bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of renoprotective approaches for persistent proteinuria in lupus nephritis: more than just immunosuppression
Authors: Castro M , Ugolini-Lopes M , Borba E F , Bonfá E , Seguro L P C 
Published: November 2018

Objective The objective of this study is to evaluate the efficacy of a tightly controlled renoprotective protocol in systemic lupus erythematosus (SLE) patients with persistent proteinuria. Methods Thirteen SLE patients with nephritis and persistent proteinuria (>1 g/24 hours) were included. The protocol consisted of regular clinical evaluations every two weeks to assess blood pressure (BP, target <130/80 mmHg), adherence to therapy, diet and smoking. No change in immunosuppressive drugs was allowed but reduction of glucocorticoid dose was permitted if indicated. Clinical, laboratory and treatment evaluations were performed at baseline and at the end of the study (after three months). Results SLE patients had a mean age of 37.85 ± 7.68 years and disease duration of 9.85 ± 7.29 years. At baseline, patients had a mean duration of maintenance therapy of 10.38 ± 7.56 months, 12 with mycophenolate mofetil (92.3%) and one with azathioprine (7.7%). At least one dose optimization of antihypertensive regimen was required in all patients during the study. Seven patients (53.8%) had BP>130/80mmHg at baseline. At the end, 11 patients (84.6%) achieved stable BP target; 92.3% were using an angiotensin-converting enzyme inhibitor, 53.9% an angiotensin receptor blocker, and 46.2% were using combined therapy. All patients had a significant reduction in proteinuria levels (2.26 ± 1.09 vs 0.88 ± 0.54 g/24 hours, p < 0.001) and 61.5% achieved proteinuria <1 g/24 hours. A significant decrease in mean prednisone dose was observed (10.96 ± 6.73 vs 5.38 ± 3.36 mg/day, p = 0.013) as well as mean Systemic Lupus Erythematosus Disease Activity Index score (4.38 ± 0.72 vs 3.08 ± 1.86, p = 0.043). No significant changes were identified in serum creatinine, albumin, potassium, complement 3 and complement 4 levels ( p > 0.05). Conclusion This study provides evidence that a tightly controlled renoprotective protocol is effective in reducing persistent proteinuria in lupus nephritis. The concomitant reduction of prednisone without any change in immunosuppression reinforces the importance of strategies beyond the treatment of nephritis activity.
Intrathecal formation of anticardiolipin antibodies in a patient with SLE-related relapsing longitudinal myelitis: a possible pathogenic connection
Authors: Aguirre-Villarreal D , Whittall L P , Fragoso-Loyo H , Cantú-Brito C , Crispín J C , Valdés-Ferrer S I 
Published: November 2018

Background Nontraumatic acute transverse myelitis (ATM) can occur in response to infectious, inflammatory and vascular triggers; 1% of patients with systemic lupus erythematosus (SLE) develop ATM, but the mechanism remains unknown. Objective The objective of this case report is to describe a case of intrathecal formation of anticardiolipin antibodies (aCL) during SLE-related ATM. Methods A single patient analysis was conducted. Results A 26-year-old housewife was diagnosed with SLE at age 19. Circulating aCL antibodies were positive at diagnosis. At age 21, she developed an episode of severe sepsis. At 23 years of age she developed an episode of ATM that left her paraplegic with a D10 sensory level, from which she recovered partially. Three years later, she developed a clinical relapse of ATM. During that second episode, serum levels of aCL were within normal limits, while cerebrospinal fluid levels were increased, suggesting intrathecal production of aCL. Conclusion Here, we present a case of a woman who developed relapsing SLE-related longitudinally extensive ATM in whom intrathecal formation of aCL was demonstrated, suggesting that local production and cross-recognition of nervous tissue by those autoantibodies may be myelopathic.
Intravenous versus intra-arterial digital subtraction angiography: Occlusion rate and complication assessment of experimental aneurysms after flow diverter treatment in rabbits
Authors: Simgen Andreas , Tomori Toshiki , Bomberg Hagen , Yilmaz Umut , Roth Christian , Reith Wolfgang , Mühl-Bennighaus Ruben 
Published: November 2018

Purpose Conventional intra-arterial digital subtraction angiography, which requires surgical exposure and ligation of the femoral or carotid artery, is a limited method of evaluating elastase-induced aneurysms in New Zealand white rabbits. The purpose of this study was to assess aneurysm morphology, occlusion rates and complications after flow diverter treatment comparing intravenous and intra-arterial digital subtraction angiography. Methods We previously published a preclinical study in which we evaluated the occlusion rates of elastase-induced aneurysms after treatment with a prototype flow diverter, by using intra-arterial digital subtraction angiography at three months ( n = 9) and six months ( n = 9). In addition to that intravenous digital subtraction angiography before treatment, after one month (early follow-up group) and after three months (late follow-up group) was performed. Occlusion rates were compared within the two groups by means of residual contrast filling. Results Baseline aneurysm characteristics revealed no significant differences between intra-arterial digital subtraction angiography and intravenous digital subtraction angiography. Aneurysm occlusion rates in both follow-up groups using intravenous digital subtraction angiography were significantly higher compared to intra-arterial digital subtraction angiography (early follow-up group: intravenous digital subtraction angiography (one month) versus intra-arterial digital subtraction angiography (three months); p = 0.03 and late follow-up group: intravenous digital subtraction angiography (three months) versus intra-arterial digital subtraction angiography (six months); p = 0.04). Intravenous digital subtraction angiography is feasible to detect and reproduce device occlusions, in-stent stenosis and post-stent stenosis. Conclusion Intravenous digital subtraction angiography can not give a sufficient statement on the aneurysm occlusion process compared to intra-arterial digital subtraction angiography and is therefore not recommended for imaging follow-up after flow diverter treatment in rabbits. Regarding untreated aneurysms and complications like device occlusions, in-stent stenosis and post-stent stenosis intravenous digital subtraction angiography proofed to be a good alternative to intra-arterial digital subtraction angiography in our study.
Acute administration of tirofiban versus aspirin in emergent carotid artery stenting
Authors: Gruber Philipp , Hlavica Martin , Berberat Jatta , Victor Ineichen Benjamin , Diepers Michael , Nedeltchev Krassen , Kahles Timo , Remonda Luca 
Published: November 2018

Background Carotid artery stenting requires antiplatelet therapy for prevention of in-stent thrombosis. Patients suffering from acute ischemic stroke undergoing intravenous thrombolysis and emergent carotid artery stenting (eCAS) are at high risk for intracranial bleeding. We assessed efficacy and safety of acute administration of intravenous tirofiban versus aspirin in these patients. Methods A retrospective, single center, cohort study was carried out of 32 patients who underwent eCAS (18 received tirofiban, 14 received aspirin) at our comprehensive stroke center (2008–2016). Results Of our 32 consecutive eCAS patients, favorable clinical outcomes (modified Rankin scale ≤ 2) were achieved in eight (47%) tirofiban patients and six (46%) aspirin patients ( p = 0.96). Overall rates were similar for symptomatic intracranial bleeding (tirofiban 22%, aspirin 29%, p = 0.68) and mortality (tirofiban 18%, aspirin 23%, p = 0.71). Conclusions Tirofiban and aspirin demonstrated similar efficacy and safety in thrombolyzed stroke patients who underwent eCAS in our cohort. Intravenous tirofiban with its short half-life might represent an alternative to aspirin in select patients.
Very delayed discontinuation of telescoped Pipeline embolization devices: a case report
Authors: Bohara Manoj , Teranishi Kosuke , Yatomi Kenji , Fujii Takashi , Kitamura Takayuki , Yamamoto Munetaka , Oishi Hidenori 
Published: November 2018

Background Flow diversion with the Pipeline embolization device (PED) is a widely accepted treatment modality for aneurysm occlusion. Previous reports have shown no recanalization of aneurysms on long-term follow-up once total occlusion has been achieved. Case description We report on a 63-year-old male who had a large internal carotid artery cavernous segment aneurysm. Treatment with PED resulted in complete occlusion of the aneurysm. However, follow-up angiography at four years revealed recurrence of the aneurysm due to disconnection of the two PEDs placed in telescoping fashion. Conclusion Herein, we present the clinico-radiological features and discuss the possible mechanisms resulting in the recanalization of aneurysms treated with flow diversion.
Prospective evaluation of preoperative and postoperative sleep quality in carpal tunnel release
Authors: Okkesim Cüneyt Emre , Serbest Sancar , Tiftikçi Uğur , Çirpar Meriç 
Published: November 2018

Sleep disturbance is a frequent symptom of carpal tunnel syndrome. The aim of this study was to investigate the effect of median nerve decompression on sleep quality of patients with this condition. The study sample consisted of 41 patients with severe carpal tunnel syndrome who were admitted to our clinic and treated with open median nerve decompression. Sensation and functional recovery of the patients were followed using the Boston Function Questionnaire, the Semmes–Weinstein monofilament test and the two-point discrimination test. Symptomatic recovery of the patients was followed by the Boston Symptom Questionnaire. The tests were used before surgery and at three and six months afterwards. Sensory, functional and symptomatic recovery from the third month to the sixth month following surgery also affected sleep parameters and improved the sleep quality of patients with carpal tunnel syndrome. Level of evidence: IV
The biochemical diagnosis of intrahepatic cholestasis of pregnancy
Authors: Morton Adam , Laurie Josephine 
Published: November 2018

Background Bile acid levels and liver function tests may be normal at presentation in women with intrahepatic cholestasis of pregnancy. The biochemical results of patients presenting with pruritus typical for intrahepatic cholestasis of pregnancy were reviewed. Methods A retrospective audit of women coded as having intrahepatic cholestasis of pregnancy over a three-year period. Results One hundred and ninety-three women (1.1% of the obstetric population) presented with pruritus typical of intrahepatic cholestasis of pregnancy. Forty (21%) of these women had normal biochemistry at presentation, half subsequently developing abnormal results. Women with a history of allergic reactions were more likely to develop intrahepatic cholestasis of pregnancy. Conclusions Normal biochemistry should not preclude a trial of ursodeoxycholic acid in women with distressing pruritus typical for intrahepatic cholestasis of pregnancy. Biochemical tests which are more sensitive and specific in the diagnosis of intrahepatic cholestasis of pregnancy would be valuable. Investigation of other populations with intrahepatic cholestasis of pregnancy regarding a possible association with atopy/allergy would be interesting.
Impact of high‐volume, intermediate‐volume and low‐volume bowel preparation on colonoscopy quality and patient satisfaction: An observational study
Authors: Waldmann E , Penz D , Majcher B , Zagata J , Šinkovec H , Heinze G , Dokladanska A , Szymanska A , Trauner M , Ferlitsch A , Ferlitsch M 
Published: November 2018

BackgroundAlthough optimal bowel preparation is essential for high‐quality screening colonoscopy, documentation of preparation quality, patient satisfaction and adherence is scarce.AimThe aim of this article is to compare low‐volume (LV, 300 ml sodium picosulfate), intermediate‐volume (IV, 2 l polyethylene glycol, PEG + ascorbic acid and sodium ascorbate), and high‐volume (HV, 4 l PEG) purgatives.ResultsA total of 5000 individuals (50.5% women) were enrolled between March 2015 and July 2017 (LV:IV:HV = 3.61:1.54:1). Overall sex‐ and age‐adjusted adenoma detection rate was 25.4% (LV 23.8%, IV 25.4%, HV 29.8%), median age was 59.6 years, and cleansing was successful in 96.8%. Success rates of bowel cleansing were highest with HV (97.6%), followed by LV (97.2%) and IV (95.3%) with OR 2.04 (CI 95% 1.20–3.45, p = 0.008) and OR 1.79 (CI 95% 1.27–2.50, p = 0.001), respectively, compared to IV. A total of 93.5% of the LV group would use the same purgative in the future, 73.2% of IV and 69.4% of HV. A total of 84.4% would prefer overnight preparation, 12.1% same‐day preparation.ConclusionAll purgatives investigated showed good bowel cleansing quality results, patient satisfaction and compliance. Improvement in patient information might lead to even higher participation rates in screening colonoscopy since one in five patients stated that bowel preparation worried him or her most prior to colonoscopy.
Investigation and treatment of premature ovarian insufficiency: A multi-disciplinary review of practice
Authors: Richardson A , Haridass SA , Ward E , Ayres J , Baskind NE 
Published: November 2018

Objectives To assess compliance with the European Society for Human Reproduction and Embryology (ESHRE) guidelines on the investigation and management of women with premature ovarian insufficiency at the Leeds Teaching Hospitals NHS Trust (LTHT) and to determine whether this varies depending on the clinical setting in which the women present. Study design A retrospective review of all females diagnosed with premature ovarian insufficiency between 1 July 2016 and 30 June 2017, presenting to one of the following clinics: reproductive medicine, specialist menopause, general gynaecology, oncology long-term follow-up, general endocrinology or paediatric endocrinology. Main outcome measures Proportion of patients who had the necessary investigations performed and relevant treatment options discussed. Results 103 women were included in the study. Overall, 40.6% had a karyotype. Screening for the Fragile-X pre-mutation, thyroid peroxidase and 21-hydroxylase antibodies occurred in 7.4%, 11.1% and 13.6% of women, respectively. Only 35.9% had their bone mineral density measured. There was significant variation in the performance of a karyotype (p < 0.001) and thyroid peroxidase antibodies (p < 0.01) between the different clinical settings. Overall, lifestyle advice was offered to 30.1%. Estrogen replacement, contraception, fertility options and bone protection were discussed with 76.0%, 38.4%, 59.0% and 75.0%, respectively. Psychological support was offered to 25.2%. There was significant variation for all apart from contraception. Conclusion The investigation and treatment of women with premature ovarian insufficiency at the LTHT is not consistent with the ESHRE guidelines and requires improvement. Furthermore, there is significant variation in management depending on the department to which the patient initially presents.
Acute myeloid leukemia induces protumoral p16INK4a-driven senescence in the bone marrow microenvironment
Authors: Abdul-Aziz Amina M. , Sun Yu , Hellmich Charlotte , Marlein Christopher R. , Mistry Jayna , Forde Eoghan , Piddock Rachel E. , Shafat Manar S. , Morfakis Adam , Mehta Tarang , Di Palma Federica , Macaulay Iain , Ingham Christopher J. , Haestier Anna , Collins Angela , Campisi Judith , Bowles Kristian M. , Rushworth Stuart A. 
Published: November 2018

Abstract
Acute myeloid leukemia (AML) is an age-related disease that is highly dependent on the bone marrow (BM) microenvironment. With increasing age, tissues accumulate senescent cells, characterized by an irreversible arrest of cell proliferation and the secretion of a set of proinflammatory cytokines, chemokines, and growth factors, collectively known as the senescence-associated secretory phenotype (SASP). Here, we report that AML blasts induce a senescent phenotype in the stromal cells within the BM microenvironment and that the BM stromal cell senescence is driven by p16INK4a expression. The p16INK4a-expressing senescent stromal cells then feed back to promote AML blast survival and proliferation via the SASP. Importantly, selective elimination of p16INK4a+ senescent BM stromal cells in vivo improved the survival of mice with leukemia. Next, we find that the leukemia-driven senescent tumor microenvironment is caused by AML-induced NOX2-derived superoxide. Finally, using the p16-3MR mouse model, we show that by targeting NOX2 we reduced BM stromal cell senescence and consequently reduced AML proliferation. Together, these data identify leukemia-generated NOX2-derived superoxide as a driver of protumoral p16INK4a-dependent senescence in BM stromal cells. Our findings reveal the importance of a senescent microenvironment for the pathophysiology of leukemia. These data now open the door to investigate drugs that specifically target the “benign” senescent cells that surround and support AML.
Preliminary experience of an expert panel using Triangle Wound Assessment for the evaluation of chronic wounds
Authors: Lázaro-Martínez José Luis , Conde-Montero Elena , Alvarez-Vazquez Juan Carlos , Berenguer-Rodríguez Juan José , Carlo Amparo Galindo , Blasco-Gil Silvia , Blasco-García Carmen , Martínez-Cuervo Fernando 
Published: November 2018

Objective: Wound assessment is an essential part of wound management and has traditionally focused on the wound bed. The Triangle of Wound Assessment (Triangle) is a new assessment tool that includes a holistic evaluation of the patient with a wound. The aim of this pilot study was to describe the use of the Triangle in our clinical practice in Spain. Methods: Prospective, consecutive patients, male and female, over 18 years old, with wounds of any aetiology and duration, who attended the centres involved in the study, were recruited between May and June 2017. The TWA was used during the first presentation, to assess the wound bed, edge and periwound skin. The study's expert panel met to discuss the results collected by the assessment, as well as the advantages and disadvantages of the system. Results: We recruited 90 patients. Non-viable tissue (necrotic/sloughy) was recorded in 57.8% of the patients, elevated exudate (medium/high) in 52.2%. Approximately 25% of the patients had signs or symptoms of local infection. Maceration was the most prevalent issue recorded on the wound edge and periwound skin assessment, affecting 31.1% and 30.0% of the patients, respectively. The presence of hyperkeratosis was high for the study population as the main aeitologies of the wounds identified here were DFU. Conclusions: The implementation of Triangle Wound Assessment could help in the holistic approach to patient care by focusing on more than local wound care, identifying barriers to achieving wound healing and evaluating wound response and patient compliance.
Deklarasi Panmunjom dan Prospek Perdamaian Korea di Era Moon Jae-In dan Kim Jong-Un
Authors: Kartini Indriana 
Published: November 2018

Abstrak Deklarasi Panmunjom yang ditandatangani oleh dua pemimpin Korea, Moon Jae-in dari Korea Selatan dan Kim Jong-un dari Korea Utara menandai era baru dalam perdamaian di Semenanjung Korea. Meskipun sikap skeptis akan implikasi positif bermunculan baik di dalam negeri maupun dunia internasional, namun komitmen dua negara Korea untuk mengakhiri perang patut diapresiasi oleh komunitas internasional. Tulisan ini menganalisis bagaimana Deklarasi Panmunjom berpengaruh terhadap keamanan regional dan internasional serta bagaimana prospek perdamaian dan unifikasi Korea pasca perjanjan Panmunjom. Berdasarkan analisis melalui pendekatan kualitatif, dapat disimpulkan bahwa meskipun terdapat beberapa persamaan antara Pertemuan Tingkat Tinggi Panmunjom dengan Pertemuan Tingkat Tinggi sebelumnya di tahun 2000 dan 2007, namun yang perlu digarisbawahi adalah kenyataan bahwa kedua negara Korea masih memiliki keinginan untuk menciptakan rezim perdamaian. Meskipun dalam mewujudkan hal tersebut masih diperlukan keterlibatan dua negara sekutu masing-masing negara Korea, yakni AS dan Cina. Kata Kunci : Deklarasi Panmunjom, perdamaian Korea, Korea Selatan, Korea Utara, Moon Jae-in, Kim Jog-un
Análise de desempenho de algoritmos de aprendizagem de máquinas para análise desagregada de viagens intermunicipais
Authors: Roma Andreza Dornelas de Souza , Souza Pitombo Cira , Guimarães Henrique Stramandinoli , Costa Luis Henrique Magalhães 
Published: November 2018

Este trabalho propõe uma análise desagregada de escolhas de destinos para viagens intermunicipais, por meio da aplicação de algoritmos de Aprendizagem de Máquinas - AM (Classification And Regression Tree - CART e Algoritmos Genéticos - AG). Foi utilizada uma Pesquisa OD, realizada pelo Centro de Estudos de Transportes e Meio Ambiente (UFBA), em 2012/2013 em onze municípios do estado da Bahia. Foi realizada a calibração de um Modelo Logit Multinomial a partir do algoritmo AG, trazendo a vantagem de associação das escolhas dos destinos a valores de coeficientes estimados das funções utilidade aleatórias, sem os problemas relativos à calibração dos modelos logit tradicionais, tais como erros identicamente distribuídos, seguindo a distribuição de Gumbel. O desempenho de cada algoritmo de AM foi comparado à abordagem tradicional (modelo gravitacional). Os resultados evidenciaram que os algoritmos de AM apresentaram melhores previsões para a escolha de destinos, sendo que o AG apresentou vantagens na obtenção dos parâmetros associados às variáveis independentes. A principal conclusão é que tais algoritmos podem ser aplicados na modelagem de distribuição de viagens, incorporando o efeito das variáveis desagregadas, sem suposições matemáticas rigorosas contidas no ajuste de modelos tradicionais desagregados.
Anti-theft Security System for Vehicles
Authors: Rana Samir , Mewari Ritu , Nautiya Lata 
Published: November 2018

In today’s world vehicles form an important asset to us, without which our life would be incomplete. But, when it comes to the security of our vehicles, we are very helpless. It is of a great concern, especially in metropolitan cities, where these incidents occur each and every day. So, in this paper, I have focussed on the security of vehicles. The setup consists of a mix of software and hardware. In software, I will be using an android application, and in hardware, a Raspberry pi board B+ model, a jaw or a gripper and other hardware devices. This whole system will allow you to connect with your vehicle from anytime, anywhere and confirm it’s security. A vehicle is usually the most expensive and important asset next to a home, so this system enables you to keep this asset at your fingertips using wireless technology. Think of it as a wireless leash to your car.
Energy Efficient Design of Wireless Sensor Network: Clustering
Authors: Murthy Garimella Ram , Reddy Edla Damodar , Kuppili Venkatanareshbabu 
Published: November 2018

One of the significant criteria of wireless sensor network is energy efficiency. Focused on the energy problem, researchers design a few algorithms based on clustering in the present era but lack of proper mathematically rigor justification. To fill this research gap, a system and method has been proposed with a mathematical proof induced from the concept of Hessian matrix of multi variable calculus for Energy efficient techniques of data gathering or routing in Wireless Sensor Networks. It is assumed that Wireless Sensor Nodes are distributed in a multidimensional space. Illustrations verify that the proposed system mathematical design for any clustering approach promises a low-energy communication structure.