bluuebunny/crossref_metadata_2025_split huggingface dataset:
Вплив модифікованої плікації шлунка та рукавної резекції шлунка у щурів із глутамат-індукованим ожирінням та стрептозотоцин- індукованим діабетом на динаміку зниження маси тіла та вуглеводний обмін
Authors: Kozakov K. H. 
Published: May 2018

Мета роботи: порівняти вплив модифікованої плікації шлунка та рукавної резекції шлунка у щурів із глутамат-індукованим ожирінням та стрептозотоцин-індукованим діабетом на динаміку зниження маси тіла та вуглеводний обмін.Матеріали і методи. Дослідження проводили на 45 білих безпородних щурах-самках з вихідною масою тіла 150–180 грам. На тваринах було змодельовано глутамат-індуковане ожиріння та стрептозотоцин-індукований діабет 2-го типу. Тварини було розділено на групи по 15 тварин: контрольну та дві експериментальні. В першій експериментальній групі було виконано рукавну резекцію шлунка, другій експериментальній групі було виконано плікацію шлунка по великій кривині з формуванням 3-ох складок і першому ряді швів та другим рядом неприривних швів. Після чого визначали масу тварин та глюкоза натще на 14-ту, 28-му, 42-гу та 60-ту доби.Результати досліджень та їх обговорення. Рівень глюкози натще в контрольній групі на 60-ту післяопераційну добу становив (18,405±1,2) ммоль/л, в першій групі, де було виконано рукавну резекція шлунка, він склав (9,539±1,14) ммоль/л, в другій групі, де виконано модифіковану плікацію шлунка, він склав (10,39±1,49) ммоль/л. Визначення глюкози в сироватці крові на 60-ту – післяопераційну добу встановило високо достовірне зниження показників глюкози сироватки крові між контрольною та першою експериментальною групою, де було виконано рукавну резекцію (p<0,01) та високо достовірне зниження глюкози сироватки крові між контрольною групою та другою експериментальною групою, де було виконано модифіковану методику плікації шлунка (p<0.01). Проте статистичнозначимої різниці між першою та другою експериментальними групами не виявлено (p>0.05). Маса тіла тварин контрольної групи на 60-ту добу становила (335±17,32) г, в першої експериментальної групи на 60-ту добу склала (260±12,96) г та в другій експериментальній групі – (258,33±11,44) г. Визначення маси тіла щурів встановило статистично достовірне зниження маси тіла на 60-ту післяопераційну добу в щурів, яким було виконано рукавну резекцію шлунка, порівняно з контрольною групою (p<0,01) та статистично достовірне зниження маси тіла в щурів на 60-ту післяопераційну добу після модифікованої плікації шлунка порівняно з контрольною групою (p<0,01). Проте статистично значущої різниці між масою тіла у щурів першої та другої експериментальних груп на 60-ту післяопераційну добу не виявлено (p>0.05).
Cost-Effectiveness of Left Atrial Appendage Closure With the WATCHMAN Device Compared With Warfarin or Non–Vitamin K Antagonist Oral Anticoagulants for Secondary Prevention in Nonvalvular Atrial Fibrillation
Authors: Reddy Vivek Y. , Akehurst Ronald L. , Amorosi Stacey L. , Gavaghan Meghan B. , Hertz Deanna S. , Holmes David R. 
Published: May 2018

Background and Purpose—
Once a patient with atrial fibrillation experiences an embolic event, the risk of a recurrent event increases 2.6-fold. New treatments have emerged as viable treatment alternatives to warfarin for stroke risk reduction in secondary prevention populations. This analysis sought to assess the cost-effectiveness of left atrial appendage closure (LAAC) compared with warfarin and the non–vitamin K antagonist oral anticoagulants dabigatran 150 mg, apixaban and rivaroxaban in the prevention of stroke in nonvalvular atrial fibrillation patients with a prior stroke or transient ischemic attack.

Methods—

A Markov model was constructed using data from the secondary prevention subgroup analyses of the non–vitamin K antagonist oral anticoagulant and LAAC pivotal trials. Costs were from 2016 US Medicare reimbursement rates and the literature. The cost-effectiveness analysis was conducted from a US Medicare perspective over a lifetime (20 years) horizon. The model was populated with a cohort of 10 000 patients aged 70 years with a CHA
2
DS
2
-VASc score of 7 (annual stroke risk=9.60%) and HAS-BLED score of 3 (annual bleeding risk=3.74%).

Results—
LAAC achieved cost-effectiveness relative to dabigatran at year 5 and warfarin and apixaban at year 6. At 10 years, LAAC had more quality-adjusted life years (4.986 versus 4.769, 4.869, 4.888, and 4.810) and lower costs ($42 616 versus $53 770, $58 774, $55 656, and $58 655) than warfarin, dabigatran, apixaban, and rivaroxaban, respectively, making LAAC the dominant (more effective and less costly) stroke risk reduction strategy. LAAC remained the dominant strategy over the lifetime analysis.

Conclusions—
Upfront procedure costs initially make LAAC higher cost than warfarin and the non–vitamin K antagonist oral anticoagulants, but within 10 years, LAAC delivers more quality-adjusted life years and has lower total costs, making LAAC the most cost-effective treatment strategy for secondary prevention of stroke in atrial fibrillation.
Magnetic Resonance Imaging Selection for Endovascular Stroke Therapy
Authors: Simonsen Claus Z. , Yoo Albert J. , Rasmussen Mads , Sørensen Kristina E. , Leslie-Mazwi Thabele , Andersen Grethe , Sørensen Leif H. 
Published: May 2018

Background and Purpose—
The GOLIATH trial (General or Local Anesthesia in Intra-Arterial Therapy) compared infarct growth and outcome in patients undergoing endovascular therapy under either general anesthesia or conscious sedation. Magnetic resonance imaging was performed before and after the procedure to study infarct growth. In this post hoc analysis of GOLIATH, we aimed to characterize the workflow of patients undergoing magnetic resonance imaging selection before endovascular therapy.

Methods—
We randomized 128 patients with anterior circulation large vessel occlusion stroke within 6 hours of onset to either general anesthesia or conscious sedation (1:1 allocation). We studied workflow time intervals to examine whether magnetic resonance imaging conferred a time delay in treatment when compared with computed tomography-based studies that emphasized rapid workflow.

Results—
Of 128 patients enrolled between March 2015 and February 2017, 65 were randomized to general anesthesia. Baseline demographic and clinical variables were balanced between the treatment arms. The median interval from scan to groin puncture was 56.5 minutes (interquartile range, 44.5–73.5) for all patients. The median interval from admission to groin puncture was 68 minutes (interquartile range, 54.5–87 minutes). Comparable intervals in recent randomized data were 51 minutes (interquartile range, 39–68) for scan to groin puncture in the ESCAPE trial (Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times) and 90 minutes (interquartile range, 69–120 minutes) for door to groin puncture in the SWIFT-PRIME study (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment).

Conclusions—
Workflow in GOLIATH demonstrates that magnetic resonance imaging selection for endovascular therapy can be accomplished rapidly and within a similar time frame as computed tomography-based selection.

Clinical Trial Registration—

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02317237.
Understanding Climate Change Perception in Community-Based Management Contexts: Perspectives of Two Indigenous Communities
Authors: Ambrosio-Albala Dr. Pepa , Mar Delgado-Serrano Dr. María 
Published: May 2018

Abstract
Many natural resources around the world are managed by indigenous communities that are closely connected to nature and have nature-based livelihoods. These communities are particularly vulnerable to climate change and in need of adaptation strategies. Therefore, understanding how a community that is connected to nature perceives climate change is crucial. Some studies have shown that the capacity to respond to climate change vulnerability might be influenced by the social ties among community members. We used Q methodology to explore and compare climate change perceptions in two indigenous communities in Colombia and Mexico. Both of these communities are characterized by nature-based livelihoods, collective ownership of land, and community-based natural resource management. We analyzed their perception of climate change and nature, their preferred options for adaptation strategies, and the sources of information they trust. The perceptions that emerged were interpreted according to the four worldviews proposed by cultural theory. Overall, this research suggests that perceptions varied across and within local contexts, meaning that different ways of understanding and dealing with climate change coexist within the communities. The results showed that hierarchy and egalitarian worldviews (as described by cultural theory) are more common in both indigenous communities. The history and lived experiences of community-based management for both communities influence preferred adaptation options to cope with climate change.
Squamous Cell Carcinoma of the Soft Palate in the United States: A Population‐Based Study
Authors: Chan Carmen K. , Han Albert Y. , Alonso Jose E. , Xu Mary J. , Mallen‐St Clair Jon , Heaton Chase M. , Ryan William R. , Kuan Edward C. , St John Maie A. 
Published: May 2018

ObjectivesTo describe the incidence and determinants of survival of patients with squamous cell carcinoma of the soft palate (SCCSP) using the Surveillance, Epidemiology, and End Results (SEER) database.Study DesignRetrospective, population‐based cohort study of patients.SettingSEER cancer registry.Subjects and MethodsPatients from the SEER cancer registry from 1973 to 2015 were used to analyze demographics and survival of SCCSP.ResultsA total of 4366 cases were identified. The average overall survival (OS) and disease‐specific survival (DSS) were 68.7 months and 161.3 months, respectively. Multivariate analysis revealed that male sex, stage, and treatment (hazard ratio [HR] = 0.690, P =. 019; HR = 1.73, P <. 001; HR = 0.64, P <. 001, respectively) were independent determinants of better or worse DSS. Age, stage, and treatment (HR = 1.02, P <. 001; HR = 1.49, P <. 001; HR = 0.66, P <. 001; HR = 0.48, P <. 001, respectively) were independent determinants of better or worse OS. For stages I, II, and III, radiation alone and surgery alone have nearly equivalent OS. Patients with stage IV disease who underwent both surgery and radiation had a significantly higher median OS at 50.0 months.ConclusionRadiation alone and surgery alone both have nearly equivalent OS benefit for stages I to III, while surgery and radiation provide the most survival benefit for stage IV disease. The large discrepancy between OS and DSS can be due to significant comorbidities. Future studies should aim to address the determinants of quality‐of‐life variables that help direct treatment decisions and might indirectly affect survival.
Ipsilateral pulmonary infarction after major lung resection
Authors: Kouritas Vasileios K , Kefaloyannis Emmanuel M , Chaudhuri Nilanjan , Milton Richard 
Published: May 2018

Background Lung infarction is a rare complication of lung resection, developing mainly because of technical errors. In some cases, a specific reason cannot be identified. This study aimed to investigate the occurrence, characteristics, and outcome of this pathology in a series of patients. Methods The medical records of patients who underwent reoperation for lung infarction without an apparent cause (based on imaging, reoperation findings, and histopathology) after major lung resection at our institution from 2006 to 2015, were investigated. Results Seven patients were identified. The mean age was 62.2 years (range 51–75 years), and 5 were male. Copious dissection or adverse events during surgery were recorded in all but 2 cases. The main presenting symptom was unsettling frank hemoptysis (4 cases) with a variable time of onset of symptoms (4–164 h). All reoperations necessitated further lung resection (4 patients had a further lobectomy and 3 had a completion pneumonectomy). During reoperation, all vessels and bronchi were intact. No apparent cause of infarction could be identified according to the histopathology report. Morbidity after reoperation was atrial fibrillation in 3 cases and bronchopleural fistula in 2, one of which required a transsternal pneumonectomy and this was the only mortality. Length of stay ranged from 8 to 90 days. Conclusion Ipsilateral lung infarction after lobectomy is a rare complication and the reason may not be identifiable. Treatment usually requires reoperation. Extensive manipulation or adverse events during surgery could induce this rare complication.
The Nitric Oxide Donor SIN-1-Produced Panic-Like Behaviour And Fear-Induced Antinociception Are Modulated By NMDA Receptors In The Anterior Hypothalamus
Authors: Falconi-Sobrinho Luiz Luciano , Coimbra Norberto Cysne 
Published: May 2018

Background: An excitatory imbalance in the hypothalamus of rodents caused by local chemical stimulation elicits fear-related defensive reactions such as escape and freezing. In addition, these panic attack-like defensive reactions induced by hypothalamic neurons may cause antinociception. However, there is a shortage of studies showing the participation of the anterior hypothalamic nucleus in these adaptive defensive mechanisms. Nitric oxide (NO) donors have been shown to evoke fear-related defensive responses when microinjected into paralimbic and limbic structures, and this excitatory neuromodulation can recruit the glutamatergic system. Aims: The aim of this work was to investigate the influence of the glutamatergic system in the nitrergic effects on fear-related defensive responses organised by anterior hypothalamic neurons. Methods: The present study evaluates the effects of the molsidomine active metabolite SIN-1 NO donor administered into the anterior hypothalamus (AH) of mice at different concentrations (75, 150 and 300 nmol/0.1 μL). Then, we investigated the effects of pre-treatment of the AH with AP-7 (an N-methyl-d-aspartate (NMDA) receptor-selective antagonist; 0.02, 0.2 and 2 nmol/0.1 μL) on the behavioural and antinociceptive effects provoked by AH chemical stimulation with SIN-1 microinjections. Results: The 300 nmol dose of SIN-1 was the most effective at causing panic-like defensive behaviours followed by a significant antinociceptive response. In addition, both of these effects were attenuated or inhibited by AH pre-treatment with AP-7. Conclusions: These findings suggest that the panicogenic and antinociceptive effects evoked by intra-AH microinjections of SIN-1 depend on NMDA receptor activation.
Icariin influences cardiac remodeling following myocardial infarction by regulating the CD147/MMP-9 pathway
Authors: Shi Yu , Yan Weihong , Lin Qiaoyan , Wang Weimin 
Published: May 2018

Objective We investigated the protective effect of icariin on myocardial infarction-induced cardiac remodeling. Methods A cardiac remodeling model was constructed by ligating rats’ coronary artery. Different icariin and CD147 concentrations were administered in the model group, and echocardiography was used to detect systolic function, screening out ideal experimental concentrations. The ventricular systolic function, myocardial apoptosis rate, and expression of collagen type I (Col I), Col III, CD147, matrix metalloproteinase 9 (MMP-9), and tissue inhibitor of metalloproteinase 1 (TIMP-1) were detected by hematoxylin–eosin staining, TUNEL assay, and western blot. MMP-9 activity was evaluated by gelatin zymography. Results The expression of Col I, Col III, CD147, and MMP-9 was higher, the expression of TIMP-1 was lower, and the maximal rates of left ventricular pressure rise and fall (+dp/dtmax and −dp/dtmax, respectively) were lower in model than control rats. The expression of CD147, MMP-9, Col I, and Col III was lower, the expression of TIMP-1 was higher, and the +dp/dtmax and −dp/dtmax were higher in the icariin than model group. The apoptosis rate was lower in the icariin and icariin + CD147 groups than control group. Conclusion Icariin attenuated myocardial apoptosis following myocardial infarction by apoptosis rate reduction and CD147/MMP-9 pathway inhibition.
A Scientific Foundation of Simulation Games for the Analysis and Design of Complex Systems
Authors: Lukosch Heide K. , Bekebrede Geertje , Kurapati Shalini , Lukosch Stephan G. 
Published: May 2018

Background. The use of simulation games for complex systems analysis and design has been acknowledged about 50 years ago. However, articles do not combine all salient factors for successful simulation games, and often stem from a clear view of one particular field of science only. With combining multiple disciplines, connect analysis and design as well as research and practice, we provide deep insights in design and use of simulation games. Aim. This article analyzes the design and evaluation process of a variety of game-based projects and activities, using existing scientific concepts and approaches, in order to establish games as a valid research tool. Our focus lies on the approach towards the use of games as design instrument; using them as an intervention in a larger, complex context, in order to design this context. With our contribution, we aim at providing insights and recommendations on the design and use of games as valid research tools, the limitations of this use, possible pitfalls, but also best practices. Method. We carried out a literature review of related work to identify the most important scientific concepts related to our approach of game design. Further use of combined quantitative and qualitative case study analyses highlights the design process and results of our own game studies. Results. The analyses yielded a consolidated conceptualization of simulation games as research instruments in complex systems analysis and design. The results also include methods for the evaluation of simulation games, additional evaluation methods, and limitations to use simulation games as research instruments. Conclusions. We propose guidelines for using simulation games as research instruments that may be of value to practitioners and scientists alike. Recommendation. We recommend practitioners and scientists to apply the guidelines presented here in their efforts to analyze and design complex systems.
Impact of postoperative haemoglobin on length of stay post fractured hip repair in patients with standardised perioperative management
Authors: Choi Siu-Wai , Leung Frankie K L , Lau Tak-Wing , Wong Gordon T C 
Published: May 2018

Introduction: Perioperative blood transfusion is not without risk and effort should be made to limit patients’ exposure to allogeneic blood. However, there is conflicting data regarding the impact of anaemia on postoperative recovery in patients with repaired hip fractures. It is hypothesised that for a given baseline functional status and fracture type, lower postoperative haemoglobin will increase rehabilitation time and prolong total length of hospital stay. Methods: This is a retrospective study on data collected prospectively on patients entered into the Clinical Pathway aged >65 years admitted to Queen Mary Hospital (QMH) with a fractured neck of femur during 2011–2013. Potential predictor variables were analysed with linear regression with respect to total length of stay and those that reached a significance level of 0.05 were included in further analysis. Results: 1092 patients were admitted to QMH with a suspected fractured neck of femur; data from 747 patients were analysed. The fracture sites were neck of femur (50%), intertrochanteric (48%) and subtrochanteric fracture (2%). Approximately 30% of patients received blood transfusions. Of these only the development of postoperative medical complications statistically prolonged hospital stay. No relationship was seen with haemoglobin levels cut-off above and below 10 g/dl with the result remaining non-significant down to a cut-off of above and below 8 g/dl. Discussion: This study revealed that post-surgical haemoglobin level of between 8 g/dl and 10 g/dL did not have an impact on the total length of hospital stay. The development of postoperative medical complications was the only factor that prolonged the total length of stay.
Health Care Costs, Hospital Admissions, and Glycemic Control Using a Standalone, Real-Time, Continuous Glucose Monitoring System in Commercially Insured Patients With Type 1 Diabetes
Authors: Gill Max , Zhu Cyrus , Shah Mona , Chhabra Harmeet 
Published: May 2018

Background: Studies comparing standalone real-time continuous glucose monitoring (rtCGM) to self-monitoring of blood glucose (SMBG) in patients with type 1 diabetes mellitus (T1DM) have found that rtCGM is associated with lower glycated hemoglobin (A1C) levels, yet does not increase the risk of severe hypoglycemia. However, little is known about the relationship between rtCGM and health care costs and utilization. The objective of this study was to compare health care spending, hospital admissions, and A1C levels of patients using rtCGM to that of patients not using rtCGM. Methods: This retrospective, cross-sectional analysis used a large repository of health plan administrative data to compare average health care costs (excluding durable medical equipment), hospital admissions, and A1C levels of those using rtCGM (N = 1027) versus not using rtCGM (N = 32 583). To control for potentially confounding variables, a propensity score method was used to match patients using rtCGM to those not using rtCGM, based on characteristics such as age, gender, and comorbidities. Results: Patients using rtCGM spent an average of approximately $4200 less in total health care costs, when compared to patients not using rtCGM ( P < .05). They also experienced fewer hospital admissions ( P < .05) and lower A1C ( P < .05) during the postindex year. Conclusions: Use of rtCGM by patients with T1DM is associated with lower health care costs, fewer hospital admissions, and better glycemic control.
The Associations between Adiposity, Cognitive Function, and Achievement in Children
Authors: RAINE LAUREN , DROLLETTE ERIC , KAO SHIH-CHUN , WESTFALL DANIEL , CHADDOCK-HEYMAN LAURA , KRAMER ARTHUR F. , KHAN NAIMAN , HILLMAN CHARLES 
Published: May 2018

ABSTRACT
Although obesity has been related to measures of academic achievement and cognition in children, the influence of fat distribution, specifically visceral adiposity, on select aspects of achievement and cognitive function remains poorly characterized among preadolescent children.

Purpose
The aim of this study was to evaluate the relation of adiposity, particularly visceral adipose tissue (VAT), on achievement and cognitive function among children.

Methods
Children with obesity (ages 8–9 yr old, N = 55, 35 females) completed cognitive and academic tests. Normal weight children (N = 55, 35 females) were matched to this group on demographic characteristics and aerobic fitness. Covariate analyses included age, Brief Intellectual Ability, socioeconomic status, and fat-free V˙O2 (V˙O2 peak adjusted for lean mass; mL·kg lean−1·min−1). Adiposity (i.e., whole body percent fat, subcutaneous abdominal adipose tissue, and VAT) was assessed using dual-energy x-ray absorptiometry.

Results
The results of this study revealed that, relative to their normal weight counterparts, children with obesity had significantly lower performance on tests of reading and math. Analyses revealed that among children with obesity, %Fat and subcutaneous abdominal adipose tissue were not related to cognitive abilities. However, higher VAT was associated with poorer intellectual abilities (Ps ≤ 0.04) and cognitive performance (i.e., thinking ability and cognitive efficiency, Ps ≤ 0.04). However, among normal weight children, VAT was positively associated with intellectual abilities and cognitive efficiency.

Conclusion
In conclusion, the results suggest that VAT was selectively and negatively related with cognition among children with obesity. Along with the dangerous metabolic nature of VAT, its detrimental relationship with obese children’s intellectual and cognitive functioning is concerning.