bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multipolar pacing by cardiac resynchronization therapy with a defibrillators treatment in type 2 diabetes mellitus failing heart patients: impact on responders rate, and clinical outcomes
Authors: Sardu Celestino , Barbieri Michelangela , Santamaria Matteo , Giordano Valerio , Sacra Cosimo , Paolisso Pasquale , Spirito Alessandro , Marfella Raffaele , Paolisso Giuseppe , Rizzo Maria Rosaria 
Published: June 2017

Abstract
Background
Type 2 diabetes mellitus (T2DM) is a multi factorial disease, affecting clinical outcomes in failing heart patients treated by cardiac resynchronization therapy with a defibrillator (CRT-d).

Methods
One hundred and ninety-five T2DM patients received a CRT-d treatment. Randomly the study population received a CRT-d via multipolar left ventricle (LV) lead pacing (n 99, multipolar group), vs a CRT-d via bipolar LV pacing (n 96, bipolar group). These patients were followed by clinical, and instrumental assessment, and telemetric device control at follow up. In this study we evaluated, in a population of failing heart T2DM patients, cardiac deaths, all cause deaths, arrhythmic events, CRT-d responders rate, hospitalizations for HF worsening, phrenic nerve stimulation (PNS), and LV catheter dislodgment events (and re-intervention for LV catheter re-positioning), comparing multipolar CRT-d vs bipolar CRT-d group of patients at follow up.

Results
At follow up there was a statistical significant difference about atrial arrhythmic events [7 (7%) vs 16 (16.7%), p value 0.019], hospitalizations for HF worsening [15 (15.2% vs 24 (25%), p value 0.046], LV catheter dislodgments [1 (1%) vs 9 (9.4%), p value 0018], PNS [5 (5%) vs 18 (18.7%), p value 0.007], and LV re-positioning [1 (1%) vs 9 (9.4%), p value 0.018], comparing multipolar CRT-d vs bipolar CRT-d group of patients. Multipolar pacing was an independent predictor of all these events.

Conclusions
CRT-d pacing via multipolar LV lead vs bipolar LV lead may reduce arrhythmic burden, hospitalization rate, PNS, LV catheters dislodgments, and re-interventions in T2DM failing heart patients.
Clinical trial number NCT03095196
Success in bone marrow failure? Novel therapeutic directions based on the immune environment of myelodysplastic syndromes
Authors: Cull Alyssa H , Rauh Michael J 
Published: June 2017

Abstract
Myelodysplastic syndromes (MDS) are clonal neoplasms of aging that are associated with BM failure, related cytopenias, fatigue, susceptibility to infections, bruising, bleeding, a shortened lifespan, and a propensity for leukemic transformation. Most frail, elderly patients are not candidates for curative allogeneic BM transplantations and instead receive expectant management, supportive blood transfusions, or empirical, nontargeted therapy. It has been known for some time that MDS arises in an abnormal BM immune environment; however, connections have only recently been established with recurring MDS-associated mutations. Understanding how mutant clones alter and thrive in the immune environment of marrow failure at the expense of normal hematopoiesis opens the door to novel therapeutic strategies that are aimed at restoring immune and hematopoietic balance. Several examples are highlighted in this review. Haploinsufficiency of microRNAs 145 and 146a in MDS with chromosome 5q deletions leads to derepression of TLR4 signaling, dysplasia, and suppression of normal hematopoiesis. Moreover, mutations of TET2 or DNMT3A—regulators of cytosine methylation—are among the earliest in myeloid cancers and are even found in healthy adults with cryptic clonal hematopoiesis. In innate immune cells, TET2 and DNMT3A mutations impair the resolution of inflammation and production of type I IFNs, respectively. Finally, a common result of MDS-associated mutations is the inappropriate activation of the NLRP3 inflammasome, with resultant pyroptotic cell death, which favors mutant clone expansion. In summary, MDS-associated mutations alter the BM immune environment, which provides a milieu that is conducive to clonal expansion and leukemic progression. Restoring this balance may offer new therapeutic avenues for patients with MDS.
Anesthetic and Obstetric Management of Syringomyelia During Labor and Delivery: A Case Series and Systematic Review
Authors: Garvey Gráinne Patricia , Wasade Vibhangini S. , Murphy Kellie E. , Balki Mrinalini 
Published: June 2017

BACKGROUND:Syringomyelia is a rare, slowly progressive neurological condition characterized by the presence of a syrinx within the spinal cord. Consensus regarding the safest mode of delivery and anesthetic management in patients with syringomyelia remains controversial and presents management dilemmas. This study reviews the cases of syringomyelia at our institution and provides a systematic review of the literature to guide decisions regarding labor and delivery management.METHODS:A retrospective review of cases at our hospital from 2002 to 2014 and a systematic review of the literature from 1946 to 2014 were undertaken. Hospital records and electronic databases were interrogated usingInternational Classification of Diseases, 10th Revisioncodes and the keywords “syringomyelia,” “syringobulbia,” and “pregnancy.” Data regarding demographics, diagnosis, radiology reports, neurological symptoms, mode of delivery, anesthetic management, and maternal-fetal outcomes were collected.RESULTS:We collected and analyzed data on a total of 43 pregnancies in 39 patients. The most common location for syrinx was in the cervicothoracic region (41.9%). The large majority of patients (n = 34; 87%) demonstrated signs and symptoms associated with syringomyelia before delivery. Syringomyelia associated with Arnold Chiari malformation was documented in 49% (n = 21) cases. General anesthesia was the most commonly used (n = 21/30, 70%) anesthetic technique for cesarean delivery. The majority (n = 9/13, 69%) of patients had an epidural sited for labor analgesia. There were no maternal or neonatal complications associated with neuraxial anesthesia; however, 3 cases (14%) raised concerns regarding general anesthesia including difficult intubation, transient worsening of neurological symptoms postpartum, and prolonged muscle paralysis after atracurium.CONCLUSIONS:Despite concerns regarding aggravation of the syrinx with vaginal delivery, this mode of delivery has never caused any documented long-term worsening of neurological condition. All techniques of anesthesia have been performed successfully without major lasting complications. All cases necessitate patient counseling and individualized multidisciplinary involvement to ensure maternal safety.
Perioperative Temperature Measurement Considerations Relevant to Reporting Requirements for National Quality Programs Using Data From Anesthesia Information Management Systems
Authors: Epstein Richard H. , Dexter Franklin , Hofer Ira S. , Rodriguez Luis I. , Schwenk Eric S. , Maga Joni M. , Hindman Bradley J. 
Published: June 2017

BACKGROUND:
Perioperative hypothermia may increase the incidences of wound infection, blood loss, transfusion, and cardiac morbidity. US national quality programs for perioperative normothermia specify the presence of at least 1 “body temperature” ≥35.5°C during the interval from 30 minutes before to 15 minutes after the anesthesia end time. Using data from 4 academic hospitals, we evaluated timing and measurement considerations relevant to the current requirements to guide hospitals wishing to report perioperative temperature measures using electronic data sources.

METHODS:
Anesthesia information management system databases from 4 hospitals were queried to obtain intraoperative temperatures and intervals to the anesthesia end time from discontinuation of temperature monitoring, end of surgery, and extubation. Inclusion criteria included age >16 years, use of a tracheal tube or supraglottic airway, and case duration ≥60 minutes. The end-of-case temperature was determined as the maximum intraoperative temperature recorded within 30 minutes before the anesthesia end time (ie, the temperature that would be used for reporting purposes). The fractions of cases with intervals >30 minutes between the last intraoperative temperature and the anesthesia end time were determined.

RESULTS:
Among the hospitals, averages (binned by quarters) of 34.5% to 59.5% of cases had intraoperative temperature monitoring discontinued >30 minutes before the anesthesia end time. Even if temperature measurement had been continued until extubation, averages of 5.9% to 20.8% of cases would have exceeded the allowed 30-minute window. Averages of 8.9% to 21.3% of cases had end-of-case intraoperative temperatures <35.5°C (ie, a quality measure failure).

CONCLUSIONS:
Because of timing considerations, a substantial fraction of cases would have been ineligible to use the end-of-case intraoperative temperature for national quality program reporting. Thus, retrieval of postanesthesia care unit temperatures would have been necessary. A substantive percentage of cases had end-of-case intraoperative temperatures below the 35.5°C threshold, also requiring postoperative measurement to determine whether the quality measure was satisfied. Institutions considering reporting national quality measures for perioperative normothermia should consider the technical and logistical issues identified to achieve a high level of compliance based on the specified regulatory language.
A review of endothermal laser ablative treatment of incompetent saphenous veins
Authors: Hartmann K. , Schuler L. 
Published: June 2017

SummaryEndovenous treatment of incompetent great and small saphenous veins has become firmly established as an alternative to cross-ectomy and stripping operations. Among other thermal and non-thermal procedures, endovenous laser ablation (EVLA) is one of the most frequently used methods. Development of the procedure has continued since its introduction in 1998: the low wavelengths used at first (810 nm) resulted in a high rate of complications (ecchymosis, pain), and over the years systems using longer wavelengths have been developed with increasingly fewer side effects. The effectiveness of the wavelength most frequently used today (1470 nm) has been reported in numerous studies. The most frequent side effects include endovenous heat-induced thrombosis (EHIT), nerve damage and ecchymosis; major complications like lung embolism are reported very rarely.
The impact of the multidisciplinary team in the management of individuals with diabetic foot ulcers: a systematic review
Authors: Buggy A. , Moore Z. 
Published: June 2017

Objective: To assess the impact of the multidisciplinary team in the management of the diabetic foot compared with those who did not receive multidisciplinary care. Method: A systematic review of the literature was conducted using the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Embase and Cochrane Library. The following search terms were used: diabetic foot, multidisciplinary team, patient care team, multidisciplinary care team. Data were extracted using a bespoke data extraction tool and quality appraisal of the studies was undertaken using the EBL Critical Appraisal checklist. Data analysis was undertaken using RevMan with results presented as odds ratio for dichotomous data, or mean difference for continuous data, all with the associated 95% confidence intervals. Results: The search identified 19 eligible studies. Severity of amputation, death rates and length of hospital stay of clients receiving multidisciplinary team care were improved when compared with those who did not receive multidisciplinary team care. Ulcer healing and quality of life showed an improvement but not all studies explored these outcomes. Only 7 of the 19 articles appraised were found to be of acceptable quality, questioning the generalisability of the results. Conclusion: From the currently available evidence a positive impact of the multidisciplinary team on diabetic foot outcomes can be seen, but due to the lack of high-quality evidence and substantial heterogeneity in the studies, these results should be interpreted with caution.
Baseline Circulating FGF21 Concentrations and Increase after Fenofibrate Treatment Predict More Rapid Glycemic Progression in Type 2 Diabetes: Results from the FIELD Study
Authors: Ong Kwok-Leung , O'Connell Rachel , Januszewski Andrzej S , Jenkins Alicia J , Xu Aimin , Sullivan David R , Barter Philip J , Scott Russell S , Taskinen Marja-Riitta , Waldman Boris , Colman Peter G , Best James D , Simes John R , Rye Kerry-Anne , Keech Anthony C 
Published: June 2017

Abstract

BACKGROUND
It is not known whether circulating fibroblast growth factor 21 (FGF21) concentrations are associated with glycemic progression in patients with established type 2 diabetes. This study reports this relationship in type 2 diabetes patients participating in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial.

METHODS
Plasma FGF21 was quantified in 9697 study participants. Among patients with lifestyle-only glucose control measures at baseline, glycemic progression was defined as the initiation of oral hypoglycemic agents or insulin therapy. We assessed the relationship of FGF21 concentrations with glycohemoglobin (Hb A1c), the homeostasis model assessment of β-cell function (HOMA-B) and insulin resistance (HOMA-IR), and glycemic progression.

RESULTS
Among 2584 patients with lifestyle-only glycemic therapy at baseline, plasma FGF21 concentrations were positively associated with HOMA-IR (5.1% increase per 100% increase in FGF21 concentrations). Patients with higher baseline plasma FGF21 concentrations had higher risk of glycemic progression over a 5-year period (P = 0.02), but the association was not significant after further adjusting for alanine aminotransferase (ALT) enzyme activity. During the fenofibrate active run-in phase, higher tertiles of fenofibrate-induced increase in FGF21 concentrations were associated with higher risk of glycemic progression (adjusted hazards ratio = 1.09 and 1.18 for tertiles 2 and 3, respectively, P for trend = 0.01), even after adjusting for ALT enzyme activity. This association was statistically significant in the fenofibrate group only (P = 0.01).

CONCLUSIONS
Higher baseline and fenofibrate-induced increase in FGF21 concentrations predict more rapid glycemic progression in type 2 diabetes patients. This association may be partly explained by hepatic function.
In- vitroantioxidant and anti-obesity properties of Bauhinia variegata
Authors: Patil M. M. , Anand T. , Ilaiyaraja N. , Khanum Farhath 
Published: June 2017

<p><em>Bauhinia variegata</em> L (Synonyms: <em>Phanera variegata</em> Benth), commonly known as orchid tree or Kachnar belongs to the family of Leguminosae and found throughout India. All parts of the plants are used in the treatment of many ailments such as obesity, dyspepsia, bronchitis, leprosy, ulcer <em>etc.</em> The objective of the present study was to assess the i<em>n- vitro</em> antioxidant and anti-obesity properties of different solvent (hexane, chloroform, ethyl acetate, acetone, methanol and distilled water) extracts of <em>Bauhinia variegata</em>leaves. All the solvent extracts were found to contain different phytochemicals with bioactive properties at varying concentrations.The results of extraction showed that methanol was the suitable solvent for extraction of phytochemical as it recorded highest yield of 6.80%. The phytochemical assay results showed the highest polyphenol content in methanol extract (243 μg GAE/mg) and flavonoids content in chloroform extract (1.87 μg CE/g).The <em>in-vitro</em> antioxidant and anti obesity property was observed more in methanolic extract than the other extracts. The overall study suggests that <em>Bauhinia variegata</em>leaf extract could be a potential ingredient for the preparation of nutraceuticals to treat obesity and oxidative stress related complications. </p>
Iron Bio-accessibility and Nutritional Attributes of Selected Disease Specific Commercial Formulations
Authors: Urooj Asna , Siddiqi Seema , S. Lakshmi 
Published: June 2017

<p>Iron deficiency is the most common form of malnutrition in the world, affecting more than 2 billion people globally. Food labeling is an important tool that provides information on the nutritional composition data to consumers. However, the information on bio accessibility values is limited; therefore, the aim of the present study is to promote the nutritional labeling by the inclusion of bio accessibility values of micronutrients of importance along with nutritional composition data. Commercial supplements commonly used for disease specific conditions were selected &amp; their iron bio accessibility was determined by equilibrium dialysis involving an in vitro simulated digestion procedure. The formulations were also subjected to nutritional composition analysis &amp; functional properties by standard AOAC methods. The total iron content of the supplements ranged between 8.66±0.5mg/100g to 21.72±1.44 mg/100g whereas the bio accessibility of micronutrient iron ranged between 0.05±0.01 mg/100g to 0.32±0.20mg/100g. The % iron bio accessibility was also determined &amp; ranged between 0.23-2.52%. Thus inclusion of bio accessibility values of vital micronutrients along with usual nutritional composition data employs as an effective tool to combat various micronutrient deficiencies. Therefore, application of supplements with higher bioavailability may result in usage of lower doses of iron with fewer side effects, thus improving treatment efficacy. This novel information has the potential application in nutritional labeling to improve the bioavailability of trace minerals and hence contributes to the human health benefit.</p>
A Game Theoretic Approach to Modelling Jamming Attacks in Delay Tolerant Networks
Authors: Ravishankar Monica , Rao D. Vijay , Kumar C.R.S. 
Published: June 2017

<p>Cyberspace plays a prominent role in our social, economic and civic welfare and cyber security issues are of paramount importance today. Growing reliance of the intertwined military and civilian applications on wireless computer networks makes these networks highly vulnerable to attacks of which jamming attacks are a vital and exigent problem. In this paper, we study defence against jamming attacks as game in a delay tolerant network, with two adversarial players: the jammer playing against the transmitter. The transmitters seek to choose an optimal time to schedule his transmission securely, so as to maximize the probability of successful delivery before his session expires, while these transmissions are subject to inference from the jammer, who attempts to minimize this probability . We design strategies for the transmitters that offset transmission period based inference of network traffic by the jammer. We model these interactions and decisions as a game and use simulation as a tool to evaluate the games. Probability distribution functions over finite set of strategies are proposed to compute the expected payoff of both the players. Simulation results are used to evaluate the expected payoff along with the resulting equilibrium in cases where players are biased and unbiased. These results are used to strategically decide on the optimal time for both the players, and evaluate the efficiency of the strategies used by the transmitters against jammer attacks. </p>
New saprobic marine fungi and a new combination
Authors: Abdel-Wahab Mohamed A. , Dayarathne Monika C. , Suetrong Satinee , Guo Sheng-Yu , Alias Siti Aisyah , Bahkali Ali H. , Nagahama Takahiko , Elgorban Abdallah M. , Abdel-Aziz Faten A. , Hodhod Mohamed S. , Al-Hebshi Mohamed O. , Hyde Kevin D. , Nor Norlailatul A.B.M. , Pang Ka-Lai , Jones E.B. Gareth 
Published: June 2017

AbstractThis paper documents five new saprobic marine fungi occurring on various substrata in the marine environment.
Influence of Information Technology on Organization Strategy
Authors: Sibanda Mabutho , Ramrathan Durrel 
Published: June 2017

Abstract
The exponential development of information technology has presented many opportunities to organizations; however, it has also presented several challenges. A key challenge is how do organizations effectively use information technology and incorporate it into their strategies to make full use of its capabilities as an enabler. The fast-changing nature of information technology has resulted in little empirical evidence on how it influences organization strategy. The Strategic Alignment Model was a popular model created to assist organizations to align their information technology and their business strategy; however, the growth of technology may have made this model irrelevant in this age. Therefore, organizations need to determine what factors drive this alignment. Using hermeneutic phenomenology, 12 in-depth interviews were conducted within IBM South Africa to determine real-life drivers that help create this alignment. The themes derived from the interview texts reveal that consumers are becoming more empowered; therefore, organizations need to be more flexible in their business models and strategies. Furthermore, the integration of cross-functional roles in the organization at the management level allow for improved alignment between information technology and strategy as better integrated roles bring a combination of these two elements.
Level of Internet use among Greek adolescents with type 1 diabetes
Authors: Daniilidou Katerina , Triantafyllou Panagiota , Resta Maria , Dimitriadou Meropi , Christoforidis Athanasios 
Published: June 2017

Abstract

Background
Compulsive Internet use has emerged as a contemporary addictive behavior. Our aim was to investigate the reasons for Greek adolescents with type 1 diabetes mellitus (T1DM) and their families to use the Internet and additionally to investigate the level of Internet use and its associations to demographic, socio-economic parameters and glycemic control.

Methods
Patients with T1DM, aged >12 years and their parents were recruited during their regular visits to the Pediatric Diabetes Clinic. A similar group of healthy children, age- and sex-matched served as a control group. All participants were asked to fill out the Greek translated version of the Internet Addiction Test (IAT). Caregivers of patients with T1DM were asked to complete a second questionnaire consisting of questions regarding demographic and socio-economic data of the family and data concerning disease management.

Results
Thirty-five patients with T1DM (mean decimal age of 14.95 ± 1.90 years) and 35 controls participated in the study. Nine patients were on an insulin pump whereas the rest were on multiple daily injections. The mean total score of the patients’ IAT questionnaires was significantly lower compared to the controls (26.26 ± 12.67 vs. 39.91 ± 18.55, p = 0.003). Controls were characterized as exhibiting moderate addictive behavior at a significantly higher percentage than patients (31.43% vs. 2.86%, p = 0.002). All patients on insulin pumps demonstrated normal Internet use. Mild addictive behavior was associated with a lower parental educational level. Finally, level of Internet use (IAT score) was positively associated to glycemic control (HbA1c value) with a correlation that was approaching significance (r = 0.315, p = 0.065).

Conclusions
Adolescents with T1DM and especially those on an insulin pump exhibit normal Internet use compared to their healthy peers. Time consumed on Internet correlates reversibly with glycemic control.