bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endovascular occlusion of pial arteriovenous macrofistulae, using pCANvas1 and adenosine-induced asystole to control nBCA injection
Authors: Lylyk P , Chudyk J , Bleise C , Serna Candel C , Aguilar Pérez M , Henkes H 
Published: July 2017

Background In large-caliber pial macrofistulae (pMF), the combination of high blood flow velocity and large efferent artery diameter makes control over the endovascular vessel occlusion difficult and may result in the inadvertent venous passage of occlusive devices or embolic agents. Case descriptions Patient 1: A 27-year-old man presented with headache and ataxia. An infratentorial pMF supplied by both superior cerebellar arteries with venous ectasia was found. The first treatment attempt using balloons and coils failed since the position of either device could not be controlled because of a distal diameter of the feeding artery of 8 mm. In a second session a pCANvas1 (phenox) was deployed at the level of the arteriovenous connection and adenosine-induced asystole allowed the controlled injection of nBCA/Lipiodol with partial occlusion of the pMF. A remaining arteriovenous shunt was occluded under asystole in a third session. The procedures were well tolerated, the patient returned to normal and DSA confirmed the occlusion of the fistula. Patient 2: A 13-year-old boy with hereditary hemorrhagic teleangiectasia presented with an intracerebral hemorrhage from an aneurysm of the left MCA. Twelve weeks after the aneurysm treatment a feeding MCA branch (diameter 4.5 mm) of a right frontal pMF was catheterized. The macrofistula was occluded by deployment of a pCANvas1, followed by the injection of nBCAl/Lipiodol under adenosine-induced asystole. Conclusion pCANvas1 and adenosine-induced asystole allow a controlled injection of nBCA/Lipiodol for the endovascular occlusion of high-flow pMF without venous passage of the embolic agent.
Feasibility of two-dimensional speckle tracking in evaluation of arterial stiffness: Comparison with pulse wave velocity and conventional sonographic markers of atherosclerosis
Authors: Podgórski Michał , Grzelak Piotr , Kaczmarska Magdalena , Polguj Michał , Łukaszewski Maciej , Stefańczyk Ludomir 
Published: July 2017

Objective Arterial stiffening is an early marker of atherosclerosis that has a prognostic value for cardiovascular morbidity and mortality. Although many markers of arterial hardening have been proposed, the search is on for newer, more user-friendly and reliable surrogates. One such potential candidate has emerged from cardiology, the speckle-tracking technique. The aim of this study was to evaluate the feasibility of the two-dimensional speckle tracking for the evaluation of arterial wall stiffness in comparison with standard stiffness parameters. Methods Carotid ultrasound and applanation tonometry were performed in 188 patients with no cardiovascular risk factors. The following parameters were then evaluated: the intima-media complex thickness, distensibility coefficient, β-stiffness index, circumferential strain/strain rate, and pulse wave velocity and augmentation index. These variables were compared with each other and with patient age, and their reliability was assessed with Bland-Altman plots. Results Strain parameters derived from two-dimensional speckle tracking and intima-media complex thickness correlated better with age and pulse wave velocity than standard makers of arterial stiffness. Moreover, the reliability of these measurements was significantly higher than conventional surrogates. Conclusions Two-dimensional speckle tracing is a reliable method for the evaluation of arterial stiffness. Therefore, together with intima-media complex thickness measurement, it offers great potential in clinical practice as an early marker of atherosclerosis.
Economic Model Predictive Control of Bihormonal Artificial Pancreas System Based on Switching Control and Dynamic R-parameter
Authors: Tang Fengna , Wang Youqing 
Published: July 2017

Background: Blood glucose (BG) regulation is a long-term task for people with diabetes. In recent years, more and more researchers have attempted to achieve automated regulation of BG using automatic control algorithms, called the artificial pancreas (AP) system. In clinical practice, it is equally important to guarantee the treatment effect and reduce the treatment costs. The main motivation of this study is to reduce the cure burden. Methods: The dynamic R-parameter economic model predictive control (R-EMPC) is chosen to regulate the delivery rates of exogenous hormones (insulin and glucagon). It uses particle swarm optimization (PSO) to optimize the economic cost function and the switching logic between insulin delivery and glucagon delivery is designed based on switching control theory. Results: The proposed method is first tested on the standard subject; the result is compared with the switching PID and the switching MPC. The effect of the dynamic R-parameter on improving the control performance is illustrated by comparing the results of the EMPC and the R-EMPC. Finally, the robustness tests on meal change (size and timing), hormone sensitivity (insulin and glucagon), and subject variability are performed. All results show that the proposed method can improve the control performance and reduce the economic costs. Conclusions: The simulation results verify the effectiveness of the proposed algorithm on improving the tracking performance, enhancing robustness, and reducing economic costs. The method proposed in this study owns great worth in practical application.
Intercontinental validation of brain volume measurements using MSmetrix
Authors: Finkelsztejn Alessandro , Fragoso Yara Dadalti , Bastos Eder Amaral , Duarte Juliana Avila , Varela Juliana Santos , Houbrechts Ruben , Sima Diana , Van Hecke Wim 
Published: July 2017

Background Brain volume assessment has become an important outcome within research and treatment of multiple sclerosis (MS). MSmetrix (Icometrix) has been developed specifically for patients with MS. The original healthy, ‘normal’ population used for determination of the acceptable brain volume data consisted mainly of Europeans. Methods In the present study, results from 295 completely normal magnetic resonance imaging scans from Brazilian subjects were plotted against the original results in MSmetrix. Results With regard to whole brain volume, only 2% of the healthy adult subjects from Brazil were below the 5th percentile of the graph, and for grey matter volume, only 3% of the subjects were below the 5th percentile of MSmetrix standards. Conclusion MSmetrix may be used across different populations.
The attitudes and beliefs of doctors towards deprescribing medications
Authors: Nadarajan Krithikaa , Balakrishnan Tharmmambal , Yee Mei Ling , Soong Jie Lin 
Published: July 2017

Background: The effects of polypharmacy and its related adverse outcomes are well documented among elderly patients. Deprescribing is now recognised as an important part of medication review in addressing polypharmacy. However, little is currently known about local practices in discontinuing medications as a means to improve quality of life. There are two aims in this study: first, to explore the attitudes and beliefs of deprescribing medications among doctors in the Department of Internal Medicine (DIM) in Singapore General Hospital (SGH), and second, to see if differences exist among junior and senior doctors in their attitudes towards deprescribing. Methods: A descriptive survey was designed to look at the attitudes and beliefs of doctors towards deprescribing. All doctors in the department were invited to complete the survey. Results: The majority of doctors (66%) believed that deprescribing is beneficial for patients. Commonly cited barriers towards deprescribing were unwillingness to stop medications prescribed by another doctor, lack of time and insufficient knowledge. Lack of a specific approach to deprescribing was noted among 73% of the participants. A third of the juniors (32%) stated that they were reluctant to deprescribe medications, which was in contrast to the responses by the seniors, most of whom (94%) indicated no reluctance in deprescribing medications. Conclusion: Most doctors believe that deprescribing is beneficial to patients. Specific measures to target the barriers faced by doctors in deprescribing medications are necessary to improve deprescribing rates and minimising polypharmacy.
The Effect of Menstrual Cycle and Contraceptives on ACL Injuries and Laxity: A Systematic Review and Meta-analysis
Authors: Herzberg Simone D. , Motu’apuaka Makalapua L. , Lambert William , Fu Rongwei , Brady Jacqueline , Guise Jeanne-Marie 
Published: July 2017

Background: Women are at substantially greater risk for anterior cruciate ligament (ACL) injuries than are men. Purpose: To conduct a systematic review and meta-analysis of the literature to clarify the effect of the menstrual cycle and contraceptives on the laxity of and noncontact injuries to the ACL. Study Design: Systematic review; Level of evidence, 4. Methods: Searches were conducted using MEDLINE (1946–August 2016), the Cochrane Library Database, clinical trial registries, and related reference lists. Search terms included athletic injuries, knee injuries, ligaments, joint instability, menstrual cycle, ovulation, hormones, and contraceptives. Investigators independently dually abstracted and reviewed study details and quality using predefined criteria and evaluated overall strength of evidence using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria. Results: Twenty-one studies totaling 68,758 participants were included: 5 on the menstrual cycle and ACL injury, 7 on hormonal contraceptives and ACL injury, as well as 13 on menstrual cycle and ligament laxity. Four of 5 studies of women not using hormonal contraception indicated that the luteal phase was the least associated with ACL injuries. The 2 largest and highest quality studies on hormonal contraceptives suggested that hormonal contraceptives may be protective against ACL injury. Six of 12 studies on ACL laxity provided quantitative data for meta-analysis, finding significantly increased laxity during the ovulatory phase compared with the follicular phase. Conclusion: The literature suggests an association between hormonal fluctuations and ACL injury. Recent studies have suggested that oral contraceptives may offer up to a 20% reduction in risk of injury. The literature on ACL injuries and the menstrual cycle has more than doubled over the past decade, permitting quantitative analysis for the first time. However, the overall strength of this evidence is low. Promising potential directions for future research include long-term observational studies with ongoing hormonal assays and large interventional trials of follicular suppression, including newer hormonal methods.
Trilateral overlap of tuberculosis, diabetes and HIV-1 in a high-burden African setting: implications for TB control
Authors: Oni Tolu , Berkowitz Natacha , Kubjane Mmamapudi , Goliath Rene , Levitt Naomi S. , Wilkinson Robert J. 
Published: July 2017

The diabetes mellitus burden is growing in countries where tuberculosis (TB) and HIV-1 remain major challenges, threatening TB control efforts. This study determined the association between TB and diabetes/impaired glucose regulation in the context of HIV-1.A cross-sectional study was conducted at a TB clinic in Cape Town (South Africa). Participants were screened for diabetes and impaired glucose regulation using fasting plasma glucose, oral glucose tolerance test and glycated haemoglobin (HbA1c).414 TB and 438 non-TB participants were enrolled. In multivariable analysis, diabetes was associated with TB (OR 2.4, 95% CI 1.3–4.3; p=0.005), with 14% population-attributable risk fraction; however, this association varied by diagnostic test (driven by HbA1c). The association remained significant in HIV-1-infected individuals (OR 2.4, 95% CI 1.1–5.2; p=0.030). A high prevalence of impaired glucose regulation (65.2% among TB cases) and a significant association with TB (OR 2.3, 95% CI 1.6–3.3; p<0.001) was also found.Diabetes and impaired glucose regulation prevalence was high and associated with TB, particularly in HIV-1-infected individuals, highlighting the importance of diabetes screening. The variation in findings by diagnostic test highlights the need for better glycaemia markers to inform screening in the context of TB and HIV-1.
Automaticversusmanual oxygen administration in the emergency department
Authors: L'Her Erwan , Dias Patricia , Gouillou Maelenn , Riou Anne , Souquiere Luc , Paleiron Nicolas , Archambault Patrick , Bouchard Pierre-Alexandre , Lellouche François 
Published: July 2017

Oxygen is commonly administered in hospitals, with poor adherence to treatment recommendations.We conducted a multicentre randomised controlled study in patients admitted to the emergency department requiring O2≥3 L·min−1. Patients were randomised to automated closed-loop or manual O2titration during 3 h. Patients were stratified according to arterial carbon dioxide tension (PaCO2) (hypoxaemicPaCO2≤45 mmHg; or hypercapnicPaCO2>45–≤55 mmHg) and study centre. Arterial oxygen saturation measured by pulse oximetry (SpO2) goals were 92–96% for hypoxaemic, or 88–92% for hypercapnic patients. Primary outcome was % time withinSpO2target. Secondary endpoints were hypoxaemia and hyperoxia prevalence, O2weaning, O2duration and hospital length of stay.187 patients were randomised (93 automated, 94 manual) and baseline characteristics were similar between the groups. Time within theSpO2target was higher under automated titration (81±21%versus51±30%, p<0.001). Time with hypoxaemia (3±9%versus5±12%, p=0.04) and hyperoxia under O2(4±9%versus22±30%, p<0.001) were lower with automated titration. O2could be weaned at the end of the study in 14.1%versus4.3% patients in the automated and manual titration group, respectively (p<0.001). O2duration during the hospital stay was significantly reduced (5.6±5.4versus7.1±6.3 days, p=0.002).Automated O2titration in the emergency department improved oxygenation parameters and adherence to guidelines, with potential clinical benefits.
Non-invasive sub-surface analysis of the male portrait underlying the Titian’s Studio Ecce Homo
Authors: Gasanova Svetlana , Bakirtzis Nikolas , Hermon Sorin 
Published: July 2017

Abstract
The present study discusses new research on the analysis of a portrait of a male figure discovered under the painting of Ecce Homo, attributed to the studio of Titian (ca. 1488–1576), with an estimated date in the 1550s. The portrait was examined with non-invasive methods: X-ray radiography (XRR), digital microscopy and micro-XRF. The examination of XRR images exposed the details of the painting’s underlying depiction, which according to the details preserved appears to be a completed or nearly finished portrait of a standing man. The application of digital microscopy on the Ecce Homo painting’s cracks enabled the identification of the work’s stratigraphy. Micro-XRF performed on selected spots allowed to identify lead white, vermilion, red iron oxide, umber, carbon black and copper green in the underlying portrait. The described investigation methodology was guided by the close visual analysis of the Ecce Homo work and proved to be effective in the identification of the pigments of the hidden painting and the reconstruction of its colour palette.
The θ-defensin retrocyclin 101 inhibits TLR4- and TLR2-dependent signaling and protects mice against influenza infection
Authors: Prantner Daniel , Shirey Kari Ann , Lai Wendy , Lu Wuyuan , Cole Alexander M , Vogel Stefanie N , Garzino-Demo Alfredo 
Published: July 2017

AbstractDespite widespread use of annual influenza vaccines, seasonal influenza-associated deaths number in the thousands each year, in part because of exacerbating bacterial superinfections. Therefore, discovering additional therapeutic options would be a valuable aid to public health. Recently, TLR4 inhibition has emerged as a possible mechanism for protection against influenza-associated lethality and acute lung injury. Based on recent data showing that rhesus macaque θ-defensins could inhibit TLR4-dependent gene expression, we tested the hypothesis that a novel θ-defensin, retrocyclin (RC)-101, could disrupt TLR4-dependent signaling and protect against viral infection. In this study, RC-101, a variant of the humanized θ-defensin RC-1, blocked TLR4-mediated gene expression in mouse and human macrophages in response to LPS, targeting both MyD88- and TRIF-dependent pathways. In a cell-free assay, RC-101 neutralized the biologic activity of LPS at doses ranging from 0.5 to 50 EU/ml, consistent with data showing that RC-101 binds biotinylated LPS. The action of RC-101 was not limited to the TLR4 pathway because RC-101 treatment of macrophages also inhibited gene expression in response to a TLR2 agonist, Pam3CSK4, but failed to bind that biotinylated agonist. Mouse macrophages infected in vitro with mouse-adapted A/PR/8/34 influenza A virus (PR8) also produced lower levels of proinflammatory cytokine gene products in a TLR4-independent fashion when treated with RC-101. Finally, RC-101 decreased both the lethality and clinical severity associated with PR8 infection in mice. Cumulatively, our data demonstrate that RC-101 exhibits therapeutic potential for the mitigation of influenza-related morbidity and mortality, potentially acting through TLR-dependent and TLR-independent mechanisms.
Targeting C-type lectin receptors: a high-carbohydrate diet for dendritic cells to improve cancer vaccines
Authors: van Dinther Dieke , Stolk Dorian A , van de Ven Rieneke , van Kooyk Yvette , de Gruijl Tanja D , den Haan Joke M M 
Published: July 2017

Abstract
There is a growing understanding of why certain patients do or do not respond to checkpoint inhibition therapy. This opens new opportunities to reconsider and redevelop vaccine strategies to prime an anticancer immune response. Combination of such vaccines with checkpoint inhibitors will both provide the fuel and release the brake for an efficient anticancer response. Here, we discuss vaccine strategies that use C-type lectin receptor (CLR) targeting of APCs, such as dendritic cells and macrophages. APCs are a necessity for the priming of antigen-specific cytotoxic and helper T cells. Because CLRs are natural carbohydrate-recognition receptors highly expressed by multiple subsets of APCs and involved in uptake and processing of Ags for presentation, these receptors seem particularly interesting for targeting purposes.
Influence of childhood trauma on diagnosis and substance use in first-episode psychosis
Authors: Tomassi S. , Tosato S. , Mondelli V. , Faravelli C. , Lasalvia A. , Fioravanti G. , Bonetto C. , Fioritti A. , Cremonese C. , Parrino R. Lo , De Santi K. , Meneghelli A. , Torresani S. , De Girolamo G. , Semrov E. , Pratelli M. , Cristofalo D. ,   the GET UP Group
Published: July 2017

BackgroundChildhood trauma has been significantly associated with first-episode psychosis, affective dysfunction and substance use.AimsTo test whether people with first-episode psychosis who had experienced childhood trauma, when compared with those who had not, showed a higher rate of affective psychosis and an increased lifetime rate of substance use.MethodThe sample comprised 345 participants with first-episode psychosis (58% male, mean age 29.8 years, s.d.=9.7).ResultsSevere sexual abuse was significantly associated with a diagnosis of affective psychosis (χ2=4.9,P=0.04) and with higher rates of lifetime use of cannabis (68%v.41%;P= 0.02) and heroin (20%v.5%;P=0.02). Severe physical abuse was associated with increased lifetime use of heroin (15%v.5%;P= 0.03) and cocaine (32%v.17%;P= 0.05).ConclusionsPatients with first-episode psychosis exposed to childhood trauma appear to constitute a distinctive subgroup in terms of diagnosis and lifetime substance use.
Frailty and emergency surgery in the elderly: Protocol of a prospective, multicenter study in Italy for evaluating perioperative outcome (The FRAILESEL Study)
Authors: Costa Gianluca , Massa Giulia , Balducci Genoveffa , Frezza Barbara , Fransvea Pietro , Nigri Giuseppe , Franco Stagnitti , Miniello Stefano , Zago Mauro , Marzaioli Rinaldo , Piazza Diego , Marini Pierluigi , Agresta Ferdinando , Luridiana Gianluigi , Crucitti Antonio , Palumbo Piergaspare , Gabrielli Francesco , Sandrucci Sergio , Ansaloni Luca , Catena Fausto , Chiara Osvaldo , Coccolini Federico , Spagnoli Alessandra ,   ERASO (Elderly Risk Assessment And Surgical Outcome) Collaborative Study Group
Published: July 2017

Introduction: Improvements in living conditions and progress in medical management have resulted in better ​quality of life and longer life expectancy. Therefore, the number of older people undergoing surgery is increasing. Frailty is often described as a syndrome in aged patients where there is augmented vulnerability due to progressive loss of functional reserves. Studies suggest that frailty predisposes elderly to worsening outcome after surgery. Since emergency surgery is associated with higher mortality rates, it is paramount to have an accurate stratification of surgical risk in such patients. The aim of our study is to characterize the clinico-pathological findings, management, and short-term outcome of elderly patients undergoing emergency surgery. The secondary objectives are to evaluate the presence and influence of frailty and analyze the prognostic role of existing risk-scores. The final FRAILESEL protocol was approved by the Ethical Committee of “Sapienza” University of Rome, Italy. Methods and analysis: The FRAILESEL study is a nationwide, Italian, multicenter, observational study conducted through a resident-led model. Patients over 65 years of age who require emergency surgical procedures will be included in this study. The primary outcome measures are 30-day postoperative mortality and morbidity rates. The Clavien-Dindo classification system will be used to categorize complications. Secondary outcome measures include length of hospital stay, length of stay in intensive care unit, and the predictive value for morbidity and mortality of several frailty and surgical risk scores. The results of the FRAILESEL study will be disseminated through national and international conference presentations and peer-reviewed journals. The study is also registered at ClinicalTrials.gov (ClinicalTrials.gov Identifier: NCT02825082).