bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraperitoneal Fluid Overestimates Hydration Status Assessment by Bioimpedance Spectroscopy
Authors: Arroyo David , Panizo Nayara , Abad Soraya , Vega Almudena , Rincón Abraham , De José Ana Pérez , López–Gómez Juan M. 
Published: March 2014

Background Bioimpedance spectroscopy (BIS) is a valuable tool to assess nutrition and volume status in peritoneal dialysis (PD) patients. However, data about the influence of intraperitoneal fluid on body composition measures are conflicting, and there is no clear consensus about whether the abdomen should be drained before the procedure. We designed a comparison study to detect the influence of intra-abdominal fluid on BIS results. Methods We performed 73 pairs of BIS measurements in 34 stable PD patients, first with the peritoneum filled with a 1.36% glucose dialysate solution and then after the solution was drained. Patients stayed in the supine position for 10 minutes before the BIS procedure, and the electrodes were not moved between measures. Clinical and demographic data were collected, as were analytic parameters of nutrition and volume status. Results Fluid overload is overestimated when BIS is performed with a full abdomen (1.82 ± 1.73 L vs 1.64 ± 1.68 L, p = 0.043). We also found a spurious overestimation in extracellular water (16.40 ± 3.21 L vs 16.24 ± 3.16 L, p < 0.001) and in relative overhydration (8.29% ± 6.96% vs 7.14% ± 6.79%, p = 0.017). No differences in intracellular water or parameters of nutrition were found. We observed negative correlations for the extracellular water overestimation with age ( r = –0.245, p = 0.037), serum B-type natriuretic peptide ( r = –0.366, p = 0.036), body mass index ( r = –0.248, p = 0.035), and lean tissue index ( r = –0.427, p = 0.001). The difference in extracellular water correlated only with body mass index ( r = –0.259, p = 0.039). We also found that, assessed at 50 KHz, whole-body impedance (–4.52 ± 8.37, p = 0.001) and phase angle (–0.08 ± 0.23 degrees, p = 0.002) were both lower when BIS was performed in patients with a full abdomen. Conclusions Fluid overload is overestimated by BIS when performed in patients with dialysate in the peritoneum. The observed differences are greater in younger, more poorly nourished, or less overhydrated patients. If more precise results are required, we suggest that the abdomen be drained before BIS is performed.
Removal of Different Classes of Uremic Toxins in APD vs CAPD: A Randomized Cross-Over Study
Authors: Eloot Sunny , Vanholder Raymond , Dequidt Clement , Van Biesen Wim 
Published: March 2014

♦Aim In this study, we investigated, and this for the different classes of uremic toxins, whether increasing dialysate volume by shifting from continuous ambulatory peritoneal dialysis (CAPD) to higher volume automated peritoneal dialysis (APD) increases total solute clearance. ♦Methods Patients on peritoneal dialysis were randomized in a cross-over design to one 24-hour session of first a CAPD regimen (3*2 L of Physioneal 1.36% and 1*2 L of icodextrin) or APD (consisting of 5 cycles of 2 L Physioneal 1.36 and 1 cycle of 2 L Extraneal), and the other week the alternate regime, each patient serving as his/her own control. Dialysate, blood and urine samples were collected and frozen for later batch analysis of concentrations of urea, creatinine, phosphorus, uric acid, hippuric acid, 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid, indoxyl sulfate, indole acetic acid, and p-cresyl sulfate. For the protein-bound solutes, total and free fractions were determined. Total, peritoneal and renal clearance (K) and mass removal (MR) of each solute were calculated, using validated models. ♦Results In 15 patients (11 male, 3 diabetics, 56 ± 16 years, 8 on CAPD, time on peritoneal dialysis 12 ± 14 months, and residual renal function of 9.9 ± 5.4 mL/min) dialysate over plasma ratio for creatinine (D/Pcrea) was 0.62 ± 0.10. Drained volume and obtained ultrafiltration were higher with APD vs CAPD (13.3 ± 0.5 L vs 8.5 ± 0.7 L and 1.3 ± 0.5 L vs 0.5 ± 0.7 L), whereas urine output was lower (1.0 ± 0.5 L vs 1.4 ± 0.6 L). Total clearance and MR tended to be higher for CAPD vs APD for all small and water soluble solutes, but mainly because of higher renal contribution, with no difference in the peritoneal contribution. For the protein-bound solutes, no differences in clearance or mass removal were observed. ♦Conclusion Although the drained dialysate volume nearly doubled, APD did not result in better peritoneal clearance or solute removal vs classic CAPD. APD resulted in better ultrafiltration, but at the expense of residual urinary output and clearance.
Low-Polydispersity Glucose Polymers as Osmotic Agents for Peritoneal Dialysis
Authors: Leypoldt John K. , Hoff Catherine M. , Akonur Alp , Holmes Clifford J. 
Published: March 2014

♦Background Peritoneal dialysis (PD) solutions containing icodextrin as the osmotic agent have advantages during long dwells. The glucose polymers that constitute icodextrin are a heterogeneous mix of molecules with a polydispersity [ratio of weight-average to number-average molecular weight (Mw/Mn)] of approximately 2.6. The present study evaluates whether modifications in the polydispersity and concentration of glucose polymers can improve ultrafiltration (UF) without an associated increase in carbohydrate absorption (CA). ♦Methods Computer simulations using a three-pore model of peritoneal transport during a long dwell in PD patients predict that, in general, compared with 7.5% icodextrin, glucose polymers with a Mw greater than or equal to 7.5 kDa, a polydispersity less than 2.6, and concentrations greater than 7% could achieve higher UF without higher CA. Based on the simulations, we hypothesized that, compared with 7.5% icodextrin, glucose polymers with a Mw of 18 – 19 kDa and a polydispersity of 2.0 at 11% concentration could achieve higher UF without a higher CA. We tested this hypothesis in experimental studies using 8-hour dwells in New Zealand White rabbits. In those studies, UF was measured by complete fluid collection, and CA was measured by subtracting the total carbohydrate in the collected fluid from the carbohydrate initially infused. ♦Results The UF was higher with 11% 19 kDa glucose polymer than with 7.5% icodextrin (mean ± standard deviation: 89 ± 31 mL vs 49 ± 15 mL; p = 0.004) without higher CA (5.2 ± 0.9 g vs 5.0 ± 0.9 g, p = 0.7). Similar results were seen with the 11% 18 kDa glucose polymer, which, compared with 7.5% icodextrin, resulted in higher UF (mean ± standard deviation: 96 ± 18 mL vs 66 ± 17 mL; p < 0.001) without higher CA (4.8 ± 0.7 g vs 5.2 ± 0.6 g, p = 0.2). ♦Conclusions The findings demonstrate that, compared with 7.5% icodextrin solution, long-dwell PD solutions containing 11% glucose polymers with a Mw of 18–19 kDa and a polydispersity of 2.0 can provide higher UF without higher CA.
Transitioning Youth with Rheumatic Conditions: Perspectives of Pediatric Rheumatology Providers in the United States and Canada
Authors: Chira Peter , Ronis Tova , Ardoin Stacy , White Patience 
Published: March 2014

Objective.To assess North American pediatric rheumatology providers’ perspectives on practices, barriers, and opportunities concerning the transition from pediatric-centered to adult-centered care.Methods.Childhood Arthritis and Rheumatology Research Alliance (CARRA) members completed a 25-item survey assessing current transition practices, transition policy awareness, and transitional care barriers and needs. Results were compared to the American Academy of Pediatrics (AAP) 2008 survey on transitional care.Results.Over half (158/288, 55%) of CARRA members completed the survey. Fewer than 10% are very familiar with AAP guidelines about transition care for youth with special healthcare needs. Eight percent have a formal written transition policy, but 42% use an informal approach. Patient request (75%) most frequently initiates transfer to adult care. Two major barriers to transition are fragmented adult medical care and lack of sufficient time to provide services. Compared with AAP survey participants, pediatric rheumatology providers are significantly more likely to help youth find an adult specialist (63% vs 45%) and discuss confidentiality and consent before age 18 (45% vs 33%), but are less likely to help with medical summary creation (16% vs 27%) or find a primary care provider (25% vs 47%). Outcomes ranked as “very important” in defining a successful transition are survival (76%), seeing an adult rheumatologist within 6 months of final pediatric rheumatology visit (66%), and maintaining insurance coverage (57%).Conclusion.This comprehensive survey of North American pediatric rheumatology providers regarding transitional care practices demonstrates deficiencies in education, resources, and a formalized process. Respondents support development of standardized rheumatology-specific transition practices.
Factors Associated with Major Cardiovascular Events in Patients with Systemic Necrotizing Vasculitides: Results of a Longterm Followup Study
Authors: Terrier Benjamin , Chironi Gilles , Pagnoux Christian , Cohen Pascal , Puéchal Xavier , Simon Alain , Mouthon Luc , Guillevin Loïc 
Published: March 2014

Objective.Systemic necrotizing vasculitides (SNV) are associated with more frequent subclinical atherosclerosis, suggesting that SNV might be associated with a higher risk of major cardiovascular events (MCVE). We aimed to identify factors predictive of MCVE in patients with SNV.Methods.Patients in remission from SNV were assessed for CV risk factors and subclinical atherosclerosis. MCVE was defined as myocardial infarction, stroke, arterial revascularization, hospitalization for unstable angina, and/or death from CV causes. MCVE-free survival curves were compared using the log-rank test.Results.Forty-two patients were followed for 7.1 ± 2.6 years. Eight patients (18.9%) had MCVE. The respective 5- and 10-year MCVE rates were 9.5% and 26.8%. National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III)-defined high-risk status [hazard ratio (HR) 5.02 (95% CI: 1.17–27.4), p = 0.03], BMI > 30 kg/m2 [HR 4.84 (95% CI: 1.46–116), p = 0.02], and plaque detection in the abdominal aorta (p = 0.01) were significantly associated with MCVE. SNV characteristics, corticosteroid maintenance therapy, and C-reactive protein > 5 mg/l were not associated with MCVE. Plaque in the aorta was significantly associated with high-risk status (p < 0.001), while BMI and high-risk status were independent variables. Thus, a BMI > 30 kg/m2 and/or a high-risk status were strongly associated with MCVE (p = 0.004). Carotid intima-media thickness (IMT) identified patients with early MCVE and was correlated with the time to MCVE (r2 = 0.68, p = 0.01).Conclusion.These results suggest that factors associated with a higher MCVE risk in patients with SNV are NCEP/ATP III-defined high-risk status and BMI > 30 kg/m2. Carotid IMT could help identify patients with SNV at risk of early MCVE.
Associations Between Biomarkers of Joint Metabolism, Hand Osteoarthritis, and Hand Pain and Function: The Johnston County Osteoarthritis Project
Authors: Aslam Imran , Perjar Irina , Shi Xiaoyan A. , Renner Jordan B. , Kraus Virginia B. , Golightly Yvonne M. , Jordan Joanne M. , Nelson Amanda E. 
Published: March 2014

Objective.To determine the associations between joint metabolism biomarkers and hand radiographic osteoarthritis [(rOA), based on Kellgren Lawrence (KL) grade ≥ 2], symptoms, and function.Methods.Cross-sectional data were available for 663 participants (mean age 63 yrs, 63% white, 49% women). Three definitions of hand rOA were considered: (1) a composite measure involving at least 3 hand joints distributed bilaterally with 2 of 3 in the same joint group, including ≥ 1 distal interphalangeal joint, without metacarpophalangeal (MCP) swelling; (2) rOA in at least 1 joint of a group; and (3) number of joints with KL ≥ 2. We assessed hand symptoms and the 15-item Australian Canadian Hand Osteoarthritis Index (AUSCAN; Likert format). We measured serum cartilage oligomeric matrix protein (sCOMP), hyaluronic acid (sHA), carboxy-terminal propeptide of type II collagen, type II collagen degradation product, urinary C-terminal crosslinked telopeptide of type II collagen, and urinary N-terminal crosslinked telopeptide. Linear regression models were performed to assess associations between each biomarker with hand rOA, AUSCAN, and symptoms, adjusting for age, sex, race, current smoking/drinking status, body mass index, and hip and knee rOA.Results.In adjusted analyses, MCP (p < 0.0001) and carpometacarpal rOA (p = 0.003), and a higher number of hand joints with rOA (p = 0.009), were associated with higher levels of sHA. Positive associations were seen between AUSCAN and hand symptoms and levels of sCOMP (p ≤ 0.003) and sHA (p ≤ 0.048).Conclusion.Hand symptoms and higher AUSCAN scores were independently associated with higher levels of both sCOMP and sHA; hand rOA was associated only with sHA levels.
Vaccine Responses in Patients with Rheumatoid Arthritis Treated with Certolizumab Pegol: Results from a Single-blind Randomized Phase IV Trial
Authors: Kivitz Alan J. , Schechtman Joy , Texter Michele , Fichtner Andreas , de Longueville Marc , Chartash Elliot K. 
Published: March 2014

Objective.To evaluate the humoral immune response to pneumococcal and influenza vaccination in adults with rheumatoid arthritis (RA) receiving certolizumab pegol (CZP).Methods.In this 6-week, single-blind, placebo-controlled trial with optional 6-month open-label extension (NCT00993668), patients were stratified by concomitant methotrexate (MTX) use and randomized to receive CZP 400 mg (loading dose; according to CZP label) or placebo at weeks 0, 2, and 4. Pneumococcal (polysaccharide 23) and influenza vaccines were administered at Week 2. Satisfactory humoral immune response, defined as ≥ 2-fold titer increase in ≥ 3 of 6 pneumococcal antigens and ≥ 4-fold titer increase in ≥ 2 of 3 influenza antigens, were assessed independently 4 weeks after vaccination.Results.Following pneumococcal vaccination, 62.5% of placebo patients and 54.5% of CZP patients without effective titers at baseline achieved a humoral response (difference in proportions was −8.0 percentage points; 95% CI −22.5 to 6.6%). Following influenza vaccination, 61.4% of placebo and 53.5% of CZP patients without effective titers at baseline achieved a humoral response (difference in proportions: −8.0 percentage points; 95% CI −22.9 to 7.0%). In all patients, including those with effective titers at baseline, 58.2% of placebo and 53.3% of CZP patients developed satisfactory pneumococcal titers, and 54.1% of placebo and 50.5% of CZP patients developed satisfactory influenza antibody titers. Vaccine responses to pneumococcal and influenza antigens were reduced similarly in both treatment groups with concomitant MTX use.Conclusion.Humoral immune responses to pneumococcal and influenza vaccination are not impaired when given during the loading phase of CZP treatment in patients with RA. (ClinicalTrials.govNCT00993668).
Updating the OMERACT Filter: Implications for Imaging and Soluble Biomarkers
Authors: D’Agostino Maria-Antonietta , Boers Maarten , Kirwan John , van der Heijde Désirée , Østergaard Mikkel , Schett Georg , Landewé Robert B. , Maksymowych Walter P. , Naredo Esperanza , Dougados Maxime , Iagnocco Annamaria , Bingham Clifton O. , Brooks Peter M. , Beaton Dorcas E. , Gandjbakhch Frederique , Gossec Laure , Guillemin Francis , Hewlett Sarah E. , Kloppenburg Margreet , March Lyn , Mease Philip J. , Moller Ingrid , Simon Lee S. , Singh Jasvinder A. , Strand Vibeke , Wakefield Richard J. , Wells George A. , Tugwell Peter , Conaghan Philip G. 
Published: March 2014

Objective.The Outcome Measures in Rheumatology (OMERACT) Filter provides a framework for the validation of outcome measures for use in rheumatology clinical research. However, imaging and biochemical measures may face additional validation challenges because of their technical nature. The Imaging and Soluble Biomarker Session at OMERACT 11 aimed to provide a guide for the iterative development of an imaging or biochemical measurement instrument so it can be used in therapeutic assessment.Methods.A hierarchical structure was proposed, reflecting 3 dimensions needed for validating an imaging or biochemical measurement instrument: outcome domain(s), study setting, and performance of the instrument. Movement along the axes in any dimension reflects increasing validation. For a given test instrument, the 3-axis structure assesses the extent to which the instrument is a validated measure for the chosen domain, whether it assesses a patient-centered or disease-centered variable, and whether its technical performance is adequate in the context of its application. Some currently used imaging and soluble biomarkers for rheumatoid arthritis, spondyloarthritis, and knee osteoarthritis were then evaluated using the original OMERACT Filter and the newly proposed structure. Breakout groups critically reviewed the extent to which the candidate biomarkers complied with the proposed stepwise approach, as a way of examining the utility of the proposed 3-dimensional structure.Results.Although there was a broad acceptance of the value of the proposed structure in general, some areas for improvement were suggested including clarification of criteria for achieving a certain level of validation and how to deal with extension of the structure to areas beyond clinical trials.Conclusion.General support was obtained for a proposed tri-axis structure to assess validation of imaging and soluble biomarkers; nevertheless, additional work is required to better evaluate its place within the OMERACT Filter 2.0.
Conventional versus Piggyback Techniques: Do They Have Different Outcomes?
Authors: Ghazaly Mohamed , Davidson Brian R. 
Published: March 2014

Background Conventional orthotopic liver transplant includes resection of the recipient's native liver, together with the retrohepatic inferior vena cava, whereas with the piggyback technique, the recipient's vena cava is preserved and the donor's vena cava is anastomosed with the recipient's hepatic veins. So the caval flow is maintained during explantation, but on the other hand, the cava must be dissected completely from the liver, prolonging hepatic excision. Objective To compare outcomes of conventional versus piggyback techniques. Primary outcomes were serious adverse events or complications, and secondary outcomes were graft survival for 3 and 12 months, quality of life, days in the intensive care unit and in the hospital, and days spent receiving mechanical ventilation. Materials and Methods From January 3, 2007, to December 31, 2008, 120 liver transplant patients were divided into 2 groups: conventional (n = 93) and piggyback (n = 27). Results Intraoperative and postoperative complications, graft survival for 3 and 12 months, quality of life, and hospital stay did not differ significantly between the 2 groups. However, the stay in the intensive care unit (median, 2 vs 3 days; range, 1–101 vs 1–60 days) and the number of days on ventilatory support (median, 1 vs 2 days; range, 0–41 vs 1–60 days) were notably lower in the conventional group. Conclusion The conventional liver transplant technique had significantly better results than the piggyback technique in terms of length of stay in the intensive care unit and duration of mechanical ventilation.
Regio‐ and Stereoselective 1,2‐Dihydropyridine Alkylation/Addition Sequence for the Synthesis of Piperidines with Quaternary Centers
Authors: Duttwyler Simon , Chen Shuming , Lu Colin , Mercado Brandon Q. , Bergman Robert G. , Ellman Jonathan A. 
Published: March 2014

AbstractThe first example of C alkylation of 1,2‐dihydropyridines with alkyl triflates and Michael acceptors was developed to introduce quaternary carbon centers with high regio‐ and diastereoselectivity. Hydride or carbon nucleophile addition to the resultant iminium ion also proceeded with high diastereoselectivity. Carbon nucleophile addition results in an unprecedented level of substitution to provide piperidine rings with adjacent tetrasubstituted carbon atoms.
Effect of the crosslinking density and programming temperature on the shape fixity and shape recovery in epoxy–anhydride shape‐memory polymers
Authors: Wu Xue Lian , Kang Shu Feng , Xu Xiao Jing , Xiao Feng , Ge Xiao Lan 
Published: March 2014

ABSTRACTIn addition to the fabrication of thermoset epoxy–anhydride shape‐memory polymers (SMPs), a systematic experimental investigation was conducted to characterize the crosslinking density, micromorphology, thermal properties, mechanical properties, and shape‐memory effects in the epoxy SMP system, with a focus on the influence of the crosslinking density and programming temperature on the shape‐fixity and shape‐recovery behaviors of the polymers. On the basis of the crosslinking density information determined by NMR technology, we concluded that the effect of the crosslinking density on the shape‐fixity behaviors was dependent on the programming temperature. The advantage of a nice combination of crosslinking density and programming temperature provided an effective approach to tailor the actual shape recovery within a wide range. The increasing crosslinking density significantly improved the shape‐recovery ratio, which could be further improved through a decrease in the programming, whereas the crosslinking density was more fundamental. This exploration should play an important role in the fabrication and applications of SMP materials. © 2014 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2014, 131, 40559.
Stereoselective Lewis Acid Mediated (3+2) Cycloadditions of N‐H‐ and N‐Sulfonylaziridines with Heterocumulenes
Authors: Craig Robert A. , O'Connor Nicholas R. , Goldberg Alexander F. G. , Stoltz Brian M. 
Published: March 2014

AbstractAlkyl and aryl isothiocyanates and carbodiimides are effective substrates in (3+2) cycloadditions with N‐sulfonyl‐2‐substituted aziridines and 2‐phenylaziridine for the synthesis of iminothiazolidines and iminoimidazolidines. Additionally, the stereoselective (3+2) cycloaddition of N‐H‐ and N‐sulfonylaziridines with isothiocyanates can be accomplished, allowing for the synthesis of highly enantioenriched iminothiazolidines. Evidence for an intimate ion‐pair mechanism is presented herein in the context of these chemo‐, regio‐, and diastereoselective transformations. The demonstrated ability to remove the sulfonyl group from the heterocyclic products displays the utility of these compounds for further derivatization and application.