bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clamshell-Thorakotomie im Rettungsdienst und Schockraum: Indikationen, Anforderungen und Technik
Authors: Rudolph Marcus , Lange Tim , Göring Martin , Schneider Niko R. E. , Popp Erik 
Published: May 2019

ZusammenfassungDie Notfallthorakotomie beim traumatischen Herz-Kreislauf-Stillstand spielte in Deutschland lange Zeit eine untergeordnete Rolle. Nach der Veröffentlichung der Reanimationsleitlinien des ERCs 2015 rückte der Algorithmus zur Versorgung dieses Verletzungsmusters in den Mittelpunkt, und speziell die Notfallthorakotomie war Auslöser einiger kontroverser Diskussionen. Die vorliegende Arbeit beschreibt nun die Indikationen für eine Thorakotomie im Rahmen einer Reanimation und erläutert die nötigen Rahmenbedingungen. Weiterhin wird die Technik Schritt für Schritt beschrieben. Darüber hinaus erfolgt eine kritische Betrachtung der Implementierung der Technik in unser Rettungsdienstsystem sowie der Hinweis auf bestehende Schulungskonzepte.
Skelettmetastasen der Extremitäten – Management und operative Behandlungskonzepte
Authors: Walther Eric , Fritzsche Hagen , Hofbauer Christine , Schaser Klaus-Dieter 
Published: May 2019

ZusammenfassungAufgrund der steigenden Anzahl an Tumorerkrankungen in Deutschland sowie der verlängerten Lebensdauer mit einer malignen Erkrankung sind Folgeerscheinungen wie Skelettmetastasen und pathologische Frakturen eine zunehmende klinische Herausforderung. Dieser Artikel stellt die Stufendiagnostik sowie die Behandlungsmöglichkeiten bei Patienten mit Skelettmetastasen der Extremitäten vor.
Definitions, Epidemiology, Clinical Risk Factors, and Health Disparities in Acute Respiratory Distress Syndrome
Authors: Kang Mohleen , Kempker Jordan 
Published: May 2019

AbstractAcute respiratory distress syndrome (ARDS) is a syndrome of inflammatory lung injury currently defined as the rapid onset of hypoxemia and radiographic opacities from a recent direct or indirect insult that is not explained by other causes. While the diagnostic criteria used to define ARDS are helpful in the clinical setting, they are not entirely specific for the characteristic pathophysiology of diffuse alveolar lung damage. This case definition introduces challenges to the reliable and accurate epidemiologic study of the condition. Within these limitations, ARDS appears to be a condition that is relatively rare within the general population but common within the context of the intensive care unit. Furthermore, the frequency and outcomes of ARDS seem to vary between populations, with no clearly discernible temporal trends in incidence or case fatality that are uniform across studies.
Acute Respiratory Distress Syndrome Phenotypes
Authors: Reilly John , Calfee Carolyn , Christie Jason 
Published: May 2019

AbstractThe acute respiratory distress syndrome (ARDS) phenotype was first described over 50 years ago and since that time significant progress has been made in understanding the biologic processes underlying the syndrome. Despite this improved understanding, no pharmacologic therapies aimed at the underlying biology have been proven effective in ARDS. Increasingly, ARDS has been recognized as a heterogeneous syndrome characterized by subphenotypes with distinct clinical, radiographic, and biologic differences, distinct outcomes, and potentially distinct responses to therapy. The Berlin Definition of ARDS specifies three severity classifications: mild, moderate, and severe based on the PaO2 to FiO2 ratio. Two randomized controlled trials have demonstrated a potential benefit to prone positioning and neuromuscular blockade in moderate to severe phenotypes of ARDS only. Precipitating risk factor, direct versus indirect lung injury, and timing of ARDS onset can determine other clinical phenotypes of ARDS after admission. Radiographic phenotypes of ARDS have been described based on a diffuse versus focal pattern of infiltrates on chest imaging. Finally and most promisingly, biologic subphenotypes or endotypes have increasingly been identified using plasma biomarkers, genetics, and unbiased approaches such as latent class analysis. The potential of precision medicine lies in identifying novel therapeutics aimed at ARDS biology and the subpopulation within ARDS most likely to respond. In this review, we discuss the challenges and approaches to subphenotype ARDS into clinical, radiologic, severity, and biologic phenotypes with an eye toward the future of precision medicine in critical care.
Pathophysiology and Management of Acute Respiratory Distress Syndrome in Obese Patients
Authors: Umbrello Michele , Fumagalli Jacopo , Pesenti Antonio , Chiumello Davide 
Published: May 2019

AbstractA rising prevalence of obesity is reported over time and throughout the world. At the same time, the acute respiratory distress syndrome (ARDS) remains an important public health problem, accounting for approximately 10% of intensive care unit admissions and leading to significant hospital mortality. Even in the absence of acute illnesses, obesity affects respiratory mechanics and gas exchange in the setting of a restrictive disease. In the presence of ARDS, obesity adds various challenges to a safe and effective management of respiratory support. Difficult airway management, altered lung and chest wall physiology, and positional gas trapping are routinely encountered. The management of such difficult cases is generally empiric, as it is based on small-sized, physiologic studies or on suggestions from the general anesthesia literature. The present review focuses on those cases in which ARDS is coincident with obesity, with the aim of presenting treatment options based on the current evidence. The first part summarizes the epidemiology of obesity and ARDS. Then the diagnostic challenges due to obesity-related artifacts of the different imaging techniques will be presented. A subsequent, detailed description of the altered respiratory anatomy and physiology of obesity will provide help in selecting an optimal, individually tailored strategy of support. Furthermore, we will discuss how esophageal manometry should be used to adjust the settings of positive end-expiratory pressure and tidal volume; the challenges of prone positioning and extracorporeal support; and the optimal strategies for weaning from mechanical ventilation, including when and how to perform a tracheostomy.
‘I do not cognize myself through being conscious of myself as thinking’: Self-knowledge and the irreducibility of self-objectification in Kant
Authors: Khurana Thomas 
Published: May 2019

AbstractThe paper argues that Kant'sdistinction between pure and empirical apperception cannot be interpreted as distinguishing two self-standing types of self-knowledge. For Kant, empirical and pure apperception need to co-operate to yield substantive self-knowledge. What makes Kant'saccount interesting is his acknowledgment that there is a deep tension between the way I become conscious of myself as subject through pure apperception and the way I am given to myself as an object of inner sense. This tension remains problematic in the realm of theoretical cognition but can be put to work and made productive in terms of practical self-knowledge.
Homotopy properties of horizontal loop spaces and applications to closed sub-Riemannian geodesics
Authors: Lerario Antonio , Mondino Andrea 
Published: May 2019

Given a manifold

M
M

and a proper sub-bundle

Δ
⊂
T
M

\Delta \subset TM

, we investigate homotopy properties of the horizontal free loop space

Λ
\Lambda

, i.e., the space of absolutely continuous maps

γ
:

S
1

→
M

\gamma :S^1\to M

whose velocities are constrained to

Δ
\Delta

(for example: legendrian knots in a contact manifold).

In the first part of the paper we prove that the base-point map

F
:
Λ
→
M

F:\Lambda \to M

(the map associating to every loop its base-point) is a Hurewicz fibration for the

W

1
,
2

W^{1,2}

topology on

Λ
\Lambda

. Using this result we show that, even if the space

Λ
\Lambda

might have deep singularities (for example: constant loops form a singular manifold homeomorphic to

M
M

), its homotopy can be controlled nicely. In particular we prove that

Λ
\Lambda

(with the

W

1
,
2

W^{1,2}

topology) has the homotopy type of a CW-complex, that its inclusion in the standard free loop space (i.e., the space of loops with no non-holonomic constraint) is a homotopy equivalence, and consequently that its homotopy groups can be computed as

π
k

(
Λ
)
≃

π
k

(
M
)
⋉

π

k
+
1

(
M
)

\pi _k(\Lambda )\simeq \pi _k(M) \ltimes \pi _{k+1}(M)

for all

k
≥
0.

k\geq 0.

In the second part of the paper we address the problem of the existence of closed sub-Riemannian geodesics. In the general case we prove that if

(
M
,
Δ
)

(M, \Delta )

is a compact sub-Riemannian manifold, each non-trivial homotopy class in

π
1

(
M
)

\pi _1(M)

can be represented by a closed sub-Riemannian geodesic.

In the contact case, we prove a min-max result generalizing the celebrated Lyusternik-Fet theorem: if

(
M
,
Δ
)

(M, \Delta )

is a compact, contact manifold, then every sub-Riemannian metric on

Δ
\Delta

carries at least one closed sub-Riemannian geodesic. This result is based on a combination of the above topological results with the delicate study of an analogue of a Palais-Smale condition in the vicinity of abnormal loops (singular points of

Λ
\Lambda

).
PKC-Mediated Endothelin-1 Expression in Endothelial Cell Promotes Macrophage Activation in Atherogenesis
Authors: Zhang Juan , Wang Yan-Jiang , Wang Xin , Xu Lin , Yang Xin-Chun , Zhao Wen-Shu 
Published: May 2019

Abstract

BACKGROUND
Atherosclerosis is a chronic inflammatory disease triggered by endothelial dysfunction and exaggerated by macrophage infiltration. Although endothelin-1 (ET-1) plays an important role in vascular inflammation and reactive oxygen species production, the individual effect of ET-1 in atherogenesis remains unclear.

METHODS AND RESULTS
ET-1 expression was increased in mouse atherosclerotic plaques and human umbilical vein endothelial cells (HUVECs) administrated by oxidized low-density lipoprotein stimulation. Moreover, the immunofluorescence co-staining showed upregulated ET-1 expression in endothelial cells. Real-time polymerase chain reaction demonstrated that ET-1 overexpression promoted adhesion molecules and chemokines secretion in HUVECs. Following this intervention, the migration of macrophages and the pro-inflammatory cytokines were increased. More importantly, the endothelial dysfunction regulated by ET-1 and subsequently the effect on macrophage activation were mediated by ETA receptor and largely reversed by protein kinase C (PKC) inhibitor. Eight-week-old male ApoE–/– mice and eET-1/ApoE–/– mice were fed with high-fat diet for 12 weeks. eET-1/ApoE–/– significantly increased atherosclerotic lesions in the whole aorta and aortic sinus, which accompanied by the induction of inflammatory cytokines and macrophages infiltration.

CONCLUSIONS
ET-1 accelerates atherogenesis by promoting adhesion molecules and chemokines, as well as subsequent macrophage activation. Collected, these evidence suggest that ET-1 might be a potential target for the treatment of atherogenesis.
Roles of membrane transporters: connecting the dots from sequence to phenotype
Authors: David Rakesh , Byrt Caitlin S , Tyerman Stephen D , Gilliham Matthew , Wege Stefanie 
Published: May 2019

AbstractBackgroundPlant membrane transporters are involved in diverse cellular processes underpinning plant physiology, such as nutrient acquisition, hormone movement, resource allocation, exclusion or sequestration of various solutes from cells and tissues, and environmental and developmental signalling. A comprehensive characterization of transporter function is therefore key to understanding and improving plant performance.Scope and ConclusionsIn this review, we focus on the complexities involved in characterizing transporter function and the impact that this has on current genomic annotations. Specific examples are provided that demonstrate why sequence homology alone cannot be relied upon to annotate and classify transporter function, and to show how even single amino acid residue variations can influence transporter activity and specificity. Misleading nomenclature of transporters is often a source of confusion in transporter characterization, especially for people new to or outside the field. Here, to aid researchers dealing with interpretation of large data sets that include transporter proteins, we provide examples of transporters that have been assigned names that misrepresent their cellular functions. Finally, we discuss the challenges in connecting transporter function at the molecular level with physiological data, and propose a solution through the creation of new databases. Further fundamental in-depth research on specific transport (and other) proteins is still required; without it, significant deficiencies in large-scale data sets and systems biology approaches will persist. Reliable characterization of transporter function requires integration of data at multiple levels, from amino acid residue sequence annotation to more in-depth biochemical, structural and physiological studies.
Periareolar Augmentation-Mastopexy
Authors: Austin Ryan E , Saheb-Al-Zamani Maryam , Lista Frank , Ahmad Jamil 
Published: May 2019

Abstract
The authors describe their surgical technique for single-stage periareolar mastopexy with subglandular breast augmentation. They have performed this procedure in 85 patients since 2009 and found that this operative technique has allowed them to achieve reproducible outcomes in a single-stage procedure. Periareolar mastopexy with subglandular breast augmentation is an excellent procedure for patients who desire a larger breast size and who present with mild to moderate nipple ptosis with a paucity of excess skin in the lower pole of the breast. This article will review the perioperative management and detailed steps of the procedure and outline its indications for utilization and some of the common complications the authors have encountered.
Entrezpy: a Python library to dynamically interact with the NCBI Entrez databases
Authors: Buchmann Jan P , Holmes Edward C 
Published: May 2019

Abstract

Summary
Entrezpy is a Python library that automates the querying and downloading of data from the Entrez databases at National Center for Biotechnology Information by interacting with E-Utilities. Entrezpy implements complex queries by automatically creating E-Utility parameters from the results obtained that can then be used directly in subsequent queries. Entrezpy also allows the user to cache and retrieve results locally, implements interactions with all Entrez databases as part of an analysis pipeline and adjusts parameters within an ongoing query or using prior results. Entrezpy’s modular design enables it to easily extend and adjust existing E-Utility functions.

Availability and implementation
Entrezpy is implemented in Python 3 (≥3.6) and depends only on the Python Standard Library. It is available via PyPi (https://pypi.org/project/entrezpy/) and at https://gitlab.com/ncbipy/entrezpy.git. Entrezpy is licensed under the LGPLv3 and also at http://entrezpy.readthedocs.io/.
Multivariate meta-analysis model for the difference in restricted mean survival times
Authors: Weir Isabelle R , Tian Lu , Trinquart Ludovic 
Published: May 2019

SUMMARYIn randomized controlled trials (RCTs) with time-to-event outcomes, the difference in restricted mean survival times (RMSTD) offers an absolute measure of the treatment effect on the time scale. Computation of the RMSTD relies on the choice of a time horizon, $\tau$. In a meta-analysis, varying follow-up durations may lead to the exclusion of RCTs with follow-up shorter than $\tau$. We introduce an individual patient data multivariate meta-analysis model for RMSTD estimated at multiple time horizons. We derived the within-trial covariance for the RMSTD enabling the synthesis of all data by borrowing strength from multiple time points. In a simulation study covering 60 scenarios, we compared the statistical performance of the proposed method to that of two univariate meta-analysis models, based on available data at each time point and based on predictions from flexible parametric models. Our multivariate model yields smaller mean squared error over univariate methods at all time points. We illustrate the method with a meta-analysis of five RCTs comparing transcatheter aortic valve replacement (TAVR) with surgical replacement in patients with aortic stenosis. Over 12, 24, and 36 months of follow-up, those treated by TAVR live 0.28 [95% confidence interval (CI) 0.01 to 0.56], 0.46 (95% CI $-$0.08 to 1.01), and 0.79 (95% CI $-$0.43 to 2.02) months longer on average compared to those treated by surgery, respectively.
Allele-specific silencing as treatment for gene duplication disorders: proof-of-principle in autosomal dominant leukodystrophy
Authors: Giorgio Elisa , Lorenzati Martina , Rivetti di Val Cervo Pia , Brussino Alessandro , Cernigoj Manuel , Della Sala Edoardo , Bartoletti Stella Anna , Ferrero Marta , Caiazzo Massimiliano , Capellari Sabina , Cortelli Pietro , Conti Luciano , Cattaneo Elena , Buffo Annalisa , Brusco Alfredo 
Published: May 2019

AbstractAllele-specific silencing by RNA interference (ASP-siRNA) holds promise as a therapeutic strategy for downregulating a single mutant allele with minimal suppression of the corresponding wild-type allele. This approach has been effectively used to target autosomal dominant mutations and single nucleotide polymorphisms linked with aberrantly expanded trinucleotide repeats. Here, we propose ASP-siRNA as a preferable choice to target duplicated disease genes, avoiding potentially harmful excessive downregulation. As a proof-of-concept, we studied autosomal dominant adult-onset demyelinating leukodystrophy (ADLD) due to lamin B1 (LMNB1) duplication, a hereditary, progressive and fatal disorder affecting myelin in the CNS. Using a reporter system, we screened the most efficient ASP-siRNAs preferentially targeting one of the alleles at rs1051644 (average minor allele frequency: 0.45) located in the 3′ untranslated region of the gene. We identified four siRNAs with a high efficacy and allele-specificity, which were tested in ADLD patient-derived fibroblasts. Three of the small interfering RNAs were highly selective for the target allele and restored both LMNB1 mRNA and protein levels close to control levels. Furthermore, small interfering RNA treatment abrogates the ADLD-specific phenotypes in fibroblasts and in two disease-relevant cellular models: murine oligodendrocytes overexpressing human LMNB1, and neurons directly reprogrammed from patients’ fibroblasts. In conclusion, we demonstrated that ASP-silencing by RNA interference is a suitable and promising therapeutic option for ADLD. Moreover, our results have a broad translational value extending to several pathological conditions linked to gene-gain in copy number variations.
PTEN Activity Defines an Axis for Plasticity at Cortico-Amygdala Synapses and Influences Social Behavior
Authors: Sánchez-Puelles Cristina , Calleja-Felipe María , Ouro Alberto , Bougamra Ghassen , Arroyo Ana , Diez Ibai , Erramuzpe Asier , Cortés Jesús , Martínez-Hernández José , Luján Rafael , Navarrete Marta , Venero César , Chan Andrew , Morales Miguel , Esteban José A , Knafo Shira 
Published: May 2019

Abstract
Phosphatase and tensin homolog on chromosome 10 (PTEN) is a tumor suppressor and autism-associated gene that exerts an important influence over neuronal structure and function during development. In addition, it participates in synaptic plasticity processes in adulthood. As an attempt to assess synaptic and developmental mechanisms by which PTEN can modulate cognitive function, we studied the consequences of 2 different genetic manipulations in mice: presence of additional genomic copies of the Pten gene (Ptentg) and knock-in of a truncated Pten gene lacking its PDZ motif (Pten-ΔPDZ), which is required for interaction with synaptic proteins. Ptentg mice exhibit substantial microcephaly, structural hypoconnectivity, enhanced synaptic depression at cortico-amygdala synapses, reduced anxiety, and intensified social interactions. In contrast, Pten-ΔPDZ mice have a much more restricted phenotype, with normal synaptic connectivity, but impaired synaptic depression at cortico-amygdala synapses and virtually abolished social interactions. These results suggest that synaptic actions of PTEN in the amygdala contribute to specific behavioral traits, such as sociability. Also, PTEN appears to function as a bidirectional rheostat in the amygdala: reduction in PTEN activity at synapses is associated with less sociability, whereas enhanced PTEN activity accompanies hypersocial behavior.
Constitution-Making in 21st-Century Thailand:The Continuing Search for a Perfect Constitutional Fit
Authors: Harding Andrew James , Leelapatana Rawin 
Published: May 2019

Abstract
In the 21st century, the constitutional and political stability that Thailand has sought seems to be harshly convulsed by the occurrence of ‘colour-coded politics’ between the Red and Yellow factions from 2006. The conflict between the two factions resulted in two military coups in 2006 and 2014, which, in turn, led to the revocation of two permanent constitutions (those of 1997 and 2007) and the enactment of two new ones (those of 2007 and 2017) as well as the promulgation of two interim constitutions (those of 2006 and 2014). In this article, we will examine the constitution-making process in 21st-century Thailand based, in particular, on its two contesting sources of legitimization—that is, the conflict between global ideas of constitutionalism and its local alternative: Thai-ness.
Influence of gender and age on haemodialysis practices: a European multicentre analysis
Authors: Weigert André , Drozdz Maciej , Silva Fatima , Frazão João , Alsuwaida Abdulkareem , Krishnan Mahesh , Kleophas Werner , Brzosko Szymon , Johansson Fredrik K , Jacobson Stefan H 
Published: May 2019

AbstractBackgroundWomen of all ages and elderly patients of both genders comprise an increasing proportion of the haemodialysis population. Worldwide, significant differences in practice patterns and treatment results exist between genders and among younger versus older patients. Although efforts to mitigate sex-based differences have been attempted, significant disparities still exist.MethodsThis retrospective cohort study included all 1247 prevalent haemodialysis patients in DaVita units in Portugal (five dialysis centres, n = 730) and Poland (seven centres, n = 517). Demographic data, dialysis practice patterns, vascular access prevalence and the achievement of a variety of Kidney Disease: Improving Global Outcomes (KDIGO) treatment targets were evaluated in relation to gender and age groups.ResultsBody weight and the prescribed dialysis blood flow rate were lower in women (P &lt; 0.001), whereas treated blood volume per kilogram per session was higher (P &lt; 0.01), resulting in higher single-pool Kt/V in women than in men (P &lt; 0.001). Haemoglobin was significantly higher in men (P = 0.01), but the proportion of patients within target range (10–12 g/dL) was similar. Men more often had an arteriovenous fistula than women (80% versus 73%; P &lt; 0.01) with a similar percentage of central venous catheters. There were no gender-specific differences in terms of dialysis adequacy, anaemia parameters or mineral and bone disorder parameters, or in the attainment of KDIGO targets between women and men &gt;80 years of age.ConclusionsThis large, multicentre real-world analysis indicates that haemodialysis practices and treatment targets are similar for women and men, including the most elderly, in DaVita haemodialysis clinics in Europe.