bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multi‐disciplinary Concurrent Management of Recurrent Hepatocellular Therapy is Superior to Sequential Therapy
Authors: Fields Tyler D. , Philips Prejesh , Scoggins Charles R. , Tatum Cliff , Kelly Lawrence , McMasters Kelly M. , Martin Robert C. G. 
Published: November 2016

AbstractBackgroundRecurrent hepatocellular carcinoma after a patient’s initial therapy, whether it is transplantation, resection, or ablation, remains a challenging clinical problem. Since recurrence occurs in 70% of all initially treated disease within 5 years, optimal management to treat this recurrence is needed. Currently, a bias exists toward mono‐therapy (i.e., ablation alone, hepatic arterial therapy alone, or sorafenib therapy alone) instead of concurrent sequential therapy—as is common in other primary and metastatic disease to the liver. Thus, the aim of our study was to evaluate the overall survival of recurrent HCC based on either mono‐therapy or multimodality therapy.MethodsA review of our prospective 2245 patient hepato‐pancreatico‐biliary database was performed for all patients who underwent treatment with curative intent for hepatocellular carcinoma and had complete recurrence treatment data from June 2002 to May 2015. Mono‐therapy was defined as initiation of a solitary therapy until disease progression or intolerance. Multimodality therapy was defined as at least 2 therapies that occurred simultaneously or within 4 weeks of each therapy.ResultsA total of 281 patients underwent treatment with curative intent for hepatocellular carcinoma, in which 192 experienced recurrence. These patients were treated with either thermal ablation or liver resection (LR) (N = 51), transarterial chemoembolization (TACE) or radiation (N = 68), systemic therapy (N = 26), or multimodality therapy (N = 47). The extent of the first recurrence was similar in regard to the number of tumors (median 1), the type of radiologic HCC, gender, BMI, and percentage of liver involvement. They differed in regard to size (MMT largest, median 5.6 cm, p = 0.02), and MMT had higher Hepatitis C involvement (37% of patients, p = 0.001). In evaluation of first recurrence treatment, after a median follow‐up of 24 months, multimodality therapy has a significant improvement in overall survival (median 40 months, range 8–85), when compared to LR/Ablation (27 months, range 4–75), TACE/XRT (13 months, range 4–68), and systemic (26 months, range 3–59) (p = 0.003).ConclusionMultimodality therapy should be considered in all patients with recurrent HCC based on tumor biology and underlying hepatic reserve. Hepatocellular cancer should be treated like other hepatic malignancies in which concurrent therapies are utilized simultaneously to optimize oncologic effects (response rates and overall survival) and minimize quality‐of‐life side effects. Multimodality therapy can lead to far superior overall survival and is well tolerated in the majority of recurrent HCC patients.
The Direct and Indirect Costs of Ultrasound-Guided Peripherally Inserted Central Catheter Repositioning at a Large Academic Medical Center
Authors: Keller Eric J. , Semaan Edouard , Lee Jung , Aragona Emily , Molina Heather , Salem Riad , Resnick Scott A. , Chrisman Howard , Collins Jeremy D. 
Published: November 2016

AbstractBackground: To assess the technical success of ultrasound (US)-guided peripherally inserted central catheter (PICC) placement at a large academic medical center and evaluate the direct and indirect costs associated with malpositioned catheters.Methods: This retrospective chart review consisted of 250 consecutive inpatients and 150 consecutive outpatients (N = 400, aged 58 ± 17 years, 225 men and 175women) who underwent US-guided PICC placement at a single center. Repositioning rates were compared between high-complexity (inpatient) and low-complexity (outpatient) groups using a χ2 test and phi coefficient. Initial and final catheter tip position was assessed by radiography. Direct costs of repositioning were estimated using Medicare reimbursement rates. Indirect costs, including additional staff time, imaging, and delays in treatment, were assessed via a survey of PICC nurses and chart reviews.Results: Initial PICC placement resulted in an optimal tip position in 34% of patients and an optimal or acceptable position in 84% of patients. Repositioning rates were significantly higher for inpatients with a low to moderate association between inpatient PICC placement and the need for repositioning (χ2 = 9.603, P = .002; σ = 0.155, P = .002). In total, 77 catheters required repositioning, costing on average an additional $186.03 and 50 minutes of staff time per catheter as well as delaying catheter use in 23 patients for at least 24 hours.Conclusions: PICC malpositioning is a significant source of inefficiency, especially for inpatient services, that should be addressed to reduce expenditures and maximize patients' perceptions of quality health care.
Co‐creating value using customer training and education in a healthcare service design
Authors: Damali Uzay , Miller Janis L. , Fredendall Lawrence D. , Moore DeWayne , Dye Cheryl J. 
Published: November 2016

AbstractIn services, which require significant customer participation to create value, customers who lack the knowledge, skills and motivation necessary to participate effectively can negatively impact service quality and cost outcomes. This paper develops a conceptual model to investigate the effectiveness of utilizing customer training and education (CTE) to improve customer readiness to provide effective behaviors in a professional service. The model was tested using survey data from patients diagnosed with diabetes who received CTE as part of their healthcare service. We found that customers who are taught why they have to perform the tasks, have higher levels of motivation to perform these tasks effectively. Further, as proposed by the customer readiness model, when their task performance is higher, they have improved health and lower healthcare costs.
Effects of Pulsed Ultrasound Therapy on Sensory Nerve Conduction Parameters and the Pain Threshold Perceptions in Humans
Authors: Schuhfried Othmar , Vukanovic Damir , Kollmann Christian , Pieber Karin , Paternostro‐Sluga Tatjana 
Published: November 2016

AbstractBackgroundTherapeutic ultrasound is an often‐used clinical modality in the nonsurgical treatment of entrapment neuropathies. To date, the possible mechanism of action of pulsed ultrasound therapy on the peripheral nerve in the treatment of entrapment neuropathies is unclear.ObjectiveTo examine the effects of pulsed ultrasound therapy on peripheral nerve conduction parameters.DesignA prospective, randomized, single blind, crossover study.SettingOutpatient clinic of a university department of physical medicine and rehabilitation.ParticipantsTwelve healthy volunteers between 22 and 38 years of age (8 male, 4 female).MethodsEach patient (blinded) received ultrasound therapy (1W/cm2, pulsed: 1:5; over the course of the superficial branch of the radial nerve of the nondominant arm) and placebo (intensity: zero). The interval between the individual interventions was 1 week.Main Outcome MeasurementThe sensory nerve conduction velocity, sensory nerve action potential, supramaximal stimulation intensity of the sensory fibers of the radial nerve, and the pressure pain threshold in the sensory area of the radial nerve before and after an ultrasound‐therapy and placebo intervention. To compare the results of the intervention with placebo, a paired‐samples t test was applied.ResultsCompared with placebo, a significant increase after pulsed ultrasound therapy was found for the supramaximal stimulation intensity (P = .02). For the other primary outcome parameters, a significant difference was not found.ConclusionsThe immediate effect of pulsed ultrasound therapy on a sensory nerve is minimal. Therefore, the previously reported benefit of pulsed ultrasound therapy in entrapment neuropathies might be not due to its effect on the sensory nerve.Level of EvidenceI
Multiple neuropathologies and dementia in the aging brain: A key role for cerebrovascular disease?
Authors: Charidimou Andreas , Viswanathan Anand 
Published: November 2016

AbstractThis short perspective discusses the conclusions of a Research Roundtable meeting held in October in 2014 within the overall theme of understanding the role of additional/comorbid pathologies in the aging brain and their potential interaction with clinical Alzheimer's disease and other dementia phenotypes. We specifically examine the key role of for cerebrovascular small vessel disease in this context and highlight future directions.
Diffusion or Confusion? Clustered Shocks and the Conditional Diffusion of Democracy
Authors: Houle Christian , Kayser Mark A. , Xiang Jun 
Published: November 2016

AbstractScholars, observing clustering in transitions to democracy, argue that democratization diffuses across borders as citizens in autocracies demand the same reforms they witness in neighboring states. We disagree. This article demonstrates that diffusion plays only a highly conditional role in democratization. We advance and test an alternative two-step theory of clustered democratization: (1) economic and international political shocks, which are clustered spatially and temporally, induce the breakdown of authoritarian regimes; then (2) democratic diffusion, in turn, influences whether a fallen dictatorship will be replaced by a democracy or a new autocracy. Diffusion, despite playing an important role, is insufficient to explain the clustering of transitions. Using data on 125 autocracies from 1875 to 2004, we show that economic crises trigger authoritarian breakdowns, while diffusion influences whether the new regime is democratic or authoritarian.
Transplanted photoreceptor precursors transfer proteins to host photoreceptors by a mechanism of cytoplasmic fusion
Authors: Singh Mandeep S. , Balmer Jasmin , Barnard Alun R. , Aslam Sher A. , Moralli Daniela , Green Catherine M. , Barnea-Cramer Alona , Duncan Isabel , MacLaren Robert E. 
Published: November 2016

AbstractPhotoreceptor transplantation is a potential future treatment for blindness caused by retinal degeneration. Photoreceptor transplantation restores visual responses in end-stage retinal degeneration, but has also been assessed in non-degenerate retinas. In the latter scenario, subretinal transplantation places donor cells beneath an intact host outer nuclear layer (ONL) containing host photoreceptors. Here we show that host cells are labelled with the donor marker through cytoplasmic transfer—94±4.1% of apparently well-integrated donor cells containing both donor and host markers. We detect the occurrence of Cre-Lox recombination between donor and host photoreceptors, and we confirm the findings through FISH analysis of X and Y chromosomes in sex-discordant transplants. We do not find evidence of nuclear fusion of donor and host cells. The artefactual appearance of integrated donor cells in host retinas following transplantation is most commonly due to material transfer from donor cells. Understanding this novel mechanism may provide alternate therapeutic strategies at earlier stages of retinal degeneration.
Fatty acid metabolic reprogramming via mTOR-mediated inductions of PPARγ directs early activation of T cells
Authors: Angela Mulki , Endo Yusuke , Asou Hikari K. , Yamamoto Takeshi , Tumes Damon J. , Tokuyama Hirotake , Yokote Koutaro , Nakayama Toshinori 
Published: November 2016

AbstractTo fulfil the bioenergetic requirements for increased cell size and clonal expansion, activated T cells reprogramme their metabolic signatures from energetically quiescent to activated. However, the molecular mechanisms and essential components controlling metabolic reprogramming in T cells are not well understood. Here, we show that the mTORC1–PPARγ pathway is crucial for the fatty acid uptake programme in activated CD4+ T cells. This pathway is required for full activation and rapid proliferation of naive and memory CD4+ T cells. PPARγ directly binds and induces genes associated with fatty acid uptake in CD4+ T cells in both mice and humans. The PPARγ-dependent fatty acid uptake programme is critical for metabolic reprogramming. Thus, we provide important mechanistic insights into the metabolic reprogramming mechanisms that govern the expression of key enzymes, fatty acid metabolism and the acquisition of an activated phenotype during CD4+ T cell activation.
Glucocorticoid receptor and Histone deacetylase 6 mediate the differential effect of dexamethasone during osteogenesis of mesenchymal stromal cells (MSCs)
Authors: Rimando Marilyn G. , Wu Hao-Hsiang , Liu Yu-An , Lee Chien-Wei , Kuo Shu-Wen , Lo Yin-Ping , Tseng Kuo-Fung , Liu Yi-Shiuan , Lee Oscar Kuang-Sheng 
Published: November 2016

AbstractLineage commitment and differentiation of mesenchymal stromal cells (MSCs) into osteoblasts in vitro is enhanced by a potent synthetic form of glucocorticoid (GC), dexamethasone (Dex). Paradoxically, when used chronically in patients, GCs exert negative effects on bone, a phenomenon known as glucocorticoid-induced osteoporosis in clinical practice. The mechanism on how GC differentially affects bone precursor cells to become mature osteoblasts during osteogenesis remains elusive. In this study, the dose and temporal regulation of Dex on MSC differentiation into osteoblasts were investigated. We found that continuous Dex treatment led to a net reduction of the maturation potential of differentiating osteoblasts. This phenomenon correlated with a decrease in glucocorticoid receptor (GR) expression, hastened degradation, and impaired sub cellular localization. Similarly, Histone Deacetylase 6 (HDAC6) expression was found to be regulated by Dex, co-localized with GR and this GR-HDAC6 complex occupied the promoter region of the osteoblast late marker osteocalcin (OCN). Combinatorial inhibition of HDAC6 and GR enhanced OCN expression. Together, the cross-talk between the Dex effector molecule GR and the inhibitory molecule HDAC6 provided mechanistic explanation of the bimodal effect of Dex during osteogenic differentiation of MSCs. These findings may provide new directions of research to combat glucocorticoid-induced osteoporosis.
Perceptual training yields rapid improvements in visually impaired youth
Authors: Nyquist Jeffrey B. , Lappin Joseph S. , Zhang Ruyuan , Tadin Duje 
Published: November 2016

AbstractVisual function demands coordinated responses to information over a wide field of view, involving both central and peripheral vision. Visually impaired individuals often seem to underutilize peripheral vision, even in absence of obvious peripheral deficits. Motivated by perceptual training studies with typically sighted adults, we examined the effectiveness of perceptual training in improving peripheral perception of visually impaired youth. Here, we evaluated the effectiveness of three training regimens: (1) an action video game, (2) a psychophysical task that combined attentional tracking with a spatially and temporally unpredictable motion discrimination task, and (3) a control video game. Training with both the action video game and modified attentional tracking yielded improvements in visual performance. Training effects were generally larger in the far periphery and appear to be stable 12 months after training. These results indicate that peripheral perception might be under-utilized by visually impaired youth and that this underutilization can be improved with only ~8 hours of perceptual training. Moreover, the similarity of improvements following attentional tracking and action video-game training suggest that well-documented effects of action video-game training might be due to the sustained deployment of attention to multiple dynamic targets while concurrently requiring rapid attending and perception of unpredictable events.
Determination of the electron-capture coefficients and the concentration of free electrons in GaN from time-resolved photoluminescence
Authors: Reshchikov M. A. , McNamara J. D. , Toporkov M. , Avrutin V. , Morkoç H. , Usikov A. , Helava H. , Makarov Yu. 
Published: November 2016

AbstractPoint defects in high-purity GaN layers grown by hydride vapor phase epitaxy are studied by steady-state and time-resolved photoluminescence (PL). The electron-capture coefficients for defects responsible for the dominant defect-related PL bands in this material are found. The capture coefficients for all the defects, except for the green luminescence (GL1) band, are independent of temperature. The electron-capture coefficient for the GL1 band significantly changes with temperature because the GL1 band is caused by an internal transition in the related defect, involving an excited state acting as a giant trap for electrons. By using the determined electron-capture coefficients, the concentration of free electrons can be found at different temperatures by a contactless method. A new classification system is suggested for defect-related PL bands in undoped GaN.
Functional defects in CD4+ CD25high FoxP3+ regulatory cells in ankylosing spondylitis
Authors: Guo Huifang , Zheng Ming , Zhang Kui , Yang Fengfan , Zhang Xin , Han Qing , Chen Zhi-Nan , Zhu Ping 
Published: November 2016

AbstractForkhead box P3 (FoxP3)-positive regulatory T cells (Tregs) play a pivotal role in the preservation of self-tolerance, and Treg dysfunction has been implicated in many autoimmune diseases. Whether and how Tregs participate in the pathogenesis of ankylosing spondylitis (AS) has not been fully elucidated. Here, we investigated Treg function and found that Tregs in peripheral blood (PB) from patients with active AS had lower FoxP3 mean fluorescence intensity (MFI) than those from healthy controls and could not fully suppress naïve T cell (Tn) proliferation. We also studied the mechanisms underlying PB Treg dysfunction in this context and found that PB Tregs failed to effectively utilize IL-2 and had relatively little STAT5 phosphorylation in active AS. Moreover, PB Tregs from patients with active AS exhibited greater CpG island methylation in the CNS2 region of the FOXP3 gene. Therefore, our findings indicate that functional defects in Tregs are present in AS. Abnormal IL-2 signalling and aberrant CNS2 epigenetic control induced functional defects in PB Tregs and represents a potential new mechanism for AS pathogenesis. These findings may aid the design of new treatment approaches for AS.
How a life-like system emerges from a simplistic particle motion law
Authors: Schmickl Thomas , Stefanec Martin , Crailsheim Karl 
Published: November 2016

AbstractSelf-structuring patterns can be observed all over the universe, from galaxies to molecules to living matter, yet their emergence is waiting for full understanding. We discovered a simple motion law for moving and interacting self-propelled particles leading to a self-structuring, self-reproducing and self-sustaining life-like system. The patterns emerging within this system resemble patterns found in living organisms. The emergent cells we found show a distinct life cycle and even create their own ecosystem from scratch. These structures grow and reproduce on their own, show self-driven behavior and interact with each other. Here we analyze the macroscopic properties of the emerging ecology, as well as the microscopic properties of the mechanism that leads to it. Basic properties of the emerging structures (size distributions, longevity) are analyzed as well as their resilience against sensor or actuation noise. Finally, we explore parameter space for potential other candidates of life. The generality and simplicity of the motion law provokes the thought that one fundamental rule, described by one simple equation yields various structures in nature: it may work on different time- and size scales, ranging from the self-structuring universe, to emergence of living beings, down to the emergent subatomic formation of matter.
Late Oligocene–Early Miocene magnetochronology of the mammalian faunas in the Lanzhou Basin–environmental changes in the NE margin of the Tibetan Plateau
Authors: Zhang Peng , Ao Hong , Dekkers Mark J. , Li Yongxiang , An Zhisheng 
Published: November 2016

AbstractA large number of terrestrial mammalian fossils were reported in the well-exposed Paleogene and Neogene fluvio-lacustrine strata in Western China. Their accurate ages are crucial to understand the mammalian and environmental evolution associated with the step-wise uplift of the Tibetan Plateau. At present their ages are surprisingly poorly constrained. Here, we present a high-resolution magnetostratigraphic dating of the Late Oligocene–Early Miocene mammal assemblages from a 233-m thick fluvio-lacustrine section in the Lanzhou Basin located at the northeastern margin of the Tibetan Plateau, China. The results suggest that the section spans from the polarity subchron C6Cn.2r to C5En, i.e. ranging from ca 23 to 18 Ma. This magnetochronology provides considerably more robust ages for three associated land mammalian faunal assemblages. Updated ages end the debate on existing ambiguous and distinctly different magnetostratigraphic correlations for those Late Oligocene–Early Miocene assemblages. The new ages now enable precise correlation of these faunas to the European Land Mammal and North American Land Mammal Ages. The faunal assemblages further suggest a mixed setting of woodlands and grasslands associated with a humid environment in the Lanzhou Basin during the Late Oligocene–Early Miocene, in contrast to its modern poor vegetation cover and arid environment.
Greater efficacy of atorvastatin versus a non-statin lipid-lowering agent against renal injury: potential role as a histone deacetylase inhibitor
Authors: Singh Ravi Shankar , Chaudhary Dharmendra Kumar , Mohan Aradhana , Kumar Praveen , Chaturvedi Chandra Prakash , Ecelbarger Carolyn M. , Godbole Madan M. , Tiwari Swasti 
Published: November 2016

AbstractStatins, 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitors have been shown to improve diabetic nephropathy. However, whether they provide protection via Histone deacetylases (HDAC) inhibition is not clear. We conducted a comparative evaluation of Atorvastatin (AT) versus the non-statin cholesterol-lowering drug, Ezetimibe (EZT) on severity of diabetic nephropathy. Streptozotocin-treated male Wistar rats were fed a cholesterol-supplemented diet and gavaged daily with vehicle, AT or EZT. Control rats received normal diet and gavaged vehicle (n = 8–9/group). Diabetes increased blood glucose, urine albumin-to-creatinine ratio (ACR), kidney pathology and HDAC activity, and reduced renal E-cadherin levels. Both AT and EZT reduced circulating cholesterol, attenuated renal pathology, and did not lower blood glucose. However, AT was significantly more effective than EZT at reducing kidney pathology and HDAC activity. Chromatin immunoprecipitation revealed a significantly higher association of acetylated H3 and H4 with the E-cadherin promoter in kidneys from AT-, relative to EZT- or vehicle-treated rats. Moreover, we demonstrated a direct effect of AT, but not EZT, on HDAC-inhibition and, H3 and H4- acetylation in primary glomerular mesangial cells. Overall, both AT and EZT attenuated diabetic nephropathy; however, AT exhibited greater efficacy despite a similar reduction in circulating cholesterol. HDAC-inhibition may underlie greater efficacy of statins in attenuating kidney injury.