bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparison of the Initial Cost Associated With Resection Versus Laparoscopic Radiofrequency Ablation of Small Solitary Colorectal Liver Metastasis
Authors: Takahashi Hideo , Akyuz Muhammet , Kahramangil Bora , Kose Emin , Aucejo Federico , Fung John , Berber Eren 
Published: September 2018

Introduction:
The aim of this report was to perform a cost-comparison between liver resection (LR) and radiofrequency ablation (RFA).

Method:
Patients with colorectal liver metastasis (CRLM)≤3 cm, who underwent LR or laparoscopic RFA between 2006 and 2015 were included in the study. Using a prospectively maintained CRLM database, clinical, oncologic, and financial parameters were compared.

Results:
Sixty-three patients underwent open or laparoscopic LR, and 25 patients underwent laparoscopic RFA. No significant difference was noted in postoperative complications, readmission rate, and local recurrence rate. With a median follow-up of 40 months for RFA, and 36 months for LR (P=0.61), mean cancer-specific overall survival was 51 months for RFA and 63 months for LR (P=0.64). The median disease-free survival was 14 months for RFA, and 21 months for LR (P=0.59). The mean operating room and hospital costs were 51% and 55% higher in the LR (P<0.001, each).

Conclusions:
The results of the study suggest that in selected patients with small solitary CRLM, laparoscopic tumor ablation might offer opportunities for cost-savings compared with resection as the primary treatment. This model may suggest possible equivalent oncologic outcomes between the 2 modalities.
Blood purification by nonselective hemoadsorption prevents death after traumatic brain injury and hemorrhagic shock in rats
Authors: McKinley Todd O. , Lei Zhigang , Kalbas Yannik , White Fletcher A. , Shi Zhongshan , Wu Fan , Xu Zao C. , Rodgers Richard B. 
Published: September 2018

BACKGROUND
Patients who sustain traumatic brain injury (TBI) and concomitant hemorrhagic shock (HS) are at high risk of high-magnitude inflammation which can lead to poor outcomes and death. Blood purification by hemoadsorption (HA) offers an alternative intervention to reduce inflammation after injury. We tested the hypothesis that HA would reduce mortality in a rat model of TBI and HS.

METHODS
Male Sprague Dawley rats were subjected to a combined injury of a controlled cortical impact to their brain and pressure-controlled HS. Animals were subsequently instrumented with an extracorporeal blood circuit that passed through a cartridge for sham or experimental treatment. In experimental animals, the treatment cartridge was filled with proprietary beads (Cytosorbents, Monmouth Junction, NJ) that removed circulating molecules between 5 kDa and 60 kDa. Sham rats had equivalent circulation but no blood purification. Serial blood samples were analyzed with multiplex technology to quantify changes in a trauma-relevant panel of immunologic mediators. The primary outcome was survival to 96 hours postinjury.

RESULTS
Hemoadsorption improved survival from 47% in sham-treated rats to 86% in HA-treated rats. There were no treatment-related changes in histologic appearance. Hemoadsorption affected biomarker concentrations both during the treatment and over the ensuing 4 days after injury. Distinct changes in biomarker concentrations were also measured in survivor and nonsurvivor rats from the entire cohort of rats indicating biomarker patterns associated with survival and death after injury.

CONCLUSION
Blood purification by nonselective HA is an effective intervention to prevent death in a combined TBI/HS rat model. Hemoadsorption changed circulating concentrations of multiple inmmunologically active mediators during the treatment time frame and after treatment. Hemoadsorption has been safely implemented in human patients with sepsis and may be a treatment option after injury.
Aortic branch vessel flow during resuscitative endovascular balloon occlusion of the aorta
Authors: Hoehn Melanie R. , Teeter William A. , Morrison Jonathan J. , Gamble William B. , Hu Peter , Stein Deborah M. , Brenner Megan L. , Scalea Thomas M. 
Published: September 2018

BACKGROUND
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a torso hemorrhage control adjunct. Aortic branch vessel flow (BVF) during REBOA is poorly characterized and has implications for ischemia-reperfusion injury. The aim of this study is to quantify BVF in hypovolemic shock with and without REBOA.

METHODS
Female swine (79–90 kg) underwent anesthesia, 40% controlled hemorrhage and sonographic flow monitoring of the carotid, hepatic, superior mesenteric, renal, and femoral arteries. Animals were randomized to REBOA (n = 5) or no-REBOA (n = 5) for 4 hours, followed by full resuscitation and balloon deflation for 1 hour.

RESULTS
All animals were successfully induced into hemorrhagic shock with a mean decrease of flow in all vessels of 50% from baseline (p < 0.001). Deployment of REBOA resulted in a 200% to 400% increase in carotid flow, but near complete abolition of BVF distal to the balloon. The no-REBOA group saw recovery of BVF to 100% of baseline in all measured vessels, except the hepatic at 50% to 75%. two-way analysis of variance confirmed a significant difference between the groups throughout the protocol (p < 0.001). During resuscitation, the REBOA group saw BVF restore to between 25% and 50%, but never achieving baseline values. The lactate at 4 hours was significantly higher in the REBOA versus no-REBOA group (17.2 ± 0.1 vs. 4.9 ± 1.4; p < 0.001).

CONCLUSION
REBOA not only abolishing BVF during occlusion, but appears to have a post-REBOA effect, reducing visceral perfusion. This may be a source of REBOA associated ischemia-reperfusion injury and warrants further investigation in order to mitigate this effect.
Impact of Donor Age on Clinical Outcomes of Primary Single Kidney Transplantation From Maastricht Category-III Donors After Circulatory Death
Authors: Favi Evaldo , Puliatti Carmelo , Iesari Samuele , Monaco Andrea , Ferraresso Mariano , Cacciola Roberto 
Published: September 2018

Background
Standard-criteria donation after circulatory death (DCD) kidney transplants (KTx) have higher primary nonfunction, delayed graft function (DGF), and rejection rates than age-matched donation after brain death (DBD) but similar graft survival. Data on expanded-criteria DCD are conflicting and many centers remain concerned regarding their use.

Methods
In this single-center observational study with 5-year follow-up, we analyzed data from 112 primary DCD Maastricht category-III single KTx receiving similar organ preservation and maintenance immunosuppression. Patients were sorted as young DCD (donor <60 years, 72 recipients) or old DCD (donor ≥60 years, 40 recipients). Old DCD outcomes were compared with young DCD and to a DBD control group (old DBD, donor ≥60 years, 40 recipients).

Results
After 5 years, old DCD showed lower patient survival (66% vs 85%; P = 0.014), death-censored graft survival (63% vs 83%; P = 0.001), and Modification of Diet in Renal Disease estimated glomerular filtration rate (34, 27.0-42.0 mL/min per 1.73 m2 vs 45.0, 33.0-58.0 mL/min per 1.73 m2; P = 0.021) than young DCD with higher DGF (70% vs 47.2%; P = 0.029) and graft thrombosis (12.5% vs 1.4%; P = 0.021). Comparison between old DCD and old DBD showed similar 5-year patient survival (66% vs 67%; P = 0.394) and death-censored graft survival (63% vs 69%; P = 0.518) but higher DGF (70% vs 37.5%; P = 0.007) and lower estimated glomerular filtration rate (34, 27.0-42.0 mL/min per 1.73 m2 vs 41, 40.0-42.0 mL/min per 1.73 m2; P = 0.029). Multivariate Cox regression analysis showed that donor 60 years or older (hazard ratio, 3.135; 95% confidence interval, 1.716-5.729; P < 0.001) and induction with anti–IL2-receptor-α monoclonal antibody (hazard ratio, 0.503; 95% confidence interval, 0.269-0.940, P = 0.031 in favor of induction with rabbit antithymocyte globulin) are independent predictors of transplant loss.

Conclusions
Overall, single KTx from DCD Maastricht category-III donors 60 years or older have inferior outcomes than KTx from donors younger than 60 years. Comparison with age-matched DBD showed similar patient and graft survivals. However, the discrepancy in graft function between DCD and DBD deserves further investigation.
Retinal Nerve Fiber Layer and Peripapillary Capillary Density Reduction Detected Using Optical Coherence Tomography Enface Images and Angiography in Optic Tract Syndrome
Authors: Goto Katsutoshi , Miki Atsushi , Yamashita Tsutomu , Araki Syunsuke , Takizawa Go , Ieki Yoshiaki , Kiryu Junichi 
Published: September 2018

Abstract:
In a patient with an optic tract syndrome, we describe the loss of retinal nerve fiber layer and retinal microvasculature using enface and optical coherence tomography angiography image analyses.
Double-Shock Stimulation of the Superficial Radial Nerve Compared With Standard Medial Plantar Nerve Conduction in the Early Detection of Asymptomatic Diabetic Neuropathy: A Pilot Study
Authors: Thabit Mohamed N. , Sedky Alaaeldin , Sayed Mohamed A. , Baddary Hemed M. , Mohamed Menatollah 
Published: September 2018

Purpose:
Diabetes mellitus is a major public health problem. Diabetic polyneuropathy (DP) is one of the most common complications of diabetes mellitus. The early detection of DP is very important for timely treatment of symptoms and preventative foot care.

Methods:
Participants were sorted into 3 age- and sex-matched groups: 20 “healthy” individuals; 21 diabetic patients without DP symptoms, “asymptomatic”; and 24 diabetic patients suffering from symptoms consistent with DP, “symptomatic.” All study participants had normal results on conventional nerve conduction studies. All groups underwent both medial plantar mixed nerve conduction (as a single-shock stimulation technique) and superficial radial nerve conduction (double-shock stimulation) measurements. Interstimulus intervals of 2 to 8 ms were used to record sensory nerve action potentials (SNAP) 1 and SNAP 2 for both stimuli.

Results:
We found statistically significant decreases in medial plantar NAPs' amplitude and conduction velocity, and SNAP1/SNAP2 ratios between the three groups, especially at smaller interstimulus intervals.

Conclusions:
Both medial plantar mixed nerve conduction and double-shock superficial radial nerve stimulation are reliable methods for the early detection of asymptomatic DP. However, the medial plantar mixed nerve technique is easier and less time-consuming.
Intraoperative Neuromonitoring of Motor-Evoked Potentials in Infants Undergoing Surgery of the Spine and Spinal Cord
Authors: Aydinlar Elif Ilgaz , Dikmen Pinar Yalinay , Kocak Muge , Baykan Nigar , Seymen Nogayhan , Ozek Memet Metin 
Published: September 2018

Purpose:The aim of this single-center prospective cohort study is to record reliable transcranial motor-evoked potentials (TcMEPs) and to determine their thresholds under inhalational anesthesia in infants undergoing spine and spinal cord surgery.Methods:A total of 15 infants (age <12 months) with mean (SD) months: 5.82 ± 3.45 were included. The entry criteria were that the child should be no older than 1 year of age and undergoing a surgical procedure at the conus-cauda region. The patients were monitored with motor-evoked potentials (TcMEPs) and bulbocavernosus reflex.Results:Transcranial motor-evoked potentials were recorded in all the patients in both upper and lower extremities in one muscle at least. All patients were monitored with a mean TcMEP threshold of 488.46 ± 99.76 V (range 310–740 V). The lowest threshold of TcMEPs was used to record the musculus abductor pollicis brevis mean of 315.15 ± 126.95 V (range 140–690 V) and the highest for musculus sphincter ani mean of 444.17 ± 138.54 V (range 206–700 V).Conclusions:Intraoperative neuromonitoring for spine and spinal cord procedures of the infant population requires higher TcMEP thresholds and train count. Most patients aged older than 6 months require significantly lower TcMEPs.
Calciphylaxis
Authors: Masoetsa Richard , A'Groof Ala , Kapoor Madan , Messenger Grace , Hussain Imtiaz 
Published: September 2018

BACKGROUND:
Calciphylaxis is a potentially life-threatening condition involving painful necrotic skin ulcerations, especially of the lower extremities. It is generally associated with chronic kidney failure but may be seen in nonuremic cases.

CASE REPORT:
We report a case of calciphylaxis in a 60-year-old man with diabetes on dialysis for end-stage renal disease and known to have other typical combination of risk factors associated with calciphylaxis syndrome. On examination, he presented with multiple intensely painful calciphylaxis wounds on his legs and ankles. Despite regular wound management of his condition in our ambulatory care setting, his ulcers deteriorated. The patient's pain also increased and he was referred for hospital admission.

CONCLUSION:
This case presentation emphasizes the importance of an interdisciplinary team in the treatment of the complex, life-threatening cutaneous manifestations of calciphylaxis. When indicated, prompt referral to a hospital setting is necessary for appropriate care.
Intermittent Catheterization and Urinary Tract Infection
Authors: Faleiros Fabiana , de Oliveira Käppler Christoph , Rosa Talita , Gimenes Fernanda Raphael Escobar 
Published: September 2018

PURPOSE:
The purpose of this study was to describe and compare factors that affect urinary tract infection (UTI) rates in people with spina bifida (SB) and neurogenic bladder dysfunction before and following initiation of intermittent catheterization (IC).

DESIGN:
A quantitative, descriptive, correlational study.

SUBJECTS AND SETTING:
The study included people who were from Germany, a high-income nation, and Brazil, a middle-income nation. Brazilian participants were recruited from a public rehabilitation hospital in the state of Minas Gerais. German participants were drawn from different regions of the country. The study sample included 200 participants; participants were either individuals diagnosed with SB and neurogenic bladder dysfunction and using IC, or caregivers of persons using IC for bladder management.

METHODS:
Data were collected through a survey questionnaire developed for urological follow-up of SB patients. A translated and validated version of the form was used to collect data in Germany. To evaluate annual episodes of UTI, we considered the number of symptomatic UTI before and after IC.

RESULTS:
Participants from Brazil were significantly younger than German patients (median age 9 vs 20 years, P < .001). Brazilians predominately used assisted catheterization (63.0%), whereas most Germans performed self-catheterization (61.0%). Use of IC greatly reduced the incidence of UTI in both groups (mean 2.8 episodes per year before IC vs mean 1.1 episodes after starting IC, P < .001). Women had a higher number of UTI, both before and after IC, but enjoyed greater reduction in UTI after initiating IC than men. Self-catheterization also promoted a greater reduction of UTI than assisted IC (P = .022).

CONCLUSIONS:
Intermittent catheterization reduced annual episodes of UTI in both samples despite differences in catheterization technique. Patients practicing and performing self-catheterization achieved a greater reduction than those who relied on assisted IC. Comparative studies among additional countries with varying median income levels are needed to better understand the needs of individuals with SB and their families, and to plan and implement safe nursing interventions.
Royalactin induces copious longevity via increased translation and proteasome activity in C. elegans
Authors: Detienne Giel , Van de Walle Pieter , De Haes Wouter , Cockx Bram , Braeckman Bart P. , Schoofs Liliane , Temmerman Liesbet 
Published: September 2018

AbstractAs demonstrated in various animal models, organismal longevity can be achieved via interventions that at the mechanistic level could be considered to entail ‘defensive’ responses: most long-lived mutants focus on somatic maintenance, while reducing growth pathway signalling and protein translation and turnover. We here provide evidence that the opposite mechanism can also lead to longevity and improved health.We report on the mode of action of royalactin, a glycoprotein activator of epidermal growth factor signalling, capable of extending lifespan in several animals. We show that in Caenorhabditis elegans, royalactin-induced longevity depends on increased protein translation and entails increased proteasome activity. We propose the term ‘copious longevity’ to describe this newly-elucidated mechanism. In contrast to what is true for many other lifespan-extending interventions, we observed no obvious trade-offs between royalactin-induced longevity and several life history traits. Our data point towards increased protein turnover to support healthy ageing, and provide a means for future comparative studies of defensive vs. copious mechanisms.
BrainNet: A Multi-Person Brain-to-Brain Interface for Direct Collaboration Between Brains
Authors: Jiang Linxing , Stocco Andrea , Losey Darby M. , Abernethy Justin A. , Prat Chantel S. , Rao Rajesh P. N. 
Published: September 2018

ABSTRACTWe present BrainNet which, to our knowledge, is the first multi-human non-invasive direct brain-to-brain interface for collaborative problem solving. The interface combines electroencephalography (EEG) to record brain signals and transcranial magnetic stimulation (TMS) to deliver information noninvasively to the brain. The interface allows three human subjects to collaborate and solve a task using direct brain-to-brain communication. Two of the three subjects are designated as “Senders” whose brain signals are decoded using real-time EEG data analysis. The decoding process extracts each Sender’s decision about whether to rotate a block in a Tetris-like game before it is dropped to fill a line. The Senders’ decisions are transmitted via the Internet to the brain of a third subject, the “Receiver,” who cannot see the game screen. The Senders’ decisions are delivered to the Receiver’s brain via magnetic stimulation of the occipital cortex. The Receiver integrates the information received from the two Senders and uses an EEG interface to make a decision about either turning the block or keeping it in the same orientation. A second round of the game provides an additional chance for the Senders to evaluate the Receiver’s decision and send feedback to the Receiver’s brain, and for the Receiver to rectify a possible incorrect decision made in the first round. We evaluated the performance of BrainNet in terms of (1) Group-level performance during the game, (2) True/False positive rates of subjects’ decisions, and (3) Mutual information between subjects. Five groups, each with three human subjects, successfully used BrainNet to perform the Tetris task, with an average accuracy of 81.25%. Furthermore, by varying the information reliability of the Senders by artificially injecting noise into one Sender’s signal, we investigated how the Receiver learns to integrate noisy signals in order to make a correct decision. We found that like conventional social networks, BrainNet allows Receivers to learn to trust the Sender who is more reliable, in this case, based solely on the information transmitted directly to their brains. Our results point the way to future brain-to-brain interfaces that enable cooperative problem solving by humans using a “social network” of connected brains.
Commensal gut bacteria convert the immunosuppressant tacrolimus to less potent metabolites
Authors: Guo Yukuang , Crnkovic Camila Manoel , Won Kyoung-Jae , Yang Xiaotong , Lee John Richard , Orjala Jimmy , Lee Hyunwoo , Jeong Hyunyoung 
Published: September 2018

AbstractTacrolimus exhibits low and variable drug exposure after oral dosing, but the contributing factors remain unclear. Based on our recent report showing a positive correlation between fecal abundance ofFaecalibacterium prausnitziiand oral tacrolimus dose in kidney transplant patients, we tested whetherF. prausnitziiand other gut abundant bacteria are capable of metabolizing tacrolimus. Incubation ofF. prausnitziiwith tacrolimus led to production of two compounds (the major one named M1), which was not observed upon tacrolimus incubation with hepatic microsomes. Isolation, purification, and structure elucidation using mass spectrometry and nuclear magnetic resonance spectroscopy indicated that M1 is a C-9 keto-reduction product of tacrolimus. Pharmacological activity testing using human peripheral blood mononuclear cells demonstrated that M1 is 15-fold less potent than tacrolimus as an immunosuppressant. Screening of 22 gut bacteria species revealed that mostClostridialesbacteria are extensive tacrolimus metabolizers. Tacrolimus conversion to M1 was verified in fresh stool samples from two healthy adults. M1 was also detected in the stool samples from kidney transplant recipients who had been taking tacrolimus orally. Together, this study presents gut bacteria metabolism as a previously unrecognized elimination route of tacrolimus, potentially contributing to the low and variable tacrolimus exposure after oral dosing.
SWI/SNF coordinates transcriptional activation through Rpd3-mediated histone hypoacetylation during quiescence entry
Authors: Spain Marla M. , Braceros Keean C.A. , Tsukiyama Toshio ,   Fred Hutchinson Cancer Research Center, Division of Basic Sciences
Published: September 2018

SummaryWhether or not a cell chooses to divide is a tightly regulated and extremely important decision. Cells from yeast to human are able to reversibly exit the cell cycle in response to environmental changes such as nutritional changes or removal of growth cues to become quiescent. An inappropriate response to environmental cues can result in overproliferation which can lead to cancer, or a failure to proliferate which can result in developmental defects, premature aging and defects in wound healing. While many of the cell signaling pathways involved in regulating cellular quiescence have been identified, how these pathways translate their messages into transcriptional outputs is not well characterized. We previously showed that the histone deacetylase Rpd3 mediates global histone deacetylation and transcription repression upon quiescence entry. How the activation of quiescence-specific genes occurs in the midst of this transcriptionally repressive environment is not well understood. We show that the SWI/SNF chromatin remodeling complex activates quiescence specific genes to promote entry into quiescence. We additionally show that SWI/SNF binding early during quiescence entry is important for facilitating localization of the transcriptional activator Gis1, as well as histone H4 hypoacetylation in coding regions later on. The increase in H4 acetylation that we observe at Snf2-regulated genes upon Snf2 depletion corresponds to a decrease in promoter-bound Rpd3, suggesting that Snf2 remodels chromatin not only to facilitate activator binding, but also the binding of Rpd3. These observations provide mechanistic insight as to how quiescence-specific genes can be activated in the face of global deacetylation and transcription repression.