bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic Performance of Narrow Band Imaging for Nasopharyngeal Cancer: A Systematic Review and Meta‐analysis
Authors: Sun Changling , Zhang Yayun , Han Xue , Du Xiaodong 
Published: April 2018

ObjectiveThe purposes of this study were to verify the effectiveness of the narrow band imaging (NBI) system in diagnosing nasopharyngeal cancer (NPC) as compared with white light endoscopy.Data SourcesPubMed, Cochrane Library, EMBASE, CNKI, and Wan Fang databases.Review MethodsData analyses were performed with Meta‐Disc. The updated Quality Assessment of Diagnostic Accuracy Studies–2 tool was used to assess study quality and potential bias. Publication bias was assessed with a Deeks asymmetry test. The registry number of the protocol published on PROSPERO is CRD42015026244.ResultsThis meta‐analysis included 10 studies of 1337 lesions. For NBI diagnosis of NPC, the pooled values were as follows: sensitivity, 0.83 (95% CI, 0.80‐0.86); specificity, 0.91 (95% CI, 0.89‐0.93); positive likelihood ratio, 8.82 (95% CI, 5.12‐15.21); negative likelihood ratio, 0.18 (95% CI, 0.12‐0.27); and diagnostic odds ratio, 65.73 (95% CI, 36.74‐117.60). The area under the curve was 0.9549. For white light endoscopy in diagnosing NPC, the pooled values were as follows: sensitivity, 0.79 (95% CI, 0.75‐0.83); specificity, 0.87 (95% CI, 0.84‐0.90); positive likelihood ratio, 5.02 (95% CI, 1.99‐12.65); negative likelihood ratio, 0.34 (95% CI, 0.24‐0.49); and diagnostic odds ratio, 16.89 (95% CI, 5.98‐47.66). The area under the curve was 0.8627. The evaluation of heterogeneity, calculated per the diagnostic odds ratio, gave an I2 of 0.326. No marked publication bias (P =. 68) existed in this meta‐analysis.ConclusionThe sensitivity and specificity of NBI for the diagnosis of NPC are similar to those of white light endoscopy, and the potential value of NBI for the diagnosis of NPC needs to be validated further.
Anterior Cruciate Ligament Reconstruction Affects Tibiofemoral Joint Congruency During Dynamic Functional Movement
Authors: Nagai Kanto , Gale Tom , Irrgang James J. , Tashman Scott , Fu Freddie H. , Anderst William 
Published: April 2018

Background: Anterior cruciate ligament reconstruction (ACLR) has been shown to alter kinematics, which may influence dynamic tibiofemoral joint congruency (a measure of how well the bone surfaces fit together). This may lead to abnormal loading of cartilage and joint degeneration. However, joint congruency after ACLR has never been investigated. Hypotheses: The ACLR knee will be more congruent than the contralateral uninjured knee, and dynamic congruency will increase over time after ACLR. Side-to-side differences (SSD) in dynamic congruency will be related to cartilage contact location/area and subchondral bone curvatures. Study Design: Descriptive laboratory study. Methods: The authors examined 43 patients who underwent unilateral ACLR. At 6 months and 24 months after ACLR, patients performed downhill running on a treadmill while synchronized biplane radiographs were acquired at 150 images per second. Dynamic tibiofemoral kinematic values were determined by use of a validated volumetric model-based tracking process that matched patient-specific bone models, obtained from computed tomography, to biplane radiographs. Patient-specific cartilage models, obtained from magnetic resonance imaging, were registered to tracked bone models and used to calculate dynamic cartilage contact regions. Principle curvatures of the subchondral bone surfaces under each cartilage contact area were calculated to determine joint congruency. Repeated-measures analysis of variance was used to test the differences. Multiple linear regression was used to identify associations between SSD in congruency index, cartilage contact area, contact location, and global curvatures of femoral or tibial subchondral bone. Results: Lateral compartment congruency in the ACLR knee was greater than in the contralateral knee ( P < .001 at 6 months and P = .010 at 24 months). From 6 to 24 months after surgery, dynamic congruency decreased in the medial compartment ( P = .002) and increased in the lateral compartment ( P = .007) in the ACLR knee. In the lateral compartment, SSD in joint congruency was related to contact location and femur global curvature, and in the medial compartment, SSD in joint congruency was related to contact area. Conclusion: ACLR appears to affect dynamic joint congruency. SSD in joint congruency was associated with changes in contact location, contact area, and femoral bony curvature. Clinical Relevance: Alterations in tibiofemoral contact location, contact area, and bone shape affect dynamic joint congruency, potentially contributing to long-term degeneration after ACLR.
HPLC Study of Uremic Fluids Related to Optical Dialysis Adequacy Monitoring
Authors: Lauri Kai , Tanner Risto , Jerotskaja Jana , Luman Merike , Fridolin Ivo 
Published: April 2018

Purpose The aim of this study was to investigate uremia-related high-performance liquid chromatography (HPLC) ultraviolet (UV) absorbance profiles of serum and spent dialysate and to study the removal of uremic retention solutes in connection with optical dialysis adequacy monitoring. Methods 10 uremic patients were investigated using online spectrophotometry at a wavelength of 280 nm over the course of 30 hemodialysis treatments. The dialysate and blood samples were taken and analyzed simultaneously using standard biochemical methods and reversed-phase HPLC. Filters with cutoff at 3 kDa and 70 kDa were used for the pre-treatment of the serum. The chromatographic peaks were detected by a UV detector at wavelengths of 254 and 280 nm. Results This study indicated that the main solute responsible for UV absorbance in the spent dialysate is a low-molecular-weight, water-soluble, non-protein-bound compound uric acid (UA). Three additional uremic retention solutes – creatinine (CR), indoxyl sulphate (IS) and hippuric acid (HA) – were identified from the HPLC profiles. The number of detected HPLC peaks was not significantly different for a serum filtered through the 3 kDa or 70 kDa cutoff filters, and was lower for the spent dialysate, indicating that the molecular weight (MW) of the main UV chromophores in the uremic fluids did not exceed 3 kDa. The reduction ratio (RR) estimated by the total area of HPLC peaks at 254 nm and 280 nm in the serum and by the online UV absorbance at 280 nm was best related to the removal of small water-soluble non-protein bound solutes like urea (UR), CR and UA. Conclusions The present study contributes new information on the removal of uremic retention solutes during hemodialysis and on the origin of the optical dialysis adequacy monitoring signal.
Early Gut Barrier Dysfunction in Patients with Severe Acute Pancreatitis: Attenuated by Continuous Blood Purification Treatment
Authors: Zhang JianBin , Yuan Chen , Hua Gan , Tong RuYan , Luo XiangFeng , Ying Zhou 
Published: April 2018

Objectives The aim of this study was to investigate the effect of continuous blood purification (CBP) on early gut mucosal dysfunction in patients with severe acute pancreatitis (SAP). Methods Patients with SAP were randomized to receive 24 hours of continuous veno-venous hemofiltration (CVVH; n=33) or no CVVH (n=30). Blood samples were taken from the patients at 0, 6, 12, and 24 hours during CVVH therapy. Serum diamine oxidase (DAO) and endotoxin, epithelial permeability, transepithelial electrical resistance (TER) and F-actin rearrangement of the epithelial monolayer were used as the markers for the assessment of gut barrier function and the effect of CBP therapy in patients with SAP. Results Patients with SAP had increased levels of serum DAO, endotoxin, and epithelial permeability when compared with normal controls, and the increase was more pronounced in patients with organ dysfunction (p<0.01). F-actin rearrangement, loose cell-cell junction, and iNOS mRNA upregulation were found in all patients. After CBP treatment, Acute Physiology and Chronic Health Evaluation II score and SOFA score improved significantly; levels of serum DAO, endotoxin, and epithelial permeability decreased (p<0.05). CBP also significantly attenuated reorganization of actin and downregulated iNOS mRNA expression and NO production (p<0.05). Conclusions CBP can not only improve the general conditions but also effectively improve gut barrier dysfunction. The beneficial effect of CBP on gut barrier dysfunction is associated with the improvement of cytoskeletal instability, by downregulating iNOS through the removal of excess proinflammatory factors.
Long-duration (>4 Weeks) Continuous Renal Replacement Therapy in Critical Illness
Authors: Baird J. Scott , Wald Eric L. 
Published: April 2018

Introduction Decreased pediatric survival has been reported with long-duration (>4 weeks) continuous renal replacement therapy (CRRT), though the practice has not been well-described. Methods Retrospective chart review in a children's hospital of all patients treated with CRRT over 2 years (2003–4), including those who underwent long (group 1) and shorter duration (group 2) therapy. Results We identified 39 patients: median age was 6 years (range: 0.3–23; 7 were infants), median PRISM III score was 16 (range: 4–35), and the most frequent primary diagnosis was a stem cell transplant (in 12 out of 39). At continuous renal replacement therapy initiation, almost all patients (38 out of 39) had multiorgan dysfunction syndrome, most (35 out of 39) were being treated with at least one inotrope or vasopressor, and median fluid overload was 18% (range: 1–43%). Survival was poor (38%). Groups 1 (n=7) and 2 (n=32) had similar age (p=0.44), PRISM III score (p=0.61), and stem cell transplant diagnosis (p=0.65). At CRRT initiation, the incidence of multiorgan dysfunction syndrome (p=0.18), inotrope or vasopressor treatment (p=0.56), and fluid overload severity (p=0.71) were similar. Those in group 1 had a longer mean CRRT as well as persistent cardiovascular dysfunction limiting the utility of intermittent dialysis. Survival was similar between groups (p=1). Conclusions Critically-ill patients treated with long and shorter duration CRRT had a similar survival rate.
Time-Dependent Metabolic Activity and Adhesion of Human Osteoblast-Like Cells on Sensor Chips with a Plasma Polymer Nanolayer
Authors: Rebl Henrike , Finke Birgit , Schroeder Karsten , Nebe J. Barbara 
Published: April 2018

Purpose To improve orthopedic implant ingrowth, knowledge of the effect of chemical surface modifications on vital cell function in vitro is of importance. Early in our investigations we recognized that amino groups, positively charged via plasma polymerized allylamine, increased cell growth and the actin-filament formation in the initial cell-material contact phase. To gain insight into continuous vital cell behavior on this plasma polymer layer, here we present the metabolic activity of osteoblasts and their time-dependent adhesion using the sensor chip technology. Methods We demonstrate a new method for continuous 24 hour-measurements with vital human osteoblast-like cells (MG-63, ATCC) on sensor chips (Bionas® SC 1000) modified with plasma polymerized allylamine (PPAAm). The PPAAm film deposited on the chip is a cross-linked, strongly fixed plasma polymer with relatively high amino functionality and well defined chemical surface composition. We assessed continuous cell adhesion and the metabolic activity, i.e., oxygen consumption and acidification. Results We determined that adhesion of vital cells on PPAAm is not only enhanced shortly (1 h) after cell seeding but remained continuously higher for 24 h, which is significant. This nanometer-thin PPAAm layer did not change the overall metabolic activity of MG-63 cells during 24 h. Conclusion This tool – using adhesion and metabolic sensor chips – appears to be a suitable method for the recognition of vital cell physiology in biocompatibility measurements of plasma chemical treated surfaces.
First Successful use of the New ab5000 Portable Circulatory Support Console as Bridge to Recovery in a Case of Dilated Cardiomyopathy
Authors: Conradi Lenard , Schirmer Johannes , Reiter Beate , Treede Hendrik , Kubik Mathias , Reichenspurner H Hermann C. , Wagner Florian M. 
Published: April 2018

Introduction Growing clinical experience and improved technology have led to more widespread use of ventricular assist devices in patients with end-stage heart failure. Methods We report the case of a patient with preexisting cardiomyopathy who arrived at our center in cardiogenic shock and received a biventricular assist device. Results The new compact Abiomed Portable Circulatory Support Console facilitated mobilization of the patient which was particularly advantageous in the face of transient hemiparesis. After recovery from cardiogenic shock, device removal was performed following a bridge-to-recovery concept. He was discharged in a state of full cardiac recompensation and is back to everyday life with stable cardiac function up to 24 months after the incident. Conclusions This is the first report describing successful clinical use of the AB5000 assist device in combination with the portable console. Furthermore, it underlines the potential of temporary circulatory support to induce permanent myocardial recovery even in cases of preexisting cardiomyopathy.
Accelerated Angiogenic Induction and Vascular Integration in a Novel Synthetic Scaffolding Matrix for Tissue Replacement
Authors: Ring Andrej , Goertz Ole , Al-Benna Sammy , Ottomann Christian , Langer Stefan , Steinstraesser Lars , Schmitz Inge , Tilkorn Daniel 
Published: April 2018

Purpose Reduced or delayed neovascularization is a major obstacle with regard to tissue-engineered constructs. The aim of this study was to evaluate the early microvascular response to a novel degradable ε-caprolactone terpolymer matrix. Methods ε-caprolactone terpolymer matrices (Suprathel Plus®; Institute of Textile and Process Engineering, Denkendorf, Germany) were implanted into dorsal skinfold chambers of balb/c mice (n=10). Microcirculatory changes were observed by intravital fluorescence microscopy. Scaffolding matrices from PEGT/PBT copolymer were used as controls (n=10). Results The formation of de novo vascular networks within both scaffolding matrices was noted throughout the experiment. A vascular ingrowth of perfused microvessels into the matrices up to 600 μm apart from the edge was noted within 10 days of implantation. The earliest signs of neoangiogenesis were visible in ε-caprolactone terpolymer matrices on day 1. In both scaffolds the new developed vessels extended centripetally from the border of the matrices towards the center and anastomosed to form a perfused microvascular network. There was significantly earlier onset of vascularization, increased vascularized area and higher vessel density in ε-caprolactone terpolymer matrices compared to PEGT/PBT copolymer matrices were observed. Conclusions The scaffolding matrix from ε-caprolactone terpolymer allowed for an earlier and more intense induction of angiogenesis and displayed the tendency to vascularize more rapidly within a shorter period of time after transplantation compared to PEGT/PBT copolymer scaffolds, thus indicating its potential application for tissue engineering purposes.
Changes in Red Blood Cell Size and Red Cell Fragmentation during Hemodialysis
Authors: Booth John , Pinney Jennifer , Davenport Andrew 
Published: April 2018

Introduction Intradialytic hypotension remains the commonest complication for outpatient hemodialysis. The majority of relative blood volume (RBV) monitoring techniques monitor changes in hematocrit. As hematocrit can potentially be affected by changes in red cell size and hemolysis we studied the change in red blood cell size (MCV) during dialysis and hemolysis. Methods MCV was prospectively measured in 176 stable regular adult hemodialysis outpatients (56% male, 27.8% diabetic, mean age 59.5 ±16.2 years) dialyzing against a range of dialysate sodiums (136–145 mmol/L), with cooled dialysate (35–36°C), containing 1 g/L glucose, with constant ultrafiltration profiles. Red cell fragmentation was studied in 41 of the cohort. Results Logistical regression analysis showed that the absolute change in MCV was related to the change in hematocrit (F=4.92, β=0.111, p=0.031), and inversely with red cell shrinkage associated with predialysis osmolality (F=5.06, β=0.83, p=0.029), and dialysate sodium (F=4.7, β=0.34, p=0.035). There was no significant increase in red cell fragments during the dialysis sessions. Conclusions Indirect assessment of RBV based upon the relative change in hematocrit, depends not only upon the change in plasma water and red blood cell numbers, but also upon MCV. Changes in MCV may theoretically lead to potential effects on RBV measurements.
Virtual study groups and online Observed Structured Clinical Examinations practices – enabling trainees to enable themselves
Authors: Davidson Dennisa , Evans Lois 
Published: April 2018

Objectives: To explore online study groups as augmentation tools in preparing for the Royal Australian and New Zealand College of Psychiatrists Observed Structured Clinical Examinations (OSCE) for fellowship. Methods: An online survey of New Zealand trainees was carried out to assess exam preparedness and openness to virtual study groups and results analysed. Relevant material around virtual study groups for fellowship examinations was reviewed and used to inform a pilot virtual study group. Four New Zealand trainees took part in the pilot project, looking at using a virtual platform to augment OSCE preparation. Results: Of the 50 respondents 36% felt adequately prepared for the OSCE. Sixty-four per cent were interested in using a virtual platform to augment their study. Virtual study groups were noted to be especially important for rural trainees, none of whom felt able to form study groups for themselves. The pilot virtual study group was trialled successfully. All four trainees reported the experience as subjectively beneficial to their examination preparation. Conclusions: Virtual platforms hold promise as an augmentation strategy for exam preparation, especially for rural trainees who are more geographically isolated and less likely to have peers preparing for the same examinations.
A comparison between Right Unilateral Ultrabrief electroconvulsive therapy and bilateral electroconvulsive therapy in the elderly: a pilot naturalistic observational study
Authors: Narchal Shalini , Harris Anthony WF , Allen Bruce 
Published: April 2018

Objectives: To compare clinical outcomes and adverse effects between Bitemporal (BT) and Right Unilateral Ultrabrief (RUL(UB)) electroconvulsive therapy (ECT) in an elderly population. Methods: Patients over the age of 65 years admitted to a tertiary referral hospital over a seven month period requiring ECT received RUL(UB) ECT. They were compared with those who received BT ECT over these and the preceding seven months. Results: Twenty-three patients entered the study. No significant differences was observed between the groups in demographic and clinical characteristics or clinical improvement. However, patients who received BT ECT were significantly more likely to be confused post treatment compared with the RUL(UB) group. Conclusions: This pilot study found RUL(UB) ECT to be an effective treatment in elderly patients. These patients also suffered significantly less confusion than patients who received BT ECT.
Perceived confidence, competence and training in evidence-based treatments for eating disorders: a survey of clinicians in an Australian regional health service
Authors: Lakeman Richard , McIntosh Christine 
Published: April 2018

Objectives: Eating disorders (EDs) are challenging to treat and contribute to considerable morbidity and mortality. This study sought to identify the educational preparedness, competence and confidence of clinicians to work with people with EDs; and to identify how services might be improved. Methods: Clinicians who worked in the emergency department, medical, paediatric wards and mental health services were invited to complete an online survey. Results: From the 136 surveys returned, 73% of respondents reported little or no confidence working with EDs. There was a strong linear correlation between perceived confidence and competence and hours of education. Those with 70 or more hours of self-reported training were 2.7 times more likely to rate themselves as both confident and competent. Improving services for people with eating disorders included the provision of appropriate training, improving access to services including psychotherapy, and facilitating consistency in and continuity of care. Conclusions: To increase the confidence and competence of the workforce, regular training around EDs should be undertaken. The establishment of a specialist team to provide services across the continuum of care for people with severe or complex EDs appears warranted in a regional health service.
Effects of Palate Repair on Cranial Base and Maxillary Morphology in Patients With Unilateral Complete Cleft Lip and Palate
Authors: Liu Xiyang , Chen Zhenqi 
Published: April 2018

Objective: To identify the effects of palate repair on cranial base and maxillary morphology in patients with unilateral cleft lip and palate (UCLP) and to discover the relevance between cranial base and maxilla through cephalometric analysis. Design: Retrospective. Patients: Thirty-seven UCLP patients with operated lip (OL) and unoperated palate constituted OL group and were classified into 5 cervical vertebral maturation (CVM) stages. Thirty-seven UCLP patients with operated lip and palate (OLP) and 37 noncleft people with skeletal class I malocclusion were CVM- and sex-matched with the OL group as OLP group and control group, respectively. CVM stage I and II were combined into group 1, CVM stage III to V were combined into group 2. Interventions: Lateral cephalograms of all participants were obtained. Main Outcome Measures: Cephalometric analysis was employed, and data were compared among groups. Results: Length of posterior cranial base (Ba-S) of the OL group was shorter than controls in group 1; Ba-S and the ratio between length of posterior and anterior cranial base (Ba-S/S-N) of the OL and OLP groups were smaller than controls in group 2. No significant differences in cranial base were found between the OL and OLP groups. In group 1, patients of the OLP group showed smaller SNA, ANS-Ptm, and ANS-Ptm/S-N, and patients of the OL group showed smaller ANS-Ptm. In group 2, both OL and OLP groups had smaller sella-nasion-A point angle (SNA), projection distance between ANS and Ptm points on FH plane (ANS-Ptm), and the ratio between ANS-Ptm and anterior cranial base length (ANS-Ptm/S-N). Conclusions: Palate repair seems to have no obvious effects on cranial base morphology in patients with UCLP. Those patients with lip operated, whether cleft palate operated or not, tend to have a smaller length of maxilla sagittally and this deformity progresses with age.