bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of in-body tissue architecture–induced Biotube vascular grafts for vascular access: Proof of concept in a beagle dog model
Authors: Furukoshi Maya , Tatsumi Eisuke , Nakayama Yasuhide 
Published: September 2019

Introduction: The first choice of vascular access for hemodialysis is an autogenous arteriovenous fistula, because prosthetic arteriovenous grafts have a high probability of failure. In this study, Biotubes, in-body tissue architecture–induced autologous collagenous tubes, were evaluated for their potential use as vascular access grafts. Three animal implantation models were developed using beagle dogs, and the in vivo performance of Biotubes was observed after implantation in the acute phase as a pilot study. Methods: Biotubes (internal diameter ca. 4.0 mm, length ca. 5.0 cm, and wall thickness ca. 0.7 mm) were prepared through subcutaneous embedding of specially designed molds in beagle dogs for 8 weeks. The Biotubes were then implanted between the common carotid artery and the jugular vein of beagles via three methods, including side-to-side (in) -end-to-end (out) as type 1 (n = 4), side-to-side (both) as type 2 (n = 4), and side-to-end (in) -end-to-side (out) as type 3 (n = 1 using a composite Biotube). Results: Although two cases in type 1 and 2 resulted in Biotube deformation, all cases were patent for 4 weeks and maintained a continuous turbulent flow. At 4 weeks after implantation, percutaneous puncture could be performed repeatedly without aneurysm formation or hemorrhage. Conclusion: Within a short implantation period, with limited animal numbers, this proof-of-concept study showed that Biotubes may have a high potential for use in vascular access.
Cost-effectiveness of telerehabilitation versus traditional care after total hip replacement: A trial-based economic evaluation
Authors: Nelson Mark , Russell Trevor , Crossley Kay , Bourke Michael , McPhail Steven 
Published: September 2019

Introduction: Physical rehabilitation for total hip replacement patients following hospital discharge is beneficial; however, accessing rehabilitation is often challenging. Telerehabilitation helps negate access issues and is efficacious in total knee and hip replacement patients. This study aims to compare the cost-effectiveness of a telerehabilitation programme delivered remotely into patients’ homes versus traditional care for total hip replacement patients following hospital discharge. Methods: A cost-effectiveness (cost-utility) analysis was conducted from the perspective of a health service alongside a two-arm randomised controlled trial comparing telerehabilitation ( n=35) with in-person care ( n=35) following hospital discharge after total hip replacement. The primary analysis used an Incremental Cost-Effectiveness Ratio to compare the cost per Quality Adjusted Life Year (QALY) accrued in the telerehabilitation group versus in-person control using costs and effects data from the randomised trial. A secondary analysis was conducted whereby the time accrued by patients attending rehabilitation sessions (including travel time) was considered the “cost” (i.e. a time burden), rather than cost from the health service perspective. Results: Estimated mean differences in healthcare costs and QALYs gained were detected but were not significant. The estimated mean (95%CI) difference in cost of telerehabilitation versus in-person was –$28.90 (–$96.37 to $40.45), favouring the telerehabilitation group. The estimated mean (95%CI) difference in QALYs gained from telerehabilitation versus in-person was –0.0025 (–0.0227 to 0.0217). The estimated mean (95%CI) difference in time burden favoured less time burden for the telerehabilitation group (–4.21 (–4.69 to –3.74) hours). Discussion: Telerehabilitation in the total hip replacement population incurred similar costs and yielded similar effects to traditional in-person care. Telerehabilitation significantly reduced the time burden for patients and carers. These findings are valuable for healthcare providers seeking to implement accessible patient-centred rehabilitation services.
Gender and diet management in type 2 diabetes
Authors: Dimova Elena Dimcheva , Swanson Vivien , Evans Josie MM 
Published: September 2019

Introduction Type 2 diabetes is a chronic health condition that requires ongoing self-management. This often includes changes in diet, which may be open to influences from relatives. Family support in terms of diet may be linked with gender and the assumption that meal preparation is a traditionally female activity. This article looks at the role of gender in diet management in people with type 2 diabetes and their relatives. Methods Seventeen semi-structured interviews were conducted with 23 participants (10 people with type 2 diabetes, 13 relatives of people with type 2 diabetes) in Scotland, UK. The aim was to uncover changes people have made to their diet following diagnosis of type 2 diabetes in oneself or a family member. Data were analysed using Framework Approach. Findings: Female relatives were more likely to manage the patient’s diet while male relatives provided support but were less likely to monitor the person’s diet. Female patients may prioritise the needs of their family while male patients are more likely to rely on their female relatives in terms of diet management. Discussion The study findings have implications for family-based interventions as gender may play a crucial role in the management of type 2 diabetes.
Repeated low-dose rituximab treatment based on the assessment of circulating B cells in patients with refractory myasthenia gravis
Authors: Choi Kyomin , Hong Yoon-Ho , Ahn So-Hyun , Baek Seol-Hee , Kim Jun-Soon , Shin Je-Young , Sung Jung-Joon 
Published: September 2019

Background: The objective of this study was to evaluate the efficacy and safety of repeated low-dose rituximab treatment guided by monitoring circulating CD19+ B cells in patients with refractory myasthenia gravis (MG). Methods: Patients with refractory MG who had received rituximab treatment at two teaching hospitals between September 2013 and January 2017 were reviewed retrospectively. The treatment protocol consisted of an induction treatment with low-dose rituximab (375 mg/m2 twice with a 2-week interval), followed by retreatment (375 mg/m2 once). Retreatment was based on either circulating CD19+ B-cell repopulation or clinical relapse. Outcome measures included the MG Foundation of America (MGFA) clinical classification and postintervention status, prednisolone dose, CD19+ B-cell counts, clinical relapse, and adverse effects. Results: Of 17 patients, 11 (65%) achieved the primary endpoint, defined as the minimal manifestation or better status with prednisolone ⩽5 mg/day, after median 7.6 months (range, 2–17 months) following rituximab treatment. Over a median follow up of 24 months (range, 7–49 months), a total of 30 retreatments were undertaken due to clinical relapse without B-cell repopulation ( n = 6), on the basis of B-cell repopulation alone ( n = 16) and both ( n = 8). B-cell recovery appeared to be in parallel with clinical relapse on the group level, although the individual-level association appeared to be modest, with B-cell repopulation observed only at 57% (8/14) of clinical relapses. Conclusions: The repeated low-dose rituximab treatment based on the assessment of circulating B-cell depletion could be a cost-effective therapeutic option for refractory MG. Further studies are needed to verify the potentially better cost-effectiveness of low-dose rituximab, and to identify biomarkers that help optimize treatment in MG patients.
Enhanced antibacterial activity of titanium by surface modification with polydopamine and silver for dental implant application
Authors: Choi Soo-Hyoen , Jang Yong-Seok , Jang Jong-Hwa , Bae Tae-Sung , Lee Sook-Jeong , Lee Min-Ho 
Published: September 2019

Background: Biofilm formation and microbial colonization on the surface of implant devices may cause dental caries and peri-implantitis. Therefore, various surface treatments have been developed to improve the antibacterial activity of titanium implant. Methods: Silver-loaded polydopamine coating was formed by immersing pure titanium in dopamine hydrochloride/HCl buffer solution for 24 h in 50 mL silver nitrate solutions with different concentrations for 30 min. Microbial growth inhibition and microbial growth curve analyses for bacterial solutions of Streptococcus mutans and Porphyromonas gingivalis incubated with the specimens were respectively conducted by counting the numbers of colonies on agar solid medium and by measuring absorbance using enzyme-linked immunosorbent assay reader. Results: Silver nanoparticles were uniformly distributed over the whole surface of the polydopamine and silver-coated titanium specimens. The numbers of microbial colonies for both bacteria cultured with surface-modified titanium were significantly lower than those cultured with uncoated titanium. When Streptococcus mutans and Porphyromonas gingivalis were cultured with surface-modified titanium, the lag phase of the growth curves for both bacteria was continually maintained, whereas the lag phase for Streptococcus mutans and Porphyromonas gingivalis changed to exponential phase after 9 and 15 h, respectively, when both bacteria were cultured with uncoated titanium. Conclusion: It was confirmed that the coating of polydopamine and silver on the surface of titanium effectively retards the microbial growth, which can cause the formation of biofilm and pathogenesis of gum disease in the mouth.
Gradual correction of proximal tibia deformity for Blount disease in adolescent and young adults
Authors: Saw Aik , Phang Zi Hao , Alrasheed Mohammed Khalid , Gunalan Roshan , Albaker Mohammed Ziyad , Shanmugam Rukmanikanthan 
Published: September 2019

Purpose: Management of Blount disease in adolescents and young adults is complex and associated with high risk of morbidities. Gradual correction with external fixator can minimize soft tissue injury and allow subsequent adjustment in degree of correction. This study investigates the surgical outcome and complication rate of gradual correction of neglected Blount disease through single-level extra-articular corticotomy. Methods: Patients treated for Blount disease using external fixator from 2002 to 2016 were recruited for the study. We used Ilizarov and Taylor Spatial Frame (TSF) external fixator to perform simultaneous correction of all the metaphyseal deformities without elevating the tibia plateau. Surgical outcome was evaluated using mechanical axis deviation (MAD), tibial femoral angle (TFA), and femoral condyle tibial shaft angle (FCTSA). Results: A total of 22 patients with 32 tibias have been recruited for the study. The mean MAD improved from 95 ± 51.4 mm to 9.0 ± 37.7 mm (medial to midpoint of the knee), mean TFA improved from 31 ± 15° varus to 2 ± 14° valgus, and mean FCTSA improved from 53 ± 14° to 86 ± 14°. Mean duration of frame application is 9.4 months. Two patients developed pathological fractures over the distracted bones, one developed delayed consolidation and other developed overcorrection. Conclusions: Correction of Blount disease can be achieved by gradual correction using Ilizarov or TSF external fixator with low risk of soft tissue complication. Longer duration of frame application should be considered to reduce the risk of pathological fracture or subsequent deformation of the corrected bone.
Clinical and functional outcomes of a novel transosseous device to treat rotator cuff tears: A minimum 2-year follow-up
Authors: Arican Mehmet , Turhan Yalçın , Karaduman Zekeriya Okan , Ayanoğlu Tacettin 
Published: September 2019

Purpose: Despite the improvements in the repair equipment techniques of rotator cuff, a gold standard method has not been defined yet and transosseous fixation through deltoid-splitting (mini-open) approach is still regarded as a good option. The primary purpose of this study is to present satisfactory clinical and functional outcomes with a novel transosseous device in full-thickness rotator cuff tear through deltoid-splitting. Materials and Methods: This retrospective study was performed on 70 consecutive patients who underwent surgery by a single surgeon from June 2014 to June 2016 for a full-thickness rotator cuff tear and was managed with a novel transosseous device. Total number of patients, mean age, percentage of male and female patients, mean duration of follow-up, percentage of involvement of the dominant extremity, affected shoulder, and tear size were recorded. Functional and clinical outcomes were assessed baseline and postoperatively at 3 and 6 months and final follow-up using Disabilities of the Arm, Shoulder and Hand (Q-DASH) and Constant-Murley scores. Results: A total of 70 (49 (70%) female, 21 (30%) male) patients whose mean age was 58.66 ± 9.19 (38–77) years were included. The mean surgery time was 35.33 ± 5.34 (28–55) min. The mean follow-up time was 28.31 ± 3.03 (24–36) months. According to the DeOrio and Cofield classification, 15 (21.43%) tears were small, 33 (47.14%) medium, 16 (22.86%) large, and 6 (8.57%) massive. By the final follow-up, the mean Constant-Murley score had significantly improved from 27.67 ± 7.46 (13–41) to 81.25 ± 3.77 (74–87; p = 0.0001) and the Q-DASH score had decreased from 82.34 ± 10.37 (65.91–100) to 10.28 ± 6.88 (0–23.45; p = 0.0001). There were no significant differences in the Constant-Murley or Q-DASH score at baseline–final follow-up between the small, medium, large, and massive tear groups ( p > 0.05). Conclusions: Treatment of full-thickness rotator cuff tear using this novel transosseous device significantly improved functional and clinical scores. However, further long-term prospective randomized multicenter trials involving comparative studies are necessary to confirm these findings.
Some advantages of three-layer medium-density fibreboard as compared to the traditional single-layer one
Authors: Akbulut Turgay , Ayrilmis Nadir 
Published: September 2019

Abstract
The aim of the study was to develop three-layer medium-density fibreboard (MDF) manufacture by adding the coarse fibres in the middle layer, like three-layer particleboard. The liquid urea–formaldehyde (UF) resin was reduced from 10.5 to 6.5 wt% in the middle layer of the MDFs. The UF resin content was kept constant at 10 wt% in the surface layers of all the MDFs. Moreover, the average density of MDFs was decreased from 730 to 650 kg/m3. The internal bond strength of three-layer MDFs decreased with decreasing UF resin content (10.5 to 8.5 wt%) in the middle layer. However, the decreases in the internal bond strength were statistically not significant. The internal bond strength values of the MDFs having density between 730 and 675 kg/m3 did not show significant differences. The cost savings of the resin were 20% when the amount of resin was reduced from 10.5 to 8.5 wt%. Three-layer MDFs had lower resin consumption at lower densities over traditional single-layer MDFs produced in the same plant with the same material components without decreasing their technological properties. In conclusion, it can be said that three-layer MDF could be produced at a lower cost than traditional single-layer MDF.
Assessing the leaching behavior of different gunshot materials in natural spring waters
Authors: Fäth Julian , Göttlein Axel 
Published: September 2019

Abstract

Background
Owing to the high environmental risk of lead-based gunshot, especially as the main source of acute lead poisoning in waterfowl, restrictions on its use in European wetlands are being put into place. In order to assess potential risks of alternative gunshot pellets to aquatic systems, we validated a recently published study that compared the leaching behavior of different game shot materials in an artificial solution and their toxicological effects to Daphnia magna. We therefore investigated the altered leaching of shot materials in natural spring waters.

Results
The different water conditions (geology/redox conditions) had a strong influence on the leaching behavior of the examined shot types. Spring water originating from siliceous bedrock showed the highest concentrations of nearly all leached metals under aerobic conditions. The results were similar to the former study, which used an artificial standardized medium for daphnids.

Conclusions
According to the conducted leaching tests, Cu- and Zn-based as well as Zn-coated gunshot should be avoided by reason of the high risks they pose to the aquatic environment. Furthermore, the use of Pb-based and Ni-alloyed or -coated game shot also should be hampered owing to their impact on birds or other wildlife. Since some of these shot materials are still on the European market, an effective toxicity screening of alternative gunshot materials is necessary. By conducting standardized leaching tests, in addition to chemical compositional standards and toxicity tests regarding birds, the environmental risks of each game shot would entirely be assessed. The method presented in this study provides a further step for initial ecotoxicological risk assessment of gunshot for aquatic systems, since it additionally assesses minor components, like thin coatings, which also can have a high impact to these ecosystems.
Adverse drug reaction detection via a multihop self-attention mechanism
Authors: Zhang Tongxuan , Lin Hongfei , Ren Yuqi , Yang Liang , Xu Bo , Yang Zhihao , Wang Jian , Zhang Yijia 
Published: September 2019

AbstractBackgroundThe adverse reactions that are caused by drugs are potentially life-threatening problems. Comprehensive knowledge of adverse drug reactions (ADRs) can reduce their detrimental impacts on patients. Detecting ADRs through clinical trials takes a large number of experiments and a long period of time. With the growing amount of unstructured textual data, such as biomedical literature and electronic records, detecting ADRs in the available unstructured data has important implications for ADR research. Most of the neural network-based methods typically focus on the simple semantic information of sentence sequences; however, the relationship of the two entities depends on more complex semantic information.MethodsIn this paper, we propose multihop self-attention mechanism (MSAM) model that aims to learn the multi-aspect semantic information for the ADR detection task. first, the contextual information of the sentence is captured by using the bidirectional long short-term memory (Bi-LSTM) model. Then, via applying the multiple steps of an attention mechanism, multiple semantic representations of a sentence are generated. Each attention step obtains a different attention distribution focusing on the different segments of the sentence. Meanwhile, our model locates and enhances various keywords from the multiple representations of a sentence.ResultsOur model was evaluated by using two ADR corpora. It is shown that the method has a stable generalization ability. Via extensive experiments, our model achieved F-measure of 0.853, 0.799 and 0.851 for ADR detection for TwiMed-PubMed, TwiMed-Twitter, and ADE, respectively. The experimental results showed that our model significantly outperforms other compared models for ADR detection.ConclusionsIn this paper, we propose a modification of multihop self-attention mechanism (MSAM) model for an ADR detection task. The proposed method significantly improved the learning of the complex semantic information of sentences.
Isolation and characterization of a sequence type 25 carbapenem-resistant hypervirulent Klebsiella pneumoniae from the mid-south region of China
Authors: Li Jun , Huang Zi-Yan , Yu Ting , Tao Xiao-Yan , Hu Yong-Mei , Wang Hai-Chen , Zou Ming-Xiang 
Published: September 2019

Abstract

Background
The molecular characterization of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) isolates is not well studied. Our goal was to investigate the molecular epidemiology of CR-hvKP strains that were isolated from a Chinese hospital.

Results
All clinical carbapenem-resistant K. pneumoniae (CR-KP) isolates were collected and identified from patient samples between 2014 and 2017 from a Chinese hospital. The samples were subjected to screening for CR-hvKP by string test and the detection of the aerobactin gene. CR-hvKP isolates were further confirmed through neutrophil phagocytosis and a mice lethality assay. The CR-hvKP isolates were investigated for their capsular genotyping, virulence gene profiles, and the expression of carbapenemase genes by PCR and DNA sequencing. Multilocus sequence type (MLST) and pulsed-field gel electrophoresis (PFGE) were performed to exclude the homology of these isolates. Twenty strains were identified as CR-hvKP. These strains were resistant to imipenem and several other antibiotics, however, most were susceptible to amikacin. Notably, two isolates were not susceptible to tigecycline. Capsular polysaccharide synthesis genotyping revealed that 17 of the 20 CR-hvKP strains belonged to the K2 serotype, while the others belonged to serotypes other than K1, K2, K5, K20, and K57. The strains were found to be positive for 10 types of virulence genes and a variety of these genes coexisted in the same strain. Two carbapenemase genes were identified: blaKPC-2 (13/20) and blaNDM-1 (1/20). PFGE typing revealed eight clusters comprising isolates that belonged to MLST types ST25, ST11 and ST375, respectively. PFGE cluster A was identified as the main cluster, which included 11 isolates that belong to ST25 and mainly from ICU department.

Conclusions
Our findings suggest that hospital-acquired infections may contribute in part to the CR-hvKP strains identified in this study. It also suggests that ST25 CR-hvKP strain has a clonal distribution in our hospital. Therefore, effective surveillance and strict infection control strategies should be implemented to prevent outbreak by CR-hvKP strains in hospitals setting.