bluuebunny/crossref_metadata_2025_split huggingface dataset:
Topiramate pharmacokinetics in neonates undergoing therapeutic hypothermia and proposal of an optimised dosing schedule
Authors: Marques María Remedios , Garcia‐Robles Ana , Usach Iris , Vento Maximo , Poveda José Luis , Peris José Esteban , Mangas‐Sanjuan Victor 
Published: July 2019

AbstractAimThe adequate dosing of topiramate in neonates undergoing therapeutic hypothermia has not been established. The aim of this study was to design a dosing schedule capable of providing topiramate serum concentrations within the accepted therapeutic range.MethodsNeonates (n = 52) with hypoxic ischaemic encephalopathy and subjected to therapeutic hypothermia were dosed with topiramate, 5 mg/kg on day one and 3 mg/kg on days two to five, to decrease seizure events. A total of 451 topiramate serum concentrations obtained in the patients were used to develop a population pharmacokinetic model using a non‐linear mixed‐effects modelling approach.ResultsA one‐compartment model with first‐order absorption and two different clearance terms, one for the cooling period and another for the post‐warming period, were used to describe the concentration‐time topiramate data. The probability of no‐seizure events could not be related to topiramate concentrations, which was attributed to excessively low topiramate concentrations. A modified dosage schedule was designed with the aim of obtaining more than 90% of patients with topiramate concentrations within the therapeutic range after the first dose.ConclusionThe dosage schedule of topiramate in these patients should be modified with the aim of decreasing the frequency of seizure events.
Urinary extracellular vesicles: Origin, role as intercellular messengers and biomarkers; efficient sorting and potential treatment options
Authors: Svenningsen Per , Sabaratnam Rugivan , Jensen Boye L. 
Published: July 2019

AbstractUrinary extracellular vesicles (uEVs) are a heterogenous group of vesicles consisting mainly of microvesicles and exosomes that originate predominantly (99.96%) from kidney, the urinary tract epithelium and the male reproductive tract. Secreted EVs contain molecular cargo from parental cells and provide an attractive source for biomarkers, a potential readout of physiological and pathophysiological mechanisms, and events associated with the urinary system. uEVs are readily enriched and isolated from urine samples and we review 6 standard methods that allow for downstream analysis of the uEV cargo. Although the use of uEVs as a surrogate readout for physiological changes in tissue protein levels is widespread, the protein abundance in uEVs is affected significantly by mechanisms that regulate protein sorting and secretion in uEVs. Data suggest that baseline kidney tissue and uEV levels of apical membrane‐associated electrolyte transport proteins are not directly related in human patients. Recent evidence indicates that EVs may contribute to physiological and pathophysiological intercellular signalling and EVs confer protection against renal ischemia‐reperfusion injury. The therapeutic use of EVs as information carriers has mainly been explored in vitro and a major hurdle lies in the translation of the in vitro findings into an in vivo setting. Thus, the EV research field is moving from a technical focus to a more physiological focus, allowing for a deeper understanding of human physiology, development of diagnostic tools and potential treatment strategies for precision medicine.
Effects of Two Web‐Based Interventions and Mediating Mechanisms on Stage of Change Regarding Physical Activity in Older Adults
Authors: Ratz Tiara , Lippke Sonia , Muellmann Saskia , Peters Manuela , Pischke Claudia R. , Meyer Jochen , Bragina Inna , Voelcker‐Rehage Claudia 
Published: July 2019

BackgroundWeb‐based, theory‐driven interventions effectively promote older adults’ physical activity. Social‐cognitive mechanisms of their effect on stage of change need to be further researched.MethodsOlder adults were randomly allocated to intervention group 1 (10‐week online physical activity program), intervention group 2 (same program plus activity tracker), or delayed intervention control group; n = 351 were analyzed (59.6% of originally allocated individuals). Stages of change for recommended endurance and strength training and social‐cognitive predictors of physical activity were assessed using questionnaires at baseline and follow‐up. Intervention effects and mediation were investigated using mixed‐effects ANOVA and ordinal least squares regression.ResultsDirect effects on stage of change were found for intervention group 1 regarding endurance training (bintervention group 1 = 0.44, 95% confidence interval [0.15, 0.73]), and both groups regarding strength training (bintervention group 1 = 1.02, [0.71, 1.33], bintervention group 2 = 1.24, [0.92, 1.56]). Social‐cognitive predictor changes in task self‐efficacy, intention, and action planning explained intervention effect on stage of change, but not to the full extent.ConclusionsThe results indicate significant web‐based intervention effects on physical activity stage, partly mediated by changes in task self‐efficacy, intention, and action planning.
Thoracoscopic subtotal esophagectomy via a right thoracic cavity approach to treat an intractable fistula after 20 months from onset of an idiopathic esophageal rupture: A case report
Authors: Imai Takeharu , Tanaka Yoshihiro , Adachi Takahito , Suetsugu Tomonari , Fukada Masahiro , Tanahashi Toshiyuki , Matsui Satoshi , Imai Hisashi , Kato Takazumi , Matsuhashi Nobuhisa , Takahashi Takao , Yamaguchi Kazuya , Shiroko Takashi , Yoshida Kazuhiro 
Published: July 2019

AbstractAn intractable fistula caused by idiopathic esophageal rupture is a rare but severe condition. In the present case, a 69‐year‐old man had been treated conservatively at another hospital for esophageal rupture but had developed an abscess in the left thoracic cavity due to an intractable fistula at the rupture site. He was referred to our hospital for treatment 19 months after the esophageal rupture. On admission, the intractable fistula was found to be continuous with an abscess in the left thoracic cavity. Preoperative continuous enteral nutrition was administered to improve the patient's nutritional status, and drainage was performed to reduce the size of the abscess. Then, to minimize the invasion of the intractable fistula, thoracoscopic subtotal esophagectomy was performed via a right thoracic cavity approach 20 months after the esophageal rupture. Preoperative management and thoracoscopic surgery via an opposite chest cavity approach was found to be safe and feasible for the intractable fistula caused by idiopathic esophageal rupture.
Laparoscopic transabdominal preperitoneal hernioplasty for recurrent obturator hernia: A case report
Authors: Amiki Manabu , Goto Manabu , Tomizawa Yuki , Sugiyama Atsuhiko , Sakon Ryota , Inoue Takahiro , Ito Shingo , Oneyama Masataka , Shimojima Reiko , Hara Yoshiaki , Narita Kazuhiro , Tachimori Yuji , Sekikawa Koji 
Published: July 2019

AbstractReports of recurrence after obturator hernia repair are few. We describe the case of an 89‐year‐old woman who presented to us with a thrice recurrent obturator hernia. She had undergone open non‐mesh repair twice and then laparoscopic non‐mesh repair. She was readmitted to our hospital 6 months after the laparoscopic repair. Manual reduction was successful, paving the way for elective transabdominal preperitoneal repair. During the endoscopic repair, surgical mesh was placed extraperitoneally over the hernia defect and then fixed to Cooper's ligament with absorbable tacks. The patient was discharged on postoperative day 2 without complications. In the 2 months that have passed since the surgery there has been no sign of recurrence, but the patient will be carefully followed up. Repair of a recurrent obturator hernia is technically challenging; however, the transabdominal preperitoneal approach seems to be reliable and safe.
The competitive endogenous RNA regulatory network reveals potential prognostic biomarkers for overall survival in hepatocellular carcinoma
Authors: Zhang Zhiqiao , Li Jing , He Tingshan , Ouyang Yanling , Huang Yiyan , Liu Qingbo , Wang Peng , Ding Jianqiang 
Published: July 2019

AbstractThe aim of the present study is to construct a competitive endogenous RNA (ceRNA) regulatory network by using differentially expressed long noncoding RNAs (lncRNAs), microRNAs (miRNAs), and mRNAs in patients with hepatocellular carcinoma (HCC), and to construct a prognostic model for predicting overall survival (OS) of HCC patients. Differentially expressed lncRNAs, miRNAs, and mRNAs were explored between HCC tissues and normal liver tissues. A prognostic model was built for predicting OS of HCC patients and receiver operating characteristic curves were used to evaluate the performance of the prognostic model. There were 455 differentially expressed lncRNAs, 181 differentially expressed miRNAs, and 5035 differentially expressed mRNAs. A ceRNA regulatory network was constructed based on 43 lncRNAs, 37 miRNAs, and 105 mRNAs. Eight mRNA biomarkers (H2AFX, SQSTM1, ITM2A, PFKP, TPD52L1, ACSL4, STRN3, and CPEB3) were identified as independent risk factors by multivariate Cox regression and were used to develop a prognostic model for OS. The C‐indexes in the model group were 0.776 (95% confidence interval [CI], 0.730‐0.822), 0.745 (95% CI, 0.699‐0.791), and 0.789 (95% CI, 0.743‐0.835) for 1‐, 3‐, and 5‐year OS, respectively. The current study revealed potential molecular biological regulation pathways and prognostic biomarkers by the ceRNA regulatory network. A prognostic model based on prognostic mRNAs in the ceRNA network might be helpful to predict the individual mortality risk for HCC patients. The individual mortality risk calculator can be used by visiting the following URL: https://zhangzhiqiao.shinyapps.io/Smart_cancer_predictive_system_HCC/.
Role of timing of exposure to pets and dampness or mould on asthma and sensitization in adolescence
Authors: Milanzi Edith B. , Koppelman Gerard H. , Smit Henriette A. , Wijga Alet H. , Vonk Judith M. , Brunekreef Bert , Gehring Ulrike 
Published: July 2019

AbstractBackgroundPet and dampness or mould exposure are considered risk factors for asthma and sensitization. It is unclear whether timing of exposure to these factors is differentially associated with asthma risk and sensitization in adolescence.ObjectiveWe investigated the role of timing of pet and dampness or mould exposure in asthma and sensitization in adolescence. Understanding this role is essential to build targeted prevention strategies.MethodsWe used data from 1871 participants of the Dutch Prevention and Incidence of Asthma and Mite Allergy (PIAMA) cohort. Residential exposure to pets, dampness or mould was assessed by repeated parental questionnaires. We used asthma data from the 17‐year questionnaire and sensitization data from the 16‐year medical examination. We characterized timing using longitudinal exposure patterns from pregnancy till age 17 using longitudinal latent class growth modelling. We used logistic regression models to analyse associations of exposure patterns with asthma at age 17 and sensitization at age 16.ResultsFor none of the time windows, exposure to pets and dampness or mould was associated with asthma at age 17, but a lower sensitization risk at age 16 was suggested, for example the odds ratio (95% confidence interval) for sensitization was 0.63 (0.35‐1.11) and 0.69 (0.44‐1.08) for early life and persistently high pet exposure, respectively, compared with very low exposure. An inverse association was also suggested for sensitization and moderate early childhood dampness or mould exposure (0.71 [0.42‐1.19]).Conclusion and clinical relevanceDifferent timing of pet and dampness or mould exposure was not associated with asthma, but lower risk of sensitization in adolescence was suggested, which could be partly attributable to reversed causation. Current findings are not sufficient to recommend pet avoidance to prevent allergic disease. More prospective studies are needed to obtain insights that can be used in clinical practice.
Mechanism of dorsal root ganglion stimulation for pain relief in painful diabetic polyneuropathy is not dependent on GABA release in the dorsal horn of the spinal cord
Authors: Koetsier Eva , Franken Glenn , Debets Jacques , Heijmans Lonne , van Kuijk Sander M.J. , Linderoth Bengt , Joosten Elbert A. , Maino Paolo 
Published: July 2019

AbstractAimsIt is hypothesized that dorsal root ganglion stimulation (DRGS), sharing some of the mechanisms of traditional spinal cord stimulation (SCS) of the dorsal columns, induces γ‐aminobutyric acid (GABA) release from interneurons in the spinal dorsal horn.MethodsWe used quantitative immunohistochemical analysis in order to investigate the effect of DRGS on intensity of intracellular GABA‐staining levels in the L4‐L6 spinal dorsal horn of painful diabetic polyneuropathy (PDPN) animals. To establish the maximal pain relieving effect, we tested for mechanical hypersensitivity to von Frey filaments and animals received 30 minutes of DRGS at day 3 after implantation of the electrode. One day later, 4 Sham‐DRGS animals and four responders‐to‐DRGS received again 30 minutes of DRGS and were perfused at the peak of DRGS‐induced pain relief.ResultsNo significant difference in GABA‐immunoreactivity was observed between DRGS and Sham‐DRGS in lamina 1‐3 of the spinal levels L4‐6 neither ipsilaterally nor contralaterally.ConclusionsDorsal root ganglion stimulation does not induce GABA release from the spinal dorsal horn cells, suggesting that the mechanisms underlying DRGS in pain relief are different from those of conventional SCS. The modulation of a GABA‐mediated “Gate Control” in the DRG itself, functioning as a prime Gate of nociception, is suggested and discussed.
Object‐Label‐Order Effect When Learning From an Inconsistent Source
Authors: Ma Timmy , Komarova Natalia L. 
Published: July 2019

AbstractLearning in natural environments is often characterized by a degree of inconsistency from an input. These inconsistencies occur, for example, when learning from more than one source, or when the presence of environmental noise distorts incoming information; as a result, the task faced by the learner becomes ambiguous. In this study, we investigate how learners handle such situations. We focus on the setting where a learner receives and processes a sequence of utterances to master associations between objects and their labels, where the source is inconsistent by design: It uses both “correct” and “incorrect” object‐label pairings. We hypothesize that depending on the order of presentation, the result of the learning may be different. To this end, we consider two types of symbolic learning procedures: the Object‐Label (OL) and the Label‐Object (LO) process. In theOLprocess, the learner is first exposed to the object, and then the label. In theLOprocess, this order is reversed. We perform experiments with human subjects, and also construct a computational model that is based on a nonlinear stochastic reinforcement learning algorithm. It is observed experimentally thatOLlearners are generally better at processing inconsistent input compared toLOlearners. We show that the patterns observed in the learning experiments can be reproduced in the simulations if the model includes (a) an ability to regularize the input (and also to do the opposite, i.e., undermatch) and (b) an ability to take account of implicit negative evidence (i.e., interactions among different objects/labels). The model suggests that while both types of learners utilize implicit negative evidence in a similar way, there is a difference in regularization patterns:OLlearners regularize the input, whereasLOlearners undermatch. As a result,OLlearners are able to form a more consistent system of image‐utterance associations, despite the ambiguous learning task.
Addressing bone quality and bone density after renal transplantation: A prospective evaluation of the evolution of trabecular bone score and bone mineral density over the first 5 years following renal transplantation in Asian patients
Authors: Chandran Manju , Hao Ying , Kwee Ann Kerwen , Swee Du Soon , Ng David Chee Eng , Kee Terence Yi Shern , Bharadwaj Pushan 
Published: July 2019

AbstractThe evolution of trabecular bone score (TBS) and bone mineral density (BMD) over the first 5 years after renal transplantation was prospectively evaluated in 164 patients. Dual energy X‐ray absorptiometry (DXA) scans were performed at 0, 6, 12, 24, and 60 months. Cumulative steroid dose, serum 25(OH)D, calcium, parathyroid hormone, and total ALP levels at these time points were checked. Incident fractures were identified from X‐rays/vertebral fracture assessments. Mean (SD) age, TBS, and lumbar spine BMD at baseline were 47.11 (9.53), 1.424 (0.097), and 0.935 (0.183) gm/cm2, respectively. Baseline TBS was lower in tertiary 1.38 (0.07) vs secondary hyperparathyroidism 1.43 (0.01) vs post‐parathyroidectomy 1.46 (0.11); P = .035. Trabecular bone score and BMD significantly decreased from baseline‐>6 months, changes after that at consecutive time points were non‐significant. 11% had incident fractures during the follow‐up period, majority being metatarsal with no vertebral or hip fractures noted. This first prospective evaluation of TBS and BMD evolution at multiple time points over 5 years suggest that microarchitectural and bone density deteriorations post‐renal transplantation stabilize after 6 months. Stabilization of these parameters could partially account for the absence of major fractures noted in this Asian population. Possible genetic and ethnic differences in fracture risk between Asian and Caucasian renal transplant patients have to be explored through large population‐based studies.
The Antinomies of Successful Mobilization: Colombian Recyclers Manoeuvre between Dispossession and Exploitation
Authors: Rosaldo Manuel 
Published: July 2019

ABSTRACTLong dismissed as too weak and fragmented to collectively organize, millions of informal workers have begun mobilizing for labour rights over the past 40 years. As informal workers gain a measure of power to reshape the structure and conditions of their work, but continue to face constraints due to their subordinated positions in the broader political economy, tensions may emerge between the imperatives of combatting exploitation and dispossession. Recent conflicts over recycler rights policy in Bogotá, Colombia are illustrative of this dilemma. For the first 25 years of its existence, the recycler rights movement experienced little tension between these two imperatives, as it had little capacity to do either. In recent years, however, recyclers have become powerful political agents, and since 2012 conflicts have erupted among recyclers and state officials over how to navigate the twin threat. Drawing on 12 months of ethnographic fieldwork, this article exposes both potentials and constraints of state‐led interventions to improve informal livelihoods. Such interventions are likely to entail thorny tradeoffs as long as they occur within a broader system of social relations that is based on exploitation and exclusion.
Addition of low‐dose liraglutide to insulin therapy is useful for glycaemic control during the peri‐operative period: effect of glucagon‐like peptide‐1 receptor agonist therapy on glycaemic control in patients undergoing cardiac surgery (GLOLIA study)
Authors: Makino H. , Tanaka A. , Asakura K. , Koezuka R. , Tochiya M. , Ohata Y. , Tamanaha T. , Son C. , Shimabara Y. , Fujita T. , Miyamoto Y. , Kobayashi J. , Hosoda K. 
Published: July 2019

AbstractAimTo test the hypothesis that the addition of a glucagon‐like peptide‐1 receptor agonist that can decrease glucose levels without increasing the hypoglycaemia risk will achieve appropriate glycaemic control during the peri‐operative period.MethodsWe studied 70 people with Type 2 diabetes who underwent elective cardiac surgery. Participants were randomized to either an insulin‐alone or an insulin plus liraglutide 0.6 mg/day group. We evaluated average M values, which indicated the proximity index of the target glucose level from day 1 to day 10.ResultsThe average M value in the liraglutide plus insulin group was significantly lower than that in the insulin‐alone group (liraglutide plus insulin 5.8 vs insulin‐alone 12.3; P < 0.001). The frequency of insulin dose modification in the liraglutide plus insulin group was significantly lower than that in the insulin‐alone group (odds ratio 0.19, 95% CI 0.08–0.49; P < 0.001). The frequency of hypoglycaemia in the liraglutide plus insulin group tended to be lower than that in the insulin‐alone group (odds ratio 0.57, 95% CI 0.15–2.23; P = 0.21).ConclusionsThe results of this study showed that the addition of low‐dose liraglutide to insulin achieved lower M values than insulin alone, suggesting that the addition of low‐dose liraglutide may achieve better glycaemic control during the peri‐operative period. (Clinical trials registry no.: UMIN 000008003)
Performance of the Freestyle Libre flash glucose monitoring (flash GM) system in individuals with type 1 diabetes: A secondary outcome analysis of a randomized crossover trial
Authors: Moser Othmar , Eckstein Max L. , McCarthy Olivia , Deere Rachel , Pitt Jason , Williams David M. , Hayes Jennifer , Sourij Harald , Bain Stephen C. , Bracken Richard M. 
Published: July 2019

AbstractAimsThe efficacy of flash glucose monitoring (flash GM) systems has been demonstrated by improvements in glycaemia; however, during high rates of glucose flux, the performance of continuous glucose monitoring systems was impaired, as detailed in previous studies. This study aimed to determine the performance of the flash GM system during daily‐life glycaemic challenges such as carbohydrate‐rich meals, bolus insulin‐induced glycaemic disturbances and acute physical exercise in individuals with type 1 diabetes.Materials and methodsThis study comprised four randomized trial visits with alternating pre‐ and post‐exercise bolus insulin doses. Throughout the four 14‐hour inpatient phases, 19 participants received three carbohydrate‐rich meals and performed moderate‐intensity exercise. Venous blood glucose and capillary blood glucose during exercise was compared to interstitial glucose concentrations. Flash GM accuracy was assessed by median absolute relative difference (MARD) (interquartile range [IQR]) using the Bland–Altman method and Clark error grid, as well as according to guidelines for integrated CGM approvals (Class II–510(K)).ResultsThe overall MARD (IQR) during inpatient phases was 14.3% (6.9%–22.8%), during hypoglycaemia (≤3.9 mmol/L) was 31.6% (16.2%–46.8%), during euglycaemia (4.0 mmol/L − 9.9 mmol/L) was 16.0% (8.5%–24.0%) and during hyperglycaemia (≥10 mmol/L) was 9.4% (5.1%–15.7%). Overall Bland–Altman analysis showed a bias (95% LoA) of 1.26 mmol/L (−1.67 to 4.19 mmol/L). The overall MARD during acute exercise was 29.8% (17.5%–39.8%), during hypoglycaemia was 45.1% (35.2%–51.1%), during euglycaemia was 30.7% (18.7%–39.2%) and during hyperglycaemia was 16.3% (10.0%–22.8%).ConclusionFlash GM interstitial glucose readings were not sufficiently accurate within the hypoglycaemic range and during acute exercise and require confirmatory blood glucose measurements.
Choosing Among Computational Software Tools to Enhance Learning in Introductory Business Statistics
Authors: Johnson Marina E. , Berenson Mark L. 
Published: July 2019

ABSTRACTAACSB has now mandated that analytics be integrated into the undergraduate business curriculum. Given that the subject of statistics provides the underpinnings of the developing discipline of business analytics, this article focuses on effective course delivery aimed at enhancing the learning of introductory business statistics in the modern world of big data. To this end, the choice and use of computational software tools are essential to the successful delivery of the course. A set of seven competing tools are compared and contrasted, their advantages and disadvantages are discussed, and a link is provided to show demonstrations of needed instructions and resulting output.