bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of potassium adsorption filter for the removal of ammonia and potassium from red blood cell solution for neonates
Authors: Fujita Hiroshi , Teratani Miyuki , Hazama Yuki , Nakahara Michiyo , Asaka Hiroyuki , Nishimura Shigeko 
Published: September 2018

BACKGROUNDAmmonia in the plasma usually does not pass through the blood–brain barrier (BBB). However, it can affect the brain as a neurotoxin in neonates with anemia of prematurity. Excess intake of ammonia should therefore be restricted in conditions involving BBB breakdown, such as in premature neonates. A potassium adsorption filter (PAF) can remove not only potassium, but also ammonia from red blood cell (RBC) solution. PAF for neonates (PAF‐n) has been recently introduced using small satellite packs. We evaluated the effects of PAF‐n on the removal of ammonia and potassium from RBC solution in small satellite packs.STUDY DESIGN AND METHODSRBC solutions were obtained from the Japanese Red Cross Society. Two units of RBC solution (280 mL) were divided into four satellite packs (70 mL/pack). The RBC solution was passed through PAF‐n (Kawasumi Laboratories Inc.) that was primed with saline (100 mL) before use. The concentrations of ammonia and potassium were measured in the solution before and after filtration (four samples of 10 mL each of filtered RBC solution) by Biomedical Laboratories.RESULTSApproximately 47 to 82 and 84% to 93% of ammonia and potassium were removed from the RBC solution, respectively, without dilution with saline.CONCLUSIONPAF‐n can remove ammonia and potassium from RBC solution in small satellite packs. PAF‐n could therefore improve the clinical prognosis of neonates with poorly developed BBB by limiting the delivery of excess ammonia found in the RBC solution.
Visuospatial skills are better predictors than dexterity for basic ultrasonographic and fluoroscopic skills in veterinary students
Authors: Walker Meagan A. , MacCormick Mathew R.A , Kilkenny Jessica J. , Phillips John , Singh Ameet , zur Linden Alex 
Published: September 2018

AbstractRadiological skills including ultrasonography and fluoroscopy, require a combination of manual dexterity and visuospatial skill to develop competency. The ability to detect veterinary students with an interest in radiology but who are deficient in these skills, may permit more individual adaptations to training programs, allowing for students training in radiology to achieve maximal potential. The objective of this cohort study was to investigate whether innate dexterity and visuospatial skill could be used to predict performance of basic ultrasound and fluoroscopic skills in veterinary students. Fifty veterinary students from the Ontario Veterinary College completed three tests of visuospatial ability, two tests of manual dexterity, a three‐dimensional mouse task, an ultrasound skill‐testing task, and a fluoroscopic skill‐testing task. Students who reported chopstick use completed the non‐dominant hand ultrasound task significantly faster than students who did not (P = 0.001). There was a significant positive association between scores on the Mental Rotations Test and time to complete the non‐dominant hand ultrasound task (P = 0.011) and fluoroscopy task (P = 0.029). No variables were associated with time to complete the dominant hand ultrasound task. The results of this study suggest that visuospatial skill, as assessed by the Mental Rotations Test, is a better predictor of baseline ultrasound and endovascular fluoroscopy skill than dexterity, with the exception of reported chopstick use, in veterinary students. Visuospatial skills can be developed and may be useful to include in the veterinary curriculum for students that are deficient, or students entering a field such as diagnostic imaging.
Arthroscopic placement of a toggle rod to correct coxofemoral luxation in a dog
Authors: Rocheleau P. J. 
Published: September 2018

AbstractObjectiveTo describe a minimally invasive toggle repair technique under arthroscopic guidance to correct a coxofemoral luxation in a canine.Study designCase reportAnimalsA 9‐year‐old, male (neutered) Alaskan husky.MethodsPrior to surgery, the coxofemoral luxation was reduced in a closed fashion. With standard arthroscopic portals, the completely torn round ligament was removed with a motorized shaver. A bone tunnel was created between the femoral head and the acetabulum by using an intra‐articular drill guide, guide wires, and a cannulated drill bit. A toggle rod was inserted into the bone tunnel and tied to a 4‐hole button located over the third trochanter. The implant position was confirmed via fluoroscopy.ResultsWithin 24 hours of surgery, the dog was weight bearing with mild lameness. Six weeks postoperatively, radiographic assessment revealed that the implant location was unchanged, with no lameness documented. At 6 months postoperatively, the dog had returned to normal function with no reported complications.ConclusionThe toggle rod repair of a coxofemoral luxation under arthroscopic guidance was successful in the dog described in this case report.Clinical significanceMinimally invasive, arthroscopic guided toggle rod stabilization may be an alternative to the currently accepted open approach when addressing coxofemoral luxations.
Medical students as agents of change: a qualitative exploratory study
Authors: Burnett Emma , Davey Peter , Gray Nicola , Tully Vicki , Breckenridge Jenna 
Published: September 2018

BackgroundThere is evidence that medical students have the potential to actively initiate, lead and bring about change through quality improvement within healthcare organisations. For effective change to occur, it is important that students are introduced to, and exposed to the value and necessity of quality improvement early in their careers. The aim of this study was to explore the perspectives and experiences of medical students and their mentors after undertaking quality improvement projects within the healthcare setting, and if such practice-based experiences were an effective way of building improvement capacity and changing practice.MethodsA qualitative interpretive description methodology, using focus groups with medical students and semi-structured interviews with academic and clinical mentors following completion of students’ 4-week quality improvement projects was adopted.ResultsThe findings indicate that there are a range of facilitators and barriers to undertaking and completing quality improvement projects in the clinical setting, such as time-scales, differing perspectives, roles and responsibilities between students and multidisciplinary healthcare professionals.ConclusionsThis study has demonstrated that quality improvement experiential learning can develop knowledge and skills among medical students and transform attitudes towards quality improvement. Furthermore, it can also have a positive impact on clinical staff and healthcare organisations. Despite inherent challenges, undertaking quality improvement projects in clinical practice enhances knowledge, understanding and skills, and allows medical students to see themselves as important influencers of change as future doctors.
Metabolomics of World Trade Center-Lung Injury: a machine learning approach
Authors: Crowley George , Kwon Sophia , Haider Syed Hissam , Caraher Erin J , Lam Rachel , St-Jules David E , Liu Mengling , Prezant David J , Nolan Anna 
Published: September 2018

IntroductionBiomarkers of metabolic syndrome expressed soon after World Trade Center (WTC) exposure predict development of WTC Lung Injury (WTC-LI). The metabolome remains an untapped resource with potential to comprehensively characterise many aspects of WTC-LI. This case–control study identified a clinically relevant, robust subset of metabolic contributors of WTC-LI through comprehensive high-dimensional metabolic profiling and integration of machine learning techniques.MethodsNever-smoking, male, WTC-exposed firefighters with normal pre-9/11 lung function were segregated by post-9/11 lung function. Cases of WTC-LI (forced expiratory volume in 1s <lower limit of normal, n=15) and controls (n=15) were identified from previous cohorts. The metabolome of serum drawn within 6 months of 9/11 was quantified. Machine learning was used for dimension reduction to identify metabolites associated with WTC-LI.Results580 metabolites qualified for random forests (RF) analysis to identify a refined metabolite profile that yielded maximal class separation. RF of the refined profile correctly classified subjects with a 93.3% estimated success rate. 5 clusters of metabolites emerged within the refined profile. Prominent subpathways include known mediators of lung disease such as sphingolipids (elevated in cases of WTC-LI), and branched-chain amino acids (reduced in cases of WTC-LI). Principal component analysis of the refined profile explained 68.3% of variance in five components, demonstrating class separation.ConclusionAnalysis of the metabolome of WTC-exposed 9/11 rescue workers has identified biologically plausible pathways associated with loss of lung function. Since metabolites are proximal markers of disease processes, metabolites could capture the complexity of past exposures and better inform treatment. These pathways warrant further mechanistic research.
No Sugar Added: A New Strategy to Inhibit Glioblastoma Receptor Tyrosine Kinases
Authors: Wahl Daniel R. , Lawrence Theodore S. 
Published: September 2018

Abstract
A novel inhibitor of N-linked glycosylation (NGI-1) inhibits the glycosylation and phosphorylation of multiple receptor tyrosine kinases in glioblastoma (GBM). NGI-1 sensitizes multiple models of GBM to chemotherapy and radiation in vitro and in vivo and may be especially effective in GBMs that retain active PTEN.
See related article by Baro et al., p. 784
Overcoming Acquired PD-1/PD-L1 Resistance with CD38 Blockade
Authors: Mittal Deepak , Vijayan Dipti , Smyth Mark J. 
Published: September 2018

Abstract
Summary: Overexpression of CD38 after PD-1/PD-L1 blockade increases extracellular adenosine levels and may contribute to acquired resistance to anti–PD-1/PD-L1 therapy. Cancer Discov; 8(9); 1066–8. ©2018 AACR.
See related article by Chen et al., p. 1156.
АКТУАЛЬНІ ПИТАННЯ ДІАГНОСТИКИ ГАСТРОЕЗОФАГЕАЛЬНОЇ РЕФЛЮКСНОЇ ХВОРОБИ З КОМОРБІДНИМ ПЕРЕБІГОМ У ЗАГАЛЬНОЛІКАРСЬКІЙ ПРАКТИЦІ
Authors: Chernobroviy V. M. , Melaschenko S. G. , Kenshyn O. O. , Chernobrova O. I. 
Published: September 2018

Ключовим фактором ризику ГЕРХ на сьогодні вважають ожиріння. Його визнано фактором ризику і есенціальної артеріальної гіпертензії (АГ), і цукрового діабету (ЦД), і первинного остеоартрозу, і ХОЗЛ.Матеріал і методи. У клініко-діагностичній гастроентерологічній лабораторії ВНМУ імені М. І. Пирогова проводили обстеження хворих на ожиріння та ГЕРХ з гіперлептинемією. За допомогою методики експрес-гастро-рН-індикації вивчали показники рН у двох групах: у хворих на ожиріння та ГЕРХ та у хворих на ГЕРХ з нормальною масою тіла. Спостерігали сталу тенденцію до більшої секреції HCl у хворих на ожиріння та ГЕРХ.У дослідженні, проведеному у хворих на ГЕРХ в поєднанні з АГ, ми намагались з’ясувати особливості порушень моторики нижнього стравохідного сфінктера при цих двох захворюваннях. Для цього проводили 3-годинний 3-канальний езофаго-гастро-рН-моніторинг. У хворих на ГЕРХ з АГ та без неї була однакова кількість кислотних та усіх рефлюксів, проте у хворих з супутньою АГ спостерігали більш тривалі найдовші рефлюкси, та загалом кислотна експозиція мала тенденцію до подовження (p>0,05).За даними дослідження, яке ми проводили на базі закладів ПМСД м. Вінниці і області у вигляді опортуністичного скринінгу анкет на першому етапі (1431 доросла особа) з подальшим інструментально-лабораторним дообстеженням, було з’ясовано, що 69,72 % хворих на ГЕРХ (343 особи) мали симптоми шлункової диспепсії. Проведення нелінійного регресійного аналізу впливу факторів ризику показало, що потужним чинником, який налаштовує на патологічний гастроезофагеальний рефлюкс, є ожиріння.Висновки. Поєднання ГЕРХ з шлунковими диспепсіями (в т.ч. ФД), гіпертензією, надлишковою масою тіла є поширеним і виявляється у 47,3 %, 45,45 % і 63,86 % обстежених відповідно. У випадку поєднання цих недуг мова йде про очевидну коморбідність. Надмірна маса тіла є основним фактором коморбідності ГЕРХ з артеріальною гіпертензією, спричиняючи більш інтенсивний рефлюкс, що відображається на збільшенні кислотної експозиції та схильності до тривалих рефлюксів. Додатковий вплив може мати схильність хворих на артеріальну гіпертензію до шлункової гіперацидності.
СТРУКТУРНІ ЗМІНИ СЛИЗОВОЇ ОБОЛОНКИ ШЛУНКА ПРИ ХРОНІЧНОМУ ГАСТРИТІ У ДІТЕЙ НА ФОНІ ПОЄДНАННЯ ПАРАЗИТАРНОЇ ТА H. PYLORI ІНФЕКЦІЇ
Authors: Glushko K. T. , Zagrychuk Yu. G. , Smachуlo A. I. , Mykolenko A. Z. , Smachуlo І. І. 
Published: September 2018

Останніми роками зростає увага дослідників до впливу паразитозів на перебіг захворювань травної системи у дітей, оскільки кишкові паразити є одними з найчастіших патогенів шлунково-кишкового тракту.Мета – проведення порівняльного аналізу структурних змін слизової оболонки шлунка у дітей, хворих на хронічний гастрит, залежно від поєднання інфікування H. pylori та інвазування Giardia intestinalis.Матеріал і методи. Проведено клініко-лабораторне та інструментальне обстеження дітей з хронічним гастритом віком від 7 до 17 років, з наступною біопсією, та досліджено морфологічні й морфометричні особливості слизової оболонки шлунка.Результати. Найменш виражені патогістологічні та морфометричні зміни слизової оболонки шлунка спостерігали у дітей з хронічним гастритом при моноінвазії Giardia intestinalis, тоді як поєднання інфікування H. pylori та лямбліозу при хронічному гастриті призводить до дистрофічно-некротичних змін епітелію, порушення регенерації, розвитку кишкової метаплазії та розладів кровообігу. Це підтверджується максимальним зниженням ядерно-цитоплазматичного індексу (0,0584±0,0047), підвищенням клітинної щільності інфільтрату на 9,84 % та зменшенням відносного об’єму капілярів та капілярно-епітеліоцитарного відношення, порівняно з моноінвазією Giardia intestinalis.Висновки. Найбільш виражені патогістологічні та морфометричні зміни виявлено у досліджуваній групі пацієнтів з хронічним гастритом, асоційованим з H. pylori, у поєднанні з лямбліозом.
Randomized Sham-Controlled Trial of Navigated Repetitive Transcranial Magnetic Stimulation for Motor Recovery in Stroke
Authors: Harvey Richard L. , Edwards Dylan , Dunning Kari , Fregni Felipe , Stein Joel , Laine Jarmo , Rogers Lynn M. , Vox Ford , Durand-Sanchez Ana , Bockbrader Marcia , Goldstein Larry B. , Francisco Gerard E. , Kinney Carolyn L. , Liu Charles Y. ,   on behalf of the NICHE Trial Investigators*, Ryan Shirley , Morales-Quezada Leon , Worthen-Chaudhari Lise , Labar Douglas , Schambra Heidi , Kappy Carlyn R. , Kissela Brett , Pratt Whitney 
Published: September 2018

Background and Purpose―
We aimed to determine whether low-frequency electric field navigated repetitive transcranial magnetic stimulation to noninjured motor cortex versus sham repetitive transcranial magnetic stimulation avoiding motor cortex could improve arm motor function in hemiplegic stroke patients when combined with motor training.

Methods―
Twelve outpatient US rehabilitation centers enrolled participants between May 2014 and December 2015. We delivered 1 Hz active or sham repetitive transcranial magnetic stimulation to noninjured motor cortex before each of eighteen 60-minute therapy sessions over a 6-week period, with outcomes measured at 1 week and 1, 3, and 6 months after end of treatment. The primary end point was the percentage of participants improving ≥5 points on upper extremity Fugl-Meyer score 6 months after end of treatment. Secondary analyses assessed changes on the upper extremity Fugl-Meyer and Action Research Arm Test and Wolf Motor Function Test and safety.

Results―

Of 199 participants, 167 completed treatment and follow-up because of early discontinuation of data collection. Upper extremity Fugl-Meyer gains were significant for experimental (
P
<0.001) and sham groups (
P
<0.001). Sixty-seven percent of the experimental group (95% CI, 58%–75%) and 65% of sham group (95% CI, 52%–76%) improved ≥5 points on 6-month upper extremity Fugl-Meyer (
P
=0.76). There was also no difference between experimental and sham groups in the Action Research Arm Test (
P
=0.80) or the Wolf Motor Function Test (
P
=0.55). A total of 26 serious adverse events occurred in 18 participants, with none related to the study or device, and with no difference between groups.

Conclusions―
Among patients 3 to 12 months poststroke, goal-oriented motor rehabilitation improved motor function 6 months after end of treatment. There was no difference between the active and sham repetitive transcranial magnetic stimulation trial arms.

Clinical Trial Registration―

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02089464.
Associations Between 30-Day Mortality, Specialist Nursing, and Daily Physician Ward Rounds in a National Stroke Registry
Authors: Paley Lizz , Williamson Elizabeth , Bray Benjamin D. , Hoffman Alex , James Martin A. , Rudd Anthony G. ,   on behalf of the SSNAP Collaboration
Published: September 2018

Background and Purpose—
Well-organized stroke care is associated with better patient outcomes, but the most important organizational factors are unknown.

Methods—
Data were extracted from the Sentinel Stroke National Audit Programme of adults with acute stroke treated in stroke hospitals in England and Wales between April 2013 and March 2015. Multilevel models with random intercepts for hospitals were used to estimate the association of each variable with 30-day mortality to estimate the impact of admission to differently organized hospitals.

Results—

Of the 143 578 patients with acute stroke admitted to 154 hospitals, 14.4% died within 30 days of admission. In adjusted analyses, admission to hospitals with higher ratios of nurses trained in swallow screening was associated with reduced odds of death (
P
=0.004), and admission to hospitals with daily physician ward rounds was associated with 10% lower odds of mortality compared with less-frequent ward rounds (95% CI, 0.82–0.98;
P
=0.013). Number of stroke admissions and overall ratio of registered nurses on duty at weekends were not found to be independently associated with mortality after adjustment for other factors.

Conclusions—
If these associations are causal, an extra 1332 deaths annually in England and Wales could be saved by hospitals providing care associated with a ratio of nurses trained in swallow screening of at least 3 per 10 beds and daily stroke physician ward rounds.
Early Mobilization After Stroke Is Not Associated With Cognitive Outcome
Authors: Cumming Toby B. , Bernhardt Julie , Lowe Danielle , Collier Janice , Dewey Helen , Langhorne Peter , Thrift Amanda G. , Green Ashleigh , Mohanraj Rajkumar , Kramer Sharon F. , Churilov Leonid , Linden Thomas ,   on behalf of the AVERT Trial Collaboration group
Published: September 2018

Background and Purpose—
We aimed to determine whether early mobilization after stroke affects subsequent cognitive function.

Methods—
AVERT (A Very Early Rehabilitation Trial) was an international, 56-site, phase 3 randomized controlled trial, conducted from 2006 to 2015. Participants were included if they were aged 18+, presented within 24 hours of stroke, and satisfied physiological limits for blood pressure, heart rate, and temperature. Participants were randomized to receive either usual stroke unit care or very early and more frequent mobilization in addition to usual stroke unit care. The Montreal Cognitive Assessment, scored 0 to 30, was introduced as a 3-month outcome during 2008.

Results—

Of the 2104 patients included in AVERT, 317 were assessed before the Montreal Cognitive Assessment’s introduction. Of the remaining 1787, 1189 (66.5%) had complete Montreal Cognitive Assessment data, 456 (25.5%) had partially or completely missing data, 136 (7.6%) had died, and 6 (0.3%) were lost to follow-up. In surviving participants with complete data, adjusting for age and stroke severity, total Montreal Cognitive Assessment score was no different in the intervention (n=595; median, 23; interquartile range, 19–26; mean, 21.9; SD, 5.9) and usual care (n=594; median, 23; interquartile range, 19–26; mean, 21.8; SD, 5.9) groups (
P
=0.68).

Conclusions—
Exposure to earlier and more frequent mobilization in the acute stage of stroke does not influence cognitive outcome at 3 months. This stands in contrast to the primary outcome from AVERT (modified Rankin Scale), where the intervention group had less favorable outcomes than controls.

Clinical Trial Registration—

URL:
https://www.anzctr.org.au
. Unique identifier: ACTRN12606000185561.
Biomarkers and arrhythmia recurrence following radiofrequency ablation of atrial fibrillation
Authors: Carballo David , Noble Stephane , Carballo Sebastian , Stirnemann Jérome , Muller Hajo , Burri Haran , Vuilleumier Nicolas , Talajic Mario , Tardif Jean-Claude , Keller Pierre-Frederic , Mach Francois , Shah Dipen 
Published: September 2018

Objective Atrial fibrillation (AF) is the most common cardiac arrhythmia, and radiofrequency catheter ablation of AF (RCAAF) has become increasingly popular. Cardiac stress and inflammation have been associated with AF. This study was performed to determine whether the pre- or post-AF ablation levels of high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro–B-type natriuretic peptide (NT-proBNP) are predictive of AF recurrence. Methods This multicenter prospective cohort study involved patients undergoing RCAAF in Switzerland and Canada. The primary endpoint was the recurrence of AF or atrial flutter at 6 months. Results Of 202 patients, 195 completed follow-up (age, 57.5 ± 9 years; mean left ventricular ejection fraction, 62%; mean left atrial size, 19.4 cm2). Patients with AF recurrence had larger atrial surfaces and longer total RCAAF times. Both the pre-ablation hs-CRP level and 1-day post-RCAAF NT-proBNP level were significantly associated with an increased risk of recurrence. Conclusions The pre-ablation hs-CRP level and immediate post-ablation NT-proBNP level were markers for atrial arrhythmia recurrence after RCAAF. This confirms growing evidence of the role of inflammation in the pathogenesis of AF. These biomarkers appear to be promising stratification tools for selection and management of patients undergoing RCAAF.
Re-reading in stylistics
Authors: Harrison Chloe , Nuttall Louise 
Published: September 2018

Cognitive stylistics is primarily concerned with the cognitive processes – mental simulations – experienced by readers. Most cognitive stylisticians agree that experiences of reading texts are dynamic and flexible. Changes in the context of reading, our attentional focus on a given day, our extra background knowledge about the text, and so on, are all factors that contribute to our experience of a fictional world. A second reading of a text is a different experience to a first reading. As researchers begin to systematically distinguish between the ‘solitary’ and ‘social’ readings that constitute reading as a phenomenon ( Peplow et al., 2016 ), the relationship between multiple readings and the nature of their processing becomes increasingly pertinent. In order to explore this relationship, firstly we examine the different ways in which re-reading has previously been discussed in stylistics, grounding our claims in an empirical analysis of articles published in key stylistics journals over the past two decades. Next, we draw on reader response data from an online questionnaire in order to assess the role of re-reading and the motivations that underpin it. Finally, we describe an exercise for the teaching of cognitive stylistics, specifically applying schema theory in literary linguistic analysis (Cook, 1994), which illustrates the need to distinguish between readings as part of an analysis. Through these three sections we argue that our experiences of texts should be considered diachronically, and propose that the different readings that make up an analysis of a text should be given greater attention in stylistic research and teaching.