bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Lumen-Apposing Metal Stents (LAMS) in the Management of Gastro Jejunostomy Stricture Following Roux En Y Gastric Bypass for Obesity.
Authors: Skidmore Adam Peter 
Published: April 2021

Abstract
Background Chronic strictures following Roux en Y Gastric Bypass (RYGB) are a troublesome complication that can lead to significant morbidity. The use of stents has been described but the need for X-ray and risk of migration have meant limited use in the management of these strictures. Lumen apposing metal stents (LAMS) have traditionally been used for management of pancreatic pseudocysts. They don’t require X-ray and are easy to deploy with a short learning curve. This paper explores the use of LAMS to treat post RYGB strictures and explores their safety and efficacy.MethodsA prospective study over a 4-year period looking at 14 patients with post RYGB strictures. These patients have been followed up for between 1 and 3 years. We have prospectively collected data on the efficacy and safety of LAMS in these patientsResults421 patients underwent RYGB in the study period. 14 of these patients developed a stricture that resulted in insertion of LAMS. There was no immediate complications and 12 patients had complete resolution of their stricture. There were no migration related issues.ConclusionLAMS are a safe and effective method to manage post RYGB strictures. They have a high rate of resolution of strictures and can be safely deployed across strictures with no immediate complication. Migration does not appear to be a problem. Insertion is straightforward and doesn’t appear to be associated with a long learning curve.
Teacrine Does Not Enhance Physical Performance or Training Status Over 8 Weeks
Authors: Cerqueira Henrique Santa Capita , Filho Hugo Tourinho , Junior Marcos Corrêa , Junior Carlos Eduardo Martinelli 
Published: April 2021

Abstract
Background: Fatigue is a condition that may affect physical performance during training sessions. Consequently, this will impact training performance, moreover in the performance of the individual in long-term. Caffeine is broadly utilized to this purpose, however contains several side effects. Thus, teacrine emerges as an alternative to the use of caffeine, providing the same benefits without the side effects. Thus, the current work had as an objective to investigate the effects of 8 weeks of supplementation with teacrine on physical performance and the training status of young amateur athletes. Methods: 22 subjects were divided into two groups – Teacrine Group (T) and Placebo Group (P) – and evaluated before and after the intervention period. Evaluations included physical tests and hormonal doses of IGF-I and IGFBP-3, utilized as markers of training status. Results: Results demonstrated that teacrine was not capable of promoting benefits in relation to physical performance of the subjects. Neither produced effects on serum secretion of IGF-I and its binding protein, IGFBP-3.Conclusion: Therefore, the findings of the present study do not support the use of teacrine for the purpose of increasing physical performance.
Intratumoral Administration of Astatine-211-labeled Gold Nanoparticle for Alpha Therapy
Authors: Kato Hiroki , Huang Xuhao , Kadonaga Yuichiro , Katayama Daisuke , Ooe Kazuhiro , Shimoyama Atsushi , Kabayama Kazuya , Toyoshima Atsushi , Shinohara Atsushi , Hatazawa Jun , Fukase Koichi 
Published: April 2021

Abstract
Background: 211At is a high-energy α-ray emitter with a relatively short half-life and a high cytotoxicity for cancer cells. Its dispersion can be imaged using clinical scanners, and it can be produced in cyclotrons without the use of nuclear fuel material. This study investigated the biodistribution and the antitumor effect of 211At-labeled gold nanoparticles (211At-AuNP) administered intratumorally.Results: AuNP with a diameter of 5, 13, 30, or 120 nm that had been modified with poly (ethylene glycol) methyl ether (mPEG) thiol and labeled with 211At (211At-AuNP-S-mPEG) were incubated with tumor cells, or intratumorally administered to C6 glioma or PANC-1 pancreatic cancers subcutaneously transplanted into rodent models. Systemic and intratumoral distributions of the particles in the rodents were then evaluated using scintigraphy and autoradiography, and the changes in tumor volumes were followed for about 40 days. 211At-AuNP-S-mPEG was cytotoxic when it was internalized by the tumor cells. After intratumoral administration, 211At-AuNP-S-mPEG became localized in the tumor and did not spread to systemic organs during a time period equivalent to 6 half-lives of 211At. Tumor growth was strongly suppressed for both C6 and PANC-1 by 211At-AuNP-S-mPEG. In the C6 glioma model, the strongest antitumor effect was observed in the group treated with 211At-AuNP-S-mPEG with a diameter of 5 nm. Conclusions: The intratumoral single administration of a simple nanoparticle, 211At-AuNP-S-mPEG, was shown to suppress the growth of tumor tissue strongly in a particle size-dependent manner without radiation exposure to other organs caused by systemic spread of the radionuclide.
Changes in immune Cell Types in Breast Suggest a Decline in Immune Surveillance and Increased Immunosuppression with Age
Authors: Zirbes Arrianna , Joseph Jesuchristopher , Lopez Jennifer C , Sayaman Rosalyn W , Basam Mudaser , Seewaldt Victoria L , LaBarge Mark A 
Published: April 2021

Abstract
Background : A majority of breast cancers (BC) are age-related and we seek to determine what cellular and molecular changes occur in breast tissue with age that make women more susceptible to cancer initiation. Immune-epithelial cell interactions are important during mammary gland development and the immune system plays an important role in BC progression. The composition of human immune cell populations is known to change in peripheral blood with age and in breast tissue during BC progression. Less is known about changes in immune populations in normal breast tissue and how their interactions with mammary epithelia change with age. Methods : We quantified densities of T cells, B cells, and macrophage subsets in pathologically normal breast tissue from 122 different women who ranged in age from 24 to 74 years old. Donor-matched peripheral blood from a subset of 20 donors was analyzed by flow cytometry. Tissue immune cell densities and localizations relative to the epithelium were quantified in situ with machine learning-based analyses of multiplex immunohistochemistry-stained tissue sections. In situ results were corroborated with flow cytometry analyses of peri-epithelial immune cells from primary organoid preparations and transcriptome analyses of public data from bulk tissue reduction mammoplasties. Results : Proportions of immune cell subsets in breast tissue and donor-matched peripheral blood were not correlated. Density (cells/mm 2 ) of T and B lymphocytes in situ decreased with age. T cells and macrophages preferentially localized near or within epithelial bilayers, rather than the intralobular stroma. M2:M1 macrophage ratio increased with age and was accompanied by an increased density of M2 in the intralobular stroma. Transcriptional signature analyses suggested age-dependent decline in adaptive immune cell populations and functions and increased innate immune cell activity. Conclusions : T cells and macrophages are so intimately associated with the epithelia that they are embedded within the bilayer, suggesting an important role for immune-epithelial cell interactions. Age-associated decreased T cell density in peri-epithelial regions, and increased M2 macrophage density in intralobular stroma suggests the emergence of a tissue microenvironment that is simultaneously immune-senescent and immunosuppressive with age .
Biogeochemical Feedbacks to Ocean Acidification in a Cohesive Photosynthetic Sediment
Authors: Vopel Kay , Marshall Alexis , Brandt Shelly , Hartland Adam , Lee Charles K , Cary S. Craig , Pilditch Conrad A 
Published: April 2021

Abstract
Ecosystem feedbacks in response to ocean acidification can amplify or diminish the diel pH oscillations that characterize productive coastal waters. We report that benthic microalgae generate such oscillations in the porewater of cohesive sediment and ask how carbonation (acidification) of the overlying seawater alters these in the absence and presence of biogenic calcite. To do so, we placed a 1-mm layer of ground oyster shells (Treatment) or sand (Control) onto intact sediment cores free of large dwelling fauna, and then gradually increased the pCO2 in the seawater above half of the Treatment and Control cores from 472 to 1216 μatm (pH 8.0 to 7.6, CO2:HCO3- from 4.8 to 9.6 x 10-4). Vertical porewater [O2] and [H+] microprofiles measured 16 d later showed that this carbonation had decreased O2 penetration in all cores, indicating a metabolic response. In carbonated seawater: (1) sediment biogeochemical processes added and removed more H+ to and from the porewater in darkness and light, respectively, than in ambient seawater increasing the amplitude of the dark–light porewater [H+] oscillations, and (2) the dissolution of calcite decreased the porewater [H+] below that in overlying seawater, reversing the dark sediment–seawater H+ flux and decreasing the amplitude of diel [H+] oscillations. This dissolution did not, however, counter the negative effect of carbonation on sediment O2 penetration. We hypothesise that the latter effect and the observed enhanced acidification of the sediment porewater were caused by an ecosystem feedback: a CO2-induced increase in the microbial reoxidation of reduced solutes with O2.
Initial combination therapy with macitentan and tadalafil in pulmonary arterial hypertension: a retrospective cohort study
Authors: Marinescu Daniel , Christiansen David , Thenganatt John , Granton John Thomas 
Published: April 2021

Abstract
Purpose: Initial combination therapy with ambrisentan and tadalafil has been demonstrated superior to either agent alone in pulmonary arterial hypertension (PAH). More recently, the OPTIMA trial showed efficacy of another combination of endothelin receptor antagonist and phosphodiesterase 5-inhibitor, macitentan and tadalafil, as initial therapy for PAH. The objective of this study was to assess the effectiveness, tolerability, and safety of macitentan and tadalafil in a real-world clinical setting.Methods: This single centre, retrospective cohort study identified adult patients newly diagnosed with PAH between January 2014 and December 2017 who were started on macitentan and tadalafil. Patients were retrospectively followed for one year. Effectiveness was evaluated via change from baseline in disease risk profile based on a validated score incorporating World Health Organization functional class, 6-minute walk distance (6MWD), B-type natriuretic peptide (BNP), and hemodynamics on follow-up right heart catheterization. Secondary endpoints included change in 6MWD, BNP, and hemodynamic variables. Drug tolerability and adverse events were assessed.Results: The cohort included 46 patients, 8 of whom (17%) did not tolerate and discontinued either macitentan or tadalafil. Median time to follow-up was 161 days (IQR 72). 42% of patients with an initially moderate or high risk disease profile improved to low risk. Secondary endpoints showed a reduction in the geometric mean of pulmonary vascular resistance of 45% (95% CI 29, 57%) and improvement in 6MWD of 88m (95% CI 27, 148m).Conclusion: In a real-world setting, macitentan and tadalafil as initial combination therapy for PAH was well tolerated and yielded clinical benefit.
Adaptive Parameter Modulation of Deep Brain Stimulation in a Computational Model of Basal Ganglia-thalamic Network
Authors: Zhu Yulin , Wang Jiang , Chang Siyuan , Li Huiyan , Deng Bin , Liu Chen 
Published: April 2021

Abstract
Deep brain stimulation (DBS) has proven to be an effective treatment for Parkinson’s disease (PD). Adaptive control strategies offer the potential to improve efficacy, limit side effects and save battery consumption via reducing the total amount of stimulation delivered. However, the mechanisms underlying the beneficial effects of DBS for PD remain poorly understood and are still under debate, which has hindered the development of closed-loop DBS. And during the chronically implanted phase, adaptive DBS needs to be further improved to maintain its advantages. In the design of new adaptive DBS, more insights into inaccuracies when establishing mathematical basal ganglia model, unknown external disturbance signal and dynamics of focal area should be considered. A controlled auto-regressive moving average is used as the representative description of stimulus-response relationship based on recursive extended least square method, where stimulation signal is applied to subthalamic nucleus (STN) and the feedback signal is selected as local field potential signal from globus pallidus (GPi). The generalized minimum variance algorithm is used for online update of stimulation frequency and amplitude in a closed-loop manner. Simulation results illustrated the efficiency of the proposed closed-loop stimulation methods in disrupting the aberrant beta band oscillation and restore normal firing pattern when compared with the PD state. Robustness of the adaptive algorithm was further verified through dynamic change of illness state.
Material Removal Rate of Double-faced Mechanical Polishing of 4H-SiC Substrate
Authors: Zhang Peng , Yang Jingfang , Qiu Huadong 
Published: April 2021

Abstract
Silicon carbide (SiC) has been a promising the-third-generation semiconductor power device material for high-power, high-temperature, substrate applications. It aims to improve the material removal rate (MRR), on the premise of ensuring the surface roughness requirements of the double-faced mechanical polishing of 6-inch SiC substrate. To obtain the relationship between any point on SiC substrate and polishing pads, the model about double-faced mechanical polishing has been built and the kinematics equations were created. Best optimized material removal rate parameters were obtained. MRR reached the maximum when speed rate of the outside ring gear to the inside sun gear m=-1, speed rate of lower plate to the inside sun gear n=5, SiC substrate distribution radius RB=75. The primary and secondary order of MRR (n>m>RB) was obtained. An accurate mathematical model of orthogonal rotary regression test of Tri-factor quadratic of MRR was established and the regression model was significant. Surface quality of SiC substrate was observed and characterized with SEM and AFM. It greatly provides a key guarantee for the next process of CMP, confirmed the importance of MRR to ultra-smooth polishing, and provides a guarantee for its application in semiconductor equipment and technology.
The effect of N-acetyl cysteine injection on renal function after coronary artery bypass graft surgery : A randomized clinical trial
Authors: Zadeh Fatemeh Javaherforoosh , Shaker Zahra , Rashidi Mahboobeh , Akhondzadeh Reza , Hayati Fatemeh 
Published: April 2021

Abstract
Objective: This study aimed to compare the effects of N-acetyl cysteine on renal function after coronary artery bypass graft surgery.Method: In this randomized clinical trial conducted in Golestan Hospital, Ahvaz, Iran, 60 candidates for coronary artery bypass graft surgery were selected and divided into two N-acetyl cysteine and control groups (30 people each).Intervention: Patients received 3 (2 intraoperative and 1 postoperative) doses of IV N-acetyl cysteine (100 mg/kg) (n=30) or placebo (n=30) over 24 hour. Prescription times were as follows: after induction of anesthesia, in the Next 4 hours, and in the 16 hours after on. Primary outcomes were serum levels of BUN and Cr, at baseline,4 and 48 hours after surgery. And also need renal replacement therapy (RRT). Secondary outcomes included the hemodynamic variables, Blood products transfusionResults: There were significant differences in BUN between groups at 4 h (P= 0.02) and 48h after surgery (P=0.001) There were significant differences in Cr level between groups at 4 h (P <0.001) and 48h after surgery (P=0.001). MAP at different times (at 4h p=0.002 and 48h after surgery P<0.001) were significantly different between the two groups. There was a significant difference between the two groups in terms of the unit of Packed cell transfusion (P=0.002) and FFP transfusion (P<0.001).Conclusion: In the present study, we found that administration of N-acetyl cysteine can reduce the incidence of acute kidney injury in patients undergoing coronary artery bypass graft surgery and improved kidney functions.Trial registry: IRCT20190506043492N3 Registered at 2020.06.07
Bilirubin Adsorption Versus Plasma Exchange for Hyperbilirubinemia in Patients After Cardiac Surgery: A Retrospective Study
Authors: Kan Ke , Zhang He , Zhong Kai , Zhang Haitao , Li Zeshi , Chen Zhong , Gu Suping , Xie Man , Pan Tuo , Cao Hailong , Wang Dongjin 
Published: April 2021

Abstract
Objective: Hyperbilirubinemia after cardiac surgery increases in-hospital mortality and is associated with poor prognosis. Our present study aimed to compare the efficacy of bilirubin adsorption (BA) and plasma exchange (PEX) in patients with hyperbilirubinemia after cardiac surgery.Methods: We retrospectively included patients who underwent BA treatment or PEX treatment due to severe hyperbilirubinemia after cardiac surgery in our center from 2015 to 2020. We collected examinations of urine and liver function before and after treatment and compared the in-hospital mortality and morbidity between two treatment groups. Results: A total of 56 patients were enrolled in this study, 14 patients received BA treatment and 42 patients received PEX treatment. BA group provided a statistically significant reduction in the TBil (p=0.016) and DBil (p=0.036) compared to PEX group. The in-hospital mortality was 85.7% (48/56) in the whole group, BA group had lower mortality than PEX group (71.4% vs. 90.5%, p=0.078). BA group showed better circulatory support, including lower risks of IABP (21.4% vs. 52.4%, p=0.044), ECMO (21.4% vs. 50.0%, p=0.061), re-intubation (64.3% vs. 40.5%, p=0.122) and ventricular arrhythmias (64.3% vs. 45.2%, p=0.217). The in-hospital mortality was still lower in BA treatment group than PEX treatment group (71.4% vs. 100%, p=0.049) in matched cohort.Conclusions: BA treatment had higher removal ability of bilirubin in patients with hyperbilirubinemia and could reduce the mortality and risks of poor clinical outcomes compared to PEX treatment. BA treatment should be considered as an effective treatment method for patients with higher TBil level or Dbil level.
Associations Between The Spiritual Well-Being (EORTC QLQ-SWB32) and Quality of Life (EORTC QLQ-C30) of Patients Receiving Palliative Care for Cancer in Cyprus
Authors: Kyranou Maria , Nicolaou Marianna 
Published: April 2021

Abstract
Background: Spiritual well-being is increasingly investigated in relation to patients’ perceived quality of life and is generally thought as having the potential to support patients with cancer who receive palliative care. Until recently, questionnaires used to assess spiritual well-being were developed mainly in the US. The purpose of this study was to translate and use the EORTC- SWB32, a newly developed tool, validated recently in 4 continents, 14 countries, and in 10 languages, to explore relationships of spiritual well-being with quality of life in patients with cancer.Methods: One hundred four patients participated in this study with an average age of 59 years. Of those, 79% were dealing with metastatic cancer. Data collection took place in three oncology centers from two large cities in Cyprus. The acceptability of the translated items was tested. Two questionnaires were employed for the assessment of quality of life and spiritual well-being, developed by the same organization: the EORTC QLQ-C30 and the EORTC QLQ-SWB32. The scores for each tool were analyzed separately and correlations between the two measures were explored. Results: Patients found the items of the SWB32 tool easy to understand and answer. They attested that filling the questionnaire prompted thoughts about their own spirituality. The mean score for Global Spiritual Well-Being was 60.4 (SD=23.7) and it was associated with the mean scores in the scales “Emotional functioning” and “Cognitive functioning” of the EORTC-QOL-C30 (0.42 and 0.40 respectively, p<0.01). The mean score for the “Relationship with God” scale (74.9, SD=29.7) reported by the Cypriot patients is high and compatible with the homogenous spiritual orientation of the island’s population.Conclusions: All subscales of the SWB32 tool demonstrated good internal consistency in this study. Significant associations were observed between dimensions of quality of life and spiritual well-being. Additionally, the participants found the items easy to answer consistent with the tool’s suggested clinical utility which lays the ground for the application of targeted interventions to enhance spiritual well-being.
Sex-Specific Differences and How to Handle Them in Early Psoriatic Arthritis
Authors: Passia Evangelia , Vis Marijn , Coates Laura , Soni Anuska , Tchetverikov Ilja , Gerards Andreas , Kok Marc , Vos Petra , Korswagen Lindy-Ann , Fodili Fouzia , Ruiterman Yvonne , Kaap Jos van der , Oosterhout Maikel van , Luime Jolanda 
Published: April 2021

Abstract
Objectives:The prevalence of Psoriatic Arthritis (PsA) is the same in men and women, however, the latter experience a higher burden of disease and are affected more frequently by polyarthritis. Here, we performed an early PsA cohort analysis to assess sex-related differences in demographics, disease characteristics and evolution over 1 year including applied treatment strategies. Methods:Our study is embedded in the Dutch south-west Early Psoriatic Arthritis cohoRt. We described patient characteristics and treatment decisions. For the comparison across sexes and baseline and 1 year follow up, appropriate tests depending on the distribution were used. Results:273 men and 294 women with no significant differences in age and ethnicity were included. Women reported significantly longer duration of symptoms before diagnosis and significantly higher tender joint count, a higher disease activity, higher levels of pain and lower functional capacity. Although minimal disease activity (MDA) rates increased over time for both sexes, MDA remained significantly more prevalent among men at one year (58.1% vs 35.7%, p<0.00). Initially, treatment strategies were similar in both sexes with Methotrexate being the most frequently used drug during the first year. Women received Methotrexate for a shorter period [196(93-364) vs 306(157-365), p<0.00] and therefore received a lower cumulative dose compared to men. Retention time was shorter for all DMARDs and women had a delayed start on b-DMARDs. Conclusion:After 1 year of standard-of-care treatment women didn’t surpass their baseline disadvantages. Despite the overall improvement, they still presented higher disease activity, higher levels of pain and lower functional capacity score than men. The nature of these findings may advocate a need for sex specific adjustment of treatment strategies and evaluation in early PsA patients.