bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of intravitreal triamcinolone acetonide injection at the end of vitrectomy for vitreous haemorrhage related to proliferative diabetic retinopathy
Authors: Takamura Yoshihiro , Shimura Masahiko , Katome Takashi , Someya Hideaki , Sugimoto Masahiko , Hirano Takao , Sakamoto Taiji , Gozawa Makoto , Matsumura Takehiro , Inatani Masaru 
Published: September 2018

Background/AimsTo investigate whether intravitreal injection of triamcinolone acetonide (IVTA) combined with vitrectomy prevents postoperative inflammation in patients with vitreous haemorrhage (VH) due to proliferative diabetic retinopathy (PDR).MethodsThis prospective, multicentre, randomised study conducted at seven sites in Japan enrolled patients diagnosed as having VH following PDR. Patients underwent vitrectomy with (IVTA+VIT group) or without (VIT group) IVTA at the end of the surgery. Anterior flare intensity (AFI), central retinal thickness (CRT), best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were measured before and at 3 days, 1 week, 1, 3 and 6 months after surgery and compared.ResultsNumber of patients who completed 6 months of follow-up was 40 and 41 in VIT group and IVTA+VIT group, respectively. AFI was significantly higher in the VIT group than in the IVTA+VIT group at 3 days (P=0.033), 1 week (P=0.019) and 1 month (P=0.037). There were no significant differences in CRT, BCVA and IOP between the groups through the observational periods. In the cases with macular oedema >350 µm of CRT at 3 days, CRT was significantly lower in the IVTA+VIT group than in the VIT group at 1 month (P=0.041).ConclusionsIVTA combined with vitrectomy and cataract surgery contributed to inhibit the postoperative inflammation in patients with VH due to PDR. The effect of IVTA in the reduction of diabetic macular oedema may be limited to the early stage after surgery.Trial registration numberUMIN000020376, Post-results.
Elastin modulation and modification by homocysteine: a key factor in the pathogenesis of Pseudoexfoliation syndrome?
Authors: Rebecca Manohar , Gayathri Ramakrishnan , Bhuvanasundar Renganathan , Sripriya Krishnamoorthy , Shantha Balekudaru , Angayarkanni Narayanasamy 
Published: September 2018

BackgroundPseudoexfoliation syndrome (PXF) is an idiopathic, elastogenesis-associated systemic disease characterised by amyloid-like material aggregates in the eye. Elevated plasma and aqueous humour (aqH) homocysteine (Hcy) is reportedly associated with PXF. This study is aimed to probe Hcy-mediated alterations in elastin expression.MethodologyLens level of Hcy (total Hcy (tHcy)), mRNA expression of Eln, CBS and MTR in lens capsule, protein expression of elastin in aqH were estimated by enzyme immunoassay, quantitative PCR and western blot, respectively in PXF, PXF with glaucoma (PXF-G) cases, in comparison with cataract-alone disease controls. Human lens epithelial cells (hLECs) were exposed to Hcy and homocysteine thiolactone (HCTL) to evaluate elastin expression in vitro. Furthermore, elastin recombinant protein was incubated with Hcy and HCTL to assess secondary and tertiary structural modifications based on circular dichroism spectroscopy, spectrophotometric and SEM studies.ResultsThe lens tHcy was significantly high in PXF (p=0.02) and PXF-G (p=0.009). Eln expression was elevated in PXF and PXF-G (p=0.0007). Elastin level in aqH was elevated in PXF (p=0.01) and PXF-G (p=0.002). Hcy (200 µM) and HCTL (1 µM) promoted elastin expression at mRNA level by 36-fold (p=0.02) and 10-fold (p=0.05), respectively, and at protein level by nearly two-fold in cultured hLECs. Secondary structure changes in elastin protein caused by Hcy were evident from 34.11% drop in α-helix and 6.17% gain in β-sheet. Fluorescence, spectral assays and SEM analyses showed aggregation and amyloid formation of elastin with homocysteinylation.ConclusionThe study reveals that lens accumulation of Hcy associated with hyperhomocysteinaemia is characteristic of PXF that augments elastin expression. Hcy causes structural changes promoting elastin aggregation, thereby contributing to defective elastin in PXF and PXF-G.
Effects of refresher training on the use of manual vacuum aspiration in the treatment of incomplete abortions: a quasi-experimental study in Malawi
Authors: Odland Maria Lisa , Membe-Gadama Gladys , Kafulafula Ursula , Jacobsen Geir Wenberg , Odland Jon Øyvind , Darj Elisabeth 
Published: September 2018

IntroductionThe maternal mortality ratio is decreasing globally, although it remains high in Malawi. Unsafe abortion is a major cause and treatment of complications after abortion is a big burden on the health system. Even though manual vacuum aspiration (MVA) is the recommended surgical treatment of incomplete abortions in the first trimester, many hospitals in Malawi continue to use sharp curettage. It is known to have more complications and is more expensive in the long run. The purpose of this study was to determine the effectiveness of a structured MVA training programme in the treatment of incomplete abortions in Malawi.MethodsA quasi-experimental before-and-after study design was employed in an MVA training programme for health personnel at three hospitals in Southern Malawi. A total of 53 health personnel at the Queen Elizabeth Central Hospital and the district hospitals of Chikwawa and Chiradzulu (intervention hospitals) were trained in the use of MVA. Kamuzu Central Hospital in Lilongwe and the Thyolo District Hospital served as control institutions. Medical files for all women treated for an incomplete abortion at the study hospitals were reviewed before and after the intervention. Information on demographic and obstetric data and the type of treatment was collected.ResultsThere was a significant increase in the use of MVA from 7.8% (95% CI 5.8 to 10.3) to 29.1% (95% CI 25.9 to 32.5) 1 year after the intervention. In comparison, we found a mere 3% increase in the control hospitals.ConclusionsBy providing a refresher training programme to health personnel who treat women with incomplete abortions, it was possible to increase the use of MVA as recommended in the Malawi national guidelines.
AIDS Therapy Evaluation in the Netherlands (ATHENA) national observational HIV cohort: cohort profile
Authors: Boender Tamara Sonia , Smit Colette , Sighem Ard van , Bezemer Daniela , Ester Catriona J , Zaheri Sima , Wit Ferdinand W N M , Reiss Peter 
Published: September 2018

PurposeIn 1998, the AIDS Therapy Evaluation in the Netherlands (ATHENA) national observational HIV cohort was established to demonstrate the lifesaving effectiveness of triple combination antiretroviral therapy, including HIV-protease inhibitors, that had recently been made available for clinical use. Subsequently, the HIV Monitoring Foundation was established by the Dutch Ministry of Health, Welfare and Sport to continue ATHENA as an open cohort in order to continue the registration and monitoring of all HIV-positive people as an integral part of HIV care in all 26 HIV treatment centres in the Netherlands.ParticipantsTo date, a total of 25 036 participants have been enrolled in the cohort, with 263 600 person-years of follow-up. As of 1 January 2017, 19 035 HIV-1-positive participants were known to be in care: 18 824 adults (81% men and 19% women) and 211 children (47% boys and 53% girls). The remaining 6001 participants had either died (46%), were lost to care (29%) or had moved abroad (25%).Findings to dateToday, with over 20 years of follow-up, the ATHENA cohort has provided extensive knowledge on HIV treatment, comorbidities and coinfections and created insight into the transmission dynamics of the HIV epidemic.Future plansATHENA continues to enrol and monitor HIV positive people entering HIV care in the Netherlands. Future research will continue to provide tangible input into HIV care and prevention policies in the Netherlands and internationally.
Pilot randomised controlled trial to improve hand hygiene through mindful moments
Authors: Gilmartin Heather , Saint Sanjay , Rogers Mary , Winter Suzanne , Snyder Ashley , Quinn Martha , Chopra Vineet 
Published: September 2018

BackgroundTo evaluate the effectiveness of a brief mindfulness intervention on hand hygiene performance and mindful attention for inpatient physician teams.DesignA pilot, pre-test/post-test randomised controlled mixed methods trial.SettingOne academic medical centre in the USA.ParticipantsFour internal medicine physician teams consisting of one attending, one resident, two to three interns and up to four medical students.InterventionA facilitated, group-based educational discussion on how mindfulness, as practised through mindful hand hygiene, may improve clinical care and practices in the hospital setting.Main outcomes and measuresThe primary outcome was hand hygiene adherence (percentage) for each patient encounter. Other outcomes were observable mindful moments and mindful attention, measured using the Mindfulness Attention Awareness Scale, from baseline to post-intervention, and qualitative evaluation of the intervention.ResultsFor attending physicians, hand hygiene adherence increased 14.1% in the intervention group compared with a decrease of 5.7% in the controls (P=0.035). For residents, the comparable figures were 24.7% (intervention) versus 0.2% (control) (P=0.064). For interns, adherence increased 10.0% with the intervention versus 4.2% in the controls (P=0.007). For medical students, adherence improved more in the control group (4.7% intervention vs 7.7% controls; P=0.003). An increase in mindfulness behaviours was observed for the intervention group (3.7%) versus controls (0.9%) (P=0.021). Self-reported mindful attention did not change (P=0.865).ConclusionsA brief, education-based mindfulness intervention improved hand hygiene in attending physicians and residents, but not in medical students. The intervention was well-received, increased mindfulness practice, and appears to be a feasible way to introduce mindfulness in the clinical setting. Future work instructing clinicians in mindfulness to improve hand hygiene may prove valuable.Trial registration numberNCT03165799; Results.
Gut microbiota relationships to lung function and adult asthma phenotype: a pilot study
Authors: Begley Lesa , Madapoosi Siddharth , Opron Kristopher , Ndum Ogechukwu , Baptist Alan , Rysso Kelly , Erb-Downward John R , Huang Yvonne Jean 
Published: September 2018

IntroductionDespite strong evidence that maturation patterns of the gut microbiome in early life influence the risk for childhood asthma, very little is known about gut microbiota patterns in adults with established asthma, and of greater interest relationships to phenotypic features that characterise asthma heterogeneity.MethodsFifty-eight faecal samples from 32 adults with (n=24) and without (n=8) asthma were analysed using 16S ribosomal RNA gene sequencing methods to characterise intestinal bacterial composition. Compositional stability of paired samples was evaluated and features of gut bacterial community structure analysed in relation to extensive clinical characterisation data collected from subjects, who were enrolled in a prospective observational cohort study at the University of Michigan.ResultsDifferences in gut bacterial community structure were associated with aeroallergen sensitisation and lung function as assessed by forced expiratory volume in 1 s (FEV1) %predicted. Associations with FEV1were consistently observed across independent analytic approaches. k-means clustering of the gut microbiota data in subjects with asthma revealed three different clusters, distinguished most strongly by FEV1(p<0.05) and trends in differences in other clinical and inflammatory features.ConclusionIn this pilot study of asthmatic and non-asthmatic subjects, significant relationships between gut microbiota composition, aeroallergen sensitisation and lung function were observed. These preliminary findings merit further study in larger cohorts to explore possible mechanistic links to asthma phenotype.
Chest wall mass: what lies beneath?
Authors: Richards Claire Elaine , Mostafa Ahmed Mamdouh Taha , Elmoheen Amr 
Published: September 2018

Clinical introductionA 24-year-old Filipino man attended the ED with a 1-month history of a discrete swelling over his upper anterior chest wall that was rapidly increasing in size and tenderness. He denied any other symptoms. His medical history was unremarkable.Examination revealed a tender, 7 cm × 6 cm mass over the upper part of the sternum (figure 1). The surface was smooth, it was immobile, non-compressible and the overlying skin was normothermic but mildly erythematous. Cervical lymphadenopathy was present. His vital signs were normal.Figure 1Chest wall mass.QuestionWhat is the most likely diagnosis?LipomaChondrosarcomaLymphomaMycobacterium tuberculosis(TB)
Outcome of transarterial treatment of dural arteriovenous fistulas with direct or indirect cortical venous drainage
Authors: Mantilla Daniel , Le Corre Marine , Cagnazzo Federico , Gascou Gregory , Eker Omer , Machi Paolo , Riquelme Carlos , Dargazanli Cyril , Costalat Vincent , Bonafe Alain , Lefevre Pierre-Henri 
Published: September 2018

Background and purposeTransarterial Onyx embolization is an effective treatment for patients with intracranial dural arteriovenous fistula (DAVF). A study was performed to determine whether the clinical and radiological outcomes after transarterial Onyx treatment were affected by the type of cortical venous drainage (direct vs indirect) of high-grade DAVF.Materials and methodsBetween May 2006 and December 2014, demographic data, clinical presentation, angiographic characteristics, and treatment-related outcomes were collected for 54 patients divided into two groups (intracranial DAVF with direct and indirect cortical venous drainage). Continuous variables were compared with the two-tailed t test and categorical variables with the χ2test. Statistical significance was set at P<0.05.ResultsFifty-two patients (71% with direct and 29% with indirect cortical venous drainage) underwent Onyx embolization. Immediate complete occlusion after treatment was observed in about 55% of patients without between-group difference. During the long-term follow-up, complete angiographic occlusion was achieved in 83% of patients. Specifically, 15 additional patients (40%) in the direct cortical venous drainage group progressed to complete occlusion, but only one (6%) in the indirect cortical venous drainage group. Overall, the rate of complete occlusion was higher in patients with DAVF with direct cortical venous drainage (92%) than in those with DAVF with indirect cortical venous drainage (62.5%) (P=0.01). The rate of permanent treatment-related complications was 4%, mostly related to ischemic events. Overall, 80.5% of patients had a good neurological outcome (modified Rankin Scale score 0–2).ConclusionsTransarterial Onyx embolization of intracranial high-grade DAVF is safe and effective, particularly for lesions with direct cortical venous drainage.
Premedication to reduce anxiety in patients undergoing coronary angiography and percutaneous coronary intervention
Authors: Vlastra Wieneke , Delewi Ronak , Rohling Wim J , Wagenaar Tineke C , Hirsch Alexander , Meesterman Martin G , Vis Marije M , Wykrzykowska Joanna J , Koch Karel T , de Winter Robbert J , Baan Jr Jan , Piek Jan J , Sprangers Mirjam A G , Henriques José P S 
Published: September 2018

AimsIn this study, we examined the effects of the routinely administration of benzodiazepines on reducing periprocedural anxiety versus no premedication.MethodsIn this open label study, we enrolled 1683 patients undergoing diagnostic coronary angiograms (CAG) or percutaneous coronary interventions (PCI). Randomisation was simulated by systematically allocating patients in monthly rotational periods to lorazepam 1  mg/sl, oxazepam 10  mg/po, diazepam 5  mg/po, midazolam 7.5  mg/po orno premedication. Anxiety was measured at four different time points using the one-item Visual Analogue Scale for Anxiety (VAS score) ranging from 0 to 10. The primary outcome was the difference in anxiety reduction (ΔVAS, preprocedure to postprocedure), between the different premedication strategies versusno premedication.ResultsAnxiety reduction was larger in patients premedicated with lorazepam (ΔVAS=−2.0, SE=1.6, P=0.007) or diazepam (ΔVAS=−2.0, SE=1.5, p=0.003) compared with patients without any premedication (ΔVAS=−1.4, SE=1.2). The use of midazolam or oxazepam did not lead to a significant reduction in anxiety compared with patients who did not receive premedication. Additionally, a high number of patients treated with midazolam (N=39, 19.8%) developed side effects.ConclusionsIn this study, the use of lorazepam or diazepam was associated with a significant, but modest anxiety reduction in patients undergoing CAG or PCI. This study does not support the standard use of oxazepam or midazolam as premedication to reduce anxiety.
Stenting for symptomatic intracranial arterial stenosis in China: 1-year outcome of a multicentre registry study
Authors: Ma Ning , Zhang Yong , Shuai Jie , Jiang Changchun , Zhu Qiyi , Chen Kangning , Liu Li , Li Baomin , Shi Xiangqun , Gao Lianbo , Liu Yajie , Wang Feng , Li Yongli , Liu Tieyan , Zheng Hongbo , Mo Dapeng , Gao Feng , Wang Yilong , Wang Yongjun , Feng Lei , Miao Zhongrong 
Published: September 2018

Background and purposeA multicentre prospective registry study of individually tailored stenting for a patient with symptomatic intracranial atherosclerotic stenosis (ICAS) combined with poor collaterals in China showed that the short-term safety and efficacy of stenting was acceptable. However, it remained uncertain whether the low event rate could be of a long term. We reported the 1-year outcome of this registry study to evaluate the long-term efficacy of individually tailored stenting for patients with severe symptomatic ICAS combined with poor collaterals.MethodsPatients with symptomatic ICAS caused by 70%–99% stenosis located at the intracranial internal carotid, middle cerebral, intracranial vertebral or basilar arteries combined with poor collaterals were enrolled. Balloon-mounted stent or balloon plus self-expanding stent were selected based on the ease of vascular access and lesion morphology determined by the operators. The primary outcome was the rate of 30-day stroke, transient ischaemic attack and death, and 12-month ischaemic stroke within the same vascular territory, haemorrhagic stroke and vascular death after stenting.ResultsFrom September 2013 to January 2015, 300 patients (ages 58.3±9.78 years) were recruited. Among them, 159 patients were treated with balloon-mounted stent and 141 with balloon plus self-expanding stent. During the 1-year follow-up, 25 patients had a primary end point event. The probability of primary outcome at 1 year was 8.1% (95% CI 5.3% to 11.7%). In 76 patients with digital subtraction angiography follow-up, 27.6% (21/76) had re-stenosis ≥50% and 18.4% (14/76) had re-stenosis ≥70%. No baseline characteristic was associated with the primary outcome.ConclusionThe event rate remains low over 1 year of individually tailored stenting for patients with severe symptomatic ICAS combined with poor collaterals. Further randomised trial of comparing individually tailored stenting with best medical therapy is needed.Trial registration numberNCT01968122; Results.
USING WBE CONJUNCTION WITH ELECTROCHEMICAL NOISE TO EVALUATE THE CORROSION REGULARITY OF ENAMEL COATING MODIFIED ON MILD STEEL IMMERSED IN CORROSIVE SOLUTION
Authors: LI YULIN , CHEN CHUAN , ZHONG QINGDONG , LI QIAN , CHENG YUFENG 
Published: September 2018

In this paper, the development and the formation of the mild steel immersed in seawater that covered with enamel coating are investigated. The wire beam electrode (WBE) was applied to evaluate pitting corrosion and local inhomogeneous corrosion that happened on the coated surface of metal substrate. This method can obtain Maps that can show corrosion potential and galvanic current distributions and the specific values can be calculated from the WBE surface that was covered by enamel coating. Corrosion potential–current and electrochemical noise were successfully measured by using a WBE scanner and electrochemical workstation. This new linkage-test method means that the combined WBE-[Formula: see text] has ability to characterize and analysis the process of enamel coating failing more accurately [Ref. 1; Ref. 2; Ref. 3; Ref. 4]. To some extent, the method can also predict the tendency and location of corrosion occurring. It was found that the coating has a good protective effect on the surface of the metal substrate because the corrosion potential is very positive and the corrosion current is very small. At the same time, in the course of the test, the distribution of the anode current is heterogeneous, as time increases, the original single anode current region gradually expands and is connected with the other anode regions in the final. In addition, corrosion often occurs at the boundary of the electrode (WBE) and then to the central area.
Brachiopods from the Upper Ordovician of Erfoud (eastern Anti-Atlas, Morocco) and the stratigraphic correlation of the bryozoan-rich Khabt-el Hajar Formation
Authors: Villas Enrique , Colmenar Jorge 
Published: September 2018

Abstract

The Khabt-el-Hajar Formation, very rich in bryozoans and echinoderms but relatively poor in other fossil groups, has provided a brachiopod association that allows an improvement in the stratigraphic correlation of this Moroccan eastern Anti-Atlas unit with those from the Upper Ordovician of SW Europe and the rest of the Anti-Atlas. The intermediate marly beds, with bryozoan and echinoderm patches, of the Khabt-el-Hajar Formation have yielded
Streptis
? sp.,
Paucicrura catalanica
and
Drabovia
sp. Of these,
P. catalanica
, the richest in the association and known up to now exclusively from the Catalonian Coastal Ranges in NE Spain, is dated as mid to late Katian (Ka2–Ka4), since it occurs in the La Mora Slates, correlatable with horizons of that age from Iberia, Sardinia or the Montagne Noire. The analysis of the stratigraphic and palaeobiogeographical ranges of the bryozoans from the same formation agrees with the correlation above. The quartzitic sandstones that underlie the Khabt-el-Hajar Formation in the surroundings of Erfoud have yielded a different brachiopod association, including
Kiaeromena
?
chouberti
and
Rostricellula termieri
among other forms more poorly represented.
K.
?
chouberti
allows its yielding horizon to be dated as mid Katian (Ka2) and supports the identification of the sandstone-dominated unit where it occurs as the Tiouririne Formation.
Late Ordovician crinoids from the Anti-Atlas region of Morocco
Authors: Botting Joseph P. 
Published: September 2018

Abstract

The crinoid fauna of the Late Ordovician (Sandbian and Katian) of Morocco is sparse, but diverse. The one previously described species,
Rosfacrinus robustus
Le Menn & Spjeldnaes, 1996
, is now known to be part of an assemblage of at least 10 species, including the new taxa
Iocrinus ouzammoui
sp. nov. (Disparida),
Superlininicrinus advorsa
gen. et sp. nov.,
Isthloucrinus praecursor
gen. et a sp. nov. (Cladida) and
Euptychocrinus
?
atelis
sp. nov. (Camerata). The fauna also includes an additional species of
Iocrinus
, and several camerates including
Trichinocrinus
sp. and a monobathrid with probable affinities to the Tanaocrinidae. Undeterminable specimens of demonstrably different taxa are described as far as possible. The fauna includes genera previously known from Laurentia and Avalonia, implying unexpected latitudinal dispersal, together with evidence for substantial endemic diversification among cladids and camerates. Several of the taxa have unusual plate arrangements, including a mosaic of primitive and derived characters; this implies that early crinoid diversification was not limited to tropical carbonate facies. The fauna remains poorly known, with low numbers of specimens, and future collecting is likely to increase the diversity significantly.