bluuebunny/crossref_metadata_2025_split huggingface dataset:
Partial nephrectomy preserves renal function without increasing the risk of complications compared with radical nephrectomy for renal cell carcinomas of stages pT2–3a
Authors: Mühlbauer Julia , Kowalewski Karl‐Friedrich , Walach Margarete T , Porubsky Stefan , Wessels Frederik , Nuhn Philipp , Wagener Nina , Kriegmair Maximilian C 
Published: August 2020

ObjectivesTo compare the operative and functional result of partial and radical nephrectomy in renal cell carcinomas of stages pT2–3a.MethodsConsecutive patients with renal cell carcinoma of stages pT2–3a, cN0 and cM0, who underwent partial or radical nephrectomy between January 2005 and October 2019 at a tertiary care center were included. Data were collected retrospectively. End‐points included severe postoperative complications (Clavien–Dindo classification ≥3), acute and chronic renal function impairment, and overall survival. Uni‐ and multivariable outcome analyses were based on logistic regression.ResultsA total of 158 patients were included (110 radical nephrectomy and 48 partial nephrectomy). Over time, partial nephrectomy was increasingly used. A RENAL score ≥10 was the only independent predictor influencing the surgical approach (radical nephrectomy vs partial nephrectomy, odds ratio 8.62, 95% confidence interval 3.32–22.37, P < 0.001). No significant differences in complications for radical nephrectomy versus partial nephrectomy were found (12.7% vs 8.3%, P = 0.424). Renal function was better preserved in the partial nephrectomy group (the latest chronic kidney disease stage ≥3: radical nephrectomy 73% vs partial nephrectomy 41%, P = 0.005). The surgical approach was a significant factor for chronic kidney disease (odds ratio 51.07, 95% confidence interval 3.57–730.59, P = 0.004). Overall survival did not significantly differ between radical nephrectomy and partial nephrectomy (mean overall survival 85.86 months, 95% confidence interval 3.83–78.36 vs 81.28 months, 95% confidence interval 4.59–72.29, P = 0.702).ConclusionsIn selected patients, partial nephrectomy can be used in large or locally advanced renal cell carcinoma. Compared with radical nephrectomy, it allows better preservation of renal function without harboring an increased risk of severe postoperative complications.
Outcomes and anticoagulation use for elderly patients that present with an acute hip fracture: multi‐centre, retrospective analysis
Authors: Creeper Katherine , Stafford Andrew , Reynolds Sophie , Samida Sapna , P'Ng Stephanie , Glennon Denise , Seymour Hannah , Grove Carolyn 
Published: August 2020

AbstractBackgroundHip fractures are a common problem and corrective surgery is recommended within 24 h. However, most peri‐operative direct oral anticoagulant (DOAC) guidelines suggest a washout period of 48 h before major surgery. There are limited data on utility of drug levels.AimTo investigate the effect of DOAC therapy on time to surgery and patient outcomes, and to explore the impact of different pre‐operative protocols on surgical delay.MethodsA multi‐centre, retrospective analysis of all adult patients that presented with acute hip fracture at three tertiary hospitals in Perth, Western Australia, was performed. Data were collated from the West Australian hip fracture registry and electronic records. Time to theatre, DOAC levels, bleeding and transfusion rates were compared between sites.ResultsOf 1240 hip fracture patients, 146 (11.9%) were on anticoagulation, with more patients taking a DOAC than warfarin. The time to surgery was significantly longer for those on a DOAC compared with those on warfarin (P = 0.003). There was no difference in bleeding, transfusion requirement or 30‐day mortality in patients taking a DOAC compared to those on warfarin. Fifty‐eight (70.7%) patients had a DOAC level prior to surgery. Of 25 patients who had a level performed within 12 h of presentation, 13 (52%) had a result of ≤50 ng/mL. Outcomes were similar between sites.ConclusionPeople on DOAC treatment had a significant delay before corrective surgery compared with those on warfarin. The frequent finding of early DOAC levels <50 ng/mL suggests this delay may be unnecessary in a significant proportion of patients.
Critical peptic ulcer bleeding requiring massive blood transfusion: outcomes of 270 cases
Authors: Ket Shara N. , Sparrow Rosemary L. , McQuilten Zoe K. , Gibson Peter R. , Brown Gregor J. , Wood Erica M. 
Published: August 2020

AbstractBackgroundCritical peptic ulcer bleeding requiring massive transfusion is a gastroenterological emergency. Few data exist on management and outcomes. The Australian and New Zealand Massive Transfusion Registry collects comprehensive data on adult patients receiving massive transfusion across all bleeding contexts.AimTo evaluate clinical factors, management (procedural interventions, transfusions) and outcomes after massive transfusion for critical peptic ulcer bleeding.MethodDemographics, diagnosis, procedures and mortality data were available for 5482 massive transfusion cases from 23 hospitals. International Classification of Diseases 10th Edition, Australian Modification codes were used to determine peptic ulcer bleeding and the Australian Classification of Health Intervention for interventions (i.e. endoscopic, radiological, surgical).ResultsPeptic ulcer bleeding accounted for 270 (4.9%) of all in‐hospital massive transfusion cases; 70% were male. Median number of red blood cell (RBC) units transfused was 7 (interquartile range, 6–10). Thirty‐day mortality was 19.6%. Age (75 vs 67 years; P = 0.009) and Charlson Comorbidity Index (3 vs 1; P < 0.001) were higher in those who died. Highest 24‐h international normalised ratio (1.5 vs 1.4; P < 0.001) and creatinine (118 μmol/L vs 96 μmol/L; P = 0.03) and nadir platelet count (86 × 109/L vs 118 × 109/L; P = 0.01) were also associated with 30‐day mortality. There were no differences in mortality according to number of RBC, platelets or plasma units transfused, gastroscopy (with or without intervention), interventional radiology or surgery.ConclusionOne in five patients with critical peptic ulcer bleeding requiring massive transfusion died by 30 days. Mortality was associated with patient characteristics rather than clinical interventions (e.g. procedures, blood product transfusion).
Practical approach to vertigo: a synthesis of the emerging evidence
Authors: Rivlin Warwick , Habershon Courtney , Tsang Benjamin K.‐T. , Kaski Diego 
Published: August 2020

AbstractVestibular presentations are common in both the acute and recurrent setting, burdening emergency departments and community clinics alike. Commonly, an unease among the emergency or general physician is felt, and historically focus has been on gaining knowledge of each potential disease rather than honing the diagnostic process. Consequently, this paper focuses on the approach itself, helping to categorise this common complaint into one of four main syndromes: the Acute Vestibular Syndrome, Recurrent Positional Vertigo, Recurrent Spontaneous Vertigo, and Imbalance. Its simplicity is aimed to minimise uncertainty and highlight clear scenarios when to refer. Together with descriptions of the clinically relevant pathophysiology, the reader should approach the vertiginous patient with a new clarity.
Inactivated pandemic 2009 H1N1 influenza A virus human vaccines have different efficacy after homologous challenge in the ferret model
Authors: Vidaña Beatriz , Brookes Sharon M. , Everett Helen E. , Garcon Fanny , Nuñez Alejandro , Engelhardt Othmar , Major Diane , Hoschler Katja , Brown Ian H. , Zambon Maria 
Published: August 2020

AbstractBackgroundThe 2009 pandemic H1N1 (A(H1N1)pdm09) influenza A virus (IAV) has replaced the previous seasonal H1N1 strain in humans and continues to circulate worldwide. The comparative performance of inactivated A(H1N1)pdm09 influenza vaccines remains of considerable interest. The objective of this study was to evaluate the efficacy of two licensed A(H1N1)pdm09 inactivated vaccines (AS03B adjuvanted split virion Pandemrix from GlaxoSmithKline and referred here as (V1) and non‐adjuvanted whole virion Celvapan from Baxter and referred here as (V2)) in ferrets as a pre‐clinical model for human disease intervention.MethodsNaïve ferrets were divided into two groups (V1 and V2) and immunised intramuscularly with two different A/California/07/2009‐derived inactivated vaccines, V1 administered in a single dose and V2 administered in 2 doses separated by 21 days. Six weeks after the first immunisation, vaccinated animals and a non‐vaccinated control (NVC) group were intra‐nasally challenged with 106.5 TCID50 of the isolate A/England/195/2009 A(H1N1)pdm09 with 99.1% amino acid identity to the vaccine strain. Clinical signs, lung histopathology, viral quantification and antibody responses were evaluated.Results and ConclusionsResults revealed important qualitative differences in the performance of both inactivated vaccines in relation to protection against challenge with a comparable virus in a naive animal (ferret) model of human disease. Vaccine V1 limited and controlled viral shedding and reduced lower respiratory tract infection. In contrast, vaccine V2 did not control infection and animals showed sustained viral shedding and delayed lower respiratory infection, resulting in pulmonary lesions, suggesting lower efficacy of V2 vaccine.
A simheuristic algorithm for the stochastic permutation flow‐shop problem with delivery dates and cumulative payoffs
Authors: Villarinho Pedro A. , Panadero Javier , Pessoa Luciana S. , Juan Angel A. , Oliveira Fernando L. Cyrino 
Published: August 2020

AbstractThis paper analyzes the permutation flow‐shop problem with delivery dates and cumulative payoffs (whenever these dates are met) under uncertainty conditions. In particular, the paper considers the realistic situation in which processing times are stochastic. The main goal is to find the permutation of jobs that maximizes the expected payoff. In order to achieve this goal, the paper first proposes a biased‐randomized heuristic for the deterministic version of the problem. Then, this heuristic is extended into a metaheuristic by encapsulating it into a variable neighborhood descent framework. Finally, the metaheuristic is extended into a simheuristic by incorporating Monte Carlo simulations. According to the computational experiments, the level of uncertainty has a direct impact on the solutions provided by the simheuristic. Moreover, a risk analysis is performed using two well‐known metrics: the value‐at‐risk and conditional value‐at‐risk.
Ultralow dielectric loss in Y‐doped SrTiO3 colossal permittivity ceramics via designing defect chemistry
Authors: Wang Bo , Pu Yongping , Shi Yu , Guo Xu , Zhang Lei , Chang Liangliang , Li Jingwei , Li Run , Ji Jiamin , Wei Tianchen 
Published: August 2020

AbstractEffects of doping of Y and sintering atmosphere on the dielectric properties of Sr1‐1.5xYxTiO3 ceramics (SYT, x = 0‐0.014) were systematically investigated. The SYT14 (x = 0.014) ceramic sintered in N2 attains a colossal permittivity (CP, Ɛr = 28 084@ 1kHz, 27 685@ 2MHz) and an ultralow dielectric loss (tanδ = 0.007@ 1kHz, 0.003@ 2MHz) at room temperature. Because of using of the A‐site deficient, there are in SYT ceramics. Through the comprehensive analysis of dielectric responses, X‐ray photoelectron spectroscopy (XPS), electron paramagnetic resonance (EPR), and complex impedance data, it is proved that doping of Y promotes the formation of (Y3+ are located at Sr2+ site), (Y3+ are located at Ti4+ site), and Ti3+, and sintering in reducing atmosphere of N2 results in more (oxygen vacancy) and (strontium vacancy) generating in SYT ceramics. The defect dipoles, , , , , , and formed by introduced defects make charge carriers localized in SYT ceramics. The combined action of the massive defect dipoles is responsible for the ultralow tanδ and CP in SYT14 ceramics sintered in N2.
Genomic prediction of growth traits for pigs in the presence of genotype by environment interactions using single‐step genomic reaction norm model
Authors: Song Hailiang , Zhang Qin , Misztal Ignacy , Ding Xiangdong 
Published: August 2020

AbstractEconomically important traits are usually complex traits influenced by genes, environment and genotype‐by‐environment (G × E) interactions. Ignoring G × E interaction could lead to bias in the estimation of breeding values and selection decisions. A total of 1,778 pigs were genotyped using the PorcineSNP80 BeadChip. The existence of G × E interactions was investigated using a single‐step reaction norm model for growth traits of days to 100 kg (AGE) and backfat thickness adjusted to 100 kg (BFT), based on a pedigree‐based relationship matrix (A) or a genomic–pedigree joint relationship matrix (H). In the reaction norm model, the herd‐year‐season effect was measured as the environmental variable (EV). Our results showed no G × E interactions for AGE, but for BFT. For both AGE and BFT, the genomic reaction norm model (H) produced more accurate predictions than the conventional reaction norm model (A). For BFT, the accuracies were greater based on the reaction norm model than those based on the reduced model without exploiting G × E interaction, with EV ranging from 0.5 to 1, and accuracy increasing by 3.9% and 4.6% in the reaction norm model based on A and H matrices, respectively, while reaction norm model yielded approximately 8.4% and 7.9% lower accuracy for EVs ranging from 0 to 0.4, based on A and H matrices, respectively. In addition, for BFT, the highest accuracy was obtained in the BJLM6 farm for realizing directional selection. This study will help to apply G × E interactions to practical genomic selection.
Successful integration of a three‐dimensional transthoracic echocardiography‐derived model with an electroanatomic mapping system to guide catheter ablation of WPW
Authors: Janson Christopher M. , Nam Hannah H. , Herz Christian , Lasso Andras , Cianciulli Alana , Jolley Matthew A. 
Published: August 2020

AbstractThree‐dimensional transthoracic echocardiography (3DE)‐derived heart models have not previously been utilized to guide catheter ablation. In this case report, we describe the creation of a 3DE model from transthoracic echocardiography, import of the model into CARTO3, and successful use of the model as a guide during mapping and ablation of a right lateral accessory pathway. We believe this technique represents a valuable alternative to the integration of computed tomography or magnetic resonance imaging‐derived anatomic data, and that it has the potential to improve the definition of the atrioventricular valve annuli during catheter ablation of accessory pathways.
Ventricular asystole in the presence of a biventricular device
Authors: Karki Roshan , Lloyd James , Mulpuru Siva K. , Asirvatham Samuel J. , DeSimone Christopher V. 
Published: August 2020

AbstractIn pacemaker‐dependent patients with a newly implanted cardiac device, acute lead dislodgement constitutes one of the most common causes of loss of capture and ventricular asystole. In a biventricular system, it would be expected that such a potentially catastrophic event would be prevented with back‐up right ventricular pacing unless both leads dislodge.
Factors associated with silent cerebral events during atrial fibrillation ablation in patients on uninterrupted oral anticoagulation
Authors: Harada Masahide , Motoike Yuji , Nomura Yoshihiro , Nishimura Asuka , Koshikawa Masayuki , Murayama Kazuhiro , Ohno Yoshiharu , Watanabe Eiichi , Ozaki Yukio , Izawa Hideo 
Published: August 2020

AbstractIntroductionSilent cerebral events (SCEs) are related to the potential thromboembolic risk in atrial fibrillation (AF) ablation. Periprocedural uninterrupted oral anticoagulation (OAC) reportedly reduced the risk of SCEs, but the incidence still remains.Methods and ResultsAF patients undergoing catheter ablation were eligible. All patients took non–vitamin K antagonist oral anticoagulants (NOACs; n = 248) or vitamin K antagonist (VKA; n = 37) for periprocedural OAC (>4 weeks) without interruption during the procedure. Brain magnetic resonance imaging was performed within 2 days after the procedure to detect SCEs. Clinical characteristics and procedure‐related parameters were compared between patients with and without SCEs. SCEs were detected in 66 patients (23.1%; SCE[+]) but were not detected in 219 patients (SCE[−]). Age was higher in SCE[+] than in SCE[−] (66 ± 10 vs. 62 ± 12 years; p < .05). Persistent AF prevalence, CHADS2/CHA2DS2‐VASc scores, serum NT‐ProBNP levels, left atrial dimension (LAD), and spontaneous echo contrast prevalence in transesophageal echocardiography significantly increased in SCE[+] versus SCE[−]. SCE[+] had lower baseline activated clotting time (ACT) before heparin injection and longer time to reach optimal ACT (>300 s) than SCE[−] (146 ± 27 vs. 156 ± 29 s and 44 ± 30 vs. 35 ± 25 min; p < .05, respectively). In multivariate analysis, age, LAD, baseline ACT, and time to reach the optimal ACT were predictors for SCEs. The average values of the ACT parameters were significantly different among NOACs/VKA.ConclusionAge, LAD, and intraprocedural ACT kinetics significantly affect SCEs during AF ablation. Different anticoagulants have different impacts on ACT during the procedure, which should be considered when estimating the risk of SCEs.
Tacrolimus ameliorates tubulointerstitial inflammation in diabetic nephropathy via inhibiting the NFATc1/TRPC6 pathway
Authors: Zhang Shumin , Wang Huafen , Liu Yifei , Yang Wenxia , Liu Jialu , Han Yuzhang , Liu Yu , Liu Fuyou , Sun Lin , Xiao Li 
Published: August 2020

AbstractTubulointerstitial inflammation is crucial for the progression of diabetic nephropathy (DN), and tubular cells act as a driving force in the inflammatory cascade. Emerging data suggested that tacrolimus (TAC) ameliorates podocyte injury and macrophage infiltration in streptozotocin (STZ) mice. However, the effect of TAC on tubulointerstitial inflammation remains unknown. We found that albuminuria and tubulointerstitial damage improved in db/db mice treated with TAC. Macrophage infiltration and expression of IL‐6, TNF‐α, fibronectin, collagen 1 and cleaved caspase 3 were inhibited as well. In addition, the expression of nuclear factor of activated T cell 1 (NFATc1) and transient receptor potential channel 6 (TRPC6) was up‐regulated in the kidneys of DN patients and correlated with tubular injury and inflammation. The expression of NFATc1 and TRPC6 also increased in the kidneys of db/db mice and HK‐2 cells with high glucose (HG), while TAC inhibited these effects. HG‐induced inflammatory markers and apoptosis were reversed by TAC and NFATc1 siRNA in HK‐2 cells, which was abolished by TRPC6 plasmid. Furthermore, HG‐induced TRPC6 expression was inhibited by NFATc1 siRNA, while NFATc1 nuclear translocation was inhibited by TAC, but was restored by TRPC6 plasmid in HK‐2 cells under HG conditions. These findings suggest that TAC ameliorates tubulointerstitial inflammation in DN through NFATc1/TRPC6 feedback loop.
Evidence of mesenchymal stromal cell adaptation to local microenvironment following subcutaneous transplantation
Authors: Preda Mihai Bogdan , Lupan Ana‐Mihaela , Neculachi Carmen Alexandra , Leti Livia Ioana , Fenyo Ioana Madalina , Popescu Sinziana , Rusu Evelyn Gabriela , Marinescu Catalina Iolanda , Simionescu Maya , Burlacu Alexandrina 
Published: August 2020

AbstractSubcutaneous transplantation of mesenchymal stromal cells (MSC) emerged as an alternative to intravenous administration because it avoids the pulmonary embolism and prolongs post‐transplantation lifetime. The goal of this study was to investigate the mechanisms by which these cells could affect remote organs. To this aim, murine bone marrow–derived MSC were subcutaneously transplanted in different anatomical regions and the survival and behaviour have been followed. The results showed that upon subcutaneous transplantation in mice, MSC formed multicellular aggregates and did not migrate significantly from the site of injection. Our data suggest an important role of hypoxia‐inducible signalling pathways in stimulating local angiogenesis and the ensuing modulation of the kinetics of circulating cytokines with putative protective effects at distant sites. These data expand the current understanding of cell behaviour after subcutaneous transplantation and contribute to the development of a non‐invasive cell‐based therapy for distant organ protection.
Modification of reproductive schedule in response to pathogen exposure in a wild insect: Support for the terminal investment hypothesis
Authors: Zurowski Kari , Janmaat Alida F. , Kabaluk Todd , Cory Jenny S. 
Published: August 2020

AbstractTrade‐offs in the time and energy allocated to different functions, such as reproductive activities, can be driven by alterations in condition which reduce resources, often in response to extrinsic factors such as pathogens or parasites. When individuals are challenged by a pathogen, they may either reduce reproduction as a cost of increasing defence mechanisms or, alternatively, modify reproductive activities so as to increase fecundity thereby minimizing the fitness costs of earlier death, a behaviour consistent with the terminal investment hypothesis (TIH). The TIH predicts that individuals with decreased likelihood of future reproduction will maximize current reproductive effort, which may include shifts in reproductive timing. We examined how wild, adult female click beetles (Agriotes obscurus) responded after exposure to the fungal pathogen Metarhizium brunneum. Field‐collected beetles exposed to a high concentration of M. brunneum died earlier and in greater numbers than those exposed to a low concentration. Using a multivariate approach, we examined the impact of pathogen challenge on lifespan and a suite of reproductive traits. Stepdown regression analysis showed that only female lifespan differed among the fungal treatments. Fungal‐induced reductions in lifespan drove changes in the reproductive schedule, characterized by a decrease in preoviposition period. Moving the start of egg laying forward allowed the females to offset the costs of a shortened lifespan. These changes suggest that there is a threshold for terminal investment, which is dependent on strength of the survival threat. From an applied perspective, our findings imply that exposing adult click beetles to M. brunneum to reduce their population density might not succeed and is an approach that needs further investigation.