bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mechanism of Drug-Eluting Absorbable Metal Scaffold Restenosis
Authors: Ueki Yasushi , Räber Lorenz , Otsuka Tatsuhiko , Rai Himanshu , Losdat Sylvain , Windecker Stephan , Garcia-Garcia Hector M. , Landmesser Ulf , Koolen Jacques , Byrne Robert , Haude Michael , Joner Michael 
Published: February 2020

Background:
The pathomechanisms underlying restenosis of the bioabsorbable sirolimus-eluting metallic scaffold (Magmaris) remain unknown. Using serial optical coherence tomography, we investigated causes of restenosis, including the contribution of late scaffold recoil versus neointimal hyperplasia.

Methods:
Patients enrolled in BIOSOLVE-II undergoing serial angiography and optical coherence tomography (post-intervention and follow-up: 6 months and/or 1 year) were analyzed. Patients were divided into 2 groups according to angiographic in-scaffold late lumen loss (LLL) <0.5 or ≥0.5 mm. End points were late absolute scaffold recoil and neointimal hyperplasia area as assessed by optical coherence tomography.

Results:

Serial data were available for analysis from 70 patients (LLL <0.5 mm: n=41; LLL ≥0.5 mm: n=29). Patient and lesion characteristics were comparable, and there was no significant difference in mean and minimal scaffold area between groups at post-intervention. Late absolute scaffold recoil was less among patients with LLL <0.5 mm (0.53±0.68 mm
2
) compared with those with LLL ≥0.5 mm (1.48±1.20 mm
2
;
P
<0.001). Neointimal hyperplasia area was smaller among patients with LLL <0.5 mm at follow-up (1.47±0.33 mm
2
) compared with patients with LLL ≥0.5 mm (1.68±0.34 mm
2
;
P
=0.013). In a matched-frame analysis (post-intervention and follow-up), late absolute scaffold recoil varied according to the underlying plaque type (lipid: 0.63±1.23 mm
2
; calcified: 0.81±1.44 mm
2
; and fibrous: 1.20±1.52 mm
2
;
P
<0.001), while there was no difference with regards to neointimal hyperplasia area (
P
=0.132).

Conclusions:
In addition to neointimal hyperplasia, late scaffold recoil contributed significantly to LLL of sirolimus-eluting absorbable metal scaffolds. The extent of late scaffold recoil was dependent on the underlying plaque morphology and was the highest among fibrotic lesions.

Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01960504.
Development of a Probabilistic Subfreezing Road Temperature Nowcast and Forecast Using Machine Learning
Authors: Handler Shawn L. , Reeves Heather D. , McGovern Amy 
Published: February 2020

ABSTRACTIn this study, a machine learning algorithm for generating a gridded CONUS-wide probabilistic road temperature forecast is presented. A random forest is used to tie a combination of HRRR model surface variables and information about the geographic location and time of day per year to observed road temperatures. This approach differs from its predecessors in that road temperature is not deterministic (i.e., provides a forecast of a specific road temperature), but rather it is probabilistic, providing a 0%–100% probability that the road temperature is subfreezing. This approach can account for the varying controls on road temperature that are not easily known or able to be accounted for in physical models, such as amount of traffic, road composition, and differential shading by surrounding buildings and terrain. The algorithm is trained using road temperature observations from one winter season (October 2016–March 2017) and calibrated/evaluated using observations from the following winter season (October 2017–March 2018). Case-study analyses show the algorithm performs well for various scenarios and captures the temporal and spatial evolution of the probability of subfreezing roads reliably. Statistical evaluation for the predicted probabilities shows good skill as the mean area under the receiver operating characteristics curve is 0.96 and the Brier skill score is 0.66 for a 2-h forecast and only degrades slightly as lead time is increased. Additionally, the algorithm produces well-calibrated probabilities, and consistent discrimination between clearly above-freezing and subfreezing environments.
Tracheostomy in the Extremely Premature Neonate: A Multi‐Institutional Study
Authors: Pereira Kevin D. , Shaigany Kevin , Zur Karen B. , Jenks Carolyn M. , Preciado Diego A. , Hamdi Osama , Banker Karen , Briddell Jenna W. , Isaiah Amal 
Published: February 2020

Objective(1) To describe characteristics associated with tracheostomy placement and (2) to describe associated in‐hospital morbidity in extremely premature infants.Study DesignPooled retrospective analysis of charts.SettingAcademic children’s hospitals.Subjects and MethodsThe patient records of premature infants (23‐28 weeks gestational age) who underwent tracheostomy between January 1, 2012, and December 31, 2017, were reviewed from 4 academic children’s hospitals. Demographics, procedural morbidity, feeding, respiratory, and neurodevelopmental outcomes at the time of transfer from the neonatal intensive care unit (NICU) were obtained. The contribution of baseline characteristics to mortality, neurodevelopmental, and feeding outcomes was also assessed.Results:The charts of 119 infants were included. The mean gestational age was 25.5 (95% confidence interval, 25.2‐25.7) weeks. The mean birth weight was 712 (671‐752) g. Approximately 50% was African American. The principal comorbidity was chronic lung disease (92.4%). Overall, 60.5% of the infants had at least 1 complication. At the time of transfer, most remained mechanically ventilated (94%) and dependent on a feeding tube (90%). Necrotizing enterocolitis increased the risk of feeding impairment (P =. 002) and death (P =. 03).ConclusionsTracheostomy in the extremely premature neonate is primarily performed for chronic lung disease. Complications occur frequently, with skin breakdown being the most common. Placement of a tracheostomy does not seem to mitigate the systemic morbidity associated with extreme prematurity.
Impact of Time to Diagnosis and Treatment in Head and Neck Cancer: A Systematic Review
Authors: Schutte Henrieke W. , Heutink Floris , Wellenstein David J. , van den Broek Guido B. , van den Hoogen Frank J. A. , Marres Henri A. M. , van Herpen Carla M. L. , Kaanders Johannes H. A. M. , Merkx Thijs M. A. W. , Takes Robert P. 
Published: February 2020

ObjectiveAn increased interval between symptomatic disease and treatment may negatively influence oncologic and/or functional outcomes in head and neck cancer (HNC). This systematic review aims to provide insight into the effects of time to treatment intervals on oncologic and functional outcomes in oral cavity, pharyngeal, and laryngeal cancer.Data SourcesPubMed, EMBASE, and Cochrane library were searched.Review MethodsAll studies on delay or time to diagnosis or treatment in oral, pharyngeal, and laryngeal cancer were included. Quality assessment was performed with an adjusted version of the Newcastle‐Ottawa scale. Outcomes of interest were tumor volume, stage, recurrence, survival, patient‐reported outcome measures (PROMs), toxicity, and functionality after treatment.ResultsA total of 51 studies were included. Current literature on the influence of delay in HNC is inconsistent but indicates higher stage and worse survival with longer delay. The effects on PROMs, toxicity, and functional outcome after treatment have not been investigated. The inconsistencies in outcomes were most likely caused by factors such as heterogeneity in study design, differences in the definitions of delay, bias of results, and incomplete adjustment for confounding factors in the included studies.ConclusionIrrespective of the level of evidence, the unfavorable effects of delay on oncologic, functional, and psychosocial outcomes are undisputed. Timely treatment while maintaining high‐quality diagnostic procedures and decision making reflects good clinical practice in our opinion. This review will pose practical and logistic challenges that will have to be overcome.
Blood Pressure and Left Ventricular Hypertrophy in Patients on Different Peritoneal Dialysis Regimens
Authors: Wang Ming-Cheng , Tseng Chin-Chung , Tsai Wei-Chuan , Huang Jeng-Jong 
Published: February 2020

Objective To examine the relation between the results of ambulatory 24-hour blood pressure monitoring (ABPM) and left ventricular mass index (LVMI), then to find the independent determinant for left ventricular hypertrophy (LVH) in peritoneal dialysis (PD) patients. Finally, to evaluate the differences in the clinical and cardiovascular characteristics between patients on continuous ambulatory PD (CAPD) and continuous cyclic PD (CCPD). Design An open, nonrandomized, cross-sectional study. Setting Divisions of nephrology and cardiology in a medical center. Patients Thirty-two uremic patients on maintenance PD therapy (22 patients on CAPD, and 10 on CCPD) without anatomical heart disease or history of receiving long-term hemodialysis. Interventions Home blood pressure (BP) and office BP were measured using the Korotkoff sound technique by sphygmomanometer. ABPM was employed for continuous measurement of BP. Echocardiography was performed for measurement of cardiac parameters and calculation of LVMI. Main Outcome Measures Multivariate logistic regression analysis was performed for independent determinant of LVH in PD patients. The differences in clinical and cardiovascular characteristics between CAPD and CCPD patients were compared. Results Simple regression analysis showed positive correlations between LVMI and the duration of hypertension, ambulatory nighttime BP/BP load/BP load > 30%, serum phosphate, calcium–phosphate product, ultrafiltration (UF) volume, and percentage of UF volume during the nighttime. A negative correlation was noted between LVMI and dipping. In multiple regression analysis, the duration of hypertension was the only variable linked to LVMI. In multivariate logistic regression analysis, only ambulatory nighttime systolic BP load > 30% had an independent association with LVH. There were correlations between office/home BP and ambulatory 24-hour BP. In addition, CCPD patients had higher LVMI, UF volume during the nighttime, and percentage of UF volume during the nighttime than those of CAPD patients. Conclusions In this study, ambulatory nighttime systolic BP load > 30% had an independent association with LVH. Office and home BP measurements were correlated with ABPM in PD patients. The result that CCPD patients had a higher LVMI than CAPD patients may be due to a relative volume overload during the daytime in CCPD patients.
Amadori Albumin and Advanced Glycation End-Product Formation in Peritoneal Dialysis using Icodextrin
Authors: Posthuma Nynke , Ter Wee Pieter M. , Niessen Hans , Donker Ab J.M. , Verbrugh Henri A. , Schalkwijk Casper G. 
Published: February 2020

Objective To study the influence of peritoneal dialysis (PD) solutions on the formation of early glycated products and advanced glycation end-products (AGEs). Design and Patients The formation of both Amadori albumin and AGEs in glucose- and icodextrin-based PD fluids was analyzed in vitro and in peritoneal effluents of continuous cyclic peritoneal dialysis (CCPD) patients. Results Albumin incubated with glucose-based PD fluids showed a time- and glucose concentration-dependent formation of Amadori albumin and AGEs. Aminoguanidine completely inhibited AGE but not Amadori albumin formation. Albumin incubated in icodextrin resulted in the lowest levels of Amadori albumin and AGE. Amadori albumin levels in effluents of 24 CCPD patients (12 glucose and 12 icodextrin for their daytime dwells) were similar. Dialysate samples collected during a mass transfer area coefficient test in 16 CCPD patients (8 glucose, 8 icodextrin) showed an increase in Amadori albumin formation from baseline ( p < 0.0001), without a difference between the groups. In the total group, there was a positive relationship between duration on PD and dialysate Amadori albumin concentration at 240 minutes ( p = 0.03). The Amadori albumin dialysate-to-plasma (D/P) ratio at 240 minutes was 0.82 ± 0.11, and its clearance amounted to 7.71 ± 1.14 mL/min, while the albumin D/P ratio was 0.010 ± 0.003 and its clearance was 0.089 ± 0.017 mL/min. In a peritoneal biopsy of a CCPD patient, Amadori albumin was observed in the mesothelial layer and the endothelium of the peritoneum. Conclusions Using icodextrin-based instead of glucose-based PD fluids can largely reduce the formation of Amadori albumin and AGEs. However, CCPD patients using icodextrin during daytime dwells do not have lower effluent levels of Amadori albumin and AGEs, probably due to the exposure to glucose during their nighttime exchanges. Kinetic studies suggest washout of locally produced Amadori albumin.
Preservation of Residual Renal Function in Dialysis Patients: Effects of Dialysis-Technique–Related Factors
Authors: Lang Susanne M. , Bergner Albrecht , Töpfer Marcel , Schiffl Helmut 
Published: February 2020

Objectives Residual renal function (RRF) is of paramount importance to dialysis adequacy, morbidity, and mortality, particularly for long-term continuous ambulatory peritoneal dialysis (CAPD) patients. Residual renal function seems to be better preserved in patients on CAPD than in hemodialysis (HD) patients. We analyzed RRF in 45 patients with end-stage renal disease (ESRD), commencing either CAPD or HD, to prospectively define the time course of the decline in RRF, and to evaluate dialysis-technique–related factors such as cardiovascular stability and bioincompatibility. Study Design Single-center prospective investigation in parallel design with matched pairs. Materials Fifteen patients starting CAPD and 15 matched pairs of patients commencing HD were matched according to cause of renal failure and RRF. Hemodialysis patients were assigned to two dialyzer membranes differing markedly in their potential to activate complement and cells (bioincompatibility). Fifteen patients were treated exclusively with the cuprophane membrane (bioincompatible) and the other 15 patients received HD with the high-flux polysulfone membrane (biocompatible). Measurements Residual renal function was determined at initiation of dialytic therapy and after 6, 12, and 24 months. Dry weight (by chest x ray and diameter of the vena cava) was closely recorded throughout the study, and the number of hypotensive episodes counted. Results Residual renal function declined in both CAPD and HD patients, although this decline was faster in HD patients (2.8 mL/minute after 6 months and 3.7 mL/min after 12 months) than in CAPD patients (0.6 mL/min and 1.4 mL/ min after 6 and 12 months respectively). It declined faster in patients with bioincompatible than with biocompatible HD membranes (3.6 mL/min vs 1.9 mL/min after 6 months). Eleven percent of the HD sessions were complicated by clinically relevant blood pressure reductions, but there were no differences between the two dialyzer membrane groups. None of the CAPD patients had documented hypotensive episodes. None of the study patients suffered severe illness or received nephrotoxic antibiotics or radiocontrast media. Conclusions The better preservation of RRF in stable CAPD patients corresponded with greater cardiovascular stability compared to HD patients, independently of the membrane used. Furthermore, there was a significantly higher preservation of RRF in HD patients on polysulfone versus cuprophane membranes, indicating an additional effect of biocompatibility, such as less generation of nephrotoxic substances by the membrane. Thus, starting ESRD patients on HD prior to elective CAPD should be avoided for better preservation of RRF.
Electrophysiology and Glucose Transport of Human Peritoneal Mesothelial Cells: Implications for Peritoneal Dialysis
Authors: Li Fu Keung , To Chi Ho , Leung Jack Kok Hung , Chan Tak Mao , Lai Ka Neng 
Published: February 2020

Objective To elucidate ionic and glucose transport across human peritoneal mesothelium, we utilized an Ussing chamber setup and studied the electrophysiological characteristics and tissue permeabilities of human peritoneal mesothelial cells (HPMC) to l- and d-glucose. Methods Human mesothelial cells were grown on polyester filters (snapwell; Costar, Cambridge, MA, U.S.A.) that, upon confluence, were fitted into Ussing chambers. Transmesothelial resistance and resting potential were determined using electro-physiological techniques. Radiolabeled glucose was added to one side of the chamber and the permeabilities determined by serial sampling in the receptive compartment. Results The transmesothelial potential and resistance were 0.54 ± 0.07 mV (apical positive) and 20.4 ± 3.2 Ω·cm2 respectively (mean ± SEM, n = 36). The course of overall transfer of d- and l-glucose was examined using l-glucose as a positive diffusion-plus-leak marker. The permeabilities of HPMC to d-glucose were 3.00 ± 0.26 cm/sec (apical-to-basolateral) and 3.25 ± 0.27 cm/sec (basolateral-to-apical) [ n = 6 experiments, p = not significant (NS)], which were not different from those of l-glucose: 3.00 ± 0.30 cm/sec (apical-to-basolateral) and 2.71 ± 0.24 (basolateral-to-apical) ( n = 6 experiments, p = NS). Conclusions The transepithelial resistance of HPMC is low and the ionic gradient, although it exists, is small and inconsequential. Passive paracellular flow accounts for the majority of transmesothelial glucose transport. The existence of a large paracellular shunt precludes the mesothelial membrane as a clinically relevant osmotic barrier.
Intraperitoneal Hyaluronan Administration in Conscious Rats: Absorption, Metabolism, and Effects on Peritoneal Fluid Dynamics
Authors: Breborowicz Andrzej , Polubinska Alicja , Pawlaczyk Krzysztof , Kuzlan–Pawlaczyk Malgorzata , Moberly James , Martis Leo , Oreopoulos Dimitrios 
Published: February 2020

Background Hyaluronan (HA) is a major component of interstitial tissue that participates in fluid homeostasis, response to inflammation, and wound healing. Previous studies have shown that intraperitoneal administration of HA can affect peritoneal fluid transport during short peritoneal dialysis exchanges in anesthetized rats. We sought to investigate the effect of high molecular weight HA on peritoneal permeability in conscious rats during dialysis exchanges up to 8 hours in duration. In addition, we sought to investigate the absorption of HA from the peritoneal cavity, its accumulation in peritoneal tissues, and its metabolism in normal and uremic rats. Methods Experiments were performed on male Wistar rats infused with 30 mL peritoneal dialysis solution (Dianeal, Baxter Healthcare; Castelbar, Ireland) containing 10 mg/dL HA or with Dianeal alone (control). Peritoneal fluid removal (net ultrafiltration), permeability to glucose, creatinine, and total proteins, and tissue and blood levels of HA were determined in separate groups of rats at 1, 2, 4, 6, and 8 hours after intraperitoneal infusion. Hyaluronan appearance and disappearance from plasma were also studied for 24 hours in separate groups of normal and uremic rats. Results Net ultrafiltration was significantly greater (27%) in rats infused with HA at 4, 6, and 8 hours ( p < 0.01) compared to controls. Transperitoneal equilibration of protein was reduced by 27% ( p < 0.001) at 4 hours and by 30% ( p < 0.01) at 8 hours. During the 8-hour exchange, peritoneal clearance of creatinine increased by 27% ( p < 0.01), whereas the clearance of total protein decreased by 27% ( p < 0.005). After 8 hours, 25.7% ± 3.1% of the administered HA was absorbed from the peritoneal cavity, peritoneal tissue HA concentration was increased by 117% ( p < 0.001), and plasma HA levels increased by 435% ( p < 0.001). Plasma HA levels returned to normal within 24 hours after intraperitoneal administration in both healthy and uremic rats. Conclusions Hyaluronan added to dialysis fluid is absorbed from the peritoneal cavity and accumulates in peritoneal tissues. Hyaluronan supplementation produces changes in peritoneal permeability, leading to higher net ultrafiltration and peritoneal creatinine clearance, whereas total protein clearance decreases. The HA that is absorbed from the peritoneal cavity appears to be rapidly metabolized in both healthy and uremic rats.
Systemic Lupus Erythematosus and Peritoneal Dialysis: Outcomes and Infectious Complications
Authors: Huang Jenq-Wen , Hung Kuan-Yu , Yen Chung-Jen , Wu Kwan-Dun , Tsai Tun-Jun 
Published: February 2020

Objective Systemic lupus erythematosus (SLE) is the most common secondary glomerulonephritis resulting in end-stage renal disease (ESRD) among young adults in Taiwan. Studies of the infectious complications and outcomes among such SLE patients undergoing peritoneal dialysis (PD) are limited. Design A retrospective age- and gender-matched case control study. Setting A university teaching hospital. Patients There were 23 SLE patients with ESRD receiving PD for more than 3 months during the past 15 years. Another 46 age- and gender-matched non-SLE nondiabetic patients receiving PD were selected as the control group in this study. Intervention All patients underwent PD as renal replacement therapy and were regularly followed up at this hospital. Main Outcome Measures Technique survival and incidences of exit-site infection (ESI) and peritonitis in these patients. Results The SLE patients had a lower predialysis serum albumin than the control group (3.16 ± 0.50 g/dL vs 3.52 ± 0.50 g/dL, p < 0.01). The incidences of exit-site infection (ESI) and peritonitis were higher for SLE patients than for control patients ( p < 0.01 and p < 0.001, respectively). Kaplan–Meier survival analysis indicated that SLE patients had shorter time intervals to first infectious complications, and poorer technique survival. Infection was the major cause of dropout and mortality in the SLE patients. The SLE patients had a reduced chance of receiving a renal transplant. The use of steroids by SLE patients was associated with a higher incidence of peritonitis ( p = 0.04), but association with ESI was insignificant. In a Cox regression model, the underlying SLE was the only risk factor for technique failure and time interval to first infectious complication. Conclusion SLE patients undergoing PD are more susceptible to infection than age- and gender-matched non-SLE nondiabetic patients and have poorer technique survival. Systemic lupus erythematosus itself may further compromise the immunity of uremic patients.