bluuebunny/crossref_metadata_2025_split huggingface dataset:
Levosimendan or milrinone for right ventricular inotropic treatment?—A secondary analysis of a randomized trial
Authors: Fredholm Martin , Jörgensen Kirsten , Houltz Erik , Ricksten Sven‐Erik 
Published: September 2019

BackgroundThe aim of the present study was to compare the effects of milrinone and levosimendan on right ventricular (RV) inotropy and lusitropy in patients after aortic valve replacement (AVR) for aortic stenosis, a procedure in which an abnormal postoperative RV function may be seen.MethodsIn a prospective, blinded trial, 31 patients were randomized to receive either milrinone (0.4 and 0.8 µg/kg/min, n = 16) or levosimendan (0.1 and 0.2 µg/kg/min, n = 15) after AVR for aortic stenosis. RV performance, afterload (pulmonary arterial elastance), RV strain, systolic (SR‐S) and early diastolic (SR‐E) strain rate were measured by pulmonary artery thermodilution catheterization and transoesophageal two‐dimensional speckle tracking echocardiography. To circumvent the indirect effects of inodilator‐induced hemodynamic changes on RV systolic and diastolic deformation, pulmonary arterial elastance, central venous pressure and heart rate were maintained constant by atrial pacing, plasma volume expansion with colloids and phenylephrine‐induced vasoconstriction during treatment with the inotropes.ResultsA dose‐dependent increase in stroke volume index and cardiac index by approximately 20% were seen with both agents at the highest doses, with no difference between groups (P = .792 and 0.744, respectively). In both groups, RV strain and SR‐S dose‐dependently increased by 20% and 15%‐19%, respectively, at the highest doses (P = .742 and 0.259, respectively) with no difference between groups. SR‐E improved by both agents 20%‐24% at the highest dose with no difference between groups (P = .714).ConclusionsThe direct RV inotropic and lusitropic effects of levosimendan and milrinone were comparable at clinically relevant infusion rates.
Neoadjuvant radiotherapy in rectal cancer – less is more?
Authors: Jootun N. , Sengupta S. , Cunningham C. , Charlton P. , Betts M. , Weaver A. , Jacobs C. , Hompes R. , Muirhead R. 
Published: September 2019

AbstractAimThere is significant international variation in the use of neoadjuvant radiation prior to total mesorectal excision. The MERCURY group advocate selective neoadjuvant chemoradiotherapy (CRT). We have performed a retrospective, single‐centre study of patients treated with CRT, where only the circumferential resection margin is threatened, with the aim of identifying whether a more selective approach to CRT provides acceptable local relapse rates (LRRs).MethodAll consecutive patients who underwent radical surgery for rectal adenocarcinoma over a 5‐year period (2007–2012) in the Oxford University Trust were considered. Electronic hospital systems were reviewed to obtain patient and tumour demographics, treatment and follow‐up information. All patients were classified into risk categories according to National Institute for Health and Care Excellence guidance. Data were analysed using Microsoft Excel and R.ResultsTwo hundred and seventy‐two patients were identified: 123, 89 and 60 in the high‐, intermediate‐ and low‐risk categories, respectively. Seventy‐nine per cent of those in the high‐risk group, 6% in the intermediate and 5% in the low‐risk group underwent CRT. The overall 5‐year LRR and distant recurrence rate (DRR) were 5.2% and 17.8%, respectively. The 5‐year LRR for those who went straight to surgery was 2.0% and for those who had neoadjuvant CRT it was 7.4%. The DRR for these two groups was 8.5% and 18.9%, respectively.ConclusionOur series demonstrates that the use of CRT only in margin‐threatening tumours, results in an exceptionally low LRR for those without margin‐threatening disease. In routine clinical care, this strategy can minimize the significant morbidity of multimodal treatment and allow earlier introduction of systemic therapy to minimize distant recurrence.
Outcomes following bioprosthetic valve replacement in prior non‐cardiac transplant recipients
Authors: Bozso Sabin J. , Kang Jimmy J. H. , Al‐Adra David , Hong Yongzhe , Moon Michael C. , Freed Darren H. , Nagendran Jayan , Nagendran Jeevan 
Published: September 2019

AbstractBackgroundWe report on overall survival and valve‐related outcomes after bioprosthetic valve replacement in prior transplant recipients.MethodsFrom January 2004 to December 2018, 20 consecutive patients (mean age 65.7‐years, 90% male) with prior non‐cardiac transplantation underwent bioprosthetic aortic (n = 18) or combined aortic and mitral (n = 2) valve replacement. Patients consisted of kidney (n = 14), lung (n = 2), liver (n = 3), and bone‐marrow (n = 2) transplants with the most common indication for valve replacement being calcific degeneration (n = 12). Outcomes were measured over a 12‐year span, with a median follow‐up duration of 3.9 years.ResultsOverall survival at 30 days was 100% and at median follow‐up was 60%. Acute kidney injury occurred in 50% (n = 10) with temporary dialysis required in 5% (n = 1) and 15% (n = 3) suffered respiratory failure. No patients experienced major bleeding, heart failure, or sternal wound infection. No patients required redo valve replacement during the study period.ConclusionsOur results provide contemporary data demonstrating that patients with prior transplant can undergo bioprosthetic valve replacement with acceptable inhospital mortality rates and long‐term survival, with a low rate of major morbidity. Furthermore, bioprosthetic valve replacement is a viable option in this group of patients with no redo valve replacement and acceptable long‐term hemodynamic valvular function.
Using spray‐dried sugar beet molasses in ice cream as a novel bulking agent
Authors: Acan Betul Gizem , Toker Omer Said , Aktar Tugba , Tamturk Faruk , Palabiyik Ibrahim , Konar Nevzat 
Published: September 2019

SummaryIn this study, it is aimed to investigate and evaluate the use of molasses which is a by‐product of sugar production as a novel bulking agent in ice cream as a sugar replacer. Sugar beet molasses (75%) and 12 DE maltodextrin (25%) were converted into powder form by spray drying. Spray‐dried sugar beet molasses (SDSM) was then used as a substitute of sugar in different ratios (0:100, 25:75, 50:50, 75:25 and 100:0) in the ice cream products. The increased amount of SDSM decreased the overrun, L*, whiteness index (WI) and melting behaviours and increased a*, b*, total phenolic content, consistency and viscosity. Meanwhile, thermal properties have not been affected by the use of SDSM (P < 0.05). The sensory findings have been particularly interesting especially when replacing above 50% sugar with SDSM, aroma, flavour and general acceptability decrease. According to the results of this study, substituting 25% of total sugar with SDSM as a bulking agent can decrease cost of the product and improve total phenolic content and some quality parameters without compromising sensorial properties.
Complement in malaria immunity and vaccines
Authors: Kurtovic Liriye , Boyle Michelle J. , Opi D. Herbert , Kennedy Alexander T. , Tham Wai‐Hong , Reiling Linda , Chan Jo‐Anne , Beeson James G. 
Published: September 2019

AbstractDeveloping efficacious vaccines for human malaria caused by Plasmodium falciparum is a major global health priority, although this has proven to be immensely challenging over the decades. One major hindrance is the incomplete understanding of specific immune responses that confer protection against disease and/or infection. While antibodies to play a crucial role in malaria immunity, the functional mechanisms of these antibodies remain unclear as most research has primarily focused on the direct inhibitory or neutralizing activity of antibodies. Recently, there is a growing body of evidence that antibodies can also mediate effector functions through activating the complement system against multiple developmental stages of the parasite life cycle. These antibody‐complement interactions can have detrimental consequences to parasite function and viability, and have been significantly associated with protection against clinical malaria in naturally acquired immunity, and emerging findings suggest these mechanisms could contribute to vaccine‐induced immunity. In order to develop highly efficacious vaccines, strategies are needed that prioritize the induction of antibodies with enhanced functional activity, including the ability to activate complement. Here we review the role of complement in acquired immunity to malaria, and provide insights into how this knowledge could be used to harness complement in malaria vaccine development.
Down‐regulation of miRNA 145 and up‐regulation of miRNA 4516 may be associated with primary hypertension
Authors: Özkan Gülsüm , Ulusoy Şükrü , Geyik Elif , Erdem Yunus 
Published: September 2019

AbstractComplex mechanisms including genetic factors have been proposed in the pathogenesis of primary hypertension (HT). Micro RNAs (miRNAs) are single‐stranded RNA molecules that are not converted into protein products. However, it has been established that genes regulate conversion into protein products. The primary aim of this study was to investigate the roles of miRNA 4516, miRNA 145, miRNA 24, and miRNA 181a in the pathogenesis of HT. The secondary aim was to investigate the relation between these miRNAs and renin, aldosterone, norepinephrine, renalase, and NOS. Fifty‐two hypertensive and 51 control normotensive individuals under observation in the Cappadocia cohort were included in the study. miRNA 4516, miRNA 181a, miRNA 24, and miRNA 145 levels were measured using the ddPCR method. miRNA 4516 and norepinephrine levels were significantly higher in the HT group (P < .005 for both), while miRNA 145 levels were significantly lower (<.05). miRNA 4516 up‐regulation (P < .05) and miRNA 145 down‐regulation (P < .05) were identified as independent predictors of HT. Renalase exhibited negative correlation with miRNA 4516 and positive correlation with miRNA 145 in the patient and control group. In addition, negative correlation was present between miRNA 24 and NE and NOS and between miRNA 181a and NOS in the patient group. Our study identified, for the first time in the literature, miRNA 4516 up‐regulation and miRNA 145 down‐regulation as independent determinants of HT. Further studies performed in the light of our findings may lead to a better understanding of the pathogenesis and new therapeutic possibilities.
A novel case of cutaneous squamous cell carcinoma at the site of previous sporotrichosis
Authors: Ji Yong‐Zhi , Ma Zhi‐Ming , Chang Li , Liu Shi‐Rui 
Published: September 2019

AbstractBackgroundCutaneous squamous cell carcinoma (cSCC) is a malignant tumor of epithelial keratinocytes, with a relatively reduced frequency of lymph node metastasis. Despite the fact that this tumor type is largely preventable, the incidence of cSCC is rising every year. Ultraviolet exposure is a major cause of cSCC and directly contributes to cSCC. Other known environmental risk factors include ionizing radiation, cigarette smoking, and certain chemical exposures.AimsIn this study, we report a clinical case of cSCC with a novel causative factor.Patient/MethodsThe report describes a 72‐year‐old male who was seen for a dermatosis condition initially. Later, epidermal hyperplasia and granulomatous inflammation of the dermis was diagnosed based on skin biopsy. Fungal culture revealed the presence of Sporothrix schenckii which led to the diagnosis of fixed‐type sporotrichosis.ResultsFour months of oral terbinafine (250 mg once a day) administration partially resolved the lesions. Patient was subsequently diagnosed with cSCC, and surgical resection with wider margins was performed.ConclusionAfter a careful and rigorous exclusion of known risk factors, we confirmed that this incidence of cSCC was caused by chronic inflammation which followed fixed‐type sporotricosis.
A prospective comparison between skin cooling and skin vibration in reducing the pain of local anesthetic infiltration
Authors: Alshahwan Mohammed 
Published: September 2019

AbstractBackgroundGrowing evidence supports skin cooling (cryoanalgesia) or skin vibration (vibroanalgesia) as potential techniques for pain alleviation.AimsTo compare the effect of skin vibration using the Buzzy® vibration device with that of skin cooling for 2 minutes, as methods to reduce the pain of 1% lidocaine‐epinephrine infiltration.Methods & MaterialsSixty healthy volunteers were recruited for this prospective study. Each subject received an intradermal injection of the anesthetic solution after application of the Buzzy® vibration device in one arm and another injection after ice application in the other arm. After each injection, the subjects rated pain of infiltration on a 100‐mm visual analog scale. Pain scores were compared using a paired t test.ResultsTwenty‐seven of sixty subjects (45%) reported that the 1% lidocaine‐epinephrine infiltration after skin cooling was more painful than after skin vibration. Eleven subjects (18.3%) gave the same pain score for both techniques. The mean pain score ± SD was 30 ± 23.14 after skin cooling and 25.5 ± 24.1 after skin vibration. The difference between mean values was not statistically significant.ConclusionSkin vibration may be more effective than skin cooling in alleviating the pain caused by local anesthetic infiltration, although the difference was not statistically significant.
Divided we stand: How contestation can facilitate institutionalization
Authors: Song Eun Young 
Published: September 2019

AbstractExisting literature on institutionalization highlights that regulatory institutions emerge from resolving disputes, paying little attention to the key behavioral aspect of disputes: contestation. In this paper, I aim to advance the literature by developing a model of contestation‐based institutionalization; contestation facilitates the adoption of new regulatory institutions, laws. Drawing on socio‐legal and network perspectives on the way people argue in a dispute, I focus ona behavioral code of contestation– the shared understanding and expectation about how to argue rather than what to argue. Contestation makes it easier for lawmakers to adopt a new regulatory institution when the lawmakers argue in conformity with the code. Network and event history analyses of animal lawsuits and laws in the United States from 1865 to 2010 confirm this model. This paper highlights the value of looking into the behavioral dimension of disputes and advances our understanding of institutionalization without emphasizing dispute resolution.
Effects of supplementing freeze‐dried Mitsuokella jalaludinii phytase on the growth performance and gut microbial diversity of broiler chickens
Authors: Tang Hooi Chia , Sieo Chin Chin , Abdullah Norhani , Chong Chun Wie , Gan Han Ming , Mohd Asrore Mohd Shaufi , Yong Chean Yeah , Omar Abdul Rahman , Ho Yin Wan 
Published: September 2019

AbstractInclusion of phytase in animal feedstuff is a common practice to enhance nutrients availability. However, little is known about the effects of phytase supplementation on the microbial ecology of the gastrointestinal tract. In this study, freeze‐dried Mitsuokella jalaludinii phytase (MJ) was evaluated in a feeding trial with broilers fed a low available phosphorus (aP) diet. A total of 180 male broiler chicks (day‐old Cobb) were assigned into three dietary treatments: Control fed with 0.4% (w/w) of available phosphorus (aP); Group T1 fed low aP [0.2% (w/w)] supplemented with MJ; and T2 fed low aP and deactivated MJ. The source of readily available P, dicalcium phosphate (DCP), was removed from low aP diet, whereby additional limestone was provided to replace the amount of Ca normally found in DCP. For each treatment, 4 replicate pens were used, where each pen consisted of 15 animals. The animals' energy intake and caecal bacterial community were monitored weekly for up to 3 weeks. The apparent metabolizable energy (AME) and apparent digestibility of dry matter (ADDM) of broilers fed with different diets were determined. In addition, the caecal microbial diversities of broilers were assessed using high‐throughput next‐generation sequencing targeting the V3‐V4 region of bacterial 16S rRNA. The results showed that broilers fed with T1 diet have better feed conversion ratio (FCR) when compared to the Control (p < .05) and T2 diets (p < .05), demonstrating the efficiency of MJ as a supplement to low aP diet. Nevertheless, MJ did not significantly affect the microbial population and diversity in broilers' caeca, which mainly consists of members from Bacteroidetes, Firmicutes, and Proteobacteria. Regardless, significant variations in the caecal bacterial composition were observed over time, probably due to succession as the broilers aged. This is the first reported study on the effect of MJ on the microbial diversity of broiler's caeca.
Delayed onset vagus nerve paralysis after occipital condyle fracture in a horse
Authors: Martin‐Giménez Tamara , Cruz Antonio M. , Barragán Agustín , Montero Estefanía , Sanchez Pedro G. , Caballero Guillermo , Corradini Ignacio 
Published: September 2019

AbstractOccipital condylar fractures (OCFs) causing delayed onset lower cranial nerve paralysis (LCNPs) are rare. We present a 7‐year‐old Friesian horse with delayed onset dysphagia caused by vagus nerve (CNX) paralysis and suspicion of glossopharyngeal nerve (CNIX) paralysis developed several days after a minor head injury. Endoscopic examination revealed right laryngeal hemiplegia and intermittent dorsal displacement of the soft palate. An area of submucosal hemorrhage and bulging was appreciated over the dorsal aspect of the medial compartment of the right guttural pouch. Radiological examination of the proximal cervical region showed rotation of the atlas and the presence of a large bone fragment dorsal to the guttural pouches. Occipital condyle fracture with delayed onset cranial nerve paralysis was diagnosed. Delayed onset cranial nerve paralysis causing dysphagia might be a distinguishable sign of OCF in horses. Delayed onset dysphagia after head injury should prompt equine clinicians to evaluate the condition of the atlanto‐occipital articulation and skull base.
Two hybrid histidine kinases, TcsB and the phytochrome FphA, are involved in temperature sensing in Aspergillus nidulans
Authors: Yu Zhenzhong , Ali Arin , Igbalajobi Olumuyiwa Ayokunle , Streng Christian , Leister Kai , Krauß Norbert , Lamparter Tilman , Fischer Reinhard 
Published: September 2019

SummaryThe adaptation of microorganisms to different temperatures is an advantage in habitats with steadily changing conditions and raises the question about temperature sensing. Here we show that in the filamentous fungus Aspergillus nidulans, the hybrid histidine kinase TcsB and phytochrome are involved in temperature‐induced gene transcription. Temperature‐activated phytochrome fed the signal into the HOG MAP kinase pathway. There is evidence that the photoreceptor phytochrome fulfills a temperature sensory role in plants and bacteria. The effects in plants are based on dark reversion from the active form of phytochrome, Pfr, to the inactive form, Pr. Elevated temperature leads to higher dark reversion rates, and hence, temperature sensing depends on light. In A. nidulans and in Alternaria alternata, the temperature response was light‐independent. In order to understand the primary temperature response of phytochrome, we performed spectral analyses of recombinant FphA from both fungi. Spectral properties after heat stress resembled the spectrum of free biliverdin, suggesting conformational changes and a softening of the binding pocket of phytochrome, possibly mimicking photoactivation. We propose a novel function for fungal phytochrome as temperature sensor.
Monitoring the topical delivery of ultrasmall gold nanoparticles using optical coherence tomography
Authors: Xu Qiuyun , Jalilian Elmira , Fakhoury Joseph W. , Manwar Rayyan , Michniak‐Kohn Bozena , Elkin Kenneth B. , Avanaki Kamran 
Published: September 2019

AbstractBackgroundOptical coherence tomography (OCT) is a promising imaging modality for skin cancer diagnosis. However, this capability has been hindered by the low contrast between normal and neoplastic tissue. To overcome this limitation, gold nanoparticles have been used to enhance the contrast in OCT images and are topically administered to reduce the risk of systematic side effects associated with intravenous injection. To ensure efficient penetration and distribution of the nanoparticles, an enhanced delivery strategy is required. In this porcine study, we assessed two delivery methods: (a) using dimethyl sulfoxide (DMSO) and (b) via sonophoresis.Materials and MethodsThe gold nanoparticles were topically applied on pig skin before evaluating DMSO and sonophoresis as penetration enhancers in topical administration. The OCT images were taken from the same locations to monitor signal change.ConclusionThe combination of DMSO and sonophoresis is an effective method to enhance the penetration and diffusion rate of nanoparticles during topical administration.SignificanceTopical administration of nanoparticles is advantageous in dermatological applications. Nevertheless, efficient topical delivery remains a challenge. DMSO and sonophoresis can be used as two effective approaches to enhance topical delivery of nanoparticles.
Analysis of the Design and Operation of a Hybrid Trigeneration-Photovoltaic System Installed in a Shopping Mall
Authors: López Vega Aldo , Rubio-Maya Carlos , Kowalski Gregory J. , Pacheco Ibarra J. Jesús 
Published: September 2019

Abstract
In this paper, the analysis of the design and operation of a hybrid trigeneration/photovoltaic system installed in a shopping mall is presented. Thermodynamic models based on the first and second laws are developed to analyze all the system's components individually and integrated all together in a trigeneration scheme. Thermodynamics models were validated through experimental data obtained from the equipment running on site. Once the models were validated, it was possible to analyze the actual operating conditions to determine the suitability of the design configuration and to predict the overall performance of the system. In the analysis of the system's design, the first and second law efficiencies, the exergy of each stream, as well as the exergy destruction in each component are reported. In the analysis of the system's operation, several scenarios under different operating conditions were studied and the most suitable scenario was determined by applying an economic analysis based on the net present value. The results show the configuration on which the maximum energy efficiency of the system is obtained as well as the best operation strategy where the greatest economic savings are achieved.