bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Transapical Approach for Prosthetic Mitral Paravalvular Leak Closure: Early Results
Authors: Aydin Unal , Sen Onur , Kadirogullari Ersin , Onan Burak , Yildirim Aydin , Bakir Ihsan 
Published: November 2016

AbstractThe objective is to demonstrate safety and early clinical results of surgical transapical closure of paravalvular leaks (PVLs) following mitral valve replacement in significant regurgitation. Between March 2014 and February 2015, 12 patients (mean age 52.1 ± 6.0 years, 66.6% male) with severe symptomatic mitral PVLs (n = 13) underwent surgical transapical closure procedure through left mini‐thoracotomy. All patients were in NYHA functional class III–IV and median logistic EuroSCORE was 24.2 ± 6.4% (range, 13.5–34.6%). Indications were heart failure (n = 10) and symptomatic hemolysis (n = 2) due to severe mitral regurgitation (MR). Amplatzer Vascular Plug‐III devices (n = 9) were used for smaller and regular defects; whereas Atrial Septal Defect closure devices (n = 4) were used for larger defects. Technical success was achieved in 10 (83.3%) patients. One (8.5%) patient with 2 + MR was treated medically. A patient with residual 4 + MR underwent re‐operation. There was no procedure‐related complication including mortality, device migration, embolization, or cardiac laceration. Mean procedure and fluoroscopy times were 166.4 ± 39.5 (range, 90–210) and 25.7 ± 17.3 (range, 16–64) minutes, respectively. The mean intensive care and hospital stays were 2.1 ± 1.3 and 10.3 ± 6.5 days, respectively. Clinical efficacy was achieved in 9 (75%) of 12 patients at early follow‐up of 8.5 ± 2.1 months. NYHA status was class II in two patients, and no hemolytic anemia was diagnosed. Echocardiographic studies revealed a significant reduction of preoperative MR (3–4+) to less than 1+ MR after operations (P < 0.05). Surgical transapical approach to PVL closure is a safe and effective procedure following mitral valve replacement. Early results show that this procedure can be an alternative to re‐operation for high‐risk patients. Further studies are needed to prove its effectiveness in the long term.
Interferon‐free regimens improve portal hypertension and histological necroinflammation in HIV/HCV patients with advanced liver disease
Authors: Schwabl P. , Mandorfer M. , Steiner S. , Scheiner B. , Chromy D. , Herac M. , Bucsics T. , Hayden H. , Grabmeier‐Pfistershammer K. , Ferlitsch A. , Oberhuber G. , Trauner M. , Peck‐Radosavljevic M. , Reiberger T. 
Published: November 2016

SummaryBackgroundHIV/HCV co‐infected patients show accelerated fibrosis progression and higher risk for complications of portal hypertension (PHT).AimTo assess the effects of interferon‐free therapy on portal pressure, liver histology and plasma biomarkers in HIV/HCV‐coinfected patients with PHT.MethodsTwenty‐two patients with paired hepatic venous pressure gradient (HVPG) measurements prior and after successful treatment (SVR) with interferon‐free regimens were included. Liver stiffness was assessed by transient elastography and biopsies were scored according to METAVIR. Plasma biomarkers were determined by ELISA.ResultsOverall, HVPG decreased from 10.7 ± 4.1 mmHg at baseline to 7.4 ± 4.2 mmHg after HCV treatment (Δ:‐3.3 ± 2.7 mmHg; p < 0.001). In patients with clinically significant PHT (HVPG≥10 mmHg, n = 11), HVPG decreased from 14.1 ± 2.9 to 10.4 ± 3.9 mmHg (Δ:‐3.7 ± 3.3 mmHg; p = 0.004) and a haemodynamic response (HVPG decrease ≥10%) was observed in 73%. In 64% of patients with subclinical PHT (HVPG 6–9 mmHg, n = 11), portal pressure normalised at SVR. Mean liver stiffness decreased from 20.8 kPa to 11.5 kPa (Δ:‐8.8 ± 7.4 kPa; p < 0.001). Fifty percent (7/14) of patients with cirrhosis were re‐classified as METAVIR ≤F3 and all patients with decompensated cirrhosis improved their Child–Pugh stage. After successful HCV treatment, 39% still had persistent histological necroinflammatory activity (METAVIR A1), which correlated with less HVPG response and more steatosis. While most biomarkers improved with SVR, METAVIR A1 patients had significantly higher plasma levels of fibrogenic (PDGF, TGF‐β) and angiogenic (VEGF, Angiopoietin1) biomarkers.ConclusionsInterferon‐free therapy reduces PHT and halts histological necroinflammatory activity in the majority of HIV/HCV‐coinfected patients after SVR, which may lead to re‐compensation of liver function in cirrhosis. Biomarkers could identify patients with persisting hepatic necroinflammation.
In vitro ruminal fermentation and in situ ruminal degradation of tamarind kernel powder extract residue in wethers
Authors: Wang Lin , Oishi Kazato , Sato Yoshiaki , Nakanishi Takashi , Hirooka Hiroyuki , Takahashi Kei , Kumagai Hajime 
Published: November 2016

AbstractWe examined the in vitro fermentation characteristics and in situ dry matter (DM) and crude protein (CP) degradability of tamarind kernel powder extract residue (TKPER), a by‐product of polysaccharides thickener processing. Two types of TKPER (I and II), of which the CP and neutral detergent fiber organic matter basis contents (%) were 41.4 and 42.0 and 1.4 and 0.5, respectively, were compared with dry heat soybean (SB), soybean meal (SBM) and dry soybean curd residue (SBCR). The TKPERs had significantly lower in vitro gas production compared to the other products at each observation time (P < 0.05). The in vitro DM and CP digestibility (%) of TKPER I and II were 67.7 and 64.9, and 64.5 and 58.0, respectively, significantly lower than those of SB and SBM (P < 0.05). We used four wethers (55.6 ± 4.6 kg) with ruminal cannulas to investigate the in situ degradability of TKPER I, SB, SBM and SBCR. At the ruminal outflow rate of 0.05/h, the effective degradability (%) values of the DM and CP of TKPER I were 64.1 and 49.7, respectively, which were similar to those of SBM. In conclusion, TKPER had high CP and exhibited in situ degradability similar to that of SBM, suggesting that TKPER could be used as a protein source feed.
Venlafaxine and oxycodone have different effects on spinal and supraspinal activity in man: a somatosensory evoked potential study
Authors: Lelic Dina , Valeriani Massimiliano , Fischer Iben W. D. , Dahan Albert , Drewes Asbjørn M. 
Published: November 2016

AimsOpioids and antidepressants that inhibit serotonin and norepinephrine reuptake (SNRI) are recognized as analgesics to treat severe and moderate pain, but their mechanisms of action in humans remain unclear. The present study aimed to explore how oxycodone (an opioid) and venlafaxine (an SNRI) modulate spinal and supraspinal sensory processing.MethodsTwenty volunteers were included in a randomized, double‐blinded, three‐way (placebo, oxycodone, venlafaxine), crossover study. Spinal and full scalp cortical evoked potentials (EPs) to median nerve stimulation were recorded before and after 5 days of treatment. Assessment of the central effects of the three treatments involved: (i) amplitudes and latencies of spinal EPs (spinal level); (ii) amplitudes and latencies of the P14 potential (subcortical level); (iii) amplitudes and latencies of early and late cortical EPs (cortical level); (iv) brain sources underlying early cortical Eps; and (v) brain networks underlying the late cortical EPs.ResultsIn the venlafaxine arm, the spinal P11 and the late cortical N60–80 latencies were reduced by 1.8% [95% confidence interval (CI) 1.7%, 1.9%) and 5.7% (95% CI 5.3%, 6.1%), whereas the early cortical P25 amplitude was decreased by 7.1% (95%CI 6.1%, 8.7%). Oxycodone increased the subcortical P14 [+25% (95% CI 22.2%, 28.6%)], early cortical N30 [+12.9% (95% CI 12.5%, 13.2%)] amplitudes and the late cortical N60–80 latency [+2.9% (95% CI 1.9%, 4.0%)]. The brainstem and primary somatosensory cortex source strengths were increased by 66.7% (95% CI 62.5%, 75.0%) and 28.8% (95% CI 27.5%, 29.6%) in the oxycodone arm, whereas the primary somatosensory cortex strength was decreased in the venlafaxine arm by 18.3% (95% CI 12.0%, 28.1%).ConclusionsOpioids and SNRI drugs exert different central effects. The present study contributed to the much‐needed human models of the mechanisms of action of drugs with effects on the central nervous system.
A prospective and randomised trial comparing fluoroscopic, total ultrasonographic, and combined guidance for renal access in mini‐percutaneous nephrolithotomy
Authors: Zhu Wei , Li Jiasheng , Yuan Jian , Liu Yongda , Wan Shaw P. , Liu Guanzhao , Chen Wenzhong , Wu Wenqi , Luo Jintai , Zhong Dongliang , Qi Defeng , Lei Ming , Zhong Wen , Zhang Ze , He Zhaohui , Zhao Zhijian , Lu Suilin , Wu Yuji , Zeng Guohua 
Published: November 2016

ObjectiveTo compare the safety and efficacy of fluoroscopic guidance (FG), total ultrasonographic guidance (USG), and combined ultrasonographic and fluoroscopic guidance (CG) for percutaneous renal access in mini‐percutaneous nephrolithotomy (mini‐PCNL).Patients and methodsThe present study was conducted between July 2014 and May 2015 as a prospective randomised trial at the First Affiliated Hospital of Guangzhou Medical University. In all, 450 consecutive patients with renal stones of >2 cm were randomised to undergo FG, USG, or CG mini‐PCNL (150 patients for each group). The primary endpoints were the stone‐free rate (SFR) and blood loss (haemoglobin decrease during the operation and transfusion rate). Secondary endpoints included access failure rate, operating time, and complications. S.T.O.N.E. score was used to document the complexity of the renal stones. The study was registered at http://clinicaltrials.gov/ (NCT02266381).ResultsThe three groups had similar baseline characteristics. With S.T.O.N.E. scores of 5–6 or 9–13, the SFRs were comparable between the three groups. For S.T.O.N.E. scores of 7–8, FG and CG achieved significantly better SFRs than USG (one‐session SFR 85.1% vs 88.5% vs 66.7%, P = 0.006; overall SFR at 3 months postoperatively 89.4% vs 90.2% vs 69.8%, P = 0.002). Multiple‐tracts mini‐PCNL was used more frequently in the FG and CG groups than in the USG group (20.7% vs 17.1% vs 9.5%, P = 0.028). The mean total radiation exposure time was significantly greater for FG than for CG (47.5 vs 17.9 s, P < 0.001). The USG had zero radiation exposure. There was no significant difference in the haemoglobin decrease, transfusion rate, access failure rate, operating time, nephrostomy drainage time, and hospital stay among the groups. The overall operative complication rates using the Clavien–Dindo grading system were similar between the groups.ConclusionsMini‐PCNL under USG is as safe and effective as FG or CG in the treatment of simple kidney stones (S.T.O.N.E. scores 5–6) but with no radiation exposure. FG or CG is more effective for patients with S.T.O.N.E. scores of 7–8, where multiple percutaneous tracts may be necessary.
Robot‐assisted partial nephrectomy: continued refinement of outcomes beyond the initial learning curve
Authors: Paulucci David J. , Abaza Ronney , Eun Daniel D. , Hemal Ashok K. , Badani Ketan K. 
Published: November 2016

ObjectivesTo evaluate trends in peri‐operative outcomes of 250 consecutive cases beyond the initial learning curve (LC) of robot‐assisted partial nephrectomy (RAPN) among multiple surgeons.Patients and MethodsA multi‐institutional database was used to evaluate trends in patient demographics (e.g. age, gender, comorbidities), tumour characteristics (e.g. size, complexity) and peri‐operative outcomes (e.g. warm ischaemia time [WIT], operating time, complications, estimated blood loss [EBL], trifecta achievement) in consecutive cases 50–300 (n = 960) from 2008 to 2016 among four experienced surgeons. Trends in outcomes were assessed using multivariable regression models adjusted for demographic and tumour‐specific variables. Outcomes for cases 50–99 were compared with those for cases 250–300.ResultsIn the study period RAPN was increasingly performed in patients with larger tumours (β = 0.001, P = 0.048), hypertension (odds ratio [OR] 1.003; P = 0.008) diabetes (OR 1.003; P = 0.025) and previous abdominal surgery (OR 1.003; P = 0.006). Surgeon experience was associated with more trifecta achievement (OR 1.006; P < 0.001), shorter WIT (β = −0.036, P < 0.001), less EBL (β = −0.154, P = 0.009), fewer blood transfusions (OR 0.989, P = 0.024) and a reduced length of hospital stay (β = −0.002, P = 0.002), but not with operating time (P = 0.243), complications (P = 0.587) or surgical margin status (P = 0.102). Tumour size and WIT in cases 50–99 vs 250–300 were 2.7 vs 3.2 cm (P = 0.001) and 21.4 vs 16.2 min (P < 0.001), respectively.ConclusionRefinement of RAPN outcomes, concomitant with the treatment of a patient population with larger tumours and more comorbidities, occurs after the initial LC is reached. Although RAPN can consistently be performed safely with acceptable outcomes after a small number of cases, improvement in trifecta achievement, WIT, EBL, blood transfusions and a shorter hospitalization continues to occur up to 300 procedures.
New age constraints from the SW Baltic Sea area – implications for Scandinavian Ice Sheet dynamics and palaeo‐environmental conditions during MIS 3 and early MIS 2
Authors: Kenzler Michael , Tsukamoto Sumiko , Meng Stefan , Frechen Manfred , Hüneke Heiko 
Published: November 2016

The study of two cliff outcrops from the Jasmund Peninsula provides new information on the ice‐sheet dynamics and palaeo‐environmental conditions during MIS 3 and the ensuing transition to MIS 2 in the southwestern Baltic Sea region. We identified interstadial fluvial sediments, with mollusc and vertebrate fauna, which were deposited between 47 and 42 ka in a steppe‐like landscape. A subsequent cooling phase led to the formation of a proglacial lake, between 30 and 22 ka, indicated by varve‐like, rhythmically bedded silty clay. This proglacial lake formation can be correlated to the blocking of the Baltic Basin by the Kattegat ice advance, previously dated to c. 29–26 ka. The transition from proglacial to terminoglacial lacustrine deposits reflects the immediate advance of the Scandinavian Ice Sheet (SIS) into the study area after the transition from MIS 3 to early MIS 2. The SIS finally reached the area at 23±2 ka (Brandenburgian phase; advance from the northeast). A subsequent ice retreat accompanied by the deposition of meltwater sediments was followed by a re‐advance of the SIS, resulting in a glaciotectonic deformation event across the study area. The age control for our study is based on optically stimulated luminescence (OSL). The investigated Pleistocene sediments show ice‐free conditions during MIS 3 and early MIS 2, indicating that neither the Ristinge nor the Klintholm advance reached the SW Baltic Sea coast of Jasmund.
Synthesis and anticholinesterase activity of new substituted benzo[d]oxazole‐based derivatives
Authors: Pouramiri Behjat , Moghimi Setareh , Mahdavi Mohammad , Nadri Hamid , Moradi Alireza , Tavakolinejad‐Kermani Esmat , Firoozpour Loghman , Asadipour Ali , Foroumadi Alireza 
Published: November 2016

A series of novel benzo[d]oxazole derivatives (6a–n) have been synthesized and biologically evaluated as potential inhibitors of acetylcholinesterases (AChE) and butyrylcholinesterase (BChE). The chemical structures of all final compounds were confirmed by spectroscopic methods. In vitro studies showed that most of the synthesized compounds are potent acetylcholinesterase and butyrylcholinesterase inhibitors. Among them, compounds 6a and 6j strongly inhibited AChE and BChE activities with IC50 values of 1.03–1.35 and 6.6–8.1 μm, respectively. Docking studies also provided the binding modes of action and identified hydrophobic pi forces as the main interaction.
Producing Spatial Words Is Not Enough: Understanding the Relation Between Language and Spatial Cognition
Authors: Miller Hilary E. , Vlach Haley A. , Simmering Vanessa R. 
Published: November 2016

Prior research has investigated the relation between children's language and spatial cognition by assessing the quantity of children's spatial word production, with limited attention to the context in which children use such words. This study tested whether 4‐year‐olds children's (N = 41, primarily white middle class) adaptive use of task‐relevant language across contexts predicted their spatial skills. Children were presented with a spatial scene description task, four spatial tasks, and vocabulary assessments. Children's adaptive use of task‐relevant language was more predictive of their spatial skills than demographic and language factors (e.g., quantity of spatial words produced). These findings identify new links between language and spatial cognition and highlight the importance of understanding the quality, not just quantity, of children's language use.
Scoring system for the diagnosis of bilateral primary aldosteronism in the outpatient setting before adrenal venous sampling
Authors: Kobayashi Hiroki , Haketa Akira , Ueno Takahiro , Ikeda Yukihiro , Hatanaka Yoshinari , Tanaka Sho , Otsuka Hiromasa , Abe Masanori , Fukuda Noboru , Soma Masayoshi 
Published: November 2016

SummaryObjectiveThe only reliable method for subtyping primary aldosteronism (PA) is adrenal venous sampling (AVS), which is costly and time‐consuming. Considering the limited availability of AVS, it would be helpful to obtain information on the diagnosis of bilateral hyperaldosteronism (BHA) from routine tests. We aimed to establish new, simple criteria for outpatients to diagnose BHA from PA before AVS.DesignWe retrospectively analysed 82 patients who were diagnosed with PA and underwent AVS. Thirty‐seven patients were diagnosed with unilateral hyperaldosteronism (UHA), and 36 with BHA and nine were undetermined. Among the variables that were significantly different between UHA and BHA in the univariate analysis, we chose three variables to be included in multivariate logistic regression models and constructed a subtype prediction score.ResultsThe subtype prediction score was calculated as follows: 3 points for no adrenal nodules on computed tomography imaging, 2 for serum potassium of ≥3·5 mmol/l and 2 for aldosterone‐to‐renin ratio of <490 after a captopril challenge test. Receiver operating characteristic curve analysis for the ability to discriminate BHA from UHA showed that a score of 7 points had 50% sensitivity and 100% specificity and a score of 5 points had 67% sensitivity and 94% specificity (area under the curve: 0·922; 95% CI: 0·863–0·980).ConclusionsOur new, simple criteria specifically distinguished BHA from UHA in the outpatient setting before AVS. Furthermore, not only endocrinologists but also general internists can use this convenient, safe scoring system.
Informing Strategic Efforts to Expand and Connect Protected Areas Using a Model of Ecological Flow, with Application to the Western United States
Authors: Dickson Brett G. , Albano Christine M. , McRae Brad H. , Anderson Jesse J. , Theobald David M. , Zachmann Luke J. , Sisk Thomas D. , Dombeck Michael P. 
Published: November 2016

AbstractUnder rapid landscape change, there is a significant need to expand and connect protected areas (PAs) to prevent further loss of biodiversity and preserve ecological functions across broad geographies. We used a model of landscape resistance and electronic circuit theory to estimate patterns of ecological flow among existing PAs in the western United States. We applied these results to areas previously identified as having high conservation value to distinguish those best positioned to maintain and enhance ecological connectivity and integrity. We found that current flow centrality was highest and effective resistance lowest in areas that spanned the border between southern Oregon and Idaho, and in northern Arizona and central Utah. Compared to other federal jurisdictions, Bureau of Land Management lands contributed most to ecological connectivity, forming “connective tissue” among existing PAs. Our models and maps can inform new conservation strategies and critical land allocation decisions, within or among jurisdictions.
Occupied! Property, Citizenship and Peasant Movements in Rural Java
Authors: Lund Christian , Rachman Noer Fauzi 
Published: November 2016

ABSTRACTRecent land occupations by peasant movements in Indonesia have done more than challenge the existing ownership of plantations and forests. They have restructured local property and authority relations by stimulating a strategic critique of public authority and governance practice within the peasant movement. ‘Plantation’ and ‘forest’ are structured under different legal regimes and institutional arrangements, which offer varied opportunities for occupation and subsequent legalization of smallholder land control. Different strategies of occupation and interaction with plantation and forest companies have therefore been pursued. However, legalization of land occupations has remained rudimentary, and possession has not been recognized as property by government institutions. Two cases of occupation history demonstrate in detail how claims to citizenship and property have been opposed, ignored and denied by statutory institutions. Furthermore, they demonstrate how land‐occupying farmers have attempted to become ‘visible’ to and recognized by government institutions, and how — while waiting for this to happen — the peasant movement experiences a sovereign moment.
Making Territory: War, Post‐war and the Entangled Scales of Contested Forest Governance in Mid‐Western Nepal
Authors: Byrne Sarah , Nightingale Andrea J. , Korf Benedikt 
Published: November 2016

ABSTRACTRuptures that constitute exceptional events in national politics intersect in different ways with local politics, where more ongoing, continuous processes of both contestation and conservation around natural resource use may persist amidst a turbulent political landscape on other scales. Nepal, with its series of unfinished revolutions, civil war (1996–2006), and recurrently contested process of state (trans‐)formation, is a case in point. Through a study of a contested forest in mid‐western Nepal, this article analyses the entanglement of rupture and realignment of contentious claims to political authority across different scales, as well as the continuities of negotiations over claims to recognition of forest use and citizenship rights. The authors analyse some of the messy and complex practices through which authority to govern forests is claimed and legitimated, and citizenship rights are asserted and defined. They show that while political ruptures caused by the war and post‐war dynamics unsettle and reshuffle the political terrain, claims to citizenship and property rights endure, even if the language and form of the claim are adapted. These claims are embedded within existing jurisdictions but, at the same time, actors lay claims to property and citizenship rights by working across scales and re‐negotiating their boundaries. ‘Making territory’, the authors conclude, is the effect of the entanglement of these different territorial politics and practices.