bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radial artery perforation: when a friend turns against you
Authors: Elwany Mostafa , Latini Roberto Adriano , Di Palma Gaetano , Cortese Bernardo 
Published: September 2019

Abstract

Background
Radial artery approach is currently the most common access site for coronary angiography and percutaneous coronary intervention. It rarely results in complications, improves patient comfort, and reduces the duration of hospitalization.

Case presentation
A 91-year-old woman presented to our institution with ST-segment elevation myocardial infarction (STEMI). The right radial access was chosen for the performance of percutaneous coronary intervention. After the introduction of 6 F sheath, there was difficulty in the advancement of 0.035 J wire that was exchanged with a Terumo hydrophilic wire. After the procedure and before sheath removal, radial arteriography was done and revealed perforation. Protamine sulfate was administered and prolonged balloon inflation was attempted but failed to seal the perforation, so a 7-F-long vascular sheath was inserted to internally tamponade the vessel, and the patient was sent to the coronary care unit for monitoring. Over the next 3 days, serial radial angiographies were done revealing the persistence of the perforation, and on the fourth day, angiography revealed multiple thrombi. Thrombus aspiration was done using Pronto V4 extraction catheter (Vascular Solutions, USA) and was followed by the deployment of a covered stent. The stent was dislodged and successfully snared. Finally, the perforation was sealed spontaneously and there were no signs of intra-arterial thrombi.

Conclusion
Despite the very low complication rate of radial approach, the interventional cardiologist should be aware of any possible complication, and how to avoid or, eventually, manage it.
Reforming fitness to plead and stand trial legislation in England and Wales
Authors: Galappathie Nuwan , Shaw Angela 
Published: September 2019

SUMMARYThe legal decision on whether a defendant can fairly take part in a criminal trial in England and Wales is currently based on the leading case of R v Pritchard (1836), which despite subsequent case law updates does not embrace the concept of mental capacity or effectively identify defendants who are unable to meaningfully participate. Further to an extensive consultation process, the Law Commission published recommendations for reform in 2016, with a proposed new test of capacity to participate effectively in a trial and detailed suggestions for statutory reform of court procedures for managing defendants found unable to participate. Here we review the proposals and consider practical implications and suggestions regarding their implementation.LEARNING OBJECTIVESAfter reading this article you will be able to:
•appreciate the current problems with the law on fitness to plead in England and Wales•understand the proposed test of capacity to participate effectively in a trial•understand the proposed changes to the procedures available when a defendant is found unable to participate.
Progesterone and Breast Cancer
Authors: Trabert Britton , Sherman Mark E , Kannan Nagarajan , Stanczyk Frank Z 
Published: September 2019

AbstractSynthetic progestogens (progestins) have been linked to increased breast cancer risk; however, the role of endogenous progesterone in breast physiology and carcinogenesis is less clearly defined. Mechanistic studies using cell culture, tissue culture, and preclinical models implicate progesterone in breast carcinogenesis. In contrast, limited epidemiologic data generally do not show an association of circulating progesterone levels with risk, and it is unclear whether this reflects methodologic limitations or a truly null relationship. Challenges related to defining the role of progesterone in breast physiology and neoplasia include: complex interactions with estrogens and other hormones (eg, androgens, prolactin, etc.), accounting for timing of blood collections for hormone measurements among cycling women, and limitations of assays to measure progesterone metabolites in blood and progesterone receptor isotypes (PRs) in tissues. Separating the individual effects of estrogens and progesterone is further complicated by the partial dependence of PR transcription on estrogen receptor (ER)α-mediated transcriptional events; indeed, interpreting the integrated interaction of the hormones may be more essential than isolating independent effects. Further, many of the actions of both estrogens and progesterone, particularly in “normal” breast tissues, are driven by paracrine mechanisms in which ligand binding to receptor-positive cells evokes secretion of factors that influence cell division of neighboring receptor-negative cells. Accordingly, blood and tissue levels may differ, and the latter are challenging to measure. Given conflicting data related to the potential role of progesterone in breast cancer etiology and interest in blocking progesterone action to prevent or treat breast cancer, we provide a review of the evidence that links progesterone to breast cancer risk and suggest future directions for filling current gaps in our knowledge.
AMPK subunits harbor largely non-overlapping genetic determinants for body fat mass, glucose- and cholesterol metabolism
Authors: Randrianarisoa Elko , Lehn-Stefan Angela , Krier Johannes , Böhm Anja , Heni Martin , Hrabě de Angelis Martin , Fritsche Andreas , Häring Hans-Ulrich , Stefan Norbert , Staiger Harald 
Published: September 2019

Abstract

Context
AMP-activated protein kinase (AMPK) is a heterotrimeric enzyme and central regulator of cellular energy metabolism. The impact of single nucleotide polymorphisms (SNPs) in all seven subunit genes on adiposity, glucose- and lipid metabolism has not been systematically studied yet.

Objective
To analyze the associations of common SNPs in all AMPK genes, and of different scores thereof, with adiposity, insulin sensitivity, insulin secretion, blood glucose, total-, LDL- and HDL-cholesterol and triglycerides.

Study Design and Methods
A cohort of 2789 non-diabetic subjects from the Tübingen Family study of type-2 diabetes, metabolically characterized by oral glucose tolerance test and genotyped by genome-wide SNP array was analyzed.

Results
We identified largely non-overlapping SNP sets across four AMPK genes (PRKAA1, PRKAA2, PRKAG2, PRKAG3) associated with adiposity, insulin sensitivity, insulin secretion, blood glucose, total-/LDL-cholesterol or HDL-cholesterol, respectively. A genetic score of body-fat-increasing alleles revealed per-allele effect sizes on BMI of +0.22 kg/m² (p=2.3·10-7), insulin sensitivity of -0.12·1019 L²/mol² (p=9.9·10-6) and 2-h blood glucose of +0.02 mmol/L (p=0.0048). Similar effects on blood glucose were observed with scores of insulin-sensitivity-reducing, insulin-secretion-reducing and glucose-raising alleles, respectively. A genetic cholesterol score increased total- and LDL-cholesterol by 1.17 mg/dL per allele (p=0.0002 and p=3.2·10-5, respectively), and a genetic HDL score decreased HDL-cholesterol by 0.32 mg/dL per allele (p=9.1·10-6).

Conclusions
We describe largely non-overlapping genetic determinants in AMPK genes for diabetes-/atherosclerosis-related traits which reflect the metabolic pathways controlled by the enzyme. Formation of trait-specific genetic scores revealed additivity of allele effects, with body-fat-raising alleles reaching a marked effect size.
C. elegans synMuv B proteins regulate spatial and temporal chromatin compaction during development
Authors: Costello Meghan E. , Petrella Lisa N. 
Published: September 2019

ABSTRACT
Tissue-specific establishment of repressive chromatin through creation of compact chromatin domains during development is necessary to ensure proper gene expression and cell fate. Caenorhabditis elegans synMuv B proteins are important for the soma/germline fate decision and mutants demonstrate ectopic germline gene expression in somatic tissue, especially at high temperature. We show that C. elegans synMuv B proteins regulate developmental chromatin compaction and that the timing of chromatin compaction is temperature sensitive in both wild type and synMuv B mutants. Chromatin compaction in mutants is delayed into developmental time periods when zygotic gene expression is upregulated and demonstrates an anterior-to-posterior pattern. Loss of this patterned compaction coincides with the developmental time period of ectopic germline gene expression, which leads to a developmental arrest in synMuv B mutants. Finally, accelerated cell division rates at elevated temperature may contribute to a lack of coordination between expression of tissue specific transcription programs and chromatin compaction at high temperature. Thus, chromatin organization during development is regulated both spatially and temporally by synMuv B proteins to establish repressive chromatin in a tissue-specific manner to ensure proper gene expression.
Stock or Print? Impact of 3-D Printing on Spare Parts Logistics
Authors: Song Jing-Sheng , Zhang Yue 
Published: September 2019

We present a general framework to study the design of spare parts logistics in the presence of three-dimensional (3-D) printing technology. We consider multiple parts facing stochastic demands and adopt procure/manufacture-to-stock versus print-on-demand to highlight the main difference of production modes featured in traditional manufacturing and 3-D printing. To minimize long-run average system cost, our model determines which parts to stock and which to print. We find that the optimal 3-D printer’s utilization increases as the additional unit cost of printing declines and the printing speed improves. The rate of increase, however, decays, demonstrating the well-known diminishing returns effect. We also find the optimal utilization to increase in part variety and decrease in part criticality, suggesting the value of 3-D technology in tolerating large part variety and the value of inventory for critical parts. By examining the percentage cost savings enabled by 3-D printing, we find that, although the reduction in printing cost continuously adds to the value of 3-D printing in a linear fashion, the impact of the improvement of printing speed exhibits S-shaped growth. We also derive various structural properties of the problem and devise an efficient algorithm to obtain near optimal solutions. Finally, our numerical study shows that the 3-D printer is, in general, lightly used under realistic parameter settings but results in significant cost savings, suggesting complementarity between stock and print in cost minimization. This paper was accepted by Victor Martínez-de-Albéniz, operations management.
Evaluating pressure redistribution surfaces for the occiput
Authors: Werthman Emily , Lynch Theresa , Ware Linda , Caffrey Julie 
Published: September 2019

Objective: Patients hospitalised in the Burn Intensive Care Unit are at increased risk of pressure ulcers (PU; also known as pressure injuries). While effective methods exist to offload pressure from other areas, offloading the head is difficult, especially with facial or head burns. An increase in occipital PUs prompted a review of practices for offloading the head in the Burn Intensive Care Unit. Method: A multidisciplinary team (MDT) of physicians, occupational therapists and nurses evaluated several devices used to prevent occipital PUs using a pressure mapping device. Pressure was measured using the SensorEdge Measure X device. The pressure mapping device provides a real-time graphic representation of pressure to the body area studied, in this case the occiput. In addition, the SensorEdge allows for numeric data to be exported to Excel format. Results: Our data showed that the occipital pressure was observed in our health volunteer using a fluidised gel positioner using pressure mapping. As a result of this we stopped using other pillows and went to exclusive use of the fluidised gel positioner. Reimplementation and consistent use of a fluidised gel positioner resulted in decreasing occipital PUs from nine to zero. Conclusion: The use of a fluidised gel positioner should be considered in other critical care environments to reduce the prevalence of hospital acquired occipital PUs.
Benefits of barbed suture utilisation in gastrointestinal anastomosis: a systematic review and meta-analysis
Authors: Wiggins T , Majid MS , Markar SR , Loy J , Agrawal S , Koak Y 
Published: September 2019

Introduction Anastomosis formation constitutes a critical aspect of many gastrointestinal procedures. Barbed suture materials have been adopted by some surgeons to assist in this task. This systematic review and meta-analysis compares the safety and efficacy of barbed suture material for anastomosis formation compared with standard suture materials. Methods An electronic search of Embase, Medline, Web of Science and Cochrane databases was performed. Weighted mean differences were calculated for effect size of barbed suture material compared with standard material on continuous variables and pooled odds ratios were calculated for discrete variables. Findings There were nine studies included. Barbed suture material was associated with a significant reduction in overall operative time (WMD: -12.87 (95% CI = -20.16 to -5.58) (P = 0.0005)) and anastomosis time (WMD: -4.28 (95% CI = -6.80 to -1.75) (P = 0.0009)). There was no difference in rates of anastomotic leak (POR: 1.24 (95% CI = 0.89 to 1.71) (P = 0.19)), anastomotic bleeding (POR: 0.80 (95% CI = 0.29 to 2.16) (P = 0.41)), or anastomotic stricture (POR: 0.72 (95% CI = 0.21 to 2.41) (P = 0.59)). Conclusions Use of barbed sutures for gastrointestinal anastomosis appears to be associated with shorter overall operative times. There was no difference in rates of complications (including anastomotic leak, bleeding or stricture) compared with standard suture materials.
A simple ex vivo model of human renal allograft preservation using the gonadal vein
Authors: Ries WP , Marie Y , Patel K , Turnbull C , Smith TB , Jamil NSM , Caldwell H , Telfer R , Neil DAH , Nath J , Inston NG 
Published: September 2019

Introduction Hypothermic machine perfusion, an organ preservation modality, involves flow of chilled preservation fluid through an allograft’s vasculature. This study describes a simple, reproducible, human model that allows for interrogation of flow effects during ex vivo organ perfusion. Materials and methods Gonadal veins from deceased human renal allografts were subjected to either static cold storage or hypothermic machine perfusion for up to 24 hours. Caspase-3, Krüppel-like factor 2 expression and electron microscopic analysis were compared between ‘flow’ and ‘no-flow’ conditions, with living donor gonadal vein sections serving as negative controls. Results The increase in caspase-3 expression was less pronounced for hypothermic machine-perfused veins compared with static cold storage (median-fold increase 1.2 vs 2.3; P < 0.05). Transmission electron microscopy provided ultrastructural corroboration of endothelial cell apoptosis in static cold storage conditions. For static cold storage preserved veins, Krüppel-like factor 2 expression diminished in a time-dependent manner between baseline and 12 hours (P < 0.05) but was abrogated and reversed by hypothermic machine perfusion (P < 0.05). Conclusions Our methodology is a simple, reproducible and successful model of ex vivo perfusion in the context of human organ preservation. To demonstrate the model’s utility, we establish that two widely used markers of endothelial health (caspase-3 and Krüppel-like factor 2) differ between the flow and no-flow conditions of the two predominant kidney preservation modalities. These findings suggest that ex vivo perfusion may mediate the induction of a biochemically favourable endothelial niche which may contribute tohypothermic machine perfusion’s association with improved renal transplantation outcomes.
Sarcopenia does not affect postoperative complication rates in oesophageal cancer surgery: a systematic review and meta-analysis
Authors: Schizas D , Frountzas M , Lidoriki I , Spartalis E , Toutouzas K , Dimitroulis D , Liakakos T , Mylonas KS 
Published: September 2019

Introduction The high morbidity and mortality rates after oesophagectomy indicate the need for rigorous patient selection and preoperative risk assessment. Although muscle mass depletion has been proposed as a potential prognostic factor for postoperative complications and decreased survival in gastrointestinal cancer patients, available data are conflicting. The purpose of the present meta-analysis is to determine whether sarcopenia predicts postoperative outcomes in patients undergoing oesophagectomy. Methods The databases MEDLINE, SCOPUS, Clinicaltrials.gov, CENTRAL and Google Scholar were searched for studies reporting on the effect of sarcopenia on postoperative outcomes following oesophageal cancer surgery. Outcomes included surgical complications, anastomotic leakage, respiratory complications, cardiovascular complications, postoperative infections, major complications and overall complications. The random effects model (DerSimonian–Laird) was used to calculate pooled effect estimates when high heterogeneity was encountered, otherwise the fixed-effects (Mantel–Haenszel) model was implemented. Findings A total of eight studies involving 1488 patients diagnosed with oesophageal cancer and who underwent oesophagectomy were included in the meta-analysis. The presence of sarcopenia did not significantly increase the rate of surgical complications (odds ratio, OR, 0.86, 95% confidence interval, CI, 0.40–1.85), anastomotic leakage (OR 0.75, 95% CI 0.42–1.35), respiratory complications (OR 0.56, 95% CI 0.21–1.48), cardiovascular complications (OR 0.94, 95% CI 0.31–2.83), postoperative infection (OR 1.14, 95% CI 0.52–2.50), major complications (OR 0.81, 95% CI 0.23–2.82) or overall postoperative complications (OR 0.80, 95% 0.32–1.99). Conclusion Sarcopenia does not seem to affect postoperative complication rates of patients undergoing oesophagectomy for oesophageal cancer. Future research should focus on determining whether prognosis differs according to muscle mass in this patient population.
Laparoscopic therapy of the coeliac artery compression syndrome: a critical analysis of the current standard procedure
Authors: Sahm M , Otto R , Pross M , Scholbach T , Mantke R 
Published: September 2019

Introduction Median arcuate ligament syndrome has been known anatomically for approximately 100 years and results from a compression of the coeliac axis by fibrous attachment of the diaphragmatic crura. Owing to the rarity of the disease and limited available data, many aspects of treatment are controversial. Currently, laparoscopic decompression is considered by several authors as standard surgical procedure. We present an analysis of the clinical routine of MALS therapy. Methods We conducted a prospective observational trial in patients with MALS between March 2016 and August 2018, in which clinical symptoms, diagnostic evaluation, procedures with complication analysis and follow-up data were recorded. Results A total of 18 patients (12 female, 6 male) with MALS, aged between 15 and 65 years, were included in this study. All patients presented with long-standing abdominal pain. Preoperative Doppler ultrasonography showed a flow velocity of the coeliac artery averaging 289.9cm/second in mid-position of the diaphragm, 285.9cm/second in expiration and 199.0cm/second in inspiration. All operated patients underwent laparoscopic decompression; two patients received an angiographic intervention. Postoperatively, a significant decrease of the flow velocity in mid-position of the diaphragm was detected (P = 0.018). At follow-up after 5.2 months, 50.0% of the patients were pain-free, 37.5% reported symptomatic relief and 12.5% showed evidence for a recurrence. Conclusion MALS is challenging both diagnostically and therapeutically. Laparoscopy with release of the median arcuate ligament is an essential part of the therapy and can be confirmed by Doppler ultrasonography. Disease outcome is also influenced by several predictive factors.
Positive Emotional Support in Premutation Carrier Mothers of Adolescents and Adults With Fragile X Syndrome: Gene by Environment Interactions
Authors: Hartley Sigan L. , DaWalt Leann S. , Hong Jinkuk , Greenberg Jan S. , Mailick Marsha R. 
Published: September 2019

Abstract
We examined the benefit of emotional support on daily health in premutation carrier mothers of adolescents and adults with fragile X syndrome (n = 114), and whether this benefit was moderated by the mother's genetic status (FMR1 CGG repeat length). In an 8-day daily diary, maternal daily health was assessed subjectively through self-reported number of physical health symptoms and physiologically via cortisol awakening response. Multilevel lagged-day models indicated that premutation carrier mothers with midrange CGG repeats derived less health benefit from a day with high positive emotional support than those with lower or higher numbers of repeats within the premutation range. The data support the influence of both genetic and environmental influences on the health of this population.
Sustaining Sherpa language and culture in New York
Authors: Sherpa Pasang Yangjee 
Published: September 2019

Sherpas moved from their original homeland in Solukhumbu district of Nepal to adjacent mountain districts and later to urban centres such as Kathmandu and Darjeeling over several generations. By the end of the twentieth century, many had also moved permanently to North American and European countries. Now, after Kathmandu in Nepal, the largest concentration of Sherpas can be found in Queens, New York, and the surrounding boroughs. The case of New York Sherpas is unique because for the first time in history, thousands of Sherpas from different parts of the Himalayas are living together and sharing a new home. Earlier, these Sherpas were separated for generations by geographic obstacles, great distances and international boundaries. Although the process of adapting to a new sociocultural environment is not novel, this article argues that the kinds of challenges and opportunities that New York has presented for the Sherpas are different from their experience elsewhere.
Sherpas are acutely aware of the risk of losing their language and culture in their new homes in the United States, especially when it comes to transmitting cultural knowledge to the next generation. Many are therefore actively involved in the preservation of their language and culture through community mobilization in the form of kyidugs.1 Based in different cities across the United States, Sherpa kyidugs uniformly emphasize the significance of promoting their language and culture within the community. A shared place of worship and gathering is key to Sherpas’ efforts to preserve and practice their culture, and so the kyidugs recognize the need for a community building, where they can gather to perform religious rituals and festivals, offer language classes or simply gather.
The damage that decorates
Authors: Bell Louise 
Published: September 2019

A wounded city can yield both sites of affect and relic-like objects. The vestiges of Plymouth's blitzed past is inscribed within the pattern and patina of place. This inscription can become overlooked with the passage of time and the fast movement of people through cityscape. By slow looking, stretching a glance into an encounter, witness marks have opportunity to communicate and temporally suture the urban landscape.
In this paper, I unravel the terms 'decoration' and 'ornamentation' through the lens of trauma studies and present occurrences of disrepair as worthy of consideration. I put forward how damage can behave as decoration and why such illustrative terminology is empathetic to the structures decorated by it. Focusing on a selection of ceramics damaged by the aerial bombardment, I explore the ways these artefacts speak to the present through their scars and how they are mimetic of their wounded city. Through a practice-based Ph.D., I employ illustration as a historiographic arts practice and attempt to unlock other ways of knowing which are always already at work within a city's fragments and disregarded sites.