bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal Changes in Cholesterol Efflux Capacities in Patients With Coronary Artery Disease Undergoing Lifestyle Modification Therapy
Authors: Boyer Marjorie , Lévesque Valérie , Poirier Paul , Marette André , Mitchell Patricia L. , Mora Samia , Mathieu Patrick , Després Jean‐Pierre , Larose Éric , Arsenault Benoit J. 
Published: June 2018

Background

Our objective was to identify the determinants of high‐density lipoprotein cholesterol efflux capacity (
HDL
‐
CEC
) changes in patients with coronary artery disease who participated in a lifestyle modification program aimed at increasing physical activity levels and improving diet quality.

Methods and Results

A total of 86 men with coronary artery disease aged between 35 and 80 years participated in a 1‐year lifestyle modification program that aimed to achieve a minimum of 150 minutes of aerobic physical activity weekly and improve diet quality.
HDL
‐
CEC
s were measured before and after the 1‐year intervention using
3
H‐cholesterol–labeled J774 and HepG2 cells. Visceral, subcutaneous, and cardiac adipose tissue levels were assessed before and after the intervention using magnetic resonance imaging. Lipoprotein particle size and concentrations were measured by proton nuclear magnetic resonance spectroscopy and a complete lipoprotein‐lipid profile was obtained. At baseline, the best correlate of
HDL
‐
CEC
s were apolipoprotein AI (
R
2
=0.35,
P
<0.0001) and high‐density lipoprotein cholesterol (
R
2
=0.21,
P
<0.0001) for J774‐
HDL
‐
CEC
s and HepG2‐
HDL
‐
CEC
s, respectively. Baseline and longitudinal changes in
HDL
‐
CEC
s were associated with several lipoprotein size and concentration indices, although high‐density lipoprotein cholesterol was the best predictor of longitudinal changes in J774‐
HDL
‐
CEC
s (
R
2
=0.18,
P
=0.002) and apolipoprotein AI was found to be the best predictor of longitudinal changes in HepG2 cholesterol efflux capacities (
R
2
=0.21,
P
=0.002).

Conclusions
Results of this study suggest that increases in high‐density lipoprotein cholesterol and apolipoprotein AI levels typically observed in patients with coronary artery disease undergoing healthy lifestyle modification therapy may be indicative of higher plasma concentrations of functional high‐density lipoprotein particles.
Coupled Map Lattices as Musical Instruments
Authors: Gravner Janko , Johnson Kyle 
Published: June 2018

Abstract
We use one-dimensional coupled map lattices (CMLs) to generate sounds that reflect their spatial organization and temporal evolution from a random initial configuration corresponding to uncorrelated noise. In many instances, the process approaches an equilibrium, which generates a sustained tone. The pitch of this tone is proportional to the lattice size, so the CML behaves like an instrument that could be tuned. Among exceptional cases, we provide an example with a metastable strange attractor, which produces an evolving sound reminiscent of drone music.
­Phylogenetic Analysis of the Genus Pohlia (Bryophyta, Bryaceae) Using Chloroplast and Nuclear Ribosomal DNA
Authors: NIU JING-YUAN , Li ☆LIN LI , SHI SHUO , LI HUI , WANG XIAO-RUI , LIU YONG-YING , NIU YU-LU , ZHAO JIAN-CHENG 
Published: June 2018

The genus Pohlia Hedwig is a large moss genus that has been placed in the Bryaceae family as traditionally determined. However, a molecular phylogenetic analysis has indicated that the Pohlia genus is more closely related to genera that are traditionally classified into the Mniaceae or Mielichhoferiaceae families. In this study, we performed a molecular phylogenetic analysis using evidence from four chloroplast regions (atpB-rbcL, rps4, trnG, and trnL-trnF) and one nuclear ribosomal intragenic spacer region (ITS) using different methods (maximum parsimony, maximum likelihood, and Bayesian inference). The phylogenetic relationships between Pohlia and its related genera are discussed. Two large clades among our samples were well supported in all of the datasets. The traditionally defined Bryaceae species, including Brachymenium pendulum, Bryum caespiticium, Bryum capillare, Anomobryum gemmigerum, and Rhodobryum ontariense, formed a monophyletic clade with high support. The second clade corresponding to the Mielichhoferiaceae-Mniaceae complex also had high support. All of the Pohlia, Mielichhoferia and Mniaceae samples were included in this latter clade. The clearest result from the phylogenetic analysis is that the Pohlia genus is non-monophyletic. The analysis is identical when using three methods and concludes that Pohlia is closer to the genera in Mielichhoferiaceae and Mniaceae. A formal taxonomic treatment of this clade was not performed because we lacked sufficient specimens of the species, although this work will be included in a future study.
Fournier's Gangrene of Genitalia: Case Report
Authors: Salciccia P. , Poveromo G. , Salciccia S. 
Published: June 2018

Fournier's gsngrene is a rare disease involving the scrotum and the penis with occasional extension up to the abdominal wall. The etiology of the disease, commonly without prodromal symptoms and with sudden onset, is still not fully understood. The organisms are usually streptococcus haemoliticus and/or anerobic bacteria. We report a case of Fournier's gangrene, presenting septic shock. The patient was treated with reanimatory care, antibiotics, local excision and debridment. Speaking about anatomical and etiopathogenetic hypotheses, we discuss the diagnostic problems and the treatment of the disease. We emphasize the role of the early diagnosis.
Needle Colposuspension: Survey of Techniques and New Procedure Report
Authors: Mantovani F. , Castelnuovo C. , Paparella S. , Bozzini G. 
Published: June 2018

To treat stress urinary incontinence plenty of techniques are today available. We present the results of a new, simple and cost free technique. The finger of the surgeon in the vagina checks Cooper ligament and guides the needle to pass behind it. Then it reaches the vagina where it takes a double suture. The needle rises up with the suture just above the ligament and crossing it, returns with the double suture in the vagina. With a large triple knot a tension free suspension is obtained. The success rate of 75 % was reported. The procedure basis its effectiveness on the ability of the new structure made up around the sutures by a fibrosis, to create a tension free suspension of vagina to Cooper ligament. This technique for the treatment of incontinence is reliable, simple and cheap and without controindications.
Retroperitoneal Leiomyoma. Transperitoneal Laparoscopic Surgery
Authors: Aresu L. , Amenta M. , Maritati F. , Occhipinti M. , Grosso G. 
Published: June 2018

70-year-old woman with retroperitoneal mass lesion undergoing laparoscopic resection of the tumor. The histological analysis revealed a leiomyoma, with positive immunostaging for estrogenic receptors. The differential diagnosis is a key element: the pathologist should be able to recognize this type of lesion and to differentiate it from a retroperitoneal leiomyosarcoma.
Safety and Tolerability of Local Treatment with Iloprost in Patients with Peyronie's Disease. A Phase 1 Pilot Study and Proposal of a new Symptom Questionnaire
Authors: Pavone Carlo , Melloni Carlo , Oxenius Irina , Napoli Giancarlo , Usala Manuela , Abbadessa Daniela 
Published: June 2018

Purpose Intralesional therapy is a less invasive method for the treatment of Peyronie's disease. The objective of this study was to evaluate safety and tolerability of intralesional injections of lloprost (I2 Prostacyclin analogue) for its property to suppress in fibroblasts CTFG (Connective tissue growth factor) production, which acts in concert with TGF-β to stimulate the fibrotic process. Methods Nineteen patients with Peyronie's disease were preliminarily evaluated by considering the degree of penile curvature, plaque size and local and systemic symptoms. Each patient then received weekly intralesional injections of 200ng of lloprost in 1 ml of normal saline for 4–5 weeks. If tolerated, the single dose increased weekly to the maximum of 400 ng (2 mL). Results The treatment has shown that all patients seem to well tolerate a 200 ng lloprost dose; 7 of them reached a 300 ng dose and 6 tolerate a 400 ng dose without showing side effects. There was no placebo control group in this study. To evaluate the efficacy of the treatment, the absence of objective parameters (except for the auto-photograph of penis in erection) led us to develop a subjective questionnaire that was given to all patients to assess sexual function, pain reduction, ecc. Conclusions Due to the relatively small size of the sample, the efficacy evaluation has been restricted to check the questionnaire reliability. Iloprost is well tolerated to a dose of 400ng in the local treatment of Peyronie's disease.
Calcifilassi e Necrosi Peniena: Case Report e Revisione Della Letteratura
Authors: Grande M. , Facchini F. , Larosa M. , Leone M. , Pozzoli G. , Valli R. , Monica B. 
Published: June 2018

Introduction Calciphylaxis is a rare clinic condition characterised by skin necrosis due to medial and intimal calcification of small and medium arteries. It's observed in patients affected by end stage renal disease associated to secondary hyperparathiroidism. Penile involvement has been documented in very few cases. We present both a case of penile calciphylaxis and a review of literature, in order to increase comprehension of patophysiology diagnosis and therapy of this rare disease. Materials and Methods A retrospective review of literature was performed after treating a case of penile calciphylaxis. We describe patient characteristics, clinical presentation, laboratory and histopathologic findings, therapeutic strategy and outcomes of the case. Results A 65 year-old man, affected by diabetes, chronic ischemic cardiopathy and chronic renal failure in emodialithic treatment, was referred to our unit for the presence of increased consistency and significative pain of the distal portion of penis evolving in a complete glans necrosis. Blood levels of parathormone (PTH), calcium (Ca) and phosphorous (P) resulted pathologically elevated, promoting tissutal calcium deposition. The patient was treated with partial penectomy and the histologic findings confirm diagnosis of calciphylaxis, showing an ulcerative necrosis of glans with extensive calcium deposition and luminal narrowing of penile small arteries. Conclusions The increase of number of patients with chronic renal failure in emodialithic treatment could make penile calciphylaxis more p\revalent in the future. Early diagnosis, lowering of pathologic blood levels of Ca and P associated to surgical treatment of necrotic lesions of the patient could be fundamental for a better prognosis of this aggressive disease.
Diagnosis and Treatment of Octogenarian Neoplastic Patients: Bladder Cancers
Authors: Destefanis Paolo , Bisconti Alessandro , Lasaponara Fedele , Fontana Dario 
Published: June 2018

Age is a risk factor for the occurrence of bladder cancer and bladder cancer is a disease of the elderly. The choice of treatment relays on the staging into non-invasive and muscle-invasive bladder cancer. Non-invasive bladder cancer is usually treated with transurethral resection of the bladder (TURB) followed by intravesical therapy with BCG or chemotherapeutic agents. The gold standard in the treatment of muscle-invasive bladder cancer is radical cystectomy. The elderly and, in particular, the octogenarian have a worse tolerance for aggressive therapies, due to the higher incidence of side effects and complications. This problem could significantly occur for intravesical BCG therapy and for radical cystectomy. When the urologist faces the treatment of an octogenarian affected by bladder cancer, he should answer many questions: 1. In case of a non-invasive bladder cancer, is it possible to use the same drugs that we use for younger patients (BCG vs chemotherapeutic agents)? Should the timing and the kind of follow-up be the same? 2. Should the octogenarian affected by muscle-invasive bladder cancer undergo radical cystectomy or a less invasive treatment? What kind of diversion should be preferred? Is it possible to propose an orthotopic neobladder to an octogenarian patient? The choice of the treatment should be made on the basis of a careful evaluation of the patient, considering not only the patient's age but also comorbidities and life expectancy.
Healing of spongiosus-cutaneous fistula with Hyperbaric Oxygen Therapy (HBOT): a case report
Authors: Della Camera Pier A. , Cito Gianmartin , Morselli Simone , Sessa Francesco , Facchiano Davide , Cocci Andrea , Gacci Mauro , Serni Sergio , Carini Marco , Natali Alessandro 
Published: June 2018

Introduction: We present a case of a spongiosus-cutaneous fistula in a 39-year-old man with recurrent episodes of cutaneous abscess in dorsal middle third penis (5 × 3 cm) treated with Hyperbaric Oxygen Therapy (HBOT). Case report: After emptying nodular abscess, the patient was noncompliant for further surgery. Therefore, it was suggested the association between HBOT and antibiotic therapy. HBOT is carried out in a hyperbaric room, where the internal pressure is increased (compression phase) by entering compressed air up to 283.71 kPa in about 10 minutes. Every HBOT cycle lasted 24 days in which the patient had been taking Amoxicillin/Clavulanic Acid 875 mg/125 mg 3 tabs/day and Sulfamethoxazole/Trimethoprim 160 mg/800 mg 2 tabs/day for 2 weeks. At the end of the treatment, a penile magnetic resonance imaging and an ultrasonography were executed and they evidenced a complete remission of the lesion. In the subsequent 22 months, there was no recurrence. Conclusions: Our results suggest that HBOT is an effective treatment for chronic wounds, including a spongiosus-cutaneous fistula of unknown cause, when used in combination with conventional standard therapy or further interventions. At present time, the gold standard remains surgery; nevertheless, our experience with HBOT may stimulate its use in clinical trials.
Prevalence of Asymptomatic Achilles Tendinosis
Authors: Noback Peter C. , Freibott Christina E. , Tantigate Direk , Jang Eugene , Greisberg Justin K. , Wong Tony , Vosseller J. Turner 
Published: June 2018

Background: Most patients who sustain Achilles tendon ruptures (ATRs) have no clinical symptoms prior to ATR. The objective of this study was to define the prevalence of ultrasound-detectable Achilles tendinopathy in asymptomatic patients in an at-risk group. Methods: This was a cross-sectional study that collected data from a group of volunteers. All participants were given IPAQ questionnaires to gauge daily activity level, in addition to a demographic form. Participants underwent a physical examination, Silfverskiold test, and an ultrasonographic examination to evaluate for presence of Achilles tendinopathy. Fifty-one volunteers (30 female, 21 male) and 102 Achilles tendons were assessed in this study. The mean age was 27.4±6.3, with an average BMI of 23.5±3.9. Ninety-two percent of participants were categorized as having moderate or high activity levels per the iPAQ questionnaire. Results: Sixteen tendons had at least 1 abnormality: 10 (9.8%) had hypoechoic foci, 9 (8.8%) had calcifications, 1 (0.9%) had increased vascularity, and 1 (0.9%) had a low-grade interstitial tear. Approximately 40% of patients were noted to have a gastroc equinus contracture on Silfverskiold testing. In addition, 14.7% of patients with a gastroc equinus had a hypoechoic focus compared to 8.6% of patients without gastroc equinus ( P = .5003). Logistic regression analysis demonstrated that an increased BMI was a significant risk factor for having an Achilles tendon abnormality on ultrasonography ( P < .01, odds ratio = 1.41). Conclusion: In this study, 16% of the Achilles tendons were abnormal and had at least 1 abnormality on ultrasonography. This group of patients was generally young, healthy, and active, thus a group at risk for ATRs. Only 40% of patients had gastrocnemius equinus, although a slightly higher non-significant percentage of those with hypoechoic foci had gastrocnemius equinus. It may be advantageous to prophylactically treat these patients with rehabilitation exercises to minimize the risk of ATR. Level of Evidence: Level II, comparative prognostic study.
Effectiveness of interventions involving nurses in secondary stroke prevention: A systematic review and meta-analysis
Authors: Parappilly Beena P , Field Thalia S , Mortenson William B , Sakakibara Brodie M , Eng Janice J 
Published: June 2018

Background and purpose: Among members of the health care team, nurses play a large role in actively engaging stroke survivors in secondary stroke prevention programs. This systematic review and meta-analysis examines the effectiveness of interventions in which nurses have a primary role on modification of risk factors among stroke survivors. Methods: We systematically searched for randomized controlled trials in relevant databases investigating the role of nurses in secondary stroke prevention. Meta-analyses were conducted using Cochrane Review Manager Software. The mean pooled effect size, a 95% confidence interval (CI), and I-squared ( I2) for heterogeneity were calculated. Results: Sixteen randomized controlled trials were included with a total of 3568 stroke and transient ischemic attack patients. After removing one outlier, the models demonstrated a statistically significant effect on reducing systolic blood pressure (SMD = −0.14 (95% CI = −0.23, –0.05), I2 = 0%; p = 0.002, six studies, n =1885) and diastolic blood pressure (SMD = −0.16 (95% CI = −0.27, –0.05), I2 = 0%; p = 0.003, four studies, n =1316). The interventions also significantly improved physical activity (five studies, n=1234), diet (three studies, n=425), medication adherence (two studies, n=270), and knowledge of risk factors (three studies, n=516). However, there was no effect on smoking cessation or reduction in use of alcohol. Conclusion: We found that interventions in which nurses had a primary role were effective on improving medical and behavioral risk factors, as well as knowledge of risk factors as part of secondary prevention of stroke.
Whole genome sequence revealed the fine transmission map of carbapenem-resistant Klebsiella pneumonia isolates within a nosocomial outbreak
Authors: Sui Wenjun , Zhou Haijian , Du Pengcheng , Wang Lijun , Qin Tian , Wang Mei , Ren Hongyu , Huang Yanfei , Hou Jing , Chen Chen , Lu Xinxin 
Published: June 2018

Abstract
Background
Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major cause of nosocomial infections worldwide. The transmission route of CRKP isolates within an outbreak is rarely described. This study aimed to reveal the molecular characteristics and transmission route of CRKP isolates within an outbreak of nosocomial infection.

Methods
Collecting case information, active screening and targeted environmental monitoring were carried out. The antibiotic susceptibility, drug-resistant genes, molecular subtype and whole genome sequence of CRKP strains were analyzed.

Results
Between October and December 2011, 26 CRKP isolates were collected from eight patients in a surgical intensive care unit and subsequent transfer wards of Beijing Tongren hospital, China. All 26 isolates harbored blaKPC-2, blaSHV-1, and blaCTX-M-15 genes, had the same or similar pulsed-field gel electrophoresis patterns, and belonged to the sequence type 11 (ST11) clone. By comprehensive consideration of genomic and epidemiological information, a putative transmission map was constructed, including identifying one case as an independent event distinct from the other seven cases, and revealing two transmissions starting from the same case.

Conclusions
This study provided the first report confirming an outbreak caused by K. pneumoniae ST11 clone co-harboring the blaKPC-2, blaCTX-M-15, and blaSHV-1 genes, and suggested that comprehensive consideration of genomic and epidemiological data can yield a fine transmission map of an outbreak and facilitate the control of nosocomial transmission.
Mood Disorders
Authors: Rakofsky Jeffrey , Rapaport Mark 
Published: June 2018

ABSTRACT

PURPOSE OF REVIEW
This article discusses the prevalence of the major mood disorders (major depressive disorder and bipolar disorder) in the community and within neurologic settings, articulates the steps taken to make a diagnosis of major depressive disorder or bipolar disorder, and reviews old and newer treatment options with proven efficacy for the treatment of these two conditions.

RECENT FINDINGS
New medications are available as treatment options for major depressive disorder and bipolar disorder, such as intranasal and IV ketamine, and somatic treatments, such as deep brain stimulation and vagal nerve stimulators, are being used to target treatment-resistant depression.

SUMMARY
Mood disorders are common in neurologic settings. They are disabling and increase morbidity and mortality. Clinicians should have a high index of suspicion if they suspect their patients seem more distressed or incapacitated than would be warranted by their neurologic disorders. If a patient does have a mood disorder, validating the patient’s experience, initiating treatment, and, if necessary, referring the patient to a primary care physician or psychiatrist are appropriate steps.
Risks and Benefits of Ultrasound, Nerve Stimulation, and Their Combination for Guiding Peripheral Nerve Blocks: A Retrospective Registry Analysis
Authors: Bomberg Hagen , Wetjen Laura , Wagenpfeil Stefan , Schöpe Jakob , Kessler Paul , Wulf Hinnerk , Wiesmann Thomas , Standl Thomas , Gottschalk André , Döffert Jens , Hering Werner , Birnbaum Jürgen , Kutter Bernd , Winckelmann Jörg , Liebl-Biereige Simone , Meissner Winfried , Vicent Oliver , Koch Thea , Bürkle Hartmut , Sessler Daniel I. , Volk Thomas 
Published: June 2018

BACKGROUND:
Ultrasound, nerve stimulation, and their combination are all considered acceptable ways to guide peripheral nerve blocks. Which approach is most effective and associated with the fewest complications is unknown. We therefore used a large registry to analyze whether there are differences in vascular punctures, multiple skin punctures, and unintended paresthesia.

METHODS:
Twenty-six thousand seven hundred and thirty-three cases were extracted from the 25-center German Network for Regional Anesthesia registry between 2007 and 2016 and grouped into ultrasound-guided puncture (n = 10,380), ultrasound combined with nerve stimulation (n=8173), and nerve stimulation alone (n = 8180). The primary outcomes of vascular puncture, multiple skin punctures, and unintended paresthesia during insertion were compared with conditional logistic regression after 1:1:1 propensity score matching. Results are presented as odds ratios and 95% CIs.

RESULTS:
Propensity matching successfully paired 2508 patients with ultrasound alone (24% of 10,380 patients), 2508 patients with a combination of ultrasound/nerve stimulation (31% of 8173 patients), and 2508 patients with nerve stimulation alone (31% of 8180 patients). After matching, no variable was imbalanced (standardized differences <0.1). Compared with ultrasound guidance alone, the odds of multiple skin punctures (2.2 [1.7–2.8]; P < .001) and vascular puncture (2.7 [1.6–4.5]; P < .001) were higher with nerve stimulation alone, and the odds for unintended paresthesia were lower with nerve stimulation alone (0.3 [0.1–0.7]; P = .03). The combined use of ultrasound/nerve stimulation showed higher odds of multiple skin punctures (1.5 [1.2–1.9]; P = .001) and lower odds of unintended paresthesia (0.4 [0.2–0.8]; P = .007) compared with ultrasound alone. Comparing the combined use of ultrasound/nerve stimulation with ultrasound alone, the odds for vascular puncture (1.3 [0.7–2.2]; P = .4) did not differ significantly. Systemic toxicity of local anesthetics was not observed in any patient with ultrasound guidance alone, in 1 patient with the combined use of ultrasound and nerve stimulation, and in 1 patient with nerve stimulation alone.

CONCLUSIONS:
Use of ultrasound alone reduced the odds of vascular and multiple skin punctures. However, the sole use of ultrasound increases the odds of paresthesia.