bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of left ventricular assist device implantation on right ventricular function: Assessment based on right ventricular pressure–volume curves
Authors: Kanemaru Eiki , Yoshitani Kenji , Fukushima Satsuki , Fujita Tomoyuki , Ohnishi Yoshihiko 
Published: June 2020

AbstractRight ventricular (RV) failure is significantly associated with morbidity and mortality after left ventricular assist device (LVAD) implantation. However, it remains unclear whether LVAD implantation could worsen RV function. Therefore, we aimed to investigate the effect of LVAD implantation on RV function by comparing RV energetics derived from the RV pressure–volume curve between before and after LVAD implantation. This exploratory observational study was performed between September 2016 and January 2018 at a national center in Japan. Twenty‐two patients who underwent LVAD implantation were included in the analysis. We measured RV energetics parameters: RV stroke work index (RVSWI), which was calculated by integrating the area within the RV pressure–volume curve; RV minute work index (RVMWI), which was calculated as RVSWI × heart rate; and right ventriculo–arterial coupling, which was estimated as RV stroke volume/RV end‐systolic volume. We compared RV energetics between before and after LVAD implantation. Although RVSWI was similar [424.4 mm Hg · mL/m2 (269.5‐510.3) vs. 379.9 mm Hg · mL/m2 (313.1‐608.8), P = 0.485], RVMWI was significantly higher after LVAD implantation [29 834.1 mm Hg · mL/m2/min (18 272.2‐36 357.1) vs. 38 544.8 mm Hg · mL/m2/min (29 016.0‐57 282.8), P = 0.001], corresponding to a significantly higher cardiac index [2.0 L/min/m2 (1.4‐2.2) vs. 3.7 L/min/m2 (3.3‐4.1), P < 0.001] to match LVAD flow. Right ventriculo–arterial coupling was significantly higher after LVAD implantation [0.360 (0.224‐0.506) vs. 0.480 (0.343‐0.669), P = 0.025], suggesting that the efficiency of RV performance improved. In conclusion, higher RVMWI with higher cardiac index to match LVAD flow and improved efficiency of RV performance indicate that LVAD implantation might not worsen RV function.
Retinal oxygen saturation and vessel diameter in patients with chronic kidney disease
Authors: Liu Ruibao , Jian Wenyuan , Zhao Ying , Lu Xuejing , Wu Yanxia , Duan Junguo 
Published: June 2020

AbstractPurposeTo investigate changes in retinal oximetry and the diameter of retinal vasculature in patients with chronic kidney disease (CKD) and relationships between retinal vasculature and the estimated glomerular filtration rate (eGFR), provide a scientific basis for the early detection and diagnosis of CKD.MethodsEighty‐three patients with CKD and 103 healthy individuals were included after providing informed consent. All participants were examined using a noninvasive technology (Oxymap Inc., Reykjavik, Iceland) for measuring the arterial (SaO2) and venous (SvO2) oxygen saturation and the arteriovenous difference in oxygen saturation (Sa‐vO2). The corresponding retinal vessel diameters of these arterioles (D‐A) and venules (D‐V) were measured. The eGFR of patients with CKD was calculated from the serum creatinine concentration.ResultsIn general, patients with CKD had higher mean SaO2 values than healthy individuals (100.15 ± 4.68% versus 97.14 ± 4.22%; p < 0.001, mean ± SD). The mean SaO2 in the superior temporal, superior nasal and inferior nasal quadrants significantly increased. There was no significant difference measured in the SvO2 when patients with CKD (63.66 ± 5.29%) and healthy individuals (62.70 ± 5.27%) were compared. The mean Sa‐vO2 of the CKD group (36.49 ± 4.98%) was increased compared with normal subjects (34.44 ± 4.76%) (p = 0.005). The retinal arteriole diameter was narrower in patients with CKD than in normal individuals (117.53 ± 14.88 μm versus 126.87 ± 14.98 μm; p < 0.001, mean ± SD), and the arteriovenous ratio was smaller than in normal individuals (0.71 ± 0.09 versus 0.77 ± 0.09; p < 0.001, mean ± SD). Pearson’s two‐tailed correlation showed a significant correlation between the SaO2 and eGFR (R = −0.363, p = 0.001), and narrower retinal arterial calibre was significantly associated with a lower eGFR (R = 0.415, p < 0.001).ConclusionBased on our results, there were alterations in retinal oxygen saturation and vascular diameter in patients with CKD. Further studies are needed to determine whether such changes play a role in the development of CKD.
Factors associated with serious vehicular accidents: A cross‐sectional study in hospital emergency rooms
Authors: Forest Karelle , Valdenaire Guillaume , Lorendeau Jean‐Paul , Sagaspe Patricia , Contrand Benjamin , Durand‐Teyssier Charlotte , Sakr Dunia , Gil‐Jardine Cédric , Boutreux Sébastien , Lagarde Emmanuel , Peyrouzet Hélène , Lassalle Régis , Moore Nicholas , Philip Pierre , Girodet Pierre‐Olivier 
Published: June 2020

AimsPictograms on medicine boxes warn of potential drug‐related driving hazard; we studied their association with serious accidents.MethodsProspective study in emergency departments of the hospitals in Bordeaux and Périgueux (France), of drivers with serious (admitted at least 24 hours) or nonserious vehicular accidents. Minors, passengers, pedestrians or subjects incapable of answering an interview were excluded. Interviews ascertained driver and accident characteristics, use of drugs with or without pictograms, use of alcohol and abuse substances, sleepiness, distractions, and mind wandering at the time of the accident,ResultsBetween 18 October 2016 and 26 December 2018, 1200 of the 6212 drivers admitted to the hospital emergency rooms, 741 nonserious, 459 serious, were interviewed. Serious accidents were associated with male sex (odds ratio 1.89, 95% confidence interval [1.36–2.64]), age above 60 years (3.64 [2.21–6.00]), driving on local roads (3.34 [2.34–4.76]), driving a motorcycle (3.39 [2.29–5.00]), having drunk alcohol within 6 hours (2.89 [1.85–4.51]) and using a drug with a pictogram during the 24 hours previous to the accident (1.57 [1.06–2.32]). From 207 police reports, 101 drivers were not responsible, and 106 were responsible, associated with age below 40 years, driving in overcast or rainy weather (2.62 [1.29–5.33]), on local roads (3.89 [1.90–7.95]), and use of at least 1 pictogram drug in the previous week (3.12 [1.31–7.41]).ConclusionThe known risks of alcohol and pictogram drugs, of riding motorcycles and using local roads were confirmed. As measured, behavioural sleepiness did not predict accidents.
The effect of initiation of renin–angiotensin system inhibitors on haemoglobin: A national cohort study
Authors: Greenhall George H.B. , Mansfield Kathryn E. , Nitsch Dorothea , Iwagami Masao , Leyrat Clémence , Johnston Rosalynd , Smeeth Liam , Tomlinson Laurie A. 
Published: June 2020

AimsTo determine whether initiation of treatment with angiotensin converting enzyme inhibitors or angiotensin II receptor blockers (ACEI/ARBs) is associated with a subsequent reduction in haemoglobin in the general population.MethodsWe undertook a national cohort study over a 13‐year period (2004–2016), using routine primary healthcare data from the UK Clinical Practice Research Datalink. We compared ACEI/ARB initiation with calcium channel blocker (CCB) initiation, to minimise confounding by indication. We included all first ACEI/ARB or CCB prescriptions in adults with at least 1 haemoglobin result in the 12 months before and 6 months after drug initiation. Our primary outcome was a ≥1 g/dL haemoglobin reduction in the 6 months after drug initiation.ResultsWe examined 146 610 drug initiation events in 136 655 patients. Haemoglobin fell by ≥1 g/dL after drug initiation in 19.5% (16 936/86 652) of ACEI/ARB initiators and 15.9% (9521/59 958) of CCB initiators. The adjusted odds ratio of a ≥1 g/dL haemoglobin reduction in ACEI/ARB initiators vs CCB initiators was 1.15 (95% confidence interval 1.12–1.19).ConclusionACEI/ARBs are associated with a modest increase in the risk of a haemoglobin reduction. For every 100 patients in our study that initiated a CCB, 16 experienced a ≥1 g/dL haemoglobin decline. If the effect is causal, 3 additional patients would have experienced this outcome if they had received an ACEI/ARB. This may have implications for drug choice and monitoring for many patients in primary care. Further research could identify patients at higher risk of this outcome, who may benefit from closer monitoring.
Fusion imaging during balloon mitral valvulopasty: First experience
Authors: Hudson Olivia , Prejean Shane P. , Von Mering Gregory , Arora Garima , Ahmed Mustafa , Nanda Navin , Andrikopoulou Efstathia 
Published: June 2020

AbstractThe EchoNavigator (EchoNav, Philips, The Netherlands) is a tool that fuses live X‐ray with three‐dimensional (3D) transesophageal echocardiogram (TEE) images allowing for enhanced precision and accuracy during interventional cardiac procedures. We present the first case of EchoNav utilization during balloon mitral valvuloplasty using the newest version (EchoNav 3.0.2). The benefits of the EchoNav application include improved procedural precision and safety due to improved demonstration of the relationship between the interventional equipment and neighboring cardiac structures.
Metaphors for social media‐enhanced foreign language teaching and learning
Authors: Reinhardt Jonathon 
Published: June 2020

AbstractAs L2 (foreign and second language) instructors and materials designers are faced with online and distance learning mandates, new perspectives on how to use familiar, everyday technologies that learners can access from home like social media are welcome. Imagining these new uses, however, may require going beyond the traditional computer‐assisted language learning (CALL) metaphors of computer‐as‐tutor or tool, which were established before social media. This article outlines four new metaphors that better capture the new user dynamics of social media: windows, mirrors, doorways, and playgrounds. After a discussion of the brief history of CALL metaphors, these new metaphors are presented with support from research alongside ideas for L2 teaching and learning.
Inhibition of Fenton reaction is a novel mechanism to explain the therapeutic effect of intra‐articular injection of PRP in patients with chronic haemophilic synovitis
Authors: Caviglia Horacio , Daffunchio Carla , Galatro Gustavo , Cambiaggi Guillermo , Oneto Paula , Douglas Price Ana Laura , Landro María Eulalia , Etulain Julia 
Published: June 2020

AbstractIntroduction and AimHaemarthroses cause major morbidity in haemophilia resulting in chronic haemophilic synovitis (CHS) and arthropathy. Oxidation of haemoglobin‐coupled iron released in synovium after haemolysis induces chondrocytes death and cartilage damage, allowing postulate using iron‐chelating drugs as potential therapeutic tool for haemophilic joint damage. Considering that albumin, the most abundant plasma protein, is a physiologic iron chelator, we aim to demonstrate that impediment of haemoglobin oxidation is exerted by plasma as a mechanism involved in the therapeutic effect of intra‐articular injection of platelet‐rich plasma in CHS.MethodsOxidation of haemoglobin (Hb) to methaemoglobin (MeHb) through Fenton reaction was induced in vitro by addition of potassium ferricyanide in the presence or absence of peripheral blood‐derived platelets‐rich or platelets‐poor plasma (PRP/PPP) or albumin. The relevance of in vitro findings was analysed in synovial fluid (SF) samples from one patient with CHS obtained before and after 6 months of PRP intra‐articular injection.ResultsMeHb formation was completely impaired either by of PPP, PRP or albumin indicating that PRP exerts an anti‐oxidative effect, probably due by plasma albumin. Analysis of SF samples revealed the presence of MeHb levels and haemosiderin‐laden macrophages in SF obtained before PRP treatment. Reduction of synovial MeHb, normalization of cellular composition and improvement of health joint haemophilic score, pain and bleeding episodes were registered after 6 months of PRP intra‐articular injection.ConclusionInhibition of Fenton reaction and the consequent normalization of joint cellular composition is a noncanonical mechanism underlying the therapeutic effect of PRP intra‐articular injection in CHS.
Decolonising Design Education through Playful Learning in a Tertiary Communication Design Programme in South Africa
Authors: Cassim Fatima 
Published: June 2020

AbstractThis article introduces playful learning as part of the decolonising project at institutes of higher learning in South Africa with specific reference to the discipline of communication design. Not only does the article interrogate the content of design education, specifically design for development, but more specifically the way that design for social innovation is taught. The article begins with a contextualisation of the decolonisation debate both locally and internationally, which is followed by a brief historical overview of formal design education. Design education’s trajectory informs the contemporary conception of design as a form of rhetoric. Design and play are then interfaced theoretically, and pragmatically through a case study to explore how deeper learning was made possible by play in a curriculum‐based project. Ultimately, the article aims to highlight the value of playful learning in design higher education to nurture alternate modes of design thinking that favour localised practice, intersubjective relationships between designers and their stakeholders and the enabling of students’ self‐realisation through real world experience.
Clinical and genetic analysis in a Chinese cohort of children and adolescents with diabetes/persistent hyperglycemia
Authors: Ding Yu , Li Niu , Lou Dan , Zhang Qianwen , Chang Guoying , Li Juan , Li Xin , Li Qun , Huang Xiaodong , Wang Jian , Jiang Fan , Wang Xiumin 
Published: June 2020

AbstractAims/IntroductionTo investigate the genetic etiology and evaluate the diagnostic application of next‐generation sequencing for diabetes/persistent hyperglycemia in children and adolescents.Materials and MethodsPatients with diabetes/persistent hyperglycemia, presenting with at least one other clinical manifestation (other than diabetes) or with a family history of diabetes, were recruited. The clinical and laboratory characteristics of the patients were recorded. Next‐generation sequencing was carried out, and candidate variants were verified by Sanger sequencing. Variant pathogenicity was further evaluated according to the American College of Medical Genetics and Genomics guidelines.ResultsThis study included 101 potential probands, 36 of whom were identified as positive by genetic testing. A further 51.2 and 20.9% of variants were determined to be pathogenic or likely pathogenic, respectively. Variants associated with the disease were primarily identified in 21 genes and three regions of copy number variants. Among the 39 variants in 21 genes, 61.5% (24/39) were novel. The genetic diagnosis of 23 patients was confirmed based on genetic evidence and associated clinical manifestations. We reported GCK variants (21.7%, 5/23) as the most common etiology in our cohort. Different clinical manifestations were observed in one family with WFS1 variants.ConclusionsOur findings support the use of next‐generation sequencing as a standard method in patients with diabetes/persistent hyperglycemia and provide insights into the etiologies of these conditions.
Engaging cultural humility diffractively
Authors: Crath Rory , Rangel J. Cristian 
Published: June 2020

AbstractBackgroundConventional models of cultural humility ‐ even those extending analysis beyond the dyad of healthcare provider‐patient to include concentric social influences such as families, communities and institutions that make clinical relationships possible ‐ aren't conceptually or methodologically calibrated to accommodate shifts occurring in contemporary biomedical cultures. More complex methodological frameworks are required that are attuned to how advances in biomedical, communications and information technologies are increasingly transforming the very cultural and material conditions of health care and its delivery structures, and thus how power manifests in clinical encounters.MethodsIn this paper, we offer a two‐pronged intervention in the cultural humility literature. At a first level of analysis, we suggest the need to broaden understandings of culture and associated workings of power to accommodate the effects of biomedicine's technologising turn. A second level of intervention invites experimentation to broaden the availability of methodological tools to analyse and assess the multidimensionality of technologies and their agentic effects in healthcare encounters.ResultsDrawing from new materialism theories, practices of care are approached “diffractively” as contingent and dynamic material‐discursive events. Our neo‐materialist framework for cultural humility expands analytical sight‐lines beyond hierarchical relationships and dichotomies privileging humans (practitioner and/or patient) as sole actants in the clinical exchange. Attended to are the ongoing dynamics of practices entangling big‐data driven knowledges and interventions, pharmacological technologies and material instruments and devices, diseases, and the bodies/subjectivities of health care providers and patients. We investigate the implications for clinical assessment if a cultural humility framework is methodologically attuned to the clinical encounter as a discontinuous, discursive‐material process producing multiple, contextually emergent data moments and objects for analysis.ConclusionEngaging evaluative inquiry diffractively allows for a different ethical practice of care, one that attends to the forms of patient and health provider accountability and responsibility emerging in the clinical encounter.
Full‐field strain of regenerated bone tissue in a femoral fracture model
Authors: KARALI A. , KAO A. P. , MEESON R. , ROLDO M. , BLUNN G. W. , TOZZI G. 
Published: June 2020

SummaryThe mechanical behaviour of regenerated bone tissue during fracture healing is key in determining its ability to withstand physiological loads. However, the strain distribution in the newly formed tissue and how this influences the way a fracture heals it is still unclear. X‐ray Computed Tomography (XCT) has been extensively used to assess the progress of mineralised tissues in regeneration and when combined with in situ mechanics and digital volume correlation (DVC) has been proven a powerful tool to understand the mechanical behaviour and full‐field three‐dimensional (3D) strain distribution in bone. The purpose of this study is therefore to use in situ XCT mechanics and DVC to investigate the strain distribution and load‐bearing capacity in a regenerating fracture in the diaphyseal bone, using a rodent femoral fracture model stabilised by external fixation. Rat femurs with 1 mm and 2 mm osteotomy gaps were tested under in situ XCT step‐wise compression in the apparent elastic region. High strain was present in the newly formed bone (εp1 and εp3 reaching 29 000 µε and –43 000 µε, respectively), with a wide variation and inhomogeneity of the 3D strain distribution in the regenerating tissues of the fracture gap, which is directly related to the presence of unmineralised tissue observed in histological images. The outcomes of this study will contribute in understanding natural regenerative ability of bone and its mechanical behaviour under loading.
Utilization of neurolysis in management of refractory head and neck cancer‐related pain in palliative patients: A retrospective review
Authors: Khawaja Shehryar Nasir , Scrivani Steven John 
Published: June 2020

AbstractBackgroundPain is a common symptom of head and neck cancers. In some instances, pain may not resolve with conventional modalities and become refractory. Chemical neurolysis is a technique that utilizes chemical neurolytic agents to temporarily denervate a targeted nerve and provide relief in pain‐related symptoms. The aim of this investigation was to determine the effectiveness, safety, and predictors of chemical neurolysis procedures for management of refractory head and neck cancer‐related pain.MethodsA retrospective chart review of patients who underwent chemical neurolysis procedure in the regions of head and neck for management of head and neck cancer‐related pain was conducted between November 2017 and November 2018. All adult male and female patients who had undergone chemical neurolysis procedure in the head and neck region for management of refractory head and neck related pain, in Orofacial Pain Clinic, Shaukat Khanum Memorial Cancer Hospital and Research Center were included in the investigation.ResultsAmong 33 participants enrolled, 72.7% of participants experienced 75% or greater relief in pain at the 1‐month follow‐up. However, 9.1% reported experiencing an adverse effect following neurolysis. A statistically significant association was found between neurolysis effectiveness and chronicity of pain.ConclusionsChemical neurolysis can provide significant relief to patients with refractory head and neck cancer‐related pain as an adjunctive therapy. However, it was found to be associated with mild risk of manageable adverse effects. Shorter chronicity of pain was found to be associated with successful outcome.
Group pain education is as effective as individual education in patients with chronic temporomandibular disorders
Authors: Gokhale Amrita , Yap Tami , Heaphy Nicole , McCullough Michael John 
Published: June 2020

AbstractBackgroundTemporomandibular disorders (TMD) are recognised as the most common chronic orofacial pain condition, with prevalence figures ranging from 3% to 12%. Patients referred to tertiary orofacial pain clinics for the management of TMD often experience delays in receiving treatment. The objective of the present study was to assess a group treatment programme to deliver effective earlier intervention for patients with chronic TMD.MethodsForty‐two patients with TMD seen at the Oral Medicine Clinic, Royal Dental Hospital of Melbourne, were administered baseline validated pain questionnaires: the Graded Chronic Pain Scale and Pain Catastrophising Scale. Twenty patients subsequently received education about basic neurophysiology of pain, TMD and relaxation techniques in either a group setting or in a one‐on‐one session and were followed longitudinally. Administration of pain questionnaires was repeated at 4‐6 weeks post‐intervention.ResultsNo evidence of difference in levels of anxiety, somatic symptoms or catastrophising was found between patients who received either group or individual intervention. Both were effective at reducing pain intensity and levels of disability. Individual intervention resulted in a greater reduction in rumination.ConclusionPatients with TMD can receive effective reduction of TMD‐related pain and catastrophising from either group or individual education regarding neurophysiology of pain, TMD and relaxation techniques. Group education should accelerate time to commencement of care in large referral‐based settings.