bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical significance of isolated gastric varices in liver cirrhotic patients: A single‐referral‐centre retrospective cohort study
Authors: Lesmana Cosmas Rinaldi A , Kalista Kemal F , Sandra Sharon , Hasan Irsan , Sulaiman Andri Sanityoso , Kurniawan Juferdy , Jasirwan Chyntia O M , Nababan Saut H , Lirendra Mutiara , Aprilicia Gita , Gani Rino A 
Published: December 2019

IntroductionGastric varices (GVs) occur in 10–30% of liver cirrhotic patients, with a mortality rate of up to 45%. Rupture of isolated GVs (IGVs) is less prevalent but often results in more severe hemorrhage and a higher risk of mortality than rupture of esophageal varices (EVs). However, there is no clear consensus yet about the optimal management for incidentally discovered IGVs.ObjectiveTo determine the clinical significance of IGVs in liver cirrhotic patients.MethodsThis was a retrospective cohort endoscopy database study within a 2‐year period (2016–2017). All study subjects were liver cirrhotic patients with OVs or GVs. The exclusion criteria were noncirrhotic portal hypertension, presence of malignancy, absence of varices, and incomplete data. Statistical analysis was performed using IBM SPSS 23.ResultsA total of 153 patients were included in this study. IGVs were found in 13 (8.49%) patients, whereas OVs were found in 112 (73.20%) patients and gastro‐OVs were found in 28 (18.30%) patients. Child‐Pugh class C (CP C) score was the strongest independent risk factor for variceal bleeding in bivariate analysis (hazard ratio [HR]: 10.21, 95% confidence interval [CI]: 4.15–25.12, P = 0.001) and multivariate analysis (HR: 12.49, 95% CI: 4.95–31.54, P 0.001); however, the presence of IGVs was not an independent risk factor. CP C score was also the only significant risk factor associated with 1‐year mortality in liver cirrhotic patients on multivariate analysis (HR: 26.77, 95% CI: 6.01–119.34, P 0.001).ConclusionThe presence of IGVs has no clinical significance in the occurrence of 1‐year rebleeding and in patient survival.
Choosing between medical management and liver transplant in urea cycle disorders: A conceptual framework for parental treatment decision‐making in rare disease
Authors: Gerstein Maya T. , Markus Anne R. , Gianattasio Kan Z. , Le Mons Cynthia , Bartos Janice , Stevens David M. , Mew Nicholas Ah 
Published: December 2019

AbstractUrea cycle disorders (UCD) are rare inherited metabolic disorders caused by deficiencies of enzymes and transporters required to convert neurotoxic ammonia into urea. These deficiencies cause elevated blood ammonia, which if untreated may result in death, but even with optimal medical management, often results in recurrent brain damage. There are two major treatments for UCD: medical management or liver transplantation. Both are associated with mortality and morbidity but the evidence comparing outcomes is sparse. Thus, families face a dilemma: should their child be managed medically, or should they undergo a liver transplant? To (a) describe the factors that contribute to treatment choice among parents of children diagnosed with UCD and to (b) organise these factors into a conceptual framework that reflects how these issues interrelate to shape the decision‐making experience of this population. Utilising grounded theory, qualitative data were collected through semi‐structured interviews with parents (N = 35) and providers (N = 26) of children diagnosed with UCD and parent focus groups (N = 19). Thematic content analysis and selective and axial coding were applied. The framework highlights the life‐cycle catalysts that frame families' personal perceptions of risks and benefits and describes the clinical, personal, social, and system factors that drive treatment choice including disease severity, stability, and burden, independence, peer experiences, and cost, coverage and access to quality care. Findings equip providers with evidence upon which to prepare for productive patient interactions about treatment options. They also provide a foundation for the development of patient‐centred outcome measures to better evaluate effectiveness of treatments in this population.
Convergently evolved muscle architecture enables high‐performance ballistic movement in salamanders
Authors: Scales Jeffrey , Bloom Segall V. , Deban Stephen M. 
Published: December 2019

AbstractElastically powered ballistic movements, such as tongue projection, are common in nature, likely due to benefits such as increased acceleration and distance of movement, and decreased thermal sensitivity imparted by elastic mechanisms. Within Plethodontidae, both muscle‐powered and elastically powered ballistic tongue projection occur. Thus, we examine how elastically powered ballistic tongue projection morphology has evolved from muscle powered projection at the level of the projector muscles (m. subarcualis rectus [SAR]). We find that two main SAR morphologies have evolved within Plethodontidae. The first SAR morphology is conducive to elastically powered ballistic projection. This ballistic SAR morphology has evolved multiple, independent times within Plethodontidae, and results from the correlated evolution of several traits including increased collagen aponeuroses, larger SAR muscles, and the loss of inner myofibers attaching directly to the tongue skeleton. While the independent evolution of ballistic SAR morphology has arrived at a similar anatomical design, other tongue structures such as tongue attachment and skeleton folding type varies among species with a ballistic SAR morphology. The second morphology is conducive to muscle‐powered projection and is similar to morphology found in an outgroup, Salamandridae. The SAR of these species have inner myofibers that attach to the tongue skeleton, limiting projection distance, coupled with reduced collagen aponeuroses present in relatively small projector muscles. This SAR morphology has likely been retained from ancestors or may be related to feeding ecology. Overall, a ballistic SAR morphology has evolved repeatedly and independently due to the correlated evolution of several SAR traits, including the loss of inner myofibers, which is likely a defining feature of ballistic projection.
A European multicentre evaluation of detection and typing methods for human enteroviruses and parechoviruses using RNA transcripts
Authors: Hayes A. , Nguyen D. , Andersson M. , Antón A. , Bailly J.‐L. , Beard S. , Benschop K. S. M. , Berginc N. , Blomqvist S. , Cunningham E. , Davis D. , Dembinski J. L. , Diedrich S. , Dudman S. G. , Dyrdak R. , Eltringham G. J. A. , Gonzales‐Goggia S. , Gunson R. , Howson‐Wells H. C. , Jääskeläinen A. J. , López‐Labrador F. X. , Maier M. , Majumdar M. , Midgley S. , Mirand A. , Morley U. , Nordbø S. A. , Oikarinen S. , Osman H. , Papa A. , Pellegrinelli L. , Piralla A. , Rabella N. , Richter J. , Smith M. , Söderlund Strand A. , Templeton K. , Vipond B. , Vuorinen T. , Williams C. , Wollants E. , Zakikhany K. , Fischer T. K. , Harvala H. , Simmonds P. 
Published: December 2019

AbstractPolymerase chain reaction (PCR) detection has become the gold standard for diagnosis and typing of enterovirus (EV) and human parechovirus (HPeV) infections. Its effectiveness depends critically on using the appropriate sample types and high assay sensitivity as viral loads in cerebrospinal fluid samples from meningitis and sepsis clinical presentation can be extremely low. This study evaluated the sensitivity and specificity of currently used commercial and in‐house diagnostic and typing assays. Accurately quantified RNA transcript controls were distributed to 27 diagnostic and 12 reference laboratories in 17 European countries for blinded testing. Transcripts represented the four human EV species (EV‐A71, echovirus 30, coxsackie A virus 21, and EV‐D68), HPeV3, and specificity controls. Reported results from 48 in‐house and 15 commercial assays showed 98% detection frequencies of high copy (1000 RNA copies/5 µL) transcripts. In‐house assays showed significantly greater detection frequencies of the low copy (10 copies/5 µL) EV and HPeV transcripts (81% and 86%, respectively) compared with commercial assays (56%, 50%; P = 7 × 10−5). EV‐specific PCRs showed low cross‐reactivity with human rhinovirus C (3 of 42 tests) and infrequent positivity in the negative control (2 of 63 tests). Most or all high copy EV and HPeV controls were successfully typed (88%, 100%) by reference laboratories, but showed reduced effectiveness for low copy controls (41%, 67%). Stabilized RNA transcripts provide an effective, logistically simple and inexpensive reagent for evaluation of diagnostic assay performance. The study provides reassurance of the performance of the many in‐house assay formats used across Europe. However, it identified often substantially reduced sensitivities of commercial assays often used as point‐of‐care tests.
New opposition cuttlefish optimizer based two‐step approach for optimal design of fractional order proportional integral derivative controller for time delay systems
Authors: Sumathi Ramakrishnan , Umasankar Periyasamy 
Published: December 2019

AbstractIn this article, an optimal design of the fractional order proportional integral derivative (FOPID) controller for time delay system is proposed. The proposed optimal design is the combined performance of both the cuttlefish optimizer (CFO) and Opposition‐based learning (OBL) scheme called CFOBL scheme. The proposed CFOBL uses the concept of opposition based population initialization and opposition based position updating to improve its searching behavior, computational speed and convergence profile in the basic CFO. In FOPID controller, apart from the three tuning parameters (GP, GI, and GD) there are two additional tuning parameters that are λ and μ. Here, CFOBL is used to tune the three controller parameters and also to find the optimal values of λ and μ. The uniqueness of the proposed technique is to reduce the FOPID controller's fault in the higher order time delay scheme by the aid of the controller's increase limits. The objective of the proposed technique is chosen by considering the set point parameters and the accomplished parameters from the time delay system. The proposed technique is used to avoid high‐order delays and reliability constraints such as small overruns, time resolution and fixed condition defects. This technique is performed on the MATLAB/Simulink platform and the results are compared with different existing techniques such as Ziegler‐Nichols (ZN) tuning method, curve fitting (CF) technique, Wang technique, and regression technique.
Supercritical fluid extraction followed by supramolecular solvent microextraction as a fast and efficient preconcentration method for determination of polycyclic aromatic hydrocarbons in apple peels
Authors: Falsafi Zohreh , Raofie Farhad , Ariya Parisa A. 
Published: December 2019

AbstractIn this work, reverse micelle‐based supramolecular solvent microextraction method coupled with supercritical fluid extraction and used for determining trace amounts of polycyclic aromatic hydrocarbons in apple peels. The extract was analyzed by high‐performance liquid chromatography equipped with a fluorescence detector. Coupling supramolecular solvent microextraction with supercritical fluid extraction method, resolve low preconcentration factor of supercritical fluid extraction method, improved limit of detection of polycyclic aromatic hydrocarbons and allow the use of supramolecular solvent microextraction in solid matrices. The effective parameters on the supramolecular solvent microextraction and supercritical fluid extraction efficiency were optimized using one variable at a time and face centered design methods, respectively. Under the optimum condition, the limits of detection and limits of quantifications were in the range of 0.34–1.27 and 1.03–3.82 µg/kg, respectively. Analysis of polycyclic aromatic hydrocarbons in apple peels showed that the supercritical fluid extraction/ supramolecular solvent microextraction method provide great potential for trace analysis of polycyclic aromatic hydrocarbons in fruit samples (RSDs < 7.7%).
Practices and perceptions of cognitive assessment for adults with age‐related hearing loss
Authors: Raymond Mallory J. , Lee Annika C. , Schader Lindsey M. , Moore Renee H. , Raol Nikhila R. , Vivas Esther X. 
Published: December 2019

AbstractObjectivesTo investigate the landscape of cognitive impairment (CI) screening for adults with age‐related hearing loss (ARHL) among otolaryngologists and audiologists. To identify provider factors and patient characteristics that impact rates of CI screening and referral.MethodsA 15 question online survey was sent to members of the Georgia Society of Otolaryngology (GSO), Georgia Academy of Audiology (GAA), American Otological Society and American Neurotology Society (AOS/ANS), and posted on the web forum for two hearing disorders special interest groups within the American‐Speech‐Language‐Hearing Association (ASHA). Responses were collected anonymously. Chi‐square tests were used to compare responses.ResultsOf the 66 included respondents, 61% (n = 40) were otolaryngologists and 35% (n = 23) were audiologists. Respondents were significantly more likely to refer patients for CI assessment than to screen (64% vs 21%, respectively, P < .001). The complaint of a neurological symptom, such as memory loss, would prompt screening or referral for only 27.3% (n = 18) and 51.52% (n = 34) of respondents, respectively. Forty‐two percent (n = 28) of respondents suggested CI screening with the MMSE vs 20% (n = 13) with the Montreal Cognitive Assessment.ConclusionsDespite recommendations for cognitive assessment in high‐risk populations, such as older adults with ARHL, the practice of CI screening and referral is not yet commonplace among otolaryngologists and audiologists. These providers have a unique opportunity to assess adults with ARHL for CI and ensure appropriate referral.Level of Evidence5
Advances in the repair of segmental nerve injuries and trends in reconstruction
Authors: Pan Deng , Mackinnon Susan E. , Wood Matthew D. 
Published: December 2019

AbstractDespite advances in surgery, the reconstruction of segmental nerve injuries continues to pose challenges. In this review, current neurobiology regarding regeneration across a nerve defect is discussed in detail. Recent findings include the complex roles of nonneuronal cells in nerve defect regeneration, such as the role of the innate immune system in angiogenesis and how Schwann cells migrate within the defect. Clinically, the repair of nerve defects is still best served by using nerve autografts with the exception of small, noncritical sensory nerve defects, which can be repaired using autograft alternatives, such as processed or acellular nerve allografts. Given current clinical limits for when alternatives can be used, advanced solutions to repair nerve defects demonstrated in animals are highlighted. These highlights include alternatives designed with novel topology and materials, delivery of drugs specifically known to accelerate axon growth, and greater attention to the role of the immune system.
Simulation of stochastic flow considering mesoscale permeability variability during the resin transfer molding process
Authors: He Longfei , Yan Shilin , Li Yongjing , Wen Pin , Xie Xiangyu , Liu Wenchao 
Published: December 2019

AbstractThis article presents a method to obtain the random permeability field of the single‐layer woven fabric. Specifically, a unit cell model based on actual geometric characteristics of a single‐layer fiber reinforcement is established in the open‐source software TexGen. The local permeability value is retrieved from flow analysis in the software ANSYS/CFX based on TexGen voxel models. Probability distribution of reinforcement permeability is determined from the image analysis. Then, continuous random fields describing the local permeability in the fiber reinforcement are generated based on the Karhunen‐Loève (K‐L) expansion method, and suitable dimension‐reducing techniques are employed to represent all the random fields in the physical system. Furthermore, influences of the selected correlation lengths on the random field are explored. Finally, it is demonstrated in the flow numerical simulation that the stochastic flow model indeed more qualitatively and quantitatively agrees with the radial injection experiment than the traditional basic model.
Fetal MRI assessment of mediastinal shift angle in isolated left congenital diaphragmatic hernia: A new postnatal survival predictive tool?
Authors: Savelli Sara , Bascetta Stefano , Carducci Chiara , Carnevale Enza , Caforio Leonardo , Romiti Anita , Tomà Paolo 
Published: December 2019

AbstractObjectiveTo quantify the mediastinal shift angle (MSA) in fetuses with isolated left congenital diaphragmatic hernia (CDH) by magnetic resonance imaging and evaluate survival.MethodFetuses from singleton pregnancies with isolated left CDH were matched for gestational age with controls without thoracic malformations. For all fetuses the MSA was determined by two operators and inter‐operator variability and differences between cases and controls were investigated. For all cases total fetal lung volume (TFLV) was calculated and the correlation between MSA and TFLV was assessed, and its predictive value towards survival was determined.ResultsThirty‐four fetuses were included as cases and 42 as controls. The mean gestational age for assessment of CDH fetuses was 32 weeks (range 27‐38). Twenty‐four fetuses survived until discharge and 10 did not. There was an excellent inter‐operator reliability for measuring the MSA and a significant difference between MSA in cases and controls. There was an inverse correlation between MSA values and survival, a correlation between TFLV and survival and an inverse correlation between MSA and TFLV. The area under the ROC curve for MSA in predicting survival was 0.931 (95% CI 0.851‐1.000).ConclusionThe MSA measured late in gestation correlates with postnatal survival in patients with isolated left CDH.
Association Between Hemoglobin A1c and Major Adverse Coronary Events in Patients with Diabetes Following Coronary Artery Bypass Surgery
Authors: Turgeon Ricky D. , Koshman Sheri L. , Youngson Erik , Pearson Glen J. 
Published: December 2019

IntroductionDiabetes is associated with a higher risk of major adverse coronary events (MACE) following coronary artery bypass grafting (CABG). Guidelines recommend disparate targets for glycemic control of patients with diabetes who have undergone CABG, ranging from a target hemoglobin A1c (HbA1c) of < 7.0% to 7.1–8.5%, based on data from non‐CABG patients. To date, no study has evaluated the long‐term impact of HbA1c concentrations on MACE post‐CABG.ObjectiveTo evaluate the association between HbA1c and MACE in CABG patients with diabetes.MethodsA secondary analysis of the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI2D) trial, which enrolled patients with type 2 diabetes and coronary artery disease, restricted to participants who underwent CABG with ≥ 1 HbA1c measurement post‐CABG, was performed. The index date was date of first post‐CABG HbA1c measurement. The primary outcome was MACE (composite of death, myocardial infarction, unstable angina, or repeat revascularization). Secondary outcomes included MACE components and heart failure. Cox proportional hazards models treating HbA1c as a time‐dependent exposure (reference group: HbA1c 6.1–7.0%) were used to derive hazard ratios (HRs) with 95% confidence intervals adjusting for age, sex and baseline characteristics selected by stepwise regression.ResultsA total of 549 patients were followed over a median 3.5 years. The median age of the cohort was 64 years, 25.1% were female, and median baseline HbA1c was 6.7%. Compared to achieving an HbA1c 6.1‐7.0%, HbA1c > 8.0% was associated with an increased risk of MACE (HR 1.77, 1.01–3.10). This association was strongest for unstable angina (HR 5.21, 1.03–26.39). Achieving an HbA1c ≤ 6.0% was associated with an increased risk of death (HR 2.41, 1.01–5.74). Other comparisons were not statistically significant.ConclusionAmong patients with type 2 diabetes who underwent CABG, achieving HbA1c 6.1–7.0% was associated with a lower risk of MACE and unstable angina versus achieving an HbA1c > 8.0% and lower risk of death versus achieving an HbA1c ≤ 6.0%.
The effects of pulmonary rehabilitation on endothelial function and arterial stiffness in patients with chronic obstructive pulmonary disease
Authors: Pereira de Araujo Cintia Laura , Pereira Reinaldo Gustavo , Foscarini Betina Gabriele , Ferreira Schneider Bárbara , Moraes Menezes Vlademir Junior , Dal Lago Pedro 
Published: December 2019

AbstractObjectivesCardiovascular disease is a major cause of mortality in chronic obstructive pulmonary disease (COPD) and endothelial dysfunction may enhance the mortality risk. Exercise training has shown to be beneficial for improvement of endothelial function in patients with cardiovascular disease, but this remains unclear in COPD. Thus, this study aimed to assess the effect of exercise‐based pulmonary rehabilitation (PR) on endothelium function, arterial stiffness and plasma nitrite levels in patients with COPD.MethodsPatients with COPD engaged a 48‐session PR program. Reactive hyperaemia index (RHI), augmentation index (AIx), and heart rate (HR) assed by peripheral arterial tonometry (PAT), plasma nitrite levels, systemic blood pressure, functional capacity (six‐minute walk test) and the BODE index were assessed at baseline and after 24 and 48 sessions of PR. Plasma nitrite levels were also assessed before and after the first session of PR.ResultsTwenty‐one subjects were included and completed 24 PR sessions, and 16 subjects completed 48 sessions. It was observed that a poorer AIx adjusted for HR in frequent COPD exacerbators (4.67 ± 16.5 vs. 20.9 ± 12.9; p = .02). PR improved functional capacity (380 ± 107 m vs. 442 ± 115 m; p < .001) and the BODE index (6 [2.8] vs. 4 [3]; p = .001), but did not change HR, systemic arterial pressure, RHI, AIx, and plasma nitrite levels during the follow‐up. Plasma nitrite levels reduced after the first session of PR (0.074 [0.079] μM vs. 0.061 [0.04] μM; p = .027). The acute change in plasma nitrite levels correlated with RHI in patients with preserved endothelial function (r = 0.71; p = .01).ConclusionsAlthough exercise‐based PR improved functional capacity and the BODE index, it did not change endothelial function and arterial stiffness in patients with COPD.
The linearity of the El Niño teleconnection to the Amundsen Sea region
Authors: Yiu Yu Yeung Scott , Maycock Amanda C. 
Published: December 2019

AbstractEl Niño Southern Oscillation (ENSO) drives interannual variability in West Antarctic climate through altering atmospheric circulation in the Amundsen Sea region (ASR). The El Niño–ASR teleconnection is known to be strongest in austral winter and spring, but its variation with El Niño amplitude is underexplored. This study uses experiments from the HadGEM3‐A climate model to investigate the El Niño–ASR teleconnection for a range of imposed SST perturbations spanning weak (0.75 K) to strong (3 K) amplitudes. In austral winter, the El Niño–ASR teleconnection behaves linearly for El Niño amplitudes up to 2.25 K, but is found to weaken for stronger forcing (3 K). The anomalous Rossby wave source in the subtropical South Pacific increases monotonically with El Niño amplitude. However, a Rossby wave reflection surface originally located in the western South Pacific sector extends progressively eastward with increasing El Niño amplitude, reducing wave propagation into the ASR. The wave reflection surface is associated with curvature in the upper tropospheric zonal winds which intensifies as the subtropical jet strengthens under El Niño forcing. In contrast, the El Niño–ASR teleconnection in austral summer, which more closely resembles the Southern Annular Mode, is found to increase linearly for El Niño amplitudes up to 3 K. The results explicitly demonstrate that a linear approximation of the El Niño teleconnection to the ASR is reasonable based on the range of El Niño amplitudes observed in recent history.