bluuebunny/crossref_metadata_2025_split huggingface dataset:
tPA Deficiency Underlies Neurovascular Coupling Dysfunction by Amyloid-β
Authors: Park Laibaik , Zhou Joan , Koizumi Kenzo , Wang Gang , Anfray Antoine , Ahn Sung Ji , Seo James , Zhou Ping , Zhao Lingzhi , Paul Steven , Anrather Josef , Iadecola Costantino 
Published: September 2020

The amyloid-β (Aβ) peptide, a key pathogenic factor in Alzheimer's disease, attenuates the increase in cerebral blood flow (CBF) evoked by neural activity (functional hyperemia), a vital homeostatic response in which NMDA receptors (NMDARs) play a role through nitric oxide, and the CBF increase produced by endothelial factors. Tissue plasminogen activator (tPA), which is reduced in Alzheimer's disease and in mouse models of Aβ accumulation, is required for the full expression of the NMDAR-dependent component of functional hyperemia. Therefore, we investigated whether tPA is involved in the neurovascular dysfunction of Aβ. tPA activity was reduced, and the tPA inhibitor plasminogen inhibitor-1 (PAI-1) was increased in male mice expressing the Swedish mutation of the amyloid precursor protein (tg2576). Counteracting the tPA reduction with exogenous tPA or with pharmacological inhibition or genetic deletion of PAI-1 completely reversed the attenuation of the CBF increase evoked by whisker stimulation but did not ameliorate the response to the endothelium-dependent vasodilator acetylcholine. The tPA deficit attenuated functional hyperemia by suppressing NMDAR-dependent nitric oxide production during neural activity. Pharmacological inhibition of PAI-1 increased tPA activity, prevented neurovascular uncoupling, and ameliorated cognition in 11- to 12-month-old tg2576 mice, effects associated with a reduction of cerebral amyloid angiopathy but not amyloid plaques. The data unveil a selective role of the tPA in the suppression of functional hyperemia induced by Aβ and in the mechanisms of cerebral amyloid angiopathy, and support the possibility that modulation of the PAI–1-tPA pathway may be beneficial in diseases associated with amyloid accumulation.SIGNIFICANCE STATEMENTAmyloid-β (Aβ) peptides have profound neurovascular effects that may contribute to cognitive impairment in Alzheimer's disease. We found that Aβ attenuates the increases in blood flow evoked by neural activation through a reduction in tissue plasminogen activator (tPA) caused by upregulation of its endogenous inhibitor plasminogen inhibitor-1 (PAI-1). tPA deficiency prevents NMDA receptors from triggering nitric oxide production, thereby attenuating the flow increase evoked by neural activity. PAI-1 inhibition restores tPA activity, rescues neurovascular coupling, reduces amyloid deposition around blood vessels, and improves cognition in a mouse model of Aβ accumulation. The findings demonstrate a previously unappreciated role of tPA in Aβ-related neurovascular dysfunction and in vascular amyloid deposition. Restoration of tPA activity could be of therapeutic value in diseases associated with amyloid accumulation.
Brief Behavioral Interventions for Substance Use in Adolescents: A Meta-analysis
Authors: Steele Dale W. , Becker Sara J. , Danko Kristin J. , Balk Ethan M. , Adam Gaelen P. , Saldanha Ian J. , Trikalinos Thomas A. 
Published: September 2020

CONTEXT:
Adolescents with problematic substance use (SU) are at risk for far-reaching adverse outcomes.

OBJECTIVE:
Synthesize the evidence regarding the effects of brief behavioral interventions for adolescents (12–20 years) with problematic SU.

DATA SOURCES:
We conducted literature searches in Medline, the Cochrane Central Register of Controlled Trials, Embase, Cumulative Index to Nursing and Allied Health Literature, and PsycInfo through October 31, 2019.

STUDY SELECTION:
We screened 33 272 records and citations for interventions in adolescents with at least problematic SU, retrieved 1831 articles, and selected 22 randomized controlled trials of brief interventions meeting eligibility criteria for meta-analysis.

DATA EXTRACTION:
We followed Agency for Healthcare Research and Quality guidelines. We categorized brief interventions into components, including motivational interviewing (MI), psychoeducation, and treatment as usual. Outcomes included SU (abstinence, days used per month) for alcohol and cannabis, and substance-related problem scales. Strength of evidence (SoE) was assessed.

RESULTS:
Both pairwise and network meta-analyses were conducted by using random effects models. Compared to treatment as usual, the use of MI reduces heavy alcohol use days by 0.7 days per month (95% credible interval [CrI]: −1.6 to 0.02; low SoE), alcohol use days by 1.1 days per month (95% CrI −2.2 to −0.3; moderate SoE), and overall substance-related problems by a standardized net mean difference of 0.5 (95% CrI –1.0 to 0; low SoE). The use of MI did not reduce cannabis use days, with a net mean difference of −0.05 days per month (95% CrI: −0.26 to 0.14; moderate SoE).

LIMITATIONS:
There was lack of consistently reported outcomes and limited available comparisons.

CONCLUSIONS:
The use of MI reduces heavy alcohol use, alcohol use days, and SU-related problems in adolescents but does not reduce cannabis use days.
Assessment of Medication Related Problems in Geriatrics Unit of Nigerian Tertiary Hospital
Authors: Mgbahurike A. A  , Wonte M. I.  
Published: September 2020

Medication related problems are prevalent especially in the geriatric populationandcancause considerable patient morbidity and in some cases death as well as increased health expenditure. The elderly population is at increased risk for medication related problems as a result of age – related physiological changes and the presence of multiple chronic diseases. Aim: This study aimed to assess medication related problems (MRP) in University of Port Harcourt Teaching Hospital, with the objective to identify and categorize the MRP according to types as well as identify the most frequent MRP encountered and interventions made by the pharmacists. Method: The study was a retrospective study carried out among 200 geriatric patientsrandomly sampled, over 18months period (January 2018 to June 2019). Data extracted include patients’ demographic information, prescribed medication and number, medical condition, and pharmacist’s intervention (where available) using data collection form. Information collected were categorized and analyzed statistically. Result: showed that female geriatric patients (64.4%) were more than male (35.5%). Most (43%) of the studied population were in the range of 60yrs – 70yrs. Out of the 200 patients assessed, 157 (78.4%) had medication related problems. Drug- drug interaction was the most frequently (64.4%) occurred MRP, as most (62.5%) of the studied group had 6 -10 medications in one prescription, and 12.5% had more than 10 medications in one prescription. Following drug interaction was incorrect drug administration (18.5%). Of the population studied, 56.5% of the patients were using their medication inappropriately. The major contributing factors responsible for these MRPs were comorbidities, poly-pharmacy, and medication non- adherence. Conclusion: The study identified categories of medication related problem in the geriatric Unit of the hospital and the need for pharmacists’ interventions.
Prognostic Value of Leukocytosis in Pediatric Head Trauma
Authors: Sahin Levent , Kayabas Murat , Aras Levent 
Published: September 2020

Introduction: The most common cause of the morbidity and mortality in the childhood period age group is head traumas. In emergency departments computed tomography (CT) for diagnostic purposes is used more frequently in head traumas that are occurred in pediatric patients than in adults. Different protocols have been defined for brain CT in children with head trauma, clinical evaluations come to the fore in these protocols; however, there is no biomarker. Objective: Our aim in this study is to investigate the relationship between age, gender, trauma etiology, presence of symptoms at the time of admission, Glasgow Coma Scale (GCS), brain CT findings and blood WBC levels at admission. Method: 305 pediatric patients [between 0 and 18 years old] who applied to the emergency department of Kafkas University Medical Faculty Hospital between 2016 and 2019 after head trauma were included in the study. The data of these patients were analyzed retrospectively from the hospital records. Age, gender, head trauma etiology, GCS scores at the time of presentation, their symptoms, their brain CT findings and blood WBC levels were examined. Chi-square test was performed between patients with and without leukocytosis and independent variables. Results: After applying exclusion factors, the data of 173 patients who underwent CT in the emergency room after head trauma and whose blood tests were studied were examined. When patients were analyzed according to gender, 111 (64.2%) were male and 62 (35.8%) were found to be female. In terms of age, it was seen that those between the ages of 0 and 2 were 54 (31.2%), and those between the ages of 2- and 18 were 119 (68.8%). Among the etiological causes of traumas, the most frequent (n = 113) 65.3% falls were seen. The number of patients with symptoms was 57 (32.9%). Patients with GCS 14 ≥ constituted 69.4% of the total patients (n = 120). There was a pathological finding in 19.0% of the brain CT' s (n = 33) taken. Leukocytosis was detected in 17.3% of the patients [n = 30]. Conclusion: As a result of this study, it was found statistically significant that the blood WBC levels were higher in children who had head trauma, whose GCS was 13 ≤ at the time of application, who had symptoms and who had pathology in brain CT compared to other groups.
Contemporary movement of the Earth's crust in the Northwestern Vietnam by continuous GPS data
Authors: Minh Le Huy , Hung Vu Tuan , Hu Jyr- Ching , Minh Nguyen Le , Huang Bor- Shouh , Chen Horng- Yue , Thang Nguyen Chien , Thanh Nguyen Ha , Thanh Le Truong , Mai Nguyen Thi , Hong Pham Thi Thu 
Published: September 2020

The paper presents an estimation of the Earth’s crustal motion from the continuous GPS data at 6 stations (MTEV, MLAY, DBIV, TGIV, SMAV and SLAV) in the Northwestern and at PHUT (Hanoi) station using GAMIT/GLOBK software. The absolute displacements of the Earth’s crust at 7 stations in the IGS14 frame are respectively: 34.10±0.71 mm/yr (DBIV), 34.31±0.65 mm/yr (PHUT), 34.51±0.75 mm/yr (SMAV), 34.55±0.80 mm/yr (MLAY), 34.80±0.72 mm/yr (TGIV), 34.93±0.99 mm/yr (SLAV) and 35.59±0.73 mm/yr (MTEV), in the southeastward with the azimuth range 104-108o. The Son La fault is a right-lateral slip fault with a shear amplitude of ~1.5 mm/yr. The Lai Chau-Dien Bien fault is a left-lateral slip fault with a shear amplitude of ~1.9 mm/yr. Although the absolute velocities at the DBIV, SMAV, SLAV, TGIV and MLAY stations are evaluated with the error <1 mm/yr, the relative displacement on the Ma River fault is of ~0.5 mm/yr, and it seems that we still do not have a reliable assessment of the slip rate on the Ma River right-lateral slip fault.
Sapientia – Scientia – Metafisica. Uwagi na marginesie tekstu Stanisława Kamińskiego o mądrości
Authors: Manikowski Maciej 
Published: September 2020

Stanisław Kamiński, polski filozofii i metodolog metafizyki jest autorem bardzo interesującego i inspirującego tekstu o mądrości. W jego filozoficznej analizie odkrywamy bardzo ważne pytanie dotyczące nie tylko samej mądrości, lecz także samego naszego filozoficznego myślenia. Mądrość nie jest jedynie zbiorem jakichś informacji pozyskanych w wyniku ludzkiej działalności w świecie, nawet gdyby taka wiedza była w pewien sposób wspomagana przez naukę. Mądrość nie jest tylko zbiorem ludzkich doświadczeń, wynikających z długiego i owocnego życia człowieka. Mądrość jest wiedzą dogłębną o rzeczywistości, w jej aspekcie odkrywania ostatecznych przyczyn i celów. Mądrość jest wiedzą, wiedzą metafizyczną, najbardziej ugruntowaną, a zatem fundamentalną, ponieważ w niej osiąga się najbardziej zasadniczą podstawę istnienia, realnie istniejący byt, a nie tylko pojęcie bytu. Mądrość jest wiedzą teoretyczną, która jest ostateczną i najpełniejszą wiedzą o świecie, jego wiecznym i najgłębszym porządku. Mądrość praktyczna natomiast jest praktyczną, użyteczną i rozumną aplikacją mądrości teoretycznej, którą wykorzystujemy w praktyce naszego codziennego życia, podejmując działania wobec świata i drugiego człowieka. W tym miejscu można się odwołać do tytułu zbioru metodologicznych i metafilozoficznych studiów Stanisława Kamińskiego, z którego pochodzi omawiany tekst Nauka a filozofia i mądrość, a który to tytuł brzmi Jak filozofować?. „Tak, by osiągnąć mądrość” – odpowiedziałby na tytułowe pytanie Kamiński.
Autoteleologia osoby a teleologia natury w antropologii Karola Wojtyły
Authors: Biesaga Tadeusz 
Published: September 2020

Artykuł rekonstruuje i analizuje Wojtyłowską propozycję przezwyciężenia dualizmu antropologicznego przez syntezę teleologicznych tendencji natury ludzkiej z autoteleologią wolności osoby. Propozycja ta zmierza równocześnie do syntezy filozofii bytu i filozofii świadomości, inaczej syntezy podmiotowego i przedmiotowego, subiektywnego i obiektywnego ujęcia człowieka oraz norm moralnych. Droga ta jest trudniejsza niż obrana przez antropologię spirytualistyczną lub jej przeciwieństwo, antropologię naturalistyczną, czy materialistyczną. Drogę tę można nazwać filozofią i antropologią ­integralną, łączącą w sobie pełne ujęcie bytu ludzkiego.
Personalistyczna etyka Karola Wojtyły wobec zarzutów współczesnego antypersonalizmu
Authors: Czachorowski Marek 
Published: September 2020

W artykule prezentuje się współczesne zarzuty wobec personalizmu etycznego, którego szczególnym przykładem jest etyka Karola Wojtyły. Odsłania się błędne założenia kryjące się za tymi zarzutami i sposób udzielenia na nie odpowiedzi, które znajdujemy w pracach Wojtyły. Współczesna krytyka personalizmu etycznego wychodzi z pozycji pozytywizmu sprowadzającego wartościową wiedzę do nauk szczegółowych, a wykluczającego ujęcie istoty moralności. Ten pozytywistyczny redukcjonizm stoi też u podstaw formułowania zarzutu błędu naturalistycznego wobec personalizmu Wojtyły. Jego „norma personalistyczna”, która wyklucza tylko instrumentalne traktowanie osoby z racji jej szczególnej wartości, jest uzasadniona w oparciu o doświadczenie aksjologiczne, między innymi obecne w doświadczeniu wstydu, który ujawnia bezpośrednio istotę i wartość osoby ludzkiej.
Improving Unjust Laws Without Inviting Unjust Plans: The Case of Abortion for Fetal Anomaly
Authors: Watt Helen 
Published: September 2020

Some laws cannot yet be entirely abrogated in a current political situation, though permitting grave injustices against some individuals; for example, unborn and/or disabled individuals. In supporting the passing of new ‘imperfect’ laws that protect only some of those who now lack protection, do we ourselves discriminate unjustly against those remaining unprotected? Or does that depend on factors such as our intentions – including what we intend that others intend? How may we collaborate with colleagues who intend, and perhaps explicitly defend, the continuation of remaining, closely-related injustices, although they are willing to join us in trying to improve some aspects of the status quo? This paper explores the moral constraints on our attempts to extend the law’s protection to some, but not to all, of those individuals currently deprived of such ­protection and at risk of serious harm.
Early postoperative effects of the hypothermia level during hypothermic circulatory arrest in patients with ascending aortic aneurysm
Authors: Kozlov B. N. , Panfilov D. S. , Sonduev E. L. , Ponomarenko I. V. 
Published: September 2020

Aim. To compare the effectiveness and safety of ascending aortic hemiarch replacement performed during hypothermic circulatory arrest with different temperature regimens.Material and methods. The study included 104 patients with ascending aortic aneurysm, who underwent ascending aortic hemiarch replacement under hypothermic circulatory arrest and antegrade cerebral perfusion. Depending on the temperature regimen, all patients were divided into two comparable groups: group 1 (n=28) — patients operated on under mild hypothermia (29-31oС), group 2 (n=76) — patients operated on under moderate hypothermia (25-28oC).Results. Comparative analysis of intraoperative data between groups of patients with mild and moderate hypothermia revealed a significant difference in the duration of cardiopulmonary bypass (111 [97; 135] min vs 125 [108.5; 170] min, p=0,031) and surgery (240 [210; 270 ] min vs 275 [240; 330] min, p=0,003). In the early postoperative period, the best results were also obtained in patients of mild hypothermia group. In these patients, compared with moderate hypothermia group, there was a lower frequency of reoperation due to bleeding (3,5% vs 5,2%, p=0,572), a decrease in transfused fresh frozen plasma volume (2 [2; 4] vs 4 [2; 4], p=0,03), a decrease in the ventilatory support duration (10 [7; 16] hours vs 18 [10; 24] hours, p=0,002), as well as a bed-day decrease in intensive care unit (2 [2; 3] and 3 [2; 4] days, p=0,005). No neurologic deficit was found in any of the patients. In-hospital mortality had no significant intergroup differences (p=0,541).Conclusion. An increase in the temperature regimen during the ascending aortic hemiarch replacement performed under hypothermic circulatory arrest is relatively safe in relation to early postoperative complications. Mild hypothermia does not increase early postoperative surgical risks compared to moderate hypothermia.
Carbon dioxide elimination pattern in assessing the risk of an unfavorable outcome in cardiac surgery
Authors: Kamenskaya O. V. , Loginova I. Yu. , Klinkova A. S. , Ponomarev D. N. , Alsov S. A. , Lomivorotov V. N. , Chernyavskiy A. M. 
Published: September 2020

Aim. To assess the influence of resting partial pressure of end-tidal carbon dioxide (PetCO2) levels on the long-term results of cardiac surgery.Materials and methods. This prospective cohort study included 454 patients with coronary artery disease who underwent elective coronary artery bypass graft surgery. Before surgery, all patients underwent pulmonary function tests, including body plethysmography, lung diffusion capacity assessment and cardiopulmonary exercise testing with the determination of ventilatory and gas exchange parameters, including PetCO2 at rest. The endpoint was the 2-year survival rate after surgery.Results. Parameters characterizing the obstructive breathing pattern, the lung diffusion capacity, and resting PetCO2 levels had a significant predictor value in relation to long-term survival after cardiac surgery. Among the baseline clinical and functional characteristics, a significant influence on long-term results was shown by the EuroSCORE II (OR 1,69 (1,26-2,27), p=0,001). The highest sensitivity and specificity in relation to long-term mortality risk after coronary artery bypass grafting was shown by resting PetCO2 value equal to 31 mm Hg (area under the ROC curve 0,74 (0,64-0,86), p<0,001).Conclusion. The resting PetCO2 level below 31 mm Hg in patients with coronary artery disease showed a significant effect on the increased long-term mortality risk after cardiac surgery, which is important for patients with exercise intolerance.
Effect of late culprit coronary artery revascularization on prognosis of patients with ST-elevation myocardial infarction
Authors: Frolov A. A. , Kuzmichev K. V. , Pochinka I. G. , Sharabrin E. G. , Savenkov A. G. 
Published: September 2020

Aim. To evaluate the effect of culprit coronary artery revascularization after 48 hours from the symptoms’ onset on the prognosis of patients with ST-elevation myocardial infarction (STEMI).Material and methods. Of the 1172 patients admitted to City Clinical Hospital № 13 in 2018 due to STEMI, 43 patients (4%) were included in the retrospective study. There were following inclusion criteria: hospitalization after 48 hours from the symptoms’ onset, no clinical signs of myocardial ischemia, and complete coronary artery occlusion according to angiography. The mean age of the subjects was 61,3±10,6 years, 34 (79%) men and 9 (21%) women. The subjects were divided into two groups: group 1 (n=22) — management with percutaneous coronary intervention (PCI), group 2 (n=21) — management with medications. The groups differ only in the severity of coronary atherosclerosis according to SYNTAX score: group 1 — 14,0 [11.0; 19.5], group 2 — 26,0 [16,5; 31,0] (p=0,009). At the end of inpatient treatment, patients underwent echocardiography. Death and myocardial infarction were monitored during hospitalization and for 12 months after discharge.Results. During hospitalization, 2 patients died (4,7%; one in each group, p=1,00). No recurrent MI were reported. The left ventricular ejection fraction in the PCI group was 50 [46; 54] %, in the group with drug therapy — 43 [38; 50] % (p=0,01). Out of 43 included patients, long-term outcomes were followed up in 32 (74%). Among them, 1 (5,8%) patient died in group 1, 6 (33,3%) patients — in group 2 (p=0,04). In total, death or recurrent MI in the first group was observed in 2 (12%) patients, in the second group — in 5 (33%) patients (p=0,14).Conclusion. Revascularization of a fully occluded culprit coronary artery in stable patients with STEMI after 48 hours of symptoms’ onset is associated with a higher inhospital left ventricular ejection fraction and a decrease in 12-month mortality.
Long-term outcomes of aortic valve repair in children with congenital heart disease and their predictors
Authors: Abdurakhmanov Z. M. , Yemets I. N. 
Published: September 2020

Aim. To retrospectively analyze the long-term results of primary aortic valve repair (AVR) in children.Material and methods. The study included 163 patients operated on from 2004 to 2019. The mean age was 9,58±9,3 years. The patients underwent commissurotomy, decalcification, raphe resection, Trusler technique, raphe shaving, free margin plication, leaflet replacement, leaflet extension, subcommissural annuloplasty, valve sparing aortic root replacement and neocuspidization. Primary endpoint was a composite outcome of freedom from reoperation, recurrent greater than moderate aortic regurgitation, stenosis, whereas secondary — overall survival.Results. The indications for the procedure were stenotic, regurgitant or mixed defect in 80 (49,1%), 38 (23,3%), and 45 (27,6%) patients, respectively. The 10-year survival rate was 99,4%. The mean follow-up was 3,6±1,8 years. Freedom from reoperation, recurrent moderate and greater aortic regurgitation, stenosis at 1,5 and 7 years was, 95%, 70% and 47%, respectively. In multivariate analysis, Trusler technique, leaflet extension, raphe shaving, use of patch, leaflet retraction, complexity of repair were predictors for composite outcome.Conclusion. Reconstruction of aortic valve in children is effective and safe. Avoidance of predictors may significantly improve the long-term results of aortic valve repair.