bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrasonic sensor concept to fit a ventricular assist device cannula evaluated using geometrically accurate heart phantoms
Authors: Dual Seraina Anne , Zimmermann Jan Michael , Neuenschwander Jürg , Cohrs Nicholas Heinrich , Solowjowa Natalia , Stark Wendelin Jan , Meboldt Mirko , Schmid Daners Marianne 
Published: October 2018

AbstractFuture left ventricular assist devices (LVADs) are expected to respond to the physiologic need of patients; however, they still lack reliable pressure or volume sensors for feedback control. In the clinic, echocardiography systems are routinely used to measure left ventricular (LV) volume. Until now, echocardiography in this form was never integrated in LVADs due to its computational complexity. The aim of this study was to demonstrate the applicability of a simplified ultrasonic sensor to fit an LVAD cannula and to show the achievable accuracy in vitro. Our approach requires only two ultrasonic transducers because we estimated the LV volume with the LV end‐diastolic diameter commonly used in clinical assessments. In order to optimize the accuracy, we assessed the optimal design parameters considering over 50 orientations of the two ultrasonic transducers. A test bench was equipped with five talcum‐infused silicone heart phantoms, in which the intra‐ventricular surface replicated papillary muscles and trabeculae carnae. The end‐diastolic LV filling volumes of the five heart phantoms ranged from 180 to 480 mL. This reference volume was altered by ±40 mL with a syringe pump. Based on the calibrated measurements acquired by the two ultrasonic transducers, the LV volume was estimated well. However, the accuracies obtained are strongly dependent on the choice of the design parameters. Orientations toward the septum perform better, as they interfere less with the papillary muscles. The optimized design is valid for all hearts. Considering this, the Bland‐Altman analysis reports the LV volume accuracy as a bias of ±10% and limits of agreement of 0%–40% in all but the smallest heart. The simplicity of traditional echocardiography systems was reduced by two orders of magnitude in technical complexity, while achieving a comparable accuracy to 2D echocardiography requiring a calibration of absolute volume only. Hence, our approach exploits the established benefits of echocardiography and makes them applicable as an LV volume sensor for LVADs.
Durable left ventricular assist device implantation in extremely obese heart failure patients
Authors: Lee Andy Y. , Tecson Kristen M. , Lima Brian , Shaikh Asad F. , Collier Justin , Still Sasha , Baxter Ronald , DiMaio John M. , Felius Joost , Carey Sandra A. , Gonzalez‐Stawinski Gonzalo V. , Nauret Richard , Wong Marcus , Hall Shelley A. , Joseph Susan M. 
Published: October 2018

AbstractLeft ventricular assist devices (LVADs) have improved clinical outcomes and quality of life for those with end‐stage heart failure. However, the costs and risks associated with these devices necessitate appropriate patient selection. LVAD candidates are becoming increasingly more obese and there are conflicting reports regarding obesity’s effect on outcomes. Hence, we sought to evaluate the impact of extreme obesity on clinical outcomes after LVAD placement. Consecutive LVAD implantation patients at our center from June 2008 to May 2016 were studied retrospectively. We compared patients with a body mass index (BMI) ≥40 kg/m2 (extremely obese) to those with BMI < 40 kg/m2 with respect to patient characteristics and surgical outcomes, including survival. 252 patients were included in this analysis, 30 (11.9%) of whom met the definition of extreme obesity. We found that patients with extreme obesity were significantly younger (47[33, 57] vs. 60[52, 67] years, P < 0.001) with fewer prior sternotomies (16.7% vs. 36.0%, P = 0.04). They had higher rates of pump thrombosis (30% vs. 9.0%, P = 0.003) and stage 2/3 acute kidney injury (46.7% vs. 27.0%, P = 0.003), but there were no differences in 30‐day or 1‐year survival, even after adjusting for age and clinical factors. Extreme obesity does not appear to place LVAD implantation patients at a higher risk for mortality compared to those who are not extremely obese; however, extreme obesity was associated with an increased risk of pump thrombosis, suggesting that these patients may require additional care to reduce the need for urgent device exchange.
Generational conflict and provisions for the elderly in Hong Kong: The relevance of position‐based interest and values
Authors: Chan Raymond K. H. , Wang Lih‐Rong 
Published: October 2018

AbstractRespect for the elderly and hence the associated rights support a generational contract. Nevertheless, the case of the recent debate on the universal retirement scheme in Hong Kong has raised concerns about its strength. We identify relevant items from the sixth wave of the World Values Survey to explore the orientations of different generations toward others. The analysis shows differences between younger and older generations. Regression analyses show that values are not significant in explaining the differences, but various positions, including sex, marital status, and education, and perceptions of the elderly are relevant. Such differences across generations might weaken the generational contract and potentially engender conflicts as shown in the recent debate about the retirement scheme. We suggest short‐ and long‐term interest calculations, informed by their positions, play a more significant role in policy discussions and decisions, rather than simply appealing to values.
Experts vs super‐experts: differences in automated performance metrics and clinical outcomes for robot‐assisted radical prostatectomy
Authors: Hung Andrew J. , Oh Paul J. , Chen Jian , Ghodoussipour Saum , Lane Christianne , Jarc Anthony , Gill Inderbir S. 
Published: October 2018

ObjectivesTo evaluate automated performance metrics (APMs) and clinical data of experts and super‐experts for four cardinal steps of robot‐assisted radical prostatectomy (RARP): bladder neck dissection; pedicle dissection; prostate apex dissection; and vesico‐urethral anastomosis.Subjects and MethodsWe captured APMs (motion tracking and system events data) and synchronized surgical video during RARP. APMs were compared between two experience levels: experts (100–750 cases) and super‐experts (2100–3500 cases). Clinical outcomes (peri‐operative, oncological and functional) were then compared between the two groups. APMs and outcomes were analysed for 125 RARPs using multi‐level mixed‐effect modelling.ResultsFor the four cardinal steps selected, super‐experts showed differences in select APMs compared with experts (P < 0.05). Despite similar PSA and Gleason scores, super‐experts outperformed experts clinically with regard to peri‐operative outcomes, with a greater lymph node yield of 22.6 vs 14.9 nodes, respectively (P < 0.01), less blood loss (125 vs 130 mL, respectively; P < 0.01), and fewer readmissions at 30 days (1% vs 13%, respectively; P = 0.02). A similar but nonsignificant trend was seen for oncological and functional outcomes, with super‐experts having a lower rate of biochemical recurrence compared with experts (5% vs 15%, respectively; P = 0.13) and a higher continence rate at 3 months (36% vs 18%, respectively; P = 0.14).ConclusionWe found that experts and super‐experts differed significantly in select APMs for the four cardinal steps of RARP, indicating that surgeons do continue to improve in performance even after achieving expertise. We hope ultimately to identify associations between APMs and clinical outcomes to tailor interventions to surgeons and optimize patient outcomes.
Is extracorporeal shockwave lithotripsy a risk factor for the development of diabetes mellitus? A population‐based study
Authors: Ordon Michael , Welk Blayne , Ghiculete Daniela , Lee Jason Y. , Pace Kenneth T. 
Published: October 2018

ObjectiveTo determine if patients treated with extracorporeal shockwave lithotripsy (ESWL) are at a greater risk of developing diabetes mellitus (DM) than those treated with ureteroscopy (URS).Patients and MethodsA retrospective population‐based cohort study was performed of all ESWL and URS stone treatments done in Ontario between January 1994 and March 2014, utilising linked encoded healthcare databases. The primary outcome was the development of DM >90 days after treatment. The Kaplan–Meier method was used for unadjusted survival analysis and multivariable analysis with Cox proportional hazards regression was used to assess the risk of DM between the ESWL and URS groups whilst controlling for age, gender, region of residence, income quintile, year of treatment, and comorbidity index. A sensitivity analysis with a subset of ESWL patients treated for left renal or proximal ureteric stones was completed.ResultsWe identified 106 963 patients who underwent ESWL or URS over the study period with a median follow‐up of 6.6 years (ESWL 8.5 years, URS 5.6 years). Unadjusted survival analysis showed an increased risk of developing DM in the ESWL group compared to the URS group (P < 0.001); however, multivariable analysis showed no increased risk of DM in the ESWL cohort (hazard ratio [HR] 0.97, 95% confidence interval [CI] 0.91–1.02; P = 0.25). Similarly, sensitivity analysis showed no increased risk of DM in the left renal/proximal ureteric stone ESWL cohort compared to the URS cohort (HR 1.04, 95% CI 0.96–1.13; P = 0.35).ConclusionsOur population‐based cohort study demonstrated no increased risk of DM in patients undergoing ESWL compared to URS.
Our Homes: An inclusive study about what moving house is like for people with intellectual disabilities in Ireland
Authors: Salmon Nancy , Garcia Iriarte Edurne , Donohoe Brian , Murray Laura , Singleton Greg , Barrett Mary , Dillon Marie 
Published: October 2018

Accessible Summary

The Inclusive Research Network (IRN) is a group of researchers who do projects that matter to people with intellectual disabilities in Ireland.

This paper is about a project we did to learn what it is like for people with intellectual disabilities in Ireland to move from one house to another.

We talked to 35 people who moved house.

Some people chose where to move but others had no choice.

Feeling safe made them happier in their new home.

One third of the people we spoke to had no choice about where they live and who they live with.

Having these choices is their right under the United Nations Convention on the Rights of Persons with Disabilities.

People with intellectual disabilities need supporters who listen and respect them.

AbstractBackgroundSupporting people with intellectual disabilities to live well in communities they choose is deinstitutionalisation's central aim and endorsed by the United Nations Convention on the Rights of Persons with Disabilities (CRPD) (UN, 2006). This study focused on the experiences of people with intellectual disabilities in Ireland when moving home using an inclusive research approach.MethodThis inclusive research project employed a qualitative approach. Participants included 19 men and 16 women (total n = 35) with ages ranging from 22 to 77 years. Structured interviews attended to the experience of moving home and the supports accessed during and after the transition to community living.ResultsThematic analysis yielded four themes: “expressing choice” in the moving process; “feeling connected or isolated when moving”; “accessing supports during and after the move”; and finally, participants' reflections on “experiencing vulnerability and feeling safe” while resettling.ConclusionsThis is the first study about people with intellectual disabilities moving home to be collaboratively designed and completed by an inclusive research team. Although much is understood about the long‐term benefits of engaging in meaningful choices about housing and supports, concerns remain about the extent to which the will and preferences of people with intellectual disabilities in Ireland are respected when moving home.
Nitric oxide in the gastrointestinal tract: opportunities for drug development
Authors: Wallace John L 
Published: October 2018

Nitric oxide (NO) plays important roles in gastrointestinal mucosal defence, as well as in the pathogenesis of several gastrointestinal diseases (e.g. irritable bowel syndrome and inflammatory bowel disease). The potent cytoprotective effects of NO have been demonstrated in a range of animal models. However, in some disease states, inhibition of NO synthesis is beneficial. Several attempts have been made to develop drugs for ulcerative and/or inflammatory disorders of the gastrointestinal tract, with varying degrees of success. Covalently linking a NO‐releasing group to non‐steroidal anti‐inflammatory drugs or to drugs used in the treatment of inflammatory bowel disease and irritable bowel syndrome has shown some benefit, although no drug of this type has yet been fully developed.Linked ArticlesThis article is part of a themed section on Nitric Oxide 20 Years from the 1998 Nobel Prize. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.2/issuetoc
Who you know in the PMO: Lobbying the Prime Minister's Office in Canada
Authors: Boucher Maxime 
Published: October 2018

AbstractThis article examines the relationship between lobbying organizations, the Prime Minister’s Office (PMO), and other central agencies of the Canadian government. First, an overall examination of the Canadian lobbying registry shows that the PMO is one of the most lobbied institutions of the executive branch. Second, a statistical model evaluates the effect of organizational (such as the interest type and policy sector) and other strategic factors on the volume of communication between lobbying organizations and the PMO. This inquiry concludes that strategic choices related to the amount of lobbying activities and the scope of lobbying campaigns have the most consistent impact on the access to top‐level policymakers. In the end, the results support the claim that lobbying should be understood as a social, self‐reinforcing process unfolding over the medium‐ and long‐term.
Prevention: Necessary But Insufficient? A 2‐Year Follow‐Up of an Effective First‐Grade Mathematics Intervention
Authors: Bailey Drew H. , Fuchs Lynn S. , Gilbert Jennifer K. , Geary David C. , Fuchs Douglas 
Published: October 2018

We present first‐grade, second‐grade, and third‐grade impacts for a first‐grade intervention targeting the conceptual and procedural bases that support arithmetic. At‐risk students (average age at pretest = 6.5) were randomly assigned to three conditions: a control group (n = 224) and two variants of the intervention (same conceptual instruction but different forms of practice: speeded [n = 211] vs. nonspeeded [n = 204]). Impacts on all first‐grade content outcomes were significant and positive, but no follow‐up impacts were significant. Many intervention children achieved average mathematics achievement at the end of third grade, and prior math and reading assessment performance predicted which students will require sustained intervention. Finally, projecting impacts 2 years later based on nonexperimental estimates of effects of first‐grade math skills overestimates long‐term intervention effects.
Paediatric‐onset and adult‐onset Graves' disease share multiple genetic risk factors
Authors: Kuś Aleksander , Radziszewski Mikołaj , Glina Aleksandra , Szymański Konrad , Jurecka‐Lubieniecka Beata , Pawlak‐Adamska Edyta , Kula Dorota , Wawrusiewicz‐Kurylonek Natalia , Kuś Joanna , Miśkiewicz Piotr , Płoski Rafał , Bolanowski Marek , Daroszewski Jacek , Jarząb Barbara , Bossowski Artur , Bednarczuk Tomasz 
Published: October 2018

AbstractBackgroundGraves' disease (GD) is an autoimmune thyroid disease (AITD) with a peak incidence between 30 and 50 years of age. Although children and adolescents may also develop the disease, the genetic background of paediatric‐onset GD (POGD) remains largely unknown. Here, we looked for similarities and differences in the genetic risk factors for POGD and adult‐onset GD (AOGD) as well as for variants associated with age of GD onset.Materials and methodsA total of 1267 GD patients and 1054 healthy controls were included in the study. Allele frequencies of 40 established and suggested GD/AITD genetic risk variants (39 SNPs and HLA‐DRB1*03) were compared between POGD (N = 179), AOGD (N = 1088) and healthy controls. Subsequently, multiple linear regression was used to explore the relationship between age of GD onset and genotype for each locus.ResultsWe identified six POGD risk loci, all of them were also strongly associated with AOGD. Although for some of the analysed variants, including HCP5 (rs3094228), PRICKLE1 (rs4768412) and SCGB3A2 (rs1368408), allele frequencies differed nominally between POGD and AOGD patients, these differences were not significant after applying multiple testing correction (Pcor = 0.05/40 = 1.25 × 10−3). Regression analysis showed that patients with higher number of HCP5 risk alleles tend to have a significantly earlier onset of GD (P = 6.9 × 10−5).ConclusionsThe results of our study revealed that POGD and AOGD share multiple common genetic risk variants. Moreover, we demonstrated for the first time that HCP5 polymorphism is associated with an earlier age of GD onset in a dose‐dependent manner.
Clinical practice update on testosterone therapy for male hypogonadism: Contrasting perspectives to optimize care
Authors: Yeap Bu B. , Wu Frederick C.W. 
Published: October 2018

AbstractUS Endocrine Society (ES) published a clinical practice guideline on testosterone therapy in men with hypogonadism, and Endocrine Society of Australia (ESA) a position statement on management of male hypogonadism. Both emphasize the importance of diagnosing men who are androgen deficient due to organic (classical or pathological) hypogonadism arising from disorders of the hypothalamus, pituitary or testes, who assuredly benefit from testosterone therapy. Both recognize that men with an intact gonadal axis may have low testosterone concentrations, for instance older men or men with obesity or other medical comorbidities. ES guidelines classify such symptomatic men as having organic (advanced age) or functional (obesity, medical comorbidities) hypogonadism, giving an option for testosterone therapy as a shared decision between clinicians and individual patients. ESA did not recommend testosterone therapy in these men. ES offers a reference range for total testosterone established in young men, while ESA cites age‐standardized reference ranges. ES recommends using free testosterone as well as total testosterone to identify men with hypogonadism in conditions where sex hormone‐binding globulin (SHBG) is altered, or when total testosterone is borderline. ESA recommends confirmatory biochemical testing with total testosterone, recognizing that this may be lower than expected if SHBG concentrations are low. Both emphasize the importance of identifying pre‐existing prostate and cardiovascular disease prior to initiating testosterone therapy, with ES providing specific recommendations for PSA measurement, deferring testosterone therapy after major cardiovascular events and indications for pituitary imaging. These contrasting approaches highlight gaps in the evidence base where individualized patient management is required.
Glucocorticoid activation by 11β‐hydroxysteroid dehydrogenase enzymes in relation to inflammation and glycaemic control in chronic kidney disease: A cross‐sectional study
Authors: Sagmeister Michael S. , Taylor Angela E. , Fenton Anthony , Wall Nadezhda A. , Chanouzas Dimitrios , Nightingale Peter G. , Ferro Charles J. , Arlt Wiebke , Cockwell Paul , Hardy Rowan S. , Harper Lorraine 
Published: October 2018

SummaryObjectivePatients with chronic kidney disease (CKD) have dysregulated cortisol metabolism secondary to changes in 11β‐hydroxysteroid dehydrogenase (11β‐HSD) enzymes. The determinants of this and its clinical implications are poorly defined.MethodsWe performed a cross‐sectional study to characterize shifts in cortisol metabolism in relation to renal function, inflammation and glycaemic control. Systemic activation of cortisol by 11β‐HSD was measured as the metabolite ratio (tetrahydrocortisol [THF]+5α‐tetrahydrocortisol [5αTHF])/tetrahydrocortisone (THE) in urine.ResultsThe cohort included 342 participants with a median age of 63 years, median estimated glomerular filtration rate (eGFR) of 28 mL/min/1.73 m2 and median urine albumin‐creatinine ratio of 35.5 mg/mmol. (THF+5αTHF)/THE correlated negatively with eGFR (Spearman's ρ = −0.116, P = 0.032) and positively with C‐reactive protein (ρ = 0.208, P < 0.001). In multivariable analysis, C‐reactive protein remained a significant independent predictor of (THF+5αTHF)/THE, but eGFR did not. Elevated (THF+5αTHF)/THE was associated with HbA1c (ρ = 0.144, P = 0.008) and diabetes mellitus (odds ratio for high vs low tertile of (THF+5αTHF)/THE 2.57, 95% confidence interval 1.47‐4.47). Associations with diabetes mellitus and with HbA1c among the diabetic subgroup were independent of eGFR, C‐reactive protein, age, sex and ethnicity.ConclusionsIn summary, glucocorticoid activation by 11β‐HSD in our cohort comprising a spectrum of renal function was associated with inflammation and impaired glucose control.
A Variational Approach to Registration with Local Exponential Coordinates
Authors: Paman Ashish , Rangarajan Ramsharan 
Published: October 2018

AbstractWe identify a novel parameterization for the group of finite rotations (SO3), consisting of an atlas of exponential maps defined over local tangent planes, for the purpose of computing isometric transformations in registration problems that arise in machine vision applications. Together with a simple representation for translations, the resulting system of coordinates for rigid body motions is proper, free from singularities, is unrestricted in the magnitude of motions that can be represented and poses no difficulties in computer implementations despite their multi‐chart nature. Crucially, such a parameterization helps to admit varied types of data sets, to adopt data‐dependent error functionals for registration, seamlessly bridges correspondence and pose calculations, and inspires systematic variational procedures for computing optimal solutions. As a representative problem, we consider that of registering point clouds onto implicit surfaces without introducing any discretization of the latter. We derive coordinate‐free stationarity conditions, compute consistent linearizations, provide algorithms to compute optimal solutions and examine their performance with detailed examples. The algorithm generalizes naturally to registering curves and surfaces onto implicit manifolds, is directly adaptable to handle the familiar problem of pairwise registration of point clouds and allows for incorporating scale factors during registration.