bluuebunny/crossref_metadata_2025_split huggingface dataset:
In Vivo Quantification of Cerebral R2*-Response to Graded Hyperoxia at 3 Tesla
Authors: Gotzamanis Grigorios , Kocian Roman , Özbay Pinar S. , Redle Manuel , Kollias Spyridon , Eberhardt Christian , Boss Andreas , Nanz Daniel , Rossi Cristina 
Published: January 2015

Objectives:
This study aims to quantify the response of the transverse relaxation rate of the magnetic resonance (MR) signal of the cerebral tissue in healthy volunteers to the administration of air with step-wise increasing percentage of oxygen.

Materials and Methods:
The transverse relaxation rate (R2*) of the MR signal was quantified in seven volunteers under respiratory intake of normobaric gas mixtures containing 21, 50, 75, and 100% oxygen, respectively. End-tidal breath composition, arterial blood saturation (SaO2), and heart pulse rate were monitored during the challenge. R2* maps were computed from multi-echo, gradient-echo magnetic resonance imaging (MRI) data, acquired at 3.0T. The average values in the segmented white matter (WM) and gray matter (GM) were tested by the analysis of variance (ANOVA), with Bonferroni post-hoc correction. The GM R2*-reactivity to hyperoxia was modeled using the Hill's equation.

Results:
Graded hyperoxia resulted in a progressive and significant (P < 0.05) decrease of the R2* in GM. Under normoxia the GM-R2* was 17.2 ± 1.1 s-1. At 75% O2 supply, the R2* had reached a saturation level, with 16.4 ± 0.7 s-1 (P = 0.02), without a significant further decrease for 100% O2. The R2*-response of GM correlated positively with CO2 partial pressure (R = 0.69 ± 0.19) and negatively with SaO2 (R = -0.74 ± 0.17). The WM showed a similar progressive, but non-significant, decrease in the relaxation rates, with an increase in oxygen intake (P = 0.055). The Hill's model predicted a maximum R2* response of the GM, of 3.5%, with half the maximum at 68% oxygen concentration.

Conclusions:
The GM-R2* responds to hyperoxia in a concentration-dependent manner, suggesting that monitoring and modeling of the R2*-response may provide new oxygenation biomarkers for tumor therapy or assessment of cerebrovascular reactivity in patients.
Dexamethasone Intravitreal Implant for Diabetic Macular Edema: Indications for a PRN Regimen of Treatment
Authors: Panozzo Giacomo , Gusson Elena , Panozzo Giorgio , Mura Giulia Dalla 
Published: January 2015

Purpose To define the mean time of first recurrence of diabetic macular edema (DME) after a single injection of dexamethasone intravitreal implant (DEX-I), reducing the burden of monthly visits during a PRN regimen of treatment. Methods Twenty phakic eyes with DME (12 eyes naïve and 8 eyes with edema persistent after previous treatments) were followed monthly after DEX-I injection until evidence of first recurrence of edema, defined as a change in visual acuity (VA) ≥5 letters and/or in foveal thickness (FT) ≥50 µm. Reaching this point, the eyes were re-treated. Monitored parameters were changes in VA, FT, intraocular pressure (IOP), and lens opacity. Results Maximal efficacy was registered at month 1, when mean VA improved by 14 letters (19%), FT decreased by 325 µm (43.7%), and in 15 eyes (75%) edema was completely reabsorbed. The mean time of first recurrence was 5.1 months. No statistical difference was found between eyes with naïve or persistent DME. Five eyes needed topical medication for modest temporary IOP increase (21-24 mm Hg) between months 2 and 4. No increase in lens opacities was registered during follow-up. Conclusions According to the results of this study, the first signs of DME recurrence after DEX-I injection appear at a mean time of 5 months, suggesting that an appropriate and prudent time schedule for a PRN regimen could be limited to monthly tonometry and a first complete examination not before 4 months.
Association of Neutrophil/Lymphocyte Ratio and Retinal Vein Occlusion
Authors: Dursun Ayhan , Ozturk Sultan , Yucel Hasan , Ozec Ayse Vural , Dursun Feyza Gulac , Toker Mustafa Ilker , Erdoğan Haydar , Arici Mustafa Kemal , Topalkara Aysen 
Published: January 2015

Purpose To evaluate the association between neutrophil/lymphocyte ratio (NLR) and the development of retinal vein occlusion (RVO). Methods Forty patients were included in the study. Forty age- and sex-matched healthy volunteers were recruited as the control group. The RVO diagnosis was made clinically, based on the findings of fundus examination. The NLR and file records of the patients and the control group were compared. Results The mean age of patients was 64 ± 12 years. Neutrophil levels were higher in RVO patients compared to the control subjects (5.1 ± 1.9 vs 3.6 ± 1.0, p<0.001). Lymphocyte levels were lower in RVO patients compared with the control subjects (2.0 ± 0.7 vs 2.6 ± 0.9, p = 0.005). The NLR was significantly higher in RVO patients compared with the control subjects (3.0 ± 2.7 vs 1.5 ± 0.3, p<0.001). According to the receiver operator characteristics curve analysis, the optimal cutoff value of NLR to predict RVO was >1.89, with 72.5% sensitivity and 100% specificity. Conclusions The current study demonstrated that higher NLR was associated with the development of RVO. The NLR may be used as a predictive tool for identifying risk for RVO.
E-Vitamin Infused Highly Cross-Linked Polyethylene: RSA Results from a Randomised Controlled Trial Using 32 mm and 36 mm Ceramic Heads
Authors: Lindalen Einar , Nordsletten Lars , Høvik Øystein , Röhrl Stephan M 
Published: January 2015

Background Polyethylene wear has been a major cause of revision of cementless total hip replacements. Highly cross-linked polyethylene has been developed to increase mechanical resistance to wear. However, cross-linking from irradiation of the polyethylene generates free radicals and these can oxidise in vivo and might over time alter the initial mechanical properties. Vitamin-E infused highly cross-linked polyethylene has been developed to reduce the amount of free radicals without compromising the mechanical properties. Purpose To measure wear of vitamin E infused highly cross-linked polyethylene and compare wear between 2 different head sizes. Methods In a prospective randomised study between 32 mm and 36 mm Biolox® delta heads in 50 hips we analysed the in vivo wear of the E-poly™ with markerless radiostereometry. Results Mean (95% CI) wear for the total material was 0.041 mm (0.015-0.066) in the vertical direction and 0.177 mm (0.155-0.200) in the total 3D direction. After the anticipated period of bedding-in we found no statistically significant differences in wear from three months to 2 years in vertical and total 3D directions. Although statistical significant differences between 32 mm and 36 mm heads were found in the total 3D direction we cannot conclude that there are significant clinical important differences in wear comparing these head sizes. Conclusions This study shows promising early results with very low wear, even for 36 mm heads, but long term follow-up is necessary to evaluate if this polyethylene will provide low wear and good mechanical properties in the long-term.
Transmission of Hepatitis B Virus in Dialysis Units: A Systematic Review of Reports on Outbreaks
Authors: Fabrizi Fabrizio , Dixit Vivek , Messa Piergiorgio , Martin Paul 
Published: January 2015

Background Changes in the delivery of healthcare in the developed world have resulted in frequent reporting of outbreaks of hepatitis B virus (HBV) infection in nonhospital healthcare settings, including hemodialysis units. Aim We performed a systematic review of HBV outbreaks in dialysis units of developed and less-developed countries published between 1992 and 2014 to elucidate the most frequent mechanisms of patient-to-patient transmission of HBV in this setting. Methods The research was performed using the PubMed Database and the Outbreak Database; studies were selected according to the PRISMA algorithm. Inclusion criteria were established before the papers were retrieved in order to avoid selection biases. Results 12 papers reported on 16 outbreaks that involved 118 patients on maintenance dialysis; 10 fatal cases occurred. European outbreaks were smaller compared with the others (P = 0.0046). Information on specific transmission pathways was given in many outbreaks (n = 10; 62%); multiple deficiencies in standard or hemodialysis-specific procedures was the most common route of patient-to-patient transmission of HBV (80%, 8/10). De novo HBV from HBsAg negative/HBV DNA positive blood donors was found in 2 (20%) oubreaks. Sharing of contaminated HD machines was mentioned in 1 report. Conclusions Our systematic review of HBV outbreaks shows that incomplete adherence to standard and dialysis-specific infection control precautions was the most important cause of patient-to-patient transmission of HBV in dialysis units. This review should serve as a reminder to HD providers that the risk of HBV infection is still present among patients undergoing dialysis and that HBV may be easily transmitted in the dialysis setting whenever appropriate infection control practices are not strictly applied.
Anti-Infective Drugs during Continuous Hemodialysis –Using the Bench to Learn What to do at the Bedside
Authors: Roehr Anka C. , Frey Otto R. , Koeberer Andreas , Fuchs Thomas , Roberts Jason A. , Brinkmann Alexander 
Published: January 2015

Purpose The main objective of this study was to investigate the clearance of 11 selected anti-infectives in an in vitro model of continuous veno-venous hemodialysis (CVVHD), in order to suggest rational dosing strategies for clinical practice. Methods Ceftazidime, ciprofloxacin, flucloxacillin, gentamicin, linezolid, meropenem, metronidazole, piperacillin, rifampicin, vancomycin and voriconazole were studied in two different solvents (sodium chloride 0.9% and HSA 5%) using a multifiltrate dialysis device by Fresenius Medical Care (Bad Homburg, Germany). For each solution, prefilter, postfilter, and dialysate samples were drawn simultaneously during one hour of dialysis and were assayed. Results The clearance of all drugs except rifampicin in sodium chloride 0.9% was comparable (mean 1.76 ± 0.11 l/h). The clearance of these agents in human serum albumin solution 5% was reduced by between 5.3% and 72.2%. The unbound drug fraction correlated with a lower clearance in HSA 5% (Pearson correlation coefficient r = 0.933; p = 0.00008). No correlation between clearance in HSA 5% and the drugs' molecular weight was found (Pearson correlation coefficient r = 0.388; p = 0.268). Rifampicin was detected to bind to the surface of the polysulfone filter used. Dialysis clearance of ceftazidime, gentamicin, linezolid, meropenem, metronidazole, piperacillin and vancomycin during CVVHD accounted for over 25% of the total body clearance of population pharmacokinetic data for renally impaired patients. Conclusions The results from this study highlight that dose adaptations are needed for most of the drugs under investigation for patients undergoing CVVHD. In combination with polysulfone filters, rifampicin should be used with care in this setting.
Fluids for Continuous Renal Replacement Therapy – an Evaluation of Microbial Integrity
Authors: Kanagasundaram Nigel S. , Perry John D. , Hoenich Nicholas A. , Clark Rauri A. , Fraser Rachel A. , Walton Katherine E. 
Published: January 2015

Purpose We have previously demonstrated widespread microbial contamination in the dialysis and replacement fluid circuits of bicarbonate-buffered, continuous renal replacement therapies (CRRTs). It is not known whether different CRRT fluids have an impact on bacterial activity. Methods In this study the in vitro growth and biofilm formation associated with seven strains of bacteria ( Burkholderia cepacia, Escherichia coli, Staphylococcus aureus, Stenotrophomonas maltophilia, Pseudomonas aeruginosa, Pseudomonas fluorescens, and Staphylococcus epidermidis) in five CRRT fluids (Prismocitrate, Monosol S, Accusol 35, tri-sodium citrate and Ci-Ca K2) were studied. The fluids were each inoculated with light and heavy concentrations of each of the bacterial strains and incubated at 22 or 37°C for up to 72 h with and without bacterial growth medium. Bacterial growth was assessed by spectrophotometry. Biofilm formation was assessed by a standard microtiter plate assay. Results Unsupplemented fluids did not support bacterial growth or biofilm formation after 72 h incubation. When supplemented with bacterial growth medium, some fluids, in particular Accusol 35, Ci-Ca K2, and tri-sodium citrate, had an inhibitory effect on bacterial growth, although none suppressed growths across the panel of tested organisms. Conclusions Different CRRT fluids have different impacts on bacterial growth and biofilm formation, but all remain susceptible to extrinsic contamination.
Anterior Gradient 2 is Correlated with EGFR Mutation in Lung Adenocarcinoma Tissues
Authors: Narumi Sodai , Miki Yasuhiro , Hata Shuko , Ebina Masahito , Saito Mikiyoshi , Mori Kazushige , Kobayashi Makoto , Suzuki Takashi , Iwabuchi Erina , Sato Ikuro , Maemondo Makoto , Endo Chiaki , Inoue Akira , Kondo Takashi , Yamada-Okabe Hisafumi , Ichinose Masakazu , Sasano Hironobu 
Published: January 2015

Background Epidermal growth factor receptor (EGFR)–tyrosine kinase inhibitor (TKI) has demonstrated a promising therapeutic response in lung adenocarcinoma patients with EGFR gene mutations. However, the predictive factors for this therapy have not been established, except for the EGFR gene mutation status of carcinoma cells. Methods We first performed microarray analysis in EGFR-TKI–sensitive lung adenocarcinoma cell lines. The results indicated anterior gradient 2 (AGR2) as a potential surrogate marker of EGFR-TKI. Therefore, we then evaluated the correlation between the status of AGR2 immunoreactivity and clinicopathological factors including overall survival (OS), progression-free survival (PFS) and clinical response to EGFR-TKI, in 147 cases of surgically resected lung adenocarcinoma. The biological significance of AGR2 was further evaluated by transfecting small interfering RNA (siRNA) against AGR2 in these cells. Results The status of AGR2 immunoreactivity was significantly higher in lung adenocarcinoma cases with EGFR gene mutations than in those with the wild type (p<0.0001), but there were no significant differences in OS, PFS and response of EGFR-TKI between the AGR2 high and low carcinoma cases. Knockdown of AGR2 gene expression following siRNA transfection resulted in a significantly lower response to EGFR-TKI in EGFR-mutated PC-3. Conclusions AGR2 could serve as an adjunctive surrogate protein marker possibly reflecting EGFR gene mutations in lung adenocarcinoma patients. Results from in vitro analysis indicated that AGR2 could be a potential clinical biomarker of EGFR-TKI therapeutic sensitivity in lung adenocarcinoma cells.
Cardiovascular changes occurring with occlusion of a mature arteriovenous fistula
Authors: Aitken Emma , Kerr Daniele , Geddes Colin , Berry Colin , Kingsmore David 
Published: January 2015

Background The aim of this study was to evaluate the relationship between Qa, cardiovascular parameters and symptomatic cardiac disease. Methods A prospective cohort study of 100 patients dialysing via an arteriovenous fistula (AVF) was performed. Qa was measured using pulsed Doppler ultrasound. Cardiovascular parameters were measured using thoracic bioimpedance technique (Medis, GmbH). Measurement of cardiovascular parameters was undertaken pre- and post-occlusion of the AVF. Results Mean age was 57.1 years (range: 19-83); 51% male. Mean values pre-occlusion: mean arterial blood pressure (MABP) 89.6 ± 16.9 mmHg; stroke volume index (SVI) 39.3 ± 4.6 mL; cardiac index (CI) 3.7 ± 0.8 L/min/m2; systemic vascular resistance index (SVRI) 585.5 ± 67.8 dyn/sec/cm−5/m2; oxygen delivery (DO2I) 607.1 ± 116.8 mL/min/m2. A total of 12% of patients had CI>4.5 L/min/m2 pre-occlusion. There was no difference in heart rate (HR), MABP and SVI following occlusion of AVF. Mean CI reduced post-AVF occlusion (∆CI: -0.42 L/min/m2; p<0.001), as did DO2I (∆ DO2I: 45.5 mL/min/m2; p<0.001). SVRI increased (∆SVRI: 170.1 dyn/sec/cm−5/m2; p<0.001). The drop in CI which occurred post-AVF occlusion was greater in patients with Qa >2000 mL/min (-2.79 ± 0.34 vs. -0.24 ± 0.48 L/min/m2; p<0.001). There was a non-significant trend towards symptomatic heart failure in those patients with a greater ∆CI following AVF occlusion (NYHA 1: -0.1 ± 0.1 L/min/m2; NHYA 2: -0.3 ± 0.7 L/min/m2; NYHA 3: -0.7 ± 1.0 L/min/m2; p = 0.06). Conclusions The relationship between AVF blood flow, cardiac output and symptomatic cardiac disease is complex. Occlusion of an AVF leads to reduced cardiac output and improved oxygen delivery, even in asymptomatic patients. This difference is most marked in patients with high-flow AVF (>2000 mL/min). High-flow AVF with large ∆CI may lead to high cardiac output state, which is reversible on occlusion of the AVF.
Inpatient Venous access Practices: PICC Culture and the Kidney Patient
Authors: McGill Rita L. , Tsukahara Tomoki , Bhardwaj Rahul , Kapetanos Anastasios T. , Marcus Richard J. 
Published: January 2015

Purpose Depleted venous access is frequently cited as a reason for low fistula achievement. These quality assurance studies were designed to clarify the interactions between kidney disease, acuity of care and vascular access practices, and define the impact of nephrology intervention. Methods The inpatient population at an urban teaching hospital was surveyed three times between May 2010 and May 2012. Data were collected on limb protection and vascular access practices, as well as level of kidney function and level of care. Results Peripherally inserted central catheter (PICC) insertion consistently exceeded 30% in patients with chronic kidney disease; reasons for insertion were often poorly defined. More than 50% of patients had devices in the nondominant arm; use of limb protection bracelets was rare. An educational intervention designed to increase nephrologist awareness increased limb protection slightly, but did not affect the distribution of vascular access devices. Conclusions PICC placement and invasion of the nondominant arm are both frequent in patients with abnormal kidney function, in spite of guidelines discouraging their use. The rate of PICC is higher than that of patients with normal kidney function. Current vascular access practices have substantial potential to affect future fistula rates. Effective vein protection may require participation of the entire medical community.
Hoe beleidsmedewerkers zelf leren evalueren
Authors: van der Veen Zwaantina , Meijneken Dymphna , Boekenoogen Marieke 
Published: January 2015

Hoe beleidsmedewerkers zelf leren evalueren
Onderzoekers van de gemeente Amersfoort geven workshops aan beleidsmedewerkers over hoe zij zelf hun projecten met inwoners kunnen evalueren. Waarom doen de onderzoekers dit en hoe ziet zo'n workshop eruit? Daarnaast wordt dieper ingegaan op de meerwaarde van zelf evalueren door beleidsmedewerkers, maar ook op de kanttekeningen die hierbij te maken zijn.
Monitoren en evalueren van integraal gezondheidsbeleid
Authors: Storm Ilse , van Koperen Marije , van der Lucht Fons , van Oers Hans , Schuit Jantine 
Published: January 2015

Monitoren en evalueren van integraal gezondheidsbeleid
Integraal gezondheidsbeleid (IGB) kent in de lokale praktijk diverse verschijningsvormen en kenmerken waardoor het lastig is dit beleid te monitoren en evalueren. In een kennissynthese van Nederlandse kernpublicaties over IGB is gekeken wat op basis van ervaringen in de IGB-praktijk tot nu toe gezegd kan worden over monitoring en evaluatie. Bij deze practice-based verkenning naar IGB-kenmerken en bijbehorende praktische instrumenten is een indeling in drie categorieën gebruikt: context, processen en impact. Voorbeelden van relevante kenmerken zijn: type IGB en setting (context), verbinden beleid en activiteiten (proces), samenwerking sectoren (proces), draagvlak en verankering in organisatie (proces), en effecten op gezondheid of determinanten (impact). Op basis van de huidige IGB-praktijk lijkt het vooral haalbaar kennis te genereren over context en procesmaten, en minder over impactmaten. Uiteindelijk is een set kenmerken die meetbaar zijn met gevalideerde instrumenten wenselijk om grip te krijgen op de voortgang van IGB. Meer theoretische onderbouwing is dan wel noodzakelijk.
Terugblik op de Raad voor Werk en Inkomen (RWI)
Authors: van Hoesel Peter 
Published: January 2015

Terugblik op de Raad voor Werk en Inkomen (RWI)
Je kunt natuurlijk wel verwachten dat Jan van Zijl, die tegenwoordig voorzitter is van de MBO Raad, positieve herinneringen heeft aan wat je zou kunnen noemen ‘zijn RWI’, maar misschien niet dat hij een paar jaar na dato nog zo uitdrukkelijk betreurt dat de RWI is opgeheven. Het was indertijd bij de oprichting wel zo dat de RWI door sommigen gezien werd als een doekje voor het bloeden voor de sociale partners in verband met het feit dat zij macht gingen verliezen na invoering van de SUWI-structuur, maar Van Zijl ging bepaald niet uit van een korte levensloop van de nieuwe raad. Dat hij de taak van de RWI serieus nam, blijkt trouwens ook uit het grote aantal indringende adviezen en rapportages dat de RWI heeft weten te produceren.
Early Art in North America: Clovis and Later Paleoindian Incised Artifacts from the Gault Site, Texas (41BL323)
Authors: Lemke Ashley K. , Wernecke D. Clark , Collins Michael B. 
Published: January 2015

AbstractEngraved and carved bone and stone artifacts capture our imaginations and are known worldwide from archaeological contexts, but they are seemingly rare and oftentimes difficult to recognize. While preservation issues play a role in the limited recovery of early art objects, research on incised stones and bone from the Gault site in Texas demonstrates that an expectation to find such artifacts plays a key role in their identification and recovery. The presence of incised stones found by collectors at Gault alerted archaeologists to the potential for finding early art in systematic excavations. To date, 11 incised stones and one engraved bone of Paleoindian age (13,000–9,000 calibrated years before present) have been recovered and of these, the Clovis artifacts are among the earliest portable art objects from secure context in North America. The presence of incised stone and bone at Gault led to the development of an examination protocol for identifying and analyzing engraved and incised artifacts that can be applied to a wide variety of archaeological contexts.
On the Inferred Age and Origin of Lithic Bi-Points from the Eastern Seaboard and their Relevance to the Pleistocene Peopling of North America
Authors: Boulanger Matthew T. , Eren Metin I. 
Published: January 2015

AbstractRecently, advocates of an “older -than- Clovis” occupation of eastern North America have suggested that bi-pointed leaf-shaped lanceolate stone bifaces provide definitive evidence of human culture on the eastern seaboard prior to the Late Glacial Maximum. This argument hinges on two suppositions : first, that points of this form are exceedingly rare in the East and second, that all known occurrences of these point forms are from landforms or depositionaI environments dating to some time before the late Pleistocene. Neither of these suppositions is supported by the archaeological record. Bi-pointed leaf shaped blades have been recoveredfrom throughout the Middle Atlantic and Northeast, where they have been repeatedly dated, either radiometrically or by association with diagnostic artifacts, to between the Late Archaic and the Early Woodland. Statistical analysis of supposed “older-than-Clovis” leaf-shaped blades demonstrates that there are no significant differences in morphology between them and unequivocally Middle Holocene leaf-shaped blades. Until such time as evidence demonstrates otherwise, there is no reason to accept that these leaf-shaped bifaces are diagnostic of a Pleistocene, much less pre-Late Glacial Maximum, occupation in eastern North America.