bluuebunny/crossref_metadata_2025_split huggingface dataset:
The transluminal attenuation gradient does not add diagnostic accuracy to coronary computed tomography
Authors: Henriksson Lilian , Woisetschläger Mischa , Alfredsson Joakim , Janzon Magnus , Ebbers Tino , Engvall Jan , Persson Anders 
Published: July 2020

Background A method for improving the accuracy of coronary computed tomography angiography (CCTA) is highly sought after as it would help to avoid unnecessary invasive coronary angiographies. Measurement of the transluminal attenuation gradient (TAG) has been proposed as an alternative to other existing methods, i.e. CT perfusion and CT fractional flow reserve (FFR). Purpose To evaluate the incremental value of three types of TAG in high-pitch spiral CCTA with invasive FFR measurements as reference. Material and Methods TAG was measured using two semi-automatic methods and one manual method. A receiver operating characteristic (ROC) analysis was made to determine the usefulness of TAG alone as well as TAG combined with CCTA for detection of significant coronary artery stenoses defined by an invasive FFR value ≤0.80. Results A total of 51 coronary vessels in 37 patients were included in this retrospective study. Hemodynamically significant stenoses were found in 13 vessels according to FFR. The ROC analysis TAG alone resulted in areas under the curve (AUCs) of 0.530 and 0.520 for the semi-automatic TAG and 0.557 for the manual TAG. TAG and CCTA combined resulted in AUCs of 0.567, 0.562 for semi-automatic TAG, and 0.569 for the manual TAG. Conclusion The results from our study showed no incremental value of TAG measured in single heartbeat CCTA in determining the severity of coronary artery stenosis degrees.
The value of combined positron emission tomography/magnetic resonance imaging to diagnose inflammatory bowel disease: a prospective study
Authors: Tenhami Mervi , Virtanen Johanna , Kauhanen Saila , Koffert Jukka , Kemppainen Jukka , Saunavaara Virva , Kujari Harry , Hurme Saija , Teperi Simo , Voutilainen Markku 
Published: July 2020

Background The clinical utility of positron emission tomography/magnetic resonance imaging (PET/MRI) in comparison to standard work-up with patients with known or suspected inflammatory bowel disease (IBD) is unknown. Purpose To evaluate the value of 18F-fluorodeoxyglucose (18F-FDG) PET/MRI in the diagnostics of IBD and further compare the data obtained using PET/MRI to histological findings. Materials and Methods Ten patients with relapse in IBD or with symptoms of suspected IBD were recruited either from a gastroenterology outpatient clinic or from a hospital ward. Intestinal inflammation was assessed with histology and 18F-FDG PET/MRI. Maximum standard uptake values (SUVmax) were calculated in six regions of the intestine (small bowel, ascending, transverse, descending and sigmoid colon, and rectum) and compared to histological analysis of inflammation activity. Results The study showed that both the inflammation activity ( P = 0.008) and the region of the biopsy in the intestine ( P = 0.015) had a significant effect on SUV. SUVs obtained from severe inflammation activity emerged significantly from the background ( P = 0.006). In addition, the SUVs obtained from moderate inflammation raised from background, but the difference was not statistically significant ( P = 0.083), while SUVs of mild inflammation were at the same level with SUVs of normal bowel wall ( P = 0.988). Conclusion 18F-FDG PET/MRI is a promising method of detecting especially severe inflammatory bowel lesions. More data are required to define its sensitivity and specificity.
Preliminary analysis of interaction of the fat fraction in the sacroiliac joint among sex, age, and body mass index in a normal Chinese population
Authors: Ning Qiuping , Fan Tiebing , Tang Jinyang , Han Shuhua , Wang Wensheng , Ren Hua , Wang Haiyi , Ye Huiyi 
Published: July 2020

Objective Iterative decomposition of water and fat with echo asymmetry and least-squares estimation-iron quantification (IDEAL-IQ) is a noninvasive and objective method used to quantitatively measure fat content. Although this technique has been used in the entire abdomen, IDEAL-IQ findings in the sacroiliac joint (SIJ) have rarely been reported. This preclinical study was performed to quantify the amount of fat in the SIJ in healthy volunteers by IDEAL-IQ. Methods From April to November 2017, 60 healthy volunteers with low back pain were included in this retrospective study. The participants were allocated into groups by age (15–30, 31–50, and ≥51 years), sex (male and female), and body mass index (BMI) (<18.5, 18.5–23.9, and ≥24.0 kg/m2). The iliac-side (Fi) and sacral-side (Fs) fat fractions were obtained in all groups. Two- and three-factor multivariate analyses were performed to analyze the effects of sex, age, and BMI on the Fi and Fs. Results The interaction among sex, age, and BMI had no statistically significant effect on the dependent variable. Both Fi and Fs were significantly influenced by age. Fs was significantly influenced by sex. Conclusion The IDEAL-IQ sequence can be used to quantitatively assess the SIJ fat content in healthy volunteers.
Low plasma levels of calcitonin gene-related peptide in persistent post-traumatic headache attributed to mild traumatic brain injury
Authors: Ashina Håkan , Al-Khazali Haidar Muhsen , Iljazi Afrim , Ashina Sait , Jørgensen Niklas Rye , Amin Faisal Mohammad , Ashina Messoud , Schytz Henrik Winther 
Published: July 2020

Objective To investigate the role of calcitonin gene-related peptide (CGRP) in persistent post-traumatic headache (PTH) attributed to mild traumatic brain injury (TBI). Methods A total of 100 individuals with persistent PTH attributed to mild TBI and 100 age- and gender-matched healthy controls were enrolled between July 2018 and June 2019. Blood was drawn from the antecubital vein and subsequently analyzed using a validated radioimmunoassay for human CGRP. Measurements were performed on coded samples by a board-certified laboratory technician who was blind to clinical information. Results CGRP plasma levels were lower in subjects with persistent PTH (mean, 75.8 pmol/L; SD, 26.4 pmol/L), compared with age- and gender-matched healthy controls (mean, 88.0 pmol/L; SD, 34.1 pmol/L) ( p = 0.04). No correlation was found of CGRP plasma levels with monthly headache days ( r = −0.11; p = 0.27), monthly migraine-like days ( r = 0.15; p = 0.13), headache quality ( r = −0.14; p = 0.15), or a chronic migraine-like headache phenotype ( r = −0.02; p = 0.85). Conclusions CGRP plasma measurements are unlikely a feasible blood-based biomarker of persistent PTH. Future studies should assess whether CGRP plasma measurements can be used to predict development of persistent PTH.
Neurophysiological and biomolecular effects of erenumab in chronic migraine: An open label study
Authors: De Icco Roberto , Fiamingo Giuseppe , Greco Rosaria , Bottiroli Sara , Demartini Chiara , Zanaboni Anna Maria , Allena Marta , Guaschino Elena , Martinelli Daniele , Putortì Alessia , Grillo Valentina , Sances Grazia , Tassorelli Cristina 
Published: July 2020

Introduction Anti-calcitonin gene-related peptide antibodies proved effective in the preventive treatment of chronic migraine. In this open label study, we aim to assess the effects of erenumab administration on neurophysiological and biomolecular profiles in a representative cohort of chronic migraine patients. Methods Forty patients with a history of chronic migraine for at least 12 months prior to enrollment, and previous failure of at least two different preventive therapies, were enrolled. After a 1-month observation period (T0), patients were treated with erenumab 70 mg s.c. (every 28 days) for a total of three administrations. At week 12, they returned for the end-of-protocol visit (T3). At T0 and T3, patients underwent recording of clinical features, recording of single stimulus (RTh), temporal summation (TST) thresholds of the nociceptive withdrawal reflex, venous blood sampling for miR-382-5p, and miR-34a-5p quantification. Results At T3, 31 patients (77.5%) qualified as 30% Responders (reduction in monthly migraine days by at least 30% in the last 4-week observation period). RTh (T0: 15.4 ± 8.1 mA, T3: 19.7 ± 8.2 mA) as well as TST (T0: 11.2 ± 5.8 mA, T3: 13.4 ± 5.0 mA) significantly increased at T3 in 30% Responders ( p = 0.001 for both), while we did not observe significant changes in NON-responder patients. MiR-382-5p and miR-34a-5p levels were significantly lower after erenumab administration in the overall study population ( p = 0.015, and p = 0.001, respectively), without significant differences between 30% Responder and NON-responder groups. Conclusions Different migraine phenotypes, characterized by different treatment susceptibility, may exist as suggested by the divergent behavior between neurophysiological and biomolecular findings in 30% Responder vs. NON-responder patients. The study protocol was registered at clinicaltrials.gov (NCT04361721).
Effect of flight/structural parameters and operating conditions on dynamic behavior of a squeeze-film damped rotor system during diving–climbing maneuver
Authors: Chen Xi , Gan Xiaohua , Ren Guangming 
Published: July 2020

During aircraft maneuvering flights, engine's rotor-bearing systems are subjected to parametric excitations and additional inertial forces, which may cause severe vibration and abnormal operation. Based on Lagrange's principle combined with finite element modeling, the differential equations of motion for a squeeze film damped rotor-bearing system mounted on an aircraft in maneuvering flight are derived. Using Newmark–Hilber–Hughes–Taylor integration method, dynamic characteristics of the nonlinear rotor system under maneuvering flight are investigated. The factors are considered, involving mass unbalance, oil–film force, gravity, parametric excitations and additional inertial forces, and instantaneous static eccentricity of journal induced by maneuvering loads. The effects of forward velocity, radius of curvature, rotating speed, mass unbalance, oil–film clearance, and elastic support stiffness on transient responses of rotor system are discussed during diving–climbing maneuver. The results indicate that when the aircraft performs a diving–climbing maneuver in the vertical plane, the journal deviates from the center of oil–film outer ring, and the excursion direction of whirl orbit is determined by centrifugal acceleration and additional gyroscopic moment. The journal whirls asynchronously around the instantaneous static eccentricity and its magnitude is related to the maneuvering loads and the supporting stiffness. Increasing forward velocity or decreasing pitching radius, the rotor vibration will enter earlier into or withdraw later from the relatively large eccentricity. Rotating near critical speeds or excessive mass unbalances should be prevented during maneuvering flights. For large maneuver, the oil–film radial clearance needs to be enlarged properly to avoid hard contact between journal and outer ring. In addition, the stiffness of elastic support needs to be appropriately determined for damping performance. Overall, it provides a flexible approach with good expandability to predict dynamic characteristics of on-board squeeze-film damped rotor system during maneuvering flights in the design process.
Five challenges to humanity: Learning from pattern/repeat failures in past disasters?
Authors: Quinlan Michael 
Published: July 2020

Human civilisation faces a series of existential threats from the combination of five global and human-engineered challenges, namely climate change, resource depletion, environmental degradation, overpopulation and rising social inequality. These challenges are arguably being manifested in both an increased likelihood and magnified impact of catastrophes like forest fires, prolonged droughts, pandemics and social dislocation/upheaval. This article argues that in understanding and addressing these challenges, important lessons can be drawn from what has repeatedly caused organisational failures. It applies the ‘Ten Pathways to Disaster’ model to a series of disasters/catastrophic events and then argues this model is salient to understanding inadequate responses to the five threats to civilisation. The article argues that because these challenges interact in mutually reinforcing ways, it is critical to address them simultaneously not in isolation.JEL Codes: H12, I14, I31, J11, Q01
New onset diabetes with ketoacidosis following nivolumab immunotherapy: A case report and review of literature
Authors: Delasos Lukas , Bazewicz Christopher , Sliwinska Aleksandra , Lia Nerea Lopetegui , Vredenburgh James 
Published: July 2020

Introduction Immune-checkpoint inhibitors have become an increasingly popular form of systemic therapy for cancer treatment. Their use has proven to be so effective that certain regimens have gained approval as first-line therapy for various solid tumor types. The most common and well-studied forms of immunotherapy include agents that target cytotoxic T-lymphocyte antigen-4, programmed death-1, and programmed death ligand-1. These therapies act by blocking signaling between immune cells and cancer cells which subsequently augment T cell-mediated destruction of tumor cells. Case report Here, we report a case of a 77-year-old black male with no history of or risk factors for diabetes mellitus who presented with acute onset of diabetic ketoacidosis after beginning immunotherapy with nivolumab for metastatic high-grade neuroendocrine tumor of the lung. He was admitted and treated for diabetic ketoacidosis but required prolonged use of an insulin infusion with frequent need of intravenous dextrose due to labile blood sugars. The patient was eventually discharged and discontinued further immunotherapy with nivolumab. Discussion Due to the unique mechanisms by which immune-checkpoint inhibitors cause immune-mediated destruction of tumor cells, clinicians may be challenged with their associated autoimmune complications referred to as immune-related adverse events. In particular, the incidence of endocrine dysfunction following immune-checkpoint inhibitor therapy is approximately 12%, with the development of insulin-dependent diabetes mellitus being a rare complication. Increasing awareness of immune-related adverse events is essential for the early recognition and effective management of patients who present with life-threatening complications related to immune-checkpoint inhibitor therapy.
Development of a Surgical Sponge Counting System Using Radiographic Images
Authors: Kusuda Kaori , Yamashita Kazuhiko , Tanaka Shinichi , Tanaka Kiyohito , Ohta Yuji 
Published: July 2020

Background. Retention of surgical sponges in patients is a relatively frequent medical malpractice. To prevent it, the surgical sites are scanned using X-ray. However, using radiography in the operation room induces X-ray exposure for both patients and staff. To prevent such issues, a novel sponge counting system was developed. Each surgical sponge used in common hospitals is composed of single radiopaque fibers. Methods. The proposed system scans surgical sponges to estimate their fiber length (EFL) and returns the number of it. In this study, an optimal image acquisition protocol was determined that allows an accurate count of sponges. X-ray doses and multi-angle image procedures were tested. Results. Measurement trials were performed and compared for both dry and blood-soaked sponges. As a result, the X-ray dose of 50 kV and 600 μA and the acquisition of 180 images per sample yielded an accurate EFL. The 180-image protocol achieved good performance in this study and allowed counting of one package of 10 sponges in 226 seconds. For these settings, a significant correlation was found between the actual number of sponges and the estimated fiber lengths. Additionally, the performance of the system was similar for either dry or blood-soaked items. Conclusion. The proposed system could accurately count surgical sponges and is a promising option in preventing the accidental retention of surgical sponges.
Faecal microbiota transplantation in Clostridioides difficile infection: real-life experience from an academic Italian hospital
Authors: Barberio Brigida , Facchin Sonia , Mele Edoardo , D’Incà Renata , Sturniolo Giacomo Carlo , Farinati Fabio , Zingone Fabiana , Quagliariello Andrea , Ghisa Matteo , Massimi Davide , Casadei Cesare , Savarino Edoardo Vincenzo 
Published: July 2020

Background: Faecal microbiota transplantation (FMT) is a reasonable therapeutic option for the treatment of Clostridioides difficile infection (CDI) recurrent and refractory (RCDI) to therapy, but little evidence on the long-term impact of this therapy is currently available in the literature. The aim of this study was to evaluate the efficacy and safety of FMT in recurrent and refractory CDI and the modifications of the recipient’s gut microbiota in the medium–long term. Methods: This prospective study collects the clinical and laboratory data of RCDI patients treated with FMT by colonoscopy from February 2016 to October 2019. Stool samples for metagenomic analysis were collected pre-FMT at 1 week and at 6 and 12–24 months post-FMT. Results: In the study period, 20 FMT procedures were performed on 19 patients. Overall, FMT was effective in 85% of treated patients. No serious adverse event was recorded. In the medium- to long-term follow up, a newly diagnosed case of collagenous colitis was observed. Post-FMT, significant changes in microbiota were observed, characterised by the transition from a low- to a greater-diversity profile. Therefore, FMT restores eubiosis and maintains it over time. Conclusion: FMT is a safe and effective treatment option in RCDI patients. This procedure induces profound microbiota changes that explain its high clinical efficacy.
Challenges in measuring integrated care models: International knowledge and the case of Québec
Authors: Wankah Paul , Guillette Maxime , Lemaitre Thomas , Belzile Louise , Couturier Yves 
Published: July 2020

Introduction The implementation of integrated care models requires significant efforts, especially due to institutional and organisational inertial forces that characterize health and social care systems of developed countries. It is therefore crucial to deploy strategies that promote continuous adjustment to these barriers so as to improve the benefits of integrating care. Measuring the implementation and effects of integrated care models are key component of these strategies. However, measuring integrated care also faces major challenges. This study aims to identify and characterise integrated care measurement challenges. Methods A review of reviews on the measurement of integrated care identified 12 papers. A thematic analysis was conducted to identify and categorize measurement challenges. Document analysis was done on the measurement of an integrated care model for older adults in Québec. Results Eight categories of measurement challenges were identified. These challenges include difficulties in measuring structures, processes, and effects of models; conceptual ambiguity and heterogeneity of organisational forms; involving multiple actors in the measurement strategy; and including multiple data sources, amongst others. These challenges revealed and explained potential gaps in the measurement of integrated care for older adults in Québec. For instance, the Québec measurement strategy did not include effects indicators. Conclusion Although the measurement of integrated care is a complex endeavour, there is a need for adequate measurement strategies that allow to appreciate important elements of integrate care. The findings of this study could be used as a reflexive tool in advancing research and practice of measuring integrated care.
Return to Play in Athletes After Thumb Ulnar Collateral Ligament Repair With Suture Tape Augmentation
Authors: Gibbs Daniel B. , Shin Steven S. 
Published: July 2020

Background: Thumb ulnar collateral ligament (UCL) tears are common in competitive athletes. These tears often occur as a result of a radially directed force on an extended thumb. To date, no literature exists on the use of suture tape augmentation for repair of the thumb UCL in a competitive athlete cohort. Hypothesis: Using suture tape augmentation for the thumb UCL will allow for a safe and expedient return to play in competitive athletes. Study Design: Case series; Level of evidence, 4. Methods: A retrospective chart review was completed to identify all patients who underwent operative primary thumb UCL repair between 2014 and 2018. All procedures were performed at a single institution by the senior author. Inclusion criteria were acute complete tears of the thumb metacarpophalangeal joint UCL, treated with primary repair via suture tape augmentation in competitive high school, collegiate, or professional athletes. Exclusion criteria included recreational athletes, patients who underwent reconstruction (rather than repair), and patients with insufficient follow-up to establish return to play. Charts of patients identified through the retrospective review were further evaluated to determine patient- and injury-related variables. Return to play was defined as return to game competition and stratified as to whether this was at the same level of competition or any level of competition. Results: A total of 18 thumbs in 17 competitive high school, collegiate, and professional athletes were included in this study. One of the professional basketball players sustained injury to both thumbs approximately 10 months apart. The study group comprised 4 collegiate baseball players, 6 professional baseball players, 3 professional basketball players, 1 professional hockey player, 1 amateur-level hockey player, 1 high school basketball player, and 1 high school volleyball player. Mean follow-up was 27.9 months, and no complications were noted. Athletes who sustained an in-season injury (n = 13; 72.2%) returned to play at any level at a mean ± SD of 30.9 ± 10.1 days and at the same level at 36.3 ± 11.2 days. Athletes who sustained an out-of-season injury (n = 5; 27.8%) returned to play at any level at 101.4 ± 86.6 days and at the same level at 114.6 ± 87.0 days. Conclusion: The findings presented here offer evidence for return to play in competitive high school, collegiate, and professional athletes with a thumb UCL tear treated with repair and suture tape augmentation. All athletes returned to the same level of play. Those attempting to return in-season returned to the same level of play at a mean of just under 5 weeks. Augmenting the repair with anchored suture may prevent prolonged immobilization, expedite thumb motion, and improve postoperative recovery.
A comparative analysis of profit inefficiency and productivity convergence between Taiwanese and Chinese banks
Authors: Chen Xiang , Fu Tsu-Tan , Juo Jia-Ching , Yu Ming-Miin 
Published: July 2020

To insure a proper and meaningful productivity assessment of DMUs with different production technologies, this article develops a difference-based profit metafrontier Luenberger productivity indicator. Adopting the proposed model, we empirically measure the profit inefficiency and examine the profit productivity convergence for samples banks consisting of 31 Taiwanese banks and 50 Chinese city banks over 2010–2014. Empirical results show that Chinese banks perform better in profit efficiency than Taiwanese banks. While Chinese banks have better technology in profit creation than Taiwanese banks, the latter may reap much higher profit gain than the former if they can adopt the profit metafrontier. The results of the profit metafrontier Luenberger productivity indicator analysis show that both Chinese and Taiwanese banks have experienced declines in profit productivity. However, the results also indicate a divergence in productivity growth for Chinese city banks and a convergent productivity growth for Taiwanese banks. JEL CLASSIFICATION: D20, G21, P34