bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative Infection in Developing World Congenital Heart Surgery Programs
Authors: Sen Amitabh Chanchal , Morrow Debra Forbes , Balachandran Rakhi , Du Xinwei , Gauvreau Kimberlee , Jagannath Byalal R. , Kumar Raman Krishna , Kupiec Jennifer Koch , Melgar Monica L. , Chau Nguyen Tran , Potter-Bynoe Gail , Tamariz-Cruz Orlando , Jenkins Kathy J. 
Published: April 2017

Background—
Postoperative infections contribute substantially to morbidity and mortality after congenital heart disease surgery and are often preventable. We sought to identify risk factors for postoperative infection and the impact on outcomes after congenital heart surgery, using data from the International Quality Improvement Collaborative for Congenital Heart Surgery in Developing World Countries.

Methods and Results—

Pediatric cardiac surgical cases performed between 2010 and 2012 at 27 participating sites in 16 developing countries were included. Key variables were audited during site visits. Demographics, preoperative, procedural, surgical complexity, and outcome data were analyzed. Univariate and multivariable logistic regression were used to identify risk factors for infection, including bacterial sepsis and surgical site infection, and other clinical outcomes. Standardized infection ratios were computed to track progress over time. Of 14 545 cases, 793 (5.5%) had bacterial sepsis and 306 (2.1%) had surgical site infection. In-hospital mortality was significantly higher among cases with infection than among those without infection (16.7% versus 5.3%;
P
<0.001), as were postoperative ventilation duration (80 versus 14 hours;
P
<0.001) and intensive care unit stay (216 versus 68 hours;
P
<0.001). Younger age at surgery, higher surgical complexity, lower oxygen saturation, and major medical illness were independent risk factors for infection. The overall standardized infection ratio was 0.65 (95% confidence interval, 0.58–0.73) in 2011 and 0.59 (95% confidence interval, 0.54–0.64) in 2012, compared with that in 2010.

Conclusions—
Postoperative infections contribute to mortality and morbidity after congenital heart surgery. Younger, more complex patients are at particular risk. Quality improvement targeted at infection risk may reduce morbidity and mortality in the developing world.
The History and Evolution of Independence Movements in Tunisia
Authors: El Houssi Leila 
Published: April 2017

After the establishment of French protectorate in 1881, the role played by the domestic nationalist movements that emerged in Tunisia during the early twentieth century is fundamentally important for any analysis of the long chain of events that ultimately led to the decolonization of the country. The first Tunisian nationalist movement was that of the Jeunes Tunisiens (Young Tunisians) in 1907, which was fronted by two charismatic leaders: al-Bašīr Ṣafar and ʿAlī Bāš Ḥānbah.
Al-Bašīr Ṣafar, the undisputed heart and soul of the movement, was among the founders of the Ḫaldūniyyah, a journalist for Le Tunisien, and, after 1908, the governor of Sousse. ʿAlī Bāš Ḥānbah as an administrator at the Collège Sadiki and co-founder of Le Tunisien. After the Great War, another movement emerged demanding the creation of a parliamentary assembly made up of both French and native citizens: the Parti Libéral Constitutionnel, or Dustūr, led by ʿAbd al-ʿAzīz al-Taʿālbī, which founded the Arabic-language newspaper “Sabīl al-Rašād”. Initially underestimated by the French authorities, Dustūr would go on become a legitimate nationalist movement. In 1934, at the Congress of Ksar Hellal, the party line imposed by Dustūr frustrated and disappointed many young nationalist militants, who split away from the group and founded a movement of their own that would go on to become the primary champion of the independence struggle: Néo-Dustūr. Among these young militants were Ḥabīb Būrqībah, the leader of the new party, which radically transformed itself with a cross-class platform capable of winning the allegiance of the Tunisian masses in the fight for greater independence.
As we shall see, the origins of decolonization in Tunisia indisputably lay in the creation and evolution of these nationalist groups, which built upon and succeeded one another during the first four decades of the twentieth century.
Mīšīl ʿAflaq’s Thought between Nationalism and Socialism
Authors: Stegagno Carlotta 
Published: April 2017

This article analyses and describes the political thought of Mīšīl ʿAflaq, the founder—together with Ṣalāḥ al-Dīn al-Bīṭār—and the main ideologue of the Arab Baʿṯ Socialist Party (Ḥizb al-Baʿṯ al-ʿarabī al-ištirākī).1 Mīšīl ʿAflaq was an atypical figure in his contemporary Middle Eastern society, who differ from the strongmen that typified his era such as Ǧamāl ʿAbd al-Nāṣer and Qaḏḏāfī. He was an intellectual, a philosopher, who, with his ideas of Panarabism and Arab socialism affected more than a generation of Arab youth. His dream of Arab Unity became a reality from 1958-1961 with the merger of Egypt and Syria into the United Arab Republic, and the Panarabist Party he created became one of the key players in Middle East from the 1940s onwards.This paper, after sketching a brief biography of Mīšīl ʿAflaq, focuses on his understanding of Nationalism and Arab Socialism, on which his ideology is grounded. By connecting these two ideas, he created a monist ideology in which the mission of Arab Unity is both the starting point and the final goal.
Natural course of untreated cluster headache: A retrospective cohort study
Authors: Lee Mi Ji , Choi Hyun Ah , Shin Jong Hwa , Park Hea Ree , Chung Chin-Sang 
Published: April 2017

Objective To determine the natural course of cluster headache. Methods We screened patients with cluster headache who were diagnosed at Samsung Medical Center and lost to follow-up for ≥5 years. Eligible patients were interviewed by phone about the longitudinal changes in headache characteristics and disease course. Remission was defined as symptom-free 1) for longer than twice the longest between-bout period and 2) for ≥5 years. Results Forty-two patients lost to follow-up for mean 7.5 (range, 5.0–15.7) years were included. The length of the last bout did not differ from the first one, while the last between-bout period was longer than the first one ( p = 0.012). Characteristics of cluster headache decreased over time: Side-locked unilaterality (from 92.9% to 78.9%), seasonal and circadian rhythmicity (from 63.9% to 60.9% and from 62.2 to 40.5%, respectively), and autonomic symptoms (from 95.2% to 75.0%). Remission occurred in 14 (33.3%) patients at a mean age of 42.3 (range, 27–65) years, which was not different from the age of last bouts in active patients ( p = 0.623). There was a trend for more seasonal and circadian predilection at baseline in the active group ( p = 0.056 and 0.063, respectively) and fewer lifetime bouts and shorter disease duration in patients in remission ( p = 0.063 and 0.090). Conclusions This study first shows the natural courses of cluster headache. Features of cluster headache become less prominent over time. Remission occurred regardless of age. Although no single predictor of remission was found, our data suggest that remission of cluster headache might not be a consequence of more advanced age, longer duration of disease, or accumulation of lifetime bouts.
An audit of suicide attempt admissions over a four-year period in a UK Major Trauma Centre
Authors: Shepherd Laura 
Published: April 2017

Background Some admissions to UK Major Trauma Centres are due to suicide attempts. Methods An audit of suicide attempt admissions to a UK Major Trauma Centre was conducted to explore frequency and trends in admissions, demographic variables and mechanisms of injuries, referrals to and outcomes of Liaison Psychiatry during admission and whether patients had been known to mental health services prior to admission. Data were analysed retrospectively from the TARN database. Results Over a four-year period, 91 admissions due to suicide attempts were recorded. Admissions appeared to be increasing, from 1.4% in 2012 to 2.2% in 2015. Admissions were most common in males and patients in the 20–29 year age range, although admissions in the 30–39 years age range had particularly increased over the time period studied. Jumping from heights was the most common mechanism of injury, followed by self-stabbings. The majority (86%) survived their injuries. Around half of the local patients were not known to a mental health service at the time of their suicide attempt. In around a fifth who survived their injuries, no referral for a psychiatric assessment had been made. Outcomes of psychiatric assessments included referrals to mental health services, talking therapy or other support in a substantial proportion. Around a quarter was considered safe for discharge with no further mental health follow-up. Conclusions Suicide attempt admissions to UK Major Trauma Centres may be increasing, and regular audits regarding this should be undertaken. The need for appropriate psychiatric input during admission is essential, and training in mental health and suicide for staff working in MTCs is likely to be important.
Use of 2% hydroxypropyl methylcellulose to prevent the corneal swelling during the in vitro mechanical characterization
Authors: Ortillés Ángel , Lanchares Elena , Á Cristóbal Jose , Calvo Begoña 
Published: April 2017

The aim of this study was to assess the use of 2% HPMC during in vitro uniaxial tensile tests, with corneal strips immediately obtained or after storing the eyes for 24 h in 0.9% NaCl solution at 4 ℃. The purpose was to establish a standardized procedure to prevent phenomena which can modify the mechanical properties of the tissue. Rabbit eyes were divided into four groups. Group A had seven eyes that were preserved in NaCl solution for 24 h before testing. Group B had seven eyes that were immediately tested. In both groups, to prevent both swelling and dehydration, 2% hydroxypropyl methylcellulose (2% HPMC) was applied. Group C had seven eyes that were preserved in NaCl solution for 24 h before testing. Group D had seven eyes that were immediately tested. In both groups, HPMC was not applied. Regarding the mechanical response, groups with HPMC showed similar Cauchy stress–stretch curves and there were no statistically significant differences at 5%, 10% and 15% strain between them, which mean that both showed similar mechanical behavior. The same result was obtained between groups without HPMC. However, for coupled groups with and without HPMC, statistically significant differences at 10% and 15% strain were observed. On the other hand, when grouped by storage time, statistically significant differences were found between groups that had eyes preserved for 24 h with and without HPMC, respectively, as well as between groups immediately tested with and without HPMC, respectively, at 15% strain. Nevertheless, if coupled groups were considered, between groups that were preserved for 24 h in NaCl before testing and groups that were immediately tested, no statistically significant differences were obtained. In addition, the Cauchy stress–stretch curves of groups without HPMC showed a decreasing slope of the linear part (strain > 8%) of the graph during the experiment. In summary, the use of HPMC during the handling of the tissue from excision to testing seems to prevent both swelling and dehydration.
Control of oxygen tension recapitulates zone-specific functions in human liver microphysiology systems
Authors: Lee-Montiel Felipe T , George Subin M , Gough Albert H , Sharma Anup D , Wu Juanfang , DeBiasio Richard , Vernetti Lawrence A , Taylor D Lansing 
Published: April 2017

This article describes our next generation human Liver Acinus MicroPhysiology System (LAMPS). The key demonstration of this study was that Zone 1 and Zone 3 microenvironments can be established by controlling the oxygen tension in individual devices over the range of ca. 3 to 13%. The oxygen tension was computationally modeled using input on the microfluidic device dimensions, numbers of cells, oxygen consumption rates of hepatocytes, the diffusion coefficients of oxygen in different materials and the flow rate of media in the MicroPhysiology System (MPS). In addition, the oxygen tension was measured using a ratiometric imaging method with the oxygen sensitive dye, Tris(2,2′-bipyridyl) dichlororuthenium(II) hexahydrate (RTDP) and the oxygen insensitive dye, Alexa 488. The Zone 1 biased functions of oxidative phosphorylation, albumin and urea secretion and Zone 3 biased functions of glycolysis, α1AT secretion, Cyp2E1 expression and acetaminophen toxicity were demonstrated in the respective Zone 1 and Zone 3 MicroPhysiology System. Further improvements in the Liver Acinus MicroPhysiology System included improved performance of selected nonparenchymal cells, the inclusion of a porcine liver extracellular matrix to model the Space of Disse, as well as an improved media to support both hepatocytes and non-parenchymal cells. In its current form, the Liver Acinus MicroPhysiology System is most amenable to low to medium throughput, acute through chronic studies, including liver disease models, prioritizing compounds for preclinical studies, optimizing chemistry in structure activity relationship (SAR) projects, as well as in rising dose studies for initial dose ranging. Impact statement Oxygen zonation is a critical aspect of liver functions. A human microphysiology system is needed to investigate the impact of zonation on a wide range of liver functions that can be experimentally manipulated. Because oxygen zonation has such diverse physiological effects in the liver, we developed and present a method for computationally modeling and measuring oxygen that can easily be implemented in all MPS models. We have applied this method in a liver MPS in which we are then able to control oxygenation in separate devices and demonstrate that zonation-dependent hepatocyte functions in the MPS recapitulate what is known about in vivo liver physiology. We believe that this advance allows a deep experimental investigation on the role of zonation in liver metabolism and disease. In addition, modeling and measuring oxygen tension will be required as investigators migrate from PDMS to plastic and glass devices.
Local and Plasma Biomarker Profiles in Localized Aggressive Periodontitis
Authors: Branco-de-Almeida L.S. , Cruz-Almeida Y. , Gonzalez-Marrero Y. , Huang H. , Aukhil I. , Harrison P. , Wallet S.M. , Shaddox L.M. 
Published: April 2017

Localized aggressive periodontitis (LAP) patients possess a systemic hyperinflammatory response after lipopolysaccharide stimulation. However, the levels of inflammatory and bone biomarkers in plasma, as well as possible associations between local and plasma biomarkers, are unknown in LAP. This cross-sectional study aimed to characterize gingival crevicular fluid (GCF) and plasma biomarker profiles in LAP patients, their healthy siblings (HS), and healthy unrelated controls (HC). Fifty-eight LAP subjects, 33 HS, and 49 HC (African Americans, aged 5 to 25 y) were included. Following collection of clinical parameters with GCF and plasma samples, levels of 16 inflammatory and bone resorption biomarkers were determined with Milliplex. Univariate and correlation analyses were performed among all clinical and laboratorial parameters. Discriminant analyses were used to investigate groups of biomarkers discriminating LAP from HS and HC in GCF and plasma. GCF levels of multiple cytokines and chemokines and RANKL:OPG ratio (receptor activator of nuclear factor kappa-B ligand:osteoprotegerin) were higher in LAP disease, most of which positively correlated with probing depth and attachment loss of sampled sites. A group of IL-12p40, IL-6, IL-12p70, IL-2, and MIP-1α discriminated LAP diseased sites from twheir healthy sites, as well as from HS and HC healthy sites. In plasma, only RANKL levels were increased in LAP versus controls, which positively correlated with the percentage of affected sites and deep/bleeding sites. A plasma inflammatory profile including MIP-1α, IL-8, IL-10, and INF-γ could significantly discriminate LAP patients from HS and HC. No correlations were found between GCF and plasma levels of biomarkers. In conclusion, an inflammatory profile including groups of specific biomarkers in GCF and plasma may significantly discriminate LAP from healthy individuals. The hyperinflammatory response previously found in the peripheral blood of LAP patients is dependent on lipopolysaccharide stimulation, apparently resulting mostly in local tissue destruction and changes in biomarker profile, with a slight influence in the systemic inflammatory profile ( ClinicalTrials.gov NCT01330719). Knowledge Transfer Statement: The results of this study can be possibly used by clinicians in the future as diagnostic tools for localized aggressive periodontitis. Thus, in the future, with proper consideration of cost, patient preference, chair-side feasibility and ultimately further studies validating the role of GCF markers for disease progression and response to treatment, this information could lead to more appropriate therapeutic decisions and the development of preventive approaches for susceptible patients.
Human definitive hematopoietic specification from pluripotent stem cells is regulated by mesodermal expression of CDX4
Authors: Creamer J. Philip , Dege Carissa , Ren Qihao , Ho Jolie T. K. , Valentine Mark C. , Druley Todd E. , Sturgeon Christopher M. 
Published: April 2017

Key PointsCDX genes are differentially expressed in mesoderm harboring definitive hematopoietic potential in a WNT-dependent manner. CDX4 expression during mesoderm specification regulates human definitive hematopoietic specification.
Repeatability and agreement of ultrasonography with computed tomography for evaluating forefoot structure in the coronal plane
Authors: Matsubara Keisuke , Matsushita Tomofumi , Tashiro Yuto , Tasaka Seishiro , Sonoda Takuya , Nakayama Yasuaki , Yokota Yuki , Suzuki Yusuke , Kawagoe Mirei , Aoyama Tomoki 
Published: April 2017

AbstractBackgroundForefoot structure is important to understand some foot problems such as hallux valgus and metatarsalgia. Ultrasonography (US) is a highly portable, noninvasive, low cost, and fast imaging method, especially when compared to magnetic resonance imaging (MRI), computed tomography (CT), and radiography. As the use of US for evaluating forefoot bony structure has not been validated, except for the presence of synovitis, erosions and bursitis within the forefoot in people with inflammatory arthritis, the purpose of this study was to determine whether US is a reliable method for evaluating forefoot structure.MethodsSixty feet (30 women, age = 40.1 ± 11.8 years) were examined by US and CT to assess agreement with CT and repeatability of US evaluation of the 2nd metatarsal head height, length between the medial sesamoid bone and 5th metatarsal head, transverse arch height, transverse arch index, sesamoid rotation angle, and area under the transverse arch. The measurement data were evaluated for agreement with CT using the intra‐class correlation coefficient (ICC)3, 1, Pearson correlation coefficient, and Bland‐Altman plot, and with ICC1, 1 for repeatability.ResultsThe ICC3, 1 values of 0.78–0.89, Pearson correlation coefficient of 0.78–0.90, and Bland‐Altman plots showed almost perfect agreements between the US and CT method for all parameters, except the area under the transverse arch (AUTA). The ICC1, 1 also showed perfect agreements (0.84–0.92) between two sets of US measurements in all parameters.ConclusionsThe US evaluation of forefoot structure in the coronal plane showed good agreement with CT and repeatability of two ultrasonograms in adult women. This reliable evaluation method of forefoot structure can contribute to a quick clinical assessment screening for risk factors of foot problems such as hallux valgus and metatarsalgia. However, because of some limitations such as a lack of inter‐observer reliability, more research is needed to validate US evaluation of forefoot structure.Trial registrationThe current study (trial registration number: R0297) was approved by the Ethical Committee for Human Experiments of Kyoto University (http://www.ec.med.kyoto‐u.ac.jp) on December 3, 2015. The first participant in this study was enrolled on November 17, 2015 and retrospectively registered.
Novel role of immature myeloid cells in formation of new lymphatic vessels associated with inflammation and tumors
Authors: Ran Sophia , Wilber Andrew 
Published: April 2017

Abstract
Inflammation triggers an immune cell-driven program committed to restoring homeostasis to injured tissue. Central to this process is vasculature restoration, which includes both blood and lymphatic networks. Generation of new vessels or remodeling of existing vessels are also important steps in metastasis—the major cause of death for cancer patients. Although roles of the lymphatic system in regulation of inflammation and cancer metastasis are firmly established, the mechanisms underlying the formation of new lymphatic vessels remain a subject of debate. Until recently, generation of new lymphatics in adults was thought to occur exclusively through sprouting of existing vessels without help from recruited progenitors. However, emerging findings from clinical and experimental studies show that lymphoendothelial progenitors, particularly those derived from immature myeloid cells, play an important role in this process. This review summarizes current evidence for the existence and significant roles of myeloid-derived lymphatic endothelial cell progenitors (M-LECPs) in generation of new lymphatics. We describe specific markers of M-LECPs and discuss their biologic behavior in culture and in vivo, as well as currently known molecular mechanisms of myeloid-lymphatic transition (MLT). We also discuss the implications of M-LECPs for promoting adaptive immunity, as well as cancer metastasis. We conclude that improved mechanistic understanding of M-LECP differentiation and its role in adult lymphangiogenesis may lead to new therapeutic approaches for correcting lymphatic insufficiency or excessive formation of lymphatic vessels in human disorders.