bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of the comprehensive environmental questionnaire for older adults requiring support for community-living
Authors: Nakamura-Thomas Hiromi , Kyougoku Makoto , Yabuwaki Kenji 
Published: January 2018

Introduction The Comprehensive Environmental Questionnaire for the Elderly (CEQ) was developed to measure satisfaction levels among community-dwelling older adults regarding their environment. The CEQ comprises 14 question items grouped into three factors, which are rated on a four-point Likert scale. To expand the applicability of the CEQ to community-dwelling older adults requiring support from long-term care and family members for their community-living, this study examined the factorial structure and scale system of the CEQ to verify its validity and reliability. Method Data were collected individually from 218 participants who receive no rehabilitative services but require homemaking services and/or support from family members. The factorial structure and scale system were examined using structural equation modeling and an item response theory (IRT) approach, respectively. Findings We obtained values between 0.93 and 0.66 for factor loadings, 0.98 for comparative fit index, and 0.97 for Tucker–Lewis index, which indicated a good to adequate fit. The value of root mean square error of approximation was 0.094, indicating a mediocre fit. The IRT analysis showed an accurate description of item function of the CEQ. Conclusion The CEQ was applicable to the present study population. Although the CEQ concept was confirmed, the questionnaire warrants further improvement.
Influence of Co-Morbidity on Health-Related Quality of Life in Patients Treated with Hemodialysis
Authors: Stojanovic M. , Ilic S. , Stefanovic V. 
Published: January 2018

Studies on the outcome of hemodialysis (HD) patients over time have mainly focused on morbidity and mortality, but currently, the importance of measuring the patient's health-related quality of life (HRQoL) is being increasingly recognized. On the other hand, comorbidity is the single most important determinant of outcome in patients on HD. The aims of this study were to evaluate HRQoL in patients at the initiation of HD therapy (incident cohort), and in patients on long-term HD treatment (prevalent cohort), and to establish the relationship between the presence of comorbidity and patient's HRQoL. The study enrolled 229 patients on HD, divided into two groups: prevalent cohort comprised 192 patients on chronic HD more than 3 months, and incident cohort with 37 patients who started their dialysis during the study. Comorbidity was assessed using the Index of Coexistent Diseases (ICED), including two sub-indexes: Index of Disease Severity (IDS), a medical record review of 16 medical conditions, and Index of Physical Impairment (IPI), an observer-based assessment of 11 physical functions. ICED scores range from 0 to 3, with higher levels reflecting more severe comorbidity. Patient's self-assessment of HRQoL was measured by the 36-item Short Form Health Survey Questionnaire (SF-36), encompassing 8 summary scales and 2 summary dimensions. Based on the ICED index level, in both groups of patients (prevalent and incident group), a high presence of associated diseases was observed, i.e. 56.8 % and 67.6 % respectively. Indicators of comorbidities have negative and statistically significant correlation, so that any increase of IDS and IPI indexes produces significant decrease of HRQoL parameters. HRQoL summary scales in both groups of patients were similar, but generally with lower values in incident subjects and with statistical significance only in social functioning (SF) scale (40.5 ± 24.9 vs 51.0 ± 27.2). In the incident group of patients, one year of HD treatment was associated with a slight improvement in all HRQoL parameters, but statistical significance (p < 0.05) was observed only in the role-physical limitation (RP) scale and SF scale. Conclusions In the patients on HD treatment, comorbid conditions have negative and statistically significant correlation with parameters of HRQoL, and could explain poor HRQoL to a remarkable extent. One year after starting HD, patients reported better scores in some domains, especially in the RP and SF scale. From a clinical perspective, parameters of HRQoL and comorbidities should be considered in the follow up of patients treated with HD. (Int J Artif Organs 2006; 29: 1053–61)
Histopathologic Changes of Acellularized Xenogenic Carotid Vascular Grafts Implanted in a Pig-to-Goat Model
Authors: Kim W.S. , Seo J.W. , Rho J.R. , Kim W.G. 
Published: January 2018

Introduction The present study was designed to determine the in vivo patency and recellularization pattern of acellularized small-diameter xenogenic arterial grafts. We implanted acellularized porcine carotid arteries in bilateral carotid arteries of goats and microscopically analyzed the recellularization pattern of these grafts with the recipient's cells over time. Material and Methods Carotid arteries of pigs weighing 30–40 kg were harvested and decellularized with hypertonic saline followed by sodium dodecyl sulfate. Acellularized porcine carotid vascular xenografts (0.4–0.5 cm in diameter) were prepared into 4 cm-long segments and implanted bilaterally in the carotid arteries of 10 black-haired goats. The in vivo patency of the implanted acellularized xenogenic grafts was evaluated at regular intervals by color Doppler ultrasonography. The goats were sacrificed at predetermined intervals (1 week, 1 month, 3 months, 6 months, 12 months after implantation), two animals at each interval. Upon retrieval, visual inspections and histopathologic examinations of the grafts were performed. To identify smooth muscle cells and functioning endothelial cells, immunohistochemical staining for alpha-smooth muscle actin and von Willebrand factor were also performed. Results and Conclusions All experimental animals survived the observation period. Nineteen out of 20 implanted grafts showed patency with no thrombi. Microscopic analysis revealed that the grafts were completely covered with the hosts' endothelial cells, beginning from anastomotic sites. The grafts were gradually recellularized with recipients'cells including fibroblasts, myofibroblasts and smooth muscle cells. In conclusion, this study suggested that acellularized xenogenic vascular grafts can be a good alternative for the small-diameter vascular graft.
Endothelial Dysfunction in Patients with Severe Acute Pancreatitis: Improved by Continuous Blood Purification Therapy
Authors: Chen Z.-H. , Liu Z.-H. , Yu C. , Ji D.-X. , Li L.-S. 
Published: January 2018

Objectives. Endothelium dysfunction is one of the critical pathophysiologic disorders in patients with severe acute pancreatitis (SAP). To investigate the effect of continuous blood purification (CBP) on endothelial function, we conducted a prospective study of 20 patients with SAP, 9 of whom had evidence of sepsis. Methods. All patients underwent CVVH for 72 h. Soluble E-selectin (sE-selectin), soluble thrombomodulin, permeability of the endothelial monolayer, and endothelial intracellular calcium ([Ca2+]i) levels were used as the markers for the assessment of endothelial function and the effect of CBP therapy in patients with SAP. Blood samples were taken from the patients at 0, 2, 12, 24, 48, and 72 h during CVVH therapy. sE-selectin and thrombomoduiln were measured by ELISA. The endothelial permeability and activation were evaluated using cultured endothelial monolayer and intracellular Ca2+ concentration. Results. The results showed that during CVVH treatment, the hemodynamics and mean arterial pressure (MAP) were stable. The Acute Physiology and Chronic Health Evaluation (APACHE) II score was improved significantly after CVVH. Endothelial dysfunction was evident in patients with SAP as compared to normal controls. Patients with SAP had increased levels of sE-selectin, endothelial permeability and intracellular [Ca2+]i, which was higher in patients with sepsis than in those without sepsis. The level of thrombomodulin showed a tendency to increase; however, these changes were not significant between SAP patients and controls. After CBP treatment, sE-selectin levels substantially decreased in all patients. CBP treatment also significantly diminished the endothelial permeability and decreased the intracellular [Ca2+] concentration. Conclusions. These data demonstrate that endothelial dysfunction is present in patients with SAP and the degree of endothelial damage may be correlated with the disease severity. CBP therapy can not only improve the general conditions, as measured by the APACHE II score, but also effectively improve endothelial dysfunction.
The Epidemiology of Cardiac Surgery-Associated Acute Kidney Injury
Authors: Hoste E.A. , Cruz D.N. , Davenport A. , Mehta R.L. , Piccinni P. , Tetta C. , Viscovo G. , Ronco C. 
Published: January 2018

Purpose To describe current knowledge on the epidemiology of cardiac surgery-associated acute kidney injury (CSA-AKI) and to formulate recommendations for clinical practice and a research agenda. Methods After a modified Delphi analysis by the Acute Dialysis Quality Initiative (ADQI), 4 questions on the epidemiology of CSA-AKI and recommendations for clinical practice and a research agenda were formulated and addressed. Results Existing studies on CSA-AKI use over 35 different definitions for CSA-AKI. In addition, there may be important differences in patient characteristics and procedures. This explains the significant variations in reported incidence. Most studies report on CSA-AKI as defined by the need for renal replacement therapy. However, even small decreases in kidney function are associated with a worsened outcome. The workgroup formulated the recommendation to use the AKIN consensus criteria for AKI. One should differentiate early CSA-AKI, caused by the procedure, and late CSA-AKI, associated with the procedure. There may be different clinical scenarios: acute on chronic CSA-AKI, AKI prior to CS, and AKI occurring post CS. Risk factors should be differentiated between pre-, intra-, and post-CS, and between patient-, process-, and procedure-related. Endpoints should include both short-term and long-term outcomes. Conclusions Existing data on the epidemiology of CSA-AKI are difficult to compare due to variations in definition and patient cohort. A modified Delphi analysis resulted in a series of recommendations for future research on CSA-AKI.
Angiogenesis without Functional Outcome after Mononuclear Stem Cell Transplant in a Doxorubicin-Induced Dilated Myocardiopathy Murine Model
Authors: Carvalho K.A.T. , Simeoni R.B. , Guarita-Souza L.C. , Francisco J.C. , Abdelwahid E. , Myiague N.I. , Chachques J.C. , Rivetti L.A. , Oliveira L. , Malvezzi M. , Olandoski M. , Gremski W. 
Published: January 2018

Objectives Cell transplantation is considered a novel approach in the treatment of myocardiopathy. The objective of this study was to evaluate the effects of autologous mononuclear stem cell therapy in doxorubicin-induced dilated myocardiopathy by conducting both functional and histopathologic analysis. Methods Seventy male rats were doxorubicin injected intraperitoneally for 2 weeks. At 1 month, the animals that had demonstrated left ventricular ejection fractions less than 40% were randomly divided into a mononuclear stem cell group and controls. Mononuclear stem cells were isolated. All animals underwent echocardiographic study: baseline, pre-cell therapy, and at 1 month post-cell therapy, and analyzed by the nonparametric Mann-Whitney test. Transplants were performed by subepicardial injections. Standard staining was performed. Results Twenty-three animals were randomly treated: mononuclear stem cell and control groups, with 11 rats completing the study. Cell viability was 85%. Mononuclear stem cells (n=5; 5×106 cells /300 μL medium) and control (n=6; 300 μL medium) were used. The resulting left ventricular ejection fraction in the cell therapy group was not significantly different compared with controls (p=0.54). New vessels were demonstrated in the subepicardial region. Conclusions Autologous mononuclear stem cell therapy was not functionally effective in doxorubicin-induced dilated myocardiopathy in the animal model under study with the experimental conditions, despite occurrence of angiogenic activity.
Body Perfusion during Adult Cardiopulmonary Bypass is Improved by Pulsatile flow with Intra-Aortic Balloon Pump
Authors: Onorati F. , Santarpino G. , Rubino A. S. , Caroleo S. , Dardano A. , Scalas C. , Gulletta E. , Santangelo E. , Renzulli A. 
Published: January 2018

Purpose To evaluate if the use of an intra-aortic balloon pump (IABP) during cardioplegic arrest improves body perfusion. Methods 158 coronary artery bypass graft (CABG) patients were randomized to linear cardiopulmonary bypass (CPB) (n=71, Group A) or automatic 80 bpm intra-aortic ballon pump (IABP) induced pulsatile CPB (n=87, Group B). We evaluated hemodynamic response by Swan-Ganz catheter, inflammation by cytokines, coagulation and fibrinolysis, transaminase, bilirubin, amylase, lactate and renal function (estimated glomerular filtration rate (eGFR), creatinine, and incidence of renal insufficiency and failure). Results IABP induced Surplus Hemodynamic Energy was 15.8±4.9 mmHg, with higher mean arterial pressure during cross-clamping (p=0.001), and lower indexed systemic vascular resistances during cross-clamping (p=0.001) and CPB discontinuation (p=0.034). IL-2 and IL-6 were lower, while IL-10 proved higher in Group B (p<0.05). Group B showed lower chest drainage (p<0.05), transfusions (p<0.05), INR (p<0.05), and AT-III (p=0.001), together with higher platelets, aPTT (p<0.05), fibrinogen (p<0.05) and D-dimer (p<0.05). Transaminases, bilirubin, amylase, lactate were lower in Group B (p<0.05); eGFR was better in Group B from ITU-arrival to 48 hours, both in preoperative kidney disease Stages 1–2 (p<0.03) and Stage 3 (p<0.05), resulting in lower creatinine from ITU-arrival to 48 hours (p<0.03). Incidence of renal insufficiency (p=0.004) and need for renal replacement therapy (p=0.044) was lower in Group B Stage 3. Group B PaO2/FiO2 and lung compliance improved from aortic declamping to the first day (p<0.003) with shorter intubation time (p=0.01). Conclusion Pulsatile flow by IABP improves whole-body perfusion during CPB.
Computer-Simulated Fluid Dynamics of Arterial Perfusion in Extracorporeal Circulation: From Reality to Virtual Simulation
Authors: Fukuda Ikuo , Osanai Satoshi , Shirota Minori , Inamura Takao , Yanaoka Hideki , Minakawa Masahito , Fukui Kozo 
Published: January 2018

Background Atheroembolism due to aortic manipulation remains an unsolved problem in surgery for thoracic aortic aneurysm. The goal of the present study is to create a computer simulation (CS) model with which to analyze blood flow in the diseased aorta. Method A three-dimensional glass model of the aortic arch was constructed from CT images of a normal, healthy person and a patient with transverse aortic arch aneurysm. Separately, a CS model of the curved end-hole cannula was created, and flow from the aortic cannula was recreated using a numerical simulation. Results Comparison of the data obtained by the glass model analyses revealed that the flow velocity and the vector of the flow around the exit of the cannula were similar to that in the CS model. A high-velocity area was observed around the cannula exit in both the glass model and the CS model. The maximum flow velocity was as large as 1.0 m/s at 20 mm from the cannula exit and remained as large as 0.5 to 0.6 m/s within 50 mm of the exit. In the aortic arch aneurysm models, the rapid jet flow from the cannula moved straight toward the lesser curvature of the transverse aortic arch. The locations and intensities of the calculated vortices were slightly different from those obtained for the glass model. Conclusions The proposed CS method for the analysis of blood flow from the aortic cannulae during extracorporeal circulation can reproduce the flow velocity and flow pattern in the proximal and transverse aortic arches.
The effects of environmental regulation on the efficiency of distribution electricity companies in Spain
Authors: Sánchez-Ortiz Jaime , García-Valderrama Teresa , Rodríguez-Cornejo Vanessa , Giner-Manso Yolanda 
Published: January 2018

The objective of this work is to detect what problems of inefficiency electricity distribution companies have, in order to disseminate this information and to allow distributors and public agencies to be more precise in calculating their costs. In turn, this will have an indirect impact on the price of the kilowatt in order to try to reduce its volatility. It should be noted that the volatility of the kilowatt price is mainly due to distribution costs and more specifically to access tolls. In the present paper, knowing that the distribution activity is a regulated activity, the efficiency in the electricity distribution companies will be studied. To this end, a study has been carried out on the efficiency of the main electricity distribution companies in Spain (Endesa, Iberdola, Union Fenosa, EDP and Viesgo) during the period of 2006–2015. The technique used was the Multi-period efficiency measurement in Data Envelopment Analysis, an input-oriented model at constant scales, working with panel data. The conclusions in this paper indicate that Spanish electricity distribution companies could improve their levels of efficiency if they improve the use of some inputs. This analysis demonstrates that overcapacity and deficit tariff have a negative influence on the efficiency level. Finally, this paper is useful as it shows that regulation again plays an essential role in regulated activities, requiring a commitment on the part of the State in order to improve efficiency in regulated activities.
Paradigm shift in psychiatry: what may it involve?
Authors: Valent Paul 
Published: January 2018

Objective: This study aims to examine the potential nature of an ongoing paradigm shift in psychiatry that has been suggested to be occurring. Conclusions: New findings in traumatology and neuroscience do form a potential platform for a paradigm shift. Prior conflicting paradigms are suggested to be due to biases arising from mental structures themselves. A new wholist perspective is proposed, which makes sense of and incorporates previous paradigms, and coheres recent understanding of right- and left-brain functioning and biopsychosocial traumatic processes and their ramifications. The perspective makes sense of the great variety of post-traumatic manifestations ranging from somatic to meaning-making dysfunctions. The wholist perspective may well be an important step in solidifying a fresh paradigmatic perspective in psychiatry.
Comparison of Juvenile Allogenous Articular Cartilage and Bone Marrow Aspirate Concentrate Versus Microfracture With and Without Bone Marrow Aspirate Concentrate in Arthroscopic Treatment of Talar Osteochondral Lesions
Authors: Karnovsky Sydney C. , DeSandis Bridget , Haleem Amgad M. , Sofka Carolyn M. , O’Malley Martin , Drakos Mark C. 
Published: January 2018

Background: The purpose of this study was to compare the functional and radiographic outcomes of patients who received juvenile allogenic chondrocyte implantation with autologous bone marrow aspirate (JACI-BMAC) for treatment of talar osteochondral lesions with those of patients who underwent microfracture (MF). Methods: A total of 30 patients who underwent MF and 20 who received DeNovo NT for JACI-BMAC treatment between 2006 and 2014 were included. Additionally, 17 MF patients received supplemental BMAC treatment. Retrospective chart review was performed and functional outcomes were assessed pre- and postoperatively using the Foot and Ankle Outcome Score and Visual Analog pain scale. Postoperative magnetic resonance images were reviewed and evaluated using a modified Magnetic Resonance Observation of Cartilage Tissue (MOCART) score. Average follow-up for functional outcomes was 30.9 months (range, 12-79 months). Radiographically, average follow-up was 28.1 months (range, 12-97 months). Results: Both the MF and JACI-BMAC showed significant pre- to postoperative improvements in all Foot and Ankle Outcome Score subscales. Visual Analog Scale scores also showed improvement in both groups, but only reached a level of statistical significance ( P < .05) in the MF group. There were no significant differences in patient reported outcomes between groups. Average osteochondral lesion diameter was significantly larger in JACI-BMAC patients compared to MF patients, but size difference had no significant impact on outcomes. Both groups produced reparative tissue that exhibited a fibrocartilage composition. The JACI-BMAC group had more patients with hypertrophy exhibited on magnetic resonance imaging (MRI) than the MF group ( P = .009). Conclusion: JACI-BMAC and MF resulted in improved functional outcomes. However, while the majority of patients improved, functional outcomes and quality of repair tissue were still not normal. Based on our results, lesions repaired with DeNovo NT allograft still appeared fibrocartilaginous on MRI and did not result in significant functional gains as compared to MF. Level of Evidence: Level III, comparative series.
Regulation of mitophagy by the ubiquitin pathway in neurodegenerative diseases
Authors: Desai Shyamal , Juncker Meredith , Kim Catherine 
Published: January 2018

Mitophagy is a cellular process by which dysfunctional mitochondria are degraded via autophagy. Increasing empirical evidence proposes that this mitochondrial quality-control mechanism is defective in neurons of patients with various neurodegenerative diseases such as Ataxia Telangiectasia, Alzheimer’s disease, Parkinson’s disease, and Amyotrophic Lateral Sclerosis. Accumulation of defective mitochondria and the production of reactive oxygen species due to defective mitophagy have been identified as causes underlying neurodegenerative disease pathogenesis. However, the reason mitophagy is defective in most neurodegenerative diseases is unclear. Like mitophagy, defects in the ubiquitin/26S proteasome pathway have been linked to neurodegeneration, resulting in the characteristic protein aggregates often seen in neurons of affected patients. Although initiation of mitophagy requires a functional ubiquitin pathway, whether defects in the ubiquitin pathway are causally responsible for defective mitophagy is not known. In this mini-review, we introduce mitophagy and ubiquitin pathways and provide a summary of our current understanding of the regulation of mitophagy by the ubiquitin pathway. We will then briefly review empirical evidence supporting mitophagy defects in neurodegenerative diseases. The review will conclude with a discussion of the constitutively elevated expression of ubiquitin-like protein Interferon-Stimulated Gene 15 (ISG15), an antagonist of the ubiquitin pathway, as a potential cause of defective mitophagy in neurodegenerative diseases.Impact statementNeurodegenerative diseases place an enormous burden on patients and caregivers globally. Over six million people in the United States alone suffer from neurodegenerative diseases, all of which are chronic, incurable, and with causes unknown. Identifying a common molecular mechanism underpinning neurodegenerative disease pathology is urgently needed to aid in the design of effective therapies to ease suffering, reduce economic cost, and improve the quality of life for these patients. Although the development of neurodegeneration may vary between neurodegenerative diseases, they have common cellular hallmarks, including defects in the ubiquitin-proteasome system and mitophagy. In this review, we will provide a summary of our current understanding of the regulation of mitophagy by the ubiquitin pathway and discuss the potential of targeting mitophagy and ubiquitin pathways for the treatment of neurodegeneration.