bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Many Technical Contributions of the Anatomage Table: Seeing Anatomy Differently
Authors: Kopcak Michael , Wika Kent , Portway Bridget , Lentz Linnea , Brockel Angela , Bollech Edward , Sand Greg 
Published: May 2021

Abstract
The Anatomage Table was originally marketed to medical schools as an anatomical training tool and to hospitals for preoperative planning. When Medtronic employees began to understand the power of the Anatomage Table for product development and data analysis, the uniqueness of how the table was utilized led to its many valuable contributions. The Anatomage Table has significantly reduced product development time with its ability to immediately render anatomical models in a way that allows the development team to evaluate outcomes and react with clear direction. It also reduces cognitive load for the users thereby expediting the interpretive process. The technology has become a tool to enhance research and training outcomes. This paper serves as an example to stimulate the use of this type of technology in similar applications. Hard data originating from controlled studies are not provided in this report due to the technology’s early use at Medtronic and the proprietary nature of the development processes on which the technology was used.
Neonatal Device for Treatment of Hyperbilirubinemia by Phototherapy and Swaddling
Authors: Hsu Annika C. , Yueh Spencer L. 
Published: May 2021

Abstract
This paper details the development of a neonatal device for treatment of hyperbilirubinemia by phototherapy and swaddling. Hyperbilirubinemia is a condition which affects more than half of all neonates. It is commonly treated by phototherapy, but conventional phototherapy does not allow for swaddling which is extremely important to neonates. The functional goals of this device are to provide adequate phototherapy, to swaddle the neonate, and to enable access to the neonate during treatment. With feedback from neonatal intensive care unit physicians and nurses, we assembled a prototype of this device to demonstrate proof-of-concept. The prototype proves the feasibility and potential for the device concept. This paper describes the design criteria, features, comfort and safety details, and next considerations for future work.
A Miniature Laser Speckle Contrast Imager for Monitoring the Neuromodulatory Effect of Transcranial Ultrasound Stimulation
Authors: Zeng Yinuo , Acord Molly , Kaovasia Tarana Parvez , Miao Peng , Sun Junfeng , Tong Shanbao , Curry Eli , Aghabaglou Fariba , Theodore Nicholas , Thakor Nitish , Manbachi Amir 
Published: May 2021

Abstract
Transcranial ultrasound stimulation is a neuromodulation technique that is capable of exciting or suppressing the neural network. The neuromodulatory effect on cerebral hemodynamics has been monitored using optical methods like laser speckle contrast imaging in animal studies. However, the bulky size and stationary nature of the imaging system constrains the application of laser speckle contrast imaging on research that requires the animal to be in irregular body positions or to be awake. Here, we present a design using a miniature laser speckle contrast imager to monitor the cerebral blood flow changes during transcranial ultrasound stimulation in a rat model. We demonstrate its feasibility by showing that the results are comparable to those acquired from a traditional benchtop imaging system.
The Calibration of a Bioelectrical Impedance Spectroscopy Device
Authors: Choi JungHun 
Published: May 2021

Abstract
A Calibration is one of the key processes to design and implement of Bioelectrical Impedance Spectroscopy. Through the simulation, the specification of hardware can be determined and examined in the ideal condition. After the implementation of the device, the theoretical and measured values are different due to the uncertainties and noises from the environment. In this paper, the calibration procedure will be introduced and discussed for the different sets of electrodes. By adjusting the different values of the active electrodes and applying for the active shields, the measured value will be compared and discussed. Active electrodes and active shields will be a very effective way to isolate and minimize the noises and avoid unwanted stray capacitance values. Further investigations need to be followed to ensure the proposed way to reduce the noises and stray capacitances.
Design of an Ultrasound Probe Holder to Minimize Motion Artifact During Sonography
Authors: Mahapatra Smruti , Kaovasia Tarana Parvez , Ainechi Sufia , Ainechi Ana , Acord Molly , Curry Eli J. , Aghabaglou Fariba , Tyler Betty , Theodore Nicholas , Manbachi Amir 
Published: May 2021

Abstract
Standard diagnostic ultrasound imaging procedures heavily rely on a sonographer for image acquisition. Given the ultrasound probe is manually manipulated by the sonographer, there is a potential for noise artifacts like blurry acquired images caused by involuntary hand movements. Certain surgical procedures can also cause patients to exhibit involuntary “jumping” movements while on the operating table leading to further deterioration in ultrasound image quality. In this study, we attempt to mitigate these problems by fabricating a 3D-printed ultrasound probe holder. Due to the lightweight nature of the device, it can attach to surgical retractors without influencing the functionality of the retractor. Therefore, the 3D printed probe holder not only reduces relative motion between the probe and the patient, but also reduce the need for a sonographer during complex surgeries.
Design and Implementation of a Targeted Cardiocerebral Extracorporeal Oxygenation Membrane System
Authors: Tucker Aaron , Retherford Breanne , Rothweiler Paul , Selim Ahmed , Erdman Arthur 
Published: May 2021

Abstract
Outcomes for cardiac arrest (CA) are currently poor, even when CA is experienced in hospital. While the gold standard for treatment is extracorporeal membrane oxygenation (ECMO), cardiopulmonary resuscitation (CPR) is most often used to treat cardiac arrest. We propose a fundamental change in ECMO technology to increase access by reducing the amount of highly trained personnel required to perform this treatment. Additionally, we propose a design in which ECMO functionality is combined with functionality of an intra-aortic balloon pump (IABP) in order to further reduce cardiac workload in cases of cardiac arrest and cardiogenic shock.
Patient-Specific Three-Dimensional Computational Heart Modeling and Printing to Enhance Clinical Understandings and Treatment Planning: Congenital Recurrent Pulmonary Artery Stenosis and Transcatheter Pulmonary Valve Replacement
Authors: Tenhoff Amanda C. , Aggarwal Varun , Ameduri Rebecca , Deakyne Alex , Iles Tinen L. , Said Sameh M. , Griselli Massimo , Iaizzo Paul A. 
Published: May 2021

Abstract
Advances in the surgical and interventional management of children with congenital heart disease has improved survival and outcomes. Each such patient is born with specific anatomical variations which call for detailed evaluations so to plan for appropriate patient-specific management. Significant progress has been made in commercially available two-dimensional imaging – i.e. echocardiogram, CT, and MRI – yet using such, three-dimensional anatomical details can be difficult to accurately represent. In addressing this concern, it has been shown that patient-specific three-dimensional modeling can be useful for interventional procedural or surgical planning [1]. Here we present two cases for which patient-specific anatomical three-dimensional modeling and printing were utilized for (1) the pre-sizing and placement of stents within a complex bifurcation pulmonary artery stenosis; and (2) evaluating the candidacy of the patient’s anatomy for a transcatheter pulmonary valve placement. Detailed within this technical brief are de-identified case information, workflows for model generations, and results regarding clinical usage. In conclusion, we found these patient-specific models to be an advantageous resource for treatment planning in these two pediatric congenital heart disease cases.
A Soft Robotic Simulator for Transseptal Puncture Training
Authors: Thompson Nicholas A. , Kocheril Abraham G. , Hsiao-Wecksler Elizabeth T. , Krishnan Girish 
Published: May 2021

Abstract
Transseptal puncture (TP) is the technique used to access the left atrium of the heart from the right atrium via the interatrial septum in increasingly common catheter-based procedures such as atrial fibrillation ablation. Through repetition, experienced TP operators develop manual skills to manipulate the transseptal catheter assembly inside the right atrium to their target on the fossa ovalis. New operators currently train on actual patients to develop this skill, resulting in increased risk of dangerous complications. To create low-risk training opportunities for new TP operators, we are developing a Soft Active Transseptal Puncture Simulator (SATPS), designed to match the dynamics, kinetostatics, and visualization of the heart during TP. The SATPS includes three main subsystems: (i) An anatomically accurate soft right atrium, fitted with pneumatic artificial muscles, mimics the dynamics of the heart felt by the operator through the catheter assembly. (ii) A replaceable, puncturable fossa ovalis simulates the tissue properties of the real fossa to provide accurate kinetostatic force feedback during tenting and puncture. (iii) A simulated intracardiac echocardiography environment gives the user live visual feedback representative of an ultrasound monitor during an actual TP procedure. The SATPS is an ongoing project, with validation and design improvements forthcoming.
Utilization of Optical Coherence Tomography to Assess Coronary Vessel Constriction after Ablation
Authors: Ramirez David A , Valenzuela Thomas F , Brigham Renee C , Iaizzo Paul A 
Published: May 2021

Abstract
Epicardial ablations are being utilized as alternative techniques to the current endocardial procedures. An epicardial approach offers some advantages, especially when treating ventricular arrhythmias, e.g., those that have epicardial or transmural sites of origin. However the potential collateral damage from these applied myocardial surface ablations has not been fully explored. In order to better visualize and understand such effects on acute coronary functioning, we have employed intracoronary optical coherence tomography (OCT) of ablated cardiac tissues. Ex-vivo swine hearts were reanimated utilizing Visible Heart® Laboratories methodologies, then the midsection of the LAD was anatomically characterized via OCT before and after an applied epicardial ablation: including using irreversible electroporation (IRE), and radiofrequency ablation (RF). Post-ablation OCT scans revealed detectable coronary diameter reductions stemming from applied adjacent epicardial ablations. These initial results demonstrate a need for further explorations to better understand and thus minimize collateral damage during epicardial ablations.
A Comparison of Modern Frameworks for the Development of Interoperable Healthcare Information Systems
Authors: Pimentel Julio C. G. , Pimentel Eric C. , Dao Son 
Published: May 2021

Abstract
Despite the strong consensus behind the need for an interoperable Healthcare Information System (HIS), the universal acceptance of a standard HIS framework has advanced very little and is yet to become a market reality. In an effort to advance this endeavor, this work provides a systematic comparison regarding two of the most relevant HIS frameworks recently proposed: The Integrated Clinical Environment (ICE) and the Healthcare Industry 4.0 Framework. The paper analyzes their differences and similarities and proposes a minimum set of requirements for prospective interoperable HIS architectures compliant with the Industry 4.0 design principles, goal-setting pillars, as well as support for closed-loop physiological systems. Finally, the paper discusses future works in the field.
Leg Joint Mechanics When Hopping at Different Frequencies
Authors: Qiao Mu 
Published: May 2021

Although the dynamics of center of mass can be accounted for by a spring-mass model during hopping, less is known about how each leg joint (ie, hip, knee, and ankle) contributes to center of mass dynamics. This work investigated the function of individual leg joints when hopping unilaterally and vertically at 4 frequencies (ie, 1.6, 2.0, 2.4, and 2.8 Hz). The hypotheses are (1) all leg joints maintain the function as torsional springs and increase their stiffness when hopping faster and (2) leg joints are controlled to maintain the mechanical load in the joints or vertical peak accelerations at different body locations when hopping at different frequencies. Results showed that all leg joints behaved as torsional springs during low-frequency hopping (ie, 1.6 Hz). As hopping frequency increased, leg joints changed their functions differently; that is, the hip and knee shifted to strut, and the ankle remained as spring. When hopping fast, the body’s total mechanical energy decreased, and the ankle increased the amount of energy storage and return from 50% to 62%. Leg joints did not maintain a constant load at the joints or vertical peak accelerations at different body locations when hopping at different frequencies.
Early and middle Miocene ice sheet dynamics in the Ross Sea: Results from integrated core-log-seismic interpretation
Authors: Pérez Lara F. , Santis Laura De , McKay Robert M. , Larter Robert D. , Ash Jeanine , Bart Phil J. , Böhm Gualtiero , Brancatelli Giuseppe , Browne Imogen , Colleoni Florence , Dodd Justin P. , Geletti Riccardo , Harwood David M. , Kuhn Gerhard , Laberg Jan Sverre , Leckie R. Mark , Levy Richard H. , Marschalek James , Mateo Zenon , Naish Timothy R. , Sangiorgi Francesca , Shevenell Amelia E. , Sorlien Christopher C. , van de Flierdt Tina ,   International Ocean Discovery Program Expedition 374 Scientists
Published: May 2021

Abstract
Oscillations in ice sheet extent during early and middle Miocene are intermittently preserved in the sedimentary record from the Antarctic continental shelf, with widespread erosion occurring during major ice sheet advances, and open marine deposition during times of ice sheet retreat. Data from seismic reflection surveys and drill sites from Deep Sea Drilling Project Leg 28 and International Ocean Discovery Program Expedition 374, located across the present-day middle continental shelf of the central Ross Sea (Antarctica), indicate the presence of expanded early to middle Miocene sedimentary sections. These include the Miocene climate optimum (MCO ca. 17–14.6 Ma) and the middle Miocene climate transition (MMCT ca. 14.6–13.9 Ma). Here, we correlate drill core records, wireline logs and reflection seismic data to elucidate the depositional architecture of the continental shelf and reconstruct the evolution and variability of dynamic ice sheets in the Ross Sea during the Miocene. Drill-site data are used to constrain seismic isopach maps that document the evolution of different ice sheets and ice caps which influenced sedimentary processes in the Ross Sea through the early to middle Miocene. In the early Miocene, periods of localized advance of the ice margin are revealed by the formation of thick sediment wedges prograding into the basins. At this time, morainal bank complexes are distinguished along the basin margins suggesting sediment supply derived from marine-terminating glaciers. During the MCO, biosiliceous-bearing sediments are regionally mapped within the depocenters of the major sedimentary basin across the Ross Sea, indicative of widespread open marine deposition with reduced glacimarine influence. At the MMCT, a distinct erosive surface is interpreted as representing large-scale marine-based ice sheet advance over most of the Ross Sea paleo-continental shelf. The regional mapping of the seismic stratigraphic architecture and its correlation to drilling data indicate a regional transition through the Miocene from growth of ice caps and inland ice sheets with marine-terminating margins, to widespread marine-based ice sheets extending across the outer continental shelf in the Ross Sea.
Child mortality associated with maternal HIV status: a retrospective analysis in Rwanda, 2005-2015
Authors: Remera Eric , Chammartin Frédérique , Nsanzimana Sabin , Forrest Jamie Ian , Smith Gerald E , Mugwaneza Placidie , Malamba Samuel S , Semakula Muhammed , Condo Jeanine U , Ford Nathan , Riedel David J , Nisingizwe Marie Paul , Binagwaho Agnes , Mills Edward J , Bucher Heiner 
Published: May 2021

IntroductionChild mortality remains highest in regions of the world most affected by HIV/AIDS. The aim of this study was to assess child mortality rates in relation to maternal HIV status from 2005 to 2015, the period of rapid HIV treatment scale-up in Rwanda.MethodsWe used data from the 2005, 2010 and 2015 Rwanda Demographic Health Surveys to derive under-2 mortality rates by survey year and mother’s HIV status and to build a multivariable logistic regression model to establish the association of independent predictors of under-2 mortality stratified by mother’s HIV status.ResultsIn total, 12 010 live births were reported by mothers in the study period. Our findings show a higher mortality among children born to mothers with HIV compared with HIV negative mothers in 2005 (216.9 vs 100.7 per 1000 live births) and a significant reduction in mortality for both groups in 2015 (72.0 and 42.4 per 1000 live births, respectively). In the pooled reduced multivariable model, the odds of child mortality was higher among children born to mothers with HIV, (adjusted OR, AOR 2.09; 95% CI 1.57 to 2.78). The odds of child mortality were reduced in 2010 (AOR 0.69; 95% CI 0.59 to 0.81) and 2015 (AOR 0.35; 95% CI 0.28 to 0.44) compared with 2005. Other independent predictors of under-2 mortality included living in smaller families of 1–2 members (AOR 5.25; 95% CI 3.59 to 7.68), being twin (AOR 4.93; 95% CI 3.51 to 6.92) and being offspring from mothers not using contraceptives at the time of the survey (AOR 1.6; 95% CI 1.38 to 1.99). Higher education of mothers (completed primary school: (AOR 0.74; 95% CI 0.64 to 0.87) and secondary or higher education: (AOR 0.53; 95% CI 0.38 to 0.74)) was also associated with reduced child mortality.ConclusionsThis study shows an important decline in under-2 child mortality among children born to both mothers with and without HIV in Rwanda over a 10-year span.
Why do people purchase antibiotics over-the-counter? A qualitative study with patients, clinicians and dispensers in central, eastern and western Nepal
Authors: Adhikari Bipin , Pokharel Sunil , Raut Shristi , Adhikari Janak , Thapa Suman , Paudel Kumar , G C Narayan , Neupane Sandesh , Neupane Sanjeev Raj , Yadav Rakesh , Shrestha Sirapa , Rijal Komal Raj , Marahatta Sujan B , Cheah Phaik Yeong , Pell Christopher 
Published: May 2021

IntroductionOver-the-counter (OTC) use of antibiotics contributes to the burgeoning rise in antimicrobial resistance (AMR). Drawing on qualitative research methods, this article explores the characteristics of OTC sales of antibiotic in Nepal, its drivers and implications for policy.MethodsData were collected in and around three tertiary hospitals in eastern, western and central Nepal. Using pre-defined guides, a mix of semi-structured interviews and focus group discussions were conducted with dispensers at drug stores, patients attending a hospital and clinicians. Interviews were audio-recorded, translated and transcribed into English and coded using a combination of an inductive and deductive approach.ResultsDrug shops were the primary location where patients engaged with health services. Interactions were brief and transactional: symptoms were described or explicit requests for specific medicine made, and money was exchanged. There were economic incentives for clients and drug stores: patients were able to save money by bypassing the formal healthcare services. Clinicians described antibiotics as easily available OTC at drug shops. Dispensing included the empirical use of broad-spectrum antibiotics, often combining multiple antibiotics, without laboratory diagnostic and drug susceptibility testing. Inappropriately short regimens (2–3 days) were also offered without follow-up. Respondents viewed OTC antibiotic as a convenient alternative to formal healthcare, the access to which was influenced by distance, time and money. Respondents also described the complexities of navigating various departments in hospitals and little confidence in the quality of formal healthcare. Clinicians and a few dispensers expressed concerns about AMR and referred to evadable policies around antibiotics use and poor enforcement of regulation.ConclusionsThe findings point to the need for clear policy guidance and rigorous implementation of prescription-only antibiotics.
Association between proton pump inhibitor use and gastric cancer: a population-based cohort study using two different types of nationwide databases in Korea
Authors: Seo Seung In , Park Chan Hyuk , You Seng Chan , Kim Jae Young , Lee Kyung Joo , Kim Jinseob , Kim Yerim , Yoo Jong Jin , Seo Won-Woo , Lee Hyung Seok , Shin Woon Geon 
Published: May 2021

ObjectiveThe association between proton pump inhibitor (PPI) use and gastric cancer related toHelicobacter pylorieradication has not been fully investigated in geographical regions with high risk of gastric cancer. We aimed to evaluate the association between PPIs and gastric cancer in Korea.DesignThis study analysed the original and common data model versions of the Korean National Health Insurance Service database from 2002 to 2013. We compared the incidence rates of gastric cancer after 1-year drug exposure, between new users of PPIs and other drugs excluding PPIs, by Cox proportional hazards model. We also analysed the incidence of gastric cancer among PPI users afterH. pylorieradication.ResultsThe analysis included 11 741 patients in matched PPI and non-PPI cohorts after large-scale propensity score matching. During a median follow-up of 4.3 years, PPI use was associated with a 2.37-fold increased incidence of gastric cancer (PPI≥30 days vs non-PPI; 118/51 813 person-years vs 40/49 729 person-years; HR 2.37, 95% CI 1.56 to 3.68, p=0.001). The incidence rates of gastric cancer showed an increasing trend parallel to the duration of PPI use. InH. pylori-eradicated subjects, the incidence of gastric cancer was significantly associated with PPI use over 180 days compared with the non-PPI group (PPI≥180 days vs non-PPI; 30/12 470 person-years vs 9/7814 person-years; HR 2.22, 95% CI 1.05 to 4.67, p=0.036).ConclusionPPI use was associated with gastric cancer, regardless ofH. pylorieradication status. Long-term PPIs should be used with caution in high-risk regions for gastric cancer.