bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perivascular Macrophages Limit Permeability
Authors: He Huanhuan , Mack Julia J. , Güç Esra , Warren Carmen M. , Squadrito Mario Leonardo , Kilarski Witold W. , Baer Caroline , Freshman Ryan D. , McDonald Austin I. , Ziyad Safiyyah , Swartz Melody A. , De Palma Michele , Iruela-Arispe M. Luisa 
Published: September 2016

Objective—
Perivascular cells, including pericytes, macrophages, smooth muscle cells, and other specialized cell types, like podocytes, participate in various aspects of vascular function. However, aside from the well-established roles of smooth muscle cells and pericytes, the contributions of other vascular-associated cells are poorly understood. Our goal was to ascertain the function of perivascular macrophages in adult tissues under nonpathological conditions.

Approach and Results—
We combined confocal microscopy, in vivo cell depletion, and in vitro assays to investigate the contribution of perivascular macrophages to vascular function. We found that resident perivascular macrophages are associated with capillaries at a frequency similar to that of pericytes. Macrophage depletion using either clodronate liposomes or antibodies unexpectedly resulted in hyperpermeability. This effect could be rescued when M2-like macrophages, but not M1-like macrophages or dendritic cells, were reconstituted in vivo, suggesting subtype-specific roles for macrophages in the regulation of vascular permeability. Furthermore, we found that permeability-promoting agents elicit motility and eventual dissociation of macrophages from the vasculature. Finally, in vitro assays showed that M2-like macrophages attenuate the phosphorylation of VE-cadherin upon exposure to permeability-promoting agents.

Conclusions—
This study points to a direct contribution of macrophages to vessel barrier integrity and provides evidence that heterotypic cell interactions with the endothelium, in addition to those of pericytes, control vascular permeability.
Prevalence and Predictors of Multiple Coronary Plaque Ruptures
Authors: Vergallo Rocco , Uemura Shiro , Soeda Tsunenari , Minami Yoshiyasu , Cho Jin-Man , Ong Daniel S. , Aguirre Aaron D. , Gao Lei , Biasucci Luigi M. , Crea Filippo , Yu Bo , Lee Hang , Kim Chong-Jin , Jang Ik-Kyung 
Published: September 2016

Objective—
Plaque rupture may be the local expression of a widespread coronary instability. This study aimed to investigate: (1) the prevalence and characteristics of nonculprit plaque rupture; (2) the pancoronary atherosclerotic phenotype in patients with and without nonculprit plaque rupture; and (3) the prevalence and predictors of multiple plaque ruptures.

Approach and Results—

Six hundred and seventy-five nonculprit plaques from 261 patients (34 acute myocardial infarction, 73 unstable angina pectoris, and 154 stable angina pectoris) were analyzed by 3-vessel optical coherence tomography. Nonculprit plaque ruptures were identified in 51 patients (20%). Patients with nonculprit plaque ruptures had higher prevalence of thin-cap fibroatheroma (51% versus 13%;
P
<0.001) in the 3 major epicardial coronary vessels. Multiple plaque ruptures were observed in 20% of patients (38% acute myocardial infarction versus 10% unstable angina pectoris versus 19% stable angina pectoris;
P
=0.042). Thin-cap fibroatheroma, intimal vasculature, and macrophages were independent morphological predictors of multiple plaque ruptures, whereas acute myocardial infarction and chronic kidney disease were independent clinical predictors. Patients with nonculprit plaque ruptures showed higher 1-year rates of nontarget lesion revascularization (11.8% versus 4.4%;
P
=0.039).

Conclusions—
Nonculprit plaque ruptures were observed in 20% of patients with coronary artery disease and were associated with pancoronary vulnerability and higher 1-year revascularization rate.
Inter-Rater Reliability of the CASCADE Criteria
Authors: Bernard Timothy J. , Beslow Lauren A. , Manco-Johnson Marilyn J. , Armstrong-Wells Jennifer , Boada Richard , Weitzenkamp David , Hollatz Amanda , Poisson Sharon , Amlie-Lefond Catherine , Lo Warren , deVeber Gabrielle , Goldenberg Neil A. , Dowling Michael M. , Roach E. Steve , Fullerton Heather J. , Benseler Susanne M. , Jordan Lori C. , Kirton Adam , Ichord Rebecca N. 
Published: September 2016

Background and Purpose—
There are limited data about the reliability of subtype classification in childhood arterial ischemic stroke, an issue that prompted the IPSS (International Pediatric Stroke Study) to develop the CASCADE criteria (Childhood AIS Standardized Classification and Diagnostic Evaluation). Our purpose was to determine the CASCADE criteria’s reliability in a population of children with stroke.

Methods—
Eight raters from the IPSS reviewed neuroimaging and clinical records of 64 cases (16 cases each) randomly selected from a prospectively collected cohort of 113 children with arterial ischemic stroke and classified them using the CASCADE criteria. Clinical data abstracted included history of present illness, risk factors, and acute imaging. Agreement among raters was measured by unweighted κ statistic.

Results—
The CASCADE criteria demonstrated a moderate inter-rater reliability, with an overall κ statistic of 0.53 (95% confidence interval [CI]=0.39–0.67). Cardioembolic and bilateral cerebral arteriopathy subtypes had much higher agreement (κ=0.84; 95% CI=0.70–0.99; and κ=0.90; 95% CI=0.71–1.00, respectively) than cases of aortic/cervical arteriopathy (κ=0.36; 95% CI=0.01–0.71), unilateral focal cerebral arteriopathy of childhood (FCA; κ=0.49; 95% CI=0.23–0.76), and small vessel arteriopathy of childhood (κ=−0.012; 95% CI=−0.04 to 0.01).

Conclusions—
The CASCADE criteria have moderate reliability when used by trained and experienced raters, which suggests that it can be used for classification in multicenter pediatric stroke studies. However, the moderate reliability of the arteriopathic subtypes suggests that further refinement is needed for defining subtypes. Such revisions may reduce the variability in the literature describing risk factors, recurrence, and outcomes associated with childhood arteriopathy.
Effects of Exercise Therapy on Balance Capacity in Chronic Stroke
Authors: van Duijnhoven Hanneke J.R. , Heeren Anita , Peters Marlijn A.M. , Veerbeek Janne M. , Kwakkel Gert , Geurts Alexander C.H. , Weerdesteyn Vivian 
Published: September 2016

Background and Purpose—
The purpose of this systematic review and meta-analysis was to investigate the effects of exercise training on balance capacity in people in the chronic phase after stroke. Furthermore, we aimed to identify which training regimen was most effective.

Methods—
Electronic databases were searched for randomized controlled trials evaluating the effects of exercise therapy on balance capacity in the chronic phase after stroke. Studies were included if they were of moderate or high methodological quality (PEDro score ≥4). Data were pooled if a specific outcome measure was reported in at least 3 randomized controlled trials. A sensitivity analysis and consequent subgroup analyses were performed for the different types of experimental training (balance and/or weight-shifting training, gait training, multisensory training, high-intensity aerobic exercise training, and other training programs).

Results—

Forty-three randomized controlled trials out of 369 unique hits were included. A meta-analysis could be conducted for the Berg Balance Scale (28 studies, n=985), Functional Reach Test (5 studies, n=153), Sensory Organization Test (4 studies, n=173), and mean postural sway velocity (3 studies, n=89). A significant overall difference in favor of the intervention group was found for the Berg Balance Scale (mean difference 2.22 points (+3.9%); 95% confidence interval [CI], 1.26–3.17;
P
<0.01;
I
2
=52%), Functional Reach Test (mean difference=3.12 cm; 95% CI, 0.90–5.35;
P
<0.01;
I
2
=74%), and Sensory Organization Test (mean difference=6.77 (+7%) points; 95% CI, 0.83–12.7;
P
=0.03;
I
2
=0%). Subgroup analyses of the studies that included Berg Balance Scale outcomes demonstrated a significant improvement after balance and/or weight-shifting training of 3.75 points (+6.7%; 95% CI, 1.71–5.78;
P
<0.01;
I
2
=52%) and after gait training of 2.26 points (+4.0%; 95% CI, 0.94–3.58;
P
<0.01;
I
2
=21, whereas no significant effects were found for other training regimens.

Conclusions—
This systematic review and meta-analysis showed that balance capacities can be improved by well-targeted exercise therapy programs in the chronic phase after stroke. Specifically, balance and/or weight-shifting and gait training were identified as successful training regimens.
White Matter Hyperintensity–Adjusted Critical Infarct Thresholds to Predict a Favorable 90-Day Outcome
Authors: Patti Jatinder , Helenius Johanna , Puri Ajit S. , Henninger Nils 
Published: September 2016

Background and Purpose—
There is increasing interest in defining stroke lesion volume thresholds to predict poststroke outcome. However, there is a paucity of data on factors that impact the association between critical infarct thresholds volume and outcome. We sought to determine whether lesion thresholds best predicting outcome depend on the degree of preexisting white matter hyperintensity (WMH) lesion burden.

Methods—
Magnetic resonance imaging infarct volumes were quantified in 414 consecutive patients with anterior circulation ischemic strokes evaluated between January 2014 and December 2014. The WMH lesion volume was graded according to the Fazekas scale and dichotomized to absent to mild versus moderate to severe. Receiver operator characteristics curves were calculated to determine the infarct volume threshold best predicting the 90-day outcome. Multivariable logistic regression was used to determine whether the critical lesion thresholds independently predicted a favorable 90-day outcome after adjusting for pertinent confounders.

Results—
The infarct volumes thresholds predicting the 90-day outcome for the entire cohort (standard thresholds) were ≤29.5 mL (modified Rankin scale [mRS] 0–1), ≤29.9 mL (mRS 0–2), and ≤34.1 mL (mRS 0–3). For patients with absent-to-mild WMH lesion burden, WMH-adjusted critical infarct thresholds were significantly greater than the standard infarct thresholds. In the fully adjusted multivariable regression models, the WMH-adjusted infarct thresholds correctly predicted the outcome to a similar degree as the standard thresholds.

Conclusions—
In this proof-of-concept study, the WMH lesion burden impacted the critical outcome-predicting infarct thresholds. If confirmed, using a WMH-adjusted infarct threshold could allow defining patients that have a favorable outcome despite having relatively large infarct volumes.
Frontogenesis and Turbulence: A Numerical Simulation
Authors: Samelson R. M. , Skyllingstad E. D. 
Published: September 2016

Abstract
A numerical simulation is analyzed that resolves the full range of motions from rotationally dominated, growing baroclinic waves to quasi-isotropic, three-dimensional shear instabilities. The results confirm a 40-yr-old prediction, made by B. Hoskins and F. Bretherton, that frontogenetic collapse of cross-frontal spatial scales, driven by baroclinic-wave deformation fields, will continue to the Kelvin–Helmholtz (K–H) turbulent transition. This process of frontal collapse followed by K–H transition provides a mechanism for spontaneous loss of balance in an initially geostrophic flow, and a direct, spectrally nonlocal pathway for downscale energy transfer that is phenomenologically distinct from traditional concepts of turbulent cascades and can contribute substantially to total kinetic energy dissipation. These results, which neglect surface drag and several other potentially relevant atmospheric processes, would suggest that the turbulence associated with collapsing fronts in the atmosphere can extend upward from the surface through roughly one-third of the troposphere.
Incidence of late atrial fibrillation in bilateral lung versus heart transplants
Authors: Magruder J Trent , Plum William , Crawford Todd C , Grimm Joshua C , Borja Marvin C , Berger Ronald D , Tandri Harikrishna , Calkins Hugh , Cameron Duke E , Mandal Kaushik 
Published: September 2016

Background We compared the incidence of late-onset atrial fibrillation in orthotopic heart transplant recipients and bilateral orthotopic lung transplant recipients. Methods We reviewed the records of all heart and lung transplant operations carried out in our institution between 1995 and 2015. We performed 1:1 propensity-matching based on patient age, sex, body mass index, and hypertension. Our primary outcome, late-onset atrial fibrillation, was defined as atrial fibrillation occurring after discharge following hospitalization for transplantation. Results Over the study period, 397 orthotopic heart transplants and 240 bilateral orthotopic lung transplants were performed. Propensity matching resulted in 173 pairs who were matched with respect to age, sex, body mass index, and preoperative hypertension. The median follow-up was 5.3 years for heart transplant patients and 3.1 years for lung transplant patients. Late-onset atrial fibrillation occurred in 11 heart transplant patients (5 of whom had biopsy-proven evidence of rejection) and 19 lung transplant patients (2 of whom had biopsy-proven evidence of rejection). On Kaplan-Meier analysis, the probability of late-onset atrial fibrillation at 5 years was 4.3% for heart transplant patients vs. 13.9% for lung transplant patients (log-rank p = 0.01). Conclusions We documented an increased probability of late-onset atrial fibrillation among bilateral orthotopic lung transplant patients compared to orthotopic heart transplant patients. This was a hypothesis-generating study that suggests a potential role for cardiac autonomic innervation in the genesis of atrial fibrillation.
Unchanging Capacity
Authors: Morey Stephanie A. , McCarley Jason S. , Thomas Nicole A. 
Published: September 2016

Complex workspaces often require operators to divide attention between information within the visual periphery and a visual central task. For an air traffic controller, for example, monitoring complex displays while also watching for potential hazards is essential for avoiding aircraft collisions. In such environments, fast and accurate detection of peripheral events may be critical for safe performance. Presenting targets redundantly offers a potential way of speeding up target detection (Little, Eidels, Fific, & Wang, 2015; Townsend & Eidels, 2011). It remains unclear, however, whether redundant-target processing remains efficient with a concurrent central task. A series of experiments examined the effects of dual-tasking on peripheral redundant-target processing, either between- (Experiments 1a & 1b) or within-participants (Experiment 4). Furthermore, Experiments 2 and 3 manipulated target-distractor discriminability and distractor presence to examine the effects of target salience on dual-task processing efficiency. One hundred and one undergraduate students ( N =20 in each of Experiments 1a to 3; N = 21 in Experiment 4) performed a redundant-target task either by itself (Experiment 1a) or whilst performing a manual tracking task (Experiments 1b-4). The tracking task required participants to maneuver a joystick using both hands to align a cursor with a moving red target. The detection task required participants to press a joystick button bimanually whenever a target appeared at a location in the peripheral visual field. Experiments 1a, 1b, and Experiment 4 employed “T” as the target item and “L” as distractor items that appeared randomly rotated in 90° steps. In Experiment 2, target salience was increased by employing “X” as the target item and “O” for the distractor items. Experiment 3 tested peripheral target processing in the absence of distractors; hence, only the target item “T” was employed. Processing efficiency in the target-detection task was calculated using measures of resiliency (Little et al., 2015) or workload capacity (Townsend & Eidels, 2011). In all five experiments, processing of redundant targets was less efficient than predicted by a standard parallel race model (Raab, 1962; Townsend & Eidels, 2011). Surprisingly, processing efficiency differed negligibly between the single and dual-task conditions. Capacity may be protected from task-load effects due to separate information-processing resource pools within the central and peripheral visual fields (Wickens, 2002). Neither increasing the discriminability between targets and distractors, nor removing distractors entirely, had any effect on redundant-target processing efficiency. Results suggest target processing in the visual periphery is capacity-limited, but that processing efficiency is robust against changes to concurrent task load or target salience.
Improving Medical Education
Authors: Yovanoff Mary , Pepley David , Mirkin Katelin , Moore Jason , Han David , Miller Scarlett 
Published: September 2016

Virtual simulation is an emerging field in medical education. Research suggests that simulation reduces complication rates and improves learning gains for medical residents. One benefit of simulators is their allowance for more realistic and dynamic patient anatomies. While potentially useful throughout medical education, few studies have explored the impact of dynamic haptic simulators on medical training. In light of this research void, this study was developed to examine how a Dynamic-Haptic Robotic Trainer (DHRT) impacts medical student self-efficacy and skill gains compared to traditional simulators developed to train students in Internal Jugular Central Venous Catheter (IJ CVC) placement. The study was conducted with 18 third year medical students with no prior CVC insertion experience who underwent a pre-test, simulator training (manikin, robotic, or mixed) and post-test. The results revealed the DHRT as a useful method for training CVC skills and supports further research on dynamic haptic trainers in medical education.
IL-17A attracts inflammatory cells in murine lung infection with P. aeruginosa
Authors: Wonnenberg Bodo , Jungnickel Christopher , Honecker Anja , Wolf Lisa , Voss Meike , Bischoff Markus , Tschernig Thomas , Herr Christian , Bals Robert , Beisswenger Christoph 
Published: September 2016

IL-17A-dependent immunity is of importance in the protection against extracellular bacterial pathogens. However, IL-17A is also suggested to mediate the pathogenesis of lung diseases, such as acute respiratory distress syndrome. Here, we studied the role of IL-17A in a mouse model of acute pneumonia. IL-17A mediated the expression of keratinocyte-derived chemokine (KC) and the recruitment of inflammatory cells in mice infected with a sub-lethal dose of Pseudomonas aeruginosa. IL-17A deficiency protected mice from lethal P. aeruginosa lung infection. A sub-lethal infection with Streptococcus pneumoniae resulted in increased bacterial burden associated with increased pulmonary inflammation. Thus, the type of infectious bacteria seemed to influence the way in which IL-17A functions during pulmonary infection. Reducing pulmonary inflammation by targeting IL-17A may be a therapeutic option in acute P. aeruginosa pneumonia.
Effect of adding intrathecal morphine to a multimodal analgesic regimen for postoperative pain management after laparoscopic bariatric surgery: a prospective, double-blind, randomized controlled trial
Authors: El Sherif Fatma Adel , Othman Ahmed Hassan , Abd El-Rahman Ahmad Mohammad , Taha Osama 
Published: September 2016

Background: Pain control after bariatric surgery is a major challenge. Our objective was to study the efficacy and safety of intrathecal (IT) morphine 0.3 mg added to bupivacaine 0.5% for postoperative pain after laparoscopic bariatric surgery. Methods: After local ethics committee approval, 100 morbidly obese patients scheduled for laparoscopic bariatric surgery were enrolled in this study. Patients were randomly assigned into two groups: Group I received IT 0.3 mg morphine (0.3 mL) added to 1.2 mL of bupivacaine 0.5%; Group II received IT 0.3 mL saline added to 1.2 mL of bupivacaine 0.5%, immediately before induction of general anaesthesia. For both groups, 60 mg ketorolac and 1000 mg paracetamol were infused 30 minutes before the end of surgery. After wound closure, 20 mL bupivacaine 0.25% was infiltrated at wound edges. Results: Visual Analogue Scale (VAS) score was significantly lower in group I immediately, 30 minutes and 1 hour postoperatively. Time to first ambulation, return of intestinal sounds and hospital stay were shorter in group I than group II (p < 0.05); total morphine consumption was significantly lower in group I than group II (p < 0.05). Sedation score was significantly higher in group I immediately postoperatively, while at 30 minutes, 1, 2 and 6 hours postoperatively sedation scores were significantly higher in group II. Itching was significantly higher in group I. Conclusion: The addition of IT morphine to a multimodal analgesic regimen after laparoscopic bariatric surgery was an effective and safe method that markedly reduced postoperative pain, systemic opioid consumption and length of hospital stay.
Comparison of fentanyl iontophoretic transdermal system and routine care with morphine intravenous patient-controlled analgesia in the management of early postoperative mobilisation: results from a randomised study
Authors: Langford Richard M , Chang Kuang-Yi , Ding Li , Abraham Jeffrey 
Published: September 2016

Introduction: Fentanyl iontophoretic transdermal system (ITS) (IONSYS®, The Medicines Company, Parsippany, NJ, USA) and morphine intravenous (IV) patient-controlled analgesia (PCA) have demonstrated equivalent pain control in several published studies. The primary objective of the current study was to compare fentanyl ITS with morphine IV PCA with regard to the patient’s ability to mobilise with acute postoperative pain. Methods: In this multicentre, open-label, randomised, active-controlled, prospective phase IV study, postoperative patients initially received IV morphine and were titrated to pain score ⩽ 4out of 10 on a Numeric Rating Scale (NRS) and then received fentanyl ITS (up to 240 µg (6 doses)/hour; up to a maximum of 3.2 mg (80 doses)/24 hours) or morphine IV PCA (doses up to 20 mg morphine/2 hours, up to 240 mg/24 hours). The primary efficacy measure was ability to mobilise, assessed using patient responses to three validated questions regarding mobility on a 6-point Likert scale (0 = no difficulty to mobilise to 5 = a very great deal of difficulty to mobilise). The study was originally planned to include ~200 patients. However, following the early suspension and termination of the study, a total of 108 patients were randomised to study treatment. Results: One hundred and eight patients were recruited prior to undergoing surgical procedures (orthopaedic surgical procedures (72%) or underwent major abdominal procedures (28%)). Postoperatively, 58 were randomised to receive fentanyl ITS, and 50 to morphine IV PCA. Fentanyl ITS patients had a greater ability to mobilise at the time of stopping study drug, with an adjusted mean ability to mobilise score (95% confidence interval (CI)) of 0.14 (−0.19, 0.47) for fentanyl ITS patients and 2.37 (1.98, 2.76) for morphine IV PCA patients (p < 0.001). Conclusion: Patients treated with fentanyl ITS reported that they were better able to mobilise than patients treated with morphine IV PCA, at all time-points following surgery out to 24 hours.