bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endovascular Aneurysm Repair Increases Aortic Arterial Stiffness When Compared to Open Repair of Abdominal Aortic Aneurysms
Authors: Gray Cleona , Goodman Patrick , Badger Stephen A. , O’Malley M. Kevin , O’Donohoe Martin K. , McDonnell Ciarán O. 
Published: May 2016

Objectives: The initial survival advantage seen with endovascular aneurysm repair (EVAR) over open repair does not persist in the long term. Pulse wave velocity (PWV) is a measure of arterial stiffness, and increased PWV is an independent risk factor for increased cardiovascular morbidity and mortality. This prospective comparative pilot study examined the effect of implantation of an aortic graft on PWV in patients undergoing open or endovascular aortic aneurysm repair. Patients and Methods: Thirty-four patients (15 open and 19 EVAR) were recruited. Patient demographics were similar in both the groups. Pulse wave velocity was calculated for all patients preoperatively and postoperatively using a standardized technique on a Philips IU22 Vascular Ultrasound machine and the results compared. Results: An increase in mean PWV following EVAR was demonstrated. The mean postprocedure PWV of 9.7 (± 4.5) cm/sec detected in the open group was significantly lower than the elevated 12.2 (± 4.5) cm/sec detected in the EVAR group. The surgical group also demonstrated a mean decrease of 0.2 (± 4.9) cm/sec in PWV following open repair compared to a mean increase of 3.3 (± 3.7) cm/sec in the EVAR group. Conclusion: EVAR patients have a significantly higher postoperative PWV measurement than those undergoing open abdominal aortic aneurysm repair. Patients who have undergone EVAR may be at a higher risk of cardiovascular morbidity in the long term. A larger scale study with a longer prospective follow-up is required.
Breast Cancer Downstaging Practices and Breast Health Messaging Preferences Among a Community Sample of Urban and Rural Ugandan Women
Authors: Scheel John R. , Molina Yamile , Patrick Donald L. , Anderson Benjamin O. , Nakigudde Gertrude , Lehman Constance D. , Thompson Beti 
Published: May 2016

Purpose Among a community sample of Ugandan women, we provide information about breast cancer downstaging practices (breast self-examination, clinical breast examination [CBE]) and breast health messaging preferences across sociodemographic, health care access, and prior breast cancer exposure factors. Methods Convenience-based sampling was conducted to recruit Ugandan women age 25 years and older to assess breast cancer downstaging practices as well as breast health messaging preferences to present early for a CBE in the theoretical scenario of self-detection of a palpable lump (breast health messaging preferences). Results The 401 Ugandan women who participated in this survey were mostly poor with less than a primary school education. Of these women, 27% had engaged in breast self-examination, and 15% had undergone a CBE. Greater breast cancer downstaging practices were associated with an urban location, higher education, having a health center as a regular source of care, and receiving breast cancer education ( P < .05). Women indicated a greater breast health messaging preference from their provider (66%). This preference was associated with a rural location, having a health center as a regular source of care, and receiving breast cancer education ( P < .05). Conclusion Most Ugandan women do not participate in breast cancer downstaging practices despite receipt of breast cancer education. However, such education increases downstaging practices and preference for messaging from their providers. Therefore, efforts to downstage breast cancer in Uganda should simultaneously raise awareness in providers and support improved education efforts in the community.
Benefit of Delayed Fertility Therapy With Preconception Weight Loss Over Immediate Therapy in Obese Women With PCOS
Authors: Legro Richard S. , Dodson William C. , Kunselman Allen R. , Stetter Christy M. , Kris-Etherton Penny M. , Williams Nancy I. , Gnatuk Carol L. , Estes Stephanie J. , Allison Kelly C. , Sarwer David B. , Diamond Michael P. , Schlaff William D. , Casson Peter R. , Christman Gregory M. , Barnhart Kurt T. , Bates G. Wright , Usadi Rebecca , Lucidi Scott , Baker Valerie , Zhang Heping , Eisenberg Esther , Coutifaris Christos , Dokras Anuja 
Published: May 2016

Context:
In overweight/obese women with polycystic ovary syndrome (PCOS), the relative benefit of delaying infertility treatment to lose weight vs seeking immediate treatment is unknown.

Objective:
We compared the results of two, multicenter, concurrent clinical trials treating infertility in women with PCOS.

Design, Setting, and Participants:
This was a secondary analysis of two randomized trials conducted at academic health centers studying women 18–40 years of age who were overweight/obese and infertile with PCOS.

Intervention:
We compared immediate treatment with clomiphene from the Pregnancy in Polycystic Ovary Syndrome II (PPCOS II) trial (N = 187) to delayed treatment with clomiphene after preconception treatment with continuous oral contraceptives, lifestyle modification (Lifestyle: including caloric restriction, antiobesity medication, behavioral modification, and exercise) or the combination of both (combined) from the Treatment of Hyperandrogenism Versus Insulin Resistance in Infertile Polycystic Ovary Syndrome (OWL PCOS) trial (N = 142).

Main Outcome Measures:
Live birth, pregnancy loss, and ovulation were measured.

Results:
In PPCOS II, after four cycles of clomiphene, the cumulative per-cycle ovulation rate was 44.7% (277/619) and the cumulative live birth rate was 10.2% (19/187), nearly identical to that after oral contraceptive pretreatment in the OWL PCOS trial (ovulation 45% [67/149] and live birth: 8.5% [4/47]). In comparison, deferred clomiphene treatment preceded by lifestyle and combined treatment in OWL PCOS offered a significantly better cumulative ovulation rate compared to immediate treatment with clomiphene. (Lifestyle: 62.0% [80/129]; risk ratio compared to PPCOS II = 1.4; 95% confidence interval [CI], 1.1–1.7; P = .003; combined: 64.3% [83/129]; risk ratio compared to PPCOS II = 1.4; 95% CI, 1.2–1.8; P &lt; .001 and a significantly better live birth rate lifestyle: 25.0% [12/48]; risk ratio compared to PPCOS II = 2.5; 95% CI, 1.3–4.7; P = .01 and combined: 25.5% [12/47]; risk ratio compared to PPCOS II = 2.5; 95% CI, 1.3–4.8; P = .01).

Conclusions:
These data show the benefit of improved ovulation and live birth with delayed infertility treatment with clomiphene citrate when preceded by lifestyle modification with weight loss compared with immediate treatment. Pretreatment with oral contraceptives likely has little effect on the ovulation and live birth rate compared with immediate treatment.
The Effect of Local Anesthetic Volume Within the Adductor Canal on Quadriceps Femoris Function Evaluated by Electromyography: A Randomized, Observer- and Subject-Blinded, Placebo-Controlled Study in Volunteers
Authors: Grevstad Ulrik , Jæger Pia , Sørensen Johan Kløvgaard , Gottschau Bo , Ilfeld Brian , Ballegaard Martin , Hagelskjaer Mike , Dahl Jørgen Berg 
Published: May 2016

BACKGROUND:
Single-injection adductor canal block (ACB) provides analgesia after knee surgery. Which nerves that are blocked by an ACB and what influence—if any—local anesthetic volume has on the effects remain undetermined. We hypothesized that effects on the nerve to the vastus medialis muscle (which besides being a motor nerve innervates portions of the knee) are volume-dependent.

METHODS:
In this assessor- and subject-blinded randomized trial, 20 volunteers were included. On 3 separate days, subjects received an ACB with different volumes (10, 20, and 30 mL) of lidocaine 1%. In addition, they received a femoral nerve block and a placebo ACB. The effect on the vastus medialis (primary endpoint) and the vastus lateralis was evaluated using noninvasive electromyography (EMG). Quadriceps femoris muscle strength was evaluated using a dynamometer.

RESULTS:
There was a statistically significant difference in EMG response from the vastus medialis, dependent on volume. Thirty-five percent (95% confidence interval [CI], 18–57) of the subjects had an affected vastus medialis after an ACB with 10 mL compared with 84% (95% CI, 62–94) following 20 mL (P = 0.03) and 100% (95% CI, 84–100) when 30 mL was used (P = 0.0001). No statistically significant differences were found between volume and effect on the vastus lateralis (P = 0.81) or in muscle strength (P = 0.15).

CONCLUSIONS:
For ACB, there is a positive correlation between local anesthetic volume and effect on the vastus medialis muscle. Despite the rather large differences in EMG recordings, there were no statistically significant differences in quadriceps femoris muscle strength. Subsequent clinical studies comparing different volumes in a surgical setting, powered to show differences not only in analgesic efficacy, but also in adverse events, are required.
The Perioperative Use of Dexmedetomidine in Pediatric Patients with Congenital Heart Disease: An Analysis from the Congenital Cardiac Anesthesia Society-Society of Thoracic Surgeons Congenital Heart Disease Database
Authors: Schwartz Lawrence I. , Twite Mark , Gulack Brian , Hill Kevin , Kim Sunghee , Vener David F. 
Published: May 2016

BACKGROUND:
Dexmedetomidine is a selective α-2 receptor agonist with a sedative and cardiopulmonary profile that makes it an attractive anesthetic for pediatric patients with congenital heart disease (CHD). Although several smaller, single-center studies suggest that dexmedetomidine use is gaining traction in the perioperative setting in children with CHD, there are limited multicenter data, with little understanding of the variation in use across age ranges, procedural complexity, and centers. The aim of this study was to use the Congenital Cardiac Anesthesia Society-Society of Thoracic Surgeons (CCAS-STS) registry to describe patient- and center-level variability in the use of dexmedetomidine in the perioperative setting in children with heart disease.

METHODS:
To describe the use of dexmedetomidine in patients for CHD surgery, we analyzed all index cardiopulmonary bypass operations entered in the CCAS-STS database from 2010 to 2013. Patient and operative characteristics were compared between those who received intraoperative dexmedetomidine and those who did not. Selective outcomes associated with dexmedetomidine use were also described.

RESULTS:
Of the 12,142 operations studied, 3600 (29.6%) received perioperative dexmedetomidine (DEX) and 8542 did not receive the drug (NoDEX). Patient characteristics were different between the 2 groups with the DEX group generally exhibiting both lower patient and procedural risk factors. Patients who received dexmedetomidine were more likely to have a lower level of Society of Thoracic Surgeons mortality complexity than patient who did not receive it. Consistent with their overall lower risk profile, children in the DEX group also demonstrated improved outcomes compared with patients who did not receive dexmedetomidine.

CONCLUSIONS:
We described the growing use of dexmedetomidine in children anesthetized for surgical repair of CHD. Dexmedetomidine appears to be preferentially given to older and larger children who are undergoing less complex CHD surgery. We believe that the data provided in this study are the largest investigating the use of an anesthetic drug in CHD patients. It is also the first analysis of the anesthesia data in the CCAS-STS Congenital Heart Disease database.
Association of Selective Serotonin Reuptake Inhibitors with Transfusion in Surgical Patients
Authors: Sajan Farrah , Conte John V. , Tamargo Rafael J. , Riley Lee H. , Rock Peter , Faraday Nauder 
Published: May 2016

BACKGROUND:
The clinical relevance of chronic exposure to selective serotonin reuptake inhibitors (SSRIs) to transfusion in surgical patients is unclear.

METHODS:
We conducted a prospective cohort study involving patients undergoing cardiac, vascular, spinal, and intracranial surgery at 2 academic medical centers. Medication use, demographics, comorbidities, and laboratory values were determined at baseline by patient interview and review of medical records. The primary outcome was transfusion of any hemostatic allogeneic blood product (i.e., fresh frozen plasma, platelets, and/or cryoprecipitate) through postoperative day 2.

RESULTS:
The study sample consisted of 767 patients; 364 patients (47.5%) underwent cardiac surgery and the remainder underwent noncardiac surgery. Eighty-eight patients (11.5%) used SSRIs preoperatively. Among cardiac patients, the absolute number of allogeneic transfusions was higher for SSRI users than nonusers (2 [0–6] vs 0 [0–2], median [25%–75%], respectively, P = 0.008), and a similar trend was observed for noncardiac surgery. After adjusting for covariates using ordinal logistic regression, preoperative SSRI use was associated with an approximately 2-fold (odds ratio, 2.2; 95% confidence interval, 1.2–3.98) increase in odds of exposure to allogeneic hemostatic blood products; similar results were observed using propensity score adjustment (odds ratio, 1.85; 95% confidence interval, 1.11–3.07). A significant interaction between SSRI use and surgery type, age, sex, or concurrent antiplatelet therapy was not found; however, heterogeneity in magnitude of effect could not be excluded.

CONCLUSIONS:
Preoperative use of SSRIs is associated with increased exposure to allogeneic hemostatic blood products in surgical patients at high risk for perioperative bleeding. Determining whether perioperative continuation or withdrawal of SSRIs produces a net clinical benefit requires randomized controlled trials.
Quantitative analysis of 3D extracellular matrix remodelling by pancreatic stellate cells
Authors: Robinson Benjamin K. , Cortes Ernesto , Rice Alistair J. , Sarper Muge , del Río Hernández Armando 
Published: May 2016

ABSTRACT
Extracellular matrix (ECM) remodelling is integral to numerous physiological and pathological processes in biology, such as embryogenesis, wound healing, fibrosis and cancer. Until recently, most cellular studies have been conducted on 2D environments where mechanical cues significantly differ from physiologically relevant 3D environments, impacting cellular behaviour and masking the interpretation of cellular function in health and disease. We present an integrated methodology where cell-ECM interactions can be investigated in 3D environments via ECM remodelling. Monitoring and quantification of collagen-I structure in remodelled matrices, through designated algorithms, show that 3D matrices can be used to correlate remodelling with increased ECM stiffness observed in fibrosis. Pancreatic stellate cells (PSCs) are the key effectors of the stromal fibrosis associated to pancreatic cancer. We use PSCs to implement our methodology and demonstrate that PSC matrix remodelling capabilities depend on their contractile machinery and β1 integrin-mediated cell-ECM attachment.
Reprogrammable CRISPR/Cas9-based system for inducing site-specific DNA methylation
Authors: McDonald James I. , Celik Hamza , Rois Lisa E. , Fishberger Gregory , Fowler Tolison , Rees Ryan , Kramer Ashley , Martens Andrew , Edwards John R. , Challen Grant A. 
Published: May 2016

ABSTRACT
Advances in sequencing technology allow researchers to map genome-wide changes in DNA methylation in development and disease. However, there is a lack of experimental tools to site-specifically manipulate DNA methylation to discern the functional consequences. We developed a CRISPR/Cas9 DNA methyltransferase 3A (DNMT3A) fusion to induce DNA methylation at specific loci in the genome. We induced DNA methylation at up to 50% of alleles for targeted CpG dinucleotides. DNA methylation levels peaked within 50 bp of the short guide RNA (sgRNA) binding site and between pairs of sgRNAs. We used our approach to target methylation across the entire CpG island at the CDKN2A promoter, three CpG dinucleotides at the ARF promoter, and the CpG island within the Cdkn1a promoter to decrease expression of the target gene. These tools permit mechanistic studies of DNA methylation and its role in guiding molecular processes that determine cellular fate.
Bedrock identification using refraction seismic method in establishment location of Hospital Education Sebelas Maret University
Authors: Rahmawati Murteza Nur Isnani , Legowo Budi , Sutomo Artono Dwijo 
Published: May 2016

<span>A research of refraction methods in estabilishment location Hospital Education Sebelas Maret <span>University has been done on October 31 2012 with P.A.S.I Seismograph Mod. 16S24 seismic <span>refraction instruments with 24 geophone. This research in order to determine the depth of bedrock <span>in the estabilishment location hospital education Sebelas Maret University. In this data <span>acquisition, the travel time data was a distance function. Processing and interpretation data used <span>Intercept Time Method. Intercept Time Method used value of intercept time concept from travel <span>time curve. This interpretation which resulted P wave velocities and layer rocks thickness in three <span>line which scattered in area of survey. The result was that we were able to obtain bedrock having <span>the depth of 4 meters until 9 meters and heaving spreading velocity 1079 m/s – 1182 m/s is <span>interpreted as talus deposits, sandstone, clay, loam, loess, sand and gravel.</span></span></span></span></span></span></span></span></span><br /></span>
Distribution mapping of metal sediment using polarization data interpretation on the field “X” in PT Newmont Nusa Tenggara (PT NNT)
Authors: Arjuna Sukri , Susilo Adi , S Sunaryo 
Published: May 2016

<span>Geophysical research has been done on mapping distribution of metal deposits in the field "X" PT <span>Newmont Nusa Tenggara using induced polarization geoelectric method pole-dipole <span>configuration. Measurements performed using IRIS intrument type Elrec Pro where measurements <span>of seven lines with length 2.3 km and electrode spacing 100 m. Induced polarization data further<br /><span>analyzed by using Res2dinv version 3.56 and Surfer 10. Interpreted based on the parameters of <span>chrageability and resistivity that correlated with regional geological information from the study <span>area. As a result, the structure of rocks beneath the surface lithology research area consists of five <span>units major rock that is tuffan claystone unit, sandstone tuffan unit, limestone unit, lava-breccia<br /><span>unit, and andesite-basalt unit. Mineralization zone at the high chargeabilitas at 69.7 to 155 msec <span>range supported by the low resistivity in the range of 4.21 to 26.5 Ωm which straight of anomalies <span>in West-East direction at the depth of ± 50-400 m.</span></span></span></span></span></span></span></span></span></span><br /></span>
MULTICULTURALISMO COMO POLÍTICA DE INCLUSÃO/EXCLUSÃO
Authors: De Sousa Renan Santiago , Ivenicki Ana 
Published: May 2016

O presente artigo tem como objetivo levantar reflexões sobre como as diferentes abordagens do multiculturalismo podem favorecer ou desfavorecer a inclusão escolar. Este texto se torna importante, pois o reconhecimento da falta de neutralidade do multiculturalismo, que pode ser tanto utilizado por grupos que buscam resistir à imposição cultural como por grupos que querem a normalização da sociedade, é extremamente necessário para pensarmos o multiculturalismo como uma verdadeira política de inclusão. De cunho qualitativo e elaborado sob a forma de um ensaio teórico, este artigo chega à conclusão de que não existe uma abordagem multicultural perfeita e que todas elas, com maior ou menor grau, favorecem a exclusão. Devemos, portanto, não engessar nossas práticas em somente uma e usar favoravelmente essas diferentes abordagens em prol da inclusão plena dos nossos estudantes. http://dx.doi.org/10.14572/nuances.v27i1.3473
Modelagem e estimação de parâmetros do processo de produção de etanol em reator batelada por Saccharomyces cerevisiae
Authors: Da Silva Caroline Leite , De Santana Pedro Leite , Silva Cristina Ferraz , Pagano Rogério Luz 
Published: May 2016

No presente trabalho foi realizado o estudo cinético da fermentação em batelada com o objetivo de descrever a produção de etanol utilizando a levedura Saccharomyces cerevisiae. A fermentação alcoólica foi realizada em biorreator sob agitação de 175 rpm, condição de temperatura igual a 32ºC e pH igual a 3,0. Com o intuito de descrever o comportamento do crescimento microbiano, da formação de produto e do consumo de substratos foram propostos três modelos matemáticos: um modelo clássico baseado nos balanços de massa para o reator batelada; um modelo baseado na cinética microbiana ponderada pela concentração máxima de microrganismo; e, por último, um modelo proposto na tentativa de prever o comportamento de decaimento celular observado experimentalmente. O modelo que melhor se ajustou aos dados experimentais foi o modelo clássico proposto com base na cinética de Monod. Todos os modelos foram implementados em FORTRAN e resolvidos aplicando a sub-rotina DASSL, por fim, o programa ESTIMA foi utilizado para realizar a estimação dos parâmetros cinéticos de cada modelo, a função objetivo adotada foi a de mínimos quadrados. Os valores estimados dos parâmetros obtidos para o modelo que melhor se ajustou aos dados experimentais foram estatisticamente significativos e fisicamente realistas e descreveram com boa precisão os dados experimentais: µmáx = 0,1155 h-1; K1 = 0,8984 h-1; K = 0,4738 h-1; YX/S = 0,0242; YX/P = 0,0451 e KS = 24,3852 g.L-1.
An assessment of clinical laboratory performance for the determination of manganese in blood and urine
Authors: Praamsma Meredith L. , Arnaud Josiane , Bisson David , Kerr Stuart , Harrington Chris F. , Parsons Patrick J. 
Published: May 2016

Abstract

Background:
Proficiency testing or external quality assessment schemes (PT/EQASs) are an important method of assessing laboratory performance. As each scheme establishes assigned values and acceptable ranges for the analyte according to its own criteria, monitoring of participant performance varies according to the scheme and can lead to conflicting conclusions.

Methods:
Standard deviations (SDs) for PT were derived from Thompson’s and biological variation models applied to blood and urine manganese (Mn) robust data from four EQASs from North America and Europe. The fitness for purpose was verified by applying these SDs to individual results.

Results:
Using Thompson characteristic function the relationship between SD and Mn concentration, expressed in nmol/L was the square root of [19.72+(0.07712×Mn concentration2)] for blood and the square root of [6.772+(0.09852×Mn concentration2)] for urine. While the biological variation model was not suitable for urine, it produced an acceptable range for blood as ±54.4 nmol/L (assigned value ≤320 nmol/L) or 17% (assigned value >320 nmol/L). For blood, individual performance evaluated by the two approaches led to similar conclusions.

Conclusions:
The biological variation model can be used to propose quality specifications for blood, however it could not be applied to urine. The Thompson characteristic function model could be applied to derive quality specifications for Mn in urine and, to a lesser extent in blood. The more lenient quality specifications for blood highlight the difficulty of determining Mn in this matrix. Further work is needed to harmonize PT, such as using assigned ranges for the specimens.