bluuebunny/crossref_metadata_2025 huggingface dataset:
Dapagliflozin Aggravates Renal Injury via Promoting Gluconeogenesis in db/db Mice
Authors: Jia Yingli , He Jinzhao , Wang Liang , Su Limin , Lei Lei , Huang Wei , Geng Xiaoqiang , Zhang Shun , Meng Xiaolu , Zhou Hong , Yang Baoxue
Published: March 2018

Background/Aims: A sodium-glucose co-transporter-2 inhibitor dapagliflozin is widely used for lowering blood glucose and its usage is limited in type 2 diabetes mellitus patients with moderate renal impairment. As its effect on kidney function is discrepant and complicated, the aim of this study is to determine the effect of dapagliflozin on the progression of diabetic nephropathy and related mechanisms. Methods: Twelve-week-old male C57BL/6 wild-type and db/db mice were treated with vehicle or 1 mg/kg dapagliflozin for 12 weeks. Body weight, blood glucose, insulin tolerance, glucose tolerance, pyruvate tolerance and 24-hour urine were measured every 4 weeks. At 24 weeks of age, renal function was evaluated by blood urea nitrogen level, creatinine clearance, urine output, urinary albumin excretion, Periodic Acid-Schiff staining, Masson’s trichrome staining and electron microscopy. Changes in insulin signaling and gluconeogenic key regulatory enzymes were detected using Western blot analysis. Results: Dapagliflozin did not alleviate but instead aggravated diabetic nephropathy manifesting as increased levels of microalbuminuria, blood urea nitrogen, and glomerular and tubular damage in db/db mice. Despite adequate glycemic control by dapagliflozin, urinary glucose excretion increased after administration before 24 weeks of age and was likely associated with renal impairment. Increased urinary glucose excretion was mainly derived from the disturbance of glucose homeostasis with elevated hepatic and renal gluconeogenesis induced by dapagliflozin. Although it had no effect on insulin sensitivity and glucose tolerance, dapagliflozin further induced the expression of gluconeogenic key rate-limiting enzymes through increasing the expression levels of FoxO1 in the kidney and liver. Conclusion: These experimental results indicate that dapagliflozin aggravates diabetes mellitus-induced kidney injury, mostly through increasing gluconeogenesis.
Sex Differences in the Association Between Measures of General and Central Adiposity and the Risk of Myocardial Infarction: Results From the UK Biobank
Authors: Peters Sanne A. E. , Bots Sophie H. , Woodward Mark
Published: March 2018

Background

There are substantial differences in the distribution of adipose tissue between women and men. We assessed the sex‐specific relationships and their differences between measures of general and central adiposity and the risk of incident myocardial infarction (
MI
).

Methods and Results

Between 2006 and 2010, the
UK
Biobank recruited over 500 000 participants aged 40 to 69 years across the United Kingdom. During 7 years of follow‐up, 5710 cases of
MI
(28% women) were recorded among 265 988 women and 213 622 men without a history of cardiovascular disease at baseline. Cox regression models yielded adjusted hazard ratios for
MI
associated with body mass index, waist circumference, waist‐to‐hip ratio, and waist‐to‐height ratio. There was an approximate log‐linear relationship between measures of general and central adiposity and the risk of
MI
in both sexes. A 1‐
SD
higher in body mass index, waist circumference, waist‐to‐hip ratio, and waist‐to‐height ratio, respectively, were associated with hazard ratios (confidence intervals) for
MI
of 1.22 (1.17; 1.28), 1.35 (1.28; 1.42), 1.49 (1.39; 1.59), and 1.34 (1.27; 1.40) in women and of 1.28 (1.23; 1.32), 1.28 (1.23; 1.33), 1.36 (1.30; 1.43), and 1.33 (1.28; 1.38) in men. The corresponding women‐to‐men ratios of hazard ratios were 0.96 (0.91; 1.02), 1.07 (1.00; 1.14), 1.15 (1.06; 1.24), and 1.03 (0.97; 1.09).

Conclusions

Although general and central adiposity measures each have profound deleterious effects on the risk of
MI
in both sexes, a higher waist circumference and waist‐to‐hip ratio conferred a greater excess risk of
MI
in women than in men. Waist‐to‐hip ratio was more strongly associated with the risk of
MI
than body mass index in both sexes, especially in women.
Beyond the Here and Now: Exploring Threaded Presence in Mediated, Improvised Performance
Authors: Carlson Kristin , Sun Prophecy , Cuykendall Shannon , Lantin Maria , Schiphorst Thecla , Corness Greg
Published: March 2018

Presence is a prominent component of our conscious human experience. Many researchers and philosophers have described presence simply as a state of being there, or in improvisation, the here and now. We explore presence by examining performers’ experiences in an improvisational, telematic performance, Presence in a Box: Crossing Liminal Spaces (see Figure 1). Through our analysis of this performance we define the concept of “Threaded Presence” which we bridge to existing literature in “Situated” and “Extended Presence.” We discuss the role of technology in creating threaded presence by acting as an additional performer, adding a layer of glitch and unpredictability to a performance that requires negotiation from the entire team. We suggest that technology does not need to be transparent in order to experience presence in a performance space and focus on three main components of experiencing presence: creating a container of presence, blending boundaries of time and space, and implementing restraints. It is the collision of these elements that brings a new sense of agency into performance and contributes to one’s experience of threaded presence.
Shift-Life Interactive Art: Mixed-Reality Artificial Ecosystem Simulation
Authors: Ch’ng Eugene , Harrison Dew , Moore Samantha
Published: March 2018

This article presents a detailed design, development, and implementation of a Mixed Reality Art-Science collaboration project which was exhibited during Darwin’s bicentenary exhibition at Shrewsbury, England. As an artist-led project the concerns of the artist were paramount, and this article presents Shift-Life as part of an ongoing exploration into the parallels between the nonlinear human thinking process and computation using semantic association to link items into ideas, and ideas into holistic concepts. Our art explores perceptions and states of mind as we move our attention between the simulated world of the computer and the real world we inhabit, which means that any viewer engagement is participatory rather than passive. From a Mixed Reality point of view, the lead author intends to explore the convergence of the physical and virtual, therefore the formalization of the Mixed Reality system, focusing on the integration of artificial life, ecology, physical sensors, and participant interaction through an interface of physical props. It is common for digital media artists to allow viewers to activate a work either through a computer screen via direct keyboard or mouse manipulation, or through immersive means. For “Shift-Life” the artist was concerned with a direct “relational” approach where viewers would intuitively engage with the installation’s everyday objects, and with each other, to fully experience the piece. The Mixed Reality system is mediated via physical environmental sensors, which affect the virtual environment and autonomous agents, which in turn reacts and is expressed as virtual pixels projected onto a physical surface. The tangible hands-on interface proved to be instinctive, attractive, and informative on many levels, delivering a good example of collaboration between the arts and science.
Dogs on Campus
Authors: Binfet John-Tyler , Struik Kathryn
Published: March 2018

Once used mostly in clinical settings such as hospitals and geriatric care centers, canine animal-assisted therapy programs have become increasingly commonplace on university campuses to reduce stress and support students’ social and emotional well-being. Researchers responding to the call for increased empirical rigor in studies assessing the effects of animal-assisted therapy and practitioners seeking to initiate well-being programs on campus can face challenges in accessing therapy dogs and their volunteer handlers. This article outlines how therapy canines and their handlers may be holistically assessed for participation in university-based initiatives and presents a model that includes the prescreening of volunteer handlers, training sessions for handlers, the use of multiple raters to assess canine temperament and behavior, the use of mock sessions, and the use of ongoing formative evaluation and feedback for handlers once they are accepted into the program.
Caddisflies (Insecta: Trichoptera) from Santa Catarina Lachatao, Oaxaca, México: New species, new geographical records, and checklist
Authors: RAZO-GONZÁLEZ MARÍA
Published: March 2018

Adults of Trichoptera were collected in four sites in Santa Catarina Lachatao, Oaxaca, México, using black light traps and entomological nets. A total of 12 families, 23 genera, and 37 species were recorded. Four new species of Trichoptera: Wormaldia noveloi n. sp., Lepidostoma zapoteca n. sp., Phylloicus gomezi n. sp., and Ochrotrichia buenoi n. sp. are described and male genitalia are illustrated. Similarities and differences among these species and those in their respective genera are discussed. In addition, nineteen species are recorded for the first time for Oaxaca, bringing the number of known Trichoptera species from this state to 170. Ithytrichia, Oxyethira, and Cheumatopsyche are new generic records for Oaxaca State. Ochrotrichia nicaragua and Wormaldia palma are registered for the first time in México.
A new phytotelm-breeding treefrog of the genus Nasutixalus (Rhacophoridae) from western Yunnan of China
Authors: YANG JIAN-HUAN , CHAN BOSCO PUI-LOK
Published: March 2018

A new treefrog of the genus Nasutixalus is described from montane evergreen forest in Yingjiang County, in western Yunnan, China. The new species, Nasutixalus yingjiangensis sp. nov., can be distinguished from its congeners by a combination of the following characters: medium body size (SVL 39.5–40.0 mm in adult males, 47.5 mm in a single female); tympanum indistinct and covered with tubercles; disc diameter of third finger greater than tympanum diameter; dorsal skin relatively smooth, scattered with small tubercles, those on head and anterior dorsum of body more dense and more prominent; light brown above with a dark brown marking between eyes and two broad dark brown lateral strips on the dorsum; iris with a weak “X”-shaped, light colored marking; interorbital distance shorter than the upper eyelid width; comparatively short foot (mean TFL/SVL ratio 67.0% and 62.9% in males and female respectively). The new species appears to be forest-dependent and was found in well-preserved montane rainforest; it inhabits the canopy and breeds in tree holes during the rainy season. The type locality of the new species is an isolated forest fragment surrounded by degraded landscape and efforts are already underway to protect the site. Nasutixalus yingjiangensis sp. nov. represents the third known species of the newly established genus Nasutixalus.
Eastern Boundary Circulation and Hydrography Off Angola: Building Angolan Oceanographic Capacities
Authors: Tchipalanga P. , Dengler M. , Brandt P. , Kopte R. , Macuéria M. , Coelho P. , Ostrowski M. , Keenlyside N. S.
Published: March 2018

The eastern boundary region off Angola encompasses a highly productive ecosystem important for the food security of the coastal population. The fish-stock distribution, however, undergoes large variability on intraseasonal, interannual, and longer time scales. These fluctuations are partly associated with large-scale warm anomalies that are often forced remotely from the equatorial Atlantic and propagate southward, reaching the Benguela upwelling off Namibia. Such warm events, named Benguela Niños, occurred in 1995 and in 2011. Here we present results from an underexplored extensive in situ dataset that was analyzed in the framework of a capacity-strengthening effort. The dataset was acquired within the Nansen Programme executed by the Food and Agriculture Organization of the United Nations and funded by the Norwegian government. It consists of hydrographic and velocity data from the Angolan continental margin acquired biannually during the main downwelling and upwelling seasons over more than 20 years. The mean seasonal changes of the Angola Current from 6° to 17°S are presented. During austral summer the southward Angola Current is concentrated in the upper 150 m. It strengthens from north to south, reaching a velocity maximum just north of the Angola Benguela Front. During austral winter the Angola Current is weaker, but deeper reaching. While the southward strengthening of the Angola Current can be related to the wind forcing, its seasonal variability is most likely explained by coastally trapped waves. On interannual time scales, the hydrographic data reveal remarkable variability in subsurface upper-ocean heat content. In particular, the 2011 Benguela Niño was preceded by a strong subsurface warming of about 2 years’ duration.
Conditional Precision of Measurement for Test Scores: Are Conditional Standard Errors Sufficient?
Authors: Nicewander W. Alan
Published: March 2018

This inquiry is focused on three indicators of the precision of measurement—conditional on fixed values of θ, the latent variable of item response theory (IRT). The indicators that are compared are (1) The traditional, conditional standard errors, [Formula: see text] = CSEM; (2) the IRT-based conditional standard errors, [Formula: see text] (where [Formula: see text] is the IRT score information function); and (3) a new conditional reliability coefficient, [Formula: see text]. These indicators of conditional precision are shown to be functionally related to one another. The IRT-based, conditional CSEM, [Formula: see text], and the conditional reliability, [Formula: see text], involve an estimate of the conditional true variance, [Formula: see text], which is shown to be approximately equal to the numerator of the score information function. It is argued—and illustrated with an example—that the traditional, conditional standard error, CSEM, is not sufficient for determining conditional score precision when used as the lone indicator of precision; hence, the portions of a score distribution, where scores are most-and-least precise, can be misidentified.
Recurrent Spindle Cell Carcinoma Shows Features of Mesenchymal Stem Cells
Authors: Ouchi T. , Morikawa S. , Shibata S. , Takahashi M. , Yoshikawa M. , Soma T. , Miyashita H. , Muraoka W. , Kameyama K. , Kawana H. , Arima Y. , Saya H. , Okano H. , Nakagawa T. , Asoda S.
Published: March 2018

This study investigated a case of spindle cell carcinoma (SpCC) in tongue pathological lesions. The patient experienced a local recurrence and distant metastasis after surgical intervention. Although standard chemotherapy was administered, a granulomatous mass continued to develop. This aggressive growth led to survival of the tumor. Secondary debulking surgery was performed to improve the patient’s quality of life at the request of the patient. Using a tissue sample derived from the secondary debulking surgery, we performed an analysis of the tumor’s cell surface antigens, differentiation potential, metastatic ability, and inhibition potential by anticancer reagents. In vitro analysis revealed that the cell population grown under adherent culture conditions expressed the mesenchymal stem cell (MSC) markers CD73, CD90, and CD105. The cell line established from this SpCC contained colony-forming unit fibroblasts (CFU-Fs) and exhibited multipotent differentiation into several mesenchymal lineages, including bone, cartilage, and fat. The SpCC cells also displayed vigorous mobilization. These characteristics suggested that they had the differentiation potential of mesenchymal cells, especially MSCs, rather than that of epithelial cells. The surgical specimen analyzed in this study resisted the molecular target reagent cetuximab, which is an epidermal growth factor receptor inhibitor. This clinical insight revealed that chemotherapy-resistant SpCC cells have different characteristics compared to most other cancer cells, which are sensitive to cetuximab. Our cell death assay revealed that SpCC cell death was induced by the anticancer drug imatinib, which is known to inhibit protein tyrosine kinase activity of ABL, platelet-derived growth factor receptor α (PDGFRα), and KIT. Here, we report recurrent SpCC with characteristics of MSCs and potential for treatment with imatinib.
Social Networks, Predispositions and Split-Ticket Voting: The Case of the 1990 German Unification Election
Authors: Leiter Debra
Published: March 2018

When casting a split-ticket ballot, voters in established democracies have strong political predispositions and electoral experience that influence their decision. However, voters in a new democracy, lacking long-term party attachment and experience with democracy, may instead be informed and motivated by their social networks. Using the 1990 Cross-National Election Project German Unification study, I examine which factors predict split-ticket voting for East and West Germans. I find that political disagreement within a social network is more influential for East Germans, while partisan predispositions, particularly party supporter type, play a greater role for West Germans. These findings indicate that, in absence of competition between long-term partisanship and democratic experience, network characteristics may have a profound impact on political decision-making.
Highly efficient film-like nanocellulose-based adsorbents for the removal of loose reactive dye during textile laundering
Authors: Vivod Vera , Neral Branko , Mihelič Aleš , Kokol Vanja
Published: March 2018

Cellulose nanofibrils (CNFs) were surface functionalized with hexamethylenediamine (HMDA) and, further, integrated with native CNFs in various weight mass ratios to fabricate water-stable films by the solvent casting method, to be used for the removal of tri-chromatic and anionic black reactive dye with the highest bleeding effect in the very first minutes of textile laundering, and in a weight mass compared to a commercial color-catcher sheet (Delta Pronatura (DP)). The effects of CNF-HMDA content on film bath absorption, surface potential and contact angle properties, as well as dye removal kinetics from different laundering baths (A – without and B – with a detergent) in up to 140 min were studied at 20℃ versus 60℃ and using different dye concentrations (0.1–1 g/L).

It was found that bath absorption is decreased significantly (up to 60%) by increasing the CNF-HMDA content in the films, as compared to using a DP color-catcher sheet, due to a morphologically denser structure with surface-positioned hydrophobic ethylene moieties of HMDA, as well as reducing electrostatic attraction groups of CNF and HMDA. Such a surface interacts kinetically faster with anionic and hydrophobic dye molecules already at 20℃, reaching up to 37–80% removal of all dye colorants in the first 20 min. In contrast, the dye removal efficacy of the DP color-catcher sheet is due to it interacting with a cationic polymer being released from the surface, which is better only for a bluish color, and at 60℃, while being between 30% and 48%, as its release is hindered and reduced by the deposition of surfactants from the detergent.
Hind Swaraj: Reading Gandhi’s Critique of Modernity in Tehran
Authors: Tajbakhsh Kian
Published: March 2018

In both Iran and India, many social and cultural obstacles to authentic and humane social development are often traced to complexities caused by an encounter with Western modernity. In this essay, I explore what the Iranian reception of modernity might gain from the Indian conversation on Hind Swaraj. I show that Gandhi’s thought contains two different critiques of modernity. The first radical option entails the rejection of modernity and its core institutions such as the nation-state; the second proposes adapting traditions, including religions, within the framework of a pluralistic democracy so as to craft alternative versions of the nation-state. The objective of the essay is to examine those aspects of the latter strand of Gandhi’s thought that may be compatible with Iranian realities. A further goal is to put Iranian and Indian voices together in a constructive dialogue with one another.
A Study of Muslims in the Newly Formed State of Telangana
Authors: Mishra Sujit Kumar
Published: March 2018

The study attempts to understand the socio-economic and living conditions of Muslim communities with an emphasis on the livelihood and status of women living in slums located in the old city of Hyderabad. To this end, it collected information 2,354 households of 19 slums using the qualitative and quantitative data gathered from their residents. Using this, this report looked closely at the policy framework and institutional capacity of the state for the socio-economic development of Muslims. Evidence culled from a review of documents and reports, interviews with government department officials and field observations hinted at improved institutional performances, thanks to initiatives such as the creation of Ministry of Minority Affairs (MoMA) in 2006 and the relaunching of the Prime Minister’s 15-Point Programme with an emphasis on educational opportunities, employment and economic activities and living conditions. However, the analysis and findings of this study still identified several institutional incapacities in terms of gaps between development needs and policies especially in the context of marginalised and poor communities.
Long Working Hours and the Risk of Chronic Disease
Authors: Pal Anita , Dwivedi Laxmi Kant , Kumari Dolly
Published: March 2018

A change in employment trends, in the nature of occupation and in the number of working hours has an impact on the diseases prevalent in people. Using data from a World Health Organization 2007 study on global ageing and adult health, this research looks at the effect of past work histories on the prevalence of selected chronic diseases such as hypertension, diabetes, stroke, angina and depression in India. By using a bivariate and multivariate analysis, this study shows that all the selected chronic diseases were significantly higher in urban areas, especially amongst people who were educated upto a higher secondary level and above and were from the richest wealth quintile. The chances of all these selected chronic diseases, except for depression, were also found to be significantly higher among those who were working in the non-manual sector. It was also found that the expected odds of having diabetes and stroke were significantly higher among those employees who worked for more than eight hours a day than their counterparts who worked for less than eight hours a day after adjusting important confounders. Based on these findings, the study suggests that the government should implement some specific policy measures; and take steps which will help employees cope with harmful work schedules.
Poverty and Inequality among the Mishing People of Assam
Authors: Konwar Paranan
Published: March 2018

The objective of the study was to examine levels of absolute poverty and relative poverty (inequality) within and across various occupations practised by the Mishing tribe of Assam. The tribe inhabits the flood-prone riverine areas of Assam, a state located in India’s Northeastern region. Our study was based on primary data collected from two sample districts of Assam: Dhemaji, remote, completely rural and extremely flood-prone and Sivasagar, a district with some urban characteristics and less susceptible to floods. The research revealed a high level of poverty among casual labour working in agricultural and non-agricultural areas. Additionally, it was observed that inequality was higher among the self-employed working in the agriculture, non-agriculture and services sector. For the diversification of agriculture, expansion of the rural non-farm sector; provision of socio-economic safety nets; creation of employment opportunities; improvement in infrastructure and a long-lasting solution of the region’s flood and erosion problem, we recommend an equity-based approach to raise the standard of living of Mishing tribes and their villages.
Prevalence and Predictors of Diabetes Mellitus and Hypertension in Armenian Americans in Los Angeles
Authors: Naccashian Zarmine , Hattar-Pollara Marianne , Ho Chong (Alex) , Ayvazian Sareen Pateel
Published: March 2018

Purpose

The purpose of this study was to describe the prevalence of diabetes mellitus (DM) and hypertension (HTN) along with associated risk factors among Armenian Americans living in Los Angeles.

Methods

After Institutional Review Board approval, a sample of 877 Armenian Americans was collected for 5 consecutive years (2011-2015) at a health fair. Collected data included: sociodemographic variables; cardiometabolic data, including systolic (SBP) and diastolic (DBP) blood pressure, glucose (Glu), and lipids; anthropometric data, including height (Ht), weight (Wt), body mass index (BMI), waist circumference (WC), and hip circumference (HC). Retrospective descriptive correlation, test of significance, and logistic regression analyses were performed.

Results

Findings showed that about 50% of the participants had abnormal waist/hip ratio and approximately one-quarter of the subjects had glucose levels that were indicative of high risk for DM. Logistic regression analysis revealed that high SBP ( P = .04), above normal WC ( P = .03), and high triglycerides ( P = .04) were significant in predicting DM. Moreover, age ( P =.0001), family history of cardiovascular disease ( P= .01), and above normal WC ( P = .04) were found to be significant predictors of HTN.

Conclusion

Waist circumference indicated to be a strong predictor for DM and HTN. Early detection and timely interventions are important to prevent DM and HTN and their associated complications. For an underserved population, health fairs become one effective avenue for screening, referral, and evaluation.
Adding It Up
Authors: Bouck Emily C. , Shurr Jordan , Bassette Laura , Park Jiyoon , Whorley Abbie
Published: March 2018

Manipulatives are a common tool in mathematics teaching and learning, including for students with disabilities. The most common manipulatives are concrete manipulatives, yet app-based manipulatives are a viable age-appropriate option for secondary students with disabilities. Through an adapted alternating treatment design with three middle school students—two with mild intellectual disability and one with a learning disability, researchers explored the impact of virtual and concrete manipulatives on students’ accuracy, independence, and task completion time for solving addition of fractions with unlike denominators. Students were equally successful in terms of accuracy and differences with independence were minimal. When comparing the two manipulative types, the results were idiosyncratic; two students were more independent with the concrete manipulative and one with the app-based manipulative. Implications for research regarding mathematics instruction and use of concrete and app-based manipulatives are discussed.
Cruel Optimism in Sport Management: Fans, Affective Labor, and the Political Economy of Internships in the Sport Industry
Authors: Hawzen Matthew G. , McLeod Christopher M. , Holden John T. , Newman Joshua I.
Published: March 2018

For university students in sport management programs, working in sports is often the end goal, and internships have become the most common curricular component for achieving this end. Sport management students bring to these internships various backgrounds and active fan attachments with sports that structure their work experiences and create certain conditions of exploitation. We thus conducted interviews with current and soon-to-be interns to understand their subjective perceptions and experiences of working in sports as fans. Drawing upon Lauren Berlant’s concept of cruel optimism as well as neo-Marxist theories of affective labor, we reveal the structuring contradictions of interns’ work in the contemporary sports industry.
Radiation exposure during TACE procedures using additional cone-beam CT (CBCT) for guidance: safety and precautions
Authors: Jonczyk M , Collettini F , Geisel D , Schnapauff D , Böning G , Wieners G , Gebauer G
Published: March 2018

Background

During transarterial chemoembolization (TACE), cone-beam computed tomography (CBCT) can be used for tumor and feeding vessel detection as well as postembolization CT imaging. However, there will be additional radiation exposure from CBCT.

Purpose

To evaluate the additional dose raised through CBCT-assisted guidance in comparison to TACE procedures guided with pulsed digital subtraction angiography (DSA) alone.

Material and Methods

In 70 of 140 consecutive patients undergoing TACE for liver cancer, CBCT was used to facilitate the TACE. Cumulative dose area product (DAP), cumulative kerma(air), DAP values of DSA, total and cine specific fluoroscopy times (FT) of 1375 DSA runs, and DAP of 91 CBCTs were recorded and analyzed using Spearman's correlation, Mann–Whitney U-test, and Kruskal–Wallis test. P values < 0.05 were considered significant.

Results

Additional CBCT increased DAP by 2% ( P = 0.737), kerma(air) by 24.6% ( P = 0.206), and FT by 0.02% ( P = 0.453). Subgroup analysis revealed that postembolization CBCT for detection of ethiodized oil deposits added more DAP to the procedure. Performing CBCT-assisted TACE, DSA until first CBCT contributed about 38% to the total DAP. Guidance CBCT acquisitions conduced to 6% of the procedure's DAP. Additional DSA for guidance after CBCT acquisition required approximately 46% of the mean DAP. The last DSA run for documentation purposes contributed about 10% of the DAP.

Conclusion

CBCT adds radiation exposure in TACE. However, the capability of CBCT to detect vessels and overlay in real-time during fluoroscopy facilitates TACE with resultant reduction of DAPs up to 46%.
Survival and functional and oncological outcomes following intersphincteric resection for low rectal cancer: short-term results
Authors: Molnar Călin , Vlad-Olimpiu Butiurca , Marian Botoncea , Cornelia Togănel , Simona Gurzu
Published: March 2018

Objective

This study was performed to evaluate the 1-year survival rate and functional outcomes of 20 patients who underwent intersphincteric resection (ISR) for low rectal cancer.

Methods

Twenty patients who underwent ISR for low rectal cancer were followed up for 1 year. Complications, functional outcomes objectified by the Wexner score, and oncological outcomes were assessed.

Results

The short-term survival rate was 100%. The median Wexner score was ≤10 in all patients at 12 months after surgery. Signs of local recurrence were absent, and antigen levels remained within the reference ranges 1 year postoperatively.

Conclusions

ISR is a feasible alternative in highly selected patients who primarily refuse a colostomy bag and present with type II or III tumors. In the present study, patient-reported continence was satisfactory, and the absence of a colostomy bag increased patients’ quality of life. The oncological outcomes were satisfactory at 1 year postoperatively.
A Mathematical Model Describing the Glycemic Response of Diabetic Patients to Meal and i.v. Infusion of Insulin
Authors: Fabietti P.G. , Calabrese G. , Iorio M. , Bistoni S. , Brunetti P. , Sarti E. , Benedetti M. Massi
Published: March 2018

Nine type 1 diabetic patients were studied for 24 hours. Düring this period they were given three calibrated meals. The glycemia was feedback-controlled by means of an artificial pancreas. The blood concentration of glucose and the infusion speed of the insulin were measured every minute. The experimental data referring to each of the three meals were used to estimate the Parameters of a mathematical model suitable for describing the glycémie response of diabetic patients at meals and at the i. v. infusion of exogenous insulin. From the estimate a marked dispersion of the Parameters was found, both interindividual and intraindividual. Nevertheless the models thus obtained seem to be usable for the synthesis of a feedback controller, especially in view of creating a portable artificial pancreas that now seems possible owing to the realization (so far experimental) of sufficiently reliable glucose concentration sensors.
rhVEGF and Experimental Rat Skin Flaps: Systemic or Local Administration and Morphological Characteristics
Authors: Tucci M.G. , Scalise A. , Lucarini G. , Pierangela M. , Pugnaloni A. , Bertani C. , Orlando F. , Aldini N. Nicoli , Santoli M. , Campodonico A. , Gavaudan F. , Ricotti G. , Bertani A. , Biagini G.
Published: March 2018

Skin flap survival is a significant problem in skin surgery; in particular, inadequate arterial or venous blood supply results in necrosis of the distalmost portion. The aim of this study was to evaluate the ability of Vascular Endothelial Growth Factor (VEGF) of modifying the morphological features of skin flaps. Bilateral epigastric skin flaps were raised in 16 Wistar male rats. The epigastric artery and vein of the left flaps were clamped and then injected with rhVEGF (8 rats) or saline (8 rats). The right flaps were not clamped and received rhVEGF or saline systemically. The rats were euthanized on the seventh day and flap skin samples collected. Tissue fragments were subject to immunohistochemical (rhVEGF, VEGFr, VIII factor, CD34 antibodies), ultrastructural and morphostructural investigations. The results showed that rhVEGF improved the condition of flaps and that systemic administration was effective in promoting the development of an adequate vascular network.
Seizures in Dialysis Patients Treated with Recombinant Erythropoietin. Review of the Literature and Guidelines for Prevention
Authors: Beccari M.
Published: March 2018

Anemia is one of the major limitations to rehabilitation in patients with end-stage renal disease (ESRD). The efficacy of recombinant human erythropoietin (rHuEPO) in the treatment of renal anemia is well established. Nevertheless, rHuEPO therapy has been associated with serious untoward effects. There appears to be an increased risk of hypertension, not infrequently accompanied by hypertensive encephalopathy and seizures. The mechanism of hypertension remains uncertain. It is associated with an increase in blood viscosity, a reversal of hypoxic vasodilatation, and, possibly, a direct pressor effect of the hormone. Seizures, otherwise, may be the result of cerebral hypoperfusion and, finally, of a focal cerebral edema. The guidelines for rHuEPO treatment and prevention of associated convulsions are outlined. The possible convulsive risk induced by this treatment, even at low doses, particularly in patients with a previous history of seizures, is stressed.
Long-Term Oral Calcium Supplementation Reduces Diastolic Blood Pressure in End Stage Renal Disease. A Randomized, Double-Blind, Placebo Controlled Study
Authors: Petersen L.J. , Rudnicki M. , Højsted J.
Published: March 2018

Previous studies suggest that oral calcium supply reduces blood pressure in patients with mild to moderate hypertension. The aim of this study was to determine whether oral calcium supply reduces blood pressure in patients undergoing haemodialysis. The study was randomized, double-blind, and placebo controlled. Eleven patients received two grams of calcium per day and 12 patients received placebo. Three patients (one from the calcium group and two from the placebo group) dropped out within the first month. The groups were comparable at inclusion regarding blood pressure, weight, and serum values. Blood pressure measurements were auscultatory with a mercury manometer and diastolic blood pressure was measured as Korotkoff phase V. At inclusion a significant positive correlation between serum phosphate and blood pressure was found. After a study period of six months a significant reduction in diastolic blood pressure was found between the two groups (p < 0.05), but no difference was found in systolic blood pressure. The reduction in diastolic blood pressure was 6.9 mmHg of the pretreatment level in the calcium group. In conclusion, the treatment of secondary hyperparathyroidism with oral calcium gives good benefits in the regulation of diastolic blood pressure. A well controlled phosphate homeostasis may also be of importance for the control of blood pressure in haemodialysis patients.
Employing L-Lactic Acid Powder in the Preparation of a Dry “Acid Concentrate” for use in a Bicarbonate-Based Dialysis Solution-Generating System: Experience in Hemodialysis Patients
Authors: Ing T.S. , Yu A.W. , Nagaraja V. , Amin N.A. , Ayache S. , Gandhi V.C. , Daugirdas J.T.
Published: March 2018

By replacing the liquid acetic acid present in the “acid concentrate” of a bicarbonate-based dialysis solution-generating system with an equimolar amount of solid L-lactic acid and by using the dry forms of the remaining constituents, we were able to create a dry “acid concentrate” just prior to use, and successfully employed this “acid concentrate” to produce a bicarbonate-based solution to hemodialyze patients.
Human Vascular Endothelial Cells on Expanded Ptfe Precoated with An Engineered Protein Adhesion Factor
Authors: Mazzucotelli J.P. , Moczar M. , Zede L. , Bambang L.S. , Loisance D.
Published: March 2018

To elucidate the role of the molecular structure of adhesive proteins in an endothelialization of synthetic vascular prosthesis in vitro, a recombinant fibronectin-like engineered adhesion factor (FP) constructed from the specific Arg-Gly-Asp cell adhesion repeats was assayed as adhesive substrate to culture human saphenous vein endothelial cells on ePTFE. ePTFE samples (1 cm2) inserted into cell culture chambers were coated by incubation with increasing amounts of FP (up to 100 μg/cm2) prior to cell seeding. At 24 hours after low density cell seeding and 20 μg/ml/cm2 FP concentration, the number of adhered cells reached a plateau and the adhered cells did not proliferate up to 6 days of culture. At 24 hours after high density seeding (105 cells/cm2), the number of adhered cells was significantly higher on ePTFE with preadsorbed FP than on fibronectin coated PTFE. About 55% of the initially adhered cells survived up to 7 days on FP, whereas cell debris and free nuclei were predominant on fibronectin coated PTFE. In the investigated model the engineered RGD polymer potentialized a short-term adhesion of vascular endothelial cells to PTFE, nevertheless it did not ensure proliferation and long-term survival of these cells.
Biocompatibility of Cardiopulmonary Bypass: Influence on Blood Compatibility of Device Type, Mode of Blood Flow and Duration of Application
Authors: Sundaram S. , Courtney J.M. , Taggart D.P. , Tweddel A.C. , Martin W. , McQuiston A.M. , Wheatley D.J. , Lowe G.D.O.
Published: March 2018

The biocompatibility of artificial organs is recognised as an area presenting difficulties in terms of the complexity of the situation. The nature of the blood response involving interactions of systems, pattern and extent of change, patient status and the influence of the whole device contribute to the complexity. Recognising these, the profile of the blood response to cardiopulmonary bypass (CPB), with respect to type of device, mode of blood flow, duration of the procedure and patient status, has been evaluated by monitoring contact phase activation [Factor XII-like activity (FXIIA)], fibrinolytic activity [Fibrin degradation products (X-FDP's)], complement activation (C3a, C5a), leucocyte activation [Granulocyte elastase (GE)] and platelet and white cell imaging. FXIIA, X-FDP's, and GE rose gradually during CPB, with levels remaining elevated post-operatively for up to 48 h. In contrast, C3a levels rose sharply with no significant elevation in the post-operative period, while C5a did not show significant changes during bypass. The use of pulsatile perfusion resulted in lesser activation of the parameters, although these were significantly less only for GE. The alterations in FXIIA, X-FDP's, C3a and GE correlated positively with the duration of CPB, with this effect pronounced in the post-operative period for FXIIA, X-FDP's and GE. However, these changes had no apparent influence on clinical outcome and the majority of patients had uncomplicated post-operative recoveries. With respect to the use of bubble/membrane oxygenators, platelet and white cell deposition and the patterns of change for FXIIA and C3a were similar in the two groups. The investigation has enabled a broad perspective of biocompatibility in CPB relevant to the clinical application of biomaterials.
Hepatitis C and Hepatitis B Virus Infection in Hemodialysis Patients and Staff: A Two Year Follow-Up
Authors: Jankovič N. , Čala S. , Nadinić B. , Varlaj-Knobloch V. , Pavlović D.
Published: March 2018

To estimate the prevalence of antibodies to the hepatitis C virus ((HCV) and hepatitis virus (HBV) and the presence of infection, 101 patients receiving renal replacement therapy and 75 staff members caring for them were tested. Evaluation included detailed history, screening for anti-HCV antibody, HBV markers and liver enzymes 38% of patients were anti-HCV positives and 15 (40%) of these had antibodies to the hepatitis B core antigen indicating previous hepatitis B infection. Positive markers indicating HBV infection only, accounted for another 18% of patients. All staff members were anti-HCV negative, although 34 (45%) were anti-HBc positive. Age, sex and history of blood transfusions did not influence the prevalence of anti-HCV and anti-HBC in patients. There was, however, a significant difference in the prevalence of anti-HCV and anti-HBc positivity between polytransfused and occasionally transfused patients (p<0.05). During a 24-months follow-up a decline was observed in HBs antigen carriers from 20% to 10% and in HBc antibody carriers from 47% to 33%. At the same time, regardless of accurate preventive measures, an increase in incidence of anti-HCV seropositivity from 30% to 38% was detected.
The Effect of Erythropoietin on Platelet Function and Fibrinolysis in Chronic Renal Failure
Authors: Stenver D. , Jeppesen L. , Nielsen B. , Nielsen J. Dalsgaard , Hædersdal C. , Mehlsen J. , Winther K.
Published: March 2018

The influence of erythropoietin therapy on platelet function and fibrinolysis was evaluated in 12 anemic hemodialysis patients. Six months of therapy with human erythropoietin (50 to 80 IU/kg initially) raised the hemoglobin level to 10.8 g/dl but did not increase platelet activity in vivo as measured by beta-thromboglobulin or platelet factor 4. There was no change in the platelet aggregation thresholds in vitro for ADP, adrenaline, thrombin or collagen during treatment. Platelet number and volume were also unaffected. Fibrinolytic activity intensified as erythropoietin treatment proceeded, with a fall of euglobulin clot lysis time and rise in the activity of t-PA. PAI-1 levels also showed a downward trend, without reaching significance. Thus erythropoietin treatment in modest doses does not seem to adversely influence the hemostatic system in patients on hemodialysis.
Characterization of Left Ventricle Function by Analysis of Pressure Responses to Steps in Rotational Speed of the Hemopump®
Authors: Kunst E.E. , Van Alsté J.A. , Arts T. , Boom H.B.K.
Published: March 2018

Optimizing the procedure of weaning the left ventricle from a left ventricular assist device requires the determination of the momentaneous condition of the left ventricle. In sheep, a method was developed to momentaneously quantify the left ventricular condition. The left ventricular pump condition was quantified by the time-varying parameters elastance and resistance. They were determined from perturbations in the left ventricular pressure of two subsequent beats induced by changes in flow of the assist device. The end-diastolic volume of the ventricle was estimated without directly measuring ventricular volume. Maximum elastance and resistance were 201.3 ± 32.7 [Palmi] and 12.3 ± 1.6 [Pa·s/ml], respectively (mean ± SE). The ventricular time constant, defined by the ratio of resistance to elastance, was 84.6 ± 17.1 [ms] (man ± SE).
Right Heart Function during Left Ventricular Assistance in an Open-Chest Porcine Model of Acute Right Heart Failure
Authors: Abe Y. , Kotoh K. , Deleuze P.H. , Miyama M. , Cooper G.J. , Loisance D.Y.
Published: March 2018

Changes in the right ventricular function measured with a thermodilution ejection fraction catheter have been recorded in open-chest normal pigs and pigs with acute right heart failure (RVF) undergoing left ventricular assistance with a pneumatic-sactype device (LVAD). To produce acute right heart failure, 5 pigs underwent ligation of the right ventricular free wall coronary arteries. Compared with normal pigs, cardiac output in ligated pigs fell by 21% (7.5 ± 0.5 vs 9.5 ± 1.2 L/min; p < 0.05) and the right ventricular end diastolic pressure rose (11.4 ± 2.6 vs 5.7 ± 3.6 vs mmHg: p <0.05). With the left ventricular assist device connected, the right atrial pressure was increased to 3, 5, 7, 10 and 12 mmHg by volume loading while maintaining the haematocrit at 35 ± 6%. The right ventricular stroke work index (RVSWI) increased with volume loading in normal pigs. In RVF pigs, RVSWI increased significantly with the LVAD (59.2 ± 5.8 vs 23.5 ± 7.8 mmHg ml/min/kg, p<0.01), approaching that of normal pigs (62.3 ± 4.8 mmHg ml/min/kg). Similar changes were observed in the cardiac output and right ventricular stroke volume. These results show that, in this model of open-chest, mild, acute right heart failure, left ventricular assistance allows right ventricular function to return to normal, despite volume overloading, by decreasing right ventricular after load and increasing right ventricular compliance
Endothelialization of Cardiac Valve Bioprostheses
Authors: Fischlein T. , Lehner G. , Lante W. , Fittkau M. , Murphy J.G. , Weinhold Ch. , Reichart B.
Published: March 2018

The main disadvantage of implanted xenograft valves used in cardiac surgery is their poor clinical long-term result, due to early tissue degeneration. In order to improve the performance of such glutaraldehyde fixed bioprostheses, a biological coating with viable endothelial cells was suggested. Therefore, glutaraldehyde preserved bovine pericard patches, as well as commercially available xenograft valves, were lined using human venous endothelial cells or microvascular cells from the subcutaneous fat tissue. Before cells were transplanted into their new environment, grafts were treated with an amino acid solution in order to neutralize the cytotoxic effect of free aldehydes, and precoated with fibronectinheparin and basic fibroblast growth factor (bFGF) or endothelial cell growth supplement (ECGS) in order to enhance cell proliferation. Coated specimens were kept in culture conditions for a further seven days. Proliferation of transplanted cells was verified by an increase of activation following 3H-thymidine incorporation, while the maintained metabolic cell activity was demonstrated via Prostacycline (PGI2) measurement. Morphology was evaluated by means of scanning electron microscopy (SEM). As evaluated by the β-Counter, 7 ng/ml bFGF (288,727 ± 39,668 counts on day 4) substantially enhanced cell proliferation after seeding, opposed to the stimulation with 30,000 ng/ml ECGS (91,924 ± 1129 counts on day 4), (p<0.001). The PGI2 release of transplanted cells was stimulated with 25 μM Na arachidonic acid by the factor 2.6 ± 0.3 and inhibited with 5 mM acetylsalecylic acid by the factor 0.7 + 0.2 on day 4 when compared with the basic level. After seven days of cultivation, SEM observation revealed that specimens stimulated with bFGF showed areas of confluent coated leaflets with an even distribution of cell layer. We therefore conclude that proliferation of transplanted cells is most favorable when stimulated with bFGF and that a special treatment of GA preserved cardiac valve bioprostheses allows a vital biological coating with human endothelial cells.