bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thrombosis in Left Ventricular Assistance Device with Centrifugal Technology: Is Early Thrombolysis a Better Solution?
Authors: Centofanti Paolo , Baronetto Andrea , Attisani Matteo , Ricci Davide , Simonato Erika , La Torre Michele W. , Boffini Massimo , Rinaldi Mauro 
Published: August 2017

Background Continuous flow left ventricular assistance devices (CF-LVADs) have revolutionized the treatment of advanced heart failure. Pump replacement for thrombosis is a high-risk procedure with a high perioperative mortality rate with possible recurrence. We aim to summarize our experience using a conservative approach with medical therapy. Methods We retrospectively reviewed records of patients who experienced pump thrombosis after LVAD implantation with HeartWare HVAD at our institution, from November 2010 to March 2016. Device thrombosis (DT) was divided into suspected (SDT) and confirmed (CDT). A conservative approach using thrombolysis and heparin was used in all patients. Results A total of 32 HeartWare HVAD pumps were implanted. Mean age was 59 ± 10 years and the mean time on mechanical support was 19.29 months (± 14.06). Pump thrombosis occurred in 7 patients (0.14 patients/year) after a mean time of 733 (231–1,606) days after LVAD implantation. Three out of 7 cases had thrombosis recurrence (43%). Overall 19 episodes were recorded (0.38 event per patient/year). Eighteen out of 19 thrombolytic treatments were successful (94.7%). No patient required LVAD replacement or transfusion of blood products. There was no significant difference in terms of survival between patients who experienced thrombotic events and patients who did not. No major complications related to thrombolysis were recorded. Conclusions Systemic thrombolysis plus heparin was an excellent therapeutic option. Early intervention in clinically stable patients without signs of heart failure but with indirect signs of device thrombosis has led to better outcomes.
Long-term Follow-up of Continuous Flow Left Ventricular Assist Devices: Complications and Predisposing Risk Factors
Authors: Adesiyun Tolulope A. , McLean Rhondalyn C. , Tedford Ryan J. , Whitman Glenn J.R. , Sciortino Chris M. , Conte John V. , Shah Ashish S. , Russell Stuart D. 
Published: August 2017

Purpose To assess LVAD complications and their overall effect on mortality and determine factors associated with development of early and long-term complications. Methods A retrospective cohort study of patients who underwent continuous flow LVAD placement between January 1, 2000 and November 30, 2013 was performed. The incidence of complications (sepsis or bacteremia, driveline infections, gastrointestinal bleeding, pump thrombosis, cerebrovascular accidents and anemia requiring transfusion) was collected and logistic regression and Cox proportional hazards analyses were performed. Results 108 patients met our inclusion criteria. Median length of follow-up was 2.2 years. In univariable logistic regression analysis, higher blood urea nitrogen (BUN), creatinine clearance <60, no prior inotrope use, higher INTERMACS class and lower platelet count were associated with early complications. On multivariable analysis, factors associated with early complications included higher BUN (odds ratio (OR) 1.03, 95% confidence interval (CI) 1.001-1.06 per mg/dL BUN), no prior inotrope use (OR 4.92, 95% CI 1.64- 14.7) and lower platelet count (OR 4.29, 95% CI 1.45-12.7 <200 10(3) cu mm); 24% of patients developed early complications and 18.5% developed an early and late complication. Early complications were significantly associated with death (p = 0.017). The presence of 2 or more complications was associated with a 2.7-fold increase in the odds of death (p = 0.016) and odds of death increased by 20% with each subsequent complication (p = 0.004). Conclusions LVADs are associated with significant long-term complications including stroke and sepsis and minimizing time on LVADs may decrease the risk of complications and subsequent morbidity and mortality.
Comparison of a Prototype Reverse Hybridization Assay and MethyLight for Detection of SFRP2 Promotor Methylation in Fecal DNA
Authors: Kriegshäuser Gernot , Enko Dietmar , Zitt Matthias , Oberwalder Michael , Oberkanins Christian , Öfner Dietmar , Zeillinger Robert , Müller Hannes Maximilian 
Published: August 2017

Background This study aimed to evaluate the diagnostic performance of a novel nonquantitative methylation-specific reverse hybridization (MSRH) assay to detect secreted frizzled-related protein 2 ( SFRP2) promotor methylation in fecal DNA. Methods SFRP2 promoter methylation was investigated in stool DNA isolated from 18 colorectal cancer (CRC) patients and 22 healthy controls using the MSRH assay based on methylation-specific DNA amplification followed by reverse hybridization of biotinylated amplicons to sequence-specific methylation detection probes, with MethyLight serving as a reference method. Results SFRP2 promotor methylation as determined by MSRH vs. MethyLight showed a sensitivity and specificity of 61.1% and 86.3% vs. 77.7% and 77.3%, respectively. Moderate agreement (κ = 0.54, 95% confidence interval [95% CI], 0.29-0.80, p<0.001) was observed between the 2 methods. However, the differences in SFRP2 promotor methylation observed between CRC patients and healthy individuals by both assays were statistically significant (p<0.001). Conclusions Our findings, although limited by the small sample size, do not support the use of the MSRH assay for CRC screening in stool.
Apoptosis regulator Bcl-2 is an independent prognostic marker for worse overall survival in triple-negative breast cancer patients
Authors: Ozretic Petar , Alvir Ilija , Sarcevic Bozena , Vujaskovic Zeljko , Rendic-Miocevic Zrinka , Roguljic Ana , Beketic-Oreskovic Lidija 
Published: August 2017

Background: The objective of this study was to examine the prognostic significance of carbonic anhydrase IX (CAIX), an endogenous marker for tumor hypoxia; the cellular tumor antigen p53; and the apoptosis regulator Bcl-2, in triple-negative breast cancer (TNBC) patients. Methods: Immunohistochemically determined expression of CAIX, p53, Bcl-2 and proliferation factor Ki-67, analyzed in 64 paraffin-embedded TNBC tissue samples, was used to assess their relation to clinicopathological variables and prognostic implications for overall survival (OS). Results: Bcl-2 expression was negatively correlated with histological grade of tumor, while expression of p53 was positively correlated with the same clinical variable (p = 0.036 and p = 0.033, respectively). The p53 expression was also positively correlated with tumor size (p = 0.010). Survival analysis showed that patients with high Bcl-2 expression (above cutoff value determined by receiver operator characteristic [ROC] curve analysis) had shorter OS (p = 0.020). The same was observed for patients with tumors larger than 5 cm (p = 0.034) or positive lymph nodes (p = 0.004). Among all 3 examined markers, multivariate analysis showed that only Bcl-2 expression was a strong independent prognostic indicator for decreased OS (hazard ratio [HR] = 15.16, 95% confidence interval [95% CI], 2.881-79.727, p = 0.001). Conclusions: Elevated expression of Bcl-2 was an independent prognostic factor for poorer OS in TNBC and as such a significant marker for tumor aggressiveness.
Repositioning of Central Venous Access Devices using a High-Flow Flush Technique - a Clinical Practice and Cost Review
Authors: Spencer Timothy R. 
Published: August 2017

Background Malpositioned central venous access device (CVAD) tip locations can cause significant mechanical and chemical vessel-related injuries and complications if left in inappropriate positions. The aim of this study is to determine the use of a high-flow flush technique (HFFT) in successful correction of malpositioned catheters into the lower superior vena cava or cavoatrial junction and provide a cost comparison to interventional/fluoroscopic-based repositioning. Methods This is a retrospective chart and radiographic review of all inserted CVADs found malpositioned between 1996-2014 in a multi-specialty 1000-bed tertiary trauma center in Sydney, Australia. 7450 CVADs placed by a nurse-led vascular access service were reviewed. Catheters repositioned pre-2010 were excluded owing to radiology repositioning interventions. Results There were 3996 peripherally inserted central catheters (PICCs) and 3454 centrally inserted central catheters (CICCs) placed. Seventy-four were malpositioned post-2010. Of these, 53 devices were repositioned using the studied technique; 86% (46/53) of catheters were successfully repositioned on the first HFFT attempt. There was supportive evidence that device insertion side is important in potential catheter malposition. Conclusions Clinical outcomes suggest that CICCs and PICCs may be successfully repositioned utilizing this technique, with no adverse events associated and a prospective cost saving benefit when compared to interventional-based repositioning procedures.
Ultrasound-Guided Intravenous Catheter Insertion in a Prone Patient using a T Probe in Emergency Setting
Authors: Lazzari Antonio , Bini Roberto , Bertucci Roberto , Coletti Antonio , Voghera Paolo 
Published: August 2017

Introduction Central venous catheterizations are common intraoperative procedures. Central venous catheter (CVC) placements are usually performed with patients lying in the supine position using real-time ultrasound (US) guidance. Case description A 43-year-old man underwent open right popliteal artery reconstruction in the prone position for a limb-threatening injury. Excessive continuous intraoperative bleeding, increased by a coexisting pelvic fracture, was temporarily stabilized by a T POD device, but with the need of external fixation, required the placement of CVC, which was not feasible whilst in the prone position without US help. A view of the left internal jugular vein (IJV) was obtained with pediatric T probe and a CVC was placed using real-time US guidance, without complications. Conclusions We demonstrated the feasibility and safety of US-guided CVC placements in an emergency setting.
Long-Term Outcome of Upper Extremity Arteriovenous Fistula using pSLOT: Single-Center Longitudinal follow-up using a Protocol-Based Approach
Authors: Darcy Michael , Vachharajani Neeta , Zhang Tracy , Mani Naganathan , Kim Seung Kwon , Matson Sarah , Wood Michaeline , Shenoy Surendra 
Published: August 2017

Introduction Functional arteriovenous fistula (AVF) is the best vascular access for end-stage renal disease patients. AVF maturation is variable and many require additional interventions to achieve functionality. Long-term benefits of such interventions are unclear. Using a protocol for AVF planning, creation, maturation evaluation and performing interventions based on objective findings along with maintaining a database on follow-up is necessary to evaluate this question. The aim of this study is to evaluate the long-term outcome of newly constructed AVFs using a protocol-based approach in a tertiary care academic center. Methods This is an observational study. Long-term outcomes of consecutive AVFs placed over a 5-year period using a protocol for creation, maturation evaluation and interventions based on objective findings were analyzed using a prospectively maintained clinical database. Results Functioning AVFs were achieved in 86.5% (n = 296) of 342 patients. Primary and secondary patency of 372 AVF procedures at 12, 24 and 60 months were 42.8%, 31.6% and 20.8%; and 81.8%, 77.6% and 71.7%, respectively. Functional patency at 12, 24 and 60 months were 95.1%, 88.7%, and 85.2%, respectively. Long-term function was similar for AVFs maturing with ≤4 interventions and without interventions. AVFs maturing with 2-4 interventions needed significantly more interventions to maintain long-term functional patency (p = 0.003). Conclusions Piggyback straight-line on-lay technique (pSLOT) improves early outcome providing opportunity to identify other problems contributing to non-maturation. A large number of AVFs needing planned interventions to mature provide good long-term function. Establishing process of care guidelines for creation and follow-up has a potential to improve AVF outcome.
Paclitaxel, oxaliplatin, 5-fluorouracil and leucovorin combination chemotherapy in patients with recurrent or metastatic gastric cancer
Authors: Lan Yan-qin , Wu Ri-ping , Huang Xiao-bing , Wang Xin-li , Zhong Dong-ta , Huang Chuan-yong , Song Jin-tian 
Published: August 2017

Purpose: This study evaluated the efficacy and toxicity of combination chemotherapy with paclitaxel, oxaliplatin, 5-fluorouracil and leucovorin (POFL) in patients with recurrent or metastatic gastric cancer. Methods: One hundred and thirty-eight patients with histologically confirmed recurrent or metastatic gastric adenocarcinoma were treated with the POFL regimen: paclitaxel at a dose of 135 mg/m2 as a 3-hour intravenous infusion on day 1, oxaliplatin 85 mg/m2 and leucovorin 400 mg/m2 as an intravenous infusion over 2 hours on day 1, followed by 5-fluorouracil 2,400 mg/m2 as an infusion over a 46-hour period on 3 consecutive days, in a 2-week cycle. Results: Twelve patients could not be evaluated for response because of the absence of any measurable lesions or early discontinuation of therapy, so responses were assessed in 126 patients. The overall objective response rate was 56.3% (95% CI, 47.5%-64.9%). The median time to progression was 6.7 months (95% CI, 5.8-7.6 months), and the median overall survival was 12.6 months (95% CI, 11.3-13.9 months). The most common grade 3 and 4 toxicities were neutropenia (50.7%), peripheral neurotoxicity (16.7%) and alopecia (27.5%). Conclusions: Combination chemotherapy with POFL offers a new, active and safe approach to the treatment of recurrent or metastatic gastric cancer.
Environmental Sustainability in Freight Transportation: A Systematic Literature Review and Agenda for Future Research
Authors: Ellram Lisa M. , Murfield Monique L. Ueltschy 
Published: August 2017

AbstractThis article presents results of a systematic review of the conceptual and empirical literature published in the area of environmentally sustainable freight transportation (ESFT) since 1990. The research has been largely atheoretical and descriptive, though that has begun to change with the dramatic growth in this literature since 2010. The literature to date provides interesting insights into the way that ESFT practice has evolved. Following an input–transformation–output model, the topical focus of the research began with an emphasis on transformation processes or activities, and then considered inputs (represented by drivers/facilitators), barriers as moderators of the process, and outcomes of practice, or outputs. This article provides extensive suggestions for future research in each of the topical areas to help fill some of the gaps in theory and to enhance practice.
Redes complexas de homônimos para análise semântica textual
Authors: Santos Jadson , Andrade Felipe , Jorge Eduardo Manuel de Freitas , Batista João , Saba Hugo 
Published: August 2017

Introdução: Estudos voltados ao processamento de linguagem natural já são bem difundidos e possuem aplicações diversas. Relacionado a essa área de pesquisa, o uso de técnicas para manipular um texto determinando a morfologia e sintaxe de suas palavras é bastante comum. Existem ferramentas que fazem esse tratamento, entretanto adicionar mecanismos de identificação semântica para essas palavras é fundamental para aumentar o entendimento automático da linguagem empregada. Objetivo: Com base nesse contexto, este artigo apresenta o processo de utilização de redes complexas como base de dados comparativa para determinar, através do contexto, o significado de palavras que expressam posicionamentos distintos. Além disso, são classificados com mesma morfologia e sintaxe, como ocorre com alguns homônimos.Metodologia: Através de uma metodologia experimental, o modelo aqui proposto baseia-se em pesquisa já consolidadas em Processamento de Linguagem Natural para montar uma rede complexa que recebe como vértices as palavras de um determinado texto e estabelece suas ligações a partir da ocorrência de adjacência entre esses termos. Assim observando as variações da rede, identifica-se como os homônimos do texto estão relacionados, e através da análise do contexto em que se encontram, verificar se é utilizado para expressar mais de um significado.Resultados: Um processo genérico com etapas de pré-processamento, montagem de Redes Complexas usando Processamento de Linguagem Natural para concepção de uma rede de homônimos para extrair informação textual semântica. Conclusões: A análise de homônimos selecionados e etiquetados é um processo não apenas morfossintático, acrescentado semântica em uma frase, parágrafo ou texto onde as palavras são empregadas. Assim, através de Processamento de Linguagem Natural acontecimentos mundiais e fatos filosóficos escritos textualmente podem ser melhor analisados, como por exemplo, o poder de argumentação e o perfil de escrita de um autor.
Psychopathological symptoms, defense mechanisms and time perspectives among subjects with alcohol dependence (AD) presenting different patterns of coping with stress
Authors: Iwanicka Katarzyna , Gerhant Aneta , Olajossy Marcin 
Published: August 2017

BackgroundThe problem of coping with stress is an important one in the context of development and persistence of alcohol dependence. In the literature to date very little attention has been paid to coping patterns construed as a configuration of specific coping styles, particularly as regards the functioning of addicted individuals. The aim of the study was to verify whether individuals with alcohol dependence characterized by different coping patterns differ with respect to the severity of psychopathological symptoms, defense mechanisms and time perspectives.MethodsParticipants were given a battery of psychological tests—Coping Inventory for Stresfull Situations (CISS), Defense Style Questionnaire (DSQ 40), Syndrom Checklist (SCL-90) and Short Zimbardo Time Perspective Inventory (SZPTI-PL). The sample comprised 112 individuals with alcohol dependence, aged 20 to 63 years old, the average age was 37.86; 78 percent were men. There were identified three sub-groups of individuals characterized by a distinctive patterns of coping with stress —“emotional-avoidant”, “task oriented” and a “mixed one”.ResultsIndividuals with the predominant emotional-avoidant coping pattern are characterized by significantly higher severity of psychopathological symptoms, less mature defense mechanisms and past time perspectives. Subjects reliant on task-oriented coping pattern were characterized by the highest level of adaptation and the most constructive way of functioning in the face of difficulties.ConclusionIt is worth regarding the examination of patterns of coping as an indispensable element of collecting medical history from alcohol dependent individuals.
Stable and radiocarbon isotopic composition of dissolved organic matter in the Gulf of Mexico
Authors: Walker B. D. , Druffel E. R. M. , Kolasinski J. , Roberts B. J. , Xu X. , Rosenheim B. E. 
Published: August 2017

AbstractDissolved organic carbon (DOC) is of primary importance to marine ecosystems and the global carbon cycle. Stable carbon (δ13C) and radiocarbon (Δ14C) isotopic measurements are powerful tools for evaluating DOC sources and cycling. However, the isotopic signature of DOC in the Gulf of Mexico (GOM) remains almost completely unknown. Here we present the first DOC Δ14C and δ13C depth profiles from the GOM. Our results suggest the Mississippi River exports large amounts of DOC with an anthropogenic “bomb” Δ14C signature. Riverine DOC is removed and recycled offshore, and some marine production of DOC is observed in the river plume. Offshore profiles show that DOC has higher Δ14C than its Caribbean feed waters, indicative of a modern deep DOC source in the GOM basin. Finally, high DOC with negative δ13C and Δ14C values were observed near the Macondo Wellhead, suggesting a transformation of Deepwater Horizon hydrocarbons into a persistent population of DOC.
MESSENGER observations of the energization and heating of protons in the near‐Mercury magnetotail
Authors: Sun W. J. , Raines J. M. , Fu S. Y. , Slavin J. A. , Wei Y. , Poh G. K. , Pu Z. Y. , Yao Z. H. , Zong Q. G. , Wan W. X. 
Published: August 2017

AbstractThe energization and heating processes for protons in the near‐Mercury tail are examined with MErcury Surface, Space ENvironment, GEochemistry, and Ranging (MESSENGER) observations. In a case study, suprathermal proton particle flux (STPF) and proton temperature are observed to be clearly enhanced during near‐Mercury substorm dipolarizations, indicating the proton energization and heating processes. STPF and proton temperature distributions in near‐Mercury central plasma sheets display dawn‐dusk asymmetries, with higher values in the dawnside plasma sheet, i.e., postmidnight, than in the duskside, i.e., premidnight. Further investigations reveal that these asymmetries are more prominent during active periods in Mercury's magnetosphere, as compared to quiet periods. Magnetic field variations in the ZMSM component display a similar feature, with variations being more prominent on the dawnside than the duskside during active periods. We propose that the dawn‐dusk asymmetry in the distributions of protons could be due to the fact that more substorm dipolarizations were initiated on the dawnside of Mercury's magnetotail.
Interferometer angle‐of‐arrival determination using precalculated phases
Authors: Younger J. P. , Reid I. M. 
Published: August 2017

AbstractA method has been developed to determine the angle of arrival (AoA) of incident radiation using precomputed lookup tables. The phase difference between two receiving antennas can be used to infer AoA as measured from the pair baseline, but there will be more than one possible solution for antenna spacings greater than or equal to half a wavelength. Larger spacings are preferable to minimize mutual coupling of elements in the receive array and to decrease the relative uncertainty in measured phase difference. We present a solution that uses all unique antenna pairs to determine probabilities for all possible azimuth and zenith values. Prior to analysis, the expected phase differences for all AoAs are calculated for each antenna pair. For a received signal, histograms of possible AoAs for each antenna pair phase difference are extracted and added to produce a two‐dimensional probability density array that will maximize at the true value of the AoA. A benefit of this method is that all possible antenna pairs are utilized rather than the restriction to specific pairs along baselines used by some interferometer algorithms. Numerical simulations indicate that performance of the suggested algorithm exceeds that of existing methods, with the benefit of additional flexibility in antenna placement. Meteor radar data have been used to test this method against existing methods, with excellent agreement between the two approaches. This method of AoA determination will allow the construction of low‐cost interferometric direction finding arrays with different layouts, including construction of difficult terrain and three‐dimensional antenna arrangements.