bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pretreatment With PCSK9 Inhibitor Protects the Brain Against Cardiac Ischemia/Reperfusion Injury Through a Reduction of Neuronal Inflammation and Amyloid Beta Aggregation
Authors: Apaijai Nattayaporn , Moisescu Dalila Monica , Palee Siripong , McSweeney Christian Mervyn , Saiyasit Napatsorn , Maneechote Chayodom , Boonnag Chiraphat , Chattipakorn Nipon , Chattipakorn Siriporn C. 
Published: January 2019

Background

Cardiac ischemic/reperfusion (I/R) injury leads to brain damage. A new antihyperlipidemic drug is aimed at inhibiting
PCSK
9 (proprotein convertase subtilisin/kexin type 9), a molecule first identified in a neuronal apoptosis paradigm. Thus, the
PCSK
9 inhibitor (
PCSK
9i) may play a role in neuronal recovery following cardiac I/R insults. We hypothesize that
PCSK
9i attenuates brain damage caused by cardiac I/R via diminishing microglial/astrocytic hyperactivation, β‐amyloid aggregation, and loss of dendritic spine.

Methods and Results

Adult male rats were divided into 7 groups: (1) control (n=4); (2)
PCSK
9i without cardiac I/R (n=4); (3) sham (n=4); and cardiac I/R (n=40). Cardiac I/R rats were divided into 4 subgroups (n=10/subgroup): (1) vehicle; (2)
PCSK
9i (10 μg/kg, IV) before ischemia; (3)
PCSK
9i during ischemia; and (4)
PCSK
9i at the onset of reperfusion. At the end of cardiac I/R protocol, brains were removed to determine microglial and astrocytic activities, β‐amyloid aggravation, and dendritic spine density. The cardiac I/R led to the activation of the brain's innate immunity resulting in increasing Iba1
+
microglia,
GFAP
+
astrocytes, and
CD
11b
+
/
CD
45
+high
cell numbers. However,
CD
11b
+
/
CD
45
+low
cell numbers were decreased following cardiac I/R. In addition, cardiac I/R led to reduced dendritic spine density, and increased β‐amyloid aggregation. Only the administration of
PCSK
9i before ischemia effectively attenuated these deleterious effects on the brain following cardiac I/R.
PCSK
9i administration under the physiologic condition did not affect the aforementioned parameters.

Conclusions

Cardiac I/R injury activated microglial activity in the brain, leading to brain damage. Only the pretreatment with
PCSK
9i prevented dendritic spine loss via reduction of microglial activation and Aβ aggregation.
Notes on the diversity and floristic affinity of mosses (Musci, Bryophyta) from Zambales Mountain Range, Luzon island, Philippines
Authors: LINIS VIRGILIO C. 
Published: January 2019

The moss flora of Zambales Mountain Range of Luzon Island, Philippines is updated based on recent and herbarium collections and is found to consist of 268 species in 126 genera. The Zambales collections yield Ectropothecium sp., a probable new species and six new records for the Philippine moss flora: Ectropothecium callichroides, E. filicaule, E. planulum, Neckeromnion calcutense, Papillidiopsis stissophylla, and Splachnobryum oorschotii. Likewise, Gammiella tonkinensis, Gymnostomiella longinervis, Leucobryum arfakianum, and Rhaphidostichum bunodicarpum are new records for Luzon Island. Additionally, the affinity of mosses in Zambales Mountain Range to other known floristically distinct areas and islands in the archipelago is discussed.
Dynamics of Lower-Tropospheric Vorticity in Idealized Simulations of Tropical Cyclone Formation
Authors: Wang Yaping , Davis Christopher A. , Huang Yongjie 
Published: January 2019

Abstract
Idealized simulations are conducted using the Cloud Model version 1 (CM1) to explore the mechanism of tropical cyclone (TC) genesis from a preexisting midtropospheric vortex that forms in radiative–convective equilibrium. With lower-tropospheric air approaching near saturation during TC genesis, convective cells become stronger, along with the intensifying updrafts and downdrafts and the larger area coverage of updrafts relative to downdrafts. Consequently, the low-level vertical mass flux increases, inducing vorticity amplification above the boundary layer. Of interest is that while surface cold pools help organize lower-tropospheric updrafts, genesis still proceeds, only slightly delayed, if subcloud evaporation cooling and cold pool intensity are drastically reduced. More detrimental is the disruption of near saturation through the introduction of weak vertical wind shear. The lower-tropospheric dry air suppresses the strengthening of convection, leading to weaker upward mass flux and much slower near-surface vortex spinup. We also find that surface spinup is similarly inhibited by decreasing surface drag despite the existence of a nearly saturated column, whereas larger drag accelerates spinup. Increased vorticity above the boundary layer is followed by the emergence of a horizontal pressure gradient through the depth of the boundary layer. Then the corresponding convergence resulting from the gradient imbalance in the frictional boundary layer causes vorticity amplification near the surface. It is suggested that near saturation in the lower troposphere is critical for increasing the mass flux and vorticity just above the boundary layer, but it is necessary yet insufficient because the spinup is strongly governed by boundary layer dynamics.
Multicenter Interrater Reliability in the Endoscopic Assessment of Velopharyngeal Function Using a Video Instruction Tool
Authors: Miller Craig , Bly Randall , Cofer Shelagh , Dahl John P. , de Serres Lianne , Goudy Steven , Hartzell Larry , Jabbour Noel , Kacmarysnki Deborah , Macarthur Carol , Messner Anna , Milczuk Henry , Rastatter Jeff , Swibel Rosenthal Laura H. , Scott Andrew , Tollefson Travis , Woolley Audie , Zdanski Carlton , Zopf Dave A. , Sie Kathleen 
Published: January 2019

ObjectiveAssess interrater agreement of endoscopic assessment of velopharyngeal (VP) function before and after viewing the video instruction tool (VIT). We hypothesized improvement in interrater agreement using the Golding‐Kushner scale (GKS) after viewing the VIT.Study DesignProspective study.SettingMulti‐institutional.MethodsSixteen fellowship‐trained pediatric otolaryngologists who treat velopharyngeal insufficiency (VPI) rated 50 video segments using the GKS before and after watching the VIT. Raters assessed gap size percentage and lateral pharyngeal wall (LPW), soft palate (SP), and posterior pharyngeal wall (PPW) movement. Intraclass correlation coefficient was estimated for these continuous measures. Raters also indicated the presence of a palatal notch, Passavant's ridge, and aberrant pulsations (categorical variables). Fleiss κ coefficient was used for categorical variables. Wilcoxon signed‐rank test was performed on the difference between the pre/post individual video ratings.ResultsReliability improved for all continuous variables after watching the instructional video. The improvement was significant for PPW (0.22‐0.30, P <. 001), SP (left: 0.63‐0.68, P <. 001 and right: 0.64‐0.68, P =. 001), and LPW (left: 0.49‐0.54, P =. 01 and right: 0.49‐0.54, P =. 09) but not significant for gap size (0.65‐0.69, P =. 36). Among categorical variables, agreement on Passavant's ridge significantly improved (0.30‐0.36, P =. 03).ConclusionExposure to a video instruction tool improves interrater agreement of endoscopic assessment of VP function. Significant improvement was observed in our primary end points, specifically posterior pharyngeal wall movement, soft palate movement, and lateral pharyngeal wall movement. There was less impact of the VIT on the interrater agreement of the categorical variables, palatal notch, Passavant's ridge, and aberrant pulsations.
Hydro-dissection assisted puncture of an esophageal balloon for percutaneous transesophageal gastrotubing: early experience concerning the technical feasibility, safety, and efficacy
Authors: Chu Hee Ho , Shin Ji Hoon , Kim Jong Woo , Kim Jin-Hyoung , Ko Heung-Kyu 
Published: January 2019

Background Percutaneous transesophageal gastrotubing (PTEG) is an alternative means of access into the stomach when conventional transabdominal gastric access is not possible. Purpose To describe the early clinical experience, technical feasibility, safety, and efficacy of the hydro-dissection assisted puncture of an esophageal balloon used for PTEG. Material and Methods A retrospective review was conducted of six, consecutive patients with feeding problems and who were treated with hydro-dissection assisted puncture of an esophageal balloon for PTEG. Patient baseline characteristics, such as age, sex, co-morbidities, and the underlying condition requiring PTEG, were recorded. The procedure and clinical outcomes of interests, including the route of approach, procedure time (defined as the time interval from the esophageal balloon insertion to the feeding tube placement), adverse events, duration of feeding through PTEG, and the place of discharge were observed. Results The PTEG creation using “hydro-dissection assisted puncture of an esophageal balloon technique” was achieved in all six patients (100% technical success). The mean procedure time was 16.5 min (range = 13–23 min) and the median duration of the feeding days through the PTEG was 87 days (range = 7–361 days). One case of deep neck infection was developed after the procedure and completely resolved by conservative treatment without removing the PTEG. Conclusions The hydro-dissection assisted puncture of an esophageal balloon is a safe and effective technique for PTEG when the commercial PTEG kits are unavailable.
Diagnostic accuracy of 3D breath-hold MR cholangiography using compressed sensing acceleration in visualizing non-dilated biliary system in living donor liver transplantation donors
Authors: Ono Ayako , Arizono Shigeki , Kohno Shigeshi , Nakai Hirotsugu , Isoda Hiroyoshi , Kühn Bernd , Togashi Kaori 
Published: January 2019

Background Visualizing non-dilated biliary system is important for preoperative mapping of living donor liver transplantation (LDLT) donors. Purpose To evaluate diagnostic accuracy of three-dimensional (3D) magnetic resonance cholangiography (MRC) within a breath-hold (BH) using compressed sensing (CS) acceleration in visualizing non-dilated biliary system in LDLT donors. Material and Methods For this prospective study, 43 donors who underwent LDLT were enrolled. Preoperative MRC sequence included BH CS-MRC (17-s BH) and conventional respiratory-triggered (RT) MRC. Two radiologists evaluated biliary configurations of the hepatic hilum, left lobe, and cystic duct. Diagnostic accuracy was assessed using intraoperative cholangiography and surgical records as a reference standard. The association between severity of artifact in RT MRC and better accuracy of BH CS-MRC in visualizing hilar biliary configuration was also evaluated. Results Diagnostic accuracy of BH CS-MRC was not significantly different from that of RT MRC for biliary configurations of the hepatic hilum (69.8% vs. 76.7%, P = 0.579 and 72.1% vs. 74.4%, P > 0.999), left lobe (48.8% vs. 60.5%, P = 0.332 and 48.8% vs. 67.4%, P = 0.080), and cystic duct (90.7% vs. 93.0%, P > 0.999 and 95.3% vs. 95.3%, P > 0.999), though it showed a slight tendency to be lower. Severe artifacts seen in RT MRC were significantly associated with better accuracy of BH CS-MRC (both P < 0.001). Conclusions BH CS-MRC can be seen as complementary to RT MRC in visualizing non-dilated biliary anatomy in LDLT donors and be useful especially for individuals whose RT MRC images show severe artifacts.
Does a change in ventricular size predict a diagnosis of cerebral venous thrombosis-related acute intracranial hypertension? Results of a retrospective imaging study
Authors: Zheng Ying-mei , Chen Jing , Yuan Ming-gang , Wu Zeng-jie , Dong Cheng 
Published: January 2019

Background Acute intracranial hypertension (IH) is commonly found in patients with cerebral venous thrombosis (CVT). Some magnetic resonance imaging (MRI) findings that are suggestive of acute IH and are thus important for planning treatment and improving clinical outcomes have been reported; however, the significance of changes in ventricular size in the presence of acute CVT-related IH remains unclear. Purpose To investigate changes in ventricular size in patients with CVT-related IH by MRI and to determine whether such changes are predictors of IH in these patients. Material and Methods Forty patients with CVT-related IH and 40 age- and sex-matched healthy volunteers who had undergone T1-weighted volumetric MRI were enrolled in this retrospective study and allocated to one of the following three groups: IH pre-treatment group (Day 1); IH post-treatment group (Day 30); and controls. Data concerning the volume of the ventricular system were compared between the groups. Results The volumes of the ventricular system in the three groups were 16.10 ± 8.22 cm3, 16.14 ± 8.14 cm3, and 15.10 ± 4.75 cm3, respectively. The volumes of the ventricular system were similar in pre-treatment and post-treatment patients with IH ( P = 0.982) and controls ( P = 0.446). Conclusion The lack of a significant difference in ventricular system volumes between the three study groups suggests that changes in ventricular size are neither a reliable MRI predictor of acute CVT-related IH caused by CVT or a predictor of the short-term prognosis (30 days) of this condition.
Counting Advertising Assertions to assess Regulatory Policy: When it Doesn't Add Up
Authors: Cohen Joel B. 
Published: January 2019

Public policy toward cigarette health claims should not be based on a “ market effects“ premise that health claim competition will reinforce consumer fears. Many have been influenced to smoke a succession of heavily advertised higher filtration, lower yield cigarettes, relying in part on the implication these were safer. None of these have been shown to reduce risks of smoking-related heart disease and other pulmonary disorders, and they are clearly no substitute for quitting. The Ringold and Calfee content analysis of cigarette advertising is criticized for its limited focus on direct verbal assertions. This approach led them to code what was said rather than what was likely to be understood. For example, claims regarding unique properties of filters were viewed as cigarette construction claims. Despite the high regard I have for the authors’ professional work and their commitment to research in a difficult and important area, I find the Ringold and Calfee [1989] paper to be flawed in three important aspects. The net result, in my view, is that their analysis and evidence contributes little to the dialogue on this topic. I will discuss each of the three problem areas in turn.
Predictors of visual impairment in primary and secondary glaucoma in a tertiary institute in North India
Authors: Raj Srishti , Savla Laxmi Prabhavathi , Thattaruthody Faisal , Seth Natasha Gautam , Kaushik Sushmita , Pandav Surinder Singh 
Published: January 2019

Aim: To find out and compare various predictors of glaucoma-related visual impairments in primary and secondary glaucoma. Methods: A prospective observational study of patients, who were above 30 years of age. They were diagnosed as primary/secondary glaucoma with visual acuity <20/200 Snellen’s/visual field showing less than 20° isopter in at least one eye, with a minimum follow-up of one year at a tertiary center. Patients were classified into advanced and end-stage glaucoma and outcome was assessed according to visual acuity and visual fields to see predictors of visual impairments. Results: There were 169 (99 primary/70 secondary) glaucoma patients with mean age of 62.67 ± 11.9 and 54.65 ± 15.26 years, respectively. Trauma (21.4%), complicated cataract surgery (15.7%), and silicon oil tamponade (14.3%) were common causes of secondary glaucoma. There was significant delay in diagnosis in primary compared to secondary glaucoma (57.57% vs 32.85%) and non-compliance was significantly higher in primary glaucoma (34.3% vs 17.1%, p = 0.01). In univariate analysis, literacy, income status, locality, and delayed or missed diagnosis were found to be significant (p < 0.05) according to visual acuity criteria. Out of the 33 patients who had undergone glaucoma filtration surgery, 18 (54.5%) were in the end-stage group. While 105 (77.2%) of 136 patients who were not subjected to any glaucoma filtration surgery reached end-stage glaucoma as per visual fields criteria (p = 0.011). Conclusion: Lack of awareness, delayed diagnosis, low literacy, and income were associated with poor visual outcome. Patients who underwent glaucoma filtration surgery had significantly better visual outcome in comparison to patients managed medically.
Does rural health system reform aimed at improving access to primary health care affect hospitalization rates? An interrupted time series analysis of national policy reforms in Iran
Authors: Rashidian Arash , Salavati Sedigheh , Hajimahmoodi Hanan , Kheirandish Mehrnaz 
Published: January 2019

Objectives To evaluate the effects of rural health insurance and family physician reforms on hospitalization rates in Iran. Methods An interrupted time series analysis of national monthly hospitalization rates in Iran (2003–2014), starting from two years before the intervention. Segmented regression analysis was used to assess the effects of the reforms on hospitalization rates. Results The analyses showed that hospitalization rates increased one year after the initiation of the reforms: 1.55 (95% CI: 1.24–1.86) additional hospitalizations per 1000 rural inhabitants per month (‘immediate effect’). This increase was followed by a further gradual increase of 0.034 per 1000 inhabitants per month (95% CI: 0.02–0.04). The gradual monthly increase continued for two years after the reforms. The higher hospitalization rates were maintained in the following years. We observed a significant increase in hospitalization rates at a national level in rural areas that continued for over 10 years after the policy implementation. Conclusion Primary health care reforms are often proposed for their efficiency outcomes (i.e. reduction in costs and use of hospitals) as well as their impact on improving health outcomes. We demonstrated that in populations with unmet needs, such reforms are likely to substantially increase hospitalization rates. This is an important consideration for successful design and implementation of interventions aimed at achieving universal health coverage in low- and middle-income countries.
Plasma NAP-2 levels are associated with critical limb ischemia in peripheral arterial disease patients
Authors: Wang Xiufang , Li Juyi , Gan Liming , Liu Qun 
Published: January 2019

Our study evaluates the relationship between plasma neutrophil-activating peptide-2 (NAP-2) levels and critical limb ischemia (CLI); 189 subjects were enrolled in this study: 59 subjects with CLI and type 2 diabetes mellitus (T2DM), 45 subjects with CLI and no T2DM, 43 patients with T2DM and no CLI, and 42 without both T2DM and CLI. Subjects with CLI had higher plasma levels of NAP-2 than those of the healthy group (2.04 ± 0.06 ng/mL vs. 1.75 ± 0.09 ng/mL, P = 0.011). Subjects with CLI and T2DM had higher plasma levels of NAP-2 than those of the T2DM group (2.08 ± 0.08 ng/mL vs. 1.73 ± 0.10 ng/mL, P = 0.007). However, subjects with CLI including CLI and T2DM+CLI had higher plasma levels of NAP-2 than those of the non-CLI group including healthy and T2DM group (2.06 ± 0.05 ng/mL vs. 1.74 ± 0.07 ng/mL, P < 0.001). The ankle brachial index (ABI) and total cholesterol (TC) were significantly and negatively correlated with plasma NAP-2 levels (rho = −0.250, P = 0.001; rho = −0.162, P = 0.026, respectively). Systolic blood pressure (SBP) positively correlated with plasma NAP-2 levels (rho = 0.187, P = 0.010). When adjusting for the factors, plasma NAP-2 levels were still significantly correlated with CLI (odds ratio = 11.543, 95% confidence intervals: 1.327–100.403, P = 0.027). The area under the curve (AUC) of NAP-2+confounders was 0.992 (95% confidence intervals 0.981 to 1.003, P < 0.001) and it was higher than those of NAP-2 alone (95% confidence intervals 0.241 to 0.407, P < 0.001) and confounders alone (AUC = 0.990, 95% confidence intervals −0.013 to 0.018, P = 0.797). In conclusion, elevated plasma NAP-2 was independently associated with CLI, but it was not correlated with T2DM. Plasma NAP-2 levels might be an early CLI diagnostic biomarker and might provide a novel target for CLI treatment. Impact statement Critical limb ischemia (CLI) is a serious arterial obstruction, resulting in serious reduction of blood flow to the extremities. CLI is a symptomatic disorder and is frequently not diagnosed in time. This results in a high mortality and elevated risk of limb amputation. Serum or plasma biomarkers play important roles in disease prevention, diagnosis, and prognosis. Elevated plasma neutrophil-activating peptide-2 (NAP-2) was found independently associated with CLI, but not with T2DM. Plasma NAP-2 levels might be an early CLI diagnostic biomarker and might provide a novel target for CLI treatment.
Reliability of shear wave elastography ultrasound to assess the supraspinatus tendon: An intra and inter-rater in vivo study
Authors: Hackett Lisa , Aveledo Ricardo , Lam Patrick H , Murrell George AC 
Published: January 2019

Introduction Shear wave elastography ultrasound is a relatively new technique that evaluates the tissue elasticity by applying an acoustic radiation force impulse. It is undetermined how reliable this modality is in assessing rotator cuff tendons. The aim of this study, therefore, was to evaluate the reliability of shear wave elastography ultrasound to assess the stiffness of normal and tendinopathic supraspinatus tendons. Methods An inter- and intra-rater reliability trial was carried out using shear wave elastography to assess the supraspinatus tendon at its distal insertion, by measuring shear wave velocity and elasticity. Twenty participants with a mean age of 37 (21–69) years old were evaluated. Ten subjects with normal supraspinatus tendon and 10 subjects with tendinopathic tendon were selected. The Virtual Touch Imaging Quantification program was used to generate the acoustic radiation force impulse and to obtain the elastography data. Three raters with different experience in conventional ultrasound were used for the inter-rater trial in normal tendons and the most experienced rater examined all subjects for the intra-rater reliability evaluation. Each rater obtained three readings in three different examinations per subject over a one-week period. Results The mean (±SEM) shear wave velocity for the normal supraspinatus tendon was 9.96 ± 0.02 m/s (=297 kPa), while in the tendinopathic supraspinatus tendon was 8.3 ± 0.2 m/s (=207 kPa) (p < 0.001). The intra-rater trial agreement was excellent, with an intraclass correlation coefficient = 0.96. In the inter-rater testing, the mean shear wave velocity in normal tendons was 9.90 ± 0.07 m/s (=294 kPa), with intraclass correlation coefficient = 0.45. Conclusion Shear wave elastography ultrasound was able to show that tendinopathic tendons were less stiff than normal tendons. It was a reliable imaging technique to assess the supraspinatus tendon, especially when used by a single experienced musculoskeletal sonographer.