bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transvenous pacemaker implantation after the bidirectional Glenn operation for patients with complex congenital disease
Authors: Harake Danielle E. , Shannon Kevin M. , Aboulhosn Jamil A. , Moore Jeremy P. 
Published: December 2017

AbstractIntroductionThe bidirectional Glenn operation for congenital heart disease produces anatomical constraints to conventional transvenous pacemaker implantation. An iliac approach, although not previously described in this population, is potentially a preferable alternative to a thoracotomy for epicardial pacing.Methods and resultsA single‐center retrospective review was performed for all patients that underwent transvenous pacemaker implantation following the bidirectional Glenn operation with partial biventricular repair. Follow‐up data, implant indications, and techniques were recorded. Five patients underwent a transvenous iliac approach (median age 26.9 years, interquartile range [IQR] 25.8–27.6). Pacing indications included AV block in 3 patients (2 requiring cardiac resychronization therapy) and sinus node dysfunction in 2. Implanted leads were atrial in 4 and ventricular in 3 (1 of the latter was placed in the coronary sinus). In two cases, transvenous leads were tunneled to a preexisting epicardial abdominal generator. Median follow‐up was 4.1 years (range 1.0–16.7 years). One patient underwent device revision for lead position‐related groin discomfort; a second patient developed atrial lead failure following a Maze operation and underwent lead replacement by the iliac approach. Patients were not routinely anticoagulated postprocedure given lead position in the subpulmonary circulation. At last follow‐up, all patients were alive. One patient underwent heart transplantation 6 months after implant with only partial resolution of pacing‐induced cardiomyopathy.ConclusionsTrans‐iliac pacemaker placement may be an effective alternative to surgery for patients requiring permanent pacing after the Glenn operation.
Clinical judgement in the era of big data and predictive analytics
Authors: Chin‐Yee Benjamin , Upshur Ross 
Published: December 2017

AbstractClinical judgement is a central and longstanding issue in the philosophy of medicine which has generated significant interest over the past few decades. In this article, we explore different approaches to clinical judgement articulated in the literature, focusing in particular on data‐driven, mathematical approaches which we contrast with narrative, virtue‐based approaches to clinical reasoning. We discuss the tension between these different clinical epistemologies and further explore the implications of big data and machine learning for a philosophy of clinical judgement. We argue for a pluralistic, integrative approach, and demonstrate how narrative, virtue‐based clinical reasoning will remain indispensable in an era of big data and predictive analytics.
Three‐dimensional digital reconstruction of skin epidermis and dermis
Authors: LIU P. , ZHU J.‐Y. , TANG B. , HU Z.‐C. 
Published: December 2017

SummaryThis study describes how three‐dimensional (3D) human skin tissue is reconstructed, and provides digital anatomical data for the physiological structure of human skin tissue based on large‐scale thin serial sections. Human skin samples embedded in paraffin were cut serially into thin sections and then stained with hematoxylin‐eosin. Images of serial sections obtained from lighting microscopy were scanned and aligned by the scale‐invariant feature transform algorithm. 3D reconstruction of the skin tissue was generated using Mimics software. Fibre content, porosity, average pore diameter and specific surface area of dermis were analysed using the ImageJ analysis system. The root mean square error and mutual information based on the scale‐invariant feature transform algorithm registration were significantly greater than those based on the manual registration. Fibre distribution gradually decreased from top to bottom; while porosity showed an opposite trend with irregular average pore diameter distribution. A specific surface area of the dermis showed a ‘V’ shape trend. Our data suggested that 3D reconstruction of human skin tissue based on large‐scale serial sections could be a valuable tool for providing a highly accurate histological structure for analysis of skin tissue. Moreover, this technology could be utilized to produce tissue‐engineered skin via a 3D bioprinter in the future.
Wnt signaling loss accelerates the appearance of neuropathological hallmarks of Alzheimer's disease in J20‐APP transgenic and wild‐type mice
Authors: Tapia‐Rojas Cheril , Inestrosa Nibaldo C. 
Published: December 2017

AbstractAlzheimer's disease (AD) is a neurodegenerative pathology characterized by aggregates of amyloid‐β (Aβ) and phosphorylated tau protein, synaptic dysfunction, and spatial memory impairment. The Wnt signaling pathway has several key functions in the adult brain and has been associated with AD, mainly as a neuroprotective factor against Aβ toxicity and tau phosphorylation. However, dysfunction of Wnt/β‐catenin signaling might also play a role in the onset and development of the disease. J20 APPswInd transgenic (Tg) mouse model of AD was treated i.p. with various Wnt signaling inhibitors for 10 weeks during pre‐symptomatic stages. Then, cognitive, biochemical and histochemical analyses were performed. Wnt signaling inhibitors induced severe changes in the hippocampus, including alterations in Wnt pathway components and loss of Wnt signaling function, severe cognitive deficits, increased tau phosphorylation and Aβ1–42 peptide levels, decreased Aβ42/Aβ40 ratio and Aβ1–42 concentration in the cerebral spinal fluid, and high levels of soluble Aβ species and synaptotoxic oligomers in the hippocampus, together with changes in the amount and size of senile plaques. More important, we also observed severe alterations in treated wild‐type (WT) mice, including behavioral impairment, tau phosphorylation, increased Aβ1–42 in the hippocampus, decreased Aβ1–42 in the cerebral spinal fluid, and hippocampal dysfunction. Wnt inhibition accelerated the development of the pathology in a Tg AD mouse model and contributed to the development of Alzheimer's‐like changes in WT mice. These results indicate that Wnt signaling plays important roles in the structure and function of the adult hippocampus and suggest that inhibition of the Wnt signaling pathway is an important factor in the pathogenesis of AD.
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How perceived feelings of “wellness” influence the decision‐making of people with predialysis chronic kidney disease
Authors: Campbell‐Crofts Sandra , Stewart Glenn 
Published: December 2017

Aims and objectivesTo identify the subjective meanings attached to decisions made by people living with chronic kidney disease as they consider their transition to renal replacement therapy.BackgroundWithin the challenging world of chronic illness, people draw upon their temporal life experiences to help them make the best or most balanced primary healthcare decisions. Understanding the risks and benefits associated with these decisions has been an area of intense interest in health research.DesignAn exploratory qualitative descriptive design.MethodA convenience sample of twelve people, at stages 3B to 5 of chronic kidney disease, attending two predialysis renal clinics in Sydney, Australia, consented to be interviewed. The semi‐structured interviews centred on their decision‐making experiences as they considered their transition to renal replacement therapy.ResultsThree themes emerged from participant narratives which have been framed into the following questions: (i) Do I need renal replacement therapy? (ii) What is the “right” renal replacement therapy for me? and (iii) When should I start renal replacement therapy? Decisions about the transition to renal replacement therapy were impacted upon by the participants’ perceived feelings of wellness and the belief that renal replacement therapy would not be needed at any time in the foreseeable future.ConclusionThis study highlights the importance of optimising person‐centred care and raises important issues for the education and management of people with chronic kidney disease in the predialysis stages of the illness.Relevance to clinical practiceIn order to facilitate the transition to renal replacement therapy, renal clinicians have a responsibility to more fully understand the patient journey during the predialysis stages of chronic kidney disease. A clearer understanding of patients’ perceptions and decision‐making experiences creates a space for mutual understanding. This is essential for the future development and implementation of collaborative, person‐centred educational strategies and long‐term renal healthcare outcomes.
Redox imbalance correlates with high Nugent score in bacterial vaginosis
Authors: Waqqar Shakeel , Aziz Salman , Shakeel Rabia , Waheed Anum , Ahmed Syed S. , Ali Asad , Khan Ayyaz A. , Shoaib Muhammad 
Published: December 2017

AbstractAimThe main goal of this work was to highlight the significance of redox imbalance in the pathophysiology of bacterial vaginosis (BV). We studied the pro‐oxidant (malondialdehyde) and antioxidants (glutathione, total antioxidant capacity) in the vaginal fluids of women and compared them on the basis of their Nugent score (NS).MethodsWomen were clinically screened using Amsel criteria (≥2 were regarded as positive) and were further screened for NS on the basis of microscopic examination. Subjects were classified into one of three groups – healthy controls, intermediate, and BV – on the basis of NS (0–3, 4–6, and 7–10, respectively). High vaginal swabs were collected from the study participants in order to estimate the levels of pro and antioxidants in the vaginal fluids.ResultsOur results indicated that levels of both pro‐ and antioxidants were elevated in high vaginal swabs of women in the intermediate (NS: 4–6) and BV (NS: 7–10) groups as compared to those of healthy control women. The difference in mean values for total antioxidant capacity and glutathione was found to be statistically significant. Furthermore, in the BV group (NS: ≥7) both antioxidants (glutathione and total antioxidant capacity) and the pro‐oxidant, malondialdehyde, were found to be negatively correlated to NS. Interestingly, the correlation between NS and malondialdehyde was statistically significant.ConclusionOur results suggest a significant correlation between redox imbalance and NS, which signifies changes in vaginal ecology from normal flora (Lactobacillus spp.) towards a more mixed bacterial population representing BV.
Performance measures for a dialysis setting
Authors: Gu Xiuzhu , Itoh Kenji 
Published: December 2017

SUMMARYObjectivesThis study from Japan extracted performance measures for dialysis unit management and investigated their characteristics from professional views.MethodsTwo surveys were conducted using self‐administered questionnaires, in which dialysis managers/staff were asked to rate the usefulness of 44 performance indicators. A total of 255 managers and 2,097 staff responded.ResultsEight performance measures were elicited from dialysis manager and staff responses: these were safety, operational efficiency, quality of working life, financial effectiveness, employee development, mortality, patient/employee satisfaction and patient‐centred health care. These performance measures were almost compatible with those extracted in overall healthcare settings in a previous study. Internal reliability, content and construct validity of the performance measures for the dialysis setting were ensured to some extent. As a general trend, both dialysis managers and staff perceived performance measures as highly useful, especially for safety, mortality, operational efficiency and patient/employee satisfaction, but showed relatively low concerns for patient‐centred health care and employee development. However, dialysis managers’ usefulness perceptions were significantly higher than staff.ConclusionsImportant guidelines for designing a holistic hospital/clinic management system were yielded. Performance measures must be balanced for outcomes and performance shaping factors (PSF); a common set of performance measures could be applied to all the healthcare settings, although performance indicators of each measure should be composed based on the application field and setting; in addition, sound causal relationships between PSF and outcome measures/indicators should be explored for further improvement.
Differing disintegration and dissolution rates, pharmacokinetic profiles and gastrointestinal tolerability of over the counter ibuprofen formulations
Authors: Bjarnason Ingvar , Sancak Ozgur , Crossley Anne , Penrose Andrew , Lanas Angel 
Published: December 2017

Abstract

Objectives
Formulations of over the counter (OTC) NSAIDs differ substantially, but information is lacking on whether this alters their gastrointestinal profiles. To assess disintegration and dissolution rates and pharmacokinetics of four preparations of OTC ibuprofen and relate these with spontaneously reported gastrointestinal adverse events.

Methods
Disintegration and dissolution rates of ibuprofen tablets as (a) acid, (b) sodium salt, (c) lysine salt, and (d) as a liquid gelatine capsule were assessed. Pharmacokinetic data gastrointestinal and spontaneously reported adverse events arising from global sales were obtained from files from Reckitt Benckiser.

Key findings
Disintegration at low pH was progressively shorter for the preparations from a-to-d with formation of correspondingly smaller ibuprofen crystals, while dissolution was consistently poor. Dissolution at a neutral pH was least rapid for the liquid gelatine capsule. Pharmacokinetic data showed a shorter tmax and a higher Cmax for preparations b–d as compared with ibuprofen acid. Spontaneously reported abdominal symptoms were rare with the liquid gelatine preparation.

Conclusions
The formulations of OTC ibuprofen differ in their disintegration and dissolution properties, pharmacokinetic profiles and apparent gastrointestinal tolerability. Spontaneously reported abdominal symptoms were five times lower with the liquid gelatine capsule as compared with ibuprofen acid despite a 30% increase in Cmax.
Materialism and Fashion Consciousness: The Moderating Role of Status Consumption Tendencies and Religiosity
Authors: Yeniaras Volkan , Akkemik K. Ali 
Published: December 2017

AbstractUnderstanding whether materialistic values translate directly into fashion consciousness or whether it is the status consumption and religiosity that intensifies this relationship within the specifics of explicitly religious consumers is important as fashion consumption appears to occupy a focal position both socially and economically in the lives of many. The Islamic fashion clothing market has begun to attract recent attention and is becoming an area of interest in consumer research. The Turkish Islamic fashion clothing consumptionscape that reached a yearly sales volume of $39 billion in 2013 within a $266 billion global market shows that the explicitly Muslim Turkish consumer gains excitement and pleasure from keeping up‐to‐date with fashion. Utilizing a unique data set from a survey in Istanbul this article examines the relationships between materialism, status consumption tendencies, intrinsic religiosity, and fashion‐novelty consciousness. Strong evidence is found for the positive relationship of materialism to fashion‐novelty consciousness. In addition, intrinsic religiosity has been identified to have a negative moderating effect on the materialism‐fashion‐novelty consciousness association.
Land‐use legacies in forests at Jefferson's Monticello plantation
Authors: Druckenbrod Daniel L. , Neiman Fraser D. , Richardson David L. , Wheeler Derek 
Published: December 2017

AbstractQuestionsWe evaluate the role of past land use on long‐term forest succession and ask fundamental questions: (i) are successional patterns along a chronosequence consistent through time; (ii) is past land use or physiography a greater driver of forest composition; and (iii) does forest composition converge with age?LocationThomas Jefferson's Monticello plantation, Virginia Piedmont, USA.MethodsCombining dendroecology, historical documents and a repeated vegetation survey from 1934, we reconstruct forest histories along a chronosequence that retains a temporal dimension. Tree‐ring data indicate initial canopy status and canopy release events using time series analysis with intervention detection.ResultsForest extent was lowest during Jefferson's tenure; however, tree ring and documentary evidence revealed the location of Jefferson's timber zone. Jefferson‐era trees in this zone are largely on the west slope with scattered Pinus recruitment starting in the late 18th century, followed by Quercus species. Pinus cohorts also recruited into former agricultural fields on south and east slopes in two chronosequence stages from the 20th century. Synchronized release events were observed during the early 1800s, 1850s–1860s and 1960s, indicating periods of intense forest use. Ordination of repeated vegetation surveys showed a progression in forest age that explained more variation in forest composition than elevation and slope. The forest age gradient is also evident independently from tree‐ring data, but the ordination does not show convergence in composition with forest age.ConclusionPast land use is a greater driver of forest composition than an inferred soil moisture gradient. The composition of the most recent chronosequence stage suggests that future forest dynamics may be novel compared to the prior two centuries because of differences in land use and species availability. These land‐use legacies demonstrate how colonial‐era agricultural decisions at Monticello continue to impact forest growth and composition more than two centuries later.
Danaparoid reduces transplant‐related mortality in stem cell transplantation for children
Authors: Kato Koji , Sakaguchi Hirotoshi , Muramatsu Hideki , Sekiya Yuko , Kawashima Nozomu , Narita Atsushi , Doisaki Sayoko , Watanabe Nobuhiro , Yoshida Nao , Matsumoto Kimikazu 
Published: December 2017

AbstractIn SCT, death from transplant‐related complications is the major obstacle hindering improvement of transplant outcomes, and proper supportive care is essential to reduce TRM. The transplant outcomes of 210 pediatric patients with malignant and non‐malignant disorders who consecutively underwent SCT in our institution from 2000 to 2013 were analyzed. The transplant years were divided into three periods: A (2000‐2004), B (2005‐2008), and C (2009‐2013), and an improvement in 5‐year OS and a decrease in 5‐year TRM were observed over these time periods; that is, OS was 61.5%, 60.3%, and 79.5% (P = .062), and TRM was 19.9%, 7.9%, and 0.0% (P < .001) in periods A, B, and C, respectively. On multivariate analysis, the prognostic factor for TRM for all patients was administration of danaparoid (HR = 0.109, 95% CI = 0.033‐0.363, P < .001), and for patients with hematological malignancies in allogeneic SCT, the prognostic factors were danaparoid (HR = 0.046, 95% CI = 0.006‐0.326, P = .002) and advanced disease at SCT (HR = 4.802, 95% CI = 1.734‐13.30, P = .003). A reduction in TRM after SCT was observed over the time periods, and supportive care with danaparoid was found to be significantly effective in reducing TRM in SCT for children.
Intact rock bridge breakage and rock mass fragmentation upon failure: quantification using remote sensing techniques
Authors: Spreafico Margherita C. , Franci Francesca , Bitelli Gabriele , Borgatti Lisa , Ghirotti Monica 
Published: December 2017

AbstractIn this work, two processes related to the onset and the evolution of large‐scale rockfalls have been analysed by means of remote sensing techniques. First, the number of rock bridges as a proportion of pre‐existing fractures has been estimated in a newly formed landslide scarp by analysing the spectral information of the rock mass in terrestrial laser scanner (TLS) and unmanned aerial vehicle (UAV) photogrammetric point clouds. Second, the fragmentation of the rock mass after failure has been assessed by comparing the percentage of newly formed fractures in the scarp and in the deposit. For this purpose, an orthophoto of the landslide deposit was classified using an object‐based method. The presented workflow gained new data on the intact rock breakage during and after failure, and consequently deepened knowledge about rock failure and fragmentation mechanisms.
Extracellular matrix/stromal vascular fraction gel conditioned medium accelerates wound healing in a murine model
Authors: Deng Chengliang , He Yunfan , Feng Jingwei , Dong Ziqing , Yao Yao , Mok Hsiaopei , Lin Maohui , Feng Lu 
Published: December 2017

AbstractConditioned medium (CM) is a new treatment modality in regenerative medicine and has shown a successful outcome in wound healing. We recently introduced extracellular matrix/stromal vascular fraction gel (ECM/SVF‐gel), an adipose‐derived stem cell and adipose native extracellular matrix‐enriched product for cytotherapy. This study aimed to evaluate the effect of CM from ECM/SVF‐gel (Gel‐CM) on wound healing compared with the conventional CM from adipose tissue (Adi‐CM) and stem cell (SVF‐CM). In vitro wound healing effect of three CMs on keratinocytes and fibroblasts was evaluated in terms of proliferation property, migratory property, and extracellular matrix production. In vivo, two full‐thickness wounds were created on the back of each mice. The wounds were randomly divided to receive Gel‐CM, Adi‐CM, SVF‐CM, and PBS injection. Histologic observations and collagen content of wound skin were made. Growth factors concentration in three CMs was further quantified. In vitro, Gel‐CM promoted the proliferation and migration of keratinocytes and fibroblasts and enhanced collagen I synthesis in fibroblasts compared to Adi‐CM and SVF‐CM. In vivo, wound closure was faster, and dermal and epidermal regeneration was improved in the Gel‐CM‐treated mice compared to that in Adi‐CM and SVF‐CM‐treated mice. Moreover, The growth factors concentration (i.e., vascular endothelial growth factor, basic fibroblast growth factor, hepatocyte growth factor, and transforming growth factor‐β) in Gel‐CM were significantly higher than those in Adi‐CM and SVF‐CM. Gel‐CM generated under serum free conditions significantly enhanced wound healing effect compared to Adi‐CM and SVF‐CM by accelerating cell proliferation, migration, and production of ECM. This improved trophic effect may be attributed to the higher growth factors concentration in Gel‐CM. Gel‐CM shows potential as a novel and promising alternative to skin wound healing treatment. But limitations include the safety and immunogenicity studies of Gel‐CM still remain to be clearly clarified and more data on mechanism study are needed.