bluuebunny/crossref_metadata_2025_split huggingface dataset:
АНАЛІЗ РЕЗУЛЬТАТІВ ХІРУРГІЧНОГО ЛІКУВАННЯ ХВОРИХ З ПОШКОДЖЕННЯМИ МАГІСТРАЛЬНИХ ЖОВЧНИХ ПРОТОК
Authors: Kurbaniyazov Z. B. , Askarov P. A. 
Published: June 2018

Останніми роками, як і у багатьох інших країнах світу, так і в Узбекистані, спостерігається зростання кількості хворих із патологією жовчовивідних шляхів. Зросло також і число оперативних втручань з цього приводу. Разом з тим зросла і частота розвитку ускладнень, а саме пошкодження жовчовивідних шляхів у 2-4 рази, та складає від 0,22 до 1,86%. Впровадження лапароскопічної холецистектомії також призвело до помітного зростання частоти та тяжкості таких пошкоджень. Середня частота травм магістральних жовчних проток складає 0,5 - 1%, таким чином в Узбекистані від таких ускладнень страждає від 50 до 100 осіб на рік.Мета дослідження. Оптимізація хірургічного лікування «свіжих» пошкоджень магістральних жовчних проток (МЖП).Матеріали та методи. Нами проаналізовано результати хірургічного лікування 42 пацієнтів зі «свіжими» пошкодженнями МЖП в період з 2006 по 2016 рр. за нашими даними, такі травми діагностовано у 26 (0,88%) хворих на 2947 холецистектомії (ХЕ), з них у 17 після лапаротомної холецистектомії (ЛХЕ), у 6 після мінілапаротомної ХЕ (МЛХЕ), у 3 після традиційної ХЕ (ТХЕ). 16 пацієнтів поступили з інших стаціонарів зі «свіжими» пошкодженнями МЖП: з них 3 після ЛХЕ, 12 - ТХЕ та 1 - МЛХЕ. У 11 (26,2%) хворих травми МЖП виявлено інтраопераційно, у решти - 31 (73,8%) у ранньому післяопераційному періоді. Серед оперованих 33 (78,6%) жінки та 9 (21,4%) чоловіків. Вік пацієнтів від 19 до 80 років. Оцінка пошкоджень проводилась за класифікацією Е.І. Гальперіна.Результати та обговорення. При виявленні пошкоджень жовчних проток у ранньому післяопераційному періоді (n=31) виконували одно- та двоетапні втручання залежно від наявності інфільтративно-запальних змін підпечінкової області.З 12 хворих з клінікою механічної жовтяниці за відсутності запального інфільтративного процесу проведено одноетапні хірургічні втручання. Операцією вибору при повному пересіканні позапечінкових жовчних проток є гепатикоеюноанастомоз по Ру. Його було виконано 14 пацієнтам з хорошим віддаленим результатом в 85,7%. Частота ускладнень у найближчому післяопераційному періоді склала 26,2%, у віддалному – 35,7%, летальність - 4,7%. Виконання операцій з формуванням співустя пошкодженої протоки з дванадцятипалою кишкою мало негативний вплив на результати лікування. У таких пацієнтів розвивався хронічний холангіт і стеноз анастомозу, що потребувало ендоскопічного втручання у 5 осіб.Висновки. Причиною невдач у лікуванні «свіжих» пошкоджень магістральних жовчних протоків є несвоєчасність діагностики та виконання неадекватних за об’ємом оперативних втручань, спрямованих на відновлення відтоку жовчі шляхом формування біліобіліарних та біліодуоденальних анастомозів.
ПРОСВІТНИЦЬКА РОБОТА КУРАТОРА ГРУПИ ЩОДО ФОРМУВАННЯ СТАТЕВОЇ КУЛЬТУРИ ПІДЛІТКІВ.
Authors: Popovych N. V. 
Published: June 2018

У статті розглянуто аспекти роботи кураторів академгруп. Підтверджено, що належним чином організована діяльність наставників академгруп виступає важливою умовою цілеспрямованого формування світогляду особистості.
BMP9 (Bone Morphogenetic Protein-9)/Alk1 (Activin-Like Kinase Receptor Type I) Signaling Prevents Hyperglycemia-Induced Vascular Permeability
Authors: Akla Naoufal , Viallard Claire , Popovic Natalija , Lora Gil Cindy , Sapieha Przemyslaw , Larrivée Bruno 
Published: June 2018

Objective—
Diabetic macular edema is a major cause of visual impairment. It is caused by blood-retinal barrier breakdown that leads to vascular hyperpermeability. Current therapeutic approaches consist of retinal photocoagulation or targeting VEGF (vascular endothelial growth factor) to limit vascular leakage. However, long-term intravitreal use of anti-VEGFs is associated with potential safety issues, and the identification of alternative regulators of vascular permeability may provide safer therapeutic options. The vascular specific BMP (bone morphogenetic protein) receptor ALK1 (activin-like kinase receptor type I) and its circulating ligand BMP9 have been shown to be potent vascular quiescence factors, but their role in the context of microvascular permeability associated with hyperglycemia has not been evaluated.

Approach and Results—
We investigated Alk1 signaling in hyperglycemic endothelial cells and assessed whether BMP9/Alk1 signaling could modulate vascular permeability. We show that high glucose concentrations impair Alk1 signaling, both in cultured endothelial cells and in a streptozotocin model of mouse diabetes mellitus. We observed that Alk1 signaling participates in the maintenance of vascular barrier function, as Alk1 haploinsufficiency worsens the vascular leakage observed in diabetic mice. Conversely, sustained delivery of BMP9 by adenoviral vectors significantly decreased the loss of retinal barrier function in diabetic mice. Mechanistically, we demonstrate that Alk1 signaling prevents VEGF-induced phosphorylation of VE-cadherin and induces the expression of occludin, thus strengthening vascular barrier functions.

Conclusions—
From these data, we suggest that by preventing retinal vascular permeability, BMP9 could serve as a novel therapeutic agent for diabetic macular edema.
Elevated Plasma D-Dimer Level Is Associated With Short-Term Risk of Ischemic Stroke in Patients With Acute Heart Failure
Authors: Hamatani Yasuhiro , Nagai Toshiyuki , Nakai Michikazu , Nishimura Kunihiro , Honda Yasuyuki , Nakano Hiroki , Honda Satoshi , Iwakami Naotsugu , Sugano Yasuo , Asaumi Yasuhide , Aiba Takeshi , Noguchi Teruo , Kusano Kengo , Toyoda Kazunori , Yasuda Satoshi , Yokoyama Hiroyuki , Ogawa Hisao , Anzai Toshihisa ,   on behalf of the NaDEF Investigators
Published: June 2018

Background and Purpose—
The incidence of heart failure increases the subsequent risk of ischemic stroke, and its risk could be higher in the short-term period after an acute heart failure (AHF) event. However, its determinants remain to be clarified. Plasma D-dimer level reflects fibrin turnover and exhibits unique properties as a biomarker of thrombosis. The aim of this study is to investigate whether D-dimer level is a determinant of short-term incidence of ischemic stroke in patients with AHF.

Methods—
We examined 721 consecutive hospitalized AHF patients with plasma D-dimer level on admission from our prospective registry between January 2013 and May 2016. The study end points were incidence of ischemic stroke during hospitalization and at 30 days after admission.

Results—

Of the total participants (mean age, 76 years; male, 60%; atrial fibrillation, 54%; mean left ventricular ejection fraction, 38%), in-hospital ischemic stroke occurred in 18 patients (2.5%) during a median hospitalization period of 21 days, and 30-day ischemic stroke occurred in 16 patients (2.2%). Higher D-dimer level on admission was an independent determinant of subsequent risk of in-hospital ischemic stroke even after adjustment by CHA
2
DS
2
-VASc score (odds ratio, 2.29; 95% confidence interval, 1.46–3.60;
P
<0.001) or major confounders, including age, atrial fibrillation, and antithrombotic therapy (odds ratio, 2.31; 95% confidence interval, 1.43–3.74;
P
<0.001). Subgroup analyses showed consistent findings in patients without atrial fibrillation (odds ratio, 2.46; 95% confidence interval, 1.39–4.54;
P
=0.002) and those without antithrombotic therapy (odds ratio, 2.79; 95% confidence interval, 1.53–5.57;
P
<0.001). Similar results were obtained for 30-day ischemic stroke as an alternative outcome.

Conclusions—
Elevated plasma D-dimer level on admission was significantly associated with increased incidence of ischemic stroke shortly after admission for AHF, suggesting a predictive role of D-dimer for short-term ischemic stroke events in patients with AHF.

Clinical Trial Registration—

URL:
https://www.umin.ac.jp/ctr/index.htm
. Unique identifier: UMIN000017024.
An Analytical Approach to the Determination of Optimal Perturbations in the Eady Model
Authors: Kalashnik Maxim V. , Chkhetiani Otto 
Published: June 2018

Abstract
Within the framework of the baroclinic instability Eady model, an analytical approach to the determination of optimal perturbations with a maximum of the energy growth rate or the ratio of the final and initial energies is considered. This approach is based on the energy balance equation and explicit expressions for the energy functionals resulting from the perturbation representation by means of the superposition of the edge Rossby waves (ERWs). The corresponding expressions are functions of the parameters of the initial perturbation, and the determination of optimal parameters reduces to the study of these functions on an extremum. For perturbations with zero potential vorticity (PV), the amplitudes of the initial buoyancy distributions at the boundaries of the atmospheric layer and the phase shift between these distributions serve as parameters. Analytical formulas are obtained for the optimal phase shift and the maximum of the energy ratio, which determine their dependence on the wavenumber and optimization time. It is also shown that the optimal perturbations always have equal boundary amplitudes. The parameters of the optimal perturbations are compared with the parameters of the growing normal modes. It is established that there exists only one exponentially growing normal mode, which is the optimal perturbation. Along with the instability, the ERWs can be excited by their interaction with the initial vortex perturbations (PV ≠ 0). The optimal regime of ERWs excitation by the initial singular distribution of PV is investigated.
On the Simulations of Global Oceanic Latent Heat Flux in the CMIP5 Multimodel Ensemble
Authors: Zhang Rongwang , Wang Xin , Wang Chunzai 
Published: June 2018

AbstractSimulations of the global oceanic latent heat flux (LHF) in the CMIP5 multimodel ensemble (MME) were evaluated in comparison with 11 LHF products. The results show that the mean state of LHF in the MME coincides well with that in the observations, except for a slight overestimation in the tropical regions. The reproduction of the seasonal cycle of LHF in the MME is in good agreement with that in the observations. However, biases are relatively obvious in the coastal regions. A prominent upward trend in global-mean LHF is confirmed with all of the LHF products during the period of 1979–2005. Despite the consistent increase of LHF in CMIP5 models, the rates of increase are much weaker than those in the observations, with an average of approximately one-ninth that in the observations. The findings show that the rate of increase of near-surface specific humidity qa in MME is nearly 6 times that in the observations, while the rate of increase of the near-surface wind speed U is less than one-half that in the observations. The faster increase of qa and the slower increase of U could both suppress evaporation, and thus latent heat released by the ocean, which may be one of the reasons that the upward trend of LHF in the MME is nearly one order of magnitude lower than that in the observations.
Association of cough hypersensitivity with tracheal TRPV1 activation and neurogenic inflammation in a novel guinea pig model of citric acid-induced chronic cough
Authors: Xu Xianghuai , Chen Qiang , Qiu Zhongmin , Shi Cuiqin , Ding Hongmei , Wang Lan , Lv Hanjing , Yu Li 
Published: June 2018

Objective This study was performed to establish a novel model of citric acid-induced chronic cough in guinea pigs and to investigate the pathogenesis of cough hypersensitivity. Methods Healthy conscious guinea pigs inhaled citric acid (0.4 M) for 3 minutes twice daily for 25 days. Cough reactivity was evaluated, substance P (SP) and calcitonin gene-related peptide (CGRP) in bronchoalveolar lavage fluid were detected, and transient receptor potential cation channel subfamily V member 1 (TRPV1) protein expression in the trachea and bronchus was determined. Tracheal and bronchial tissues were examined for TRPV1. Results Inhalation of 0.4 M citric acid increased coughing in a time-dependent manner: coughing peaked at 15 days and reached the lowest level at 25 days. This was accompanied by similar changes in SP, CGRP, and TRPV1 protein expression. TRPV1 was mainly observed in the mucosal and submucosal layer of the trachea and bronchi. The areas of TRPV1 positivity in the trachea and bronchi of citric acid-treated animals were significantly larger than in the control group. Conclusions Repeated inhalation of citric acid can be employed to establish a chronic cough model in guinea pigs. Cough hypersensitivity in this model is related to tracheal TRPV1 activation and neurogenic inflammation.
Red flag findings in children with headaches: Prevalence and association with emergency department neuroimaging
Authors: Tsze Daniel S , Ochs Julie B , Gonzalez Ariana E , Dayan Peter S 
Published: June 2018

Background Clinicians appear to obtain emergent neuroimaging for children with headaches based on the presence of red flag findings. However, little data exists regarding the prevalence of these findings in emergency department populations, and whether the identification of red flag findings is associated with potentially unnecessary emergency department neuroimaging. Objectives We aimed to determine the prevalence of red flag findings and their association with neuroimaging in otherwise healthy children presenting with headaches to the emergency department. Our secondary aim was to determine the prevalence of emergent intracranial abnormalities in this population. Methods A prospective cohort study of otherwise healthy children 2–17 years of age presenting to an urban pediatric emergency department with non-traumatic headaches was undertaken. Emergency department physicians completed a standardized form to document headache descriptors and characteristics, associated symptoms, and physical and neurological exam findings. Children who did not receive emergency department neuroimaging received 4-month telephone follow-up. Outcomes included emergency department neuroimaging and the presence of emergent intracranial abnormalities. Results We enrolled 224 patients; 197 (87.9%) had at least one red flag finding on history. Several red flag findings were reported by more than a third of children, including: Headache waking from sleep (34.8%); headache present with or soon after waking (39.7%); or headaches increasing in frequency, duration and severity (40%, 33.1%, and 46.3%). Thirty-three percent of children received emergency department neuroimaging. The prevalence of emergent intracranial abnormalities was 1% (95% CI 0.1, 3.6). Abnormal neurological exam, extreme pain intensity of presenting headache, vomiting, and positional symptoms were independently associated with emergency department neuroimaging. Conclusions Red flag findings are common in children presenting with headaches to the emergency department. The presence of red flag findings is associated with emergency department neuroimaging, although the risk of emergent intracranial abnormalities is low. Many children with headaches may be receiving unnecessary neuroimaging due to the high prevalence of non-specific red flag findings.
Baerveldt tube shunt implantation through a long scleral tunnel
Authors: Kusaka Mami , Kujime Yuki , Yamakawa Momoko , Akimoto Masayuki 
Published: June 2018

Purpose:To develop a new technique for the placement of a Baerveldt glaucoma implant tube through a long scleral tunnel.Materials and methods:Patients with refractory glaucoma undergoing the maximum tolerated medical therapy were recruited. We created a scleral tunnel with a 24-gauge catheter needle and used the external tube for guidance when introducing a Baerveldt glaucoma implant tube. Main outcome measures included intraocular pressure, supplemental medical therapy score, intraoperative complications, and postoperative complications.Results:Nine eyes of six patients were included in the study. The mean preoperative intraocular pressure (score) was 41.0 mmHg (4.78). Mean postoperative intraocular pressures were 18.3 mmHg (0.22), 18.8 mmHg (0.13), and 16.9 mmHg (0.50) at postoperative 1, 3, and 6 months, respectively. Minor vitreous hemorrhages were observed in three cases. Postoperative hypotony (<5 mmHg) was observed only in the first case at postoperative day 3. In one case, a stent suture could not be placed because the patient was restive intraoperatively, which resulted in an expulsive hemorrhage at 3 months postoperatively. The tube could have penetrated into the anterior chamber in another case. Tube exposure and corneal erosions were not observed in all cases.Conclusion:We developed a new technique to place a Baerveldt glaucoma implant tube through a long scleral tunnel. The outcomes were comparable to other reports of Baerveldt glaucoma implant surgery, although the number of cases was limited in this study. A long scleral tunnel can substitute for a preserved scleral patch and self-scleral flap to avoid tube-related complications.
Challenges and research opportunities for lung cancer screening in China
Authors: Wang Zixing , Wang Yuyan , Huang Yao , Xue Fang , Han Wei , Hu Yaoda , Wang Lei , Song Wei , Jiang Jingmei 
Published: June 2018

AbstractFollowing publication of the results of the National Lung Screening Trial in the United States, a randomized controlled trial in Italy (ITALUNG) and two simulation studies in China reported similar findings in 2017 favoring lung cancer screening with low‐dose computed tomography among smokers. With such advances in lung cancer screening, worldwide interest has gradually shifted from evaluating whether refining lung cancer screening protocols is effective in preventing deaths. However, there are several practical problems to be resolved, including the balance of enrollment criteria and cost effectiveness, precise measurements to reduce false positive findings, risk‐based optimization of screening frequency, challenges associated with cancer heterogeneity, strategies to combine image screening with novel biomarkers, dynamic monitoring of the natural history of cancer, accurate identification and diagnosis of cases among huge populations, and the impact of tobacco control policy and environment protection. As one in three individuals with lung cancer worldwide resides in China, these questions pose great challenges as well as research opportunities for population screening programs in China.
Improved Outcome by Adding Concurrent Chemotherapy to Cetuximab and Radiotherapy for Locally Advanced Head and Neck Carcinomas: Results of the GORTEC 2007-01 Phase III Randomized Trial
Authors: Tao Yungan , Auperin Anne , Sire Christian , Martin Laurent , Khoury Cedric , Maingon Philippe , Bardet Etienne , Kaminsky Marie-Christine , Lapeyre Michel , Chatellier Thierry , Alfonsi Marc , Pointreau Yoann , Jadaud Eric , Géry Bernard , Zawadi Ayman , Tourani Jean-Marc , Laguerre Brigitte , Coutte Alexandre , Racadot Séverine , Hasbini Ali , Malaurie Emanuelle , Borel Christian , Meert Nicolas , Cornely Alexandre , Ollivier Nathalie , Casiraghi Odile , Sun Xu Shan , Bourhis Jean 
Published: June 2018

Purpose To investigate the effect of adding concurrent chemotherapy (CT) to cetuximab plus radiotherapy (RT; CT-cetux-RT) compared with cetuximab plus RT (cetux-RT) in locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). Patients and Methods In this phase III randomized trial, patients with N0-2b, nonoperated, stage III or IV (nonmetastatic) LA-SCCHN were enrolled. Patients received once-daily RT up to 70 Gy with weekly cetuximab or with weekly cetuximab and concurrent carboplatin and fluorouracil (three cycles). To detect a hazard ratio (HR) of 0.64 for progression-free survival (PFS) with 85% power at a two-sided significance level of P = .05, 203 patients needed to be included in each arm. Results Four hundred six patients were randomly assigned to either CT-cetux-RT or cetux-RT. Patient and tumor characteristics were well balanced between arms, including p16 status. With a median follow-up of 4.4 years, the HR for PFS favored the CT-cetux-RT arm (HR, 0.73; 95% CI, 0.57 to 0.94; P = .015), with 3-year PFS rates of 52.3% and 40.5% and median PFS times of 37.9 and 22.4 months in the CT-cetux-RT and cetux-RT arms, respectively. The HR for locoregional control was 0.54 (95% CI, 0.38 to 0.76; P < .001) in favor of CT-cetux-RT. These benefits were observed regardless of p16 status for oropharynx carcinomas. Overall survival (HR, 0.80; P = .11) and distant metastases rates (HR, 1.19; P = .50) were not significantly different between the two arms. The CT-cetux-RT arm, compared with cetux-RT, had a higher incidence of grade 3 or 4 mucositis (73% v 61%, respectively; P = .014) and of hospitalizations for toxicity (42% v 22%, respectively; P < .001). Conclusion The addition of concurrent carboplatin and fluorouracil to cetux-RT improved PFS and locoregional control, with a nonsignificant gain in survival. To our knowledge, this is the first evidence of a clinical benefit for treatment intensification using cetux-RT as a backbone in LA-SCCHN.
CARMENA: Cytoreductive nephrectomy followed by sunitinib versus sunitinib alone in metastatic renal cell carcinoma—Results of a phase III noninferiority trial.
Authors: Mejean Arnaud , Escudier Bernard , Thezenas Simon , Beauval Jean-Baptiste , Geoffroy Lionnel , Bensalah Karim , Thiery-Vuillemin Antoine , Cormier Luc , Lang Herve , Guy Laurent , Gravis Gwenaelle , Rolland Frederic , Linassier Claude , Timsit Marc Olivier , Albiges Laurence , Beisland Christian , Aitchison Michael , Colas Sandra , Lebret Thierry , Ravaud Alain 
Published: June 2018

LBA3 Background: Cytoreductive nephrectomy (CN) has been the standard of care in mRCC in the past twenty years, supported by randomized and large retrospective studies. However the efficacy of targeted therapies has challenged this standard. CARMENA was designed to answer the question of whether upfront CN should continue to be performed before sunitinib. Methods: CARMENA was a randomized phase III trial. Patients (pts) with synchronous mRCC, amenable to CN, were enrolled after confirmation of clear cell histology on biopsy if PS 0-1, absence of symptomatic brain metastasis, acceptable organ function and eligible for sunitinib therapy. Pts were randomized 1:1 to either CN followed by sunitinib (arm A) or sunitinib alone (arm B), and stratified by MSKCC risk groups. Sunitinib was given at 50 mg/d, 4/6wk with dose adaptation to routine practice. In arm A, sunitinib had to start 4 to 6 wk after surgery. Primary endpoint was overall survival (OS). A total of 576 pts had to be enrolled to demonstrate non inferiority hypothesis (H0: λE/λC > 1.20), with 80% power at a 1-sided significance level of 5%. Results: 450 pts were included from 9/09 to 9/17, 226 and 224 in arm A and B, respectively. Median age was 62, ECOG-PS was 0 in 56% and 1 in 44%. MSKCC risk groups were intermediate/poor in 55.6/44.4% (arm A) and in 58.5/41.5% (arm B). In arm A, 6.7% did not have CN and 22.5% never received sunitinib. In arm B, 4.9 % never received sunitinib and 17% had secondary nephrectomy. At the time of the analysis, 326 deaths have been observed with a median follow-up of 50.9 mo. OS was not inferior in arm B, overall as well as by MSKCC risk groups (table). No difference in response rate and PFS was observed. Safety of sunitinib was as expected in both arms. Conclusions: Sunitinib alone is not inferior to CN followed by sunitinib in synchronous mRCC both in intermediate and poor MSKCC risk groups. CN should not be anymore the standard of care when medical treatment is required. Clinical trial information: NCT00930033. [Table: see text]