bluuebunny/crossref_metadata_2025_split huggingface dataset:
Time Dependent Non-Newtonian Numerical Study of the Flow Field in a Realistic Model of Aortic Arch
Authors: Del Gaudio C. , Morbiducci U. , Grigioni M. 
Published: January 2018

A three-dimensional time dependent numerical simulation was performed in a geometric model of aortic arch complete with a realistic aortic root and major branches originating from the arch, for a peak Reynolds number set at 2200 and Womersley number set at 20.4. The computational fluid dynamic analysis was aimed to provide spatial and temporal distribution of the shear stress all along the entire model together with the velocity patterns, related both to the non planar geometry of the aortic system here considered and to the pulsatility imposed on the numerical model to simulate physiologic conditions. A non-Newtonian evolving fluid was considered to account for the actual rheological nature of blood; a comparison on the incidence of wall shear stress, implementing a Newtonian fluid, was also made as reference. The spatial shear stress pattern, within the cardiac cycle, was shown to have higher values in correspondence to the inner wall of the aortic arch and the sites where the major vessels originated from the arch itself. The velocity patterns, on transversal sections of the aorta, resulted in highly skewed morphology. The resulting complex fluid dynamics, established in the aortic arch and in its branches, can be related to the possible endothelium response to mechanical stimuli, induced by wall shear stress, in the promotion of inflammatory events.
Coronary Artery Calcification, Common Carotid Artery Intima-Media Thickness and Aortic Pulse Wave Velocity in Patients on Peritoneal Dialysis
Authors: StompóR T. , Rajzer M. , Pasowicz M. , KraśNiak A. , SuƗOwicz W. , Kawecka-Jaszcz K. , Tracz W. , Janda K. , Tabor B. , Kowalczyk-MichaƗEk M.E. , WÓJcik K. , Konieczynska M. , Klimeczek P. , Janusz-Grzybowska E. 
Published: January 2018

An increasing body of evidence suggests that atherosclerosis in patients with uremia differs from that found in general population in terms of advancement and localization of vascular lesions. It has also been suggested that different non-invasive techniques of vascular system evaluation are designed to show different types of lesions (i.e. vascular calcification, stiffness or “classical” atherosclerosis). The aim of the study was to search for possible associations between results obtained with three different non-invasive methods of vascular system assessment in three different vascular sites in patients treated with peritoneal dialysis (PD). 61 patients (28 F, 33 M), mean age of 50.4 ± 13.6 years, on maintenance PD for a median period of 10 months (range 1–96 months) were included. Coronary artery disease (CAD) was present in 21 subjects. In all subjects coronary artery calcification score (CaSc) using multi-row spiral computed tomography (MSCT), aortic pulse wave velocity (AoPWV) and ultrasound-based common carotid artery intima-media thickness (CCA-IMT) were performed as methods for assessing coronary calcium burden, arterial stiffness and atherosclerosis, respectively. Median value of CaSc equaled 11.5 Agatston units (range 0–5502.8 units). Median AoPWV was 10.4 m/s (range 7.56–18.1 m/s), and median CCA-IMT – 0.6 mm (range 0.3–1.0 mm). In 16 patients (26.2%) at least one plaque in at least one common carotid artery was found on ultrasound. CaSc correlated with AoPWV (R = 0.32, p < 0.01) and with CCA-IMT (R = 0.35, p < 0.005), whereas no association was found between AoPWV and CCA-IMT. AoPWV, but not CaSc nor IMT correlated with blood pressure. The values of CCA-IMT and AoPWV increased together with consecutive Agatston categories (with p < 0.001 for differences in AoPWV and p < 0.05 for CCA-IMT). Patients with at least one plaque found in at least one CCA and patients with CAD were characterized with significantly higher values of CaSc, IMT and PWV, when compared to plaque-free and CAD- negative subjects, respectively. Association between CaSc and both IMT and PWV may suggest that the mechanism of three assessed vascular pathologies may be based, to some extent, on the process of pathologic calcium-phosphate deposition. Lack of correlation found between PWV and IMT may suggest that aortic stiffness and carotid atherosclerosis may partially differ in their pathologic background and/or are dissociated in time.
Histomorphometric Analysis of Poly-L/D-Lactide 96/4 Sutures in the Gastrocnemius Tendon of Rabbits
Authors: Kangas J. , Pajala A. , Leppilahti J. , RyhäNen J. , LäNsman S. , TöRmäLä P. , Waris T. , Ashammakhi N. 
Published: January 2018

Background Common Achilles tendon ruptures are not usually fixed by bioabsorbable sutures due to limitations in their strength retention properties. Modern technology has made it possible to develop bioabsorbable sutures with prolonged strength retention. Aims To evaluate histologically tissue reactions of poly-L/D-lactide (PLDLA) sutures implanted in Achilles tendon of rabbits. Material and Methods Fifteen rabbits were evaluated at 2, 6 and 12 weeks postoperatively, with five rabbits in each follow-up group. PLDLA monofilament sutures were implanted into the medial gastrocnemius tendon. Polyglyconate monofilament sutures with similar diameter (Maxon® 4–0, Cyanamid of Great Britain Ltd., Gosport, UK) were implanted in the contralateral gastrocnemius tendon. The histology was studied in hard-resin embedded samples. The thickness of the formed fibrous tissue capsule was determined histomorphometrically. Results PLDLA led to formation of significantly thinner fibrous tissue capsule than Maxon® sutures of the same diameter. Median thickness (PLDLA vs. Maxon®) at two weeks was 5.26 vs. 13.22μm, at six weeks 11.66 vs. 80.97μm, and at 12 weeks 10.63 vs. 17.59μm (p<0.01). Conclusions During the 12 week follow-up period, PLDLA sutures implanted intratendineously formed thinner fibrous capsule than Maxon® sutures of the same diameter. The suture materials were not totally absorbed by 12 weeks.
Comparison of Inflammatory Response during on-pump and off-pump Coronary Artery Bypass Surgery
Authors: Rimmelé Thomas , Venkataraman Ramesh , Madden Nicholas J. , Elder Michele M. , Wei Lawrence M. , Pellegrini Ronald V. , Kellum John A. 
Published: January 2018

Purpose On-pump coronary artery bypass graft (CABG) surgery has been traditionally associated with a higher magnitude of inflammatory response than off-pump CABG. However, with the development of polymer-coated biocompatible extracorporeal circuits, we wanted to see if cardiopulmonary bypass still played an important role in triggering this inflammatory response. Methods In this prospective observational study, 33 patients undergoing CABG surgeries (25 on-pump and 8 off-pump patients) were studied. Serial plasma cytokine (TNF, IL-6, IL-10) and procalcitonin concentrations were measured at different time-points during and after the surgery. Demographic and baseline clinical data, intra-operative management details and post-operative complications were also collected from the patients' charts. Results Plasma levels of all 4 mediators increased during surgery and returned towards normal post-operatively. There were no differences between groups for any mediator at any time-point. Conclusions We conclude that with the use of recent polymer-coated biocompatible extracorporeal circuits, the inflammatory response triggered by on-pump CABG becomes very similar in magnitude and pattern to that triggered by off-pump CABG. Thus, the surgical procedure contributes to most of the inflammatory response, with the extra-corporeal circuit having minimal to no effect on this response.
Improved Management of Intradialytic Hypotension (IDH) using Vitamin E-bonded polysulfone Membrane Dialyzer
Authors: Matsumura Masaki , Sasaki Hisako , Sekizuka Kumiko , Sano Hiroyuki , Ogawa Kouji , Shimizu Chihiro , Yoshida Hiroaki , Kobayashi Satsuki , Koremoto Masahide , Aritomi Masaharu , Ueki Kazue 
Published: January 2018

Background Intradialytic hypotension (IDH) is a common clinical trait in hemodialysis (HD) which is caused by poor biocompatibility of the dialyzer membrane. Aiming to improve IDH, vitamin E-bonded polysulfone dialyzer (VPS-H) was evaluated in a pilot study. Methods Eight IDH patients on standard HD were switched from their conventional high-flux dialyzers to VPS-H, and intradialytic blood pressure (BP) was monitored regularly for 10 months. Results The results showed that hypotension of systolic BP (SBP), diastolic BP (DBP) and pulse pressure (PP) during the session were improved after changing the dialyzer. Notably, almost all the values recorded from 120 minutes into the session until the end of the treatment in the period between the second and tenth month after treatment were significantly different from the corresponding baseline values. Moreover, after 8 to 10 months, the SBP prior to a dialysis session was significantly reduced compared with baseline values. On the other hand, the pulse rate showed no difference throughout the study period. Conclusions This study provides early evidence of the beneficial role that vitamin E-bonded dialyzers may have in preventing IDH. Larger controlled trials are needed to confirm this original finding.
Improvement of Cytokine Response and Survival Time by Bioartificial Kidney Therapy in Acute Uremic Pigs with Multi-Organ Dysfunction
Authors: Wang Hengjin , Zhang Miao , Wang Xiaoyun , Mao Huijuan , Ying Xumin , Zhu Wenbin , Sun Cheng , Jiang Chunming 
Published: January 2018

Objective To explore whether bioartificial kidney (BAK) ameliorates cytokine response and biochemical indices, and prolongs the survival time in acute uremic pigs with multiple organ dysfunction syndrome (MODS). Methods Hybridized pigs suffering from MODS and acute renal failure (ARF) were treated with BAK (Group A, n=6) or sham-BAK containing no cells (Group B, n=6), or received no treatment (Group C, n=5). Data on blood pressure, hepatic and renal function, IL-10, TNF-α, arterial blood gas, and survival time of all the pigs was recorded. Results Mean arterial pressure (MAP, mmHg) responded more rapidly and reached higher values in Group A (91.82±5.73) compared with Groups B and C at 24 hours (p<0.01). The peak level of serum IL-10 (pg/mL) in Group A (249.57±43.51) was significantly higher than in Groups B and C (132.06±17.53, 104.25±13.42, p<0.01). Serum TNF-α level (pg/mL) in Group A dropped gradually to 402.91±32.47 at 24 hours, and showed a significant discrepancy compared with those before treatment (537.16±38.45) and Group B (512.94±19.5, p<0.05). There was no difference in plasma endotoxin and serum IL-6 between pre-treatment and post-treatment in Groups A and B. BAK treatment, however, resulted in a significant decline in IL-6/IL-10 ratios. The average survival time (hours) in Group A (113.01±14.32) was significantly longer, prolonged by 35.93% and 63.90% compared to Groups B and C (p<0.01), respectively. Conclusions The addition of renal tubule cell therapy to hemofiltration in an acutely uremic animal model with MODS altered systemic cytokine balance, ameliorated MAP, and prolonged survival time.
Microcontact Printing of Fibronectin on a Biodegradable Polymeric Surface for Skeletal Muscle Cell Orientation
Authors: Altomare Lina , Riehle Mathis , Gadegaard Nikolaj , Tanzi Mariacristina , Farè Silvia 
Published: January 2018

Background and Objectives Micropatterning and microfabrication techniques have been widely used to control cell adhesion and proliferation along a preferential direction according to contact guidance theory. One of these techniques is microcontact printing, a soft lithographic technique based on the transfer of a “molecular ink” from an elastomeric stamp to a surface. This method allows the useful attachment of biomolecules in a few seconds on a variety of surfaces with sub-micrometer resolution and control, without modifying the biomolecule properties. The aim of this study is to develop an easy and versatile technique for in vitro production of arrays of skeletal muscle myofibers using microcontact printing technique on biodegradable substrata. Methods Microcontact printing of fibronectin stripes (10, 25, 50 μm in width) was performed onto biodegradable L-lactide/trimethylene carbonate copolymer (PLLA-TMC) films. C2C12, a murine myoblast cell line, was used for the production of parallel myofibers. Results This approach proved to be simple, reliable and effective in obtaining a stable pattern of fibronectin on the PLLA-TMC surface as observed by fluorescence microscopy. C2C12 cells were well aligned along the pattern 24 hours after seeding, especially on fibronectin stripes 10 and 25 μm in width. Seven days after confluence cells fused and formed aligned multinucleated cells expressing α-actinin. Conclusions Fibronectin patterning seems to be a useful method to induce cell alignment and to improve myotube formation. Further studies will be focused on the possibility of applying external stimuli to these structures to obtain healthy myotubes and to induce myofiber development.
Prolonged Hypoxemia and Acidemia in Anesthetized Pigs: A Model for Research on Extracorporeal Organ Support in an Intensive Care Setting
Authors: Russ Martin , Ott Sascha , Bedarf Janis R. , Haacke Nadine , Keckel Tobias , Unger Juliane K. 
Published: January 2018

Purpose Hypoxemia and acidemia (hypoxemia/acidemia) are serious complications in the critically ill and often occur in unstable patients exposed to extracorporeal organ support. Still, little is known about the biocompatibility interactions of hypoxemia/acidemia with extracorporeal circuits (ECC). Existing animal models often include the release of mediator cascades (sepsis-, lung injury models) or are based on small laboratory animals. We established a porcine model of hypoxemia/acidemia without an underlying disease and further challenged the situation with an extracorporeal circuit (ECC). Methods Hypoxemia/acidemia were induced (3.5 h) and maintained (3 h) in anesthetized pigs (40 kg) by a stepwise reduction in oxygenation, infusion of 0.4 mol·l−1 lactic and hydrochloric acid and by low tidal volume ventilation, targeting an PaO2 < 70 mmHg, SvO2 < 65%, pH ~ 7.2. Venovenous hemofiltration (CVVH) operated in recirculation mode without volume exchange was chosen to prove the suitability of the model for studies on ECCs under clinical conditions (ECC group, n=6). Another 6 animals underwent the same protocol except for the CVVH (reference group, n=6). Results The median PaO2 during hypoxemia/acidemia was 62 mmHg, the median SvO2 was 38%, and the median pH was 7.22. Hypoxemia/acidemia was successfully induced and maintained for 6.5 h in all pigs. CVVH could be performed for 3 h with blood flow rates up to 300 ml·min−1 and filtrate rates up to 60 ml·min−1. Conclusions Our model provides hypoxemia/acidemia with blood gas values comparable to critically ill adult patients for several hours, during which it is possible to perform CVVH. Thus, it enables research on the biocompatibility reactions of extracorporeal circuits under intensive care conditions.
Time-Dependent Effects of Rifampicin on Staphylococcal Biofilms
Authors: Gattringer Klaus-Bernhard , Suchomel Miranda , Eder Michaela , Lassnigg Andrea M. , Graninger Wolfgang , Presterl Elisabeth 
Published: January 2018

Objective To test the time-dependent effects of rifampicin on established biofilms of Staphylococcus epidermidis isolated from patients with cardiac implant infections and catheter-related bacteremia. Methods Biofilms were grown in microtiter plates for 24 hours, dyed and stained with crystal violet. The mean optical density (OD) was used for quantification. The OD ratio (ODr = OD of the treated biofilm/OD of the untreated biofilm) was used to measure changes in the thickness of the biofilms over the time. Biofilms were incubated with rifampicin (0.6 mg/mL) for 1, 5, 15, 30 and 60 minutes. Unstained biofilms were sonicated and plated on Columbia agar for time-kill curves. Results The incubation of the biofilms with rifampicin led to a significant reduction of the OD of the biofilms within 1 minute (ODr baseline: 1; ODr 1 min: 0.333 ± 0.131) (p<0.001). With regard to bacterial killing, rifampicin reduced the mean log count, but viable bacteria were still grown from biofilms in 13 out of 28 isolates despite MIC values < 0.01 mg/L. Conclusions In conclusion, our results confirm that rifampicin at a concentration of 1.2 mg/mL immediately reduces established biofilms formed by S. epidermidis although it is not bactericidal despite very low MICs at planktonic conditions.
Antimicrobial Activity of Sodium Hypochlorite-Based Irrigating Solutions
Authors: Poggio Claudio , Arciola Carla Renata , Dagna Alberto , Chiesa Marco , Sforza Dario , Visai Livia 
Published: January 2018

Purpose The objective of the present study was the in vitro evaluation of the antimicrobial activity of three different NaOCl-based endodontic irrigating solutions: a 5.25% conventional sodium hypochlorite solution; and two new irrigating solutions, a 5.25% sodium hypochlorite solution with the addition of a proteolytic enzyme and a surfactant; and a 5.25% sodium hypochlorite gel with inorganic silicate. Methods Enterococcus faecalis, Staphylococcus aureus and Streptococcus mutans strains were selected to evaluate the antimicrobial activity of the endodontic irrigating solutions by the agar disc diffusion test. Paper disks were saturated with each one of the tested solutions (at room temperature and pre-warmed at 45°C) and placed onto culture agar-plates pre-adsorbed with bacterial cells and further incubated for 24 h at 37°C. The growth inhibition zones around each irrigating solution were recorded and compared for each bacterial strain. Results The results were significantly different among the tested irrigating solutions: 5.25% sodium hypochlorite solution produced the highest inhibition areas; 5.25% sodium hypochlorite solution with a proteolytic enzyme and a surfactant, and 5.25% sodium hypochlorite gel with inorganic silicate showed the lowest zones of inhibition. Conclusions Even if all tested irrigating solution possessed antibacterial activity versus all tested bacterial strains, 5.25% sodium hypochlorite solution with a proteolytic enzyme and a surfactant, and 5.25% sodium hypochlorite gel with inorganic silicate showed lower in vitro efficacy than 5.25% conventional sodium hypochlorite solution.
Intensity of Care at the End of Life Among Older Adults in Korea
Authors: Kim Su Hyun , Kang Sangwook , Song Mi-Kyung 
Published: January 2018

Aim: To examine the intensity of care at the end of life among older adults in Korea and to identify the individual and institutional factors associated with care intensity. Methods: This secondary data analysis included a sample of 6278 decedents aged 65 years or older who were identified from the 2009 to 2010 Korean National Health Insurance Service–National Sample Cohort Claims data. We examined the medical care received by the cohort in the last 30 days of their lives. Results: Overall, 36.5% of the sample received at least 1 intensive care procedure in the last 30 days of their lives; 26.3% of patients experienced intensive care unit admission, with an average stay of 7.45 days, 19.5% received mechanical ventilation, 12.3% received cardiopulmonary resuscitation, and 15.5% had a feeding tube placement. A statistical analysis using a multiple logistic regression model with random effects showed that younger age, higher household income, primary diagnoses of diseases (ischemic heart disease, infectious disease, chronic lung disease, or chronic heart disease), and characteristics of care setting (large hospitals and facilities located in metropolitan areas) were significantly associated with the likelihood of receiving high-intensity care at the end of life. Conclusion: A substantial number of older adults in Korea experienced high-intensity end-of-life care. Both individual and institutional factors were associated with the likelihood of receiving high-intensity care. Gaining an understanding of the intensity of care at the end of life and the impact of the determinants would advance efforts to improve quality of care at the end of life for older adults in Korea.
Centralization of Cleft Lip and Palate Services in the United Kingdom
Authors: Stock Nicola Marie , Anwar Hamza , Sandy Jonathan R. , Rumsey Nichola 
Published: January 2018

Background: Since the implementation of centralized services in the United Kingdom for those affected by cleft lip and/or palate (CL/P), several studies have investigated the impact of service rationalization on the delivery of care. While large-scale quantitative studies have demonstrated improvements in a range of patient outcomes, and smaller studies have reported on the benefits and challenges of centralization from the views of health professionals, little research has attempted to capture the patient perspective. Furthermore, few studies have investigated the views of adult “returners” who have undergone treatment both pre- and postcentralization. Methods: Qualitative data relevant to the subject of this article were extracted from 2 previous larger studies carried out between January 2013 and March 2014. A total of 16 adults born with CL/P contributed data to the current study. These data were subjected to inductive thematic analysis. Results: The findings suggest that centralization of CL/P services has considerably enhanced the patient experience. Specifically, the overall standard and coordination of care has improved, service delivery has become more patient centered, and access to professional psychological support and peer support has greatly improved patients’ capacity to cope with the associated emotional challenges. Conclusions: The data collected provide additional insight into the impact of centralization from the perspective of a largely unexplored patient population. In combination with other literature, these findings are also relevant to future efforts to centralize other specialist services around the world.
Prevalence of Vitamin D Deficiency in Patients With Talar Osteochondral Lesions
Authors: Telleria Jessica J. M. , Ready Lauren V. , Bluman Eric M. , Chiodo Christopher P. , Smith Jeremy T. 
Published: January 2018

Background: Vitamin D deficiency affects over 1 billion people worldwide and is common in foot and ankle patients. The prevalence in those with osteochondral lesions of the talus (OLTs) is unknown. This study identified the prevalence and risk factors for hypovitaminosis D in patients with an OLT. Methods: Serum 25(OH)D levels were obtained from patients presenting with an OLT from May to November during 2007 to 2016. Hypovitaminosis D was defined as 25(OH)D less than 30 ng/mL (75 nmol/L). Patients presenting with an acute ankle sprain (AS) during the same months served as a control group. Specific medical risk factors for hypovitaminosis D were recorded. The final OLT population included 46 patients (31 women [67.4%]; mean [SD] age 43.6 [14.8] years). The comparison AS group had 40 patients (32 women [80.0%]; mean [SD] age 56.2 [13.0] years). Results: The mean (SD) 25(OH)D in the OLT and AS cohorts were 31.2 (12.6) ng/mL and 37.1 (13.5) ng/mL, respectively ( P = .039). Hypovitaminosis D was identified in 54% of the OLT population and 28% of the AS population ( P = .012). Conclusion: Hypovitaminosis D is intimately related to decreased bone mineral density. This study identified a significantly higher rate of hypovitaminosis D in patients with an OLT compared to a cohort of AS patients. These findings suggest that when patients present with an OLT, health care providers should consider evaluating for and treating hypovitaminosis D. Level of Evidence: Level III, comparative study.