bluuebunny/crossref_metadata_2025_split huggingface dataset:
Most exposed: the endothelium in chronic kidney disease
Authors: Vila Cuenca Marc , Hordijk Peter L , Vervloet Marc G 
Published: March 2019

Abstract
Accumulating evidence indicates that the pathological changes of the endothelium may contribute to the development of cardiovascular complications in chronic kidney disease (CKD). Non-traditional risk factors related to CKD are associated with the incidence of cardiovascular disease, but their role in uraemic endothelial dysfunction has often been disregarded. In this context, soluble α-Klotho and vitamin D are of importance to maintain endothelial integrity, but their concentrations decline in CKD, thereby contributing to the dysfunction of the endothelial lining. These hormonal disturbances are accompanied by an increment of circulating fibroblast growth factor-23 and phosphate, both exacerbating endothelial toxicities. Furthermore, impaired renal function leads to an increment of inflammatory mediators, reactive oxygen species and uraemic toxins that further aggravate the endothelial abnormalities and in turn also inhibit the regeneration of disrupted endothelial lining. Here, we highlight the distinct endothelial alterations mediated by the abovementioned non-traditional risk factors as demonstrated in experimental studies and connect these to pathological changes in CKD patients, which are driven by endothelial disturbances, other than atherosclerosis. In addition, we describe therapeutic strategies that may promote restoration of endothelial abnormalities by modulating imbalanced mineral homoeostasis and attenuate the impact of uraemic retention molecules, inflammatory mediators and reactive oxygen species. A clinical perspective on endothelial dysfunction in CKD may translate into reduced structural and functional abnormalities of the vessel wall in CKD, and ultimately improved cardiovascular disease.
Cerebrovascular Operative Anatomy: An Immersive 3D and Virtual Reality Description
Authors: Hendricks Benjamin K , Hartman Jerome , Cohen-Gadol Aaron A 
Published: March 2019

Abstract

BACKGROUND
The innate detail of the cerebrovasculature is a demonstration of the structural complexity exhibited within the nervous system and highlights the challenges intrinsic to surgically influencing this system. Bridging the knowledge gap between the 2-dimentional learning environment and the 3-dimensional (3D) clinical setting is a challenge requiring experience. Computer graphic technology provides an opportunity for the learner to step into a new era of learning via the use of interactive 3D models and virtual reality.

OBJECTIVE
To create virtually anatomically accurate cerebrovascular models with superior detail and visual appeal.

METHODS
High-resolution angiographic radiological studies were utilized to create virtual 3D models which were edited for anatomical accuracy and artistry post-processing.

RESULTS
We have created anatomically realistic and detailed 3D virtual models of the cerebrovascular structures including the arterial and venous systems. The relevant surgical anatomy of the bony and brain structures was also included. In addition, these models were used to illustrate the pathoanatomy of a deep vascular malformation to demonstrate the potential of this technology. These models allow user interactivity in the 3D environment for improved understanding of anatomical relationships.

CONCLUSION
Advances in computer graphics have invited a new era of education and experiential learning. The authors have created an immersive virtual 3D model of the cerebrovasculature to augment education, research, and clinical applications.
The dominant origin of diffuse Lyα halos around Lyα emitters explored by spectral energy distribution fitting and clustering analysis
Authors: Kusakabe Haruka , Shimasaku Kazuhiro , Momose Rieko , Ouchi Masami , Nakajima Kimihiko , Hashimoto Takuya , Harikane Yuichi , Silverman John D , Capak Peter L 
Published: March 2019

AbstractThe physical origin of diffuse Lyα halos (LAHs) around star-forming galaxies is still a matter of debate. We present the dependence of LAH luminosity [L(Lyα)H] on the stellar mass (M⋆), star formation rate, color excess [E(B − V)⋆], and dark matter halo mass (Mh) of the parent galaxy for ∼900 Lyα emitters (LAEs) at z ∼ 2 divided into ten subsamples. We calculate L(Lyα)H using the stacked observational relation between L(Lyα)H and central Lyα luminosity of Momose et al. (2016, MNRAS, 457, 2318), which we find agrees with the average trend of VLT/MUSE-detected individual LAEs. We find that our LAEs have relatively high L(Lyα)H despite low M⋆ and Mh, and that L(Lyα)H remains almost unchanged with M⋆ and perhaps with Mh. These results are incompatible with the cold stream (cooling radiation) scenario and the satellite-galaxy star-formation scenario, because the former predicts fainter L(Lyα)H and both predict steeper L(Lyα)H vs. M⋆ slopes. We argue that LAHs are mainly caused by Lyα photons escaping from the main body and then scattering in the circum-galactic medium. This argument is supported by LAH observations of Hα emitters (HAEs). When LAHs are taken into account, the Lyα escape fractions of our LAEs are about ten times higher than those of HAEs with similar M⋆ or E(B − V)⋆, which may partly arise from lower H i gas masses implied from lower Mh at fixed M⋆, or from another Lyα source in the central part.
Systematic study for gas-to-dust ratio of short gamma-ray burst afterglows
Authors: Yoshida Kazuki , Yonetoku Daisuke , Arimoto Makoto , Sawano Tatsuya , Kagawa Yasuaki 
Published: March 2019

Abstract
Extragalactic X-ray absorption and optical extinction are often found in gamma-ray burst (GRB) afterglows, and they could be tracers of both circumburst and host galaxy environments. By performing spectral analyses of the spectral energy distribution of nine short GRB (SGRB) afterglows with a known redshift, we investigated the ratio of the equivalent hydrogen column density to the dust extinction, $N_{\rm H}^{\rm rest}/A_{V}^{\rm rest}$, in the rest frame of each SGRB. We found that the distribution of $N_{\rm H}^{\rm rest}/A_{V}^{\rm rest}$ is systematically smaller than for long GRBs, and is roughly consistent with the gas-to-dust ratio in the Milky Way. This result means that the measured gas-to-dust ratio of SGRBs would originate from the interstellar medium in each host galaxy. This scenario supports the prediction that SGRBs occur in non-star-forming regions in the host galaxies.
A Bioinformatic Analysis of MicroRNAs’ Role in Human Intervertebral Disc Degeneration
Authors: Wang Xue-Qiang , Tu Wen-Zhan , Guo Jia-Bao , Song Ge , Zhang Juan , Chen Chang-Cheng , Chen Pei-Jie 
Published: March 2019

AbstractObjectives The aim of our study was to ascertain the underlying role of microRNAs (miRNAs) in human intervertebral disc degeneration (IDD).Design Bioinformatic analysis from multiple databases.Methods Studies of the association of miRNAs and IDD were identified in multiple electronic databases. All potential studies were assessed by the same inclusion and exclusion criteria. We recorded whether miRNA expression was commonly increased or suppressed in the intervertebral disc tissues and cells of IDD subjects. We used String to identify biological process and cellular component pathways of differentially expressed genes.Results We included fifty-seven articles from 1,277 records in this study. This report identified 40 different dysregulated miRNAs in 53 studies, including studies examining cell apoptosis (26 studies, 49.06%), cell proliferation (15 studies, 28.3%), extracellular matrix (ECM) degradation (10 studies, 18.86%), and inflammation (five studies, 9.43%) in IDD patients. Three upregulated miRNAs (miR-19b, miR-32, miR-130b) and three downregulated miRNAs (miR-31, miR-124a, miR-127-5p) were considered common miRNAs in IDD tissues. The top three biological process pathways for upregulated miRNAs were positive regulation of biological process, nervous system development, and negative regulation of biological process, and the top three biological process pathways for downregulated miRNAs were negative regulation of gene expression, intracellular signal transduction, and negative regulation of biological process.Conclusions This study revealed that miRNAs could be novel targets for preventing IDD and treating patients with IDD by regulating their target genes. These results provide valuable information for medical professionals, IDD patients, and health care policy makers.
How Much Is Needed? Comparison of the Effectiveness of Different Pain Education Dosages in Patients with Fibromyalgia
Authors: Amer-Cuenca Juan J , Pecos-Martín Daniel , Martínez-Merinero Patricia , Lluch Girbés Enrique , Nijs Jo , Meeus Mira , Ferrer Peña Raúl , Fernández-Carnero Josué 
Published: March 2019

AbstractObjectiveTo assess the effect of different dosages of pain neuroscience education (PNE) programs on central nociceptive processing in patients with fibromyalgia. Second, to compare the effects of different dosages of PNE programs on numerical pain rating scale (NPRS), disability, and psychological variables.DesignSingle-blind randomized controlled trial.SettingThree fibromyalgia centers in Spain (Valencia, Alcorcón, Alcalá de Henares).SubjectsSeventy-seven patients with fibromyalgia.MethodsParticipants were randomized to four groups of PNE: 1) high-dose PNE (N = 20), 2) low–concentrated dose PNE (N = 20), 3) diluted low-dose PNE (N = 20), and (4) control treatment (N = 17), conducted in two 30–50-minute sessions in groups of four to six participants. Conditioned pain modulation (CPM), temporal summation (TS), and pressure pain thresholds (PPTs) were assessed at baseline and at three-month follow-up. Secondary outcome measures were the Fibromyalgia Impact Questionnaire, Pain Catastrophizing Scale, and Pain Anxiety Symptoms Scale.ResultsThere were significant between-group differences for NPRS in favor of the groups receiving high-dose PNE, with a large effect size at three-month follow-up (P &lt; 0.01, η2p = 0.170), but there were no significant differences between groups for the remaining variables (P &gt; 0.05). All groups improved for central nociceptive processing, psychological variables, disability, and pain intensity (NPRS).ConclusionsIn patients with fibromyalgia, higher dosages of PNE produced a larger improvement in pain severity at three-month follow-up than other dosages of PNE and biomedical education. However, PNE was not superior to biomedical education in the central nociceptive processing, disability, or psychological variables in patients with fibromyalgia.
PR3-ANCA-associated vasculitis is associated with a specific motif in the peptide-binding cleft of HLA-DP molecules
Authors: Gregersen Jon Waarst , Erikstrup Christian , Ivarsen Per , Glerup Rie , Krarup Elizabeth , Keller Kresten Krarup , Hansen Ib Tønder , Møller Bjarne Kuno 
Published: March 2019

Abstract

Objectives
This study aimed to characterize the association between HLA alleles and ANCA-associated vasculitis (AAV) in a genetically homogeneous population, and to analyse the contribution of specific HLA molecule amino acid sequences to the risk of AAV.

Methods
We included 187 Danish patients with AAV and 1070 healthy controls. All were HLA typed at two-field resolution. The association of HLA alleles to PR3- or MPO-AAV was analysed. The contribution of the dominant molecular motifs of the HLA-DPB1 molecule to the risk of AAV was investigated by association studies that included specific amino acid sequences of the hypervariable regions in exon 2.

Results
Ninety-four percent of patients with PR3-AAV were carriers of HLA-DPB1*04:01 while all patients with PR3-AAV were carriers of an HLA-DPB1*04 allele, and 85% were homozygous. This was significantly more than in the control group (P < 0.0001). The association was even stronger when HLA-DPB1*04:02 and -DPB1*23:01 were included. HLA-DPB1*04:01, -DPB1*04:02 and -DPB1*23:01 share amino acids in positions 8–9, 69, 76 and 84–87 within the hypervariable regions, but only positions 69 and 84–87 contributed significantly to the disease risk. HLA-DRB1*15 was associated with an increased risk of developing PR3-AAV, while HLA-DRB1*04, -DRB1*07 and -DQB1*03 were associated with a reduced risk of kidney involvement in PR3-AAV. MPO-AAV was only weakly associated with HLA class I alleles.

Conclusion
PR3-AAV is strongly associated with the HLA-DPB1 alleles HLA-DPB1*04:01, -DPB1*04:02 and -DPB1*23:01, which share amino acid sequences crucial for the peptide-binding groove.
Efficacy of the Buzzy Device for Pain Management During Needle-related Procedures
Authors: Ballard Ariane , Khadra Christelle , Adler Samara , Trottier Evelyne D. , Le May Sylvie 
Published: March 2019

Objective:
This systematic review and meta-analysis examined the effectiveness of the Buzzy device combining cold and vibration for needle-related procedural pain in children.

Materials and Methods:
Databases search was conducted from inception to December 2017 to identify randomized controlled trials using the Buzzy device for pain management in children undergoing needle-related procedures. Selection of studies, data extraction, and assessment of risk of bias and quality of evidence were independently performed by 2 reviewers. Quantitative and qualitative analyses were conducted.

Results:
A total of 9 studies involving 1138 participants aged between 3 and 18 years old were included in the systematic review and 7 were suitable for meta-analysis. The meta-analysis compared the Buzzy device with a no-treatment comparator and the effect of the device was significant in reducing self-report procedural pain (standardized mean difference [SMD]: −1.11; 95% confidence interval [CI]: −1.52 to −0.70; P<0.0001), parent-reported procedural pain (SMD: −0.94; 95% CI: −1.62 to −0.27; P=0.006), observer-report procedural pain (SMD: −1.19; 95% CI: −1.90 to −0.47; P=0.001), observer-reported procedural anxiety (SMD −1.37; 95% CI: −1.77 to −0.96; P<0.00001), and parent-reported procedural anxiety (SMD −1.36; 95% CI: −2.11 to −0.61; P=0.0004). There was no significant difference for the success of the procedure at first attempt and the occurrence of adverse events.

Discussion:
The Buzzy device seems to be a promising intervention for procedural pain management in children. However, the comparative effect is uncertain due to the presence of significant heterogeneity and very low-quality evidence. There is a need to improve the methodological quality and rigor in the design of future trials to conclude to the efficacy of the Buzzy device.
The Association Between Conditioned Pain Modulation and Manipulation-induced Analgesia in People With Lateral Epicondylalgia
Authors: Muhsen Ahmad , Moss Penny , Gibson William , Walker Bruce , Jacques Angela , Schug Stephan , Wright Anthony 
Published: March 2019

Objectives:
Conditioned pain modulation (CPM) and manipulation-induced analgesia (MIA) may activate similar neurophysiological mechanisms to mediate their analgesic effects. This study assessed the association between CPM and MIA responses in people with lateral epicondylalgia.

Materials and Methods:
Seventy participants with lateral epicondylalgia were assessed for CPM followed by MIA. A single assessor measured pressure pain thresholds (PPT) before, during, and after cold water immersion (10°C) of the asymptomatic hand and contralateral lateral glide (CLG) mobilization of the neck. For analyses, linear mixed models evaluated differences in CPM and MIA responses. Pearson partial correlations and regression analyses evaluated the association between CPM and MIA PPT.

Results:
There was a significant increase (CPM and MIA, P<0.001) in PPT from baseline during the interventions (CPM mean: 195.84 kPa for elbow and 201.87 kPa for wrist, MIA mean: 123.01 kPa for elbow and 126.06 kPa for wrist) and after the interventions (CPM mean: 126.06 kPa for elbow, 114.24 kPa for wrist, MIA mean: 123.50 kPa for elbow and 122.16 kPa for wrist). There were also significant moderate and positive partial linear correlations (r: 0.40 to 0.54, P<0.001) between CPM and MIA measures, controlling for baseline measures. Regression analyses showed that CPM PPT was a significant predictor of MIA PPT (P<0.001) and the models explained between 73% and 85% of the variance in MIA PPT.

Discussion:
This study showed that CPM and MIA responses were significantly correlated and that the CPM response was a significant predictor of MIA response.
Musculoskeletal Pain in Individuals With Inflammatory Bowel Disease Reflects Three Distinct Profiles
Authors: Falling Carrie , Stebbings Simon , Baxter George D. , Gearry Richard B. , Mani Ramakrishnan 
Published: March 2019

Objectives:
Pain affects over 70% of individuals with inflammatory bowel disease (IBD), with abdominal and musculoskeletal pain representing the most common symptoms. Musculoskeletal pain in IBD is reported to be associated with multiple clinical features, however the scope and nature of pain is not well understood. Primary aims were to identify subgroups of musculoskeletal pain in individuals with IBD based on clinical features of pain and assess how these subgroups differ in aspects of demographics, comorbidity, and IBD characteristics.

Methods:
Cross-sectional online survey was performed on adults with IBD. Domains included: demographics, comorbidity, and clinical IBD and pain features. Latent class analysis was used to identify subgroups with similar attributes of: pain (severity, location, interference, and quality), IBD (activity, quality of life, and abdominal pain), and symptoms related to central sensitization. Correlation and regression analyses were used to profile identified subgroups.

Results:
Of 305 included participants, 208 indicated the presence of musculoskeletal pain. Three identified subgroups were characterized as “mixed mechanism,” “central mechanism,” and “regional and remission.” Between subgroup differences included: total comorbidity score (P=0.005), osteoarthritis (P=0.027), osteoporosis (P=0.045), depression (P=0.001), anxiety (P=0.025), and chronic fatigue syndrome (P=0.020). Sex and age were identified as confounders for depression and anxiety.

Conclusions:
Study results suggest multiple mechanisms contributing to pain experiences in IBD, to include central mechanisms. Features related to demographics, extraintestinal manifestations, IBD subtype, and clinical IBD features were not predictors of subgroup membership. However, total comorbidity demonstrated association with pain subgroups in this population.
Nociception-guided versus Standard Care during Remifentanil–Propofol Anesthesia
Authors: Meijer Fleur S. , Martini Chris H. , Broens Suzanne , Boon Martijn , Niesters Marieke , Aarts Leon , Olofsen Erik , van Velzen Monique , Dahan Albert 
Published: March 2019

Abstract

Editor’s Perspective

What We Already Know about This Topic
The nociception level index (Medasense Biometrics Ltd., Ramat Gan, Israel), is a reliable measure of moderate to intense noxious stimulation during anesthesia and surgery

What This Article Tells Us That Is New
In a randomized trial in patients having major abdominal surgery, compared to standard practice, nociception level-guided analgesia resulted in 30% less intraoperative remifentanil consumption

Background
The multidimensional index of nociception, the nociception level, outperforms blood pressure and heart rate in detection of nociceptive events during anesthesia. We hypothesized that nociception level–guided analgesia reduces opioid consumption and suboptimal anesthesia events such as low blood pressure and use of vasoactive medication.

Methods
In this single-blinded randomized study, 80 American Society of Anesthesiologists class I–III adult patients of either sex, scheduled for major abdominal procedures under remifentanil/propofol anesthesia by target-controlled infusion, were included. During the procedure nociception level, noninvasive blood pressure, and heart rate were monitored. Patients were randomized to receive standard clinical care or nociception level–guided analgesia. In the nociception level–guided group, remifentanil concentration was reduced when index values were less than 10 or increased when values were above 25 for at least 1 min, in steps of 0.5 to 1.0 ng/ml. Propofol was titrated to bispectral index values between 45 and 55. The primary outcomes of the study were remifentanil and propofol consumption and inadequate anesthesia events.

Results
Compared with standard care, remifentanil administration was reduced in nociception level–guided patients from (mean ± SD) 0.119 ± 0.033 to 0.086 ± 0.032 μg · kg-1 · min-1 (mean difference, 0.039 μg · kg-1 · min-1; 95% CI, 0.025–0.052 μg · kg-1 · min-1; P < 0.001). Among nociception level–guided patients, 2 of 40 (5%) experienced a hypotensive event (mean arterial pressure values less than 55 mm Hg) versus 11 of 40 (28%) patients in the control group (relative risk, 0.271; 95% CI, 0.08–0.77; P = 0.006). In the nociception level–guided group, 16 of 40 (40%) patients received vasoactive medication versus 25 of 40 (63%) patients in the standard care group (relative risk, 0.64; 95% CI, 0.40–0.99; P = 0.044).

Conclusions
Nociception level-guided analgesia during major abdominal surgery resulted in 30% less remifentanil consumption.
Middle third clavicular fractures fixed with precontoured locking compression plate or reconstruction plate: comparison of outcomes and complications
Authors: Kariya Ankur D. , Jain Pramod A. , Patond Kisan 
Published: March 2019

Background:
Fractures of the clavicle account for 2.6% to 4% of all fractures. Operative management of displaced fractures of the midshaft clavicle is preferred due to better outcomes. Various plates are used for fixation of these fractures, which include reconstruction plates, dynamic compression plates, and precontoured locking plates. Very few studies have documented whether the proposed benefits of precontoured plates are realized in a clinical setting. In this study, we compared the outcomes and complications of displaced midshaft clavicular fractures fixed using precontoured and reconstruction plates.

Methods:
Patients with Robinson Type 2B fractures of the clavicle treated using reconstruction plates (46 patients) or precontoured plates (68 patients) were included in the study. Parameters such as duration of surgery, functional outcome at 6 mo, and occurrence of complications, such as nonunion, infection, hardware prominence, and overall reoperation rates, were compared between the two groups.

Results:
There was no significant difference in functional outcomes between the reconstruction plate group and precontoured plate group (Constant score: 85.23 vs. 86.75, respectively). However significantly higher rate of hardware prominence (32.6% vs. 7.3%, respectively), implant removal (15.2% vs. 2.9%, respectively), and reoperation (19.5% vs. 4.4%, respectively) was found with reconstruction plates compared to precontoured plates.

Conclusions:
The treatment of displaced midshaft clavicular fractures with either reconstruction plates or precontoured plates offers a return to excellent shoulder function. However, a significant decrease in duration of surgery, hardware prominence, and reoperation rate was seen with precontoured plates.