bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of mini‐incision microdissection testicular sperm extraction in men with cryptozoospermia and non‐obstructive azoospermia
Authors: Almajed Wael , Alharbi Mohannad , Zini Armand 
Published: April 2020

AbstractIntroductionMicrodissection testicular sperm extraction (micro‐TESE) is a procedure commonly utilized to harvest spermatozoa in severe male factor infertility. We have developed a technique involving a mini tunica albuginea incision with superficial tissue dissection (mini‐incision micro‐TESE). The modification is designed to reduce potential tissue injury, and we studied its effectiveness to harvest spermatozoa in men with cryptozoospermia and non‐obstructive azoospermia.Materials and MethodsWe performed a retrospective analysis of 103 infertile men with NOA and cryptozoospermia who underwent a mini‐incision micro‐TESE between March 2015 and August 2018 at the OVO fertility clinic. We consider the mini‐incision micro‐TESE procedure successful when at least five spermatozoa are identified in the micro‐biopsies obtained from the superficial tissue exposed by the 1‐cm mini‐incision. If no spermatozoa are identified through the mini‐incision, we can easily extend the incision to the standard micro‐TESE.ResultsThe mini‐incision procedure allowed for successful recovery of spermatozoa (intra‐operative recovery of ≥ 5 spermatozoa) in 58% of men with cryptozoospermia and 25.6% of men with NOA. Overall, a successful sperm retrieval (with conversion to conventional micro‐TESE if mini‐incision was not successful) was achieved in 89% of men with cryptozoospermia and 48% of men with NOA. A successful mini‐incision micro‐TESE was associated with a significantly lower number of biopsies than conventional micro‐TESE (8.8 vs 24.2, P < .0001). Moreover, in men undergoing a redo micro‐TESE after a previously successful micro‐TESE, 64% (9/14) had spermatozoa found and 21% (3/14) of these men only required a mini‐incision micro‐TESE.ConclusionOur data suggest that mini‐incision micro‐TESE is a useful approach in men undergoing micro‐TESE, allowing for a shorter incision and a high sperm retrieval rate in men with cryptozoospermia. Furthermore, the findings of our study offer insight into the distribution of spermatogenesis in men with cryptozoospermia and NOA.
Cold‐inducible RNA binding protein agonist enhances the cardioprotective effect of UW solution during extended heart preservation
Authors: Pan Hai‐Zhou , Zhang Li‐Jing , Liu Yi‐Wei , Li Yong‐Nan , Su Zhan‐Hao , Meng Jian , Zhang Hao 
Published: April 2020

AbstractIn heart transplantation, time restriction is an unavoidable thorny problem during cardiac transport. Cold storage is an important organ preservation method in donor heart transport. Cold‐inducible RNA binding protein (CIRBP) has been proven to play a protective role under cold stress. In this study, we investigated the role of CIRBP in hypothermic cardioprotection during heart preservation in UW solution and explored a new approach to extend the heart preservation time. Cirbp‐knockout (Cirbp−/−), Cirbp‐transgenic (Cirbp‐Tg), and wild‐type rats were, respectively, randomized into two groups based on various heart preservation times (6 or 12‐hour group) (n = 8 per group). After preservation in UW solution, all hearts were mounted on a Langendorff apparatus and underwent measurement of cardiac parameters, histological analysis, and molecular study. Within the 6‐hour preservation group, no significant difference was found in cardiac functions and histological changes between different rat species. However, after 12 hours of preservation, Cirbp−/− rat hearts showed more apoptosis and worse cardiac function, but less apoptosis and better cardiac function were observed in Cirbp‐Tg rat hearts. Furthermore, we found CIRBP‐mediated cardiac ubiquinone (CoQ10) biosynthesis plays an important role in extending heart preservation, and ubiquinone biosynthesis protein COQ9 was an essential down‐stream regulator during this process. Finally, we found that zr17‐2, a CIRBP agonist, could enhance the expression of CIRBP, which further enhances the synthesis of CoQ10 and promotes scavenging of reactive oxygen species and ATP production to extend heart preservation. This study demonstrated that CIRBP‐enhanced CoQ10 biosynthesis during hypothermic heart preservation and zr17‐2‐supplemented UW solution could be a promising approach to ameliorate heart damage and extend heart preservation during cardiac transport.
Normothermic extracorporeal membrane oxygenation support: Improving the function of intestinal grafts obtained from cardiac death donors
Authors: Guo Mingxiao , Lu Chunlei , Li Linlin , Yao Danhua , Li Yousheng 
Published: April 2020

AbstractExtracorporeal membrane oxygenation (ECMO) could ameliorate the energy status and viability of bowel grafts from cardiac death donors. However, the function of these grafts after transplantation is not clear. The purpose of the study was to evaluate the early function of intestinal grafts after transplantation from expected cardiac death donors supported with normothermic extracorporeal support using a porcine allogeneic orthotopic segmental small bowel transplantation model. Eighteen domestic crossbred donor pigs were assigned to living donation (LD), donation after cardiac death (DCD), and ECMO groups. In the LD group, small bowels were harvested and preserved immediately in cold storage. In the other two groups, the donor pigs received conventional rapid recovery treatment or 1‐hour normothermic extracorporeal support after 10‐minutes expected cardiac arrest. Subsequently, the small bowels were removed and preserved in cold storage. After 5‐6 hours of preservation, small bowel grafts were transplanted into the recipient pigs that underwent enterectomy. The pathology and electron microscopy results, cell apoptosis rate, tight junction protein expression level in the intestinal mucosa, and plasma endotoxin level were evaluated after transplantation. All grafts functioned on the basis of the maltose absorption test results at day 7 after transplantation. There were no significant differences in the morphological changes in the intestinal mucosa among the three groups at day 7 after transplantation. The cell apoptosis rate and plasma endotoxin level in the ECMO group did not differ significantly than those in the LD group, but were evidently lower than those in the DCD group (P < .001). The intestinal absorptive function improved significantly in the ECMO group in contrast with that in the DCD group (P < .001). Short‐term ECMO intervention can alleviate ischemia–reperfusion injuries in intestinal grafts and improve intestinal absorptive function in the early stage after transplantation. Reducing caspase‐3 protein expression and cell apoptosis in the intestinal mucosa may be one of the protective mechanisms of ECMO intervention.
Acute stunning effect of hemodialysis on myocardial performance: A three‐dimensional speckle tracking echocardiographic study
Authors: Guler Hasan Selim , Tulunay Kaya Cansin , Kumru Gizem , Kosku Hakan , Ozyuncu Nil , Sengul Sule , Kutlay Sim 
Published: April 2020

AbstractThe effects of acute changes during hemodialysis (HD) on the myocardium are not yet known. The invention of three‐dimensional speckle tracking echocardiography (3DSTE) has offered clinicians a new method to assess the movements of ventricular segments simultaneously in three spatial directions. The aim of this study was to evaluate the effect of first weekly standard HD process on the left ventricle (LV) and right ventricle (RV) global and regional myocardial function in patients with normal left ventricle ejection fraction using 3DSTE‐derived indices. Patients (n=38) receiving maintenance HD in our clinic who have no known cardiovascular disease are examined just before and after a HD session using 3DSTE. Demographic and comorbidity data, renal replacement treatment characteristics, and laboratory test results are recorded. 3DSTE analysis is performed to calculate the LV global longitudinal, circumferential area and radial peak systolic strain, as well as RV septum and free‐wall longitudinal strain and fractional area change. Patients are aged 52.8 ± 13.6 years and 52.6% of them are male. Mean dialysis duration is 56 months. The LV strain values of the patients changed markedly before and after HD (GLS: −14.2 ± 5.2, −11.1 ± 4.6 [P < .001], GCS: −14.8 ± 4.2, −12.4 ± 5.28 [P < .009]; GRS: 41.5 ± 16, 33.3 ± 16.5 [P = .003]; AREA −24.7 ± 7.2, −20.1 ± 7.6 [P = .001], respectively). We could not demonstrate any improvement in RV strain values before or after HD. LV strain values are positively correlated with blood pressure variability during the dialysis sessions. LV function is preserved better after HD in patients on beta or calcium channel blocker therapy compared to those who do not use these agents (P < .001, P < .01, respectively). HD treatment results in deterioration in all LV strain directions but not in RV. Strain assessment may improve vascular risk stratification of patients on chronic HD.
Determining factors for hemodiafiltration to equal or exceed the performance of expanded hemodialysis
Authors: Maduell Francisco , Broseta José Jesús , Gómez Miguel , Racionero Pablo , Montagud‐Marrahi Enrique , Rodas Lida , Arias‐Guillén Marta , Fontseré Néstor , Vera Manel , Rico Nayra 
Published: April 2020

AbstractThe aim of the study was to compare expanded hemodialysis (HDx) with hemodiafiltration (HDF) at different infusion flows to identify the main determinants, namely blood flow (Qb), replacement volume, infusion flow (Qi), ultrafiltration flow (Quf), filtration fraction (FF), and the point at which the effectiveness of HDF equals or exceeds that of HDx. We conducted a prospective, single‐center study in 12 patients. Each patient underwent 12 dialysis sessions: six sessions with Qb 350 and six with Qb 400 mL/min; with each Qb, one session was with HDx and five sessions were with FX80 (one in HD, and four with Qi 50, 75, 90/100 mL/min or autosubstitution in postdilution HDF). The reduction ratios (RR) of urea, creatinine, ß2‐microglobulin, myoglobin, prolactin, α1‐microglobulin, α1‐acid glycoprotein, and albumin were compared intraindividually and the global removal score (GRS) was calculated. The mean replacement volume with Qb 350 mL/min was 13.77 ± 0.92 L with Qi 50 mL/min, 20.75 ± 1.17 L with Qi 75, 23.83 ± 1.92 L with Qi 90, and 27.51 ± 2.77 L with autosubstitution. Similar results were obtained with Qb 400 mL/min, and the results were only slightly higher with Qi 100 mL/min or in autosubstitution. The GRS was positively correlated with replacement volume with Qb 350 (R2 = 0.583) and with Qb 400 (R2 = 0.584); with Quf with Qb 350 (R2 = 0.556) and with Qb 400 (R2 = 0.604); and also with FF with Qb 350 (R2 = 0.556) and with Qb 400 mL/min (R2 = 0.603). The minimum convective volume in HDF from which it is possible to overcome the efficacy of HDx was 19.2 L with Qb 350 and 17.6 L with Qb 400 mL/min. The cut‐off point of Quf at which HDF exceeded the effectiveness of HDx was 80.6 mL/min with Qb 350 and 74.1 mL/min with Qb 400 mL/min. The cut‐off point at which FF in HDF exceeded the effectiveness of the HDx was 23.0% with Qb 350 and 18.6% with Qb 400 mL/min. In conclusion, this study confirms the superiority of postdilution HDF over HDx when replacement volume, convective volume, Quf, or FF exceeds certain values. Increasing the Qb in postdilution HDF manages to increase the convective dose and more easily overcome the HDx.
Decellularized scaffolds for tissue engineering: Current status and future perspective
Authors: Rajab Taufiek Konrad , O’Malley Thomas J. , Tchantchaleishvili Vakhtang 
Published: April 2020

AbstractBased on Organ Procurement and Transplantation Network data as of December 2019, more than 113 000 patients require an organ transplantation, yet, over the course of this past year, only 36 000 patients received a transplant. This discrepancy between those that need a donor organ and those that receive one remains one of medicine’s biggest challenges. Multiple solutions, both biologic and artificial, have been proposed to mitigate this difference. One of the most promising approaches to generate bioartificial organs for transplantation involves re‐seeding decellularized scaffolds with appropriate cells. Decellularization involves physical, chemical, or biological methods that typically require intimate contact of various decellularization solutions with each cell. Consequently, conventional submersion decellularization has been limited to simple tissues such as heart valves. The invention of perfusion decellularization was a breakthrough that allowed the generation of tissue‐engineered scaffolds from tissues with higher structural organization and entire organs. Such scaffolds are composed of a myriad of extracellular matrix (ECM) components that include collagen, elastin, proteoglycans, and glycoproteins. Together, these components allow the scaffolds to fulfill specialized functions, such as structural functions as well as biological functions including the regulation of cellular processes and extracellular molecules. These specialized functions of decellularized scaffolds can increasingly be harnessed for applications in tissue engineering.
A case series of patients with left ventricular assist devices and concomitant mechanical heart valves
Authors: Al Saadi Tareq , Andrade Ambar , Chickerillo Krystina , Joshi Anjali , Sciamanna Christopher , Pauwaa Sunil , Macaluso Gregory , Dia Muhyaldeen , Cotts William , Tatooles Antone , Pappas Patroklos 
Published: April 2020

AbstractMechanical heart valves left in situ at the time of left ventricular assist device (LVAD) implantation are thought to potentially increase the risk of thromboembolism. Recommendations exist to replace dysfunctional mechanical mitral valves and any mechanical aortic valves at the time of LVAD implantation. Due to potential increases in cardiopulmonary bypass time and associated comorbidities with valve replacement, leaving a functional mechanical valve in place at LVAD implantation has been suggested to be a safe option. We retrospectively reviewed all patients with prior mechanical mitral or aortic valves undergoing LVAD implantation at our center between 2012 and 2017. Echocardiograms were read by a single cardiologist to assess for mechanical valve dysfunction. We identified 15 patients. Five patients had major bleeding requiring transfusion. On follow‐up, 2 patients had hemorrhagic stroke and 2 had transient ischemic attach/ischemic stroke. In addition, 2 patients had LVAD thrombosis and 2 patients had LVAD driveline malfunction. Mild mechanical valve regurgitation was identified on follow‐up echocardiograms of 2 patients. Rate of complications in patients with mechanical valves undergoing LVAD implantation was comparable to that reported for the general LVAD population. Leaving a functional mechanical valve in place at the time of LVAD implantation could be a reasonable alternative to valve replacement. More data are required to further guide patient care in these individuals.
High recurrence rate in patients with choroidal hemangioma treated with limited single spot photodynamic therapy during long‐term follow‐up
Authors: Stehouwer Marilette , Schlingemann Reinier O. , Verbraak Frank D. 
Published: April 2020

AbstractPurposeTo evaluate the long‐term follow‐up of patients with a circumscribed choroidal hemangioma (CCH) treated with limited single spot photodynamic therapy (PDT) at the Amsterdam University Medical Center, location AMC (AUMC).MethodsThis cross‐sectional study included 17 patients, treated between 2001 and 2012. Evaluation included best corrected visual acuity, slitlamp examination, fundoscopy, ophthalmic ultrasonography (USG), fluorescein/indocyanine green angiography (FA/ICG), fundus autofluorescence (FAF) and optical coherence tomography (OCT). Primary outcome: recurrence rate, secondary outcomes: long‐term functional and structural changes.ResultsAn unexpected high recurrence rate of 35% (n6) was found with a mean follow‐up time between treatment and recurrence of almost 6 years, range 2.8–10.7 years. With a recurrence, the classical CCH pattern was no longer recognizable on FA or ICG. Signs of leakage were best observed with OCT, and the recurrence could be confirmed with USG. Retreatment with PDT of all recurrences was successful. After a successful initial PDT, the achieved visual acuity (VA) showed a small decrease over time, median VA from 0.10 LogMar to 0.15 LogMar (p 0.09) after a mean follow‐up of 11.36 years (range 5.1–15.5 years). During follow‐up study visit, the OCT revealed a slightly increased thickness of the choroid in 86% of cases at the site of the original tumour, without a clear correlation to the recurrences.ConclusionLimited single spot PDT is a safe and effective treatment for CCH preserving a good VA. However, because of the relatively high recurrence rate found in this study, we recommend regular follow‐up with OCT every 6 months.
Perioperative risk of bleeding with antithrombotic agents in macular surgery: a national, prospective, multicentre study
Authors: Louison Solenne , Gabrielle Pierre‐Henry , Soudry Agnès , Meillon Cyril , Blanc Julie , Béal Guillaume , Arsène Sophie , Le Mer Yannick , Berrod Jean‐Paul , Kodjikian Laurent , Creuzot‐Garcher Catherine ,   for the CFCR Research net
Published: April 2020

AbstractPurposeTo compare the risk of haemorrhagic complications in elective macular surgery between patients with no antithrombotic (AT) treatment (defined as patients with no history of AT therapy or who discontinued AT therapy) and patients who continued AT treatment during the surgery.MethodsE‐case report forms were prospectively recorded in a database before vitreoretinal surgery and 1 month after. Data on patient characteristics, surgical techniques, haemorrhagic complications and antithrombotic status were collected. Patients with retinal detachment, proliferative diabetic retinopathy and previous retinal haemorrhage were excluded.ResultsA total of 748 procedures (single procedure in one eye per patient) were performed between January and May 2019. Among them, 202 patients (27.0%) were treated with antithrombotic therapy at the time of surgery: 19.5% with antiplatelet agents (n = 146), 6.3% with anticoagulants (n = 47) including 3.2% (n = 24) patients treated with novel oral anticoagulants, 0.8% (n = 6) with anticoagulants and antiplatelet agents, and 0.4% (n = 3) with heparin. Overall, 92 patients (12.3%) developed one or more haemorrhagic complications, of which 63 (11.5%) and 29 (14.4%) were in the non‐AT and AT group, respectively. The multivariate logistic regression model showed no difference between AT treatment groups regarding ocular bleeding complications (odds ratio [OR] 1.2, 95% confidence interval (CI) [0.7–2.2], p = 0.54).ConclusionNo cases of uncontrolled or severe perioperative haemorrhage in patients continuing antithrombotic agents were reported in this selected population. For the majority of the patients taking antiplatelets or anticoagulants, these agents could be safely continued during macular surgery.
The network approach to assess the structure of knowledge: Storage, distribution and retrieval as three measures in analysing concept maps
Authors: Kapuza Anastasiya , Koponen Ismo T. , Tyumeneva Yulia 
Published: April 2020

AbstractWe present three new standardised network concept map (CM) measures that can provide unique information about learning‐related progress, which cannot be determined from previously known measures. Grounded in cognitive development theory on the one hand, and network theory on the other hand, our measures reveal how knowledge is stored, distributed and retrieved. We validated the new measures by testing their ability to discriminate between CMs of respondents with different levels of competency in statistics (students before and after taking an introductory statistics course and experts in the field of statistics). We also validated our measures against the most commonly used traditional and network measures. Based on a small sample of respondents, we show that two of the newly proposed compound measures reveal significant differences between experts and novices in the field, with higher values for experts, showing that expert knowledge is better distributed, more connected and balanced. More importantly, our measures were sensitive enough to show learning‐related progress for students, albeit statistically non‐significant, while common indicators from network theory did not demonstrate these small shifts. The validity of our new measures can be inferred from the consistency of the results from different sets of measures.Practitioner NotesWhat is already known about this topicA concept map (CM) is a knowledge assessment tool that can be used to evaluate student understanding of a topic and learning‐related progress.However, there has been a lack of standardised, complex and domain‐general CM metrics.Network theory has been shown to be useful in developing a standardised approach to CM evaluation.What this paper addsBased on the theory of cognitive development, we derived three standardised network measures of a CM: knowledge storage capacity, knowledge distributivity and knowledge retrieval.The new measures were empirically found to discriminate between groups of students with different levels of competency.Implications for practice and/or policyThe new measures provide unique information about learning‐related progress.The newly developed measures enable educational researchers to make more objective evaluations of individual map elements, while simultaneously allowing for a holistic view of the quality of the knowledge structure of students.
Synthesis, pharmacological evaluations, and molecular docking studies on a new 1,3,4,11b‐tetrahydro‐1H‐fluoreno[9,1‐cd]azepine framework: Rigidification of D1 receptor selective 1‐phenylbenzazepines and discovery of a new 5‐HT6 receptor scaffold
Authors: Giri Rajan , Alberts Ian , Harding Wayne W. 
Published: April 2020

AbstractThe novel 1,3,4,11b‐tetrahydro‐1H‐fluoreno[9,1‐cd]azepine framework, a structurally rigidified variant of the 1‐phenylbenzazepine template, was synthesized via direct arylation as a key reaction. Evaluation of the binding affinities of the rigidified compounds across a battery of serotonin, dopamine, and adrenergic receptors indicates that this scaffold unexpectedly has minimal affinity for D1 and other dopamine receptors and is selective for the 5‐HT6 receptor. The affinity of these systems at the 5‐HT6 receptor is significantly influenced by electronic and hydrophobic interactions as well as the enhanced rigidity of the ligands. Molecular docking studies indicate that the reduced D1 receptor affinity of the rigidified compounds may be due in part to weaker H‐bonding interactions between the oxygenated moieties on the compounds and specific receptor residues. Key receptor–ligand H‐bonding interactions, salt bridges, and π–π interactions appear to be responsible for the 5‐HT6 receptor affinity of the compounds. Compounds 10 (6,7‐dimethoxy‐2,3,4,11b‐tetrahydro‐1H‐fluoreno[9,1‐cd]azepine) and 12 (6,7‐dimethoxy‐2‐methyl‐2,3,4,11b‐tetrahydro‐1H‐fluoreno[9,1‐cd]azepine) have been identified as structurally novel, high affinity (Ki = 5 nM), selective 5‐HT6 receptor ligands.