bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of venous malformations with localized intravascular coagulopathy with diffusion-weighted magnetic resonance imaging
Authors: Razek Ahmed AKA , Ashmalla Germeen A 
Published: May 2018

Background Venous malformations may be complicated by localized intravascular coagulopathy which is a serious condition with hematological sequel. Prediction of localized intravascular coagulopathy is mandatory for prompt anticoagulation therapy. Laboratory and routine magnetic resonance imaging can predict localized intravascular coagulopathy in venous malformations; however, the results are variable. Purpose To predict venous malformations with localized intravascular coagulopathy with diffusion-weighted magnetic resonance imaging. Material and methods A retrospective analysis was performed on 55 patients (34 male, 21 female aged 14–64 years: mean 39 years) with venous malformations that underwent diffusion-weighted magnetic resonance imaging. The apparent diffusion coefficient value of venous malformations was calculated. Results The mean apparent diffusion coefficient value of venous malformations with localized intravascular coagulopathy (n = 26) (1.28 ± 0.18 × 10−3 mm2/s) was significantly different ( P = 0.001) from venous malformations without localized intravascular coagulopathy (n = 29) (1.60 ± 0.18 × 10−3 mm2/s). When apparent diffusion coefficient value of 1.454 × 10−3 mm2/s was used as a threshold value for the prediction of venous malformations with localized intravascular coagulopathy, the best result was obtained with an accuracy of 83.6%, sensitivity of 84.6%, specificity of 82.8%, and area under the curve of 0.895. The apparent diffusion coefficient value of venous malformations was correlated with D-dimer level ( r = −0.59, P = 0.006) and fibrinogen level ( r = 0.73, P = 0.001). Conclusion The apparent diffusion coefficient value is a non-invasive imaging parameter that can be used to predict venous malformations with localized intravascular coagulopathy.
Suspended Life Pattern: A Qualitative Study on Personal Life Among Family Caregivers of Hemodialysis Patients in Iran
Authors: Ebadi Abbas , Sajadi Seyedeh A. , Moradian Seyed T. , Akbari Roghayeh 
Published: May 2018

Purpose To determine the personal life of family caregivers of patients undergoing hemodialysis. Methodology In this qualitative study, individual semistructured interviews were carried out with 19 caregivers of hemodialysis patients. All interviews were recorded, typed, and imported into the Open Code Software. The Graneheim and Lundman's content analysis approach was used for the analysis. Findings The theme of this study was suspended life pattern that was extracted from two categories of “Imbalance between caregiving and life” and “ambiguity in life status.” The category of “Imbalance between caregiving and life” included some subcategories including compulsive compliance, suspension, and deferral of roles, conflicts between leisure time and caregiving and caregivers' time limits. Moreover, the category “ambiguity in life” was extracted from two subcategories of fear and hope and life satisfaction depending on care recipients' condition. Conclusion Caring for hemodialysis patients leads to instability and ambiguity in a caregiver's personal life. Therefore, authorities, policymakers, and health-care providers should pay more attention to support these people.
Newly Proposed Sepsis-Induced Coagulopathy Precedes International Society on Thrombosis and Haemostasis Overt-Disseminated Intravascular Coagulation and Predicts High Mortality
Authors: Iba Toshiaki , Arakawa Makoto , Di Nisio Marcello , Gando Satoshi , Anan Hideaki , Sato Koichi , Ueki Yutaka , Levy Jerrold H. , Thachil Jecko 
Published: May 2018

Background: Disseminated intravascular coagulation (DIC) has been recognized as an urgent and critical condition in patients with sepsis. Therefore, unfamiliar and time-consuming tests or a complex scoring system are not suitable for diagnosis. Sepsis-induced coagulopathy (SIC), a newly proposed category delineated by a few global coagulation tests, has been established as an early warning sign for DIC. The purpose of this study was to elucidate the characteristics of SIC, especially in relation to the score of the International Society on Thrombosis and Haemostasis (ISTH) for overt DIC. Method: A data set for 332 patients with sepsis who were suspected to have DIC, antithrombin activity <70%, and treated with antithrombin substitution was utilized to examine the relationship between SIC and overt DIC. The performance of SIC calculated at baseline (ie, before treatment) as well as on days 2, 4, or 7 was analyzed in terms of its ability to predict 28-day mortality and overt DIC. Results: At baseline, 149 (98.7%) of 151 patients with overt DIC according to the ISTH definition were diagnosed as having SIC. Of the 49, 46 (93.9%) patients who developed overt DIC between days 2 and 4 had received a prior diagnosis of SIC. The sensitivity of baseline SIC for the prediction of death was significantly higher than that of overt DIC (86.8% vs 64.5%, P < .001). The sensitivity of SIC on days 2, 4, and 7 was significantly higher than those of overt DIC (96.1%, 92.3%, and 84.4% vs 67.1%, 57.7%, and 50.0%, P < .001, .001, and .001, respectively), although the specificity of SIC was lower at all time points.
Antimicrobial stewardship through telemedicine and its impact on multi-drug resistance
Authors: dos Santos Rodrigo P , Dalmora Camila H , Lukasewicz Stephani A , Carvalho Otávio , Deutschendorf Caroline , Lima Raquel , Leitzke Tiago , Correa Nilson C , Gambetta Marcelo V 
Published: May 2018

Introduction Telemedicine technologies are increasingly being incorporated into infectious disease practice. We aimed to demonstrate the impact of antimicrobial stewardship through telemedicine on bacterial resistance rates. Methods We conducted a quasi-experimental study in a 220-bed hospital in southern Brazil. An antimicrobial stewardship program incorporating the use of telemedicine was implemented. Resistance and antimicrobial consumption rates were determined and analysed using a segmented regression model. Results After the intervention, the rate of appropriate antimicrobial prescription increased from 51.4% at baseline to 81.4%. Significant reductions in the consumption of fluoroquinolones (level change, β = −0.80; P < 0.01; trend change, β = −0.01; P = 0.98), first-generation cephalosporins (level change, β = −0.91; P < 0.01; trend change, β = +0.01; P = 0.96), vancomycin (level change, β = −0.47; P = 0.04; trend change, β = +0.17; P = 0.66) and polymyxins (level change, β = −0.15; P = 0.56; trend change, β = −1.75; P < 0.01) were identified. There was an increase in the consumption of amoxicillin + clavulanate (level change, β = +0.84; P < 0.01; trend change, β = +0.14; P = 0.41) and cefuroxime (level change, β = +0.21; P = 0.17; trend change, β = +0.66; P = 0.02). A significant decrease in the rate of carbapenem-resistant Acinetobacter spp. isolation (level change, β = +0.66; P = 0.01; trend change, β = −1.26; P < 0.01) was observed. Conclusions Telemedicine, which provides a tool for decision support and immediate access to experienced specialists, can promote better antibiotic selection and reductions in bacterial resistance.
Silk flow-diverter stent for the treatment of complex intracranial aneurysms: A one-year follow-up multicenter study
Authors: Foa Torres G , Roca F , Noguera A , Godes J , Petrocelli S , Aznar I , Ales S , Muszynski P , Maehara R , Vicente M , Pumar JM 
Published: May 2018

Background Flow-diverter stents have been successfully used in the treatment of complex aneurysms with limited therapeutic alternatives. We report our experience using the Silk flow diverter (SFD; Balt Extrusion, Montmorency, France) for the treatment of complex aneurysms in four Argentine centers. Methods We conducted a retrospective review of 246 consecutive patients who were treated with the SFD at four Argentine centers between January 2009 and January 2017. The patient and aneurysm characteristics, as well as the details of the procedure, were analyzed. The angiographic and clinical findings were recorded during and immediately after the procedure and at 12-month follow-up. Results Angiography follow-up at 12 months was possible in 235 patients (95.5%) with 282 aneurysms. A total of 265 aneurysms (93.9%) presented with complete occlusion of the aneurysmal sac (class 1) and 17 aneurysms (6.1%) presented with partial occlusion (class 2). The 12-month clinical follow-up showed 11 patients with major events (seven, scale 2; five, scale 3; and two, scale 4). The morbidity and mortality rates were 4.2% (11/289) and 2.1% (5/289), respectively. Conclusions The treatment of aneurysms with the SFD was associated with a low rate of complications and a high percentage of aneurysmal occlusion. These findings suggest that SFD is an effective and safe alternative in the endovascular treatment of complex aneurysms.
Extracorporeal shockwave therapy for intermittent claudication: Medium-term outcomes from a double-blind randomised placebo-controlled pilot trial
Authors: Green Jordan Luke , Harwood Amy Elizabeth , Smith George Edward , Das Tushar , Raza Ali , Cayton Thomas , Wallace Tom , Carradice Daniel , Chetter Ian Clifford 
Published: May 2018

Objectives Peripheral arterial disease most commonly presents as intermittent claudication (IC). Early evidence has suggested that extracorporeal shockwave therapy is efficacious in the short term for the management of intermittent claudication. The objective of this pilot trial was to evaluate the medium-term efficacy of this treatment. Methods This double-blind randomised placebo-controlled pilot trial randomised patients with unilateral intermittent claudication in a 1:1 fashion to receive extracorporeal shockwave therapy or a sham treatment for three sessions per week over three weeks. Primary outcomes were maximum walking distance and intermittent claudication distance using a fixed-load treadmill test. Secondary outcomes included pre- and post-exertional ankle-brachial pressure indices, safety and quality of life assessed using generic (SF36, EQ-5D-3L) and disease-specific (vascular quality of life) measures. All outcome measures were assessed at 12 months post-treatment. Results Thirty participants were included in the study (extracorporeal shockwave therapy, n = 15; sham, n = 15), with 26 followed up and analysed at 12 months (extracorporeal shockwave therapy, n = 13; sham, n = 13). Intragroup analysis demonstrated significant improvements in maximum walking distance, intermittent claudication distance and post-exertional ankle-brachial pressure indices ( p < 0.05) in the active treatment group, with no improvements in pre-exertional ankle-brachial pressure indices. Significant improvements in quality of life were observed in 3 out of 19 domains assessed in the active group. A re-intervention rate of 26.7% was seen in both groups. Conclusions These findings suggest that extracorporeal shockwave therapy is effective in improving walking distances at 12 months. Although this study provides important pilot data, a larger study is needed to corroborate these findings and to investigate the actions of this treatment. ISRCTN: NCT02652078.
Incidence, mechanisms and impact outcome of hyperglycaemia in severe scorpion-envenomed patients
Authors: Bahloul Mabrouk , Turki Olfa , Chaari Anis , Bouaziz Mounir 
Published: May 2018

Hyperglycaemia is often observed in severe scorpion-envenomed patients. It is due to a severe autonomic storm with a massive release of catecholamines, increased glucagon levels, cortisol levels, and either decreased insulin levels or insulin resistance. The presence of hyperglycaemia is an indicator of severity in this specific condition. Indeed, hyperglycaemia was associated with the severity of clinical manifestations of severe scorpion envenomation requiring intensive care unit (ICU) admission. In fact, the presence of hyperglycaemia was associated with the presence of respiratory failure, pulmonary oedema, haemodynamic instability, neurological failure, multisystem organ failure, and an increased mortality and ICU length of stay. As a consequence, we think the presence of hyperglycaemia in scorpion-envenomed patients at the emergency department prompts searching for presence of systemic manifestations or cardiorespiratory manifestations. As a consequence, the presence of hyperglycaemia can help screen severe patients at the emergency department. The current management of severe scorpion envenomation involves the admission and close surveillance in the ICU, where vital signs and continuous monitoring enable early initiation of therapy for life-threatening complications. The use of antivenom for scorpion stings remains controversial. All patients with pulmonary oedema should receive prazosin and possibly dobutamine, according the scorpion’s species. Mechanical ventilation is usually used in severe cases. Insulin should be reserved for severe cases with confirmed excessive hyperglycaemia (>10 mmol/l).
Differences in Hip Joint Biomechanics and Muscle Activation in Individuals With Femoroacetabular Impingement Compared With Healthy, Asymptomatic Individuals: Is Level-Ground Gait Analysis Enough?
Authors: Rutherford Derek J. , Moreside Janice , Wong Ivan 
Published: May 2018

Background: Femoroacetabular impingement (FAI) is a recognized cause of hip and groin pain and a significant factor in hip joint function during sport. Objective tests for understanding hip function are lacking in this population. Purpose: To determine whether biomechanical and electromyographic features of hip function during level-ground walking differ between a group diagnosed with FAI and those with no symptoms of FAI. Study Design: Controlled laboratory study. Methods: A total of 20 asymptomatic individuals and 20 individuals with FAI walked on a dual-belt instrumented treadmill at self-selected walking velocities. Sagittal and frontal plane joint motions, moments, and muscle activation for the gluteus medius, gluteus maximus, rectus femoris, and medial and lateral hamstrings were analyzed. Discrete measures were extracted from each biomechanical waveform, and principal component analysis was used to determine hip joint muscle activation and hip adduction moment patterns. Statistical significance was determined by use of Student t tests with Bonferroni adjustments for multiple comparisons (α = .05). Results: Individuals with FAI walked more slowly ( P = .015) and had lower self-reported function ( P < .001). No differences in muscle strength were found between the symptomatic and contralateral legs in the FAI group ( P > .017), but those with FAI had lower strength in the knee extensors and flexors and the hip extensors, flexors, and adductors compared with the asymptomatic group ( P < .017). Individuals with unilateral symptomatic FAI walked with similar biomechanical and hip muscle electromyographic results bilaterally. The only differences found were a greater amplitude of gluteus maximus activation in the FAI symptomatic leg compared with the asymptomatic group and greater medial hamstring activation than lateral hamstring activation in the FAI group in both limbs compared with the asymptomatic group. Conclusion: Individuals with FAI were generally deconditioned and reported significantly more functional limitations. No biomechanical differences existed between groups during level walking, yet hamstring and gluteus maximus activation differed when the symptomatic group was compared with the asymptomatic group. Clinical Relevance: The field lacks objective testing of hip joint function to understand implications of FAI for dynamic movements, particularly with applications to biomechanics and electromyography. Level walking was of limited value for understanding FAI hip function, and the development of a more challenging gait assessment is warranted.
Targeting HSP90 dimerization via the C terminus is effective in imatinib-resistant CML and lacks the heat shock response
Authors: Bhatia Sanil , Diedrich Daniela , Frieg Benedikt , Ahlert Heinz , Stein Stefan , Bopp Bertan , Lang Franziska , Zang Tao , Kröger Tobias , Ernst Thomas , Kögler Gesine , Krieg Andreas , Lüdeke Steffen , Kunkel Hana , Rodrigues Moita Ana J. , Kassack Matthias U. , Marquardt Viktoria , Opitz Friederike V. , Oldenburg Marina , Remke Marc , Babor Florian , Grez Manuel , Hochhaus Andreas , Borkhardt Arndt , Groth Georg , Nagel-Steger Luitgard , Jose Joachim , Kurz Thomas , Gohlke Holger , Hansen Finn K. , Hauer Julia 
Published: May 2018

Key Points
We have developed a first-in-class C-terminal HSP90 inhibitor (AX) that is effective against TKI-resistant CML and leukemic stem cells. Unlike the majority of HSP90 inhibitors, AX does not induce the HSR as a resistance mechanism.
The DOT1L inhibitor pinometostat reduces H3K79 methylation and has modest clinical activity in adult acute leukemia
Authors: Stein Eytan M. , Garcia-Manero Guillermo , Rizzieri David A. , Tibes Raoul , Berdeja Jesus G. , Savona Michael R. , Jongen-Lavrenic Mojca , Altman Jessica K. , Thomson Blythe , Blakemore Stephen J. , Daigle Scott R. , Waters Nigel J. , Suttle A. Benjamin , Clawson Alicia , Pollock Roy , Krivtsov Andrei , Armstrong Scott A. , DiMartino Jorge , Hedrick Eric , Löwenberg Bob , Tallman Martin S. 
Published: May 2018

Key Points
Pinometostat demonstrates first evidence of DOT1L target inhibition and clinical responses in a subset of MLL-r advanced leukemia patients. The observed safety profile of pinometostat shows potential for exploration of combination therapies in leukemia.
Wide‐pulse, high‐frequency, low‐intensity neuromuscular electrical stimulation has potential for targeted strengthening of an intrinsic foot muscle: a feasibility study
Authors: James Darren C. , Solan Matthew C. , Mileva Katya N. 
Published: May 2018

AbstractBackgroundStrengthening the intrinsic foot muscles is a poorly understood and largely overlooked area. In this study, we explore the feasibility of strengthening m. abductor hallucis (AH) with a specific paradigm of neuromuscular electrical stimulation; one which is low‐intensity in nature and designed to interleave physiologically‐relevant low frequency stimulation with high‐frequencies to enhance effective current delivery to spinal motoneurones, and enable a proportion of force produced by the target muscle to be generated from a central origin. We use standard neurophysiological measurements to evaluate the acute (~ 30 min) peripheral and central adaptations in healthy individuals.MethodsThe AH in the dominant foot of nine healthy participants was stimulated with 24 × 15 s trains of square wave (1 ms), constant current (150% of motor threshold), alternating (20 Hz–100 Hz) neuromuscular electrical stimulation interspersed with 45 s rest. Prior to the intervention, peripheral variables were evoked from the AH compound muscle action potential (Mwave) and corresponding twitch force in response to supramaximal (130%) medial plantar nerve stimulation. Central variables were evoked from the motor evoked potential (MEP) in response to suprathreshold (150%) transcranial magnetic stimulation of the motor cortex corresponding to the AH pathway. Follow‐up testing occurred immediately, and 30 min after the intervention. In addition, the force‐time‐integrals (FTI) from the 1st and 24th WPHF trains were analysed as an index of muscle fatigue. All variables except FTI (T‐test) were entered for statistical analysis using a single factor repeated measures ANOVA with alpha set at 0.05.ResultsFTI was significantly lower at the end of the electrical intervention compared to that evoked by the first train (p < 0.01). Only significant peripheral nervous system adaptations were observed, consistent with the onset of low‐frequency fatigue in the muscle. In most of these variables, the effects persisted for 30 min after the intervention.ConclusionsAn acute session of wide‐pulse, high‐frequency, low‐intensity electrical stimulation delivered directly to abductor hallucis in healthy feet induces muscle fatigue via adaptations at the peripheral level of the neuromuscular system. Our findings would appear to represent the first step in muscle adaptation to training; therefore, there is potential for using WPHF for intrinsic foot muscle strengthening.
All I Really Needed to Know I Learned during Gastrulation
Authors: Gilbert Scott F. 
Published: May 2018

Note from the Editor Points of View (POV) address issues faced by many people within the life science education community. CBE—Life Sciences Education (CBE-LSE) publishes the POV Feature to present two or more opinions published side-by-side on a common topic. We consider POVs to be “Op-Ed” pieces designed to stimulate thought and dialogue on significant educational issues. They are not meant to be exhaustive treatments of a subject. In this issue, we ask the question, “What are key concepts in developmental biology?” We present three POVs. The first is by CBE-LSE Editor-in-Chief, William Wood, and it is in part based on his experience teaching developmental biology to undergraduates at the University of Colorado, Boulder, including his collaborative experiments in the classroom with Jennifer Knight, the first results of which have been published in CBE-LSE ( Knight and Wood, 2005 ). The second, a partially tongue-in-cheek list of key concepts to convey to students about embryonic development, is by Scott Gilbert (Swarthmore College), author of the leading textbook worldwide for teaching developmental biology, Developmental Biology, 8th ed. (Sinauer Associates, Inc.). The third is by Jeff Hardin (University of Wisconsin–Madison), who has produced Web-based educational materials for teaching developmental biology that are used nationally and internationally for conveying dynamic events during early development (see the WWW feature in this issue by Stark for more details), and who deals with the vexing problem of trying to convey the essential four-dimensional nature of embryonic development to introductory students. This list of key principles in animal development was presented as “life lessons” at the Society for Developmental Biology national meeting in 2005, and it has been edited somewhat for inclusion here. For the video presentation, visit http://sdbonline.org/fly/gilbert/gilbert01.htm .
The contributions of cancer cell metabolism to metastasis
Authors: Pascual Gloria , Domínguez Diana , Benitah Salvador Aznar 
Published: May 2018

ABSTRACT
Metastasis remains the leading cause of cancer-related deaths worldwide, and our inability to identify the tumour cells that colonize distant sites hampers the development of effective anti-metastatic therapies. However, with recent research advances we are beginning to distinguish metastasis-initiating cells from their non-metastatic counterparts. Importantly, advances in genome sequencing indicate that the acquisition of metastatic competency does not involve the progressive accumulation of driver mutations; moreover, in the early stages of tumorigenesis, cancer cells harbour combinations of driver mutations that endow them with metastatic competency. Novel findings highlight that cells can disseminate to distant sites early during primary tumour growth, remaining dormant and untreatable for long periods before metastasizing. Thus, metastatic cells must require local and systemic influences to generate metastases. This hypothesis suggests that factors derived from our lifestyle, such as our diet, exert a strong influence on tumour progression, and that such factors could be modulated if understood. Here, we summarize the recent findings on how specific metabolic cues modulate the behaviour of metastatic cells and how they influence the genome and epigenome of metastatic cells. We also discuss how crosstalk between metabolism and the epigenome can be harnessed to develop new anti-metastatic therapies.