bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complete percutaneous angio-guided approach using preclosing for venoarterial extracorporeal membrane oxygenation implantation and explantation in patients with refractory cardiogenic shock or cardiac arrest
Authors: Martin-Tuffreau Anne-Sophie , Bagate François , Boukantar Madjid , Saiydoun Gabriel , Mangiameli Andrea , Rostain Laura , Mouillet Gauthier , Fiore Antonio , Langeron Olivier , Mekontso-Dessap Armand , Mongardon Nicolas , Folliguet Thierry , Teiger Emmanuel , Gallet Romain 
Published: March 2021

Abstract
Background
The approach for veno-arterial extracorporeal membrane oxygenation implantation (VA-ECMO) in patients with cardiogenic shock can be either surgical or percutaneous. Complete angio-guided percutaneous implantation and explantation could decrease vascular complications. We sought to describe the initial results of complete percutaneous angio-guided ECMO implantation and explantation using preclosing.

Methods
All consecutive patients who underwent peripheral femoro-femoral VA-ECMO percutaneous implantation for refractory cardiogenic shock or cardiac arrest were enrolled in a prospective registry (03/2018–12/2020). Percutaneous preclosing using two closing devices (Perclose ProGlide, Abbott) inserted before cannulation was used in both femoral artery and vein. Explantation was performed using a crossover technique under angiographic guidance. The occurrence of vascular complication was recorded.

Results
Among the 56 patients who underwent percutaneous VA-ECMO implantation for cardiogenic shock or refractory cardiac arrest, 41 underwent preclosing. Femoral vessel cannulation was successful in all patients and total cannulation time was 20 (10–40) min. Weaning from ECMO was possible in 22/41 patients (54%) and 12 (29%) patients were alive at day 30. Significant vascular complications occurred in 2/41 patients. Percutaneous decannulation was performed in 20 patients with 19/20 technical success rate. All femoral arteries and veins were properly closed using the pre-closing devices without bleeding on the angiographic control except for one patient in whom surgical closure of the artery was required. No patient required transfusion for access related significant bleeding and no other vascular complication occurred. Furthermore, no groin infection was observed after full percutaneous implantation and removal of ECMO.

Conclusion
Emergent complete percutaneous angio-guided VA-ECMO implantation and explantation using pre-closing technique can be an attractive strategy in patients referred for refractory cardiogenic shock.
Dichotomic response to interleukin-6 blockade in idiopathic multicentric Castleman disease: two case reports
Authors: Ferrero Simone , Ragaini Simone 
Published: March 2021

Abstract
Background
Human herpervirus-8/human immunodeficiency virus negative Idiopathic multicentric Castleman disease (iMCD) is a lymphoproliferative disorder sustained by a pro-inflammatory condition of hypercytokinemia mostly mediated by Interleukin-6 (IL-6). According to iMCD consensus guidelines, anti-IL-6 blockade should be the first-line therapy for iMCD. However, despite the existing therapeutic alternatives, a large proportion of iMCD patients still lacks an effective therapy.

Case presentation
Here, we report two real-life iMCD cases with a different response to IL-6 blockade. The first presented patient obtained a prompt resolution of symptoms and a complete regression of adenopathies after IL-6 blockade therapy administration. Conversely, the second patient did not respond neither to Rituximab and Etoposide association nor to IL-6 blockade therapy (both Siltuximab and Tocilizumab). Furthermore, Intravenous immunoglobulin, Cyclosporine A, Sirolimus and anti-Interleukin-1 Anakinra were all attempted without any results. Since no treatment was successful, after a further confirmation of iMCD diagnosis by a second lymph node biopsy, patient has been candidate for thalidomide, cyclophosphamide and prednisone association therapy.

Conclusions
The iMCD cases we reported are coherent with the evidences that IL-6 blockade is a safe and an effective therapy for iMCD. Despite this, more than half of patients do not respond to anti IL-6 drugs. In such cases, therapeutic alternatives could be represented by Sirolimus, targeting PI3K/AKT/mTOR signaling or by associations of conventional drugs such as thalidomide, cyclophosphamide and prednisone. However, the two reported iMCD cases, confirm the need to more deeply investigate iMCD pathogenesis and to better dissect the heterogeneity of the disease in order to develop novel, effective therapeutic strategies.
Social support and strain and emotional distress among Latinos in the northeastern United States
Authors: Lerman Ginzburg Shir , Lemon Stephenie C. , Romo Eric , Rosal Milagros 
Published: March 2021

Abstract
Background
US Latinos report high levels of emotional distress. Having positive familial and friend social support buffers emotional distress among US Latinos, but thus far no research has been done on social support and ataque de nervios in that population, or on social strain and emotional distress.

Methods
This paper assesses social support and strain across three relationship types (partner, family, and friends) with three measures of emotional distress (depression, anxiety, and ataque de nervios). The sample for partner, family, and friend support included 508 Latino adults 21 and older. Multivariate logistic regression models were used to assess the association of social support and strain with each outcome.

Results
As all social support types increased, the odds of emotional distress symptoms decreased. Conversely, as each unit of partner and family strain increased, the odds of emotional distress symptoms increased. Increased friend strain was associated with greater odds of depressive and anxiety symptoms only.

Conclusion
Social support in all three network types (partner, family, and friend) was associated with a decrease in the odds of emotional distress, assessed as symptoms of depression, anxiety, and ataque de nervios.
Oil spill discrimination of multi-time-domain shipborne radar images using active contour model
Authors: Xu Jin , Pan Xinxiang , Wu Xuerui , Jia Baozhu , Fei Juan , Wang Haixia , Li Bo , Cui Can 
Published: March 2021

AbstractAccidental oil spills cause serious pollution to the ocean and are difficult to control in short time. It is an important guarantee for emergency disposal to effectively monitor oil spills. Remote sensing is the main means to monitor oil spills. High false alarm rate has been an important bottleneck of this technology. In this paper, a multi-time-domain shipborne radar images discrimination mechanism was proposed. Based on the improved Sobel operator, Otsu and linear interpolation, the co-frequency interference noises were detected and suppressed. Gray intensity correction model (GICM) and dual-threshold method were used to eliminate highlighted continuous pixels. Oil films were extracted by using an active contour model (ACM). Finally, a multi-time-domain discrimination mechanism based on variation range tolerance of identified oil films centroids was designed to reduce the false alarm rate. It can provide technical support for decision-making and emergency response.
Automated assessment of functional lung imaging with 68Ga-ventilation/perfusion PET/CT using iterative histogram analysis
Authors: McIntosh Lachlan , Jackson Price , Hardcastle Nicholas , Bressel Mathias , Kron Tomas , Callahan Jason W. , Steinfort Daniel , Bucknell Nicholas , Hofman Michael S. , Siva Shankar 
Published: March 2021

Abstract
Purpose
Functional lung mapping from Ga68-ventilation/perfusion (V/Q) PET/CT, which has been shown to correlate with pulmonary function tests (PFTs), may be beneficial in a number of clinical applications where sparing regions of high lung function is of interest. Regions of clumping in the proximal airways in patients with airways disease can result in areas of focal intense activity and artefact in ventilation imaging. These artefacts may even shine through to subsequent perfusion images and create a challenge for quantitative analysis of PET imaging. We aimed to develop an automated algorithm that interprets the uptake histogram of PET images to calculate a peak uptake value more representative of the global lung volume.

Methods
Sixty-six patients recruited from a prospective clinical trial underwent both V/Q PET/CT imaging and PFT analysis before treatment. PET images were normalised using an iterative histogram analysis technique to account for tracer hotspots prior to the threshold-based delineation of varying values. Pearson’s correlation between fractional lung function and PFT score was calculated for ventilation, perfusion, and matched imaging volumes at varying threshold values.

Results
For all functional imaging thresholds, only FEV1/FVC PFT yielded reasonable correlations to image-based functional volume. For ventilation, a range of 10–30% of adapted peak uptake value provided a reasonable threshold to define a volume that correlated with FEV1/FVC (r = 0.54–0.61). For perfusion imaging, a similar correlation was observed (r = 0.51–0.56) in the range of 20–60% adapted peak threshold. Matched volumes were closely linked to ventilation with a threshold range of 15–35% yielding a similar correlation (r = 0.55–0.58).

Conclusions
Histogram normalisation may be implemented to determine the presence of tracer clumping hotspots in Ga-68 V/Q PET imaging allowing for automated delineation of functional lung and standardisation of functional volume reporting.
Continuous pericapsular nerve group block for postoperative pain management in total hip arthroplasty: report of two cases
Authors: Fujino Takashi , Odo Masahiko , Okada Hisako , Takahashi Shinji , Kikuchi Toshihiro 
Published: March 2021

Abstract
Background
Total hip arthroplasty (THA) is one of the surgical procedures associated with severe postoperative pain. Appropriate postoperative pain management is effective for promoting early ambulation and reducing the length of hospital stay. Effects of conventional pain management strategies, such as femoral nerve block and fascia iliaca block, are inadequate in some cases.

Case presentation
THA was planned for 2 patients with osteoarthritis. In addition to general anesthesia, continuous pericapsular nerve group (PENG) block and lateral femoral cutaneous nerve (LFCN) block were performed for postoperative pain management. Numerical rating scale (NRS) scores measured at rest and upon movement were low at 2, 12, 24, and 48 h postoperatively, suggesting that the treatments were effective for managing postoperative pain. The Bromage score at postoperative days (POD) 1 and 2 was 0.

Conclusion
Continuous PENG block and LFCN block were effective for postoperative pain management in patients who underwent THA. PENG block did not cause postoperative motor blockade.
The interplay between non-alcoholic fatty liver disease and innate immunity in hepatitis B virus patients
Authors: Megahed Fayed Attia Koutb , Zhou Xiaoling , Sun Pingnan , Elmaghrabi Marwa Mohamed 
Published: March 2021

AbstractBackgroundNon-alcoholic fatty liver disease (NAFLD) is the most epidemic liver disorder worldwide as a result of rapid lifestyle transformation over the past few decades and is expected to elevate in the next few years as well as it is ranging from plain hepatic steatosis via non-alcoholic steatohepatitis (NASH) to liver cirrhosis and hepatocellular carcinoma (HCC).Main textNAFLD can also stimulate the diseases progression as diabetes and cardiovascular. Therefore, understanding the NAFLD pathogenesis is of vital clinical interest additionally is a crucial for disease treatment and prevention. After analyzing NAFLD and liver diseases prevalence, it has been a belief regarding the interaction between NAFLD and chronic hepatitis B (CHB).ConclusionThe liver is an essential innate immune organ with large numbers of innate immune cells that contribute in NAFLD pathogenesis, additionally play the influential role that control NAFLD progression in the hepatitis B patients. Here, we summarized the recent advances in understanding and managing the NAFLD patients with chronic hepatitis B infection and interplay with innate immunity.
Association Between Midlife Obesity and Its Metabolic Consequences, Cerebrovascular Disease, and Cognitive Decline
Authors: Morys Filip , Dadar Mahsa , Dagher Alain 
Published: March 2021

AbstractContextChronic obesity is associated with several complications, including cognitive impairment and dementia. However, we have only piecemeal knowledge of the mechanisms linking obesity to central nervous system damage. Among candidate mechanisms are other elements of obesity-associated metabolic syndrome, such as hypertension, dyslipidemia, and diabetes, but also systemic inflammation. While there have been several neuroimaging studies linking adiposity to changes in brain morphometry, a comprehensive investigation of the relationship has so far not been done.ObjectiveTo identify links between adiposity and cognitive dysfunction.MethodsThis observational cohort study (UK Biobank), with an 8-year follow-up, included more than 20 000 participants from the general community, with a mean age of 63 years. Only participants with data available on both baseline and follow-up timepoints were included. The main outcome measures were cognitive performance and mediator variables: hypertension, diabetes, systemic inflammation, dyslipidemia, gray matter measures, and cerebrovascular disease (volume of white matter hyperintensities on magnetic resonance imaging).ResultsUsing structural equation modeling, we found that body mass index, waist-to-hip ratio, and body fat percentage were positively related to higher plasma C-reactive protein, dyslipidemia, hypertension, and diabetes. In turn, hypertension and diabetes were related to cerebrovascular disease. Finally, cerebrovascular disease was associated with lower cortical thickness and volume and higher subcortical volumes, but also cognitive deficits (largest significant pcorrected = 0.02).ConclusionsWe show that adiposity is related to poor cognition, with metabolic consequences of obesity and cerebrovascular disease as potential mediators. The outcomes have clinical implications, supporting a role for the management of adiposity in the prevention of late-life dementia and cognitive decline.
A Novel Familial PHP1B Variant With Incomplete Loss of Methylation at GNAS-A/B and Enhanced Methylation at GNAS-AS2
Authors: Hanna Patrick , Francou Bruno , Delemer Brigitte , Jüppner Harald , Linglart Agnès 
Published: March 2021

Abstract

Context
Pseudohypoparathyroidism type 1B (PHP1B), also referred to as inactivating PTH/PTHrP signaling disorder (iPPSD), is characterized by proximal renal tubular resistance to parathyroid hormone (PTH) leading to hypocalcemia, hyperphosphatemia, and elevated PTH values. Autosomal dominant PHP1B (AD-PHP1B) with loss of methylation at the maternal GNAS A/B:TSS-DMR (transcription start site-differentially methylated region) alone can be caused by maternal deletions involving STX16.

Objective
Characterize a previously not reported AD-PHP1B family with loss of methylation at GNAS A/B:TSS-DMR, but without evidence for a STX16 deletion on the maternal allele and assess GNAS-AS2:TSS-DMR methylation.

Methods
DNA from 24 patients and 10 controls were investigated. AD-PHP1B patients without STX16 deletion from a single family (n = 5), AD-PHP1B patients with STX16 deletion (n = 9), sporPHP1B (n = 10), unaffected controls (n = 10), patUPD20 (n = 1), and matUPD20 (n = 1). Methylation and copy number analyses were performed by pyrosequencing, methylation-sensitive multiplex ligation-dependent probe amplification, and multiplex ligation-dependent probe amplification.

Results
Molecular cloning of polymerase chain reaction–amplified, bisulfite-treated genomic DNA from healthy controls revealed evidence for 2 distinct GNAS-AS2:TSS-DMR subdomains, named AS2-1 and AS2-2, which showed 16.0 ± 2.3% and 31.0 ± 2.2% methylation, respectively. DNA from affected members of a previously not reported AD-PHP1B family without the known genetic defects revealed incomplete loss of methylation at GNAS A/B:TSS-DMR, normal methylation at the 3 well-established maternal and paternal DMRs, and, surprisingly, increased methylation at AS2-1 (32.9 ± 3.5%), but not at AS2-2 (30.5 ± 2.9%).

Conclusion
The distinct methylation changes at the novel GNAS-AS2:TSS-DMR will help characterize further different PHP1B/iPPSD3 variants and will guide the search for underlying genetic defects, which may provide novel insights into the mechanisms underlying GNAS methylation.
Fenofibrate Delays the Need for Dialysis and Reduces Cardiovascular Risk Among Patients With Advanced CKD
Authors: Yen Chieh-Li , Fan Pei-Chun , Lin Ming-Shyan , Lee Cheng-Chia , Tu Kun-Hua , Chen Chao-Yu , Hsiao Ching-Chung , Hsu Hsiang-Hao , Tian Ya-Chung , Chang Chih-Hsiang 
Published: March 2021

Abstract

Context
Fenofibrate provides limited cardiovascular (CV) benefits in the general population; however, little is known about its benefit among advanced chronic kidney disease (CKD) patients.

Objective
This study compared outcomes among advanced CKD patients treated with fenofibrate, statins, a combination of both, and none of these.

Methods
This national cohort study was based on Taiwan’s National Health Insurance Research Database. Patients younger than 20 years with advanced CKD were identified and further divided into 4 groups according to treatment. The inverse probability of treatment weighting was used to balance baseline characteristics. Patients received fenofibrate, statins, a combination of fenofibrate and statins, or none of these in the 3 months preceding the advanced CKD date. Main outcome measures included all-cause mortality, CV death, and incidence of permanent dialysis.

Results
The fenofibrate and statin groups exhibited a lower risk of CV death (fenofibrate vs nonuser: hazard ratio [HR]: 0.84; 95% CI, 0.75-0.94; statins vs nonuser: HR: 0.94; 95% CI, 0.90-0.97) compared with the nonuser group. The fenofibrate group further exhibited the lowest incidence of permanent dialysis (fenofibrate vs nonuser: subdistribution HR [SHR]: 0.78; 95% CI, 0.77-0.80; statins vs fenofibrate: SHR: 1.27; 95% CI, 1.26-1.29; combination vs fenofibrate: SHR: 1.15; 95% CI, 1.13-1.17). Furthermore, the combined administration of fenofibrate and high-intensity statins exhibited a lower risk of major adverse cardiac and cerebrovascular events.

Conclusion
For patients with advanced CKD, continuing fenofibrate may provide a protective effect on CV outcomes equal to that of statins, and it may further delay the need for permanent dialysis. The combination of fenofibrate and high-intensity statins may have additional benefits.
Insights from system leaders about operationalising a knowledge translation department in the Oman Ministry of Health
Authors: Al Sabahi Sultana , Wilson Michael G. , Lavis John N. , El-Jardali Fadi , Moat Kaelan 
Published: March 2021

Background: Oman has prioritised enhanced efforts for supporting evidence-informed policymaking (EIPM), including establishing a knowledge translation department in the Omani Ministry of Health (MOH).
Aim and objective: Our aim was to gather insights to guide the process of activating this department.
Methods: We conducted a document review and in-depth, semi-structured interviews with policymakers, researchers, and stakeholders who are familiar with the Omani system.
Findings: We conducted 17 interviews, which highlighted that policymakers in Oman use multiple sources of data and evidence to inform policymaking about health systems. However, several challenges to using evidence were identified, including low quality and limited availability of local evidence, system fragmentation, low interest in research, and lack of skills, capacity and time for finding, synthesising and using research evidence. Five possible activities for the department were refined with participants: building capacity, finding evidence, sparking action, embedding supports, and evaluating innovations. Participants viewed each of these activities as equally important and they should be pursued simultaneously. However, when asked to rank the most important option, participants identified capacity building as the most important to enable cultural changes needed within the MOH.
Discussion and conclusions: This study provides insights for activating the knowledge translation department in the Omani MOH. Fully operationalising the department will require convening a codesign process to reach consensus on the scope of the activities undertaken by the department. Implementation will also require capitalising on the relevant experience of highly qualified staff and existing infrastructure as well as continuing to foster a supportive climate for EIPM.
Pengembangan Mobile Apps Android sebagai Media Pembelajaran Matematika Berbasis Pendekatan Kontekstual untuk Memfasilitasi Pemahaman Konsep
Authors: Basya Yuhan Futri , Rifa’i Aulia Faqih , Arfinanti Nurul 
Published: March 2021

Penelitian ini bertujuan mengembangkan mobile apps android yang berkualitas sebagai media pembelajaran matematika berbasis pendekatan kontekstual untuk memfasilitasi pemahaman konsep. Mobile apps ini berisikan materi Fungsi Komposisi yang disajikan sesuai aspek pendekatan kontekstual untuk memfasilitasi pemahaman konsep. Kriteria ketercapaian kualitas adalah valid dan praktis. Penelitian ini dilaksanakan pada bulan Oktober 2016 hingga Februari 2017. Penelitian ini diujicobakan di SMA Negeri 7 Yogyakarta kepada 24 siswa. Penelitian ini merupakan penelitian pengembangan (Research and Development) dengan menggunakan prosedur pengembangan software SDLC model waterfall. Tahapan waterfall meliputi analisis masalah, desain produk, coding, serta testing. Hasil dari penelitian ini adalah berupa mobile apps android yang digunakan sebagai media pembelajaran matematika diluar pembelajaran. Mobile apps ini telah melalui tahap pengujian, yaitu pengujian alpha dan pengujian beta. Hasil pengujian alpha yang dilakukan oleh 3 orang ahli materi memperoleh persentase rata-rata 91% (Sangat Baik) serta 3 orang ahli media dengan memperoleh persentase rata-rata 86% (Sangat Baik) sehingga dikatakan valid. Hasil pengujian beta yang dilakukan oleh siswa memperoleh persentase 74% (Setuju) sehingga dikatakan praktis. Hasil penelitian ini menunjukkan bahwa mobile apps android telah layak digunakan sebagai media pembelajaran matematika berbasis pendekatan kontekstual untuk memfasilitasi pemahaman konsep.