bluuebunny/crossref_metadata_2025_split huggingface dataset:
Defining complete wound closure: Closing the gap in clinical trials and practice
Authors: Gould Lisa , Li William W. 
Published: February 2019

AbstractWe investigate how wound closure is determined in recent randomized controlled wound trials and real‐world studies, identify solutions to the current limitations of wound assessment, and propose a standard methodology to define and assess wound healing in research. We searched PubMed for randomized clinical trials using the terms “complete wound closure” and “wound healing rate” and for real‐world studies using the terms “real‐world wound healing,” “real‐world wound data,” and “wound registries” dating from March 2010 through March 2018. We selected studies that had “complete wound closure” or “healed wound” as an endpoint. Sixty‐five trial articles and 10 real‐world articles met our criteria, from which we extracted the wound type studied, definition of healed wound used, wound assessment method, the number of weeks assessed, the number of wounds, and the percent of healed wounds in the study group(s) and control group. There were 7,194 trial wounds included. The most common definition of healing used by 26 studies (40.6%) was complete/full/100% (re)epithelialization or closure without discharge, drainage/scab, and/or dressing. Fifty‐two studies (81.2%) used blinded wound assessment, and at least 10 studies (15.6%) used blinded adjudication. The real‐world studies analyzed more than 901,396 wounds. Only three studies (33.3%) defined a healed/closed wound, two of which used “complete epithelialization.” Eight studies (88.9%) did not define the wound assessment method; none indicated a blinded assessment. We support the Food and Drug Administration definition: 100% reepithelialization of the wound surface with no discernable exudate and without drainage or dressing, confirmed at two visits 2 weeks apart, and we recommend blinded adjudication for wound assessment. The widespread adoption of a standard wound healing definition and assessment method in wound care research would allow for stronger comparisons of treatment effects across studies to improve the evidence base and strengthen the treatment decision‐making process in clinical practice.
A review of pig liver xenotransplantation: Current problems and recent progress
Authors: Zhang Xuan , Li Xiao , Yang Zhaoxu , Tao Kaishan , Wang Quancheng , Dai Bin , Qu Shibin , Peng Wei , Zhang Hong , Cooper David K. C. , Dou Kefeng 
Published: February 2019

AbstractPig liver xenotransplantation appears to be more perplexing when compared to heart or kidney xenotransplantation, even though great progress has been achieved. The relevant molecular mechanisms involved in xenogeneic rejection, including coagulopathy, and particularly thrombocytopenia, are complex, and need to be systematically investigated. The deletion of expression of Gal antigens in the liver graft highlights the injurious impact of nonGal antigens, which continue to induce humoral rejection. Innate immunity, particularly mediated by macrophages and natural killer cells, interplays with inflammation and coagulation disorders. Kupffer cells and liver sinusoidal endothelial cells (LSECs) together mediate leukocyte, erythrocyte, and platelet sequestration and phagocytosis, which can be exacerbated by increased cytokine production, cell desialylation, and interspecies incompatibilities. The coagulation cascade is activated by release of tissue factor which can be dependent or independent of the xenoreactive immune response. Depletion of endothelial anticoagulants and anti‐platelet capacity amplify coagulation activation, and interspecies incompatibilities of coagulation‐regulatory proteins facilitate dysregulation. LSECs involved in platelet phagocytosis and transcytosis, coupled with hepatocyte‐mediated degradation, are responsible for thrombocytopenia. Adaptive immunity could also be problematic in long‐term liver graft survival. Currently, relevant evidence and study results of various genetic modifications to the pig donor need to be fully determined, with the aim of identifying the ideal transgene combination for pig liver xenotransplantation. We believe that clinical trials of pig liver xenotransplantation should initially be considered as a bridge to allotransplantation.
Prevalence and risk factors of myopic maculopathy in rural southern China: the Yangxi Eye Study
Authors: Li Zhixi , Liu Ran , Jin Guangming , Ha Jason , Ding Xiaohu , Xiao Wei , Xu Xiao , An Lei , Zhao Jialiang , He Mingguang 
Published: February 2019

AimsTo evaluate the prevalence of myopic maculopathy among participants aged 50 years and older in rural southern China.MethodsPopulation-based, cross-sectional study. Subjects were recruited using cluster sampling from Yangxi County, Guangdong Province, China from August to November in 2014. Non-cycloplegic autorefraction and fundus photography were performed on all of the participants. Myopic maculopathy was graded based on fundus photographs using the International Classification of Myopic Maculopathy.ResultsAmong 5825 individuals who participated (90.7% response rate), a total of 4469 participants with gradable fundus photographs for myopic maculopathy and automated refractive data were included in this study. The mean age of these participants was 65.50±9.70 years. The crude prevalence of myopic maculopathy was 1.4% (62/4469; 95% confidence interval [CI] 1.0% to 1.8 %) and age-standardised prevalence was 1.2% (95% CI 1.1% to 1.2%). Diffuse chorioretinal atrophy, patchy chorioretinal atrophy, macular atrophy, lacquer cracks and staphyloma were observed in 43 (1.0%), 3 (0.1%), 1 (0.1%), 15 (0.3%) and 8 eyes (0.2%), respectively. Myopic maculopathy was more common in eyes of older participants (OR 1.07; 95% CI 1.03 to 1.11) and more myopic spherical equivalence (OR 1.69; 95% CI 1.57 to 1.84).ConclusionThe prevalence of myopic maculopathy was low among the rural southern Chinese population. Diffuse chorioretinal atrophy was the most common retinal finding among Chinese myopes.
Surgical versus balloon valvotomy in neonates and infants: results from the UK National Audit
Authors: Dorobantu Dan Mihai , Taliotis Demetris , Tulloh Robert Michael , Sharabiani Mansour Thagavi Azar , Mohamed Ahmed Eltayeb , Angelini Gianni Davide , Stoica Serban Constantin 
Published: February 2019

ObjectiveThere are conflicting data on choosing balloon aortic valvoplasty (BAV) or surgical aortic valvotomy (SAV) in neonates and infants requiring intervention for aortic valve stenosis. We aim to report the outcome of both techniques based on results from the UK national registry.MethodsThis is a retrospective study, including all patients under 1 year undergoing BAV/SAV between 2000 and 2012. A modulated renewal approach was used to examine the effect of reinterventions on outcomes.ResultsA total of 647 patients (488 BAV, 159 SAV, 292 neonates) undergoing 888 aortic valve procedures were included, with a median age of 40 days. Unadjusted survival at 10 years was 90.6% after initial BAV and 84.9% after initial SAV. Unadjusted aortic valve replacement (AVR) rate at 10 years was 78% after initial BAV and 80.3% after initial SAV. Initial BAV and SAV had comparable outcomes at 10 years when adjusted by covariates (p>0.4). AVR rates were higher after BAV and SAV reinterventions compared with initial valvoplasty without reinterventions (reference BAV, HR=3 and 3.8, respectively, p<0.001). Neonates accounted for 29/35 of early deaths after the initial procedure, without significant differences between BAV and SAV, with all late outcomes being worse compared with infants (p<0.005).ConclusionsIn a group of consecutive neonates and infants, BAV and SAV had comparable survival and freedom from reintervention as initial procedures and when performed as reinterventions. These findings support a treatment choice based on patient characteristics and centre expertise, and further research into the best patient profile for each choice.
Proximal pressure reducing effect of wave reflection in the pulmonary circulation disappear in obstructive disease: insight from a rabbit model
Authors: Vanden Eynden Frederic , El-Oumeiri Bachar , Bové Thierry , Van Nooten Guido , Segers Patrick 
Published: February 2019

Locating the site of increased resistance within the vascular tree in pulmonary arterial hypertension could assist in both patient diagnosis and tailoring treatment. Wave intensity analysis (WIA) is a wave analysis method that may be capable of localizing the major site of reflection within a vascular system. We investigated the contribution of WIA to the analysis of the pulmonary circulation in a rabbit model with animals subjected to variable occlusive pulmonary disease. Animals were embolized with different sized microspheres for 6 wk ( n = 10) or underwent pulmonary artery (PA) ligation for 6 wk ( n = 3). These animals were compared with a control group ( n = 6) and acutely embolized animals ( n = 4). WIA was performed and compared with impedance-based methods to analyze wave reflections. The control group showed a relatively high extent of reflected waves (15.7 ± 10.6%); reflections had a net effect of pressure reduction during systole, suggesting an open-end reflector. The pattern of wave reflection was not different in the group with partial PA ligation (12.4 ± 4.1%). In the chronically embolized group, wave reflection was not observed (3.6 ± 1.5%). In the acute embolization group, wave reflection was more prominent (37.3 ± 12.6%), with the appearance of a novel wave increasing pressure, suggesting the appearance of a closed-end reflector. Wave reflections of an open-end type are present in the normal rabbit pulmonary circulation. However, the pattern and nature of reflections vary according to the extent of pulmonary vascular occlusion. NEW & NOTEWORTHY The study proposes an original framework of a complementary analysis of wave reflections in the time domain and in the frequency domain. The methodology was used in the pulmonary circulation with different forms of chronic obstructions. The results suggest that the pulmonary vascular tree generates a reflection pattern that could actually assist the heart during ejection, and chronic obstruction significantly modifies the pattern.
Safety and Efficacy of Polymer-Free Drug-Eluting Stents
Authors: Chiarito Mauro , Sardella Gennaro , Colombo Antonio , Briguori Carlo , Testa Luca , Bedogni Francesco , Fabbiocchi Franco , Paggi Anita , Palloshi Altin , Tamburino Corrado , Margonato Alberto , Pivato Carlo Andrea , Baber Usman , Calcagno Simone , Giordano Arturo , Godino Cosmo , Stefanini Giulio G. ,   on behalf of the RUDI-Free and ASTUTE Investigators
Published: February 2019

Background:
Polymer-free drug-eluting stents are based on different technologies for drug binding and release without the use of polymer coatings. It is unknown whether different polymer-free drug-eluting stents are comparable in terms of safety and efficacy profiles.

Methods and Results:

Polymer-free BioFreedom biolimus-eluting stents (BES) and polymer-free Cre8 amphilimus-eluting stents (AES) were investigated in 2 recent multicenter registries including 2320 all-comer patients undergoing percutaneous coronary interventions at 22 Italian centers. Using propensity score matching, safety and efficacy outcomes were compared among 1280 patients (640 matched pairs) treated with BioFreedom BES or Cre8 AES. The primary end point was target lesion failure—a composite of cardiac death, target vessel myocardial infarction, and target lesion revascularization (TLR). At 1 year, target lesion failure occurred in 4.0% of BES and 4.2% of AES-treated patients (hazard ratio [HR] 0.98, 95% CI, 0.57–1.70). Risks of cardiac death (2.0% versus 2.1%; HR, 1.03; 95% CI, 0.47–2.26), target vessel myocardial infarction (0.8% versus 0.3%; HR, 1.89; 95% CI, 0.50–6.80), TLR (1.5% versus 2.2%; HR, 0.74; 95% CI, 0.34–1.62), and definite/probable stent thrombosis (0.9% versus 0.8%; HR, 1.17; 95% CI, 0.36–3.81) were comparable in patients treated with BioFreedom BES and Cre8 AES. A differential treatment effect by diabetes mellitus status was observed, indicating a benefit of AES in patients with diabetes mellitus (
P
interaction=0.003).

Conclusions:
The present study shows that BioFreedom BES and Cre8 AES have favorable and comparable safety and efficacy profiles in all-comer patients undergoing percutaneous coronary intervention. Further evaluation in large-scale, randomized trials are necessary to confirm our findings.
Relationship Between Endothelial Function and the Eliciting Shear Stress Stimulus in Women: Changes Across the Lifespan Differ to Men
Authors: Holder Sophie M. , Brislane Áine , Dawson Ellen A. , Hopkins Nicola D. , Hopman Maria T. E. , Cable N. Timothy , Jones Helen , Schreuder Tim H. A. , Sprung Victoria S. , Naylor Louise , Maiorana Andrew , Thompson Andrew , Thijssen Dick H. J. , Green Daniel J. 
Published: February 2019

Background

Premenopausal women have a lower incidence of cardiovascular disease, which may partly be due to a protective effect of estrogen on endothelial function. Animal studies suggest that estrogen may also improve the relationship between shear rate (
SR
) and endothelial function. We aimed to explore the relationship between endothelial function (ie, flow‐mediated dilation [
FMD
]) and
SR
(ie,
SR
area under the curve [
SRAUC
]) in women
versus
men, and between pre‐
versus
postmenopausal women.

Methods and Results

Brachial artery
FMD
and
SRAUC
were measured in accordance with expert‐consensus guidelines in 932 healthy participants who were stratified into young adults (18‐40 years, 389 men, 144 women) and older adults (>40 years, 260 men, 139 women). Second, we compared premenopausal (n=173) and postmenopausal women (n=110). There was evidence of a weak correlation between
SRAUC
and
FMD
in all groups but older men, although there was variation in strength of outcomes. Further exploration using interaction terms (age‐sex×
SRAUC
) in linear regression revealed differential relationships with
FMD
(young women
versus
young men [β=−5.8
−4
,
P
=0.017] and older women [β=−5.9
−4
,
P
=0.049]). The correlation between
SRAUC
and
FMD
in premenopausal women (
r
2
=0.097) was not statistically different from that in postmenopausal women (
r
2
=0.025; Fisher
P
=0.30). Subgroup analysis using stringent inclusion criteria for health markers (n=505) confirmed a stronger
FMD
‐
SRAUC
correlation in young women compared with young men and older women.

Conclusions

Evidence for a stronger relationship between endothelial function and the eliciting
SR
stimulus is present in young women compared with men. Estrogen may contribute to this finding, but larger healthy cohorts are required for conclusive outcomes.
Impact of Diabetes Mellitus on Ventricular Structure, Arterial Stiffness, and Pulsatile Hemodynamics in Heart Failure With Preserved Ejection Fraction
Authors: Chirinos Julio A. , Bhattacharya Priyanka , Kumar Anupam , Proto Elizabeth , Konda Prasad , Segers Patrick , Akers Scott R. , Townsend Raymond R. , Zamani Payman 
Published: February 2019

Background

Heterogeneity in the underlying processes that contribute to heart failure with preserved ejection fraction (
HF
p
EF
) is increasingly recognized. Diabetes mellitus is a frequent comorbidity in
HF
p
EF
, but its impact on left ventricular and arterial structure and function in
HF
p
EF
is unknown.

Methods and Results

We assessed the impact of diabetes mellitus on left ventricular cellular and interstitial hypertrophy (assessed with cardiac magnetic resonance imaging, including T1 mapping pregadolinium and postgadolinium administration), arterial stiffness (assessed with arterial tonometry), and pulsatile arterial hemodynamics (assessed with in‐office pressure‐flow analyses and 24‐hour ambulatory monitoring) among 53 subjects with
HF
p
EF
(32 diabetic and 21 nondiabetic subjects). Despite few differences in clinical characteristics, diabetic subjects with HFpEF exhibited a markedly greater left ventricular mass index (78.1 [95%
CI
, 70.4–85.9] g versus 63.6 [95%
CI
, 55.8–71.3] g;
P
=0.0093) and indexed extracellular volume (23.6 [95%
CI
, 21.2–26.1] mL/m
2
versus 16.2 [95%
CI
, 13.1–19.4] mL/m
2
;
P
=0.0008). Pronounced aortic stiffening was also observed in the diabetic group (carotid‐femoral pulse wave velocity, 11.86 [95%
CI
, 10.4–13.1] m/s versus 8.8 [95%
CI
, 7.5–10.1] m/s;
P
=0.0027), with an adverse pulsatile hemodynamic profile characterized by increased oscillatory power (315 [95%
CI
, 258–373] mW versus 190 [95%
CI
, 144–236] mW;
P
=0.0007), aortic characteristic impedance (0.154 [95%
CI
, 0.124–0.183] mm Hg/mL per second versus 0.096 [95%
CI
, 0.072–0.121] mm Hg/mL per second;
P
=0.0024), and forward (59.5 [95%
CI
, 52.8–66.1] mm Hg versus 40.1 [95%
CI
, 31.6–48.6] mm Hg;
P
=0.0010) and backward (19.6 [95%
CI
, 16.2–22.9] mm Hg versus 14.1 [95%
CI
, 10.9–17.3] mm Hg;
P
=0.0169) wave amplitude. Abnormal pulsatile hemodynamics were also evident in 24‐hour ambulatory monitoring, despite the absence of significant differences in 24‐hour systolic blood pressure between the groups.

Conclusions

Diabetes mellitus is a key determinant of left ventricular remodeling, arterial stiffness, adverse pulsatile hemodynamics, and ventricular‐arterial interactions in
HF
p
EF
.

Clinical Trial Registration

URL
:
https://www.clinicaltrials.gov
. Unique identifier:
NCT
01516346.
Using Weather Pattern Recognition to Classify and Predict Summertime Heavy Rainfall Occurrence over the Upper Nan River Basin, Northwestern Thailand
Authors: Nguyen-Le Dzung , Yamada Tomohito J. 
Published: February 2019

Abstract
In this study, self-organizing maps in combination with K-means clustering are used to objectively classify the anomalous weather patterns (WPs) associated with the summertime [May–June (MJ) and July–August–September (JAS)] heavy rainfall days during 1979–2007 over the Upper Nan River basin, northwestern Thailand. The results show that in MJ, intensive rains are mainly brought by the remarkable enhancement of the westerly summer monsoon. Meanwhile, westward-propagating tropical disturbances including tropical cyclones are the primary factors that reproduce heavy rainfall over the Upper Nan in JAS. These results also suggest that the occurrence time of local heavy rainfall is strongly related to the seasonal transition of the summer monsoon over the Indochina Peninsula. The classification results are then implemented with the perfect prognosis and analog method to predict the occurrence (yes/no) of heavy rainfall days over the studied basin in summer 2008–17 using prognostic WPs from the operational Japan Meteorological Agency Global Spectral Model (GSM). In general, the forecast skill of this approach up to 3-day lead times is significantly improved, in which the method not only outperforms GSM with the same forecast ranges, but also its 3-day forecast is better than the 1–2-day forecasts from GSM. However, the false alarms ratio is still high, particularly in JAS. Nevertheless, it is expected that the new approach will provide warning and useful guidance for decision-making by forecasters or end-users engaging in water management and disaster prevention activities.
High‐risk pregnancy in a patient with pulmonary arterial hypertension due to congenital heart disease (PAH‐CHD) with temporary shunt inversion and deoxygenation
Authors: Hohmann Christopher , Dumitrescu Daniel , Gerhardt Felix , Kramer Tilmann , Rosenkranz Stephan , Huntgeburth Michael 
Published: February 2019

Atrial septal defect (ASD) is one of the most frequent congenital heart diseases (CHD). Up to 10% of adults with an ASD develop pulmonary arterial hypertension (PAH, PAH‐CHD) in their lifetime. Despite improved therapy options, gravidity remains a substantial risk for both maternal and neonatal mortality in PAH‐CHD patients.In our patient, gravidity remained uncomplicated until week 32, under specific monotherapy with tadalafil, before onset of dyspnea and markedly increase of systolic pulmonary arterial pressure (PAP) was observed in echocardiography. Urgent Caesarian delivery was performed without any complications and a healthy baby was born. However, immediately afterwards, the patient desaturated (SpO2 65%, PaO2 37 mmHg) due to a shunt inversion with now right‐to‐left shunt through the residual ASD. She was admitted to our intensive care unit and specific PH therapy was escalated to a triple combination of tadalafil, ambrisentan, and iloprost. Hereafter, in a slow process of approximately three weeks, the patient's condition improved to baseline.This rare case of a young woman with high‐risk pregnancy in PAH‐CHD highlights the hemodynamic changes and treatment options during pregnancy in these patients and emphasizes the urgency of a close monitoring at specialized GUCH/PAH centers with experience in managing PAH under these circumstances.
Multiple supporting cell subtypes are capable of spontaneous hair cell regeneration in the neonatal mouse cochlea
Authors: McGovern Melissa M. , Randle Michelle R. , Cuppini Candice L. , Graves Kaley A. , Cox Brandon C. 
Published: February 2019

ABSTRACT
Supporting cells (SCs) are known to spontaneously regenerate hair cells (HCs) in the neonatal mouse cochlea, yet little is known about the relative contribution of distinct SC subtypes which differ in morphology and function. We have previously shown that HC regeneration is linked to Notch signaling, and some SC subtypes, but not others, lose expression of the Notch effector Hes5. Other work has demonstrated that Lgr5-positive SCs have an increased capacity to regenerate HCs; however, several SC subtypes express Lgr5. To further investigate the source for spontaneous HC regeneration, we used three CreER lines to fate-map distinct groups of SCs during regeneration. Fate-mapping either alone or combined with a mitotic tracer showed that pillar and Deiters' cells contributed more regenerated HCs overall. However, when normalized to the total fate-mapped population, pillar, Deiters', inner phalangeal and border cells had equal capacity to regenerate HCs, and all SC subtypes could divide after HC damage. Investigating the mechanisms that allow individual SC subtypes to regenerate HCs and the postnatal changes that occur in each group during maturation could lead to therapies for hearing loss.
The Effect of Sprint Interval Training on Body Composition of Postmenopausal Women
Authors: BOUTCHER YATI N. , BOUTCHER STEPHEN H. , YOO HYE Y. , MEERKIN JARROD D. 
Published: February 2019

ABSTRACT

Introduction
Menopause is accompanied by body composition changes that include a decrease in lean mass and aerobic fitness and an increase in fat mass. Sprint interval training (SIT) may be able to reverse these changes.

Purpose
To examine the effect of an 8-wk SIT program on body composition and aerobic fitness of overweight postmenopausal women.

Methods
Forty postmenopausal women were randomized into SIT (n = 20) or control (n = 20) groups. The SIT group completed three SIT sessions a week for 8 wk with each session consisting of 20 min of alternating 8-s sprints and 12-s of light pedaling. Total mass, regional lean mass, and fat mass were assessed using dual-energy x-ray absorptiometry. Maximal oxygen uptake (V˙O2max) was predicted using a submaximal test.

Results
Total lean mass was significantly increased from pretest (48.1 ± 5.81 kg) to posttest (48.8 ± 5.96 kg) and fat mass was significantly reduced (pre, 29.5 ± 7.29 kg; post, 29.1 ± 7.61 kg) for the SIT group. Lean mass was mostly increased in the trunk (pre, 24.4 ± 2.79 kg; post, 24.8 ± 2.93 kg) and legs (pre, 15.6 ± 2.31 kg; post, 15.9 ± 2.34 kg). V˙O2max was significantly increased from pretest (21.7 ± 4.89 mL⋅kg−1⋅min−1) to posttest (24.4 ± 5.96 mL⋅kg−1⋅min−1) for the SIT group only.

Conclusions
The SIT intervention increased total lean mass, decreased fat mass, and increased aerobic fitness of postmenopausal women after only 8 h of actual exercise over 8 wk.