bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of clinically relevant operating conditions for left ventricular assist device investigations
Authors: Wisniewski A , Medart D , Wurm F-H , Torner B 
Published: July 2020

Standardized boundary conditions for flow rate and pressure difference are currently not available for the development and certification process of ventricular assist devices. Thus, interdisciplinary studies lack comparability and quantitative assessment. Universally valid boundary conditions could be used for the application of numerical and experimental investigations and the approval procedure of ventricular assist devices. In order to define such boundaries, physiological data from INCOR® patients were evaluated. A total of 599 out of possible 627 ventricular assist device patients were analyzed regarding their cardiac demands of flow rate and pressure head. An analysis of long-term data was performed, in order to provide respective, static mean values for benchmark testing. Furthermore, the short-term data of 188 patients delivered field data-based dynamic flow and pressure curves. The results of the study revealed physiologically reasonable boundary conditions, which can be applied in numerical or experimental investigations of ventricular assist devices. For steady flow analysis, single values for flow rate (4.46 L/min) and pressure head (62 mmHg) are suggested. For the support of pulsatile and unsteady flow studies, seven typical patients and one representative dynamic curve for flow rate and pressure head are proposed. The standardized results provided in this article, can be used in favor of interdisciplinary comparability of future numerical computations or in vitro ventricular assist device tests in research, development, and approval.
Descemet membrane endothelial keratoplasty in patients with prior glaucoma surgery
Authors: Boutin Tanguy , Sorkin Nir , Einan-Lifshitz Adi , Mednick Zale , Mimouni Michael , Cohen Eyal , Trinh Tanya , Santaella Gisella , Buys Yvonne M , Trope Graham , Chan Clara C , Rootman David S 
Published: July 2020

Objective: To present outcomes of Descemet membrane endothelial keratoplasty (DMEK) in eyes with prior trabeculectomy or a glaucoma drainage device (GDD). Methods: A retrospective case series, including patients that had previously undergone trabeculectomy and/or GDD implantation, who later underwent DMEK between 2013 and 2016 at Toronto Western Hospital and the Kensington Eye Institute. Outcome measures: best spectacle-corrected visual acuity (BSCVA), endothelial cell (EC) density, intraoperative and postoperative complications. Results: Twenty-seven eyes of 27 patients were included. All DMEK procedures were uneventful. Mean follow-up time was 14.6 ± 6.1 months. In eyes with no visually limiting comorbidities ( n = 16), BSCVA improved from 1.34 ± 0.65 logMAR (Snellen equivalent ~20/440) preoperatively to 0.51 ± 0.24 logMAR (Snellen equivalent ~20/65) and 0.50 ± 0.33 logMAR (Snellen equivalent ~20/65) at 6 and 12 months, respectively ( p < 0.001 for both). In eyes with visually limiting comorbidities ( n = 11), BSCVA improved from 1.92 ± 0.72 logMAR (Snellen equivalent ~20/1665) preoperatively to 1.43 ± 0.83 logMAR (Snellen equivalent ~20/540) and 1.37 ± 0.99 logMAR (Snellen equivalent ~20/470) at 6 and 12 months, respectively ( p = 0.008 and p = 0.037). Graft detachment rate was 24.1% and rebubble rate was 17.2%. Primary and secondary graft failure rates were 3.7% and 10.3%, respectively. Rejection rate was 17.2%. EC-loss rate at 6 months and 12 months was 36.7% and 50.5%, respectively. Conclusions: DMEK performed in eyes with previous trabeculectomy or a GDD is more challenging than conventional DMEK, but has good outcomes. Higher rates of graft rejection and secondary graft failure in this setting should be further evaluated in long-term studies.
Outcomes in buried versus non-buried peritoneal dialysis catheters: A retrospective cohort study
Authors: Tan Rebekah , Weng Weijie , Raymond Warren D , Sieunarine Kishore 
Published: July 2020

Aims: To compare the rates of infections (peritonitis and exit site infections) in patients undergoing non-buried versus buried peritoneal dialysis catheterisation for end-stage renal failure. Methods: A retrospective review of all patients who underwent peritoneal dialysis catheter placement by one primary surgeon between January 2008 and August 2019. Information collected included, catheter characteristics, immediate post-operative complications, date of catheter exteriorisation, date of peritoneal dialysis commencement, rate of successful catheter function at initiation of peritoneal dialysis and rates of catheter-related complications (i.e. infection, revision status and obstruction). Results: 110 peritoneal dialysis catheters were inserted (43 non-buried and 67 buried peritoneal dialysis catheters). The non-buried group was associated with a higher proportion acquiring an infection than the buried group (15% vs 30%, p = 0.054). Patients with buried catheters also had a 72% and 65% decreased likelihood of experiencing a catheter-related infection and peritonitis, respectively, over time compared to patients with non-buried catheters in the unadjusted (crude incidence rate ratio 0.28, 95% confidence interval 0.11, 0.70; P = 0.003). The proportion of catheter function at first use was 85% in the non-buried group and 78% in the buried group. Patients with non-buried versus buried catheters had similar proportions of complications, including: obstructions (25.6% vs 20.9%, p = 0.770), herniation (7.0% vs 4.0%, p = 0.327) and leaks (7.0% vs 1.5%, p = 0.134). Conclusion: The use of the buried peritoneal dialysis catheter technique as compared to the standard technique has revealed fewer overall catheter-related infections, particularly episodes of peritonitis and similar rates of mechanical complications in our series. In addition to that, the other benefits of buried peritoneal dialysis catheters such as lower healthcare cost, patient convenience and a viable option for patients in remote communities should prompt physicians to continue assessing suitable candidates for buried peritoneal dialysis catheters.
Preliminary balloon dilation of both saphenous fascia and the saphenous vein increases the below-knee fistula patency, but not maturation
Authors: Kahraman Doğan , Şener Uğur , Olgaç Tahir , Moda Mehmet , Yoğurtçuoğlu Burak 
Published: July 2020

Objective: There is no reliable secondary site for fistula creation in patients with preclusions for further use of upper extremity vessels as viable hemodialysis access. Below-knee vessels resemble the forearm vascular anatomy and, therefore, methods to improve the outcomes of fistula creation at this level would also help to improve the quality of life for those patients. The aim of the present study was to examine the efforts to improve the functionality of below-knee fistulas in a sample of dialysis patients. Methods: We retrospectively evaluated the results of ankle fistulas created following preliminary balloon dilatation of both the saphenous fascia and the saphenous vein in 11 patients who were considered eligible if they did not have concomitant venous or arterial lower extremity disease. We assessed the changes in fistula flow within 6 months as well as patency and maturation rates. Results: Though the patency rate at 6 months was 63.6% (seven patients), only three fistulas (27.3%) were used for routine dialysis. All mature fistulas were observed in patients with a preoperative posterior tibial artery flow of more than 35 mL/min. Conclusion: Saphenous vein dilation throughout the below-knee promotes fistula patency, but the posterior tibial artery shows inadequate response as an inflow supplier at the ankle level. More proximal connection of saphenous vein after balloon dilation may be used in the future to achieve adequate flow from leg arteries.
Gene signature and prognostic merit of M6a regulators in colorectal cancer
Authors: Zhang Jinfeng , Cheng Xuedi , Wang Junzheng , Huang Yongjie , Yuan Junhui , Guo Dawen 
Published: July 2020

Although new diagnostic techniques and treatments are increasingly updated, the clinical outcomes of CRC patients are still not encouraging with a low survival rate. N6-methyladenosine as a popular modification on mRNA is associated with multiple types of cancers. Our purpose is to evaluate gene signature and prognostic ability of N6-methyladenosine in CRC. We used the gene expression, copy number variation, simple nucleotide variation and clinical messages from The Cancer Genome Atlas database. We first identified mutation and copy number variations of N6-methyladenosine regulatory genes in both colon adenocarcinoma and rectum adenocarcinoma. Fourteen of all 17 N6-methyladenosine regulatory genes were related with higher mRNA expression, whereas deletion leads to reduced expression. Using univariate Cox regression analysis, RBM15, YTHDC2, and METTL14 genes in the rectum adenocarcinoma samples were conspicuously associated with the prognosis of patients. Based on the least absolute shrinkage and selection operator regression models, we built a 2-gene (YTHDC2 and IGF2BP3) signature of N6-methyladenosine regulators with prognostic ability. The 1-, 3-, and 5-year AUCs of this signature were all greater than 0.6, and the P-value for risk prediction for patients was also less than 0.0001. Moreover, high IGF2BP3 gene expression was significantly associated with IFN-γ in colon adenocarcinoma , and related to the azurophil granule membrane pathway in rectum adenocarcinoma. High YTHDC2 expression in colon adenocarcinoma is closely related to cell energy metabolism. In the rectum adenocarcinoma, high YTHDC2 gene expression is related to the cell centrosome pathway. In conclusion, for the first time, we identified genetic changes of N6-methyladenosine modulators and built a prognostic gene signature in CRC. Impact statement Although new diagnostic techniques and treatments are increasingly updated for CRC, the clinical outcomes of CRC patients are still not encouraging with a low survival rate. N6-methyladenosine (m6A) as a popular modification on mRNA is associated with multiple types of cancers. Our purpose is to identify gene signature and prognostic ability of m6A modulators in CRC. For the first time, we identified genetic changes of m6A modulators and built prognostic gene signature in CRC, which may provide effective targets for the diagnosis and management of CRC.
The effects of intramuscular administration of scopolamine augmentation in moderate to severe major depressive disorder: a randomized, double-blind, placebo-controlled trial
Authors: Zhou Jingjing , Yang Jian , Zhu Xuequan , Zghoul Tarek , Feng Lei , Chen Runsen , Wang Gang 
Published: July 2020

Introduction: Major depressive disorder (MDD) is a common affective disorder. Currently established pharmacotherapies lack rapid clinical response, thereby limiting their ability to bring instant relief to patients. A series of clinical trials has demonstrated the antidepressant effects of scopolamine, yet few have studied the effects of add-on scopolamine to currently available antidepressants. It is not known whether conventional antidepressant treatment with a 3-day scopolamine injection could speed up oral antidepressant efficacy. The main focus of this study is to detect the capacity of the rapid-onset efficacy of such a treatment option. Methods and analysis: This study consisted of a single-centre, double-blind, three-arm randomized trial with a 4-week follow-up period. Sixty-six participants meeting entry criteria were randomly allocated to three treatment groups: a high-dose group, a low-dose group and a placebo control group. Psychiatric rating scales were administered at baseline and seven viewing points following the administration of intramuscular injections. The primary outcome measure was length of time from randomization (baseline) to early improvement. Results: Both primary and secondary outcome measures consistently showed no differences among the three groups. The cumulative response rate and the remission rate were 72.7% (48/66) and 47.0% (31/66). Intramuscular scopolamine treatment was relatively well tolerated. Two subjects with high-dose injections dropped out because of a drug-related side effect. Conclusion: Contrary to our prediction, we found that, compared to placebo (0.9% saline i.m.), scopolamine was not associated with a significantly faster antidepressant response rate. Trial registration: ClinicalTrials.gov, NCT03131050. Registered on 18 April 2017.
Diagnostic management of inpatients with a positive D‐dimer test: developing a new clinical decision‐making rule for pulmonary embolism
Authors: Lei Min , Liu Chang , Luo Zhuang , Xu Zhibo , Jiang Youfan , Lin Jiachen , Wang Chu , Jiang Depeng 
Published: July 2020

BackgroundA positive D‐dimer test has high sensitivity but relatively poor specificity for the diagnosis of pulmonary embolism, causing difficulty for clinicians unskilled in pulmonary embolism diagnosis in determining whether a patient with a positive D‐dimer test needs to undergo computed tomographic pulmonary angiography.ObjectivesWe sought to develop a new clinical decision‐making rule based on a positive D‐dimer result to predict the probability of pulmonary embolism and to guide clinicians in making decisions regarding the need for computed tomographic pulmonary angiography.MethodsWe conducted a prospective, multicenter study in three hospitals in China. A total of 3014 inpatients with positive D‐dimer results were included. In the derivation group, we built a multivariate logistic regression model and deduced a regression equation from which our score was derived. Finally, we validated the score in an independent cohort.ResultsOur score included nine variables (points): chest pain (1.4), chest tightness (2.3), shortness of breath (3.6), hemoptysis (3.4), heart rate ≥100 beats/min (3.6), blood gas analysis (2.9), electrocardiogram presenting a typical S1Q3T3 pattern (4.1), electrocardiogram findings (2.4), and ultrasonic cardiogram findings (3.7). The sensitivities and specificities were 100% and 86.94%, respectively, in the derivation group and 100% and 90.82%, respectively, in the validation group. Additionally, the observed and predicted proportions of patients who underwent computed tomographic pulmonary angiography were 16.82% and 10.76%, respectively, in the derivation group and 18.72% and 11.40%, respectively, in the validation group.ConclusionsThe new score can categorize inpatients with a positive D‐dimer test as pulmonary embolism‐likely or pulmonary embolism‐unlikely, thus reducing unnecessary computed tomographic pulmonary angiography examinations.
Temporal trends and predictors of inhospital death in patients hospitalised for heart failure in Germany
Authors: Keller Karsten , Hobohm Lukas , Ostad Mir A , Göbel Sebastian , Lankeit Mareike , Konstantinides Stavros , Münzel Thomas , Wenzel Philip 
Published: July 2020

Abstract

Aims
We investigated trends in incidence, case fatality rate, patient characteristics and adverse inhospital events of patients hospitalised for heart failure in Germany.

Methods and results
The German nationwide inpatient sample (2005–2016) was used for this analysis. Patients hospitalised due to heart failure were selected for analysis. Temporal trends in the incidence of hospitalisations, case fatality rate and treatments were analysed and predictors of inhospital death were identified. The analysis comprised a total number of 4,539,140 hospitalisations (52.0% women, 81.0% aged ≥70 years) due to heart failure. Although hospitalisations increased from 381 (2005) to 539 per 100,000 population (2016) (β estimate 0.06, 95% confidence interval (CI) 0.06 to 0.07, P &lt; 0.001) in parallel with median age and prevalence of comorbidities, the inhospital case fatality rate decreased from 11.1% to 8.1% (β estimate –0.36, 95% CI –0.37 to –0.35, P &lt; 0.001) and the rate of major adverse cardiovascular and cerebrovascular events (β estimate –0.24, 95% CI –0.25 to –0.23, P &lt; 0.001) decreased from 12.7% to 10.3%. Age 70 years and older (odds ratio (OR) 2.60, 95% CI 2.57 to 2.63, P &lt; 0.001) and cancer (OR 1.93, 95% CI 1.91 to 1.96, P &lt; 0.001) were independent predictors of inhospital death.

Conclusion
Hospitalisations for heart failure increased in Germany from 2005 to 2016, whereas the major adverse cardiovascular and cerebrovascular event rate and inhospital case fatality rate decreased during this period despite higher patient age and increasing prevalence of comorbidities.
The role of surgery in antineutrophil cytoplasmic antibody–associated vasculitides affecting the nose and sinuses: A systematic review
Authors: Pendolino Alfonso Luca , Unadkat Samit , Zhang Henry , Pendolino Monica , Bianchi Gerolamo , Randhawa Premjit S , Andrews Peter J 
Published: July 2020

Background: The ear, nose and throat region has been reported to be one of the commonest sites involved in antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis diseases and often precedes the diagnosis of ANCA–associated vasculitis by many months. Although treatment for ANCA–associated vasculitis primarily requires systemic immunosuppressive therapy, there are specific indications for sinonasal surgery during the course of the disease process. The three major roles for surgery in sinonasal vasculitis are to aid diagnosis through biopsy, enable symptom relief and nasal reconstructive surgery consideration when in remission. Purpose: The aim of this systematic review is to provide an overview of the surgical procedures which can be performed in patients with ANCA–associated vasculitis presenting with sinonasal involvement. Materials and methods: A systematic literature search was performed for scientific articles on MEDLINE (PubMed Advanced MEDLINE Search) and EMBASE. The search included all articles up to April 2020. Conclusion: Surgical intervention during the active phase of ANCA–associated vasculitis disease can improve the patient’s symptoms and enable histological diagnosis. The surgical decision to manage the nose requires a multidisciplinary approach involving the vasculitis specialist and the ear, nose and throat surgeon. Nasal reconstruction can be performed to restore form and function but only when the disease is in remission so as to maximise success and minimise complications.
The retrospective research of enteral nutrition with medium-chain triglyceride and total parenteral nutrition support of postoperative chylothorax in adults
Authors: Zheng Jie , Chen Ying-Yi , Zhang Chun-Ying , Zhang Wen-Qian , Rao Zhi-Yong 
Published: July 2020

Background: Chylothorax is caused by thoracic lymphatic system injuries that leads to the lymph extravasating into the thoracic cavity. There are few reports comparing the therapeutic effects of enteral nutrition with medium-chain triglyceride and total parenteral nutrition, and the results are inconsistent. Our study aimed to research the optimum nutrition support method for chylothorax. Study design: We retrospectively reviewed 35 chylothorax patients after heart and chest surgery from 2014 to 2018, at West China Hospital of Sichuan University, among them there were 27 post-heart surgery patients. We analyzed the therapeutic effects and costs of enteral nutrition with medium-chain triglyceride (E group) and total parenteral nutrition (T group) for chylothorax. Results: The results were similar in patients with all surgeries and patients with only post heart surgery. The total cost during hospitalization in E group was higher than T group ( P < 0.01), whereas the nutrition support cost was lower ( P < 0.001). The length of hospital stay was longer in E group than T group ( P > 0.05). Time from admission to surgery was shorter and from surgery to chylothorax diagnosis was longer in E group compared with T group. Time to resolution and removal of drainage was shorter in E group than T group but the differences were not significant. Conclusion: The therapeutic effects in enteral nutrition with medium-chain triglyceride and total parenteral nutrition had no obvious differences. Moreover, enteral nutrition with medium-chain triglyceride is safer and more economical. Therefore, we suggest that enteral nutrition with medium-chain triglyceride could be the first choice to treat postoperative chylothorax when the gastrointestinal tract function is allowed, and this result could be considered for postoperative chylous ascites.
Non-invasive brain stimulation as add-on therapy for subacute post-stroke aphasia: a randomized trial (NORTHSTAR)
Authors: Zumbansen Anna , Black Sandra E , Chen Joyce L , J Edwards Dylan , Hartmann Alexander , Heiss Wolf-Dieter , Lanthier Sylvain , Lesperance Paul , Mochizuki George , Paquette Caroline , Rochon Elizabeth A , Rubi-Fessen Ilona , Valles Jennie , Kneifel Heike , Wortman-Jutt Susan , Thiel Alexander ,   on behalf of the NORTHSTAR-study group
Published: July 2020

Introduction Non-invasive brain stimulation (NIBS) with speech therapy might improve recovery from post-stroke aphasia. This three-armed sham-controlled blinded prospective proof-of-concept study tested 1 Hz subthreshold repetitive transcranial magnetic stimulation (rTMS) and 2-mA cathodal transcranial direct current stimulation (ctDCS) on the right pars triangularis in subacute post-stroke aphasia. Patients and methods Sixty-three patients with left middle cerebral artery infarcts were recruited in five hospitals (Canada/United States/Germany, 01–2014/03–2018) and randomized to receive rTMS ( N = 20), ctDCS ( N = 24) or sham stimulation ( N = 19) with ST for 10 days. Primary outcome variables were Z-score changes in naming, semantic fluency and comprehension tests and adverse event frequency. Secondary outcome variable was the percent change in the Unified Aphasia Score. Intention-to-treat analyses tested between-group effects at days 1 and 30 post-treatment with a pre-planned subgroup analysis for lesion location (affecting Broca’s area or not). Results Naming was significantly improved by rTMS (median = 1.91/interquartile range = 0.77/ p =  .01) at 30 days versus ctDCS (median = 1.11/interquartile range = 1.51) and sham stimulation (median = 1.02/interquartile range = 1.71). All other primary results were non-significant. The rTMS effect was driven by the patient subgroup with intact Broca’s area where NIBS tended to improve UnAS (median = 33.2%/interquartile range = 46.7%/ p =  .062) versus sham stimulation (median = 12.5%/interquartile range = 7.9%) at day 30. Conversely, in patients with infarcted Broca’s area, UnAS tended to improve more with sham stimulation (median = 75.0%/interquartile range = 86.9%/ p =  .053) versus NIBS (median = 12.7%/interquartile range = 31.7). Conclusion: We found a delayed positive effect of low-frequency rTMS targeting the right pars triangularis on the recovery of naming performance in subacute post-stroke aphasia. This intervention may be beneficial only in patients with morphologically intact Broca’s area.