bluuebunny/crossref_metadata_2025_split huggingface dataset:
UBC‐Nepal expedition: phenotypical evidence for evolutionary adaptation in the control of cerebral blood flow and oxygen delivery at high altitude
Authors: Hoiland Ryan L. , Howe Connor A. , Carter Howard H. , Tremblay Joshua C. , Willie Chris K. , Donnelly Joseph , MacLeod David B. , Gasho Chris , Stembridge Mike , Boulet Lindsey M. , Niroula Shailesh , Ainslie Philip N. 
Published: April 2019

Key points
Sherpa have lived in the Nepal Himalaya for 25–40 thousand years and display positive physiological adaptations to hypoxia.
Sherpa have previously been demonstrated to suffer less negative cerebral side effects of ascent to extreme altitude, yet little is known as to whether or not they display differential regulation of oxygen delivery to the brain compared to lowland natives.
We demonstrate that Sherpa have lower brain blood flow during ascent to and acclimatization at high altitude compared to lowlanders and that this difference in flow is not attributable to factors such as mean arterial pressure, blood viscosity and pH.
The observed lower cerebral oxygen delivery in Sherpa likely represents a positive adaptation that may indicate a cerebral hypometabolic conservation of energy at altitude and/or decreased risk of other cerebral consequences such as vasogenic oedema.
AbstractDebilitating side effects of hypoxia manifest within the central nervous system; however, high‐altitude natives of the Tibetan plateau, the Sherpa, experience negligible cerebral effects compared to lowland natives at extreme altitude. Phenotypical optimization of the oxygen cascade has been demonstrated in the systemic circulation of Tibetans and Sherpa, likely underscoring their adapted capacity to thrive at altitude. Yet, little is known as to how the cerebral circulation of Sherpa may be adapted. To examine potential differences in cerebral oxygen delivery in Sherpa compared to lowlanders we measured arterial blood gases and global cerebral blood flow (duplex ultrasound) during a 9 day ascent to 5050 m. Although cerebral oxygen delivery was maintained during ascent in lowlanders, it was significantly reduced in the Sherpa at 3400 m (−30.3 ± 21.6%; P < 0.01) and 4371 m (−14.2 ± 10.7%; P = 0.03). Furthermore, linear mixed effects modelling indicated that independent of differences in mean arterial pressure, pH and blood viscosity, race accounts for an approximately 100 mL min−1 (∼17–34%) lower cerebral blood flow in Sherpa compared to lowlanders across ascent to altitude (P = 0.046). To ascertain the role of chronic hypoxia independent of the ascent, Sherpa who had not recently descended were also examined at 5050 m. In these Sherpa, cerebral oxygen delivery was also lower compared to lowlanders (∼22% lower; P < 0.01). We highlight new information about the influence of race and genetic adaptation in the regulation of cerebral oxygen delivery. The lower cerebral oxygen delivery in the Sherpa potentially represents a positive adaptation considering Sherpa endure less deleterious cerebral consequences than lowlanders at altitude.
A blood-based prognostic biomarker in IBD
Authors: Biasci Daniele , Lee James C , Noor Nurulamin M , Pombal Diana R , Hou Monica , Lewis Nina , Ahmad Tariq , Hart Ailsa , Parkes Miles , McKinney Eoin F , Lyons Paul A , Smith Kenneth G C 
Published: April 2019

ObjectiveWe have previously described a prognostic transcriptional signature in CD8 T cells that separates patients with IBD into two phenotypically distinct subgroups, termed IBD1 and IBD2. Here we sought to develop a blood-based test that could identify these subgroups without cell separation, and thus be suitable for clinical use in Crohn’s disease (CD) and ulcerative colitis (UC).DesignPatients with active IBD were recruited before treatment. Transcriptomic analyses were performed on purified CD8 T cells and/or whole blood. Phenotype data were collected prospectively. IBD1/IBD2 patient subgroups were identified by consensus clustering of CD8 T cell transcriptomes. In a training cohort, machine learning was used to identify groups of genes (‘classifiers’) whose differential expression in whole blood recreated the IBD1/IBD2 subgroups. Genes from the best classifiers were quantitative (q)PCR optimised, and further machine learning was used to identify the optimal qPCR classifier, which was locked down for further testing. Independent validation was sought in separate cohorts of patients with CD (n=66) and UC (n=57).ResultsIn both validation cohorts, a 17-gene qPCR-based classifier stratified patients into two distinct subgroups. Irrespective of the underlying diagnosis, IBDhi patients (analogous to the poor prognosis IBD1 subgroup) experienced significantly more aggressive disease than IBDlo patients (analogous to IBD2), with earlier need for treatment escalation (hazard ratio=2.65 (CD), 3.12 (UC)) and more escalations over time (for multiple escalations within 18 months: sensitivity=72.7% (CD), 100% (UC); negative predictive value=90.9% (CD), 100% (UC)).ConclusionThis is the first validated prognostic biomarker that can predict prognosis in newly diagnosed patients with IBD and represents a step towards personalised therapy.
Serum levels of interleukin-6, interleukin-8, interleukin-10, and tumor necrosis factor-α, renal function biochemical parameters and clinical outcomes in pediatric cardiopulmonary bypass surgery
Authors: Gorjipour Farhad , Totonchi Ziya , Gholampour Dehaki Maziar , Hosseini Saeid , Tirgarfakheri Koroush , Mehrabanian Mohamadjavad , Mortazian Meysam , Arasteh Manesh Shaghayegh , Rahab Mehdi , Shafighnia Shora , Taiyari Saeed , Gorjipour Fazel 
Published: April 2019

Background: Cardiopulmonary bypass causes detrimental effects on remote organs due to inflammatory response. One of these organs is kidney that is frequently affected by cardiac surgery. Acute kidney injury is a post-cardiopulmonary bypass complication, which may result in increased post-operative morbidity and mortality. Post-cardiopulmonary bypass inflammatory response may contribute to remote organ dysfunction. In the present study, we investigated the relation between cytokines including interleukin-6, interleukin-8, interleukin-10, and tumor necrosis factor-α, and renal function tests such as creatinine and blood urea nitrogen (BUN). Methods: In total, 91 patients between the ages of 4 and 60 months were enrolled for elective cardiac surgery with cardiopulmonary bypass after informed consent. Data regarding renal function tests and clinical outcomes were carefully recorded until 24 hours after admission to intensive care unit and analyzed. Results: Our findings support that there is a direct correlation between cytokines including interleukin-6, interleukin-8, interleukin-10, and tumor necrosis factor-α and cardiopulmonary bypass time, duration of operation, and intensive care unit stay. Longer cardiopulmonary bypass time was associated with higher interleukin-8 at cross-clamp removal and 24 hours post- intensive care unit as well as higher interleukin-10 at declamp time. Higher interleukin-6 at declamp time was directly correlated with higher post-operative BUN. Interleukin-8 level after anesthesia induction was directly correlated with intensive care unit stay duration. Higher blood interleukin-6 and tumor necrosis factor-α levels following 24 hours of admission to intensive care unit were associated with longer mechanical ventilation time. Conclusion: Higher circulatory pro-inflammatory cytokine level is associated with adverse outcomes such as increased intensive care unit stay and longer mechanical ventilation time in pediatric patients. It is also correlated with unfavorable biochemical parameter of renal function, BUN. Findings hint that proper control of the inflammatory response is vital for the control of unfavorable clinical and pathological outcomes.
Veno-venous extracorporeal life support for blastomycosis-associated acute respiratory distress syndrome
Authors: Al-Fares Abdulrahman , Fan Eddy , Husain Shahid , Di Nardo Matteo , Cypel Marcelo , Keshavjee Shaf , Herridge Margaret S , Del Sorbo Lorenzo 
Published: April 2019

Background: Blastomyces is a dimorphic fungus endemic to regions of North America, which can lead to pneumonia and fatal severe acute respiratory diseases syndrome in up to 89% of patients. Extracorporeal life support can provide adequate oxygenation while allowing the lungs to rest and heal, which might be an ideal therapy in this patient group, although long-term clinical and radiological outcomes are not known. Clinical features: We report on five consecutive patients admitted to Toronto General Hospital intensive care unit between January 2012 and September 2016, with progressive respiratory failure requiring veno-venous extracorporeal life support within 24-96 hours following mechanical ventilation. Ultra-lung protective mechanical ventilation was achieved within 24 hours. Recovery was the initial goal in all patients. Extracorporeal life support was provided for a prolonged period (up to 49 days), and four patients were successfully discharged from the intensive care unit. Long-term radiological assessment in three patients showed major improvement within 2 years of follow-up with some persistent disease-related changes (bronchiectasis, fibrosis, and cystic changes). In two patients, long-term functional and neuropsychological outcomes showed similar limitations to what is seen in acute respiratory distress syndrome patients who are not supported with extracorporeal life support and in acute respiratory distress syndrome patients without blastomycosis, but worse pulmonary function outcomes in the form of obstructive and restrictive changes that correlated with the radiological imaging. Conclusion: Veno-venous extracorporeal life support can effectively provide prolonged support for patients with blastomycosis-associated acute respiratory distress syndrome that is safe and associated with favorable long-term outcomes.
‘It was peaceful, it was beautiful’: A qualitative study of family understandings of good end-of-life care in hospital for people dying in advanced age
Authors: Gott Merryn , Robinson Jackie , Moeke-Maxwell Tess , Black Stella , Williams Lisa , Wharemate Rawiri , Wiles Janine 
Published: April 2019

Background: Hospitals are important sites of end-of-life care, particularly for older people. A need has been identified to understand best practice in hospital end-of-life care from the service-user perspective. Aim: The aim of this study was to identify examples of good care received in the hospital setting during the last 3 months of life for people dying in advanced age from the perspective of bereaved family members. Design: A social constructionist framework underpinned a qualitative research design. Data were analysed thematically drawing on an appreciative enquiry framework. Setting/participants: Interviews were conducted with 58 bereaved family carers nominated by 52 people aged >80 years participating in a longitudinal study of ageing. Data were analysed for the 21 of 34 cases where family members were ‘extremely’ or ‘very’ satisfied with a public hospital admission their older relative experienced in their last 3 months of life. Results: Participants’ accounts of good care aligned with Dewar and Nolan’s relation-centred compassionate care model: (1) a relationship based on empathy; (2) effective interactions between patients/families and staff; (3) contextualised knowledge of the patient/family; and (4) patients/families being active participants in care. We extended the model to the bicultural context of Aotearoa, New Zealand. Conclusion: We identify concrete actions that clinicians working in acute hospitals can integrate into their practice to deliver end-of-life care with which families are highly satisfied. Further research is required to support the implementation of the relation-centred compassionate care model within hospitals, with suitable adaptations for local context, and explore the subsequent impact on patients, families and staff.
Usefulness of plateletcrit in the prediction of major adverse cardiac and cerebrovascular events in patients with carotid artery stenosis
Authors: Aslan Serkan , Demir Ali Rıza , Demir Yusuf , Taşbulak Ömer , Altunova Mehmet , Karakayalı Muammer , Yılmaz Emre , Gürbak İsmail , Ertürk Mehmet 
Published: April 2019

Objectives Platelets play an important role in the pathogenesis of atherosclerosis and the physiopathology of cardiovascular events. Plateletcrit provides complete information on total platelet mass. The relationship between plateletcrit values and long-term outcomes in patients with carotid stenosis is not known. The purpose of the present study is to evaluate the reliability of plateletcrit for predicting major adverse cardiac and cerebrovascular events (MACCE) in patients with carotid stenosis. Methods A total of 230 patients with more than 50% stenosis of the carotid artery were retrospectively included in this study. All cases were divided into two groups according to the calculated threshold value of plateletcrit with receiver operating characteristics curve and baseline parameters and clinical outcomes were compared. Univariate and multivariate analyses were used to evaluate the association between the plateletcrit and MACCE. Results The cut-off value for plateletcrit was found to be 0.233 for predicting MACCE, with 56.2% sensitivity and 68.0% specificity. High plateletcrit levels were demonstrated to be statistically higher in patients with MACCE (0.247 in the MACCE (+) group vs. 0.213 in the MACCE (–) group, p < 0.001). In the Kaplan–Meier survival analysis, the long-term mortality rate was higher in the high plateletcrit group ( p = 0.006). Multivariate regression analysis showed that plateletcrit was independently associated with MACCE (OR: 2.196, CI: 1.200–4.018; p = 0.011). Conclusions Our data suggest that plateletcrit has an independently predictive value for long-term mortality and MACCE, and it can be used as a marker to predict the long-term adverse outcomes in patients with carotid stenosis.
How professional memory influences vocational teachers’ perception of changes related to students
Authors: Sirk Meidi , Liivik Reeli , Ümarik Meril , Loogma Krista 
Published: April 2019

Kutseõpetajate professionaalsust mõjutavad oluliselt õpilaskonna muutused, millega on kaasnenud uued nõudmised tööle. Varasemates uurimustes on rõhutatud, et muutuste kogemisele avaldab mõju professionaalne mälu, mis sisaldab ametialaseid mälestusi ja sündmusi, kujundades nende kaudu professionaalseid teadmisi ja tööalaseid tavasid. Käsitledes professionaalset mälu kui ühte kutseõpetajate professionaalsuse karakteristikut, oleme seadnud uurimuse eesmärgiks selgitada kutseõpetajate kogetud muutusi õpilaskonnas, tuginedes professionaalse mälu kontseptsioonile. Artikkel põhineb kombineeritud uurimisviisil, kus andmeid koguti kvantitatiivse küsitluse ja kvalitatiivse poolstruktureeritud intervjuudega. Uurimistulemustest ilmneb, et lühema staažiga ja nooremad kutseõpetajad kogevad muutusi õpilaskonnas positiivsemalt kui pikema staažiga ja vanemad kutseõpetajad. Lisaks mõjutab muutuste kogemist töö kontekst. Õpilaskonna muutustele antud tähendused sõltuvad ühiskondlikest ja hariduspoliitilistest sündmustest, millega õpetajad on kokku puutunud, ning tööga seotud nostalgilistest mälestustest.
Summary
СПЛАХНОНИМИЧЕСКАЯ ЛЕКСИКА ВО ФРАЗЕОЛОГИЧЕСКИХ ЕДИНИЦАХ: ЛИНГВОПРАГМАТИЧЕСКИЙ АСПЕКТ
Authors: Nemchinova Natalya Viktorovna 
Published: April 2019

Цель. Статья посвящена выявлению, описанию и анализу фразеологических единиц, содержащих наименование внутренних органов человека.Предметом анализа выступают фразеологические единицы русского языка со сплахнонимической лексикой. Авторы ставят целью рассмотреть выявленные фразеологические единицы с позиции лингвистической прагматики.Метод или методология проведения работы. Основу исследования образуют анализ и синтез эмпирического материала, его обобщение и классификация, а также дефиниционный анализ.Результаты. Результаты работы заключаются в том, что соматические фразеологизмы были расклассифицированы относительно намерений говорящего. Выбранные единицы для лингвистического анализа были описаны с применением основных положений лингвистической прагматики. Определены соматические единицы с прямым и скрытым воздействием на получателя информации.Область применения результатов. Результаты исследования могут быть применены в дальнейших научно-исследовательских работах, связанных с изучением фразеологических единиц, содержащих в своем составе соматизмы, а именно наименование внутренних органов человека.
Benefit Finding in Adults Treated for Benign Meningioma Brain Tumours: Relations with Psychosocial Wellbeing
Authors: Kangas Maria , Williams Janet R. , Smee Robert I. 
Published: April 2019

AbstractIntroduction: Research has indicated that individuals may report benefit finding (BF) as a result of experiencing potentially life-threatening traumatic events, such as being diagnosed with cancer or sustaining an acquired brain injury (ABI). No study to date has examined the incidence and correlates of BF in adult brain tumour samples. The present study aimed to investigate the association between BF and demographic and psychosocial variables in adults treated for a benign meningioma. Method: Seventy participants aged 36 to 87 years completed questionnaires that assessed perceived BF resulting from one's meningioma experience, intrusion and avoidance symptoms, emotional wellbeing and perceived quality of social support. Results: 39% of the sample had been diagnosed with their tumour within a 2-year period prior to assessment (‘early’ meningioma subgroup), while the remaining 61% of participants had been diagnosed with their tumour for more than 2 years (‘late’ meningioma subgroup). Almost two thirds (63%) of the sample reported deriving a moderate amount of BF due to their meningioma experience; although different psychological variables were found to be associated with BF according to group status. Whereas greater BF was found to be significantly associated with elevated depressive symptoms in the ‘early’ subsample, elevated BF was significantly positively correlated with intrusions and avoidance symptoms in the ‘late’ subsample. Conclusions: The findings indicate that BF may co-occur in context of both adaptive and positive illusory processes, which is consistent with the Janus-Face model of growth following adversity. The findings also support the use of psychosocial interventions to facilitate psychosocial adjustment following health crises.
Intracystic Hemorrhage Complicating Polycystic Liver Disease in a 90-Year-Old Woman
Authors: Purdy Amanda C. , Grigorian Areg , Fernando Dayantha , Nahmias Jeffry , Demirjian Aram N. 
Published: April 2019

ABSTRACT
Nonparasitic hepatic cysts are common benign tumors that are often asymptomatic and incidentally discovered on imaging. Intracystic hemorrhage is a rare complication of hepatic cysts. We review the literature and discuss a case of intracystic hemorrhage in a 90-year-old woman with polycystic liver disease. The patient underwent cyst aspiration and percutaneous drain placement with subsequent resolution of symptoms. To our knowledge, we report the oldest patient to present with hemorrhage into a hepatic cyst. This case presents unique challenges in management, both because of the patient's age and because of her polycystic liver disease.
Combined Immunodeficiency With Inflammatory Bowel Disease in a Patient With TTC7A Deficiency
Authors: Broome David T. , Young Andrew , Torbic Heather , Krishnan Sudhir , Gordon Ilyssa , Lai Keith , Rizk Maged , Rieder Florian 
Published: April 2019

ABSTRACT
Tetratricopeptide repeat domain-7A (TTC7A) deficiency causing combined immunodeficiency with inflammatory bowel disease (IBD) is rare. This case report alerts physicians to the possibility of TTC7A deficiency causing combined immunodeficiency with IBD and also highlights some of the current treatment options. We describe a 19-year-old patient with a compound heterozygote TTC7A mutation causing combined immunodeficiency, IBD, and multiple intestinal atresia. Compound heterozygote TTC7A mutations are known to cause combined immunodeficiency and IBD. Although rare, clinicians should be alerted to this variant and should understand the general approach to treatment.
Corrosion performance of cold deformed austenitic stainless steels for biomedical applications
Authors: Talha Mohd , Ma Yucong , Lin Yuanhua , Pan Yong , Kong Xiangwei , Sinha O.P. , Behera C.K. 
Published: April 2019

AbstractAustenitic stainless steels possess an excellent balance of strength and ductility along with the high ability to further raise their strength during cold deformation (CD). Corrosion resistance of austenitic stainless steels (SSs) is affected by cold deformation because passive films on the surface of steels are expected to be modified. A low level of CD enhances the surface diffusion, which results in the formation of a stable passive film leading to an increase in the corrosion resistance in neutral chloride solutions. The chromium content in the passive film on a deformed steel surface is usually richer, with a higher Cr/Fe ratio than that formed on annealed steels. A higher chromium content makes surface films more stable, which improves the corrosion resistance. However, severe CD results in the formation of strain-induced martensite phase and deformation twins, which decreases the localized corrosion resistance by increasing the number of active anodic sites on the surface. The corrosion resistance, especially the pitting resistance, in SSs is diminished with increasing volume fraction of the martensite. In this review, we highlighted the failure modes of corrosion of stainless steel implants, factors affecting corrosion, and effect of CD on mechanical properties and emphatically on the corrosion resistance of SSs for biomedical applications.
An Intelligent Vehicle Control System for Enhancing Road Safety Using Optimal Visible Light Communication Network
Authors: Begum Shaeista , Patil Nagaraj B. 
Published: April 2019

Abstract
A visible light communication (VLC) provides potential and effective communication paradigm due to the demand of high data-rate applications. VLC networks, consisting of multiple light emitting diodes (LEDs) and it provides the low-cost high data-rate transmission to multiple users simultaneously in indoor environments. VLC has been recently introduced as a secure directional data transmission in vehicle to vehicle to provide an intelligent vehicle control system. However, the performance of this system is mostly affected by the collision of data transmission between different users. In this paper, we introduce an optimal visible light communication (OVLC) network that allows vehicles which have provides collision aware data transmission to improve the chance of transmitting information successively according to the network condition. Firstly, the next forwarding node is selected by the chaotic fish swarm optimization (CFSO) algorithm with the help of vehicle information’s such as intensity of light, the distance and speed of neighboring vehicles. The second contribution is to illustrate the congestion control (CC) system for avoiding extra time due to the control packets exchange process. The optimal result is then forward to the source vehicle equipped device, which helps the driver to make a healthy to control vehicle and efficiently avoid or prevent road accidents under different circumstances. The results show that the proposed OVLC network performs very efficient than existing network in terms of quality metrics, such as throughput, delay, packet loss rate, energy consumption and fairness index.