bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel protective role for MAP kinase phosphatase 2 in inflammatory arthritis
Authors: Schroeder Juliane , Ross Kirsty , McIntosh Kathryn , Jabber Shilan , Woods Stuart , Crowe Jenny , Patterson Kane Janet , Alexander James , Lawrence Catherine , Plevin Robin 
Published: January 2019

ObjectivesWe have previously shown mitogen-activated protein kinase phosphatase 2 (MKP-2) to be a key regulator of proinflammatory cytokines in macrophages. In the study presented here, we investigated the role of MKP-2 in inflammatory arthritis with a particular focus on neutrophils.MethodsTo achieve this, we subjected MKP-2 deficient and wild type mice to collagen antibody induced arthritis, an innate model of arthritis, and determined disease pathology. To further our investigation, we depleted neutrophils in a prophylactic and therapeutic fashion. Last, we used chemotaxis assays to analyse the impact of MKP-2 deletion on neutrophil migration.ResultsMKP-2-/-mice showed a significant increase in disease pathology linked to elevated levels of proarthritic cytokines and chemokines TNF-α, IL-6 and MCP-1 in comparison to wild type controls. This phenotype is prevented or abolished after administration of neutrophil depleting antibody prior or after onset of disease, respectively. While MCP-1 levels were not affected, neutrophil depletion diminished TNF-α and reduced IL-6, thus linking these cytokines to neutrophils. In vivo imaging showed that MKP-2-/-mice had an increased influx of neutrophils into affected joints, which was higher and potentially prolonged than in wild type animals. Furthermore, using chemotaxis assays we revealed that MKP-2 deficient neutrophils migrate faster towards a Leukotriene B4 gradient. This process correlated with a reduced phosphorylation of ERK in MKP-2-/-neutrophils.ConclusionsThis is the first study to show a protective role for MKP-2 in inflammatory arthritis.
Peripheral disease contributes significantly to the level of disease activity in axial spondyloarthritis
Authors: de Winter Janneke J , Paramarta Jacqueline E , de Jong Henriëtte M , van de Sande Marleen G , Baeten Dominique L 
Published: January 2019

ObjectiveSpondyloarthritis (SpA) can encompass axial, peripheral and extra-articular disease manifestations. Patients are classified as axial or peripheral SpA depending on the presence or absence of current back pain, independently of the other disease manifestations. Therefore, we aimed to assess the percentage of patients with axial SpA with peripheral disease and how this peripheral disease contributes to the overall disease activity.MethodsPrevalence and disease activity of peripheral disease manifestations were assessed in a real-life observational cohort of 314 patients with the clinical diagnosis of SpA and fulfilling the Assessment of SpondyloArthritis international Society (ASAS) criteria.ResultsOf the 314 patients fulfilling the ASAS criteria, 230 fulfilled the axial and 84 the peripheral SpA criteria. Of the 230 patients with axial SpA, 49% had purely axial disease without peripheral disease manifestations whereas 51% had combined axial (back pain) and peripheral (arthritis, enthesitis and/or dactylitis) disease. The latter group had the highest disease activity in comparison with pure axial SpA as well as with peripheral SpA.ConclusionHalf of the patients classified as axial SpA according to the ASAS criteria also have peripheral disease manifestations such as arthritis, enthesitis and/or dactylitis. These peripheral disease manifestations contribute significantly to overall disease activity.
Dead space ventilation promotes alveolar hypocapnia reducing surfactant secretion by altering mitochondrial function
Authors: Kiefmann Martina , Tank Sascha , Tritt Marc-Oliver , Keller Paula , Heckel Kai , Schulte-Uentrop Leonie , Olotu Cynthia , Schrepfer Sonja , Goetz Alwin E , Kiefmann Rainer 
Published: January 2019

BackgroundIn acute respiratory distress syndrome (ARDS), pulmonary perfusion failure increases physiologic dead space ventilation (VD/VT), leading to a decline of the alveolar CO2 concentration [CO2]iA. Although it has been shown that alveolar hypocapnia contributes to formation of atelectasis and surfactant depletion, a typical complication in ARDS, the underlying mechanism has not been elucidated so far.MethodsIn isolated perfused rat lungs, cytosolic or mitochondrial Ca2+ concentrations ([Ca2+]cyt or [Ca2+]mito, respectively) of alveolar epithelial cells (AECs), surfactant secretion and the projected area of alveoli were quantified by real-time fluorescence or bright-field imaging (n=3–7 per group). In ventilated White New Zealand rabbits, the left pulmonary artery was ligated and the size of subpleural alveoli was measured by intravital microscopy (n=4 per group). Surfactant secretion was determined in the bronchoalveolar lavage (BAL) by western blot.ResultsLow [CO2]iA decreased [Ca2+]cyt and increased [Ca2+]mito in AECs, leading to reduction of Ca2+-dependent surfactant secretion, and alveolar ventilation in situ. Mitochondrial inhibition by ruthenium red or rotenone blocked these responses indicating that mitochondria are key players in CO2 sensing. Furthermore, ligature of the pulmonary artery of rabbits decreased alveolar ventilation, surfactant secretion and lung compliance in vivo. Addition of 5% CO2 to the inspiratory gas inhibited these responses.ConclusionsAccordingly, we provide evidence that alveolar hypocapnia leads to a Ca2+ shift from the cytosol into mitochondria. The subsequent decline of [Ca2+]cyt reduces surfactant secretion and thus regional ventilation in lung regions with high VD/VT. Additionally, the regional hypoventilation provoked by perfusion failure can be inhibited by inspiratory CO2 application.
Radial Artery Versus Right Internal Thoracic Artery Versus Saphenous Vein as the Second Conduit for Coronary Artery Bypass Surgery: A Network Meta‐Analysis of Clinical Outcomes
Authors: Gaudino Mario , Lorusso Roberto , Rahouma Mohamed , Abouarab Ahmed , Tam Derrick Y. , Spadaccio Cristiano , Saint‐Hilary Gaëlle , Leonard Jeremy , Iannaccone Mario , D'Ascenzo Fabrizio , Di Franco Antonino , Soletti Giovanni , Kamel Mohamed K. , Lau Christopher , Girardi Leonard N. , Schwann Thomas A. , Benedetto Umberto , Taggart David P. , Fremes Stephen E. 
Published: January 2019

Background

There remains uncertainty regarding the second‐best conduit after the internal thoracic artery in coronary artery bypass grafting. Few studies directly compared the clinical results of the radial artery (
RA
), right internal thoracic artery (
RITA
), and saphenous vein (
SV
). No network meta‐analysis has compared these 3 strategies.

Methods and Results

MEDLINE
and
EMBASE
were searched for adjusted observational studies and randomized controlled trials comparing the
RA
,
SV
, and/or
RITA
as the second conduit for coronary artery bypass grafting. The primary end point was all‐cause long‐term mortality. Secondary end points were operative mortality, perioperative stroke, perioperative myocardial infarction, and deep sternal wound infection (
DSWI
). Pairwise and network meta‐analyses were performed. A total of 149 902 patients (4 randomized, 31 observational studies) were included (
RA
, 16 201,
SV
, 112 018,
RITA,
21 683). At
NMA
, the use of
SV
was associated with higher long‐term mortality compared with the
RA
(incidence rate ratio, 1.23; 95%
CI
, 1.12–1.34) and
RITA
(incidence rate ratio, 1.26; 95%
CI
, 1.17–1.35). The risk of
DSWI
for
SV
was similar to
RA
but lower than
RITA
(odds ratio, 0.71; 95%
CI
, 0.55–0.91). There were no differences for any outcome between
RITA
and
RA
, although
DSWI
trended higher with
RITA
(odds ratio, 1.39; 95%
CI
, 0.92–2.1). The risk of
DSWI
in bilateral internal thoracic artery studies was higher when the skeletonization technique was not used.

Conclusions

The use of the
RA
or the
RITA
is associated with a similar and statistically significant long‐term clinical benefit compared with the
SV
. There are no differences in operative risk or complications between the 2 arterial conduits, but
DSWI
remains a concern with bilateral
ITA
when skeletonization is not used.
Development of a Shock‐Wave Catheter Ablation System for Ventricular Tachyarrhythmias: Validation Study in Pigs In Vivo
Authors: Morosawa Susumu , Yamamoto Hiroaki , Hirano Michinori , Amamizu Hirokazu , Uzuka Hironori , Ohyama Kazuma , Hasebe Yuhi , Nakano Makoto , Fukuda Koji , Takayama Kazuyoshi , Shimokawa Hiroaki 
Published: January 2019

Background

Although radiofrequency catheter ablation is the current state‐of‐the‐art treatment for ventricular tachyarrhythmias, it has limited success for several reasons, including insufficient lesion depth, prolonged inflammation with subsequent recurrence, and thromboembolisms due to myoendocardial thermal injury. Because shock waves can be applied to deep lesions without heat, we have been developing a shock‐wave catheter ablation (
SWCA
) system to overcome these fundamental limitations of radiofrequency catheter ablation. In this study, we evaluated the efficacy and safety of our
SWCA
system for clinical application to treat ventricular tachyarrhythmia.

Methods and Results

In 33 pigs, we examined
SWCA
in vivo for the following 4 protocols. First, in an epicardial substrate model (n=8), endocardial
SWCA
significantly decreased the sensing threshold (pre‐ versus postablation: 11.4±3.8 versus 6.8±3.6
mV
;
P
<0.05) and increased the pacing threshold (pre‐ versus postablation: 1.6±0.8 versus 2.0±1.1 V;
P
<0.05), whereas endocardial radiofrequency catheter ablation failed to do so. Second, in a myocardial infarction model (n=3), epicardial
SWCA
of the border zone of the infarcted lesion was as effective as ablation of the normal myocardium. Third, in a coronary artery application model (n=10), direct application of shock waves to the epicardial coronary arteries caused no adverse effects in either the acute or chronic phase. Fourth, with an epicardial approach (n=8), we found that 90 shots per site provided an ideal therapeutic condition to create deep lesions with less superficial damage.

Conclusions

These results indicate that our new
SWCA
system is effective and safe for treatment of ventricular tachyarrhythmias with deep arrhythmogenic substrates.
Assessing the interaction of air from a jet diffuser on a thermal plume in a room using two-dimensional particle image velocimetry
Authors: Xu Yukun , Wang Xin , Huang Chen , Du Guangyao , Zhang Yujie 
Published: January 2019

Traditional design of airflow distributions in large spaces does not consider the interference of thermal plumes on jets. In order to quantitatively describe the indoor environment, it is first necessary to quantify how the airflow gets distributed. In this study, a two-dimensional particle image velocimetry (PIV) system for measuring a wide indoor flow field was established. A total of 24 sub-regions (each with a size of 400 mm × 350 mm) were accurately measured in an unmanned room, and the overall cross-sectional flow field was obtained by splicing. Uncertainty analysis proved the rationality of this experimental method. According to the damage extent of the jet structure introduced by the thermal plume, two groups were divided, i.e. Groups A and B. The distribution of velocity fields, trajectories and velocity attenuation of jet centerlines, and velocity magnitude profiles at nozzle and head levels were compared and analyzed in detail. Through this investigation, detailed information of indoor air flow in large spaces can be effectively characterized, which can be useful to help understand the indoor physics and validate CFD models. Practical application: The key to creating a comfortable and healthy indoor thermal environment is the rational design of the airflow distribution. This paper proposes a method for quantitatively describing the airflow distribution in an enclosed space. The equation of the non-dimensional velocity attenuation of jet centerlines is obtained by using advanced technology (PIV), which provides theoretical basis and useful reference for the design of airflow distribution.
Mobile extracorporeal membrane oxygenation for children: single-center 10 years’ experience
Authors: Fouilloux Virginie , Gran Célia , Ghez Olivier , Chenu Caroline , El Louali Fedoua , Kreitmann Bernard , Le Bel Stéphane 
Published: January 2019

Objectives: Extracorporeal membrane oxygenation has become a gold standard in treatment of severe refractory circulatory and/or pulmonary failure. Those procedures require gathering of competences and material. Therefore, they are conducted in a limited number of reference centers. Emergent need for such treatments induces either hazardous transfers or a mobile pediatric extracorporeal membrane oxygenation team able to remote implantation and transportation. The aim of this work is not to focus on pediatric extracorporeal membrane oxygenation outcomes or indications, which have been extensively discussed in the literature. This study would like to detail the implementation, safety, and feasibility, even in a middle-size pediatric cardiac surgery reference center. Patients: This is a retrospective analysis of a series of patients initiated on extracorporeal membrane oxygenation in a peripheral center and transferred to a reference center. The data were collected from 10 consecutive years: from 2006 to 2016. Results: A total of 57 pediatric patients with a median weight of 6.00 (3.2-14.5) kg and median age of 2.89 (0.11-37.63) months were cannulated in peripheral center and transported on extracorporeal membrane oxygenation. We did not experience any adverse event during transport. The outcomes were comparable to our literature-reported on-site extracorporeal membrane oxygenation series with 42 patients (74%) weaned from extracorporeal membrane oxygenation and a 30-day survival of 60%. Neither patient’s age nor weight, indication for extracorporeal membrane oxygenation or length of transport, was statistically significant in terms of outcomes. Conclusion: Offsite extracorporeal membrane oxygenation implantation and ground or air transport for pediatric patients on extracorporeal membrane oxygenation appeared to be safe when performed by a dedicated and experienced team, even within a mid-size center.
Adverse events reported by anxious school refusing adolescents receiving cognitive behavioral therapy with and without fluoxetine
Authors: Melvin Glenn A , Finnin Linda , Taffe John , Dudley Amanda L , Klimkeit Ester I , Gordon Michael S , Tonge Bruce 
Published: January 2019

Background: Investigating adverse events associated with antidepressant treatments in adolescents is important given the concerns about increased risk of suicidal ideation and behavior in this age group. The aim of this study is to investigate adverse and serious adverse events associated with the treatment of anxiety (cognitive behavioral therapy (CBT)-only, CBT-plus-placebo, and CBT-plus-fluoxetine) in anxious school-refusing adolescents. Methods: A side-effect symptom checklist was completed by participants prior to commencing treatment and during treatment (weekly/fortnightly). Results: CBT-plus-fluoxetine was well tolerated and not associated with higher levels of adverse events than the other treatments. Adverse events in all groups decreased over time, and the only adverse event distinct to fluoxetine was nausea. Baseline anxiety predicted higher levels of adverse events. There was one suicide attempt in the CBT-plus-placebo group but no statistically significant difference in suicide attempts between groups. Participants with a comorbid depressive disorder were more likely to report self-injury ideation but not suicidal ideation compared with those who did not have comorbid depressive disorder. Frequency of suicidal ideation and non-suicidal self-injury was significantly lower in the CBT-plus-fluoxetine group compared with the CBT-only group. Frequency of self-injury ideation was significantly lower in the CBT-plus-fluoxetine group compared with both other groups. Conclusions: Overall, the treatments were well tolerated and fluoxetine plus CBT appeared to be protective against suicidal ideation, non-suicidal self-injury, and self-injury ideation in this sample.
Case study of tacrolimus as an effective treatment for idiopathic membranous glomerulonephritis in pregnancy
Authors: Irish GL , Jesudason S 
Published: January 2019

Background Tacrolimus has been used in pregnant women following transplantation and for management of lupus nephritis. We report a case of successful control of nephrotic syndrome due to membranous glomerulonephritis during pregnancy using tacrolimus. Case report A 26-year-old female presented with severe nephrotic syndrome in her first pregnancy. Post-partum renal biopsy confirmed idiopathic membranous glomerulonephritis. She had persistent proteinuria of 6 g/day with hypoalbuminaemia despite angiotensin receptor blockade. Treatment with tacrolimus monotherapy led to remission of proteinuria, three months prior to conceiving again. She maintained remission with tacrolimus therapy in pregnancy, resulting in a successful birth outcome. Conclusions Membranous glomerulonephritis can be successfully and safely managed with tacrolimus monotherapy during pregnancy. This provides an alternative immunosuppressant with a favourable side effect profile suitable for use in women planning a pregnancy when other immunosuppressive drugs should be avoided.
Detecting the propped fracture by injection of magnetic proppant during fracturing
Authors: Liu Junrong , Cao Shijie , Wu Xingru , Yao Jun 
Published: January 2019

Hydraulic fracturing is key to enhancing the productivity of shale and tight hydrocarbon reservoirs, as well as geothermal resources from hot dry rock. Assessing the range and efficiency of hydraulic fracturing is very important for onsite fracturing operations and decision making on subsequent fracturing plans and well-pattern deployment. The idea of injecting fluid mixed with magnetic material into a formation to detect subterranean structure has been considered for a long time. The detectability of the characteristics of propped fractures using magnetic field measurement is discussed and evaluated with an analytical model. The magnetic proppants synthesized with superparamagnetic nanoparticles should be “silent” during injection and could be activated by an external current. By measuring the magnetic field before and after the fracture was created and the magnetic proppants were magnetized, the magnetic anomalies can be obtained. The result indicates that the magnetic field caused by a fracture filled with magnetic proppants is very weak, so that magnetometers with higher precision and resolution should be used to capture such subtle signal. The higher susceptibility contrast of the magnetic nanoparticles is, the stronger external magnetic induction field could be detected. It is suggested that the superparamagnetic nanomaterial with effective magnetic susceptibility contrast of greater than 0.4–0.5 should be used for fracture monitoring in deep wells. To infer the fracture characteristics with the magnetic anomaly, the ground and adjacent wells’ monitoring practices are recommended.
The frequency of occurrence of Hepatocellular Carcinoma after direct antiviral therapy in Hepatitis C virus patients
Authors: Aziz Bilal , Nazar Tazeen , Akhlaq Suhair 
Published: January 2019

Objective: To study the frequency of occurrence of hepatocellular carcinoma (HCC) in hepatitis C virus patients treated with direct acting antiviral (DAA) agents.
Methods: This hospital based cross-sectional study was conducted in Mayo Hospital, Lahore from June, 2016 to January, 2018. Total 300 patients with HCV genotype 3, selected via Non-Probability Purposive Sampling technique, without prior or concurrent history of HCC, were given DAA agents and were followed up for 6 months after completion of therapy. Results were based on Quantitative PCR to assess Sustained Virological Response (SVR) and Ultrasound Abdomen to look for the appearance of any new lesion. Data was presented as mean±SD, frequency and percentages and was analyzed using SPSS Version 24.0.
Results: Out of 300 patients, 179 (59.7%) were males and 121(40.3%) were females. Mean age of the patients was 55.08 ± 5.602 years. 214(71.3%) patients had compensated cirrhosis at the start of treatment and 86(28.7%) had decompensated cirrhosis. SVR was achieved in 200(93.4%) out of 214 patients with compensated cirrhosis and in 76(88.3%) out of 86 patients with decompensated cirrhosis. At six months post- treatment, 10(3.33%) patients developed HCC,2(0.7%) in the compensated group and 8(2.7%) in the decompensated group, out of which 5(6.6%) patients had achieved SVR.
Conclusion: The frequency of HCC following DAA agents is significant (3.3%) even after achieving SVR. Caution must be exercised in prescribing DAA agents to HCV patients keeping this complication of HCC in mind.
How to cite this:Aziz B, Nazar T, Akhlaq S. The frequency of occurrence of Hepatocellular Carcinoma after direct antiviral therapy in Hepatitis C virus patients. Pak J Med Sci. 2019;35(1):101-105. doi: https://doi.org/10.12669/pjms.35.1.109
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Does an increased number of cesarean sections result in greater risk for mother and baby in low-risk, late preterm and term deliveries?
Authors: Hancerliogullari Necati , Yaman Selen , Aksoy Rifat Taner , Tokmak Aytekin 
Published: January 2019

Objective: To compare surgical complications and maternal and neonatal outcomes of low-risk, late preterm and term pregnant women who have had one or two previous cesarean sections (CSs) with those who have had three or more CSs.
Methods: We conducted a retrospective study of 850 patients undergoing repeat CS at a tertiary level maternity hospital in Ankara, Turkey. Of those, 380 had previously undergone one or two CSs (Group-I: second or third CS) and 470 had previously undergone three or four CSs (Group-II: fourth or fifth CS). Outcomes and complications were compared between the groups.
Results: The two groups were statistically significantly different in terms of maternal age, parity, body mass index, maternal weight gain during pregnancy, and length of hospital stay (all p<0.001). Although the prevalence of intraperitoneal adhesions and placenta previa was higher in Group-II than in Group-I (p<0.001), there was no statistically significant difference in terms of cesarean hysterectomy and adjacent organ injuries (p>0.05). There were also no significant differences between the groups in terms of neonatal outcomes (p>0.05).
Conclusion: Although the increase in the number of CSs appears to be associated with intraperitoneal adhesions and placenta previa, adverse maternal and neonatal outcomes were not observed in those women with low-risk pregnancies who underwent CS for the fourth or fifth time. Therefore, fourth and fifth CSs may be considered relatively safe surgical procedures in this cohort.
How to cite this:Hancerliogullari N, Yaman S, Aksoy RT, Tokmak A. Does an increased number of cesarean sections result in greater risk for mother and baby in low-risk, late preterm and term deliveries? Pak J Med Sci. 2019;35(1):10-16. doi: https://doi.org/10.12669/pjms.35.1.364
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.