimens with and without fiber reinforcements. The major parameters having effects on the dynamic behavior such as fiber content, fiber length, and relative density on the liquefaction behavior and the excess pore water pressure developments of specimens with and without fibers were investigated. If the fiber content or the fiber length was increased in the specimens, higher number of loading cycles was needed in order to experience the liquefaction of sands. The reinforcement effect in medium‐dense specimens was found to be apparently distinctive compared to loose specimens. The curves of pore water pressures and shear strains were achieved for the fiber‐reinforced sands. The boundaries of pore water pressure curves presented in the literature on the clean sands were utilized in comparison with the pore water pressure curves of fiber‐reinforced sands of this study. As a conclusion, the results presented in this study are useful to develop insight into the behavior of clean and fiber‐reinforced sands under seismic loading conditions. Based on the test results, it was found that the number of loading cycles had a strong impact on the excess pore pressure generation.
The Research on Second-Order ADRC Algorithm of Using Wind Turbine Virtual Inertia to Participate in Primary Frequency Regulation in a Small Stand-Alone Microgrid
Authors: Yi Wang , Hanhong Jiang , Pengxiang Xing
Published: March 2018

In order to improve the transient stability of frequency in a small stand-alone microgrid (SSM), this paper takes a SSM composed of a direct-drive permanent magnet synchronous generator (D-PMSG) and a micro gas turbine (MGT) as the background and uses wind turbine generator (WTG) virtual inertia (VI) to participate in the primary (short-term) system frequency regulation. First of all, this paper constructs a grid-connected model composed of a WTG and a MGT, analyzes the WTG virtual inertia frequency regulation mechanism, and explains the principle of proportional-differentiation (PD) virtual inertia control (VIC) and its shortcomings. Secondly, the paper introduces the structure principle of n-order active disturbance rejection control (ADRC) and deduces the design process of second-order ADRC-VIC. Finally, through the simulation and experimental verification, comparing the frequency perturbation of without-VIC, PD-VIC, and ADRC-VIC, it is concluded that PD-VIC and ADRC-VIC both can use the WTG virtual inertia to participate in the primary frequency regulation. The frequency regulation effect of ADRC-VIC is better than PD-VIC, ADRC-VIC can extend the rotor speed recovery time and avoid overshoot, and its frequency fluctuation amplitude and settling time are obviously improved, and ADRC-VIC can effectively avoid the overshoot phenomenon of the MGT output power.
Epidemic Spreading in Complex Networks with Resilient Nodes: Applications to FMD
Authors: Kim Pilwon , Lee Chang Hyeong
Published: March 2018

At the outbreak of the animal epidemic disease, farms that recover quickly from partially infected state can delay or even suppress the wide spreading of the infection over farm networks. In this work, we focus on how the spatial transmission of the infection is affected by both factors, the topology of networks and the internal resilience mechanism of nodes. We first develop an individual farm model to examine the influence of initial number of infected individuals and vaccination rate on the transmission in a single farm. Based on such intrafarm model, the farm network is constructed which reflects disease transmission between farms at various stages. We explore the impact of the farms vaccinated at low rates on the disease transmission into entire farm network and investigate the effect of the control on hub farms on the transmission over the farm network. It is shown that intensive control on the farms vaccinated at low rates and hub farms effectively reduces the potential risk of foot‐and‐mouth disease (FMD) outbreak on the farm network.
A Case of Placenta Percreta Managed with Sequential Embolisation Procedures
Authors: Armstrong-Kempter Shannon , Kapurubandara Supuni , Trudinger Brian , Young Noel , Arrage Naim
Published: March 2018

Background. The incidence of morbidly adherent placenta, including placenta percreta, has increased significantly over recent years due to rising caesarean section rates. Historically, abnormally invasive placenta has been managed with caesarean hysterectomy; however nonsurgical interventions such as uterine artery embolisation (UAE) are emerging as safe alternative management techniques. UAE can be utilised to decrease placental perfusion and encourage placental resorption, thereby reducing the risk of haemorrhage and other morbidities. Case. We describe one of the very few reported cases of placenta percreta which was successfully treated primarily with sequential artery embolisation. Our patient underwent four embolisation procedures over a period of 248 days, with no major morbidity or complications. Conclusion. Repeat UAE may be a beneficial primary management modality in cases of placenta percreta with bladder involvement.
Terapia en aerosol
Authors: Beroiza Williamson Teresa , Moreno Bolton Rodrigo
Published: March 2018

Sin resumen
Músculos respiratorios en la limitación crónica del flujo aéreo
Authors: Lisboa Basualto Carmen
Published: March 2018

Sin resumen
Crónica
Authors: Escuela de Medicina Boletín
Published: March 2018

Sin resumen
Trastornos de ánimo
Authors: Bitran Colodoro Jose
Published: March 2018

Sin resumen
Costo-efectividad en Cirugía
Authors: Rossi F. Ricardo , Ibañez A. Luis , Dagnino S. Jorge
Published: March 2018

Sin resumen
Reunión Anatomoclínico
Authors: Arriagada M. Domingo
Published: March 2018

Sin resumen
Artritis reactivas: Conceptos generales
Authors: Gutierrez Valenzuela Francisco J.
Published: March 2018

Sin resumen
Perfil Clínico y manejo de artritis reactivas
Authors: Gutierrez Valenzuela Francisco J.
Published: March 2018

Sin resumen
Aprendizaje basado en la resolución de problemas
Authors: Moreno Bolton Rodrigo
Published: March 2018

Sin resumen
Prevalencia de la obesidad en Chile
Authors: Rozowski Narkunska Jaime
Published: March 2018

Sin resumen
Etiopatogenia de la obesidad
Authors: Arteaga Llona Antonio
Published: March 2018

Sin resumen
Síndrome confusional agudo en Geriatría
Authors: Hoyl Moreno Maria Trinidad
Published: March 2018

Sin resumen
Nuevos antiepilépticos
Authors: Godoy Fernandez Jaime
Published: March 2018

Sin resumen
Imagenología en patología pleural
Authors: Ríos Olsen Guillermo
Published: March 2018

Sin resumen
Complicaciones neurológicas de la radioterapia
Authors: Valenzuela Mangini Raúl
Published: March 2018

Sin resumen
Detección de malformaciones del tracto urinario por ultrasonografpia obstétrica. Manejo pre y post natal
Authors: Baquedano Droguett Paulina
Published: March 2018

Sin resumen
Cirugía laparoscópica biliar. Fisiopatología
Authors: Torregrosa Zuñiga Samuel
Published: March 2018

Sin resumen
Mutant IDH1 Cooperates with ATRX Loss to Drive the Alternative Lengthening of Telomere Phenotype in Glioma
Authors: Mukherjee Joydeep , Johannessen Tor-Christian , Ohba Shigeo , Chow Tracy T. , Jones Lindsey , Pandita Ajay , Pieper Russell O.
Published: March 2018

A subset of tumors use a recombination-based alternative lengthening of telomere (ALT) pathway to resolve telomeric dysfunction in the absence of TERT. Loss-of-function mutations in the chromatin remodeling factor ATRX are associated with ALT but are insufficient to drive the process. Because many ALT tumors express the mutant isocitrate dehydrogenase IDH1 R132H, including all lower grade astrocytomas and secondary glioblastoma, we examined a hypothesized role for IDH1 R132H in driving the ALT phenotype during gliomagenesis. In p53/pRb–deficient human astrocytes, combined deletion of ATRX and expression of mutant IDH1 were sufficient to create tumorigenic cells with ALT characteristics. The telomere capping complex component RAP1 and the nonhomologous DNA end joining repair factor XRCC1 were each downregulated consistently in these tumorigenic cells, where their coordinate reexpression was sufficient to suppress the ALT phenotype. RAP1 or XRCC1 downregulation cooperated with ATRX loss in driving the ALT phenotype. RAP1 silencing caused telomere dysfunction in ATRX-deficient cells, whereas XRCC1 silencing suppressed lethal fusion of dysfunctional telomeres by allowing IDH1-mutant ATRX-deficient cells to use homologous recombination and ALT to resolve telomeric dysfunction and escape cell death. Overall, our studies show how expression of mutant IDH1 initiates telomeric dysfunction and alters DNA repair pathway preferences at telomeres, cooperating with ATRX loss to defeat a key barrier to gliomagenesis.

Significance: Studies show how expression of mutant IDH1 initiates telomeric dysfunction and alters DNA repair pathway preferences at telomeres, cooperating with ATRX loss to defeat a key barrier to gliomagenesis and suggesting new therapeutic options to treat low-grade gliomas. Cancer Res; 78(11); 2966–77. ©2018 AACR.
Acquired Resistance to a MET Antibody In Vivo Can Be Overcome by the MET Antibody Mixture Sym015
Authors: Pollmann Sofie Ellebaek , Calvert Valerie S. , Rao Shruti , Boca Simina M. , Madhavan Subha , Horak Ivan D. , Kjaer Andreas , Petricoin Emanuel F. , Kragh Michael , Poulsen Thomas Tuxen
Published: March 2018

Failure of clinical trials due to development of resistance to MET-targeting therapeutic agents is an emerging problem. Mechanisms of acquired resistance to MET tyrosine kinase inhibitors are well described, whereas characterization of mechanisms of resistance toward MET-targeting antibodies is limited. This study investigated mechanisms underlying in vivo resistance to two antibody therapeutics currently in clinical development: an analogue of the MET-targeting antibody emibetuzumab and Sym015, a mixture of two antibodies targeting nonoverlapping epitopes of MET. Upon long-term in vivo treatment of a MET-amplified gastric cancer xenograft model (SNU-5), emibetuzumab-resistant, but not Sym015-resistant, tumors emerged. Resistant tumors were isolated and used to establish resistant cell lines. Characterization of both tumors and cell lines using extensive protein and signaling pathway activation mapping along with next-generation sequencing revealed two distinct resistance profiles, one involving PTEN loss and the other involving activation of the PI3K pathway, likely via MYC and ERBB3 copy number gains. PTEN loss left one model unaffected by PI3K/AKT targeting but sensitive to mTOR targeting, while the PI3K pathway–activated model was partly sensitive to targeting of multiple PI3K pathway proteins. Importantly, both resistant models were sensitive to treatment with Sym015 in vivo due to antibody-dependent cellular cytotoxicity–mediated tumor growth inhibition, MET degradation, and signaling inhibition. Taken together, our data provide key insights into potential mechanisms of resistance to a single MET-targeting antibody, demonstrate superiority of Sym015 in preventing acquired resistance, and confirm Sym015 antitumor activity in tumors resistant to a single MET antibody. Mol Cancer Ther; 17(6); 1259–70. ©2018 AACR.
TRPM7 Regulates AKT/FOXO1–Dependent Tumor Growth and Is an Independent Prognostic Indicator in Renal Cell Carcinoma
Authors: Zhao Zhijian , Zhang Mengping , Duan Xiaolu , Chen Yiwen , Li Ermao , Luo Lianmin , Wu Wenqi , Peng Zhenwei , Qiu Huijuan , Zeng Guohua
Published: March 2018

Transient receptor potential melastatin 7 (TRPM7) is important for the tumorigenesis and progression of several cancers. However, little is known about TRPM7 expression and its clinical significance in clear cell renal cell carcinoma (ccRCC). The expression dynamics of TRPM7 was examined in a clinical cohort of RCC specimens by qPCR, immunoblotting, and IHC staining. A series of in vitro and in vivo assays were performed to elucidate the function of TRPM7 in RCC and the underlying mechanisms. For the first time, results demonstrate that TRPM7 expression is markedly higher in RCC cell lines and clinical samples and had a positive correlation with T status, tumor size, and poor patients' overall survival and progression-free survival. Preclinical studies using multiple RCC cells and a mouse model indicate that TRPM7 promotes cell proliferation and colony formation in vitro and tumor growth in vivo. Mechanistically, TRPM7 promotes AKT phosphorylation, leading to repression of the FOXO1 expression and transcriptional activity. Moreover, luciferase reporter assays demonstrate that miR-129-3p directly targets the 3′-UTR of TRPM7 and acts as a negative regulator of TRPM7. These findings reveal an important role for TRPM7 in the regulation of RCC growth and represent a novel prognostic biomarker for this disease.

Implications: TRPM7 is an independent prognostic indicator in RCC, and targeting the TRPM7 signaling pathway may be a novel therapeutic approach for the treatment of RCC. Mol Cancer Res; 16(6); 1013–23. ©2018 AACR.
Chest X-Ray Revealed a Slowly Progressive Giant Right Coronary Artery Aneurysm in an Asymptomatic Patient
Authors: Hiki Masaru , Iwata Hiroshi , Kawaguchi Yuko , Takamura Kazuhisa , Hiki Makoto , Miyazaki Tetsuro , Fujimoto Shinichiro , Amano Atsushi , Daida Hiroyuki
Published: March 2018

A giant right coronary artery aneurysm (60 × 70 mm in size) was incidentally found by chest X-ray as an abnormal right atrial enlargement, and it needed surgical resection. Although the majority of giant coronary artery aneurysms present with symptoms of coronary ischemia, this case presented without any specific symptom. This study indicates that when chest X-ray shows abnormal atrial enlargement, a differential diagnosis of giant coronary artery aneurysm may need to be considered.
Genotype-Phenotype Analysis, Neuropsychological Assessment, and Growth Hormone Response in a Patient with 18p Deletion Syndrome
Authors: Sun Huihui , Wan Naijun , Wang Xinli , Chang Liang , Cheng Dazhi
Published: March 2018

18p deletion syndrome is a rare chromosomal disease caused by deletion of the short arm of chromosome 18. By using cytogenetic and SNP array analysis, we identified a girl with 18p deletion syndrome exhibiting craniofacial anomalies, intellectual disability, and short stature. G-banding analysis of metaphase cells revealed an abnormal karyotype 46,XX,del(18)(p10). Further, SNP array detected a 15.3-Mb deletion at 18p11.21p11.32 (chr18:12842-15375878) including 61 OMIM genes. Genotype-phenotype correlation analysis showed that clinical manifestations of the patient were correlated with LAMA1, TWSG1, and GNAL deletions. Her neuropsychological assessment test demonstrated delay in most cognitive functions including impaired mathematics, linguistic skills, visual motor perception, respond speed, and executive function. Meanwhile, her integrated visual and auditory continuous performance test (IVA-CPT) indicated a severe comprehensive attention deficit. At age 7 and 1/12 years, her height was 110.8 cm (-2.5 SD height for age). Growth hormone (GH) treatment was initiated. After 27 months treatment, her height was increased to 129.6 cm (-1.0 SD height for age) at 9 and 4/12 years, indicating an effective response to GH treatment.
ОБГРУНТУВАННЯ ОРГАНІЗАЦІЇ МЕДИКО-СОЦІОЛОГІЧНОГО МОНІТОРИНГУ ОЖИРІННЯ У ДІТЕЙ в БАГАТОПРОФІЛЬНОМУ ЗАКЛАДІ ОХОРОНИ ЗДОРОВ’Я
Authors: Dyachuck D. D. , Zabolotna I. E.
Published: March 2018

Мета: вивчити відповідність нормативно-правових, кадрових та матеріально-технічних можливостей щодо організації медико-соціологічного моніторингу ожиріння у дітей на рівні закладу охорони здоров’я та розробити програму його впровадження.Матеріали і методи. Нормативно-правове забезпечення організації профілактичних медичних оглядів дітей, форми обліку їх результатів, клінічний аудит з оцінки якості проведення профілактичних медичних оглядів школярів та дані про стан їх здоров’я. Обсяг вибірки – 2081 електронних форм № 112/о. У роботі використано такі методи дослідження: бібліосемантичний, інформаційно-аналітичний, клінічного тематичного аудиту, соціологічний, медико-статистичний, системного аналізу та концептуального моделювання.Результати. Встановлено невідповідність між галузевими регламентуючими і обліковими документами у частині визначення та обліку показника «індекс маси тіла». Обґрунтовано організацію медико-соціологічного моніторингу ожиріння у дітей для закладу охорони здоров’я відповідно до Європейської ініціативи ВООЗ з епіднагляду за дитячим ожирінням.Висновок. Існуюча система організації медичного спостереження за дітьми з ожирінням є недосконалою. Запровадження медико-соціологічного моніторингу ожиріння у дітей сприятиме зниженню захворюваності на ожиріння та асоційовані з ним хвороб.
АКТУАЛЬНІСТЬ ПІДГОТОВКИ МЕНЕДЖЕРІВ ДЛЯ ВПРОВАДЖЕННЯ ДЕРЖАВНО-ПРИВАТНОГО ПАРТНЕРСТВА В ОХОРОНІ ЗДОРОВ'Я
Authors: Kravchenko V. V.
Published: March 2018

Мета роботи: Обґрунтувати необхідність підготовки менеджерів для  реалізації державно-приватного партнерства у системі охорони здоров'я.Матеріали та методи дослідження. Для досягнення поставленої мети у роботі використані загальнонаукові методи аналізу, синтезу, узагальнення, інтерпретації наукових даних, а також системний і структурно-функціональний підходи.Результати. Обґрунтовано доцільність підготовки менеджерів з навичками ефективного економічного управління для закладів охорони здоров'я комунального і регіонального рівня, які переходять на принципи ДПП.Висновки. Управлінський апарат діючих державних і комунальних закладів охорони здоров'я не в змозі використати економічні важелі та підвищити соціальну та економічну ефективність охорони здоров'я. Пріоритетними напрямками розвитку медичних закладів у нових економічних умовах є формування їх господарського механізму на принципах державно-приватного партнерства та підготовка менеджерів для управління новим типом закладів.
ПСИХОЛОГІЧНІ ОСОБЛИВОСТІ ФОРМУВАННЯ ПОЗИТИВНОГО ПСИХОЛОГІЧНОГО КЛІМАТУ В КОЛЕКТИВІ СТУДЕНТІВ-МЕДИКІВ
Authors: Lenchuk T. L.
Published: March 2018

Мета: дослідити психологічні особливості формування позитивного психологічного клімату в колективі, виявити психологічні особливості формування позитивного психологічного клімату та розробити практичні рекомендації щодо формування позитивного клімату в коллективі студентів-медиків.Матеріали і методи. Для оцінювання деяких основних проявів психологічного клімату в колективі ми скористалися картою-схемою Л. Н. Лутошкина. В експерименті взяв участь 31 студент-медик.Результати. Розглядаючи окремо показники кожного студента-медика можна в контрольній групі виявити декілька низьких результатів. У контрольній групі були такі студенти-медики, які у відповідях на питання зазначали, що, швидше за усе, перейшли б в іншу групу, і оцінювали взаємини у своїй групі гірше, ніж у більшості колективів. У експериментальній групі в основному студенти-медики набирали високі бали і у відповідях вказували, що хотіли б залишитися навчатися у своєму колективі, а також високо оцінювали взаємини між членами своєї групи.Висновки. Соціально-психологічний клімат – це психологічний настрій в групі, який відображає характер взаємин між людьми. Сприятлива атмосфера не лише продуктивно впливає на її результати, але і перебудовує людину, формує у неї нові можливості й проявляє потенціал. У зв’язку з цим, виникає необхідність в оптимізації стилю міжособистісної взаємодії в студентів-медиків.
АНАЛІТИЧНЕ ДОСЛІДЖЕННЯ МІЖНАРОДНОГО ДОСВІДУ ОРГАНІЗАЦІЇ МЕДИЧНОЇ ПІСЛЯДИПЛОМНОЇ ОСВІТИ
Authors: Sichkoriz O. Ye.
Published: March 2018

Мета: Аналітичне дослідження та вивчення досвіду організації післядипломної медичної освіти в різних країнах світу для підвищення рівня післядипломної освіти в Україні.Матеріали і методи. У роботі проведено аналітичне дослідження літературних джерел міжнародного досвіду організації післядипломної освіти у світі.Результати. Як відомо, що в провідних країнах світу досвід підготовки фахівців у медичній галузі відрізняється від українського як за змістом, так і за обсягом. Структура медичної післядипломної освіти формується від моделі системи охорони здоров’я в кожній країні, структури національної системи охорони здоров’я, її фінансування, економічного розвитку країни та рівня культури. Все це призводить до деяких термінологічних відмінностей і відносності при порівнянні навчальних процесів.Висновки. У розвинутих країнах світу рівень післядипломної освіти є доволі високим, проте сьогодні спостерігають певну її стагнація та інертність, що перешкоджає її прогресу та удосконаленню відповідно до сучасних умов, які невпинно змінюються. Програми підготовки професіонала-фахівця у розвинутих країнах є більш різноманітні. Університети постійно пропонують широкий спектр програм підготовки.
Análise da influência de atributos fisiográficos e morfométricos na definição da suscetibilidade de bacias hidrográficas à ocorrência de corridas de massa
Authors: Cerri Rodrigo Irineu , Reis Fábio Augusto Gomes Vieira , Gramani Marcelo Fischer , Gabelini Beatriz Marques , Zaine José Eduardo , Sisto Felipe Pereira , Giordano Lucilia Do Carmo
Published: March 2018

A Serra do Mar paulista, nos últimos 50 anos, passou por uma série de eventos pluviométricos intensos, que ocasionaram acidentes diversos relacionados a processos de dinâmica superficial, com consequências sociais, econômicas e ambientais catastróficas, principalmente nos municípios de Cubatão, São Sebastião e Caraguatatuba. Em 1967, ocorreu, entre Caraguatatuba e São Sebastião, um dos eventos mais excepcionais de escorregamentos generalizados associados a corridas já registrados no país. O objetivo do trabalho foi analisar atributos fisiográficos e morfométricos em relação à potencialidade de bacias hidrográficas à ocorrência de corridas de massa, na Serra do Mar do litoral norte do Estado de São Paulo. A área de estudo foi dividida em 13 unidades fisiográficas, abrangendo compartimentos de planícies; escarpas da Serra do Mar e espigões digitados; relevo de morros rebaixados e soerguidos pela Falha Camburu; relevos montanhosos e de morros com diferentes características no Planalto de Juqueriquerê; Planalto de Paraitinga na borda das escarpas da Serra do Mar; e morros, morrotes e colinas isoladas. Os resultados demonstraram que bacias hidrográficas localizadas em porções escarpadas, com alta declividade e forte estruturação das drenagens por fraturas/falhas, com vales encaixados, como a unidade fisiográfica II, apresentam maiores valores para os parâmetros morfométricos, indicando maior potencialidade à ocorrência de corridas. Portanto, a compartimentação fisiográfica e a análise dos parâmetros morfométricos possibilitaram a avaliação integrada de diferentes atributos do meio físico em relação à suscetibilidade de bacias hidrográficas à ocorrência de corridas, demonstrando que o controle estrutural na evolução geomorfológica dessas bacias é um fator fundamental tanto na distribuição de encostas com direções favoráveis à ocorrência de escorregamentos como nos resultados dos parâmetros morfométricos.
Granito Aragão — Suíte intrusiva Nhandú — um granito oxidado, tipo A2, de 1967 a 1964 Ma na Província Aurífera Alta Floresta — Cráton Amazônico
Authors: Dezula Samantha Evelyn Max , Barros Marcia Aparecida Sant’Ana , Pierosan Ronaldo , Santos João Orestes Schneider , Assis Rafael Rodrigues
Published: March 2018

O Granito Aragão, localizado na Província Aurífera Alta Floresta (PAAF), consiste de um stock granítico de ~ 80 km2, de granulação média a grossa, textura porfirítica e composição modal monzogranítica a sienogranítica. Os dados geoquímicos indicam afinidade com magmas graníticos tipo-A2, similares àqueles gerados em margens continentais ativas evoluídas. As idades de cristalização U-Pb SHRIMP em zircão de 1964 ± 11 Ma e 1967 ± 2 Ma permitem incluí-lo na Suíte Intrusiva Nhandú (SINH) e correlacioná-lo com a Suíte Intrusiva Creporizão (SIC) na Província Mineral do Tapajós (PMT), no Pará. Associado ao Granito Aragão ocorre um megaenclave fanerítico médio a grosso, de textura porfirítica e composição modal granodiorítica a monzogranítica. O enclave apresenta padrão geoquímico semelhante a magmas graníticos shoshoníticos, e sua idade de cristalização U-Pb SHRIMP em zircão (1995 ± 5 Ma) indica relação com granitoides do Complexo Cuiú-Cuiú. O Granito Aragão ocorre alojado em granitoides foliados com idade de cristalização U-Pb SHRIMP de 2009 ± 4 Ma. Estes resultados sugerem que as rochas hospedeiras do Granito Aragão fazem parte do Complexo Cuiú-Cuiú. As correlações estratigráficas estabelecidas no presente trabalho indicam que a porção leste da PAAF representa a extensão da Província Tapajós-Parima, ao sul do Gráben do Cachimbo, norte do Estado de Mato Grosso.
Impaired Collateral Vessel Formation in Sickle Cell Disease
Authors: Okwan-Duodu Derick , Hansen Laura , Joseph Giji , Lyle Alicia N. , Weiss Daiana , Archer David R. , Taylor W. Robert
Published: March 2018

Objective—

The adaptive response to vascular injury is the formation of functional collateral vessels to maintain organ integrity. Many of the clinical complications associated with sickle cell disease can be attributed to repeated bouts of vascular insufficiency, yet the detailed mechanisms of collateral vessel formation after injury are largely unknown in sickle cell disease. Here, we characterize postischemic neovascularization in sickle cell disease and the role of neutrophils in the production of reactive oxygen species.

Approach and Results—

We induced hindlimb ischemia by ligation of the femoral artery in Townes SS (sickle cell) mice compared with AA (wild type) mice. Perfusion recovery, ascertained using LASER (light amplification by stimulated emission of radiation) Doppler perfusion imaging, showed significant diminution in collateral vessel formation in SS mice after hindlimb ischemia (76±13% AA versus 34±10% in SS by day 28;
P
<0.001; n=10 per group). The incidence of amputation (25% versus 5%) and foot necrosis (80% versus 15%) after hindlimb ischemia was significantly increased in the SS mice. Motor function recovery evaluation by the running wheel assay was also impaired in SS mice (36% versus 97% at 28 days post-hindlimb ischemia;
P
<0.001). This phenotype was associated with persistent and excessive production of reactive oxygen species by neutrophils. Importantly, neutrophil depletion or treatment with the antioxidant N-acetylcysteine reduced oxidative stress and improved functional collateral formation in the SS mice.

Conclusions—

Our data suggest dysfunctional collateral vessel formation in SS mice after vascular injury and provide a mechanistic basis for the multiple vascular complications of sickle cell disease.
Electrocardiographic Repolarization Abnormalities and Electroanatomic Substrate in Arrhythmogenic Right Ventricular Cardiomyopathy
Authors: Kubala Maciej , Pathak Rajeev K. , Xie Shuanglun , Casado Arroyo Ruben , Tschabrunn Cory M. , Hayashi Tatsuya , Garcia Fermin C. , Supple Gregory E. , Santangeli Pasquale , Frankel David S. , Zado Erica S. , Callans David J. , Marchlinski Francis E.
Published: March 2018

Background:

Repolarization abnormalities in arrhythmogenic right ventricular (RV) cardiomyopathy and their relationship to ventricular tachycardia substrate are incompletely understood.

Methods and Results:

In 40 patients (29 men, mean age 38 years) with arrhythmogenic RV cardiomyopathy, we compared the extent and location of abnormal T (NegT) waves ≥1 mm in depth (n=32) and downsloping elevated ST segment (n=13), in ≥2 adjacent leads, to area and location of endocardial bipolar (<1.5 mV) and unipolar (<5.5 mV) and epicardial bipolar (<1.0 mV) voltage abnormalities. Abnormal unipolar RV endocardial area of 33.4±19.3% was present in 8 patients without NegT waves. Patients with NegT waves extending beyond lead V
3
(n=20) had larger low bipolar (31.4±18.9% versus 16.5±14.6%;
P
=0.008) and unipolar endocardial areas (66.0±19.6% versus 47.4±25.1%;
P
=0.013) and larger epicardial low bipolar area (56.0±19.3% versus 40.1±24.9%;
P
=0.030) compared with those with NegT waves limited to leads V
1
through V
3
(n=20). ECG location of NegT waves regionalized to location of substrate. Patients with downsloping elevated ST segment, all localized to leads V
1
and V
2
, had more unipolar endocardial abnormalities (71.8±18.1% versus 49.4±23.5%;
P
=0.005) involving outflow and mid-RV, compared with patients without downsloping elevated ST segment.

Conclusions:

In arrhythmogenic RV cardiomyopathy, abnormal electroanatomic mapping areas are proportional to extent of T-wave inversion on 12-lead ECG. Marked voltage abnormalities can exist without repolarization change. Downsloping elevated ST-segment pattern in V
1
and V
2
occurs with more unipolar endocardial voltage abnormality, consistent with more advanced transmural disease.
Long-Term Outcome of Pulmonary Vein Isolation With and Without Focal Impulse and Rotor Modulation Mapping
Authors: Mohanty Sanghamitra , Mohanty Prasant , Trivedi Chintan , Gianni Carola , Della Rocca Domenico G. , Di Biase Luigi , Natale Andrea
Published: March 2018

Background:

This meta-analysis systematically evaluated the outcome of pulmonary vein isolation (PVI) with and without focal impulse and rotor modulation (FIRM) ablation in patients with atrial fibrillation.

Methods and Results:

Extensive literature search was performed for studies reporting outcomes of PVI alone and PVI+FIRM procedures. For PVI alone, only randomized trials conducted in the past 3 years reporting single-procedure off-antiarrhythmic drugs success rate at ≥12-month follow-up were included. In PVI+FIRM group, all published studies reporting single-procedure off-antiarrhythmic drugs success rate with at least 1-year follow-up were identified. Meta-analytic estimates were derived using DerSimonian and Laird random-effects models, and pooled estimates of success rate (95% confidence interval) were computed. Statistical heterogeneity was assessed using Cochran
Q
test and
I
2
. Study quality was assessed using Newcastle–Ottawa Scale. Fifteen trials were included, 10 with PVI+FIRM (n=511, nonrandomized prospective design), and 5 with PVI-only trials (n=295, randomized trials). All patients in PVI-only trials had 100% nonparoxysmal atrial fibrillation, except 1 study, and no prior ablations. About 24% of PVI+FIRM population had paroxysmal atrial fibrillation. After 15.9±5.5 (median 12) months follow-up, the off-antiarrhythmic drugs pooled success rate was 50% in FIRM+PVI (95% confidence interval, 28%–72%) and 58% in PVI (95% confidence interval, 46%–71%). Difference in effect size between groups was not statistically significant (
P
=0.21). No significant heterogeneity (total or within group) was observed in this meta-analysis (negative
I
2
values considered equal to zero).

Conclusions:

The overall pooled estimate did not show any therapeutic benefit of PVI+FIRM approach over PVI alone, which suggests the need to reevaluate the clinical use of FIRM ablation in atrial fibrillation.
Single-Cell RNA-Seq Reveals the Transcriptional Landscape and Heterogeneity of Aortic Macrophages in Murine Atherosclerosis
Authors: Cochain Clément , Vafadarnejad Ehsan , Arampatzi Panagiota , Pelisek Jaroslav , Winkels Holger , Ley Klaus , Wolf Dennis , Saliba Antoine-Emmanuel , Zernecke Alma
Published: March 2018

Rationale:

It is assumed that atherosclerotic arteries contain several macrophage subsets endowed with specific functions. The precise identity of these subsets is poorly characterized as they have been defined by the expression of a restricted number of markers.

Objective:

We have applied single-cell RNA sequencing as an unbiased profiling strategy to interrogate and classify aortic macrophage heterogeneity at the single-cell level in atherosclerosis.

Method and Results:

We performed single-cell RNA sequencing of total aortic CD45
+
cells extracted from the nondiseased (chow fed) and atherosclerotic (11 weeks of high-fat diet) aorta of low-density lipoprotein receptor–deficient (
Ldlr
−/−
) mice. Unsupervised clustering singled out 13 distinct aortic cell clusters. Among the myeloid cell populations, resident-like macrophages with a gene expression profile similar to aortic resident macrophages were found in healthy and diseased aortas, whereas monocytes, monocyte-derived dendritic cells, and 2 populations of macrophages were almost exclusively detectable in atherosclerotic aortas, comprising inflammatory macrophages showing enrichment in
Il1b
and previously undescribed TREM2
hi
(triggered receptor expressed on myeloid cells 2) macrophages showing enrichment in
Trem2
. Differential gene expression and gene ontology enrichment analyses revealed specific gene expression patterns distinguishing these 3 macrophage subsets and monocyte-derived dendritic cells and uncovered putative functions of each cell type. Notably, TREM2
hi
macrophages seemed to be endowed with specialized functions in lipid metabolism and catabolism and presented a gene expression signature reminiscent of osteoclasts, suggesting a role in lesion calcification. TREM2 expression was moreover detected in human lesional macrophages. Importantly, these macrophage populations were present also in advanced atherosclerosis and in
Apoe
−/−
aortas, indicating relevance of our findings in different stages of atherosclerosis and mouse models.

Conclusions:

These data unprecedentedly uncovered the transcriptional landscape and phenotypic heterogeneity of aortic macrophages and monocyte-derived dendritic cells in atherosclerotic and identified previously unrecognized macrophage populations and their gene expression signature, suggesting specialized functions. Our findings will open up novel opportunities to explore distinct myeloid cell populations and their functions in atherosclerosis.
Distinct Hemodynamic Changes After Interventional Mitral Valve Edge‐to‐Edge Repair in Different Phenotypes of Heart Failure: An Integrated Hemodynamic Analysis
Authors: Schrage Benedikt , Kalbacher Daniel , Schwarzl Michael , Rübsamen Nicole , Waldeyer Christoph , Becher Peter Moritz , Tigges Eike , Burkhoff Daniel , Blankenberg Stefan , Lubos Edith , Schäfer Ulrich , Westermann Dirk
Published: March 2018

Background

Percutaneous mitral valve edge‐to‐edge repair (
pMVR
) with a MitraClip is beneficial for the clinical symptoms of patients irrespective of the ejection fraction (
EF
). Nevertheless, the consequences on hemodynamics are poorly understood. Therefore, we used data from noninvasive pressure‐volume loops to investigate the left ventricular (LV) remodeling of patients after
pMVR
dependent on their baseline EF.

Methods and Results

In 130 patients with successful
pMVR
, the end‐diastolic pressure‐volume relationship (EDPVR) and end‐systolic pressure‐volume relationship were estimated noninvasively from echocardiographic data. We compared
EDPVR
and end‐systolic pressure‐volume relationship at discharge and follow‐up between patients with a reduced
EF
(<40%) and patients with a mid‐ranged or preserved
EF
(≥40%). Reduced
EF
was present in 71 patients (54%). Mean follow‐up duration was 277±117 days. We observed a significant reduction in degree of mitral regurgitation and an improvement in functional status at follow‐up irrespective of baseline
EF
. In patients with a mid‐ranged or preserved
EF
, the
EDPVR
and end‐systolic pressure‐volume relationship were shifted leftwards, suggesting an improvement in
LV
function. In contrast, in patients with a reduced
EF
,
EDPVR
and end‐systolic pressure‐volume relationship remained stable, although comparison with the baseline data indicates a rightward shift of the
EDPVR
. This indicates that there is no improvement in
LV
function after
pMVR
in patients with reduced EF.

Conclusions

The pMVR is associated with improved clinical symptoms in all patient subgroups. However, it leads to different hemodynamic responses. In patients with mid‐ranged or preserved
EF
, we found reverse remodeling with reduced
LV
dilatation and increased contractility. In contrast, in patients with reduced
EF
, we observed no reverse remodeling and no improvement in
LV
function.
Downregulation of L‐Type Voltage‐Gated Ca
2+
, Voltage‐Gated K
+
, and Large‐Conductance Ca
2+
‐Activated K
+
Channels in Vascular Myocytes From Salt‐Loading Offspring Rats Exposed to Prenatal Hypoxia
Authors: Liu Bailin , Shi Ruixiu , Li Xiang , Liu Yanping , Feng Xueqin , Chen Xueyi , Fan Xiaorong , Zhang Yingying , Zhang Wenna , Tang Jiaqi , Zhou Xiuwen , Li Na , Lu Xiyuan , Xu Zhice
Published: March 2018

Background

Prenatal hypoxia is suggested to be associated with increased risks of hypertension in offspring. This study tested whether prenatal hypoxia resulted in salt‐sensitive offspring and its related mechanisms of vascular ion channel remodeling.

Methods and Results

Pregnant rats were housed in a normoxic (21% O
2
) or hypoxic (10.5% O
2
) chamber from gestation days 5 to 21. A subset of male offspring received a high‐salt diet (8% NaCl) from 4 to 12 weeks after birth. Blood pressure was significantly increased only in the salt‐loading offspring exposed to prenatal hypoxia, not in the offspring that received regular diets and in control offspring provided with high‐salt diets. In mesenteric artery myocytes from the salt‐loading offspring with prenatal hypoxia, depolarized resting membrane potential was associated with decreased density of L‐type voltage‐gated Ca
2+
(Cav1.2) and voltage‐gated K
+
channel currents and decreased calcium sensitive to the large‐conductance Ca
2+
‐activated K
+
channels. Protein expression of the L‐type voltage‐gated Ca
2+
α1C subunit, large‐conductance calcium‐activated K
+
channel (β1, not α subunits), and voltage‐gated K
+
channel (

K
V

2.1, not

K
V

1.5 subunits) was also decreased in the arteries of salt‐loading offspring with prenatal hypoxia.

Conclusions

The results demonstrated that chronic prenatal hypoxia may program salt‐sensitive hypertension in male offspring, providing new information of ion channel remodeling in hypertensive myocytes. This information paves the way for early prevention and treatments of salt‐induced hypertension related to developmental problems in fetal origins.