bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multilayer Microstructure of Idiopathic Epiretinal Macular Membranes
Authors: Azzolini Claudio , Congiu Terenzio , Donati Simone , Passi Alberto , Basso Petra , Piantanida Eliana , Mariotti Cesare , Testa Francesco , Caprani Simona M. , Cattaneo Jennifer , Vinciguerra Riccardo 
Published: June 2017

Purpose To identify the ultramicroscopic structure of idiopathic epiretinal macular membranes (iEMMs) by scanning electron microscopy (SEM). Methods We examined 28 iEMMs surgically removed from 28 eyes of 28 patients. All specimens, previously observed at stereomicroscope, were treated with an osmium maceration technique. Fine resolution of iEMMs’ 3D architecture and their interaction with the retina were studied using a Philips SEM-FEG XL-30 microscope. Results The specimens appeared as laminar connective structures partially or completely adherent to the inner limiting membrane (ILM). We identified 4 types of structures: ( 1 ) distinct layers of thin sheets of woven fibers; ( 2 ) folded layers of inhomogeneous thickness of fibrous material more consistent; ( 3 ) thicker and more rigid layers recognizable as collagen fibrils with typical 64-nm period, collagen fibrils isolated or intermingled between them; ( 4 ) lacunar structures with inflammatory and/or necrotic material. The first 3 types of structures appear to thicken towards a centripetal direction from the ILM to the vitreous in order from 1 to 3. The interface of ILM-iEMM tissue shows particular small bridges of connection. Cells are rarely found, especially in the tissue near the ILM. Conclusions Layers of various materials follow one another in iEMMs. Cells are rarely found. The interface ILM-iEMM tissue shows particular small bridges of connection. The dynamic modeling of bended layers begins in soft tissue.
Iris reconstruction using artificial iris prosthesis for management of aniridia
Authors: Mostafa Yehia S. , Osman Amr A. , Hassanein Dina H. , Zeid Ashraf M. , Sherif Ahmed M. 
Published: June 2017

Purpose: To discuss the limitations and benefits of the BrightOcular prosthetic artificial iris device in management of aniridia associated with aphakia or cataract. Methods: This is a retrospective study including 5 eyes of 4 patients who underwent implantation of the BrightOcular iris prosthesis (Stellar Devices) for total or partial aniridia. The cases included 2 eyes of 1 patient with congenital aniridia associated with congenital cataract and 3 eyes with traumatic aniridia: 1 with subluxated cataractous lens and 2 with aphakia. In all cases, the iris prosthesis was implanted after a 3-piece acrylic intraocular lens was implanted. We evaluated the clinical course with a minimum follow-up period of 6 months, the intraoperative and postoperative complications, and the cosmetic satisfaction of patients. Results: All patients had improved uncorrected distance visual acuity and best-corrected distance visual acuity. All patients had a transient corneal edema that resolved within the first postoperative week. Only the patient with congenital aniridia had a permanent increase in intraocular pressure and developed a band keratopathy throughout a 2-year follow-up period. The prosthesis was well-centered in all eyes except for one case that required scleral suture fixation after 3 months. All patients had a satisfactory cosmetic appearance. Conclusions: BrightOcular iris prosthesis is a safe and useful tool to correct aniridia associated with pseudophakia or aphakia. Being foldable, it is easy to be implanted through a small incision and placed in the ciliary sulcus without sutures when properly sized. Cosmetic results are satisfactory. Sizing methods should be improved.
Evaluation of Color Changes of Dental Luting Materials in Food Colorant Solutions
Authors: Akay Canan , Taniş Merve Ç. 
Published: June 2017

Background The purpose of this study was to compare the color stability and water absorption of 3 commercially available resin cements in vitro by storing them in 0.15% erythrosine, dark brown and sunset yellow for 30 days. Methods 2 self-adhesive resin cements and 1 dual/light curing, resin-based dental luting material were evaluated (total 120 samples). The CIE L, a, b of 10 mm diameter-2.0 mm height disk shaped samples was measured using a spectrophotometer for color stability on a white background, 10 mm diameter-1.0 mm height disk shaped samples were measured for water absorption before and after storage in food colorant solutions. Results The self-adhesive resin cement-sunset yellow group caused the most severe discoloration (27.89 ± 3.64) that is clinically unacceptable. The lowest discoloration was seen in the self-adhesive resin cement control group (3.35 ± 1.13). The highest water absorption was observed in the self-adhesive resin cement-dark brown group (2.41 ± 0.60) and the lowest water absorption in the dental luting material-control group (0.65 ± 0.17). Conclusions: Storage food colorant solutions affected the color stability and water absorption of different resin cement materials.
Development of a Prolonged Warm Ex Vivo Perfusion Model for Kidneys Donated after Cardiac Death
Authors: Urcuyo Daniel , Blum Matthew F. , Liu Qiang , Nassar Ahmed , Buccini Laura D. , Uso Teresa Diago , Poggio Emilio D. , Baldwin William M. , Goldfarb David A. , Quintini Cristiano 
Published: June 2017

Purpose Ex vivo perfusion of marginal kidney grafts offers the chance to expand the donor pool, but there is no current clinical standard for the prolonged warm perfusion of renal grafts. This exploratory pilot study seeks to identify a stable ex vivo kidney perfusion model that can support low intravascular resistance and preserve histologic architecture in a porcine donation after cardiac death (DCD) model. Methods 15 kidneys were preserved in 1 of 3 settings: normothermic whole blood (NT-WB), normothermic Steen Solution™ (XVIVO Perfusion) with whole blood (NT-Steen/WB), or subnormothermic Steen Solution™ at 21°C (SNT-Steen). Kidneys were primarily assessed using hemodynamic parameters and histologic analysis. Results NT-WB perfusion resulted in high vascular resistance and glomerular necrosis. NT-Steen/WB and SNT-Steen resistance ranged between 0.18–0.45 mmHg/mL per minute and 0.25–0.53 mmHg/mL per minute, respectively, enabling stable perfusion for up to 24 hours. NT-Steen/WB demonstrated tubular and glomerular necrosis, while the histologic architecture of SNT-Steen was preserved with the exception of numerous proteinaceous casts. Conclusions Our results suggest that ex vivo kidney perfusion with Steen Solution™ at 21°C supports low and stable vascular resistance and provides adequate histologic preservation during 24-hour perfusion.
A New Approach Combining Venoarterial Extracorporeal Membrane Oxygenation and CRRT for Adults: A Retrospective Study
Authors: Zhou Xing-Liang , Chen Yan-He , Wang Qing-Yun 
Published: June 2017

Purpose This study aimed to assess a new approach combining venoarterial (VA) extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) in adults, while monitoring CRRT circuit pressures. Methods The inlet and outlet of the CRRT circuit were connected to preoxygenator port and postoxygenator port, respectively. Then, complications and CRRT circuit pressures were evaluated. Results 7 patients underwent combined VA-ECMO and CRRT; 16 filters were used. CRRT blood flow ranged from 150 to 200 mL/min; the CRRT to ECMO blood flow ratio was <0.1. The CRRT pressures at treatment initiation were normal. No complications were reported. Conclusions This approach combining VA-ECMO and CRRT in adults did not compromise the accuracy of pressure monitoring systems for CRRT circuit function, and caused no complications. Hence, it may be a feasible method for performing combined VA-ECMO and CRRT in adults.
Des-Gamma-Carboxy Prothrombin in Hepatocellular Cancer Patients Waiting for Liver Transplant: A Systematic Review and Meta-Analysis
Authors: Lai Quirino , lesari Samuele , Sandri Giovanni Battista Levi , Lerut Jan 
Published: June 2017

Background The use of des-gamma-carboxy prothrombin (DCP) as a predictor of the risk of recurrence of hepatocellular cancer (HCC) after liver transplant (LT) has recently gained interest, especially in view of the recent extension of the eligibility criteria of these patients for LT. The aim of the present study is to look into this important matter based on a systematic review and meta-analysis. Methods A systematic literature review about the role of DCP in the specific setting of LT for HCC has been conducted. Results Three selected studies, which showed a high rate of homogeneity (I2 = 0.0%), confirmed that the tumor marker DCP is a useful predictive factor, indicating a 5-fold increased risk for HCC recurrence after LT (p<0.001). Conclusions The meta-analysis enabled us to underline the importance of DCP in the refinement of the eligibility criteria of HCC patients for LT. This information, based on Japanese studies performed in the setting of living-donor LT only, needs further validation in the Western world both in the setting of post-mortem and living-donor LT.
Meta-Analysis of Prognostic Role of Ki-67 Labeling Index in Gastric Carcinoma
Authors: Pyo Jung-Soo , Kim Nae Yu 
Published: June 2017

Background This meta-analysis aimed to elucidate the prognostic role of the Ki-67 labeling index (LI) in gastric cancer (GC). Methods The current study included 3,615 GC patients in 20 eligible studies, and evaluated the prognostic role of Ki-67 LI in GC. Subgroup analysis was conducted based on depth of invasion and cutoff value for high Ki-67 LI. Results A high Ki-67 LI correlated significantly with worse survival (hazard ratio [HR] = 1.214, 95% confidence interval [CI], 1.004-1.468). However, there was no significant correlation between high Ki-67 LI and worse survival in advanced GC (HR = 1.252, 95% CI, 0.801-1.956). The subgroup with cutoff value ≤25% showed a significant correlation with worse survival, but this was not seen in the subgroup with cutoff >25% (HR = 1.433, 95% CI, 1.094-1.876 vs. HR = 1.005, 95% CI, 0.801-1.262). In addition, in the 10% < Ki-67 LI ≤ 20% range, there was a significant correlation between high Ki-67 LI and worse overall survival (HR = 1.931, 95% CI, 1.013-3.310). Conclusions A high Ki-67 LI correlated significantly with a worse prognosis in GC patients. Further cumulative studies for the optimal cutoff value for high Ki-67 LI are needed before application in clinical practice.
Acellular Dermal Matrix and Heel Reconstruction: A New Prospective
Authors: Scalise Alessandro , Torresetti Matteo , Verdini Federica , Capecci Marianna , Andrenelli Elisa , Mengarelli Alessandro , Ceravolo Maria Gabriella , Fioretti Sandro , Di Benedetto Giovanni 
Published: June 2017

Background Heel reconstruction represents a challenge for all plastic surgeons due to the anatomical and functional features of this weight-bearing area. In the last decade a combined use of acellular dermal matrices and skin grafts has been proposed as a reliable and less invasive alternative for complex wound management; nevertheless only a few cases have been reported in the literature. Methods We describe the long-term outcome of 2 cases of severe degloving trauma of the plantar region with massive soft tissue defects of the foot, that underwent surgical reconstruction with artificial dermis and skin grafts. At the fifth year of follow-up, both patients underwent a clinical and a computerized gait analysis to study their functional outcomes and the kinematics of their gait. Results Both patients recovered functional ambulation and returned to their own work and vocational activities, showing a symmetric gait and parameters of upright posture fully comparable to normality. Conclusions Despite the initial concerns about the use of acellular dermal matrices and skin grafts for this kind of injury, they seem to be a simple and safe alternative for weight-bearing reconstruction of the degloved foot. The authors believe that the current study yields useful information and reassurance about their long-term reliability.
Effect of Storage Medium and Aging Duration on Mechanical Properties of Self-Adhesive Resin-Based Cements
Authors: Liebermann Anja , Ilie Nicoleta , Roos Malgorzata , Stawarczyk Bogna 
Published: June 2017

Background The aim of this study was to investigate the effects of storage medium and aging duration on Martens hardness (HM) and indentation modulus (EIT) of self-adhesive resin-based cements (SARCs). Methods A total of 416 discs were fabricated from 8 SARCs (n = 52 per SARC): (i) BeautyCem (BEA), (ii) Bifix SE (BIF), (iii) Clearfil SA Cement Automix (CLE), (iv) RelyX Unicem2 Automix (RXU), (v) SeT (SET), (vi) SmartCem 2 (SMC), (vii) SoloCem (SOC) and (viii) SpeedCEM (SPC). The specimens were ground and stored in (a) physiological saliva, (b) artificial saliva, (c) sodium chloride and (d) distilled water, at 37°C for 1, 7, 14, 28, 90 and 180 days. Non-aged specimens (3 hours after photo-initiation) of each SARC acted as control groups. HM and EIT were assessed using a universal hardness testing machine. Data were analyzed using Kolmogorov-Smirnov and Kruskal-Wallis tests and paired t-test, and 3-, 2- and 1-way ANOVA with post hoc Scheffé test (p<0.05). Results SARC materials exerted the highest influence on HM and EIT values (p<0.001, partial eta squared [ηP²] = 0.753 and 0.433, respectively), closely followed by aging duration (p<0.001, ηP² = 0.516 and 0.255) and storage medium (p<0.001, ηP² = 0.043 and 0.033). The interaction effect of the combinations of the 3 independent parameters was also significant (p<0.001, ηP² = 0.163 and 0.133). The lowest initial HM and EIT was presented by CLE, followed by SET and SPC; highest HM was for BIF, followed by RXU and SMC. SET gave a greater HM and EIT percentage decrease than SOC, SPC, BEA, SMC, RXU or CLE. Conclusions Aging duration is a major factor affecting the micromechanical properties of SARCs, while storage medium was shown to have a significant but minor role.
Multicentre Experience with ZSI 375 Artificial Urinary Sphincter for the Treatment of Stress Urinary Incontinence in Men
Authors: Ostrowski Ireneusz , Blewniewski Mariusz , Neugart Frank , von Heyden Burkhard , Selvaggio Oscar , Iori Francesco , Foley Steeve , Fernández Arjona Manuel , Carvajal Obando Alejandro , Pottek Tobias 
Published: June 2017

Objectives The aim of this study was to evaluate the safety and efficacy of the artificial urinary sphincter ZSI 375 device in male patients with stress urinary incontinence (SUI) at 10 centres. Methods This was a retrospective, nonrandomised, multicentre study. From January 2012 to December 2014, and follow-up to February 2016, men with SUI were treated with the ZSI 375 device. The primary outcome was continence. The secondary outcome was complications rate. Results A total of 147 patients with moderate-to-severe stress incontinence and mean age of 70.67 (26-85) years underwent implantation of the ZSI 375 device at 10 centres. The most common indication for placement was incontinence after radical prostatectomy (121 patients: 82.31%). The ZSI 375 device was considered successful in 86.40% of cases after 12 months follow-up, 83.52% after 24 months follow-up and 78.26% after 36 months follow-up. The infection rate was 6.12%, urethral erosion was 12.92% and mechanical failure was limited to 3.40% leading to ZSI 375 improvement. Conclusions This study confirmed safety and efficacy of ZSI 375 device to treat moderate-to-severe SUI in men.
De flexibele onderneming: een kwestie van competitie én imitatie
Authors: Dekker Fabian 
Published: June 2017

The flexible firm: A matter of competitive and institutional pressures
In recent decades, the Dutch labour market has become more flexible. Flexible labour contracts enable firms to adjust employment to a changing market environment and to competitive pressures. Almost without exception, academic studies on the drivers behind the use of flexible labour contracts at the company level, are motivated by competitive pressures. However, companies may be susceptible to institutional pressures as well. Based on a survey among more than 650 managers in the Netherlands, we conclude that firms are vulnerable to institutional (mimetic) forces. This finding has several implications for policy-making and labour flexibility research.
Deliberatieve democratie: ervaringen met diversiteit in burgertop Amsterdam
Authors: Smets Peer , Vlind Marloes 
Published: June 2017

Deliberative democracy: experiences with diversity in a citizens’ summit in Amsterdam
This paper will show how citizens’ summits in the Netherlands cope with diversity of participants and the impact of this on those initiatives. This provides insight in why diversity is hard to reach and what can be done to improve it. Presently, dissatisfaction about the Dutch democratic system is widespread. Solutions are being sought to strengthen Dutch participatory democracy. For this objective, citizens’ summits develop different kind of initiatives. However, citizens participating in these summits are a homogeneous group, namely mainly white, middle aged and highly educated. Mechanisms of exclusion, selection of candidates, homogeneous composition of the organization, and a dominating intellectual/rational way of debating are playing a role here. Citizens with different backgrounds need to be included in these initiatives to obtain a better representation of society’s voices. This notion has been strengthened by theory, which shows that diversity enables more creativity and innovation.
Effect of Tele-ICU on Clinical Outcomes of Critically Ill Patients
Authors: Pereira Adriano J. , Noritomi Danilo T. , dos Santos Maura Cristina , Corrêa Thiago D. , Ferraz Leonardo J. R. , Schettino Guilherme P. P. , Cordioli Eduardo , Morbeck Renata A. , Morais Lúbia C. , Salluh Jorge I. F. , Azevedo Luciano C. P. , Biondi Rodrigo S. , Rosa Regis G. , Cavalcanti Alexandre B. , Berwanger Otavio , Serpa Neto Ary , Ranzani Otavio T. 
Published: October 2024

ImportanceDespite its implementation in several countries, there has not been a randomized clinical trial to assess whether telemedicine in intensive care units (ICUs) could improve clinical outcomes of critically ill patients.ObjectiveTo determine whether an intervention comprising daily multidisciplinary rounds and monthly audit and feedback meetings performed by a remote board-certified intensivist reduces ICU length of stay (LOS) compared with usual care.Design, Setting, and ParticipantsA parallel cluster randomized clinical trial with a baseline period in 30 general ICUs in Brazil in which daily multidisciplinary rounds performed by board-certified intensivists were not routinely available. All consecutive adult patients (aged ≥18 years) admitted to the participating ICUs, excluding those admitted due to justice-related issues, were enrolled between June 1, 2019, and April 7, 2021, with last follow-up on July 6, 2021.InterventionRemote daily multidisciplinary rounds led by a board-certified intensivist through telemedicine, monthly audit and feedback meetings for discussion of ICU performance indicators, and provision of evidence-based clinical protocols.Main Outcomes and MeasuresThe primary outcome was ICU LOS at the patient level. Secondary outcomes included ICU efficiency, in-hospital mortality, incidence of central line–associated bloodstream infections, ventilator-associated events, catheter-associated urinary tract infections, ventilator-free days at 28 days, patient-days receiving oral or enteral feeding, patient-days under light sedation, and rate of patients with oxygen saturation values under that of normoxemia, assessed using generalized linear mixed models.ResultsAmong 17 024 patients (1794 in the baseline period and 15 230 in the intervention period), the mean (SD) age was 61 (18) years, 44.7% were female, the median (IQR) Sequential Organ Failure Assessment score was 6 (2-9), and 45.5% were invasively mechanically ventilated at admission. The median (IQR) time under intervention was 20 (16-21) months. Mean (SD) ICU LOS, adjusted for baseline assessment, did not differ significantly between the tele–critical care and usual care groups (8.1 [10.0] and 7.1 [9.0] days; percentage change, 8.2% [95% CI, −5.4% to 23.8%]; P = .24). Results were similar in sensitivity analyses and prespecified subgroups. There were no statistically significant differences in any other secondary or exploratory outcomes.Conclusions and RelevanceDaily multidisciplinary rounds conducted by a board-certified intensivist through telemedicine did not reduce ICU LOS in critically ill adult patients.Trial RegistrationClinicalTrials.gov Identifier: NCT03920501
Genetic Susceptibility to Hidradenitis Suppurativa and Predisposition to Cardiometabolic Disease
Authors: Nielsen Valdemar Wendelboe , Bundgaard Vad Oliver , Holgersen Nikolaj , Paludan-Müller Christian , Meseguer Monfort Laia , Beyer Astrid Filt , Jemec Gregor Borut Ernst , Kjærsgaard Andersen Rune , Egeberg Alexander , Thyssen Jacob P. , Svendsen Jesper Hastrup , Rosenø Nana Aviaaja Lippert , Hansen Peter Riis , Thomsen Simon Francis , Salling Olesen Morten 
Published: October 2024

ImportanceHidradenitis suppurativa (HS) is associated with an increased prevalence of cardiovascular diseases compared with the general population. Any association between polygenic risk for HS, risk of incident cardiometabolic outcomes, and the plasma proteome is unclear.ObjectiveTo investigate the genetic correlation between HS and cardiometabolic disease.Design, Setting, and ParticipantsThis cohort study used a polygenic risk score (PRS) for HS to examine the risks of coronary artery disease (CAD) and diabetes and identify changes in the plasma proteome in individuals of European ancestry from the UK Biobank. Participants were enrolled from January 1, 2006, to December 31, 2010. End of follow-up was January 1, 2023. Correlations were assessed between HS susceptibility and cardiometabolic traits using linkage disequilibrium score regression. Odds ratios were assessed in logistic regressions. The risk of incident CAD and diabetes was estimated in cause-specific survival models designed as time-to-event analyses.ExposureThe PRS for HS.Main Outcomes and MeasuresMain outcomes were CAD and diabetes diagnosis measured by logistic regressions and incident disease measured by Cox proportional hazards regression models adjusted for sex, age, body mass index, and smoking status.ResultsThe study included 391 481 individuals (median [IQR] age, 58 [51-64] years; 209 235 [53%] female). Genetic variants for HS correlated significantly with variants associated with CAD, diabetes, and plasma levels of high-density lipoprotein cholesterol, triglycerides, and C-reactive protein. Compared with the low-risk group, a high PRS for HS (≥75th percentile) conferred odds ratios of 1.09 (95% CI, 1.06-1.12; P &amp;lt; .001) for CAD and 1.13 (95% CI, 1.10-1.17; P &amp;lt; .001) for diabetes. Estimates remained consistent when examining only incident CAD and diabetes. The PRS for HS was significantly associated with altered expression of 58 plasma proteins. Integrating this proteomic profile and the PRS for HS in a machine learning model improved prediction of CAD and diabetes compared with a reference model based on sex, age, and body mass index.Conclusions and RelevanceThese findings suggest that a high genetic risk of HS is associated with increased risk of subsequent CAD and diabetes and altered composition of the plasma proteome. Additional investigation into the identified proteins and their potential roles as drug targets is warranted.