bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impaired left ventricular global longitudinal strain improves with radiofrequency catheter ablation in patients with PVC‐induced cardiomyopathy
Authors: Koca Hasan , Koca Fadime , Icen Yahya Kemal , Demirtas Abdullah Orhan , Aslan Muhammed Zubeyir , Sumbul Hilmi Erdem , Coskun Mükremin , Erdoğdu Tayfur , Koc Mevlut 
Published: July 2020

AbstractBackgroundIn our study, we aimed to evaluate left ventricular global longitudinal strain (LV‐GLS) value in patients with premature ventricular contractions (PVCs) and reduced LV ejection fraction (LVEF) and to determine the effect of radiofrequency catheter ablation (RFA) procedure on LV‐GLS.MethodsIn this cross‐sectional study, 150 patients who underwent three‐dimensional RFA with the diagnosis of PVCs were included. LV‐GLS was measured with strain echocardiography in all patients before RFA and in the sixth‐month control. Patients included in the study were grouped as LVEF <50% (Group I) and LVEF ≥50% (Group II) according to baseline LVEF, and patients within Group I were grouped as LVEF <50% (Group A) and LVEF ≥50% (Group B) according to the sixth‐month LVEF.ResultsThere were 39 patients (26%) with baseline LVEF <50%. In 14 (36%) of these patients, LVEF <50% was observed to continue during the sixth‐month controls. Both the baseline and sixth‐month LV‐GLS values were significantly lower in Group I patients (<0.01). RFA treatment significantly increased both LVEF and LV‐GLS (<0.01). It was found that age, N‐terminal pro‐brain natriuretic peptide, LV diameters, and baseline LVEF were higher, and baseline LV‐GLS level was lower in Group A patients (P < .01). Baseline LVEF and LV‐GLS values were found to independently determine the patients in Group A (P < .01). In receiver operator characteristic analysis, when the limit value is accepted as 40% for baseline LVEF and 18% for baseline LV‐GLS, it can determine Group A with acceptable sensitivity and specificity.ConclusionsLV‐GLS decreases significantly in patients with reduced LVEF and PVCs. In these patients, RFA treatment significantly increases both LVEF and LV‐GLS.
Hydromorphone population pharmacokinetics in pediatric surgical patients
Authors: Balyan Rajiv , Dong Min , Pilipenko Valentina , Geisler Kristie , Vinks Alexander A. , Chidambaran Vidya 
Published: July 2020

AbstractBackgroundHydromorphone is an opioid agonist used for pediatric analgesia. Due to lack of data, pediatric dosing (based on adult pharmacokinetic models) is not optimal.AimThis study characterizes hydromorphone population pharmacokinetics in pediatric surgical patients.MethodsIn this prospective observational study, 34 children (4‐18 years, bodyweight 23‐89.6 kg) received multiple intravenous hydromorphone boluses followed by postoperative hydromorphone patient‐controlled analgesia. Arterial blood samples were collected before and at 3, 10, 30, and 90 (and few samples at 1350) minutes after the first dose. Hydromorphone concentrations were measured by validated LC‐MS/MS assay. Nonlinear mixed‐effects modeling was used for pharmacokinetic model development. The final population pharmacokinetic model was evaluated by visual predictive check and bootstrap analysis. Monte Carlo simulations based on the final pharmacokinetic model determined optimal patient‐controlled analgesia parameters to achieve a target of 20 ng/mL (as the median effective analgesic concentration), using minimum effective analgesic concentration of 4 ng/mL as a proxy for patient‐controlled analgesia dose demand, and not exceeding the defined safe upper threshold of 40 ng/mL.ResultsHydromorphone pharmacokinetic profiles were adequately described by a two‐compartmental model with first‐order elimination. Bodyweight was found to be a significant covariate for hydromorphone clearance. Allometrically scaledpharmacokinetic parameter estimates (per 70 kg), systemic clearance (0.748 L/min), volume of distribution (33 L), peripheral clearance (1.57 L/min), and peripheral volume of distribution (146 L) were similar to reported adult parameter estimates. Sex, race, age, and type of surgery were not identified as significant covariates. To identify optimal patient‐controlled analgesia dosing parameters, we simulated several initial loading doses, demand doses, and lockout intervals. Our simulations support an initial patient‐controlled analgesia loading dose of 15 µg/kg followed by a demand dose of 6 µg/kg with lockout intervals of 20 minutes.ConclusionsAfter intravenous hydromorphone, plasma pharmacokinetic profiles in children undergoing different surgeries were well described by a two‐compartment population allometric pharmacokinetic model using bodyweight as the size descriptor. Model informed simulations identified patient‐controlled analgesia parameters to inform initial settings, with adjustments as needed based on observed individual effects.
A Randomized Controlled Pilot Study Comparing the Efficacy of Pulsed Radiofrequency Combined With Exercise Versus Exercise Alone in Pain Relief and Functional Improvement for Chronic Knee Osteoarthritis
Authors: Han Qi , Ma Yantao , Jia Peiyu , Wang Xiaolei , Wang Bo , Zheng Yongjun 
Published: July 2020

AbstractObjectivesTo compare the long‐term efficacy between pulsed radiofrequency (PRF) combined with passive stretching (PRF‐PS) exercise and PS exercise alone in reducing pain and improving quadriceps muscle strength and knee function.MethodsSixty‐two participants were randomly assigned with a 1:1 allocation to the PRF‐PS exercise group or the PS exercise group. Level of pain, muscle strength, and knee function were assessed from baseline to the first, third, and sixth months after treatment using the VAS, peak torque (PT), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively.ResultsThere were no significant differences at baseline between the 2 groups. Compared to exercise alone, participants achieved superior efficacy with PRF‐PS in pain relief, improvement of muscle strength, and knee function. Moreover, the improvement of all variables was maintained for a longer period of time in the PRF‐PS group. The reduction in participants’ VAS pain intensity scores was superior for PRF‐PS vs. PS with overall estimation (adjusted mean difference: −1.85 cm; 95% confidence interval [CI] −2.25, −1.45 cm; P = 0.000). The increase in participants’ PT scores was superior for PRF‐PS vs. PS with overall estimation (adjusted mean difference: 15.53 N. m; 95% CI 7.07, 23.98 N. m; P = 0.000; and 12.62 N. m; 95% CI 0.96, 24.28 N. m; P = 0.000 for PT 60 degrees/s and PT 180 degrees/s, respectively). The reduction in participants’ WOMAC scores was superior for PRF‐PS vs. PS with overall estimation (adjusted mean difference: −16.43; 95% CI −22.22, −10.64; P = 0.000).DiscussionThe improvement in pain relief and knee function might be associated with restoration of muscle strength after PRF‐PS exercise by overcoming muscle inhibition.
Pubertal outcomes of children transplanted with allogeneic stem cells after myeloablative total body irradiation or busulfan: Influence of age and sex is confirmed, while a role of chronic graft‐versus‐host disease in delayed puberty onset is revealed
Authors: Weinhard Sara , Wiedemann Arnaud , Leheup Bruno , Dalle Jean‐Hugues , Lebon Labich Béatrice , Pochon Cécile 
Published: July 2020

AbstractIntroductionMyeloablative conditioning before allogeneic HSCT during childhood exposes to serious long‐term complications, especially gonadal dysfunction. Pubertal issues are less described than other post‐HSCT sequelae in childhood.MethodsPubertal development and biological gonadal parameters were assessed in a retrospective monocentric cohort of prepubertal patients who underwent HSCT after myeloablative conditioning with TBI or busulfan between 1981 and 2017.ResultsSeventy‐four patients (28 girls and 46 boys) were included. No spontaneous pubertal development was found in 50% of girls and 10% of boys (P < .001), and delayed puberty or no spontaneous pubertal development was found in 57% of girls and 24% of boys (P = .009). HRT was used in 82% of girls and 24% of boys (P < .001). In univariate analysis, TBI conditioning (P = .05), female sex (P < .001), acute GVHD (P = .05), extensive chronic GVHD (P = .021), steroid treatment >6 months (P = .016), and malignant diseases (P = .016) were associated with no spontaneous pubertal development, whereas TBI conditioning (P = .003) and extensive chronic GVHD (P = .005) were associated with delayed puberty. In multivariate analysis, factors independently associated with no spontaneous puberty onset were female sex (P = .001) and age >10 years (P = .033). Factors independently associated with delayed puberty were extensive chronic GVHD (P = .041) and age >10 years (P = .031).ConclusionThis study highlighted the toxicity of MAC in prepubescent children: TBI did worse, but this was especially true for the most susceptible patients (girls, leukemic patients, and patients older than 10 years). It suggests a possible role of GVHD in delayed puberty.
Estimating the effect of New Jersey’s 2005 administrative nurse mandate on mortality and hospitalizations for medicare hemodialysis patients
Authors: Schemenaur Michael , Norris Conor , Timmons Edward , Jacob Allan 
Published: July 2020

AbstractBackground and objectivesIn 2005, the New Jersey Department of Health enacted a rule requiring that an administrator or designate always be present in a hemodialysis clinic and that the individual may not be involved in patient care activities at any time. Our investigation examines the effect of this unique rule on patient mortality and hospitalizations and is meant to inform the public policy discussion.Design, setting, participants, and measurementsWe utilized a synthetic control estimation to analyze the effect of this rule on patient mortality in New Jersey. We also compared trends for hospitalizations in New Jersey to other similar states.ResultsWe find no evidence that the law affected patient mortality or the number of hospitalizations for Medicare patients in New Jersey.ConclusionsThe New Jersey law poses substantial costs to hemodialysis clinics and we find little evidence of any measurable benefit to patients.
Temporal changes in dialysate [Na+] prescription from 1996 to 2018 and their clinical significance as judged from a meta‐regression of clinical trials
Authors: Marshall Mark R. , Karaboyas Angelo 
Published: July 2020

AbstractOver the last two decades, the clinical care of dialysis patients has refocused sharply on fluid volume control. Dialysate [Na+] is a key, albeit under‐investigated, clinical tool for manipulation of fluid volume on dialysis. In the article, we firstly use data from the Dialysis Outcomes and Practice Patterns Study to document the global decrease in dialysate [Na+] that has occurred from 1996 to 2018, and demonstrate the virtual disappearance of [Na+] profiling from routine dialysis practice over the same period. Second, we used data from previously synthesized randomized clinical trial evidence combined with that of a more recently published trail to assess the clinical significance of these changes, estimating the effects of different levels of low dialysate [Na+] on key clinical outcomes. Our analyses suggest that current levels of dialysate [Na+] in some health jurisdictions are possibly causing harm to many patients, especially given that real world populations are significantly less robust and more vulnerable than clinical trial ones. To quote a recent editorial, “more evidence needed before lower dialysate sodium concentrations can be recommended.” That evidence is coming, and no further changes should be made to default customary practice until it is available.
Understanding by Testimony: A Reply to Malfatti
Authors: Gilbertson Eric 
Published: July 2020

AbstractFederica Malfatti criticizes recent arguments against the possibility of understanding transmission. While she offers no positive argument for the claim that understanding can be transmitted, she does defend a liberal conception of transmission that allows for the possibility of understanding transmission. In this article, I have three aims. First, I will show that there is a stronger version of one of the arguments against understanding transmission that Malfatti considers, which avoids her objection. This argument also fails, however, and the reason it fails suggests that if understanding cannot be transmitted this is not due to the nature of epistemic trust. Second, I will offer a positive argument for understanding transmission on Malfatti's behalf, and defend the view of understanding on which it depends. Finally, I will raise a further challenge to the proponent of understanding transmission. The upshot is that although Malfatti is right that we have no clear reason to exclude the possibility of understanding transmission – and, if I am right, we have positive reason to accept it – nevertheless a puzzle remains about such transmission.
Syncopal‐type reactions tend to be delayed and result in falls among elderly blood donors
Authors: Namba Noriko , Ishimaru Fumihiko , Kondo Gaku , Hashizume Tatsuma , Kunii Noriko , Shibata Reiko , Sawamura Yoshihiro , Kato Tsuneo 
Published: July 2020

BackgroundDelayed syncopal‐type complications are infrequent among blood donors, but sometimes have critical consequences, such as severe injury. We retrospectively investigated the characteristics of donors with delayed syncopal‐type complications or falls.Study design and methodsWe defined a delayed reaction (DR) as syncopal‐type complications occurring >20 min after needle removal. Subjects were stratified by sex, age, estimated blood volume (EBV), body mass index (BMI) and frequency of donation. Multiple logistic regression analysis and propensity score weighted M estimation were performed to evaluate the covariate‐adjusted risk of syncopal DRs among donors giving 400 ml of whole blood (WB). The DR rate was calculated as the number of DRs divided by the number of all syncopal‐type reactions after needle removal. The risk of falls was assessed similarly. Donors who discontinued before completing phlebotomy (donation of 400 ml) were excluded.ResultsAmong 3818 syncopal‐type reactions after needle removal, there were 359 DRs and 93 falls. Elderly donors and female donors with syncopal‐type reactions had a significantly higher risk of DRs (P for trend < 0·001). Elderly donors with syncopal‐type reactions also had a higher risk of falls (P for trend < 0·001). Among all donors with syncopal‐type reactions, the risk of DRs or falls was not correlated with EBV, BMI or donation frequency.ConclusionIn female donors and elderly donors (donating 400 ml of WB), syncopal‐type reactions tended to be delayed. Elderly donors with syncopal‐type reactions had a significantly higher risk of falls.
Dynamic characteristics of cerebrovascular reactivity or ventilatory response to change in carbon dioxide
Authors: Ogoh Shigehiko , Shibata Shigeki , Ito Go , Miyamoto Tadayoshi 
Published: July 2020

New Findings

What is the central question of this study?
What are the dynamic characteristics of cerebrovascular carbon dioxide reactivity and the central respiratory chemoreflex?

What is the main finding and its importance?
The transfer function gain from the end‐tidal partial pressure of carbon dioxide to cerebral blood flow or ventilation decreased in the high frequency range at rest and during exercise. These findings indicate that the dynamic characteristics of both systems were not constant in all frequency ranges, and this trend was not modified by exercise.

AbstractThe purpose of this study was to examine the dynamic characteristics of cerebrovascular reactivity and ventilatory response to change in arterial CO2 in all frequency ranges at rest using frequency domain analysis, and also to examine whether this is modified by dynamic exercise as with the traditionally determined cerebrovascular CO2 reactivity. In nine healthy young subjects, at rest and during exercise (cycling exercise at constant predetermined work rate corresponding to a level of 0.90 l min−1), the dynamic characteristics of cerebrovascular CO2 reactivity and the central respiratory chemoreflex were assessed by transfer function analysis using a binary white‐noise sequence (0–7% inspired CO2 fraction) from the end‐tidal partial pressure of CO2 () to the mean middle cerebral artery mean blood velocity (MCA Vm) or minute ventilation (), respectively. In the high frequency range, both transfer function gains decreased but, interestingly, the cut‐off frequency in the transfer function gain from to MCA Vm response was higher than that from to response at rest (0.024 vs. 0.015 Hz) and during exercise (0.030 vs. 0.011 Hz), indicating that cerebrovascular CO2 reactivity or central respiratory chemoreflex was not constant in all frequency ranges, and this trend was not modified by exercise. These findings suggest that dynamic characteristics of the cerebrovascular CO2 reactivity or central chemoreflex need to be assessed to identify the whole system because the traditional method cannot identify the property of time response of these systems.
Overview of the 2018 Workshop on Iterative Errors in Unsteady Flow Simulations
Authors: Eça L. , Vaz G. , Hoekstra M. , Pal S. , Muller E. , Pelletier D. , Bertinetti A. , Difonzo R. , Savoldi L. , Zanino R. , Zappatore A. , Chen Y. , Maki K. J. , Ye H. , Drofelnik Jernej , Moss Benjamin , Da Ronch Andrea 
Published: July 2020

Abstract
Two workshops were held at the ASME V&V Symposiums of 2017 and 2018 dedicated to Iterative Errors in Unsteady Flow Simulations. The focus was on the effect of iterative errors on numerical simulations performed with implicit time integration, which require the solution of a nonlinear set of equations at each time-step. The main goal of these workshops was to create awareness to the problem and to confirm that different flow solvers exhibited the same trends. The test case was a simple two-dimensional, laminar flow of a single-phase, incompressible, Newtonian fluid around a circular cylinder at the Reynolds number of 100. A set of geometrically similar multiblock structured grids was available and boundary conditions to perform the simulations were proposed to the participants. Results from seven flow solvers were submitted, but not all of them followed exactly the proposed conditions. One set of results was obtained with adaptive grid and time refinement using triangular elements (CADYF) and another used a compressible flow solver with a dual time stepping technique and a Mach number of 0.2 (DLR-Tau). The remaining five submissions were obtained with five different incompressible flow solvers (ansyscfx 14.5, pimplefoam, refresco, saturne, starccm+ v12.06.010-R8) using implicit time integration in the proposed grids. The results obtained in this simple test case showed that iterative errors may have a significant impact on the numerical accuracy of unsteady flow simulations performed with implicit time integration. Iterative errors can be significantly larger (one to two orders of magnitude) than the residuals and/or solution changes used as convergence criteria at each time-step. The Courant number affected the magnitude of the iterative errors obtained in the proposed exercise. For the same iterative convergence criteria at each time-step, increasing the Courant number tends to increase the iterative error.
Dietary intake of total, animal, and plant proteins and risk of all cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of prospective cohort studies
Authors: Naghshi Sina , Sadeghi Omid , Willett Walter C , Esmaillzadeh Ahmad 
Published: July 2020

AbstractObjectiveTo examine and quantify the potential dose-response relation between intake of total, animal, and plant protein and the risk of mortality from all causes, cardiovascular disease, and cancer.DesignSystematic review and meta-analysis of prospective cohort studies.Data sourcesPubMed, Scopus, and ISI Web of Science until December 2019, and references of retrieved relevant articles.Study selectionProspective cohort studies that reported the risk estimates for all cause, cardiovascular, and cancer mortality in adults aged 18 or older.Data synthesisRandom effects models were used to calculate pooled effect sizes and 95% confidence intervals for the highest versus lowest categories of protein intake and to incorporate variation between studies. Linear and non-linear dose-response analyses were done to evaluate the dose-response relations between protein intake and mortality.Results32 prospective cohort studies were included in the systematic review and 31 in the meta-analysis. During the follow-up period of 3.5 to 32 years, 113 039 deaths (16 429‬ from cardiovascular disease and 22 303‬ from cancer) occurred among 715 128 participants. Intake of total protein was associated with a lower risk of all cause mortality (pooled effect size 0.94, 95% confidence interval 0.89 to 0.99, I2=58.4%, P<0.001). Intake of plant protein was significantly associated with a lower risk of all cause mortality (pooled effect size 0.92, 95% confidence interval 0.87 to 0.97, I2=57.5%, P=0.003) and cardiovascular disease mortality (pooled hazard ratio 0.88, 95% confidence interval 0.80 to 0.96, I2=63.7%, P=0.001), but not with cancer mortality. Intake of total and animal protein was not significantly associated with risk of cardiovascular disease and cancer mortality. A dose-response analysis showed a significant inverse dose-response association between intake of plant protein and all cause mortality (P=0.05 for non-linearity). An additional 3% energy from plant proteins a day was associated with a 5% lower risk of death from all causes.ConclusionsHigher intake of total protein was associated with a lower risk of all cause mortality, and intake of plant protein was associated with a lower risk of all cause and cardiovascular disease mortality. Replacement of foods high in animal protein with plant protein sources could be associated with longevity.