bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transversus Abdominis Plane Blockade as Part of a Multimodal Postoperative Analgesia Plan in Patients Undergoing Radical Cystectomy
Authors: Matulewicz Richard S. , Patel Mehul , Jordan Brian J. , Morano Jacqueline , Frainey Brendan , Bhanji Yasin , Bux Mahreen , Nader Antoun , Kundu Shilajit D. , Meeks Joshua J. 
Published: April 2018

Background: Radical cystectomy (RC) is a morbid procedure with frequent complications that may benefit from implementation of an enhanced recovery after surgery (ERAS) protocol. Objective: To examine the benefits of a multimodal analgesic plan that uses continuous transversus abdominis plane (TAP) blockade as part of an ERAS protocol after RC. Methods: A retrospective comparison of consecutive patients undergoing RC over a 4-year period was conducted. Patients were designated as having surgery either before or after implementation of an ERAS protocol. A major component of the ERAS protocol was a multi-modal analgesia plan with TAP blockade. Patient demographics, comorbidities, operative details, and outcomes, including days to flatus, bowel movement (BM), narcotic usage, and length of stay (LOS) were compared. Results: In total, 171 patients were included: 100 pre-ERAS and 71 ERAS. There were no differences in age, smoking status, operative approach, or diversion type. The patients in the ERAS cohort were less likely to be male, had a higher median BMI, and more likely to have received neoadjuvant chemotherapy. Total and early postoperative narcotic use were lower in the ERAS cohort: 89 vs. 336 mg ( p < 0.001) and 62 vs 203 mg ( p = 0.001), respectively. The ERAS cohort had fewer days to flatus (3 vs. 4, p < 0.001) and fewer days to bowel movement (4 vs. 5, p < 0.001). Median LOS was shorter in the ERAS cohort (7 vs. 8.5d, p = 0.001). There were no differences in complications or readmission rates between the two cohorts. Conclusions: TAP blockade as part of an ERAS multi-modal pain plan is associated with low narcotic usage, and significant improvement in time to flatus, BM, and LOS compared to traditional post-RC pain management.
Bladder Cancer Genetic Susceptibility. A Systematic Review
Authors: de Maturana Evangelina López , Rava Marta , Anumudu Chiaka , Sáez Olga , Alonso Dolores , Malats Núria 
Published: April 2018

Background: The variant/gene candidate approach to explore bladder cancer (BC) genetic susceptibility has been applied in many studies with significant findings reported. However, results are not always conclusive due to the lack of replication by subsequent studies. Objectives: To identify all epidemiological investigations on the genetic associations with BC risk, to quantify the likely magnitude of the associations by applying metaanalysis methodology and to assess whether there is a potential for publication/reporting bias. Methods: To address our aims, we have catalogued all genetic association studies published in the field of BC risk since 2000. Furthermore, we metaanalysed all polymorphisms with data available from at least three independent case-control studies with subjects of Caucasian origin analyzed under the same mode of inheritance. Results: The characterization of the genetic susceptibility of BC is composed of 28 variants, GWAS contributing most of them. Most of the significant variants associated with BC risk are located in genes belonging to chemical carcinogenesis, DNA repair, and cell cycle pathways. Causal relationship was also provided by functional analysis for GSTM1-null, NAT2-slow, APOBEC-rs1014971, CCNE1-rs8102137, SLC14A1-rs10775480, PSCA-rs2294008, UGT1A-rs1189203, and TP63-rs35592567. Conclusions: Genetic susceptibility of BC is still poorly defined, with GWAS contributing most of the strongest evidence. The systematic review did not provide evidence of further genetic associations. The potential public health translation of the existing knowledge on genetic susceptibility on BC is still limited.
The Role of Adjuvant Radiation Therapy in Locally Advanced Bladder Cancer
Authors: Lewis Gary D. , Haque Waqar , Verma Vivek , Butler E. Brian , Teh Bin S. 
Published: April 2018

Background: The standard of care for locally advanced bladder cancer (LABC) is neoadjuvant chemotherapy followed by cystectomy. However, the role of adjuvant therapy for locally advanced bladder cancer is unclear. Objective: The purpose of this study was to evaluate the outcomes of adjuvant radiation therapy (RT) for patients with LABC, and to determine which risk factors best predict for patients who may best benefit from adjuvant RT. Methods: The National Cancer Data Base (NCDB) was queried (2004– 2013) for patients with newly-diagnosed pT3-4N0-3M0 urothelial carcinoma of the bladder that received neoadjuvant chemotherapy and cystectomy. Patients were divided into two groups based on the adjuvant therapy they received: RT or observation. Statistics included multivariable logistic regression to determine factors predictive of receiving adjuvant RT, Kaplan-Meier analysis to evaluate overall survival (OS), and Cox proportional hazards modeling to determine variables associated with OS. Results: Altogether, 1,646 patients met inclusion criteria; 59 (3.6%) patients received adjuvant RT, while 1,587 (96.4%) were observed. Patients treated with adjuvant RT were more likely to be female, have positive surgical margins, and receive treatment at a non-academic facility. There was no difference in median overall survival (OS) between patients treated with RT when compared to patients observed (17.7 months vs. 23.5 months; p = 0.085). However, an improvement in median OS with the use of adjuvant RT was observed among patients with positive surgical margins (20.3 months vs. 13.1 months; p = 0.032). On multivariate analysis, advancing age, pT4 stage, positive N stage, positive margins, and lower socioeconomic status were associated with worse OS. Conclusions: In the largest study to date evaluating efficacy of adjuvant radiotherapy in patients with locally advanced bladder cancer, use of RT was not associated with OS in all patients, while RT was associated with improvemed OS among patients with positive surgical margins. Prospective studies are recommended to confirm these findings.
Systematic Review: Characteristics and Preclinical Uses of Bladder Cancer Cell Lines
Authors: Zuiverloon Tahlita C.M. , de Jong Florus C. , Costello James C. , Theodorescu Dan 
Published: April 2018

Background: Bladder cancer (BC) cell lines are indispensable in basic and preclinical research. Currently, an up-to-date and comprehensive overview of available BC cell lines is not available. Objective: To provide an overview and resources on the origin, pathological and molecular characteristics of commonly used human, murine and canine BC cell lines. Methods: A PubMed search was performed for relevant articles published between 1980 and 2017 according to the following MeSH terms: cell line; cell line, tumor; urinary bladder neoplasms; carcinoma, transitional cell. The Cellosaurus database was searched, using the term “bladder” and/or “urothelial carcinoma”. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: We provide information on 157 human, murine and canine BC cell lines. 103 human BC cell lines have molecular data available, of which 69 have been profiled by at least one “omic” technology. We outline how these cell lines are currently being used for in vitro and in vivo experimental models. These results allow direct comparison of BC cell lines to patient samples, providing information needed to make informed decisions on the most genomically appropriate cell line to answer research questions. Furthermore, we show that cross-contamination remains an issue and describe guidelines for prevention. Conclusions: In the BC field, multiple human, murine and canine BC cell lines have been developed and many have become indispensable for in vitro and in vivo research. High-throughput -omic technologies have dramatically increased the amount of molecular data on these cell lines. We synthesized a comprehensive overview of these data as a resource for the BC scientific community.
Effects of polymer-coated boron nitrides with increased hemorheological compatibility on human erythrocytes and blood coagulation
Authors: Kim Jeongho , Nafiujjaman Md , Nurunnabi Md , Lim Sinye , Lee Yong-Kyu , Park Hun-Kuk 
Published: April 2018

BACKGROUND: Boron nitride (BN) nanomaterials are promising in biomedical research owing to their large surface area, graphene-like structure, and chemical and thermal properties. However, the toxicological effects of BN on erythrocytes and blood coagulation remain uninvestigated. OBJECTIVE: The aims of our study were to synthesize glycol chitosan (GC)- and hyaluronic acid (HA)-coated BNs, and to investigate the effects of these BNs on human cancer cells, erythrocytes, and whole blood. METHODS: We prepared hemocompatible forms of BN coated with GC and HA, and evaluated them using cell uptake/viability tests, hemolysis analysis and FE-SEM, as well as through hemorheological evaluation methods such as RBC deformability and aggregation, and blood coagulation. RESULTS: GC/BN and HA/BN were both ∼200 nm, were successfully taken into cells, and emitted blue fluorescence. Both BNs were less toxic than bare BN, even at higher concentrations. The aggregation index of human red blood cells (RBCs) after 2 h incubation with BN, GC/BN, and HA/BN was greatly influenced, whereas RBC deformability did not dramatically change. CONCLUSIONS: We found that GC/BN affected the intrinsic coagulation pathway, whereas both GC/BN and HA/BN affected the extrinsic pathway. Therefore, HA/BN is less detrimental to RBCs and blood coagulation dynamics than bare BN and GC/BN.
Application of contrast-enhanced ultrasound in the diagnosis of small breast lesions
Authors: Du Yan-Ran , Wu Yang , Chen Man , Gu Xin-Gang 
Published: April 2018

BACKGROUND: Breast cancer is the most common cancer in women worldwide. The purpose of the study was to observe the features of contrast-enhanced ultrasound (CEUS) and the combination with Breast Imaging-Reporting and Data System (BI-RADS) of conventional ultrasound for assessing small breast lesions. OBJECTIVES: The study was to explore the small breast lesions’ features of contrast-enhanced ultrasound (CEUS) and the combination with Breast Imaging-Reporting and Data System (BI-RADS) of conventional ultrasound, in order to improve the diagnostic accuracy of early breast cancer. METHODS: 105 lesions were subject to conventional US (ultrasound) and CEUS before operations or biopsies. Among 105 breast lesions, six patient diagnoses were established by thick core-needle biopsy, while the rest were all confirmed by surgery and pathology. RESULTS: Significant differences were found between benign and malignant lesions in qualitative and quantitative indexes (peak) of CEUS ( P < 0.05). The qualitative features of malignant small breast lesions were as follows: (1) enhanced intensity within the lesion was not uniform (61/61,100%); (2) the speed of wash-in was earlier than the surrounding tissue (58/61, 95.1%); (3) lesion interior and the surrounding tissues had contrast vessel performance (61/61,100%). Peak of malignant lesions (35.77±11.45) was higher than that of benign lesions (31.96±10.76) ( P < 0.05). The diagnostic performance of BI-RADS-US plus qualitative indexes (method one) in terms of area under receiver operating characteristic curve (AUROC) were the highest (i.e., AUROC = 0.817), in comparison with other combined diagnostic methods. The associated sensitivity, specificity and accuracy were 78.69%, 84.09% and 80.95%, respectively. With method one, however, was similar with US-BI-RADS in specificity, 11 malignant breast lesions were regarded as a higher classification of BI-RADS and classified into malignant group, which were identified as benign on US-BI-RADS originally. CONCLUSIONS: CEUS was useful to differentiate benign from malignant small breast lesions, and the combination of CEUS and BI-RADS-US can improve the early diagnosis of breast cancers.
Pulmonary hemodynamic effects and pulmonary arterial compliance during hypovolemic shock and reinfusion with human relaxin-2 (serelaxin) treatment in a sheep model
Authors: Schiffner René , Lehmann Thomas , Bischoff Sabine J. , Zippelius Timo , Nistor Marius , Schmidt Martin 
Published: April 2018

BACKGROUND: Previous studies on the recombinant form of human relaxin-2 (serelaxin) have shown a decrease of pulmonary hemodynamics after serelaxin injection. Currently, the effect of serelaxin treatment during hypovolemia in a large animal model remains mostly unknown. METHODS: 12 sheep were randomly assigned to a sham or serelaxin (30μg/kg serelaxin) group and underwent right heart catheterization. 50% of the estimated total blood volume were removed to induce hypovolemia, and subsequently retransfused 20 min later (reinfusion). Blood gases, heart rate, peripheral and pulmonary arterial oxygen saturation, systolic, diastolic and mean values of both pulmonary artery pressure (PAP) and pulmonary capillary wedge pressure (PCW) were measured. Cardiac output (CO), pulmonary vascular resistance (PVR), pulmonary arterial compliance (PAcompl) and systemic vascular resistance (SVR) were calculated. RESULTS: Hypovolemia and shock led to a similar decrease of PAP and PCW in both groups ( p≤0.001). CO, SV and PAcompl decreased only in the control group ( p≤0.05) and remained higher in the serelaxin-treated group. The results of this study suggest that serelaxin treatment did not negatively influence hemodynamic parameters during hypovolemic shock. CONCLUSION: The main conclusion of this study is that cardiopulmonary adaption mechanisms are not critically altered by serelaxin administration during severe hypovolemia and retransfusion.
The combined effects of the microcirculatory status and cardiopulmonary bypass on platelet count and function during cardiac surgery
Authors: Di Dedda Umberto , Ranucci Marco , Porta Alberto , Bari Vlasta , Ascari Alice , Fantinato Angela , Baryshnikova Ekaterina , Cotza Mauro 
Published: April 2018

BACKGROUND: Cardiac surgery with cardiopulmonary bypass is associated with important changes in the microcirculation, usually attributed to endothelial dysfunction. Another common finding of cardiac surgery is postoperative thrombocytopenia and platelet loss of function. OBJECTIVE: To investigate the association between microvascular flow pattern and postoperative changes in platelet count and function in cardiac surgery patients. METHODS: Twelve adult cardiac surgery patients received microvascular circulation (sidestream darkfield sublingual mucosa analysis) and platelet count and function (multiple electrode aggregometry ADPtest and TRAPtest) assessment before and after cardiopulmonary bypass. RESULTS: After cardiopulmonary bypass, sublingual microcirculation showed a significantly ( P = 0.001) decreased microvascular flow index and increased heterogeneity index ( P = 0.006). Platelet function significantly decrease after cardiopulmonary bypass both at ADPtest ( P = 0.011) and TRAPtest ( P = 0.002). Preoperative patterns of poor microvascular perfusion (low perfused vessels density and total vessels density) were significantly associated with lower values of post-cardiopulmonary bypass platelet function (ADPtest, P = 0.009, TRAPtest, P = 0.031) and count ( P = 0.048). CONCLUSIONS: A preoperative disturbance of the microcirculation is associated with a greater postoperative platelet dysfunction. Endothelial damage, chemical and mechanical stimuli are the possible link between the two patterns.
Beta-estradiol and ethinylestradiol enhance RBC deformability dependent on their blood concentration
Authors: Farber Paulo L. , Freitas Teresa , Saldanha Carlota , Silva-Herdade Ana Santos 
Published: April 2018

BACKGROUND: Natural and synthetic estrogens seems to have opposite effects on thrombosis and female cardiovascular system, since natural estrogen was supposed to be protective against cardiovascular diseases and synthetic estrogen has been related to thrombosis and cardiovascular diseases. In this work we have investigated if these differences could be related with the effects on those hormones on some hemorheological parameters. OBJECTIVE: The objective of this work was to investigate the hemorheological changes of different concentrations of beta-estradiol and ethinylestradiol, on RBC aggregation and RBC deformability. METHODS: Samples of blood of healthy donors were added with different concentrations of natural beta-estradiol or synthetic ethinylestradiol and were analyzed for red blood cell (RBC) aggregation and RBC deformability. RESULTS: There were no significant changes in RBC aggregation. Both beta-estradiol and ethinylestradiol increase the RBC deformability in shear stresses above 3.0 Pa accordingly with the hormone’s concentration. CONCLUSIONS: Beta-estradiol and ethinylestradiol enhance RBC deformability dependent of their concentration. These findings may explain the different patterns of thrombotic and cardiovascular effects in different phases of the menstrual cycle or different dosages of oral contraceptive or hormonal replacement therapy.
Two-dimensional shear wave elastography for differential diagnosis between mastitis and breast malignancy
Authors: Liu Shui-Qing , Liu Yan-Ping , Zhou Bang-Guo , Deng Xiao-Hong , Li Xiao-Long , Xiang Li-Hua , Ren Wei-Wei , Xu Hui-Xiong 
Published: April 2018

OBJECTIVE: To determine the diagnostic performance of conventional ultrasound (US) and two-dimensional shear wave elastography (2D SWE) in the differential diagnosis between mastitis and breast malignancy. METHODS: Between January 2016 and March 2017, 105 patients with 105 pathologically proven breast lesions were enrolled. All the lesions were subject to conventional US and 2D SWE examinations. In 2D SWE, the qualitative parameter of stiff rim sign and quantitative parameter of maximal shear wave velocity (SWV) were obtained. The diagnosis performances of US and combination of US and 2D SWE were evaluated, including sensitivity, specificity and the area under the receiver operating characteristic curve (AUROC). The AUROC of US and the combined method were also evaluated in subgroups with different diameters. RESULTS: Pathologically, 26 breast lesions were confirmed to be mastitis and 79 were malignant. The cut-off value for maximal SWV was 6.75 m/sec. The AUROC of stiff rim sign and maximal SWV were 0.701 (95% CI: 0.587–0.815) and 0.753 (95% CI: 0.659–0.832) respectively. Compared with US, the specificity and AUROC of the combined method increased significantly (specificity: 11.5% vs. 96.1%, AUROC: 0.520 vs. 0.752; both P < 0.05). CONCLUSIONS: The combination of US and 2D SWE improved the diagnostic performance in the differential diagnosis between mastitis and breast malignancy in comparison with the conventional US alone.
Limitations of an automated embolism segmentation method in clinical practice
Authors: Wang Ruifeng , Yu Nan , Zhou Sheng , Dong Fuwen , Wang Jun , Yin Nan , Bai Lu , Shen Cong , Guo Youmin 
Published: April 2018

PURPOSE: Automated pulmonary embolism (PE) segmentation is frequently used as a preprocessing step in the quantitative analysis of pulmonary embolism. Objective of this study is to analyze the potential limitation in automated PE segmentation using clinical cases. METHODS: A database of 304 computer tomography pulmonary angiography (CTPA) examinations was collected and confirmed to be PE. After processing using an automated scheme, two radiologists classified these cases into four groups of A, B, C and D, which represent 4 different segmentation results namely, (1) entire pulmonary artery identified without motivation artifacts, (2) entire pulmonary artery identified with motivation artifacts, (3) part of the pulmonary artery identified, and (4) none of the pulmonary artery identified. Then, the possible failed reasons in PE segmentation were analyzed and determined based on the image characterization of the diseases and the applied CTPA scanning protocols. RESULTS: In the study, 143 (47.0%., 30 (9.9%., 110 (36.2%. and 21 (6.9%. examinations were classified into groups A, B, C and D, respectively. Group C and D included the cases with failed segmentation. Fifteen failure reasons, including intrapulmonary abnormalities, extra-pulmonary abnormalities, diffuse pulmonary diseases, enlarged heart, absolute occluded vessels, embolism attached to artery wall, delayed scan time, skewed location, low scan dose, obvious artifact of superior vena cava, previous chest surgery, congenital deformities of the chest, incorrect positioning, missed images and other unknown reasons, were determined with corresponding case percentages ranging from 0.3%.o 9.2%. CONCLUSIONS: Automated segmentation failures were caused by specific lung diseases, anatomy varieties, improper scan time, improper scan dose, manual errors or other unknown reasons. Realization of those limitations is crucial for developing robust automated schemes to handle these issues in a single pass when a large number of CTPA examinations need to be analyzed.
N2 fixation as a dominant new N source in the western tropical South Pacific Ocean (OUTPACE cruise)
Authors: Caffin Mathieu , Moutin Thierry , Foster Rachel Ann , Bouruet-Aubertot Pascale , Doglioli Andrea Michelangelo , Berthelot Hugo , Guieu Cécile , Grosso Olivier , Helias-Nunige Sandra , Leblond Nathalie , Gimenez Audrey , Petrenko Anne Alexandra , de Verneil Alain , Bonnet Sophie 
Published: May 2018

Abstract. We performed nitrogen (N) budgets in the photic layer of three
contrasting stations representing different trophic conditions in the western
tropical South Pacific (WTSP) Ocean during austral summer conditions
(February–March 2015). Using a Lagrangian strategy, we sampled the same
water mass for the entire duration of each long-duration (5 days) station,
allowing us to consider only vertical exchanges for the budgets. We
quantified all major vertical N fluxes both entering (N2 fixation,
nitrate turbulent diffusion, atmospheric deposition) and leaving the photic
layer (particulate N export). The three stations were characterized by a
strong nitracline and contrasted deep chlorophyll maximum depths, which were
lower in the oligotrophic Melanesian archipelago (MA, stations LD A and LD B)
than in the ultra-oligotrophic waters of the South Pacific Gyre (SPG, station
LD C). N2 fixation rates were extremely high at both LD A
(593 ± 51 µmol N m−2 d−1) and LD B
(706 ± 302 µmol N m−2 d−1), and the diazotroph
community was dominated by Trichodesmium. N2 fixation rates
were lower (59 ± 16 µmol N m−2 d−1) at LD C, and
the diazotroph community was dominated by unicellular N2-fixing
cyanobacteria (UCYN). At all stations, N2 fixation was the major source
of new N (> 90 %) before atmospheric deposition and upward nitrate
fluxes induced by turbulence. N2 fixation contributed circa 13–18 %
of primary production in the MA region and 3 % in the
SPG water and sustained
nearly all new primary production at all stations. The e ratio
(e ratio = particulate carbon export ∕ primary production) was
maximum at LD A (9.7 %) and was higher than the e ratio in most studied
oligotrophic regions (< 5 %), indicating a high efficiency of the WTSP
to export carbon relative to primary production. The direct export of
diazotrophs assessed by qPCR of the nifH gene in sediment traps
represented up to 30.6 % of the PC export at LD A, while their
contribution was 5 and < 0.1 % at LD B and LD C, respectively. At the
three studied stations, the sum of all N input to the photic layer exceeded
the N output through organic matter export. This disequilibrium leading to N
accumulation in the upper layer appears as a characteristic of the WTSP
during the summer season.